Surgical treatment of blefarochalasis

Catedra de chirurgie generală semiologie nr. 3, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Blefarochalazisul reprezintă atrofia pielii pleoapelor superioare, provocând atât dereglări funcționale cât și cosmetice. Blefaroplastia reprezintă una din cele mai eficiente și durabile metode de tratament. Aceasta constă în excizia pielii excesive a pleoapelor, cu sau fără grăsimea periorbitală. Material și metode: Pe parcursul anilor 2014 – 2018 au fost efectuate 47 de blefaroplastii, dintre care 30 au fost pentru pleoapele superioare și 17 pentru ambele pleoape superioare și inferioare. Lotul studiat a fost reprezentat de 42 femei și 5 bărbați (raport 8:1). Vârsta bolnavilor a variat de la 21 la 69 ani. Blefaroplastia tradițională s-a efectuat cu o incizie externă în șanțul superior al pleoapelor. Preoperator, am marcat reperele chirurgicale și exciziile de piele planificate pe pacient. Pentru închiderea plăgii postoperatorii, am utilizat: sutură prin puncte separate și sutură de tip surjet intradermal. Ca materialul de sutură am utilizat Nylon neresorbabil 6.0. Rezultate: Rezultatele au fost apreciate subiectiv de către pacienți ca bune în 43 cazuri, satisfăcătoare – în 12 și 2 pacienți au rămas nesatisfăcuți. Acești pacienți au avut indicații relative, doar cosmetice, ce și a impus o apreciere subiectivă a rezultatelor. Complicații pe lotul studiat nu s-au înregistrat. La distanță recidive nu am observat. Concluzii: Blefaroplastia reprezintă o metodă sigură și durabilă în tratamentul blefarochalazisului. Rezultate pozitive postoperatorii mai bune se obțin în cazul prezenței nu doar a defecitului cosmetic, dar și funcțional.Background: Blepharochalasis represents the atrophy of the skin of the upper eyelids, causing both functional and cosmetic disorders. Blepharoplasty is one of the most effective and sustainable methods of treatment and consists in excision of excessive eyelid skin, with or without periorbital fat. Methods and materials: During 2014-2018, 47 blepharoplasties were performed, 30 of which were for upper eyelids and 17 for both upper and lower eyelids. The study group was 42 women and 5 men (ratio 8:1). The age of the patients varies from 21 to 69 years. Traditional blepharoplasty was performed with an external incision in the top of the eyelid. Preoperatively, we marked surgical signs and skin excisions planned on the patient. For postoperative wound closure, we used: separate sutures and intradermal continous sutures. As the suture material we used 6.0 unsorted Nylon. Results: The results were subjectively assessed by patients as good in 43 cases, satisfactory - in 12 and 2 patients remained unsatisfied. These patients had only relative, cosmetic indications, and imposed a subjective assessment of the results. Complications on the studied lot were not recorded. The long-term recidives were not noticed. Conclusion: Blepharoplasty is a safe and durable method for the treatment of blepharochalasis. Positive postoperative results are obtained in the presence of not only cosmetic defect but also functional

Auto-dermoplasty in the treatment of trophic ulcers of lower extremities

Catedra de chirurgie generală semiologie nr. 3, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Spitalul Clinic Municipal nr.1, Chişinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Ulcer trofic – este defectul pielii sau mucoasei, caracterizat de evoluţia îndelungată, fără tendinţă spre vindecare spontană sau recidive periodice. Datele statistice arată, că în secţiile specializate ulcerul de gambă ocupă peste 20% din paturi şi consumă peste 30% din zilele de spitalizare. Pentru lichidarea ulcerului trofic se recomandă aplicarea Shave-therapy cu autodermoplasie (ADP) ulterioară cu lambou cutanat despicat. Material şi metode: Au fost examinate rezultatele tratamentului ale 163 pacienţi cu ulcere trofice, inclusiv de origine venoasă în stadiul clinic C6 CEAP. Pacienţi a fost internaţi în Clinica chirurgie în perioada Ianuarie 2009 – Iulie 2015. Vârsta pacienților a variat de la 30 până la 85 ani. Durata existenței ulceraţiilor trofice era un an şi mai mult la 94% de bolnavi, și până la un an – la 6%. Rezultate: Din 163 pacienți cu ulcere trofice, ADP a fost efectuată la 90 (55,21%). Debridare chirurgicală și aplicarea peliculei de colagen cu ADP ulterioară – în 44,79% cazuri. Rezultat pozitiv, cu închiderea totală a ulcerului, s-a obținut în 91,20% cazuri. Rejetul transplantului cutanat, închidere parțială a ulcerului au fost înregistrate la 8,80% din pacienți. Concluzii: ADP cu lambou cutanat despicat reprezintă metoda de elecție în tratamentul ulcerului trofic, fiind asociată cu rezultate pozitive în 91,20% de cazuri, iar nereușita în doar 8,80%. Epitelizarea definitivă a ulcerului s-a obținut în prima lună după intervenția chirurgicală.Background: Trophic ulcer represents a defect of skin or mucosa, characterized by a long evolution without a tendency to spontaneous healing or periodic relapses. Statistical data shows that in the specialized sections, the ulcer of lower limbs occupies over 20% of the beds and consumes over 30% of the hospitalization days. The Shave-therapy method with subsequent auto-dermoplasty (ADP) with split skin flap is recommended for the treatment of trophic ulcers. Methods and materials: The treatment results of 163 patients with trophic ulcers, including those caused by venous insufficiency at the C6 CEAP clinical stage were assessed. Patients were admitted in the Department of Surgery between January 2009 and July 2015. The age of patients ranged from 30 to 85 years. Duration of trophic ulcer was one year and more in 94% of the patients, and up to one year – in 6%. Results: The ADP was performed in 90 (55.21%) of the 163 patients with trophic ulcers. Surgical debridement and collagen membrane application with subsequent ADP – in 44.79% cases. In 91.20% cases was obtained a positive result, with total ulcer closure. Dermal flap rejection with partial closure of the ulcer were noted in 8.80% of patients. Conclusion: Split skin flap ADP is the method of choice in the treatment of trophic ulcers, being associated with positive results in 91.20% of cases, and failure in 8.80%. Complete ulcer epithelization was observed in the first month following surgery

