Maintenance of safeno-femural jonction intact in the case of surgical intervention for various illness

Catedra Chirurgie nr.1 ”Nicolae Anestiadi”, Universitatea de Stat de Medicină și Farmacie ”Nicolae Testemițanu”, Spitalul ”Sf. Arhanghel Mihail”, Chișinau, 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: Conform diferitor date în 20-30% din populația adultă din întreaga lume suferă de maladia varicoasă (MV). Cu toate aceste o problemă comună după inervențile chirurgicale la pacienții cu MV cronică sunt venele varicoase reziduale și recidivante. În majoritatea publicațiilor științifice se raportează o rată a recurenței după operație de 20-40%. Material și metode: În studiu au fost incluși 110 bolnavi (157 extremități afectate) cu MV primară. De la momentul operației până la efectuarea examenului clinic au trecut 82,01±1,7 luni (45-155 luni). Femei-75 (68.18%), bărbați-35 (31,82%). Vârsta medie la momentul operației a fost 48,3±11,79 ani (19-70 ani). Durata medie a MV la momentul operației a fost 19,34±11,46 ani (1-48 ani). Recidiva MV se atestă în 29,29% cazuri (prezența refluxului patologic venos și a venelor varicoase vizibile). Rezultate: Păstrarea joncțiunii safeno-femurale intacte a fost depistată în 8 cazuri, ceea ce constituie 5,09% din numărul total de observații și 15,68% din numărul total de cazuri ale recidivei refluxului în regiunea joncțiunii safeno-femurale. Indicicele mediu al masei corporale la pacienții cu păstrarea crosei intacte a fost 28,99±4,42 kg/m2 , versus 26,86±3,98 kg/m2 la persoanele cu deconectarea joncțiunii safeno-femurale (P=0,07). Accesul pentru crosectomie a fost situat mult mai distal de plica inghinală la pacienții cu păstrarea joncțiunii safeno-femurale intacte. Concluzii: Păstrarea joncțiunii safeno-femurale intacte mai rămâne o cauză a recidivei MV, fiind favorizată de indicele crescut al masei corporale la momentul intervenției chirurgicale și abordul chirurgical inadecvat mai distal de plica inghinală.Introduction: According to different data, 20-30% of the adult population worldwide suffers from Varicose Veins (VV). However, a common problem after surgical intervention to patients with chronic VV is remanent varicose veins and relapsing varicose veins. In most scientific publications, a recurrence rate of 20-40% is reported. Material and methods: In the study, 110 patients (157 affected extremities) with primary VV. From the time of surgery to the clinical examination 82.01 ± 1.7 months (45-155 months). Women–75 (68.18%), male–35 (31.82%). The mean age at the time of surgery was 48.3±11.79 years (19–70 years). VV duration at the time of surgery 19.34±11.46 years (1–48 years). VV relapse is evident in 29.29% cases (presence of venous pathological reflux and visible varicose veins). Results: The maintenance of the sapheno-femoral junction intact was detected in 8 cases, representing 5.09% of the total observations and 15.68% of the total cases of reflux relapsing in the region of the sapheno-femoral junction. The mean body mass index for patients with intact crown was 28.99±4.42 kg/m2 , versus 26.86±3.98 kg/m2 in people with disconnection of the sapheno-femoral junction (P=0.07). Access to crosectomy was far removed from the inguinal regeion to patients with intact sapheno-femoral junction. Conclusions: Keeping the intact sapheno-femoral junction still remains a cause of VV relapse, being favored by the increased body mass index at the time of surgical intervention and the inappropriately more distal surgical approach of the inguinal region

Markers of Liver Function as Potential Prognostic Indicators of SARS-CoV-2 infection: A Retrospective Analysis during the First and Second Waves of COVID-19 Pandemic

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is known to cause a predominant respiratory disease, although extrapulmonary manifestations can also occur. One of the targets of Coronavirus disease 2019 (COVID-19) is the hepatobiliary system. The present study aims to describe the correlation between the increase of liver damage markers (i.e. alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TB]) and COVID-19 outcomes (i.e., in-hospital mortality [IHM] and intensive care unit [ICU] transfer). Methods: All patients with confirmed SARS-CoV-2 infection admitted to the Infectious Diseases Unit of the St. Anna University-Hospital of Ferrara from March 2020 to October 2021 were retrospectively included in this single-centre study. ALT, AST and TB levels were tested in all patients and IHM or ICU transfer were considered as main outcomes. Co-morbidities were assessed using Charlson Comorbidity Index. Results: A total of 106 patients were retrieved. No hepatic marker was able to predict IHM, whereas all of them negatively predicted ICU transfer (ALT: OR 1.005, 95%CI 1.001-1.009, p= 0.011; AST: OR 1.018, 95%CI 1.006-1.030, p= 0.003; TB: OR 1.329, 95%CI 1.025-1.724, p= 0.032). Age was the only parameter significantly related to mortality. Conclusions: The present study, by correlating liver damage markers with COVID-19 outcome, showed that an increase of ALT, AST and TB predicted patients' severity, although not mortality

Rapid and Versatile Construction of Diverse and Functional Nanostructures Derived from a Polyphosphoester-Based Biomimetic Block Copolymer System

A rapid and efficient approach for the preparation and modification of a versatile class of functional polymer nanoparticles has been developed, for which the entire engineering process from small molecules to polymers to nanoparticles bypasses typical slow and inefficient procedures, and rather employs a series of steps that capture fully the “click” chemistry concepts that have greatly facilitated the preparation of complex polymer materials over the past decade. The construction of various nanoparticles with functional complexity from a versatile platform is a challenging aim to provide materials for fundamental studies and also optimization toward a diverse range of applications. In this paper, we demonstrate the rapid and facile preparation of a family of nanoparticles with different surface charges and functionalities based on a biodegradable polyphosphoester block copolymer system. From a retrosynthetic point of view, the non-ionic, anionic, cationic and zwitterionic micelles with hydrodynamic diameters between 13 nm to 21 nm and great size uniformity were quickly formed by suspending, independently, four amphiphilic diblock polyphosphoesters into water, which were functionalized from the same parental hydrophobic-functional AB diblock polyphosphoester by “click” type thiol-yne reactions. The well-defined (PDI < 1.2) hydrophobic-functional AB diblock polyphosphoester was synthesized by an ultrafast (< 5 min) organocatalyzed ring-opening polymerization in a two-step, one-pot manner with the quantitative conversions of two kinds of cyclic phospholane monomers. The whole programmable process starting from small molecules to nanoparticles could be completed within 6 h, as the most rapid approach for the anionic and non-ionic nanoparticles, although the cationic and zwitterionic nanoparticles required ca. 2 days due to purification by dialysis. The micelles showed high biocompatibility, with even the cationic micelles exhibiting a 6-fold lower cytotoxicity toward RAW 264.7 mouse macrophage cells, as compared to the Lipofectamine(®) commercial transfection agent