Urodynamic disorders in patients with proctologic operations

Catedra de chirurgie nr. 5, Facultatea stomatologie, Universitate de Stat de Medicină și Farmacie ”Nicolae Testemițanu”, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Retenţia acută a urinei si ischuria postoperatorie după operaţiile efectuate la nivelul zonei anorectale ramân a fi într-un procent înalt. Datele literaturii relatează, că după orice operaţie, chiar și minim-invazivă, pot surveni aceste dereglări. Scopul: Profilaxia apariției manifestărilor disurice la pacienții cu operații proctologice. Material și metode: În secţia chirurgie a SCC or. Chișinău s-au aflat la tratament chirurgical în perioada anilor 2008-2017, 345 pacienţi cu diverse patologii a zonei anorectale: HC 217; fisură anală cronică 67; paraproctită acută 19 pacienți; paraproctită cronică 42; raportul barbaţi / femei fiind 295 / 50, vârsta între 18-82 ani. Rezultate: Hemoroidectomia Milligan-Morgan sau Whithead - 192 cazuri, pentru HC stadiu IV și prolaps rectal gr. I-II - WhitheadVercescu- 25 cazuri, HC si fisura anală cronică complicată cu strictură a canalului anal- Milligan- Morgan cu sfincterotomie dozată extramucoasă tip Rijih- 67 cazuri,HC asociați cu fistula pararectală s-a practicat metoda Gabriel si hemoroidectomia cu restabilirea parțială a punţilor cutaneo-mucoase sau plaga semideschisă 42 cazuri. Retentie acută urinară s-a constatat la 30 pacienți (17 bărbați și 13 femei), care s-a rezolvat ulterior prin administrarea preparatului ,,Omnic” 4 mg, uroseptice și antispastice, iar la 3 pacienti a fost necesar de aplicat cateter Foley pe 5 zile. Concluzii: Administrarea preparatelor α-adrenoblocatori, urosepticelor și antispasticelor duc la lichidarea semnelor clinice ale manifestărilor disurice, un rol important în profilaxie revenindu-i examenului USG al bazinului mic.Background: Acute retention of urine and postoperative ischuria after anorectal surgeries remain to have a high percentage. Literature data report that these disturbances may occur after any surgical intervention even though it is minimally invasive. Aim of the study: Prophylaxis of dysuria manifestations in patients with proctologic operations. Methods and Materials: 345 patients with various anorectal pathologies underwent surgical treatment in 2008-2017 at CCS Surgery Department from Chisinau: CH 217; chronic anal fissure 67; acute paraproctitis 19 patients; chronic paraproctitis 42; male / female ratio being 295/50, aged 18-82 years. Results: Milligan-Morgan or Whithead hemorrhoidectomy - 192 cases for CH stage IV and rectal prolapse gr.I-II- Whithead- Vercescu25 cases, CH and chronic anal fissure complicated with stricture of the anal canal -Milligan-Morgan with Rijin dosed extramucosal sphincterotomy - 67 cases, CH associated with pararectal fistula, Gabriel method and hemorrhoidectomy with partial restoration of cutaneous mucosal bridges or semi-open wound were performed in 42 cases. Acute urinary retention was found in 30 patients (17 males and 13 females) being subsequently resolved administering 4mg ,,Omnic”, uroseptic and antispasmodic preparations, whereas Foley catheter was necessary to be applied for 5 days in 3 patients. Conclusions: The administration of α-adrenoblocker, uroseptic and antispastic preparations, leads to the elimination of disuric manifestations clinical signs, USG examination of the pelvis plays an important role in prophylaxis

