The treatment of electric injuries in Moldova

Secția Leziuni Termice, Spitalul Clinic de Traumatologie și Ortopedie, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Arsurile electrice au fost cunoscute încă din cele mai vechi timpuri, fulgerul fiind singura cauză a producerii acestor leziuni. Progresul tehnico-științific, cu utilizarea pe larg a energiei electrice atât în industrie cât și în viața uzuală a adus și acest tip de traumatisme. Deși pe larg sunt mediatizate regulile de protecție de traumatism electric anual sunt înregistrate astfel de traume la pacienți cu vârste cuprinse între 15-44 ani ce reprezintă 1-2% din numărul total de leziuni termice în Moldova. Material și metode. A fost analizată structura adresabilității și internării pacienților cu leziuni termice și electrice în CRLT pe parcursul ultimilor 15 ani. Rezultate. Din 6.266 de bolnavi internați cu leziuni termice de diferită geneză bolnavii cu electrotraume (fulger, flamă electrică, flacără de scurtcircuit, electroarsuri de tensiune înaltă sau joasă) constituie 3,1% (192 de bolnavi). Traumatism la serviciu au suportat 32 (16,7%) pacienți. 138 (72%) de bolnavi prezentat dizabilitate și au pierdut ireversibil capacitatea de muncă. În 5 (2,6%) cazuri a fost înregistrat decesul bolnavilor. Concluzii. Asistența medicală calificată sau specializată este de urgență majoră, necrofasciotomiile precoce aplicate în primele 4 ore fiind de importanță vitală pentru segmentele afectate. Cu toate că exprimarea leziunilor prin marca electrică nu prezice gradul de afectare, deteriorarea structurilor anatomice profunde de regulă este mai severă. Examinarea pacienților trebuie să fie completă, mai ales în zonele flexorii, inclusiv și pentru leziuni traumatice ale locomotorului. Trebuie luate în considerare ECG, enzimele cardiace, mioglobinuria și monitorizarea obligatorie a pacienților cu excepția cazurilor asimptomatice, fără tulburări cardiace ce au avut doar o scurtă expunere la curent de uz casnic.Introduction. Electrical burns have been known since ancient times, lightning being the only cause of these lesions. Scientific and technical progress, with extensive use of electricity in industry and in daily life brought this type of trauma. Although rules of protections against electrical shock are widely publicized, such injuries are recorded annually in patients aged between 15-44 years representing 1-2% of the total of thermal injuries in Moldova. Material and methods. The structure of the addressability and hospitalization of patients with thermal and electric injuries to Department of Burns over the last 15 years is reviewed. Results. Of 6266 patients hospitalized with thermal injuries, patients with electric injuries of different etiology (lightning, electrical flame, short circuit flame, high or low voltage electric burns) represent 3.1% (192 patients). 32 have suffered injury at work (16.7%) patients. 138 (72%) presented disabilities. In 5 (2.6%) cases were recorded deaths of patients. Conclusion. Specialized qualified medical assistance is a major emergency, early fasciotomies applied within first 4 hours are vital for the affected segments. Although injuries expressed via electric signs do not predict the extent of damage, damage to deep anatomical structures is usually more severe. The primary examination of the patients must be complete, particularly in flexors areas, including for traumatic injuries of locomotors. ECG should be examined, cardiac enzymes, myoglobinuria and the monitoring of patients is mandatory except asymptomatic cases without heart disorders that had only a short exposure to low voltage electricity

