Treatment of the posttraumatic damage of the pelvic limb in patients with diabetes

Catedra de ortopedie și traumatologie, USMF ”Nicolae Testemițanu”, Clinica de chirurgie plastică și microchirurgie reconstructivă a locomotorului, IMSP IMU, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Riscul de fractura a piciorului la persoanele cu diabet zaharat este legat de existenta neuropatiei diabetice periferice, ce reprezintă un factor important in dezvoltarea defectelor piciorului, infecțiilor si amputațiilor de membre inferioare Scop. Analiza defectelor posttraumatice in asociere cu polineuropatia diabetica a membrului pelvin si posibilități de acoperire a acestora. Material și metodă. Cei 15 pacienți au fost împărțiți in 4 categorii: lambouri de vecinătate, lambouri la distanta, plastie cu piele libera despicata, amputație. Parametrii urmăriți sunt: vârsta, sex, tipul diabetului zaharat, localizarea. Rezultate. 4 femei si 11 bărbați au fost repartizați in 4 categorii după tipul intervențiilor chirurgicale: plastii cu lambouri de vecinătate 4, lambouri la distanta 2, plastie cu piele libera despicata 7, amputație 2. Din lotul total de pacienți cu diabet zaharat tip II au fost 12 pacienți, iar 3 pacienți cu diabet zaharat insulin-dependent. Cei 15 pacienți, care au beneficiat de reconstrucții prin lambouri, au avut defecte la gamba distala si picior, iar pacienții care au suferit amputație per primam, au avut leziuni la nivelul gambei proximale, care au constat in necroze tegumentare si de părți moi, cu afectare osoasa si osteita, semn al gradului avansat al afectării vasculare. La pacienții care au beneficiat de plastie cu piele libera despicata, majoritatea defectelor au fost la nivelul gambei si erau prezente leziuni tegumentare. Concluzii. Defectele posttraumatice la pacienții cu polineuropatii diabetice a membrului pelvin pot fi rezolvate prin plastie cu piele libera despicata, reconstrucții prin lambouri, astfel rata amputațiilor scade.Introduction. Leg fracture risk at people with diabetes is related to the existence of diabetic peripheral neuropathy, which is an important factor in the development of foot defects, infections and amputations of lower limb. Purpose. Analysis of the posttraumatic damage coupled with diabetic polyneuropathy of the pelvic limb and possibilities of healing the defects. Material and methods. The 15 patients were divided in 4 subgroups according to the type of surgical procedure performed: split skin grafts, the neighboring flaps, distant flaps, amputation at different levels. The descriptive parameters included: age, gender, the presence of type I or type II diabetes, the location. Results. 15 patients included in this study, out of which 4 women and 11 men were divided into four subgroups based on type of performed surgeries: the neighboring flaps - 4, distant flaps - 2, split skin grafts - 7, amputation in 2 cases. 12 patients had diabetes of type II, and the remaining 3 patients were insulin dependent. The 6 patients who had reconstruction through flaps, had distal defects (foot or ankle), whereas the patients who suffered per primam amputation had lesions at the ankle which were skin and soft tissue necrosis, with bone disease and osteitis, with signs of severe vascular disease. The majority of patients who had benefited from split skin grafts, suffered from skin lesion at the ankle level. Conclusions. Posttraumatic defects in patients with diabetic polyneuropathy of the pelvic limb can be treated through flaps or split skin grafts, so the amputation rate decreases significantly

