Analysis of piezomotor driver for laser beam deflection

A mechanical laser beam deflection using piezoactuator is analyzed in the paper. Wide angular range was required therefore mechanical mirror positioning using a multilayer piezoceramics friction drive configuration was chosen. The paper reports on research results of the deflection system parameters. Dynamic and static motion parameters such as angular speed, breaking displacement, positioning repeatability and angular resolution have been analyzed. For this purpose the measurement equipment have been designed and manufactured. Analysis of breaking characteristics has revealed that breaking angular displacement is dependant on driving voltage. Conducted positioning repeatability experiments indicate that the relative error between steps was about 1 %. Analysis of the complex electrical impedance of the piezoactuator over frequency range under varying load conditions was conducted. The equipment for measurement of electrical parameters has been described. Experimental research results of the actuator complex impedance are presente

Spontaneous bacterial peritoniti: current opportunities of diagnosis and treatment

Departamentul Medicină internă, Catedra Chirurgie 2, USMF „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Actualmente, managementul terapeutic optim al peritonitei bacteriene secundare (PBS) nu reprezintă încă un consens şi continuă să ridice discuţii în ceea ce priveşte tactica terapeutică şi chirurgicală. Material şi metode: Au fost evaluaţi 27 de pacienţi cu PBS dezvoltată pe fondalul cirozei hepatice, care s-au aflat la tratament în perioada 2008-2015, cu vârsta cuprinsă între 25 şi 64 ani. Toţi pacienţii au avut o durată a bolii hepatice cronice peste 5 ani. Regula terapeutică adresată PBS a inclus diagnostic precoce, tratament cu cefalosporine de generaţia a III-a cu toxicitate redusă, tactica expectativă chirurgicală la pacienţii cu evoluţie extrem de gravă şi operaţii minim-invazive ghidate după principiul „primum non nocere”, adresate pacienţilor cu PBS. Rezultate: Paleta de manifestări a fost de la bacterascită asimptomatică până la un sepsis cu o progresie rapidă spre exitus. Cele mai frecvente semne: febra, encefalopatia, durerea abdominală, diareea, ileusul. Douăzeci de pacienţi au fost trataţi medicamentos, în 7 cazuri s-a intervenit chirurgical, în 3 dintre acestea – pe cale minim-invazivă laparoscopică. Evoluţia PBS s-a complicat: cu hemoragie digestivă superioară (3 cazuri), EP (8 cazuri), sindrom hepato-renal (7 cazuri). Letalitatea generală – 9 cazuri (33%), recidiva de PBS – 2 cazuri. Concluzii: Experienţa acumulată ne permite să constatăm că atitudinea interdisciplinară față de PBS este justificată şi absolut necesară: echipa instruită compusă din hepatolog/gastroenterolog, reanimatolog, endoscopist şi chirurg este indispensabilă.Introduction: At present, the optimal therapeutic management of secondary bacterial peritonitis (SBP) does not reach yet a consensus and continue to rise the discussion regarding the therapy and surgery. Material and methods: Twenty seven patients (aged between 25 and 64 years) with SBP developed on the basis of liver cirrhosis, treated during 2008-2015 were evaluated. All patients had chronic liver disease lasting more than 5 years. Therapeutic approach addressed SBP included: early diagnosis, treatment with third generation of cephalosporins with low toxicity, using of expecting surgical tactics in patients with extremely severe condition and minimally invasive operations guided by the principle of „primum non nocere” to patients with SBP. Results: The manifestations varied from asymptomatic bacterial ascytis up to a sepsis with rapid progression to death. The most common signs were: fever, encephalopathy, abdominal pain, diarrhea, and ileus. Twenty patients were treated medically, surgery was performed in 7 cases, 3 of them – minimally invasive laparoscopic. SBP evolution was complicated with upper digestive bleeding (3 cases), EP (8 cases), hepato-renal syndrome – (7 cases). General mortality was – 9 cases (33%), recurrent SBP – 2 cases. Conclusions: The experience allows us to conclude that SBP obligatory requires the interdisciplinary approach as well as trained team composed from hepatologist / gastroenterologist, reanimatologist, endoscopist and the surgeon

