Appendicopathies in emergency surgery - a substantian problem

Catedra Chirurgie, FEC MF, USMF „N. Testemițanu”, Chișinău, Moldova, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Dacă pînă în prezent au fost atinse succese notabile în chirurgia apendicitei acute, nu ne dă posibilitatea să constatăm faptul că problema este rezolvată definitiv, au rămas probleme neclare şi discutabile: 1) nu este perfectă diagnostica; 2) sunt divergenţe în privinţa tacticii chirurgicale; 3) lipsesc intraoperator criteriile unice a modificărilor macroscopice; 4) sunt divergenţe în diagnosticul clinic şi rezultatele morfohistologice. Studiile din literatura franceză au constatat faptul că la 20% din cei operaţi s-a înlăturat apendicele neafectat. Au fost studiaţi 235 pacienţi cu vîrsta 14-80 ani. Femei-bărbaţi 1,5:1. Durerea manifestată la 100% bolnavi caracterizată prin (spontană, permanentă, intermitentă, difuză, localizată, violentă, transfixiantă, iradiere topografică). Defens muscular, meteorism, pulsmetria, temperatura corpului s-au manifestat în raport variabil. Simptoamele subiective (diaree, constipaţie, vomă, s.Koher, greţuri) prezente la toţi bolnavii. Prevalenţa s. obiective (Blumberg, Rowzing, triada Dieulafoy, Bartomie-Mihelson, Coop) a fost notată la bolnavii cu semne evidente de apendicită acută. La 80% - hiperleucocitoză. Polinucleoza a fost marcată variabil: normal, moderată, notabilă, excesivă şi majorată enorm. USG abdominală : pneumatoză intestinală, apendice vizualizat, mobil, imobil, îngroşat, lichid în cavitatea abdominală notate variabil. Intraoperator s-a înregistrat lichid seros, serohemoragic, seropurulent, purulent cu variaţii. S-a constatat faptul că 22% nu au modificări patomorfologice în apendice. Coeficientul identificării diagnosticului clinic cu cel patomorfologic este în raport 4,5:1. Acestea sunt cazurile apendicopatiilor cu manifestări clinice evidente şi cu lipsă de substrat patomorfologic, mai bine spus, apendice neafectat. Concluzii: 1. Apendicopatiile diferă radical de apendicita acută prin faptul că ele se manifestă clinic printr-un complex simptomatologic evident de apendicită acută şi cu lipsa totală a substratului patomorfologic. 2. Pentru a clarifica aceste probleme definitiv, va fi necesar un studiu clinic mai profund si identificarea mai sigură a modificărilor patologomorfologice. 3. Extirparea apendicelui alterat în apendicopatie, cauză a fenomenelor dureroase sau a crizelor repetate, se impune ca singura măsură de a vindeca răul prezent şi de a evita pericolele viitorului.The fact that until now has been achieved notable success in the surgery of acute appendicitis doesn’t give us the possibility to say that the problem is entirely solved; there still are many confusing and contestable problems: 1) the diagnosis is not perfect. 2) there are many divergences about the surgical tactics. 3) there are no unique criteriafor macroscopical changes during the operation. 4) there are different opinionsamong surgeons as for clinical diagnosis and morphological characteristics. The study of French literature have concluded that in the case of 20% of operations unaffected appendix has been removed. 235 patients aged 14-80 years in rapport of 1,5:1 women and men have been examined. The pain manifested at 100% of patients was characterized as spontaneous, continuous, intermittent, diffuse, localized, violent, topographical radiation. The muscle defense, flatulence, pulsation, high temperature occurred in several cases. Subjective symptoms (diarrhea, constipation, vomiting, Koher’s sign and nausea) have been noticed at all the patients. The prevalence of objective symptoms (Blumberg, Rowzing, Dieulafoy triad, Bartomie-Mihelson, Coop) has been noticed at the patients with obvious signs of acute appendicitis. 80% manifested hyperleukocytosis. The mark of polynucleosys was variable: normal, moderate, noticeable, excessive and increased enormously. The ultrasound check of abdomen showed intestinal pneumatosis, visible, mobile, immobile, thickened, fluid appendix in the abdominal cavity has been detected in several cases. Intraoperative serous, sero-hemorrhagic, seropurulent and purulentliquid was noticed 22% of patients had no pathomorphologicchanges coefficient was 4,5:1. These are the appendicopathy cases with clinicalmanifestations and lack of pathomorphological base, batter said: normal, unaffected appendix. Conclusions: 1. Appendicopathies differ radically from acute appendicitis in that they manifest clinically evident symptomatic complex of acute appendicitis and total lack of pathomorphological substrate. 2. To clarify these issues ultimately a deeper clinical study and a more reliable identification of pathomorphological changes would be necessary. 3. The removal of altered appendix in appendicitis, cause of pain phenomena or repeated crisis imposes itself as the only measure to cure the present disease and to avoid future dangers