The first rays joint fractures and treatment modalities

Catedra de ortopedie și traumatologie, USMF „Nicolae Testemițanu”, Clinica de chirurgie plastică și microchirurgie reconstructivă a locomotorului, IMSP IMU, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Incidenţa crescută a traumatismelor mâinii ocupa primul loc in traumatismele corpului uman. Aceasta stimulează în permanenţă ingeniozitatea chirurgilor în a găsi noi metode reconstructive tot mai performante. Deși, ei se confruntă pe de o parte, cu anatomia complexă a mâinii, iar pe de altă parte cu obligativitatea de a păstra integritatea sistemului nervos, vascular şi tendinos totuși, este reala posibilitatea unei reconstrucţii complexe cu ţesuturi similare fără a crea defecte secundare importante.Scopul. Eșalonarea incidenței lezionale a policelui în complexul de traumatisme ale mâinii si separarea itimilor depistați în funcție de suprafață și pe nivele razei digitale. Material si metode. În lucrare am inclus un lot de 460 de pacienți pe perioada anului 2015. Limitele de vârsta au fost între 19-70 ani, divizați pe categorii a câte 10 ani. Repartizarea pe sexe dintre cei 79 de pacienți cu traumatisme a policelui a constituit: 69 (87.34%) bărbați si 10 (12.66%) femei. Frecvența traumatismelor înregistrate la membrul stâng 40 (50.34%) a fost mai mare decât la membrul drept 39 (49.67%). 79 (17.17%) pacienți din lotul total au suferit traumatisme ale policelui, dintre care: separat al policelui 46 (58.22%) și în complex cu alte degete 33 (41.78%). În traumatismele policelui pe segmente au fost incluși pacienții tratați in staționar. Falanga proximală s-a dovedit a fi cel mai des traumată 39 (49.36%) de cazuri, apoi urmează falanga distală 37 (46.83%) de cazuri și doar în 3 (3.79%) cazuri au avut de suferit ambele falange. Rezultate. Incidența traumatismului policelui separat se întâlnesc la 46(58.22%) de pacienți și in complex cu alte degete la 33 (41.78%) de pacienți. Ceia ce constituie din ansamblu de traumatisme ale mâinii 17.17%. Prelucrarea materialului obținut denota prevalenta incidentei pentru falanga distală a policelui dar nu si ca gravitate care se manifesta mai accentuat pe măsura avansării spre baza lui. Aceasta a dictat managementul tratamentului si complexitatea intervențiilor chirurgicale efectuate. Concluzie. Leziunile policelui in complexul traumatismelor mâinii se întâlnesc mai des ca fiind un traumatism separat decât in asociere cu celelalte degete ale mâinii, prevalând la bărbați, iar membrul superior stâng fiind afectat intr-o incidenta ușor mai sporită.Introduction. The increased incidence of hand trauma injuries ranks first in the human body. This continually stimulates surgeons ingenuity to find new performant ways in reconstructive methods. Although, they are facing, on the one hand, with complex hand’s anatomy complex and, on the other hand, with the obligation to preserve the integrity of the nervous, vascular and tendon system, however, it is real the possibility of a complex reconstruction with similar tissues without creating significant defects. Purpose. Distribution of thumb’s lesional incidence in hand’s trauma complex and items separation detected depending on the surface and levels of digital beam. Material and methods. In this paper we included a group of 460 patients treated during the 2015 year. The age limits were between 19-70 years, divided into categories of 10 years. The sex ratio of the 79 patients with thumb injury was: 69 (87.34%) men and 10 (12.66%) women. Frequency of trauma registered in left member - 40 (50.34%), was higher than in the right one - 39 (49.67%). 79 (17.17%) patients from total group have suffered thumb’s trauma, including: separate thumb - 46 (58.22%) and in complex with other fingers - 33 (41.78%). In thumb’s trauma, according to segments, were included patients treated in hospital. Proximal phalanx was found to be most traumatized - 39 (49.36%) cases, followed by the distal phalanx - 37 (46.83%) cases and only in 3 (3.79%) cases have suffered both phalanges. Results. Incidents of separate thumb’s trauma are met at 46 (58.22%) patients and in complex with other fingers in 33 (41.78%) patients, which constitutes in the ensemble of hand’s trauma 17.17%. Processing of obtained material denotes prevalence of incidence of thumb’s distal phalanx, but not the severity that manifests more pronounced as it progresses toward its base. This dictated the treatment’s management and complexity of performed surgery. Conclusion. Thumb’s injuries in complex of hand’s trauma are more often met as a separate trauma than in association with other fingers of the hand, with prevalence in men, and left upper limb is affected with a slightly increased incidence

Iatrogenic and post traumatic injuries of sciatic nerve

Catedra de ortopedie și traumatologie, USMF „Nicolae Testemițanu”, Clinica de chirurgie plastică și microchirurgie reconstructivă a locomotorului, IMSP IMU, Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Neuropatia nervului sciatic legata de intervențiile chirurgicale constituie un eveniment cu repercusiuni neplăcute asupra pacientului si a echipei. Localizarea precisa a extinderii leziunii nervului, determinarea continuității, severitatea leziunii si distribuția leziunilor fasciculare sunt esențiale pentru evaluarea potențialului de recuperare spontana si de a evita terapia intirziata sau nepotrivita. Scop. Identifica si a detaliza neuropatiile posttraumatice cât și cele postoperatorii. Material si metode. Am identificat 11 pacienți diagnosticați cu neuropatia nervului sciatic posttraumatica inclusiv si postoperatorie. Am examinat datele clinice, informații cu privire la traumatism, intervenții chirurgicale, simptome precum si fisele medicale. Rezultate si discuții. Din lotul de pacienți implicați in studiu,9 pacienți au fost bărbați. Vârsta pacienților a variat de la 21 de ani până la 63 ani. Am constatat ca 5 cazuri au apărut in imediata apropiere traumatismului sau intervenției chirurgicale, iar 6 cazuri la distanță. Datele noastre își găsesc confirmarea in lucrarea autorilor: Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Concluzie. Cunoașterea complicațiilor ne permite descoperirea masurilor preventive care sunt direcționate spre monitorizarea complexului neurofiziologic intra operator in funcție de procedura efectuata.Introduction. Sciatic nerve neuropathy surgical related is an unpleasant event with repercussions on the patient and the surgical team. The precise localization and extension of the nerve lesion, the determination of nerve continuity, lesion severity, and fascicular lesion distribution are essential for assessing the potential of spontaneous recovery and thereby avoiding delayed or inappropriate therapy. Purpose. Identify and detail posttraumatic and postoperative neuropathies. Material and methods. We identified 11 patients diagnosed with the posttraumatic sciatic nerve palsy, including postoperative one. We examined clinical data, trauma’s information, surgery, symptoms and medical records. Results and discussions. From the group of patients involved in the study 9 patients were men. Patients age ranged from 21 to 63 years old. We determined that 5 cases were during trauma or after surgery, and in 6 cases – at distance. Our data find their confirmation in literature data published by the authors: Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Conclusion. Knowing the complications allows finding the preventive measures that are targeted towards monitoring the intraoperative neurophysiological complex depending on performed procedure