Смешанная тугоухость у детей с экссудативными отитами

Catedra Otorinolaringologie, USMF „Nicolae Testemiţanu”, Conferinţa naţională ştiinţifico-practică în domeniul otorinolaringologiei pediatrice, 30 octombrie 2009, Chişinău, Republica MoldovaMixed hearing loss developed in 5% of the cases in a study of 36 children who suffered from otitis media with effusion. The work up included detailed anamnesis, otoscopy, pneumatic otoscopy, otomicroscopy, tympanometry, registration of the acoustic reflex, conventional audiometry and surgical findings. The effectiveness of treatment depends on the duration of the disease and the patient’s medical and personal background.Представлены результаты обследования 36 детей с экссудативными отитами, у которых при аудиологическом обследовании была обнаружена смешанная форма тугоухости. Исследование включает детальный анамнез, отоскопию, пневмоотоскопию, тимпанометрию, определение акустического рефлекса, тональную и поведенческую аудиометрию, функциональные результаты в динамике. Смешанная форма тугоухости была обнаружена у 5% детей с экссудативными отитами, находящихся под наблюдением авторов. Результаты лечения зависят от длительности заболевания и наличия сопутствующей патологии у пациента

Management of hearing aid in children

Catedra de Otorinolaringologie USMF „Nicolae Testemiţanu” Centrul Republican de Audiologie, Protezare auditivă şi reabilitare medico-pegagogicăThe Republican Center of Audiology, Hearing Aid and Medical-Pedagogical Rehabilitation for children (Center), placed within the „Em.Cotaga” Republican Hospital for Children, has been created to improve the audiological assistance services in the Republic of Moldova. During the year 2012, 1460 children with neurosensorial hearing loss have been registered in the Center. From 2006 to 2011, 1400 children received hearing aid treatment. The success of fitting of hearing aid depends on the joint work of a large team of specialists, such as ENT-audiologist, audioprosthesis specialist, logopedist, psychologist and, of course, members of the child’s family. Pentru ameliorarea serviciului de audiologie din republică a fost constituit Centrul Republican de Audiologie, Protezare auditivă şi reabilitare medico-pegagogică care activează în baza IMSP SCRC “Em. Coţaga”. Conform Hotărîrii de Guvern Nr.804 din 10.07.2006 a început programul de asigurare gratuită cu aparate auditive a persoanelor cu deficienţe de auz. În Centru se află la evidenţă 1460 copii din republică, diagnosticaţi cu surditate sensoroneurală. În total pe parcursul anilor 2006-2011 au fost efectuate 1400 de protezări. Reuşita protezării auditive impune lucrul unei echipe de specialişti, cum ar fi medici ORL-audiologi, audioprotezist, logoped, psiholog şi familia copilului surd

The importance of local immunostimulation in complex treatment of chronic tonsillitis in children