The reasons of migration of rural youth

Рассматриваются причины оттока современной российской молодежи в крупные города. В качестве значимых факторов выделяются низкие шансы в реализации образовательной и профессиональной стратегий, невозможность удовлетворения социальных и культурных запросов, поддержания современных стандартов жизни.The reasons of modern Russian youth outflow in big cities. As significant factors stand out in the low odds of realization of educational and professional strategies, inability to meet the social and cultural needs, maintaining modern living standards

The Use of Infrared Spectroscopy in the Investigation of Urolithiasis Ulilizarea spectroscopiei în infraroşu pentru investigarea urolitiazei

Abstract Infrared (IR) spectroscopy is a modern physical-chemical method suitable for the investigation of kidney stones composition. The application of this method in our wor

Характеристики перинатального периода, связанного с воспалительными процессами в случае преждевременной мертворождаемости

IMSP Institutul Mamei şi CopiluluiMaternal or fetal infections account for 50% of the causal structure of mortality in underdeveloped or developing countries, as opposed to highly developed countries where the same rate is 10-25%. Purpose of the study: evaluation of perinatal period peculiarities associated with inflammatory processes in preterm stillbirth. Materials and methods: to achieve the aim of the proposed study, we analyzed 237 patients who were born during 2015-2017 within the PMSI Institute of Mother and Child. Results: complication of polyhydramnios pregnancy is associated with a 2-fold greater likelihood of complication with stillbirth, a similar trend with complicated pregnancy with intrauterine infection and an increase in chronic infections of the lower genital tract. The relative risk of intrauterine infection on the preterm stillbirth phenomenon increases proportionally with the term of gestation. Preterm pregnancy complicated with uterine death in the fetus is commonly preceded by corioamnonitis, and birth is complicated by partial retention of placenta or amniotic membranes.Инфекции матери или плода составляют 50% причинно-следственной структуры мертворождаемости в слаборазвитых или развивающихся странах, в отличие от высокоразвитых стран, где такой же показатель составляет 10-25%. Цель исследования: оценить перинатальные особенности, связанные с воспалительными процессами в преждевременной мертворождаемости. Материалы и методы: для достижения цели предлагаемого исследования было проанализировано 237 пациенток, родивших в течение 2015-2017 гг. В Институте Матери и Ребенка. Результаты: Выявлена тесная связь между мертворождаемостью при недоношенной беременности с наличием многоводия, внутриутробной инфекцией и обострениями хронических инфекций мочевыводительной системы. Уровень относительного риска влияния внутриутробной инфекции на возникновение мертворождаемости при недоношенной беременности прямопропорционально сроку гестации

RESEARCHES ON SOME BIOLOGICAL AND ECOLOGICAL CHARACTERISTICS OF SWEET CORN

Sweet corn is a stenotermal plant that endures limited temperature variations requiring also adequate levels of humidity. Many farmers assume some risks in this direction, but they can sometimes compromise a significant percentage of culture. So many times to reach the phrase "first on market gets high-prices" is to resort to sowing too early and not to purchase early hybrids. Objective of this paper was to elucidate some aspects regarding behavior of certain hybrids of sweet corn with regard to certain attributes of production under Transylvanian Plateau conditions. Also, for growing surfaces cultivated with sweet corn, the biological material was also analyzed in terms of adaptability to mechanized harvesting. Delicios hybrid is distinguished by the lowest values of the coefficient of variation in the two years, indicating a good uniformity of cob insertion and the possibility of mechanized harvesting

A new approach to radon temporal correction factor based on active environmental monitoring devices