Surgical tactics in anorectal associated pathology

Catedra de chirurgie nr. 5, Facultatea stomatologie, Unversitatea de Stat de Medicină și Farmacie ”Nicolae Testemițanu”, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Problema abordului chirurgical al hemoroizilor cronici (HC) asociați cu fistulă pararectală, paraproctită acută, fisură anală cronică preocupă majoritatea chirurgilor, iar dilema chirurgului este de a efectua intervenție unimomentană sau de a planifica în doi sau mai mulți timpi, scopul fiind izbăvirea pacientului de operații repetate, sindromul algic persistent postoperator, cât și de cheltuelile financiare suportate. Scopul: ameliorarea rezultatelor tratamentului chirurgical al patologiei asociate al zonei anorectale cît și aprecierea tacticii chirurgicale abordate. Material și metode: În secţia chirurgie a SCC or. Chișinău s-au aflat la tratament chirurgical în perioada anilor 2008-2017, 345 pacienţi cu diverse patologii a zonei anorectale: HC 217; fisură anală cronică 67; paraproctită acută 19 pacienți; paraproctită cronică 42. Raportul barbaţi / femei fiind 295 / 50, vârsta între 18-82 ani. Rezultate: Hemoroidectomia Milligan-Morgan sau Whithead - 192 cazuri, pentru HC stadiu IV si prolaps rectal gr.I-II- WhitheadVercescu- 25 cazuri,HC si fisura anală cronică complicată cu strictură a canalului anal- Milligan- Morgan cu sfincterotomie dozată extramucoasă tip Rijih- 67 cazuri,HC asociați cu fistula pararectală s-a practicat metoda Gabriel si hemoroidectomia cu restabilirea partială a punţilor cutaneo-mucoase sau plaga semideschisă 42 cazuri. Concluzii: Tactica chirurgicală depinde de localizarea proceselor purulente, gradul de complexitate a traiectului fistulos si stadiul bolii hemoroidale asociate, intervenția unimomentană are o perspectivă de dezvoltare cu impact economic al tacticii alese, îmbunataţirea stării psiho-emoţionale a pacientului și integrarea precoce în câmpul muncii.Background: The surgical approach problem of chronic hemorrhoids (CH) associated with pararectal fistula, acute paraproctitis, chronic anal fissure concerns most surgeons, and surgeon’ dilemma is to perform unimomental surgery or to plan it in a short period of time, the aim being to protect patient from repeated surgeries, persistent painful postoperative syndrome, and incurred financial expenses. Purpose: improvement of the surgical treatment results of the associated pathology of the anorectal area and appreciation of the approached surgical tactics. Methods and materials: 345 patients with various anorectal pathologies underwent surgical treatment in 2008-2017 at CSS Surgery Department from Chisinau: CH 217; chronic anal fissure 67; acute paraproctitis 19 patients; chronic paraproctitis 42; male / female ratio being 295/50, ages 18-82 years. Results: Milligan-Morgan or Whithead hemorrhoidectomy - 192 cases for CH stage IV and rectal prolapse gr.I-II- WhitheadVercescu- 25 cases, CH and chronic anal fissure complicated with anal canal stricture Milligan-Morgan with Rijih dosed extramucosal sphincterotomy - 67 cases, CH associated with the pararectal fistula Gabriel method and hemorrhoidectomy with partial restoration of cutaneous mucosal bridges or semi-open wound was used in 42 cases. Conclusions: Surgical tactics depends on purulent processes location, complexity degree of the fistula tract and associated hemorrhoidal disease stage, unimomental intervention has a developmental perspective with economic impact of the chosen tactics, the improvement of patient’s psycho-emotional state and the early integration into the workplace

Slow dynamics, aging, and glassy rheology in soft and living matter

We explore the origins of slow dynamics, aging and glassy rheology in soft and living matter. Non-diffusive slow dynamics and aging in materials characterised by crowding of the constituents can be explained in terms of structural rearrangement or remodelling events that occur within the jammed state. In this context, we introduce the jamming phase diagram proposed by Liu and Nagel to understand the ergodic-nonergodic transition in these systems, and discuss recent theoretical attempts to explain the unusual, faster-than-exponential dynamical structure factors observed in jammed soft materials. We next focus on the anomalous rheology (flow and deformation behaviour) ubiquitous in soft matter characterised by metastability and structural disorder, and refer to the Soft Glassy Rheology (SGR) model that quantifies the mechanical response of these systems and predicts aging under suitable conditions. As part of a survey of experimental work related to these issues, we present x-ray photon correlation spectroscopy (XPCS) results of the aging of laponite clay suspensions following rejuvenation. We conclude by exploring the scientific literature for recent theoretical advances in the understanding of these models and for experimental investigations aimed at testing their predictions.Comment: 22 pages, 5 postscript figures; invited review aricle, to appear in special issue on soft matter in Solid State Communication

Usage d'un jeu de rôles pour l'analyse préalable d'un SIG : DJOLIBOIS, un jeu spatialisé pour l'approvisionnement en bois-énergie de la ville de Bamako (Mali).

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Resonant reshaping of colloidal clusters on a current carrying wire

Colloids in confined geometries promise a path towards tailored microscopic superstructures. Yet, a major roadblock is posed by kinetically trapped states that prevent the assemblies from reaching their anticipated shapes. We investigate magnetic colloids trapped on a cylindrical surface of a current carrying wire. If kinetic traps could be avoided the wire’s surface would act as an ideal mold for colloidal rings and helical fibers. We devise here a way to dynamically shake down the clusters and avoid kinetic traps in their energy landscape. A low frequency magnetic modulation wave around the wire axis effectively eliminates defects from the clusters and stretches them into slender rings and helical filaments. A theoretical model is developed that qualitatively explains the observed resonant reshaping response of clusters