Traumatic rupture of the right atrium with haemopericardium due to blunt car crash accident thoracic trauma, resolved in department of general surgery (Case report)

Secţia Chirurgie, Secţia ATI, Spitalul Judeţean de Urgenţă, Drobeta-Turnu Severin, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: Autorii prezintă un caz de ruptură de atriu drept în urma unui traumatism toracic închis fără fracturi costale şi fără marca traumatică tegumentară, ca urmare a unui accident rutier. Bolnava în vârstă de 31 de ani este adusă la Spitalul Judeţean de Urgenţă Tr-Severin la circă 30 de minute de la producerea accidentului, prezentând stare generală gravă, colaps vascular periferic, stare comatoasă. Investigaţiile imagistice (ecografie, CT) evidențiază numai hemopericard. S-a intervenit chirurgical prin toracotomie stângă şi sternotomie parţiala. S-a găsit ruptura de auricul drept, pentru care s-a practicat ligatura plăgii auriculare. Perioada postoperatorie a fost fără complicaţii, pacienta a supravieţuit.Clinical case: The authors present a case of the right atrium rupture following a blunt chest injury as a result of a car crash accident, without rib fractures and traumatic marks of skin. The patient aged 31 years is transported to Emergency County Hospital Tr-Severin approximately 30 minutes after trauma, presenting poor general condition, peripheral vascular collapse, and coma. Imaging studies (ultrasound, CT) reveal haemopericardium only. Left thoracotomy and partial sternotomy was performed. Auricle rupture was found, which required ligation of auricle wound. Postoperative period was uneventful, and the patient survived

Characteristics and tendencies in the steel industry, globally and regionally

The objective of this paper is to highlight the current state of the steel industry at the global and regional level, in terms of its level of important indicators, such as: production capacity, production volume, level of consumption, exports and imports. The data used are systemized on time intervals, resulting in that the steel industry remains an attractive sector for investors in terms of large profits generated, but extremely sensitive to economic fluctuations and measures taken by the authorities. In this regard, the disparities and trends of the analyzed periods at global and regional level highlight the different ways of managing the situation in the steel sector, overcapacity representing a highly controversial element nowadays

π\pi-Electron Ferromagnetism in Metal Free Carbon Probed by Soft X-Ray Dichroism

Elemental carbon represents a fundamental building block of matter and the possibility of ferromagnetic order in carbon attracted widespread attention. However, the origin of magnetic order in such a light element is only poorly understood and has puzzled researchers. We present a spectromicroscopy study at room temperature of proton irradiated metal free carbon using the elemental and chemical specificity of x-ray magnetic circular dichroism (XMCD). We demonstrate that the magnetic order in the investigated system originates only from the carbon $\pi$-electron system.Comment: 10 pages 3 color figure

The dimensioning of performance in metallurgical industry from Romania

The paper shows the importance of using the indicators for the analysis the financial performance, corresponding with the particularities determined by branch, object of activity or size. Also, our paper aims to identify the state of financial performance in metallurgical industry, taking into account the data recorded at the level of some enterprises in the metallurgical sector in Romania for the period 2009 - 2013 as well as the level of entire branches

Competitiveness and economic-financial performance in the metallurgical industry companies in Romania

The paper presents the level and evolution of indicators for determining the degree of competitiveness in the metallurgical industry in Romania. For this purpose, were used aggregate data for a sample of 22 of the largest companies in Romania operating in metallurgy, for the period 2004 - 2013. The aim of the paper is to identify the factors that determined the negative trend in terms of economic and financial performance of the companies analyzed

On limit periodicity of discrete time stochastic processes

We consider a discrete time dynamic system described by a difference equation with periodic coefficients and with additive stochastic noise. We investigate the possibility of the periodicity of the solution. In particular, we established sufficient conditions for convergence of the solution in mean square or almost surely to some stochastic periodic process

COMPARATIVE STUDY OF VIBRATIONS IN APPARATUS COMBINATIONS TANGENTIAL THRESHING

          Vibrations are dynamics phenomenon which appear in some environment as a result of an external force whose action consist on an oscillation. The effect of these oscillations harm to the environment where they appear and if this environment is the human body then the results are more harmful, hauling consequences, sometimes irreversible, on the health of the human body. In this respect, studying and knowing the effects of the vibrations on human body have become a necessity, the research taking place in order to find out the limit to which the men could work in an environment with vibrations such as the agricultural machinery (self-propelled combines for cereals crop in a way) without no effects on the health of human being

