False acute abdomen with medical-legal implications

Spit. CF 2, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Bolnvul A.M. de 26 de ani se internează în garda pentru dureri abdominale, grețuri urmate de văsături, stare subfebrilă. Analizele de urgență consemnează doar o leucocitoza de 8000. Se pune diagnosticul de apendicită acută și se practică în urgență apendicectomie. Intraoperator, aspectul morfopatologic al apendicelui nu justifica simptomatologia bolnavului (fig. 1). Postoperator, starea generală se agraveaza brutal, instalandu-se un sindrom de ocluzie intestinală. Considerandu-se o complcație postoperatorie, se reintervine în a 4-a zi de evoluție nefavorabilă. Intraoperator nu se constată decât tumora voluminoasă non-epitelială D III - dificultăți de diagnostic și tratament un ileus dinamic și îngroșarea apreciabilă a mezenterului. S-a practicat ileostomie de degajare (fig. 2). Evoluție postoperatorie nefavorabilă. Se instalează același sindrom de ocluzie intestinală. Starea bolnavului devine critică. Transfer la Cinica de chirurgie Spitalul Floreasca.După o reevaluare cliniăa si paraclinică se practică o nouă reintervenție chirurgicală pentru același sindrom de ocluzie intestinală, când se constată un mezenter mult îngroșat, de 8-10 cm, și staza în circulația portală (fig. 3). Evoluția postoperatorie este gravă cu deces în a 5-a zi prin stop cardio-respirator. Cazul este trimis direct la Institutul de Medicină Legală pentru malpraxis într-o operație de apendicectomie. Dupa 60 de zile, concluzia IML: Sindrom BuddChiari prin ingestie de alcool metilic, producând o endoflebită ocluzivă pe venele suprahepatice cu bloc posthepatic ce a dezvoltat o formă malignă de hipertensiune portală cu evoluție letală.The patient A.M., 26 years old, is urgently hospitalized for abdominal pains, nausea followed by eructation, subfebrile temperature. The emergency analyses show only a leukocytosis of 8000. It is diagnosed as acute appendices and it is practiced an appendicectomy. During surgery, the morpho-pathological aspect of the appendix does not justify the symptomatology of the patient. (Figure 1). After surgery, the general state was brutally exasperated, with the syndrome of intestinal occlusion. Being considered a post-surgery complication, it shall be intervened in the forth day of unfavorable evolution. During surgery, it is not observed nothing but a dynamic ileus and the severe swelling of mesentery. It was practiced ileostomy of release. (Figure 2). Unfavorable post-surgery evolution. It is observed the same syndrome of intestinal occlusion. The physical state became critical. Transfer to the Surgery Clinic, Floreasca Hospital. After a clinical and paraclinical reevaluation it is practiced a new surgical intervention for the same syndrome of intestinal occlusion and it is observed a thicker mesentery, of 8-10 cm, and stasis in portal circulation (Figure 3). Post – surgery evolution is critical with death in the fifth day, by cardiopulmonary arrest. The case is sent directly to the Institute of Forensic medicine for malpractice in appendicectomy surgery. After 60 days, the IML conclusion: syndrome Budd-Chiari by ingestion of methyl alcohol, producing an occlusive endophlebitis on the suprahepatic veins with post-hepatic blocks which developed a malign form of portal hypertension with lethal evolution

Honey health benefits and uses in medicine

The generation of reactive oxygen species (ROS) and other free radicals during metabolism is an essential and normal process that ideally is compensated through the antioxidant system. However, due to many environmental, lifestyle, and pathological situations, free radicals and oxidants can be produced in excess, resulting in oxidative damage of biomolecules (e.g., lipids, proteins, and DNA). This plays a major role in the development of chronic and degenerative illness such as cancer, autoimmune disorders, aging, cataract, rheumatoid arthritis, cardiovascular, and neurodegenerative diseases (Pham-Huy et al. 2008; Willcox et al. 2004). The human body has several mechanisms to counteract oxidative stress by producing antioxidants, which are either naturally synthetized in situ, or externally supplied through foods, and/or supplements (Pham-Huy et al. 2008).info:eu-repo/semantics/publishedVersio