The present study aims to identify novel means of increasing the accuracy of the estimated annual indoor radon concentration based on the application of temporal correction factors to short-term radon measurements. The necessity of accurate and more reliable temporal correction factors is in high demand, in the present age of speed. In this sense, radon measurements were continuously carried out, using a newly developed smart device accompanied by CR-39 detectors, for one full year, in 71 residential buildings located in 5 Romanian cities. The coefficient of variation for the temporal correction factors calculated for combinations between the start month and the duration of the measurement presented a low value (less than 10%) for measurements longer than 7 months, while a variability close to 20% can be reached by measurements of up to 4 months. Results obtained by generalized estimating equations indicate that average temporal correction factors are positively associated with CO2 ratio, as well as the interaction between this parameter and the month in which the measurement took place. The impact of the indoor-outdoor temperature differences was statistically insignificant. The obtained results could represent a reference point in the elaboration of new strategies for calculating the temporal correction factors and, consequently, the reduction of the uncertainties related to the estimation of the annual indoor radon concentration.Acknowledgements: The research is supported by the project ID P_37_229, Contract No. 22/01.09.2016, with the title, Smart Systems for Public Safety through Control and Mitigation of Residential Radon linked with Energy Efficiency Optimization of Buildings in Romanian Major Urban Agglomerations SMART-RAD-EN” of the POC Programme

InterGEO: a digital platform for university education on geomorphological heritage

The project InterGEO was carried out with the objective to disseminate knowledge on geomorphological heritage by developing a digital learning platform. It aims at improving students' autonomy by the reduction of face-to-face teaching and increasing autonomous learning as well as promoting international interactions between students interested in geomorphological heritage. A completely free-access virtual course on geomorphosites was developed with the Learning Management System Moodle. The course is divided into 24 thematic chapters, each of them containing a short description, a list of references and selected publications, as well as other educational material (videos, virtual fieldtrips, etc.). In particular, several videos allow presenting in a dynamic way concepts and examples. The paper presents the tool and its use in academic programmes in six European universities, where it was tested, in various contexts (Bachelors' and Masters' programmes; students in geography or geology; general courses in geomorphology and specific courses on geoheritage and geoconservation), before discussing the advantages and challenges the tool is facing. The InterGEO platform is an easy-to-use and friendly educational tool, which allows developing blended learning activities; it is flexible and adaptable in various learning contexts.The coordination tasks (appointment of an assistant) and two workshops in Lausanne were financed by the University of Lausanne (Teaching Innovation Fund and Investment Fund of the Faculty of Geosciences and Environment, FGSE). The videos were designed and created with support of the universities of Lausanne (TIF) and Savoie Mont Blanc (IDEFI Promising and ReflexPro; LabEx ITEM)

Характеристики перинатального периода, связанного с воспалительными процессами в случае преждевременной мертворождаемости

IMSP Institutul Mamei şi CopiluluiMaternal or fetal infections account for 50% of the causal structure of mortality in underdeveloped or developing countries, as opposed to highly developed countries where the same rate is 10-25%. Purpose of the study: evaluation of perinatal period peculiarities associated with inflammatory processes in preterm stillbirth. Materials and methods: to achieve the aim of the proposed study, we analyzed 237 patients who were born during 2015-2017 within the PMSI Institute of Mother and Child. Results: a complication of polyhydramnios pregnancy is associated with a 2-fold greater likelihood of complication with stillbirth, a similar trend with complicated pregnancy with intrauterine infection, and an increase in chronic infections of the lower genital tract. The relative risk of intrauterine infection on the preterm stillbirth phenomenon increases proportionally with the term of gestation. Preterm pregnancy complicated with uterine death in the fetus is commonly preceded by chorioamnionitis, and birth is complicated by partial retention of the placenta or amniotic membranes.Инфекции матери и плода составляют 50% причинно-следственной структуры мертворождаемости в слаборазвитых или развивающихся странах, в отличие от высокоразвитых стран, где такой же показатель составляет 10-25%. Цель исследования: оценить перинатальные особенности, связанные с воспалительными процессами c преждевременной мертворождаемостью. Материалы и методы: для достижения цели исследования было проанализировано 237 пациенток, родившихся в течение 2015-2017 гг. в Институте Матери и Ребенка. Результаты: осложнение беременности многоводием связано с 2-кратно большей вероятностью при преждевременной мертворождаемости, аналогичная тенденция имеется при беременности, осложненной внутриутробной инфекцией и острыми хроническими инфекциями мочевых путей. Относительный риск влияния внутриутробной инфекции на уровень преждевременной смертности увеличивается пропорционально сроку беременности. Хориоамнонит обычно предшествует преждевременную беременность, с внутриутробной гибелью плода, а роды осложняются частичной задержкой отделения плаценты или амниотических мембран