Assessment of portal hemodinamics in patients with liver cirrhosis, treated surgically

Catedra radiologie şi imagistică medicală, Departamentul medicină internă, Catedra 2 Chirurgie, USMF „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Dezvoltarea tehnicilor imagistice a adus o contribuţie importantă în cunoaşterea complexităţii tulburărilor hemodinamicii portale (HDP) generate de afectarea hepatică cronică. Scopul lucrării este evaluarea imagistică eco-Doppler şi analiza comparativă a parametrilor HDP la pacienţii cu ciroză hepatică trataţi chirurgical. Material şi metode: Într-un lot de 111 pacienţi cirotici trataţi chirurgical cu vărsta între 19 şi 47 ani, s-a evaluat gradul de severitate a modificărilor HDP studiat prin ecografie Doppler duplex color cu aprecierea parametrilor cantitativi atât pe versantul arterial, cât şi pe cel venos. Evaluarea severităţii cirozei hepatice a fost apreciată conform clasificării de prognostic Child-Pugh. Rezultate: Preoperator a fost stabilită o corelare importantă a hipersplenismului cu majorarea rezistenţei vasculare la nivelul arterei lienale (r=0,454, Se 79%, Sp 69%, RP +2,5), iar indicele splenoportal a crescut evident paralel cu avansarea sindromului de hipersplenism (r=0,516). Scorul Child corelează puternic cu gradele de severitate a dereglărilor HDP evaluate imagistic. După tratamentul chirurgical se atestă o micşorare a diametrului venei porte şi a fluxului portal, iar fluxul la nivelul arterei hepatice denotă o creştere în paralel cu diminuarea rezistenţei vasculare la acest nivel (p<0,001). Concluzii: Rezultatele obținute prin evaluarea imagistică a HDP trebuie interpretate în context clinic, biologic şi morfologic. Utilizarea unui algoritm care ar asocia parametrii enunţaţi poate reprezenta metoda optimă de stadializare şi monitorizare a tulburărilor HDP.Introduction: The development of imaging techniques has made an important contribution to knowledge of the complexity of portal haemodynamic (PH) disorders caused by chronic liver disease. The purpose of study was the eco-Doppler imaging assessment and comparative analysis of PH parameters in patients with liver cirrhosis treated surgically. Material and methods: In a group of 111 cirrhotic patients treated surgically with age between 19 and 47 years, the severity of PH disturbances was evaluated by color Doppler duplex ultrasound with quantitative analysis of the characteristics of arterial and venous blood flow. Liver cirrhosis severity was assessed and graded according to Child-Pugh prognostic classification. Results: Preoperative was established significant hypersplenism with increasing of vascular resistance in splenic artery (r=0.454, Se 79%, Sp 69%, RP +2.5) and splenoportal index increase obvious parallel with advancing of hypersplenism syndrome (r=0.516). Child score strongly correlates with the degree of severity of PH disturbances rated by imaging. After surgery there was a reduction in the diameter of the portal vein and portal flow and hepatic artery flow shows an increase in parallel with the decrease of vascular resistance at this level (p<0.001). Conclusions: The results of the imaging assessment of PH must be interpreted in clinical, biological and morphological context. Utilization of an algorithm that can associate above mentioned parameters could optimize the staging and monitoring of PH disorders

PHOTOVOLTAIC PRODUCTION MANAGEMENT IN STOCHASTIC OPTIMIZED MICROGRIDS

The microgrids are composed of small scale fueled generation capacities, renewable energy sources, storage energy systems, controllable loads, and autonomously can connect or disconnect from the mains supply. The microgrids can operate connected to the upstream main grid, or in an islanded operation mode following a large perturbation in the upstream grid. The microgrid analyzed in this paper is composed of a photovoltaic system, a thermal engine, an electrochemical storage system, critical and interruptible loads. As backup generation is considered a classical generation engine and a small scale storage unit. The autonomous switching between grid-connected and islanding operation modes can occur, under an excess/deficit of generation and function of the electricity market price. The paper deals with an optimization model for minimizing the microgrid operation costs under intermittent generation and variable demand function of microgrid operation constrains. The optimization model is tested on a 24 hours horizon. The gridconnected optimized operation accounts also the exchanged power with the upstream grid function of the electricity price within the public network

