Colon intussusception treated endoscopically (case report)

Secția endoscopie, Institutul Medicinei de Urgență, Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: În Clinică la 30 octombrie 2013 s-a adresat pacientul SA de 19 ani, cu acuze la dureri intense în flancul stîng, vomă repetată cu conținut gastric, astenie pronunțată, inapetență, lipsa scaunului (2 zile), lipsa emisiei de gaze (24 ore). Din anamneză, în copilărie – diagnosticat cu megacolon congenital, părinții au refuzat tratamentul chirurgical. La internare: abdomenul moderat balonat, simetric, dolor intens la palpare în flancul stîng și mezogastru, semne peritoneale – absente, per rectum – conținut intestinal, pereții – dilatați. Spitalizat cu diagnosticul de ocluzie intestinală joasă. Ecografia cavității abdominale a evidențiat un minim de lichid liber interileal. Radiografia abdomenului – aerocolie pronunțată. La 31 octombrie 2013 s-a efectuat colonoscopie pînă la flexura lienală, înaintarea fiind neinformativă (în lumen – materii fecale). În sigmoid, la distanța 25 cm de la orificiul anal pînă la 40 cm, peretele intestinului nu se reexpansiona complet, mucoasa – edemațiată, culoare violacee, cu peteșii hemoragice. Lumenul colonului nu se vizualiza. La insuflarea aerului porțiunea proximală de perete intestinal a glisat, eliberînd lumenul sigmoidului. Colonul descendent examenat – mărit în dimensiuni atît longitudinal cît și transversal. Mucoasa examinată subțiată, cu desen vascular pronunțat. Haustrele intestinale – absente. Peristaltismul intestinal – absent. Unghiul lienal – permeabil. Biopsia din mucoasa schimbată macroscopic al sigmoidului nu a fost prelevată din cauza pericolului hemoragiei și a perforației. La pacient s-a constatat o invaginație de colon la nivelul sigmoidului, megadolicocolon. După colonoscopie starea generală a pacientului s-a ameliorat, acesta fiind externat din staționar recomandîndu-se tratamentul chirurgical programat al dolicocolonului.Clinical case: This article reports a clinical case of intestinal obstruction intussusception, which was solved by colonoscopy. A 19-years-old patient was admitted on October 30, 2013 to the Hospital with the following complaints: severe pain in left abdominal flank, repeated vomiting, pronounced asthenia, decreased appetite, constipation and a lack of gas (2 days). In anamnesis, childhood-diagnosed with congenital megadolichocolon, parents refused surgical treatment. Physical exam: the swollen abdomen, abdominal pain on palpation, no peritoneal signs. Hospitalized with intestinal obstruction. Abdomenal cavity ultrasound showed minimal free liquid. X-rays of the abdomen showed a bowel distension. October 31, 2013 was conducted colonoscopy. In the sigmoid, at a distance of 25 cm from the anus, up to 40 cm, the intestinal wall was not deployed fully, the swelling, purple mucous with petechial hemorrhages. The lumen of the colon was not see. Under the inspiration of the air, the proximal portion of the intestinal wall, to drag it, giving the lumen of the sigmoid. Colon descending seen, increased in size, both lengthwise and transversely. Mucous were narrowed, with strikes pronounced. The folds of the intestine absented. Peristalsis was absent. No biopsy was taken of the macroscopic changed mucous of sigmoid, because of the risk of bleeding and perforation. The patient was found to intussusception of the colon sigmoid. After the colonoscopy the general condition of the patient improved, was discharged from the hospital and it was recommended surgical treatment of dolichocolon

Clindamycina în tratamentul prostatitei uretrogene (rezultate preliminare)

Summary. The study was performed on the basis of the data accumulated while applying antibacterial treatment for 53 patients with sexual transmitted disease. The results showed the increased efficiency of clindamycine in treatment of chronic uretrogenic prostatitis associated with Chi. Trachomatis si Ur. Urealythicum (Мус. Hominis)

Alternativă contemporană în tratamentul bolilor sexual transmisibile la bărbați (rezultate preliminare)

Summary The study was performed on the basis of the data accumulated while applying antibacterial treatment for 69 patients with sexual transmitted disease. The results showed the increased efficiency of clatithromycine in treatment of chronic uretritis caused by Chi. Trachomatis, Ur. Urealythicum and Мус. Hominis

Case Study About Resistance Projection Welding of Aluminized Steel Parts

Resistance projection welding is a non-polluting mechanized process used to obtain an assembly between similar or dissimilar metallic materials. The main advantages of this welding process are the possibility to achieve many different welded points at the same time and the long life of the electrodes compared to the spot-welding process. The paper analyses the effects of thin aluminium coating existing on mild steel parts of on the correct formation of welding points when assembling moulds for the manufacture of baking bread. From optical and electron microscopy analyses it resulted that some adjacent welded points show an interrupted fusion line, sprinkled with elongated islands of aluminium-rich compounds. The paper presents the effect of changing the values ​​of the welding parameters on the weld spot size, in correlation with the Al-rich inclusions that appear on the weld fusion zone. The best results have been obtained when the welding parameters values were the follows: electrode pressure of 2.6 bar, welding power of 19.18kVA and welding time of 7ms. The problems that occur when electric resistance welding of parts with aluminium coating have been highlighted, being useful for specialists who make products using this welding process