Aspects of treatment of frostbite and hypothermia in Moldova

Secția Leziuni Termice, Spitalul Clinic de Traumatologie și Ortopedie, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Deși adresabilitatea cu Degerături și Hipotermie generală are un caracter sezonier prejudiciul adus pacienților rămâne relevant pentru specialiștii de profil. Este de menționat că, în anumite condiții, această problemă medicală capătă un aspect social prin incidența ridicată a handicapului. Ca urmare a degerăturii profunde ale segmentelor anatomice de locomotor 60-80% dintre pacienți devin invalizi din cauza mutilării forțate prin amputare. Material și metode. Pe parcursul anilor 2010-2015 în CRLT au beneficiat de tratament 170 de pacienți (123 bărbați și 47 femei) cu Degerături și Hipotermii, ce reprezintă 7-8% din numărul total de spitalizări. 165 (97%) de pacienți au fost internați în stare avansată de ebrietate. Toți pacienții au suportat un tratament complex de debridare primară a zonelor afectate, terapie de detoxicare, anticoagulante, dezagregante, spasmolitice, reologice, antibioticoterapie, analgezice, etc. Zonele afectate au fost supuse unui tratament fizioterapic preoperator. Debridarea sau Amputația zonelor degerate au fost efectuate după demarcarea certă a necrozei. Rezultate. Durata medie de tratament a constituit 22,8 zile, perioada preoperatorie – 7,3 zile, bolnavii suportând 368 de intervenții chirurgicale: 52 (14%) cazuri grefare de plăgi restante, în 301 (82%) cazuri – amputații transcarpale, transmetatarsiene sau de degete, în 15 (4%) cazuri – amputație de gambă. În 4 (0,2%) din cazurile observate au fost înregistrate decese, cauzate preponderent de Hipotermii generale ireversibile. Concluzii. Structura procentuală a Degerăturilor și Hipotermiilor generale tratate în CRLT rămâne aproape constantă pe parcursul ultimilor ani, dar crește numărul bolnavilor cu comorbidități de ordin psihiatric și narcologic. Cele mai mari deficiențe întâlnite la tratamentul acestei categorii de bolnavi sunt legate de absența legislativului cu privire la conlucrarea serviciului social (persoane fără loc de muncă și de trai) și serviciului de evidență a populației (nu sunt în vizorul serviciului de evidență a populației RM).Introduction. Although the number of the medical addresses with frostbites and general hypothermia has a seasonal basis, the injuries caused to the patients remain relevant for the professionals in the field. It is worth mentioning that, in some circumstances, this medical problem acquires a social aspect by the high incidence of the caused disability. Due to the deep frostbites of the anatomical segments of the locomotor system, 60-80% of patients become disabled as a result of the forced mutilation through amputation. Materials and methods. During 2010-2015 years, a number of 170 patients (123 men and 47 women) with frostbite and hypothermia have received treatment in the Republican Center of Thermal Injuries, which represents 7-8% of the total number of hospitalizations. A number of 165 patients (97%) of those hospitalized, were drunk. All patients have received a complex treatment of primary debridement of the affected areas, a detoxification therapy, a drug therapy, anticoagulants, spasmolytic, analgesics, etc. The affected areas have been treated with high-frequency ray physiotherapy. The debridement or the amputations of the frostbitten areas were carried out after a definite necrosis demarcation. Results. The average treatment duration was 22.8 days, the presurgical period - 7.3 days, the patients bearing 368 surgical interventions: 52 (14%) cases of remaining wounds with transplanted tissue, 301 (82%) cases of transcarpal, metatarsian or finger amputations, 15 (4%) cases of shank amputations. 4 (0.2%) of the observed cases resulted with death, mainly caused by a general irreversible hypothermia. Conclusion. The percentage structure of general treated frostbite and hypothermia cases in the Republican Center of Thermal Injuries remains almost constant over the last few years, but the number of the patients with psychiatric and narcological comorbidities increases. The biggest difficulties encountered in the treatment of this category of patients are related to the absence of a legislation regarding the cooperation of the social services (unemployed and homeless people) and the population registration services (people that are not in the supervision of the registration services of the Republic of Moldova)

The treatment of burns in Republic of Moldova

Secția Leziuni Termice, Spitalul Clinic de Traumatologie și Ortopedie, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Numărul total de arsuri înregistrate în Republica Moldova este de 3.000-3.500 pe an. Incidenţa arsurilor constituie 87,8-127,1 cazuri la 100.000 populație. Anual sunt internați în secțiile chirurgicale1.800-2.500 de pacienţi, iar în secţiile specializate 1.200-1.500 de pacienţi, dintre care 7-23% pierd ulterior capacitatea de muncă, iar 75-82% din ei au vârstă aptă de muncă. Anual decedează în spitale50-60 de pacienţi arși. Material și metode. A fost analizată structura adresabilității și internării pacienților cu leziuni termice și consecințelor în CRLT pe parcursul ultimilor 5 ani. Rezultate. Pe parcursul anilor 2010-2015 în CRLT au beneficiat de asistență medicală consultativă 5.989 de pacienți,dintre care au fost internați 2.170(36%) de bolnavi. În 1.284(59,2%) cazuri au suportat intervenții chirurgicale de debridare și plastie cutanată etapizată. Durata medie de tratament este de 23,1 zile, perioada preoperatorie constituie 5,6zile, iar cea postoperatorie 12, 7zile. Letalitatea generală constituie 6,5-8%, iar în STI 17,8-25%. Concluzii. Gravitatea sechelelor arsurilor sunt direct proporţionale cu greşelile şi lacunele de tratament în perioada acută a bolii arşilor, când sunt ignorate principiile de tratament chirurgical. În cazurile asistate în CRLT s-au înregistrat interferenţe chirurgicale, psihiatrice, narcologice (etilism cronic, delir etilic),infecţioase, ftiziatrice, ce necesită o conlucrare permanentă cu specialiști de diferit profil.Introduction. A total number of burns registered in the Republic of Moldova is about 3.000-3.500 per year. The incidence of burns is 87,8-127,1 cases per 100.000. Annually in surgery departments are hospitalized 1.800- 2.500 patients, and in specialized departments 1.200-1.500 patients, of which 7-23% become disabled, and 75- 82% of which are in the working age. Annually, in hospitals die 50-60burned patients. Materials and methods. An analysis of the structure of addressability and hospitalization of burned patients in the Department of Burns was performed for last 5 years. Rezults. During 2010-2015 in the Department of Burns 5.989 patients were consulted, of which2.170(36%) were hospitalized. In 1.284(59,2%) cases patients were treated by surgical wound debridement and skin grafting. Average treatment duration is of 23,1 days, presurgical hospitalizationis of 5,6 days, and the postoperative stay is of 12,7 days. General mortality represents 6,5-8%, and in the ICU 17,8-25%. Conclusion. The gravity if burns sequela is directly depending of mistakes and shortcomings in treatment during the acute period of the burn disease, when basic surgical principals of treatment are ignored. Incases treated in the department of burns were registered surgical, psychiatrical, narcologic (chronic alcoholism, alcoholic delirium) infectious, phtisiatric interferences which need a permanent cooperation with specialists of different profile