Действиe имупурина при экспериментальных токсических и вирусных гепатитax

Catedra Farmacologie şi Farmacologie clinică, USMF „Nicolae Testemiţanu”The entomologic remedy has manifested the hepatoprotective properties in the pretreatment and treatment of the toxic and viral hepatic disorders. Experimentally, imupurin contributes to the diminishing of cytolytic syndrome (decreasing of AlAT and AsAT) and to the correction of metabolic disturbances. The usage of entomologic drug added to the complex treatment of hepatic diseases contributes to the diminishing of clinical symptoms and laboratory parameters (AsAT. AlAT, LDH, immunologic parameters etc.), decreasing of the hepatic and spleen diameters, more rapid than in the control group. Imupurin manifests immunotropic and hepatotropic properties because of its composition aminoacids (essential and non/ essential), polypeptides, lipoproteic complexes, and antioxidants, witch lead to immunomodulating and protective effects of hepatocytes. This study is dedicated to the investigation of the imupurin properties - an entomologic drug obtained from Lepidoptera pupa. При экспериментальном гепатите, вызванном парацетамолом, энтомологический препарат действует в качестве гепатопротектора, а также как средство профилактики и лечения данного заболевания. Результаты опытов показывают, что имупурин снижает показатели цитолитического синдрома (уровень AlAT и AsAT) и устраняет метаболические нарушения. Использование энтомологического препарата в комплексном лечении печеночных заболеваний приводит к снижению клинических симптомов и лабораторных показателей (AlAT, AsAT LDH, иммунологических показателей и т. д.) на более ранних стадиях в сравнении с контрольной группой. Для имупурина характерны имунотропное и гепатопротекторное действие благодаря своему составу: аминокислоты, полипептиды, липопротеиновые и антиоксидантные комплексы, которые имеют сложный механизм иммуномодуляции и гепатопротекции. Имупурин является веществом энтомологической природы, получаемым из кокон рода Lepidoptera

От чего зависит качество жизни пациентов с хроническими вирусными гепатитами?

Medical Clinic of Gastroenterology No 4, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaThe quality of life of chronic viral hepatitis (VH) patients is determined by the complexity of interactions between the pathological mechanisms of the disease and the psycho-emotional state of the patient. We have investigated 147 patients with chronic viral hepatitis (B, C, D). Special psychometric tests have been made: the Hamilton test for depression quantification and the SF-36 questionnaire to measure the quality of life. All clinical, laboratory and psychometric parameters were compared with those in the control group – 29 healthy people. We observed the high co-morbidity of depression in chronic VH (85%) and particularly the decrease of quality of life parameters (not depending of viral stage or transaminazes activity) in depressive patients with the lowest indexes in cases of severe and moderate depression.Сложность проблемы хронических вирусных гепатитов (ХВГ) выражается в наличии взаимосвязей между патофизиологическими механизмами и психоэмоциональным статусом больных, отражающихся на качестве жизни пациентов. Нами было обследовано 147 больных с хроническими гепатитами вирусной этиологии (B, C, D). Пациентам были проведены специфические психометрические исследования: определение уровня депрессии с помощью теста Гамильтона, а также определение качества жизни, используя опросник SF-36. Все клинические, лабораторные и психометрические данные были сопоставлены с таковыми в группе сравнения, состоявшей из 29 практически здоровых лиц. Показана высокая коморбидность ХВГ с депрессией (85%). Выявлено снижение показателей качества жизни при ХВГ (независимо от вирусной фазы и активности печеночного процесса) за счет депрессивных больных, самые низкие из показателей наблюдались среди пациентов с высокой степенью депрессии

Хронический вирусный гепатит В и поражения гастродуоденальной зоны, вызванные Helicobacter pylori

