The cone of Betti tables over three non-collinear points in the plane

We describe the cone of Betti tables of all finitely generated graded modules over the homogeneous coordinate ring of three non-collinear points in the projective plane. We also describe the cone of Betti tables of all finite length modules

Efficiency assessment of the information system on surveillance of communicable diseases and public health events

Department of Epidemiology, Nicolae Testemitsanu State University of Medicine and Pharmacy, National Center of Public Health, Chisinau, the Republic of MoldovaBackground: The process of the implementation of information technologies in the system of public health surveillance is going on, providing an essential support in improving the quality and accessibility of the data on the epidemiological situation and morbidity trends as well as in improving the surveillance optimization and control of communicable diseases and health events in the terms of time, human resources and effective financial management. Material and methods: The efficiency evaluation of the electronic system of surveillance over communicable diseases and public health events has been performed by analyzing the system functionalities and assessing the health workers’ satisfaction in the light of simplicity, flexibility, quality and acceptability of the system. Results: The level of the satisfaction of medical personnel (family doctors and epidemiologists) concerning the electronic system functionalities has a direct correlation with the general computer knowledge and working skills. The informatization of the main activities of the public health service corresponds to the information complex integrated into the health care system and e-government strategy and consists of its subsequent integration into the unified information space of the country. Conclusions: At present the integration of information systems in the field of medical care and public health supervision is a problem that requires an integrated and comprehensive approach, focused on the consolidation and optimization of the management of human and financial resources and the achievements of the best indicators in the public health service

New technics for removal of intradural spinal tumours

Introduction. Neuronavigation is a computer-assisted technology based on pre- and intraoperative images that permit neurosurgeons to have a better approach of the brain and intradural spinal tumors. The neuronavigation systems have been a significant progress in neurosurgery. These systems allow neurosurgeons to evaluate surgical risks, select the best interventional method, localize better the tumors in order to improve the accuracy of the resection and decide on the optimal trajectory for the surgical procedure, resulting in decreased patient morbidity and mortality. Material: Spinal cord tumors are rare and uncommon lesions. Their growth result in compression of the spinal cord, which can cause severe neurologic deficits such as limb dysfunction, motor and sensation loss with the possibility of leading to death. We present o short report of a study publicated by Stefini et al. in 2018 regarding the use of neuronavigation for removal of intradural spinal tumors. Conclusion: The benefits of using neuronavigation in resection of the intradural spinal tumors include decreased risk of bad localization of the tumor, minimal invasive surgery technique and reduction of bone removal

Small bowel intussusception in adults

Catedra Chirurgie nr.1 “N.Anestiadi”, Laboratorul Chirurgie Hepato-Pancreato-Biliară, USMF „Nicolae Testemițanu”, Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Invaginația se definește ca telescoparea unui segment al tractului digestiv în cel adiacent. Invaginația intestinului subțire (IIS) este o formă de obstrucție intestinală ce se întâlnește foarte rar la adulți. Scopul lucrării: Analiza cazurilor de IIS la adulți. Material și metode: S-a efectuat reviul retrospectiv a 79 pacienți adulți cu tumori ale intestinului subțire pe parcursul anilor 1992 - 2014. Au fost selectați pacienții cu IIS. Rezultate: Au fost selectate 8 (10,1%) cazuri de IIS (F-7, B-1) cu vârsta medie de 41,6±52 ani (95%CI: 29,33–53,92). Simptomele principale au fost: durerea abdominală, grețurile, voma. Laparotomia a relevat invaginație ileo-ileală (n=7), iar întrun caz – jejuno-jejunală (p=0,0101), cauzate de o masă intramurală. După o dezinvaginare atentă se efectuează rezecția intestinului subțire (n=6) și rezecție cuneiformă (n=2) cu anastomoză primară termino-terminală (n=7) și jejunostomie Maydl (n=1). Examenul histologic a relevat: fibrom (vimentin +++; CD117 –, desmin –, actin –, S–100 –) (n=4), adenocarcinom (n=1), tumoră gastrointestinală stromală (c-kit/CD117 +++) (n=1), lipom (n=1) și tumora Vanek (n=1). Concluzii: Invaginația la adulți se manifestă printr-o varietate acută, intermitentă și cronică de simptome, făcând astfel diagnosticarea preoperatorie dificilă. O dezinvaginare atentă poate fi încercată în IIS dacă segmentul implicat este viabil și nu se suspectă malignizarea. Tratamentul constă, de obicei în rezectarea segmentului invaginat.Introduction: Intussusception is defined as telescoping of one segment of the digestive tract into an adjacent one. Small bowel intussusception (SBI) is rare form of intestinal obstruction which occurs infrequently in adults. The aim of study: To analyze the cases of SBI in adults. Material and methods: A retrospective review of 79 adult patients with small-bowel tumors between 1992 – 2014 was conducted. Pts with diagnosis of SBI were selected. Results: There were 8 (10.1%) cases of SBI (F-7, M-1) with mean age 41.6±5.2 years (95%CI: 29.33–53.92). Abdominal pain, nausea, and vomiting were the most common symptoms. Laparotomy revealed ileo–ileal (n=7) and jejuno–jejunal (n=1) intussusception (p=0.0101), caused by an intramural mass. After gentle reduction a small bowel resection (n=6) and wedge resection (n=2) were performed with primary anastomosis – end-to-end (n=7) and Maydl jejunostomy (n=1). Histological examination of the specimen revealed: fibroma (vimentin +++; CD117 –, desmin –, actin –, S–100 –) (n=4), adenocarcinoma (n=1), gastrointestinal stromal tumors (c-kit/CD117 +++) (n=1), lipoma (n=1) and Vanek's tumour (n=1). Conclusions: Adult intussusception presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. Gentle reduction can be attempted in SBI if the segment involved is viable or malignancy is not suspected. Treatment usually requires resection of the invaginated bowel segment

