Traumatismele vasculare. Experiența Serviciului de chirurgie vasculară a Spitalului Clinic Republican

Cursul de chirurgie cardiovasculară, USMF „Nicolae Testemiţanu”, Spitalul Clinic Republican „Timofei Moșneaga”Background. Vascular trauma represents approximately 2% of all trauma and 15-20% require urgent intervention. The lethality in the traumas of the main vessels comprises up to 15-25%, they justify the interest that must be given to these injuries. Objective of the study. Analysis of the vascular trauma treatment algorithm, based on the experience of the CRH Vascular Surgery Department. Material and Methods. During (1977-2020) the Vascular Surgery Department provided surgical assistance to 1242 patients with vascular trauma. Basic interventions - marginal suturing of the injured vessel or prosthesis with a saphenous graft. In case of destruction of the surrounding tissues, extraanatomical bypasses, the "open wound" method, were used. 3 patients were treated endovascularly. Results. Post interventional lethality consisted 3,2%. Amputation rate (in case of arterial trauma of the limbs) consisted 4,3%. Conclusion. The vascular trauma treatment algorithm is characterized by the efficient management of peripheral vascular trauma, the organization and observance of the rules for providing medical assistance. The main vectors are early diagnosis and establishment of optimal interventional tactics.Introducere. Trauma vasculară reprezinta aproximativ 2% dintre toate traumatismele și 15-20% dintre traumatismele care necesită intervenție urgentă. Letalitatea în traumatismele vaselor magistrale cuprinde până la 15-25%, acestea justificp interesul care trebuie acordat acestor leziuni. Scopul lucrării. Analiza algoritmului de tratament al traumatismelor vasculare, bazat pe experiența secției chirurgie vasculară a SCR. Material și Metode. În perioada anilor 1977-2020 s-a acordat ajutor chirurgical la 1242 pacienți cu traumatisme vasculare. Intervențiile de bază au fost suturarea marginală a vasului lezat sau protezarea lui cu grefon safen. În caz de distrugere a țesuturilor înconjurătoare au fost folosite bypass-uri extraanatomice, metoda de „plagă deschisă”. 3 pacienți au fost tratați endovascular. Rezultate. Letalitatea postoperatorie a fost de 3,2%. Rata amputațiilor (în cazul traumatismelor arteriale ale membrelor) de 4,3 %. Concluzii. Algoritmul de tratament al traumatismelor vasculare se caracterizează prin managementul eficient al traumei vasculare periferice, organizarea şi respectarea regulilor de acordare a asistenţei medicale. Vectorii sunt diagnosticul precoce și stabilirea tacticii intervenționale optimale

The first seroepidemiological survey for Angiostrongylus vasorum in domestic dogs from Romania

Abstract Background Angiostrongylus vasorum is a metastrongyloid nematode localized in the right heart and the pulmonary arteries of domestic dogs. The number of reports in Europe has recently increased, presumably as a consequence of a growing awareness among clinicians, animal owners and researchers, but also due to a growing incidence and territorial spread. So far, no studies have been conducted to assess the prevalence and distribution of A. vasorum in domestic dogs in Romania, and the awareness among veterinarians is limited or absent. The aim of the present study was to evaluate the countrywide seroprevalence of circulating antigens of A. vasorum and specific antibodies against A. vasorum in domestic dogs from Romania. Methods Between November 2016 and July 2017, blood was sampled from a total of 1545 domestic dogs from 23 counties of Romania. Details about their gender, age, breed, housing, use and origin were collected. All serum samples were tested for the presence of A. vasorum circulating antigens (AG) using monoclonal and polyclonal antibodies in a sandwich ELISA. Additionally, a sandwich ELISA using A. vasorum adult somatic antigen purified by monoclonal antibodies was used for specific antibody (AB) detection. Results A total of 33 dogs (2.14%, 95% CI: 1.82–3.56%) were seropositive for A. vasorum antigen or antibodies against the parasite. Three dogs were positive for antigen only (0.19%, 95% CI: 0.07–0.57%) and 30 dogs (1.94%, 95% CI: 1.36–2.76%) were positive for antibodies only. No dog was positive for both tests. The overall prevalence (AB or AG) and the AB prevalence were significantly higher in pure breed dogs compared to mixed breeds and mongrel dogs (P < 0.05) and in shepherd dogs compared to other groups (P < 0.05). There was no significant difference between males and females, between urban and rural dogs, between dogs with unrestricted access and with restricted access to the environment, and between dogs living outdoors and indoors. Conclusions Our data suggest that the disease is present in Romania in dogs, as it was previously demonstrated in foxes. However, so far, no clinical case has been reported in the country and this may be related to a low awareness among vets