Analiza efectului clinic al aplicării unguentului „Argidină” efectuat în Centrul Republican de leziuni termice

Catedra Ortopedie - Traumatologie şi Сhirurgie în Campanie a USMF "Nicolae Testemitanu”The analysis of obtained clinical results after application of ”Argidina” salve demonstrates its high efficacy in treatment of superficial and profound burns of reduced surfaces. The ”Argidina” salve diminishes the colonies of infection, the bandage is atraumatic, creates optimum conditions of wound regeneration in case of burns of II-IIIAB grade, of sectors of donor wounds

Quantitative in vivo Analyses Reveal Calcium-dependent Phosphorylation Sites and Identifies a Novel Component of the Toxoplasma Invasion Motor Complex

Apicomplexan parasites depend on the invasion of host cells for survival and proliferation. Calcium-dependent signaling pathways appear to be essential for micronemal release and gliding motility, yet the target of activated kinases remains largely unknown. We have characterized calcium-dependent phosphorylation events during Toxoplasma host cell invasion. Stimulation of live tachyzoites with Ca2+-mobilizing drugs leads to phosphorylation of numerous parasite proteins, as shown by differential 2-DE display of 32[P]-labeled protein extracts. Multi-dimensional Protein Identification Technology (MudPIT) identified ∼546 phosphorylation sites on over 300 Toxoplasma proteins, including 10 sites on the actomyosin invasion motor. Using a Stable Isotope of Amino Acids in Culture (SILAC)-based quantitative LC-MS/MS analyses we monitored changes in the abundance and phosphorylation of the invasion motor complex and defined Ca2+-dependent phosphorylation patterns on three of its components - GAP45, MLC1 and MyoA. Furthermore, calcium-dependent phosphorylation of six residues across GAP45, MLC1 and MyoA is correlated with invasion motor activity. By analyzing proteins that appear to associate more strongly with the invasion motor upon calcium stimulation we have also identified a novel 15-kDa Calmodulin-like protein that likely represents the MyoA Essential Light Chain of the Toxoplasma invasion motor. This suggests that invasion motor activity could be regulated not only by phosphorylation but also by the direct binding of calcium ions to this new component

Quantitative in vivo Analyses Reveal Calcium-dependent Phosphorylation Sites and Identifies a Novel Component of the Toxoplasma Invasion Motor Complex

Apicomplexan parasites depend on the invasion of host cells for survival and proliferation. Calcium-dependent signaling pathways appear to be essential for micronemal release and gliding motility, yet the target of activated kinases remains largely unknown. We have characterized calcium-dependent phosphorylation events during Toxoplasma host cell invasion. Stimulation of live tachyzoites with Ca2+-mobilizing drugs leads to phosphorylation of numerous parasite proteins, as shown by differential 2-DE display of 32[P]-labeled protein extracts. Multi-dimensional Protein Identification Technology (MudPIT) identified ∼546 phosphorylation sites on over 300 Toxoplasma proteins, including 10 sites on the actomyosin invasion motor. Using a Stable Isotope of Amino Acids in Culture (SILAC)-based quantitative LC-MS/MS analyses we monitored changes in the abundance and phosphorylation of the invasion motor complex and defined Ca2+-dependent phosphorylation patterns on three of its components - GAP45, MLC1 and MyoA. Furthermore, calcium-dependent phosphorylation of six residues across GAP45, MLC1 and MyoA is correlated with invasion motor activity. By analyzing proteins that appear to associate more strongly with the invasion motor upon calcium stimulation we have also identified a novel 15-kDa Calmodulin-like protein that likely represents the MyoA Essential Light Chain of the Toxoplasma invasion motor. This suggests that invasion motor activity could be regulated not only by phosphorylation but also by the direct binding of calcium ions to this new component

Mitotic Spindle Proteomics in Chinese Hamster Ovary Cells

Mitosis is a fundamental process in the development of all organisms. The mitotic spindle guides the cell through mitosis as it mediates the segregation of chromosomes, the orientation of the cleavage furrow, and the progression of cell division. Birth defects and tissue-specific cancers often result from abnormalities in mitotic events. Here, we report a proteomic study of the mitotic spindle from Chinese Hamster Ovary (CHO) cells. Four different isolations of metaphase spindles were subjected to Multi-dimensional Protein Identification Technology (MudPIT) analysis and tandem mass spectrometry. We identified 1155 proteins and used Gene Ontology (GO) analysis to categorize proteins into cellular component groups. We then compared our data to the previously published CHO midbody proteome and identified proteins that are unique to the CHO spindle. Our data represent the first mitotic spindle proteome in CHO cells, which augments the list of mitotic spindle components from mammalian cells