Department of Otorhinolaryngology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Laboratory of Immunology and Allergology, Chiril Draganiuc Institute of Phtisiopulmonology, Laboratory of Tissue Engineering and Cells Cultures, Chisinau, the Republic of MoldovaBackground: Chronic respiratory infections affect the particularitation of general immune system, impaired local immunity and increased frequency of allergic diseases. The methods used in the treatment of chronic tonsillitis are not effective enough and now it is required developing new diagnostic criteria and reasonable tactics complex conservative therapy. Modern methods of treatment of chronic tonsillitis are oriented to normalization of general immune status of the body, restoring the function of drainage gaps tonsil, hypo-sensitization, and decreased symptoms of local inflammation. Material and methods: The children with compensated chronic tonsillitis were divided into two groups: 26 patients (1-st group) were subjected to therapeutic traditional treatment and immunomodulatory local treatment with application of activated mononuclear autocells and 26 patients (2-nd group), that have been treated by traditional therapeutic method. All patients were tested: the functional activity of neutrophils in nitro-blue tetrazolium test (NBT); the content of phagocytic neutrophils and their phagocytic activity; total hemolytic activity of the complement; normal antibody titer, lymphocyte subpopulations were determinated by immunofluorescence using monoclonal antibodies reaction; the level of immunoglobulins; the content of circulating immune complexes; ASL-O rheumatoid factor; reactive protein – C; blast transformation reaction of lymphocytes with phytohaemaglutinin. The smear was taken from the patients and the bacterial flora and its susceptibility to antibiotics before and after the conservative treatment was investigated. Results: After treatment, in 1-st group comparativly 2-nd group, was appreciated a more pronounced decrease in the levels of indexes CIC, IgE, CD-4/CD-8 antigens streptococcus sensitivity and a greater increase of phagocytic activity and the number of neutrophils, the functional activity of T-lymphocytes. Conclusions: Thanks to investigations of preimmune reactivity and immunological changes in the body in case of compensated chronic tonsillitis in children was appreciated the effectiveness of conservative treatment with topical application of complex activated mononuclear autolimfocite that has a positive effect with clinical and immunological high level

Этиопатогенетическое лечение хронического тонзиллита у детей

Catedra Otorinolaringologie, USMF „Nicolae Testemiţanu”, Spitalul Clinic Republican pentru Copii „Em. Coţaga”, Conferinţa naţională ştiinţifico-practică în domeniul otorinolaringologiei pediatrice, 30 octombrie 2009, Chişinău, Republica MoldovaThe palatine tonsils are situated at the entrance of the respiratory and alimentary tracts and represent the first site of contact with a variety of microorganism and other antigenic substances present in food and inhaled air. The purpose of this article is to present the immune physiology of the tonsils and their role as active immune organs of the entire upper aero digestive tract and the importance of conservative treatment of chronic tonsillitis. In the Pediatric Otorhinolaryngological Clinic we treated 280 children with chronic tonsillitis from 1995 to 2009. In 86% of the cases we obtained positive results after selection of methods of treatment.Согласно современным представлениям, небные миндалины относятся к периферическим органам иммунной системы и с первых дней жизни ребенка принимают активное участие в формировании реакций клеточного и гуморального иммунитета. Это обусловливает их функцию как органа, который первый в системе иммунитета подвергается непосредственному воздействию экзогенных факторов, определенным образом реагирует на них, подготавливая организм к наиболее оптимальным вариантам иммунного ответа. В оториноларингологическом отделении ДРКБ “ Ем. Коцага” в течение 1995 -2009 гг. было проведено комплексное лечение и взято под наблюдение 280 детей с хроническим компенсированным тонзиллитом. Положительные результаты были получены в 86% случаев, что позволило сохранить целостность лимфоидной ткани лимфоглоточного кольца

Histopathological picture before and after applying the local treatment in children with chronic hypertrophic rhinitis

Catedra de anatomie a omului, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu” Chișinău, Republica Moldova, Conferința Ştiinţifică Internaţională ”Probleme actuale ale morfologiei” dedicată celor 70 de ani de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chişinău, 15-16 octombrie 2015Abstract Background: Currently, chronic nasal obstruction due to chronic hypertrophic rhinitis is one of the most common problems encountered in rhinology. The aim of the study: to determine the morphological changes in the lower nasal concha hypertrophy caused by hypertrophic chronic rhinitis in children and the local influence of local medicines. Material and methods: To realize our aims were analized 100 patients with unilateral or bilateral to hypertrophic chronic rhinitis hospitalized in the pediatric department of Otorhinolaryngology from Emilian Cotaga Hospital, clinical base of State University of Medicine and Pharmacy „Nicolae Testemitanu”. The research has been focused on clinical observation of the patient surgery protocols, as well as fragments resulting from the resection of the inferior nasal concha. Results: Inferior nasal concha suffers substantial and irreversible chronic hypertrophic changes in all tissue layers. The research demonstrates the efficacy of local used drugs with vasoconstriction and antiinflamatory proprietes in the simptomatic treatment of the chronic hypertrophic rhinitis. Conclusions: Both medicines reduces local morphological changes by reducing the inflammatory process, the degree of vein congestion, the degree of hyperplasia of the glands, but their effect is relatively short and is associated with their permanent usage, which may later develop tolerance and increasing need for their use