History of Nicolae Testemitsanu State University of Medicine and Pharmacy through its rectors

Nicolae Anestiadi Department of Surgery, Nicolae Testemitsanu Department of Social Medicine and Sanitary Management, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: The authors present the history of Nicolae Testemitsanu State University of Medicine and Pharmacy from the beginning, since the transfer of Leningrad Institute of Medicine No 1 in November 1945. Rectors: Ipatie Sorocean, Nicolai Harauzov, Leonid Ganul, Nicolae Starostenco, Nicolae Testemitsanu, Vasile Anestiadi, Leonid Cobaleanschi, Ion Ababii are presented with a broad feature of their work – teaching, scientific, managerial. A particular attention is given to rectors academicians: Nicolae Testemitsanu, Vasile Anestiadi and current rector Ion Ababii. A decisive role in the development of the university belongs to Nicolae Testemitsanu, who was the first local rector to promote national staff, contributed to the opening of the faculties of Dentistry, Continuous Medical Education, Preventive Medicine and Pharmacy. He sent local staff for advanced studies to different USSR centers, who after returning occupied the positions of heads of departments and laboratories. Vasile Anestiadi continued the promotion of the university, which became one of the most prestigious medical institutions in the former Soviet Union. Ion Ababii, the current rector, has promoted the university applying European ideas, liaising with other universities of the same type, a strategic partnership with future effects. Thus, Nicolae Testemitsanu State University of Medicine and Pharmacy reached the anniversary of 70 years, having an imposing history and a foreseeable future, occupying a deserved place among higher educational institutions of the Republic of Moldova. Conclusions: The history of Nicolae Testemitsanu State University of Medicine and Pharmacy represents an important page of our country’s history. The teaching team brings new achievements in the training process of medical staff of the Republic of Moldova

Pulmonary thromboembolism associated with surgical diseases

Nicolae Anestiadi Department of Surgery, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: The pulmonary thromboembolism (PTE) has demonstrated a serious evolution and a high lethality level and is on the third place as a cause of a sudden death and remains one of the most actual issues in medicine. The actuality of the problem consists not only in the disease severity and lethality, but also in the difficulties in the diagnostics. Material and methods: By the necropsy data, the incidence of PTE is estimated as about 15% of cases. A retrospective study of 33 patients who died from PTE in the period of 2008-2013 is presented. In the studied group the following risk factors have been identified: intravenous catheters, surgery, immobilization in bed, smoking and atrial fibrillation. In the studied group PTE prophylaxis has been performed with heparin, nadroparin and enoxaparin. The authors have been dissatisfied with the research due to PTE fatality. Results: It has been revealaed that an important factor in decreasing the lethality is the administration of antiplatelet drug support to all the patients with PTE risk. Conclusions: 1. PTE is a frequent complication with a high lethality even in the case of its prevention. 2. The presence of risk factors, regardless of their number, strongly requires a preventive treatment. 3. The most effective anticoagulant drugs at the moment are those from the group of anticoagulants with a low molecular weight in preventive doses (Fondaparinux, Enoxaparin, Nadroparin). 4. It is necessary to reevaluate the anticoagulant medication support and prescribe it to the people above 40 years old. 5. The problem of PTE remains open for the further research with regard to the evidences of risk factors and the lethality decrease

Синдром Буверета

According to the literature Bouveret’s syndrome is a rare disease with an unclear clinical picture and difficulties in diagnosis. The known diagnostic methods include X-ray examination, ultrasonography, computerized tomography, the endoscopic examination of the gastrointestinal tract. Researchers indicate that the most successful diagnosis can be made when combining ultrasound and contrast radiography. There isn’t a clear opinion about Bouveret’s syndrome surgical treatment. Preference is given to the simple methods - enterotomy with the extraction of the biliary concrement leaving the elimination of the fistula and cholecystectomy for the second phase of treatment. In this case there appear a risk of the recurrence of biliary obstruction and the occurrence of cholangitis. A clinic case of a 62-year-old woman, who had difficulties in the diagnosis of biliary ileus has been described. The clinical picture has not corresponded to the X-ray examination results. The increase of obstruction syndrome and lack of the effect of conservative therapy have required a classical surgical treatment. In this case the solution of the problem has been reached by one stage treatment: cholecystectomy, enterotomy with gall stone extraction and the liquidation of gastric defect. The postoperative period has been complicated with a bilateral pleurisy, which has been succesfully cured by carrying out the pleural puncture and antibiotic therapy.В соответствии с данными литературы, синдром Буверета – это редкое заболевание с неясной клинической картиной и сложной диагностикой. Среди методов его диагностики наиболее известны рентгенологические методы, ультразвуковое исследование, компьютерная томография, эндоскопическое исследование желудочно-кишечного тракта. Исследователи отмечают наибольшую вероятность успешной диагностики при сочетании УЗИ с контрастным рентгенологическим исследованием. Нет единого мнения и относительно хирургического лечения синдрома Буверета. Предпочтение отдаётся простым методам – энтеротомии с удалением желчного камня, при том, что ликвидация свища и холецистэктомия остаются на второй этап лечения. Но, в этом случае остаётся опасность рецидива билиарной непроходимости и возникновения холангита. Приводится клинический случай женщины 62 лет, у которой были трудности диагностики кишечной непроходимости билиарного генеза. Клиническая картина не соответствовала данным рентгенологического исследования. Нарастание клиники кишечной непроходимости и отсутствие эффекта от консервативной терапии потребовало хирургического лечения классическим способом. В нашем случае решение проблемы достигнуто проведением одноэтапного лечения: холецистэктомия, энтеротомия с извлечением камня и закрытие дефекта желудка. Послеоперационный период осложнился двухсторонним плевритом, который успешно вылечили посредством проведения плевральной пункции и терапии антибиотиками