Neuromodulation devices nowadays

Introduction. Neuromodulation devices have known a great progress in the past years being used in treatment of drug resistant neurological diseases such as epilepsies and migraines. A neuromodulation device can stimulate profound or superficial neural pathways in order to balance chronic drug-resistant disorders that involve disturbances of cellular electrical potentials. Material. Cranial neuromodulation devices implants used until now usually determined skull irregularities, implant site infection, resorption of the bone flap or osteomyelitis. In order to solve these problems, it was needed a customized cranial implant that integrates the neuromodulation device. We report the first description of a fully integrated neuromodulation device within a customized cranial implant, publicised in 2018 by Gordon et al., that demonstrates the utility of a computerized neurostimulation device combined with clear custom-designed cranial implant. Conclusion. The new approach of neurotechnology confines a better solution for neuroimplants devices with less follow-up complications and great patient’s satisfaction

Von Recklinghausen's disease associated with gastrointestinal tumors: a case seria

Catedra Chirurgie 1 „Nicolae Anestiadi”, Laboratorul Chirurgie Hepato-Pancreato-Biliară, USMF „NicolaeTestemiţanu”, Secţia Chirurgie Toraco-abdominală, Institutul Oncologic, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Boala von Recklinghausen (VR) reprezintă una dintre cele mai frecvente afecţiuni cu transmitere autozomaldominantă cu penetranţă mare a genotipurilor și expresivitate variabilă, cauzată de mutaţia genei supresiei tumorale NF1. Mutaţia acestei gene duce la pierderea funcției supresoare tumorale, care la rândul său, determină dezvoltarea tumorilor benigne și maligne. Tabloul clinic se caracterizează prin prezenţa neurofibromatozelor multiple, afectării pielii (pete pigmentare „cafe au lait”), pistruilor și hamartromelor în iris (noduli Lisch). În 25% cazuri se observă manifestări gastrointestinale, cel mai frecvent – tumori stromale gastrointestinale (GIST). Cazuri clinice: Se prezintă trei cazuri (bărbaţi, n=3) cu vârste cuprinse între 40-65 ani cu tumori gastro-intestinale asociate cu boala VR. Cazul # 1: Bărbat de 65 ani se prezintă cu durere violentă abdominală şi pierdere în greutate cu GIST multiple de stomac (CD117++, Ki-67 24,7%). S-a intervenit cu o rezecţie subtotală a stomacului. Cazul # 2: Pacientul de 40 ani a fost internat în spital cu semne clinice de perforaţie a intestinului cu hemoragie intraluminală. Intraoperator au fost depistate tumori stromale gastrointestinale (GIST) a jejunului (CD117++), s-a efectuat rezecția de intestin cu anastomoză termino-terminală. Peste 8 ani – reoperat din cauza ocluziei intestinale. Cazul # 3: Pacientul de 52 ani cu multiple GIST a jejunului (CD117+++, CD34+++) în asociere cu tumoare neuroendocrină a papilei mici a duodenului (NSE+, Cromogranina A+), manifestate prin ocluzie intestinală înaltă a fost tratat prin rezecţie pancreatoduodenală (procedeul Kausch-Whipple). Concluzii: Boala von Recklinghausen reprezintă o afecţiune ereditară cu transmitere autozomal-dominantă, care duce la dezvoltarea tumorilor benigne și maligne. În cele mai frecvente cazuri tumorile stromale gastrointestinale apar spontan, însă pacienţii cu boala VR au un risc crescut pentru dezvoltarea acestor tumori. Diagnosticul precoce a manifestărilor abdominale ale acestei afecţiuni este necesar pentru un tratament adecvat şi evitarea complicaţiilor organice severe legate de prezenţa