Through the Public’s Lens: Are Museums Active Members of Society? An Investigation During the COVID-19 Pandemic

Traditionally, museums have cultural and educational roles. Increasingly, however, museums are also assuming a social role in engaging with visitors and communities and strengthening social involvement coherently given the changing expectations of the public. Museums have become participatory organisations that contribute to the well-being of society. Considering the global health challenge of the COVID-19 pandemic, this chapter investigates the way museums have responded to support their communities, as well as the public’s perception of museums’ civic profile. An online survey was applied in Italy, Romania, and the Republic of Moldova to identify the dimensions of the activity of museums regarding how the support offered by museums is visible and appreciated. The study shows that museums reacted to the COVID-19 pandemic crisis, developing online and digital sources to adapt and deliver their offers, to have a voice within society. Generally speaking, it seems that the public does not pay much attention to museums concerned in contemporary societal debates. Understanding the public image of museums helps museums redesign their organisation and activities to meet the expectations of contemporary audiences coherently, given the recent societal developments. This investigation is among the first to highlight the way museums have assumed an activist role, providing support to the wider public, by reacting to the COVID-19 pandemi

Modeling socially responsible consumption and the need for uniqueness: a PLS-SEM approach

Purpose: The purpose of the present study is intended to fill a research gap, by advancing a conceptual model which brings novel insights on the relationships between socially responsible consumption and consumer\u2019s need for uniqueness. Design/methodology/approach: Relying on a questionnaire-based survey for data collection, the proposed model was tested using the partial least squares (PLS) algorithm for structural equation modeling (SEM), which allows the assessment of the models containing both formative and reflective constructs. Findings: The research found that 73.7 per cent of the variance in the consumer\u2019s belief in the importance of personal power to make a difference through socially responsible choices is explained by the proposed model. Moreover, four of the five factors of socially responsible consumption fully mediate the positive effect of the consumer\u2019s need for uniqueness on the importance attached to personal socially responsible choices in driving positive change. Research limitations/implications: The study avails a phenomenological perspective by offering novel insights from a Romanian sample. The limitation associated with a country-centric vision is compensated through the contextual analysis and integration of a new point of reference in the overall framework of socially responsible consumption. Practical implications: The evidence is indicative of new consumption insights and should be closely considered by companies. Originality/value: The study draws upon a conceptual model integrating the relationships between socially responsible consumption and a psychological characteristic \u2013 the consumer\u2019s need for uniqueness \u2013 which has been never tested as such before

Strategica

In all industrialized countries, the automotive sector is regarded as the locomotive of economy in terms of its contribution to economy and pioneering of the other sectors today and it is of great economic importance thanks to the value added it creates, its contribution to employment, its tax revenues, and its demand creating state in many sectors. In this sector, competition among firms is increasing rapidly and such elements as an increase in productivity, the efficient use of resources and administrative and technical organization gain great importance accordingly. To obtain a competitive advantage, it is necessary to keep up with the dynamic structure of the age and be open to change and innovations. That's why enterprises must adapt the new systems, techniques, and technologies to themselves. Based on continuous improvement and aiming at continuous development and elimination of waste, lean production is a production system which contains no unnecessary element in its structure and in which such elements as error, cost, inventory, workmanship, the development process, production area, wastage, and customer dissatisfaction are minimized. This study describes the improvement activities in the conveyor line at Toyota Motor Manufacturing Turkey where the outer body parts of vehicles are assembled in line with the understanding of lean production. Within this scope, it is aimed to determine the standards of the conveyor line specified by the automotive factory and ensure that the operators work in conformity with these standards; to increase the network rates in processes and process productivity by making detailed work analyses of the processes in the line; and to create the flexible workforce line characteristics which will enable the processes to work with complete productivity