Endoscopic treatment of perforated ulcer

Cu introducerea în anul 1976 a agenţilor anti H2, s-a micşorat evident numărul cazurilor de tratament chirurgical adresate ulcerului uo enal sau stomacal. Necatând la aceasta, incidenţa complicaţiilor asociate cu maladie ulceroase, în special perforaţia, practic nu s-a schimbat. Din 1990. când Mouret a descris în primieră suturarea laparoscopică a ulcerului duodenal perforat şi Nathanson. care a e ectuat primul tratament cu succes al ulcerului peptic perforat, metoda laparoscopică a devenit o procedură folosită pe larg. Primele cazuri de tratament laparoscopic al ulcerului perforat în Moldova au fost efectuate în 1997. Studiul prezentat se bazează pe analiza a 54 cazuri de ulcer perforat (48 barbaţi şi 6 femei), spitalizaţi în secţiile de chirurgie a Centrul Naţional Practico-Știinţific in Medicina de Urgenţă cu vârsta medie 25, 16 ani (15-60 ani). Analiza clinică confirmă: tratamentul laparoscopic este .o metoda eficientă de tratament, reduce durata de spitalizare a pacientului, există o reluare rapidă a tranzitului intestinal, iar complicaţiile postoperatorie sunt reduse.With the introduction of H2 receptor antagonist in 1976 there is a significant reduction of elective surgical cases carried out for duodenal and gastric ulcers. However the incidence of complications associated with peptic ulcer disease particularly perforation has not changed appreciably. Since 1990 when Mouret reported the first laparoscopic sutureless repair for a perforated duodenal ulcer and Nathanson the first successful laparoscopic suture repair for perforated peptic ulcer, laparoscopic approach became a widespread procedure. The first cases of treatment laparoscopic of perforated ulcer in Moldova were performed in 1997. The study is based on the analysis of 54 cases of perforated ulcer (48 men and 6 women), hospitalized in the surgical department of the Republican Emergency Hospital, mean age 25, 16 (limits 16 - 60 years). The performed clinical analysis attests that laparoscopic treatment is a safe and efficient method, it reduces the hospitalizing period and has a low rate of complications

Isomers production in 238U photofission

The fission process induced by gamma quanta up to 25 MeV energy on 238U was analyzed. Experimental observables as cross sections, fragments mass distribution yields of some nuclides of interest and average prompt neutrons multiplicity characterizing 238U photofission process were theoretically evaluated using TALYS 1.9 software. Theoretical evaluations of isomer ratios using Talys supplied by author’s own code as well as experimental isomer ratios obtained at MT - 25 Microtron are presented

Transition from ballistic to diffusive behavior of graphene ribbons in the presence of warping and charged impurities

We study the effects of the long-range disorder potential and warping on the conductivity and mobility of graphene ribbons using the Landauer formalism and the tight-binding p-orbital Hamiltonian. We demonstrate that as the length of the structure increases the system undergoes a transition from the ballistic to the diffusive regime. This is reflected in the calculated electron density dependencies of the conductivity and the mobility. In particular, we show that the mobility of graphene ribbons varies as mu(n) n^(-lambda), with 0<lambda<0.5. The exponent lambda depends on the length of the system with lambda=0.5 corresponding to short structures in the ballistic regime, whereas the diffusive regime lambda=0 (when the mobility is independent on the electron density) is reached for sufficiently long structures. Our results can be used for the interpretation of experimental data when the value of lambda can be used to distinguish the transport regime of the system (i.e. ballistic, quasi-ballistic or diffusive). Based on our findings we discuss available experimental results

Embedded hardware for closing the gap between research and industry in the assistive powered wheelchair market

Literature is abound with smart wheelchair platforms of various developments, yet to date there has been little technology find its way to the market place. Many trials and much research has taken place over the last few decades however the end user has benefited precious little. There exists two fundamental difficulties when developing a smart powered wheelchair assistive system, the first is need for the system to be fully compatible with all of the manufacturers, and the second is to produce a technology and business model which is marketable and therefore desirable to the manufacturers. However this requires the researchers to have access to hardware which can be used to develop practical systems which integrate and communicate seamlessly with current manufacturer’s wheelchair systems. We present our powered wheelchair system which integrates with 95% of the powered wheelchair controller market; our system allows researchers to access the low level embedded system with more powerful computational devices running sophisticated software enabling rapid development of algorithms and techniques. When they have been evaluated they can be easily ported to the embedded processor for real-time evaluation and clinical trial