A new approach to radon temporal correction factor based on active environmental monitoring devices

The present study aims to identify novel means of increasing the accuracy of the estimated annual indoor radon concentration based on the application of temporal correction factors to short-term radon measurements. The necessity of accurate and more reliable temporal correction factors is in high demand, in the present age of speed. In this sense, radon measurements were continuously carried out, using a newly developed smart device accompanied by CR-39 detectors, for one full year, in 71 residential buildings located in 5 Romanian cities. The coefficient of variation for the temporal correction factors calculated for combinations between the start month and the duration of the measurement presented a low value (less than 10%) for measurements longer than 7 months, while a variability close to 20% can be reached by measurements of up to 4 months. Results obtained by generalized estimating equations indicate that average temporal correction factors are positively associated with CO2 ratio, as well as the interaction between this parameter and the month in which the measurement took place. The impact of the indoor-outdoor temperature differences was statistically insignificant. The obtained results could represent a reference point in the elaboration of new strategies for calculating the temporal correction factors and, consequently, the reduction of the uncertainties related to the estimation of the annual indoor radon concentration.Acknowledgements: The research is supported by the project ID P_37_229, Contract No. 22/01.09.2016, with the title, Smart Systems for Public Safety through Control and Mitigation of Residential Radon linked with Energy Efficiency Optimization of Buildings in Romanian Major Urban Agglomerations SMART-RAD-EN” of the POC Programme

The Ukrainian war and the pandemic: the impact on public health and the need for new health digital tools and the next level of intelligence.

Against the background of the war in Ukraine, the COVID-19 pandemic has waned from public consciousness as the threat of the virus to health is outweighed by safety concerns during the war. Pandemic restrictions in the European region are being lifted despite low vaccination rates in Central and Eastern European countries and a lack of effective containment strategies. However, Central and Eastern European countries are influenced most by the flow of refugees from neighboring Ukraine where a triple health crisis occurs: an overloaded health system, an ongoing COVID-19 pandemic, and the war. The aim: to review the progress regarding viral surveillance technologies that use genomics, digital, and informational tools, to find the gap in the literature and formulate policy recommendations for continuing surveillance in the context of permacrisis. Unstructured search was conducted through scientific (PubMed and Google Scholar databases) and grey literature using the keywords. The paper highlights aspects of war-related problems of infectious diseases control in Europe, new challenges in healthcare connected with COVID-19 pandemic and war in Ukraine and provides discussion on the role of innovative surveillance systems in tackling infection outbreaks (with COVID-19 pandemic as an example). The paper overviews perspectives of the implementation of the discussed measures. Future COVID-19 outbreaks and new variants are possible. Complex adaptive system models, new tools, and the next level of health and digital intelligence are needed to provide timely and valuable insights. Combining lessons learned from the COVID-19 pandemic, the threat of war, and the need for continuous outbreaks surveillance, new public health and digital intelligence tools must be designed and implemented at regional, European, and global levels

The FIRST large-scale mapping of radon concentration in soil gas and water in Romania