Resection of a juxtarenal aneurysm complicated by rupture. Clinical case

Caz clinic. Se prezintă un caz clinic de tratament chirurgical soldat cu succes al unui anevrism de aortă juxtarenal complicat cu ruptură al unui pacient de 76 ani. Boala a debutat de 3 zile cu dureri puternice în regiunea lombară, cu iradiere în abdomen. Internat în spitalul orășenesc, unde la CT angiografie s-a depistat un anevrism al aortei abdominale complicat cu ruptură in spațiul retroperitoneal. Pacientul a fost transferat în SCR ,,T. Moșneaga” operat în mod urgent. La laparotomie xifopubiană s-a depistat circa un litru de lichid sero-sangvinolent, anevrism juxtarenal cu hematom retroperitoneal. După clamparea aortei suprarenale s-a efectuat rezecția anevrismului rupt, cu protezare aorto-femurală pe dreapta și iliacă pe stânga. Perioada postoperatorie fără complicații. Externat la a 11-a zi în stare satisfăcătoare. CT angiografie de control peste 6 luni- proteza aortală funcțională, fără alte patologii. Concluzie. În cazul anevrismelor aortei abdominale complicate cu ruptură, care nu pot fi rezolvate endovascular din diferite motive (anatomie nepotrivită, lipsa utilajului necesar la moment etc) este necesar tratamentul chirurgical deschis în mod urgent. Posedarea metodelor deschise nu trebuie exclusă din arsenalul chirurgului vascular.Clinical case. We present a clinical case of a successful surgical treatment of a ruptured juxtarenal aortic aneurysm in a 76-year-old patient. The disease started three days ago with severe pain in the lower back, radiating to the abdomen. The patient was transferred to the local hospital, where a CT angiography revealed an abdominal aortic aneurysm complicated by retroperitoneal rupture. The patient was urgently transferred to the "T. Moșneaga'' Intensive Care Unit for surgery. Xipho-pubic laparotomy revealed approximately one liter of serosanguinous fluid, a juxtarenal aneurysm with a retroperitoneal hematoma. After clamping the suprarenal aorta, resection of the ruptured aneurysm was performed, followed by aortic-femoral grafting on the right side and iliac grafting on the left side. The postoperative period was uneventful. The patient was discharged in satisfactory condition on the 11th day. A follow-up CT angiography after 6 months showed a functional aortic graft without any other pathologies. Conclusions. In cases of abdominal aortic aneurysms complicated by rupture, which cannot be resolved endovascularly due to various reasons (inappropriate anatomy, lack of necessary equipment at the moment, etc.), urgent open surgical treatment is necessary. Proficiency in open surgical techniques should not be excluded from the vascular surgeon's armamentarium

Optimizing surgical techniques in extra-anatomical ilio-femoral bypasses

Scopul lucrării. Bypass-ul extraanatomic ilio-femural crossover este o procedura chirurgicala utilizată pentru revascularizarea segmentului aorto-femural, când intervențiile endovasculare nu sunt posibile, iar aplicarea unui bypass aorto sau ilio-femural este dificilă sau chiar imposibilă din cauza condițiilor tehnice sau a stării pacientului. Scopul este studierea rezultatelor precoce și tardive pentru favorizarea unor schimbări și implementarea unor gesturi tehnice în aplicarea bypass-urilor crossover ilio-femural, pentru a crea o geometrie cât mai fiziologică ce poate oferi o soluție durabilă pe termen lung. Materiale și metode. Pe parcursul anilor 2001-2022 au fost efectuate 142 bypass-uri crossover ilio-femurale. Rezultate. În perioada postoperatorie a fost un singur deces și s-au efectuat 3 amputații. Au fost analizate duplex scanările și CT angiografiile în primele 12 luni postoperatorii, pentru aprecierea altor leziuni aterosclerotice, care ar necesita revascularizare deschisă s-au endovasculară atît in bazinul recipient cât și cel donator. Totodată, a fost apreciata poziția și forma bypass-ului ce a dus la folosirea ulterioară a unor noi procedee tehnice ce diferă de cele descrise anterior. Concluzii. Optimizarea tehnicilor chirurgicale creând o geometrie cât mai fiziologică, excluderea maximală a angulărilor stenozante ale grefei poate oferi bypass-ului extraanatomic crossover ilio-femural o durabilitate îndelungată. Acest lucru poate favoriza creșterea frecvenței indicațiilor la folosirea bypass-urilor crossover ilio-femural.Aim of study. The extra-anatomic ilio-femoral crossover bypass is a surgical procedure used for revascularizing the aorto-femoral segment when endovascular interventions are not possible, and when applying an aorto- or ilio-femoral bypass is difficult or even impossible due to technical conditions or the patient's condition. The aim was to study the early and late outcomes to promote changes and implement technical gestures in the application of ilio-femoral crossover bypasses, aiming to create a more physiological geometry that can provide a durable long-term solution. Materials and methods. Between 2001 and 2022, a total of 142 ilio-femoral crossover bypasses were performed. Results. There was one death and three amputations in the postoperative period. Duplex scans and CT angiography were analyzed in the first 12 months postoperatively to assess other atherosclerotic lesions that would require open or endovascular revascularization in both the recipient and donor areas. Additionally, the position and shape of the bypass were evaluated, leading to the subsequent use of new technical procedures that differ from those previously described. Conclusions. Optimizing surgical techniques by creating a more physiological geometry and minimizing stenotic angles of the graft can provide the extra-anatomic ilio-femoral crossover bypass with long-lasting durability. This may increase the frequency of indications for using ilio-femoral crossover bypasses