Catedra Medicină internă nr. 4, Laboratorul Gastroenterologie, USMF ”Nicolae Testemiţanu”The study involved 58 patients with Chronic Hepatitis B (CHB), which were dominated by males - 62.07% (36) and persons younger than 45 years, 65.52% (38). All patients underwent clinical, laboratory and instrumental examination of the functional state of the liver, FGDS, and determined the presence of HP in gastric mucosa. Histological and urease methods assessed the degree of colonization of HP in the gastric mucosa from minimum: (+) - gr. A, up to maximum: (+++++) - gr. B. In CHB severity of bacterial infection of the gastric mucosa caused by HP occurs more frequently in men and in patients younger than 45 years, with a maximum degree of activity of hepatic process. The degree of HP infection of the gastric mucosa influences clinical course of disease in CHB. The symptoms of heartburn, vomiting, epigastric pain observed in 100% of cases in a maximum degree of colonisation of HP (gr. B). At the same time the asthenic syndrome, 95.35% (41) and hepatomegaly, 90% (45), chronic gastritis -77.5%, chronic duodenitis-88, 8% were observed more often. The erosive forms of gastro-duodenal alterations predominated in the group with a significant degree of HP contamination in gastric mucosa. The CHB, gr. B patients, demonstrated significant increase in the activity of AST, increase of Ig A, CIC concentration, and total T-lymphocytes with reduction of B-lymphocytes. The above mentioned data indicate a relationship between the two infections: bacterial-HP and viral-VHB. Persistence of HP infection aggravates immune abnormalities in patients with CHB and promotes the progression of hepatic process. Обследовано 58 больных хроническим гепатитом В (ХГВ), среди которых преобладали мужчины – 62,07% (36) и лица моложе 45 лет – 65,52% (38). Всем больным проведено клинико-лабораторное и инструментальное обследование функционального состояния печени, ФГС и определено наличие Helicobacter Pylori (НР) в слизистой желудка. Гистологическим и уреазным методами оценена степень обсемененности НР слизистой желудка от минимальной (+) – гр. А до максимальной (+++++) – гр. Б. При ХГВ выраженность бактериальной инфекции НР слизистой желудка чаще наблюдается у мужчин и у лиц моложе 45 лет, при максимальной степени активности печеночного процесса. Степень инфицирования НР слизистой желудка оказывает воздействие на клиническое течение болезни при ХГВ. При выраженном обсеменении (гр. Б) симптомы изжоги, рвоты, боли в эпигастрии отмечены в 100% случаев. Чаще наблюдался астенический синдром - 95,35% (41) и гепатомегалия - в 90% (45) случаев, хронический гастрит - 77,5%, хронический дуоденит - 88,8%. Эрозивные формы превалировали в группе со значительной степенью обсемененности НР слизистой желудка. В обследованной группе Б больных ХГВ было отмечено достоверное повышение активности АСТ, увеличение концентрации Ig A, ЦИК, общие Т-лимфоциты и снижение В-лимфоцитов. Приведенные данные свидетельствуют о наличии взаимосвязи между двумя инфекциями: бактериальной-НР и вирусной-VHB. Персистенция НР усугубляет иммунные нарушения у больных ХГВ и способствует прогрессированию печеночного процесса

Энтомологические препараты в комплексном лечении хронического вирусного гепатита

Entomologic treatment complex preparation in patients with chronic viral hepatitis contributed to the more reduction of asteno-vegetativ, algyc and dispeptic syndromes and a semnificative decrease of transaminase, alkaline phosphatase, gamma-glutamyltranspeptidase activities and the total bilirubine level. The reduction of the intensity of lipid-peroxide processes increases synthetic hepatic function and the modulation of immune status.Применение энтомологических препаратов в комплексном лечении больных хроническим вирусным гепатитом способствовало более эффективному устранению астено-вегетативного, болевого и диспептического синдрома, значительному уменьшению активности трансаминаз, щелочной фосфатазы, гамма-глутамилтранспептидазы и уровня общего билирубина. Также отмечалось снижение интенсивности процессов перекисного окисления липидов, повышение синтетической функции печени и модуляция иммунного статуса