In the framework of the last Council Directive 2013/59 (Euratom, 2014) laying down basic safety standards for protection against the dangers arising from exposure to ionizing radiation, the problem of radon was assumed in Romania at national level by responsible authorities through the design and development of a National Radon Action Plan and an adequate legislation (HG nr. 526/2018). In order to identify radon risk areas, however, it is necessary to perform systematic radon measurements in different environmental media (soil gas, water, indoor air) and to map the results. This paper presents an atlas of up-to-date radon in soil and water levels for central and western part of Romania. The radon in soil map includes data from 2564 measurements carried out on-site, using Luk3C radon detector. The Luk-VR system was used to measure radon activity concentration from 2452 samples of drinking water. The average radon activity concentration was 29.3?kBq?m-3 for soil gas, respectively 9.8?Bq?l-1 for water dissolved air. Mapping of radon can be a useful tool to implement radon policies at both the national and local levels, defining priority areas for further study when land-use decisions must be made.This work was supported by the Romanian National Authority for Scientific Research and Innovation, CNCS-UEFISCDI, by the project ”Radon map (residential, geogenic, water) for center, west and north-west regions from Romania (RAMARO), PN-II-PCCA-PT-73/2012 and by the project ID P_37_229, Contract No. 22/01.09.2016, with the title „Smart Systems for Public Safety through Control and Mitigation of Residential Radon linked with Energy Efficiency Optimization of Buildings in Romanian Major Urban Agglomerations SMARTRAD-EN” of the POC Programme

Methodological Approaches to Radon in Water Measurements: Comparative Experiences between Romania and Spain

The EC Directive 2013/51/EURATOM of 22 October 2013 represents the first time that a radon limit for drinking water has been proposed. Transposition of this Directive into Spanish legislation was by means of the recent RD 314/2016 which sets a limit value of 500 Bq l?1 for radon (222Rn) in water for human consumption while that in Romanian legislation the Law 301/2015 provides a limit value of 100 Bq l-1 for 222Rn concentration in water for human consumption as well as a total effective dose of 0.1 mSv y-1 from all radionuclides present in water (same dose value established by Spanish law). For several years, both in Romania and in Spain, there have been campaigns to measure the concentration of 222Rn in waters of different origins in order to determine the possible exposure of the population through this irradiation path, and also to use the presence of radon dissolved in water as a source of indoor radon in thermal spa facilities, and also as a tracer of dynamic processes (C. Sainy et al., Sci. Tot. Envir. 543, 460 (2016); 1). In this article, an assessment of the results from measurement campaigns in both countries will be presented and compared. In addition, the different measurement techniques used will be described, and the description of an intercomparison exercise on radon measurement in water organized by the Environmental Radioactivity Laboratory of the University of Cantabria (LaRUC) will be presented, in order to evaluate the quality of the performance of the techniques used.This work was partially supported by the project ID P_37_229, Contract No. 22/01.09.2016, with the title Smart Systems for Public Safety through Control and Mitigation of Residential Radon linked with Energy Efficiency Optimization of Buildings in Romanian Major Urban Agglomerations SMART-RAD-EN of the POC Programme

Diaqua­bis­(propane-1,3-diamine)­copper(II) bis­[diamminetetra­kis­(thio­cyanato-κN)chromate(III)] dimethyl sulfoxide octa­solvate

The ionic title complex, [Cu(C3H10N2)2(H2O)2][Cr(NCS)4(NH3)2]·8C2H6OS, consists of complex [Cu(dipr)2(H2O)2]2+ copper cations (dipr is propane-1,3-diamine), complex [Cr(NCS)4(NH3)2]− anions and uncoord­inated solvent dimethyl sulfoxide (DMSO) mol­ecules. All the metal atoms lie on crystallographic centers of symmetry. The cations are connected to the anions through N—H⋯O hydrogen bonds between the NH3 mol­ecules of the anion and the water mol­ecules of the cation. The DMSO mol­ecules are involved in hydrogen-bonded linkage of the [Cr(NCS)4(NH3)2]− anions into supra­molecular chains through bridging O atoms. A network of hydrogen bonds as well as short S⋯S contacts [3.5159 (12) and 3.4880 (12) Å] between the NCS groups of the complex anions link the mol­ecules into a three-dimensional supra­molecular network

An Innovative System for Monitoring Radon and Indoor Air Quality

Nowadays, a global trend towards increasing the performance of a building is the reduction in energy consumption. In this respect, for existing residential buildings the most common techniques are the application of a thermal insulation layer to the exterior wall of the building and / or window replacements. Unfortunately, their application without proper education of those involved may have a negative effect on the indoor air quality. The use of a continuous monitoring device can give the owner the ability to understand the impact of his behaviour on indoor air quality and, as such, to adjust his routine in order to maintain the indoor air quality at the desired level. This paper introduces a prototype, called ICA system, for continuous, real-time indoor air quality monitoring. The ICA system presents sensors for monitoring the concentration of radon, CO2, CO, VOCs, as well as meteorological parameters, such as temperature, pressure, and relative humidity. Experiments were performed both in laboratory and in situ conditions for testing and validating the proposed system.This work was supported by the project ID P_37_229, Contract No. 22/01.09.2016, with the title “Smart Systems for Public Safety through Control and Mitigation of Residential Radon linked with Energy Efficiency Optimization of Buildings in Romanian Major Urban Agglomerations SMART-RAD-EN” of the POC Programme