tumorilor.Introduction: The von Recklinghausen's (VR) disease is one of the most common autosomal dominant disorders with almost complete penetration and with variable expression, caused by mutations in the NF1 tumor suppressor gene. The mutation of this gene leads to the loss of tumor suppressor function, which in turn causes the development of benign and malignant tumors. Clinical diagnostic features are multiple neurofibromas, „cafe au lait”, skin fold freckles, and iris hamartomas (Lisch nodules). In 25% of the cases gastrointestinal manifestations are found, most often gastrointestinal stromal tumors (GIST). Clinical cases: We describe three males aged 40-65 years with gastrointestinal tumors associated with VR disease. Case # 1: 65 years old patient presented a severe abdominal pain and weight loss with multiple GIST of the stomach (CD117++, Ki-67 27.4%). It was practiced subtotal gastrectomy. Case # 2: 40 years old patient was hospitalized with clinical signs of intestinal perforation and intraluminal bleeding. Intraoperatively were found GIST of jejunum (CD117++). It was performed resection with end-to-end anastomosis. After 8 years he was reoperated for intestinal obstruction. Case # 3: 52 years old patient with multiple jejunal GIST (CD117+++, CD34+++) and neuroendocrine tumor (NSE+, Cromogranina A+) of the minor duodenal papilla, manifested with proximal intestinal obstruction and resolved by pancreatoduodenectomy (Kausch-Whipple procedure). Conclusions: The von Recklinghausen's disease is an autosomal dominant genetic disorder that leads to the development of benign and malignant tumors. In the most cases gastrointestinal stromal tumors appear spontaneously, but the patients with VR disease have some higher risk for developing of these tumors. Early diagnosis of abdominal manifestations of this disease is necessary for appropriate treatment and prevention of severe organic complications related to tumor

Associations between eating speed, diet quality, adiposity, and cardiometabolic risk factors

Objective: To assess the associations between eating speed, adiposity, cardiometabolic risk factors, and diet quality in a cohort of Spanish preschool-children. Study design: A cross-sectional study in 1371 preschool age children (49% girls; mean age, 4.8 ± 1.0 years) from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort was conducted. After exclusions, 956 participants were included in the analyses. The eating speed was estimated by summing the total minutes used in each of the 3 main meals and then categorized into slow, moderate, or fast. Multiple linear and logistic regression models were fitted to assess the β-coefficient, or OR and 95% CI, between eating speed and body mass index, waist circumference, fat mass index (FMI), blood pressure, fasting plasma glucose, and lipid profile. Results: Compared with participants in the slow-eating category, those in the fast-eating category had a higher prevalence risk of overweight/obesity (OR, 2.9; 95% CI, 1.8-4.4; P < .01); larger waist circumference (β, 2.6 cm; 95% CI, 1.5-3.8 cm); and greater FMI (β, 0.3 kg/m2; 95% CI, 0.1-0.5 kg/m2), systolic blood pressure (β, 2.8 mmHg; 95% CI, 0.6-4.9 mmHg), and fasting plasma glucose levels (β, 2.7 mg/dL, 95% CI, 1.2-4.2 mg/dL) but lower adherence to the Mediterranean diet (β, −0.5 points; 95% CI, −0.9 to −0.1 points). Conclusions: Eating fast is associated with higher adiposity, certain cardiometabolic risk factors, and lower adherence to a Mediterranean diet. Further long-term and interventional studies are warranted to confirm these associations