Клинические эволюционные особенности акушерских септических инфекций

USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaClinical and instrumental examination of the patient are important of getting informed about clinical status. Given that obstetric septic infections often occur with erased clinical picture , making it difficult to diagnostic, and getting late beginning treatment in each individual case it is necessary to solve issues of diagnosis. Irrational antibiotic (not adequate dose without systemic administration) does not allow establishing the optimal concentrations. Belated treatment, when it occurred anatomical and structural mutations both, the penetration of antibiotics in primary tumor tissue is difficult.Клинико-параклинические и инструментальные обследования больных имеют важное значение только в случае их информативности. Учитывая что акушерские септические инфекции чаще протекают со стертой клинической картиной, что затрудняет диагносцирование и отдаляет начало лечения, в каждом индивидуальном случае необходимо решать вопросы диагностики. Нерациональная антибиотикотерапия (неадекватные дозы, несистематическое введение) не позволяет достичь оптимальных концентраций в очаге. Запоздалая терапия, когда уже произошли анатомические и структурные изменения, затрудняет проникновение антибиотиков в ткани первичного очага

Оценка факторов риска в развитии ALI/ARDS

USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaThe risk of ALI / ARDS development in a patient with phlegmon of the right leg complicated with severe endotoxic intoxication, and profuse bleeding from the trunk of the vessel on a background of compromised somatic status is initially very high. The main role of the development of that syndrome is given of infection, profuse bleeding, metabolic disturbances, massive blood transfusion, and immunodeficiency. In most cases, distress respiratory syndrome (ARDS) is both the most severe form of respiratory failure and the determining factor in the development of patient’s general state.Риск развития АLI /ARDS у больного с флегмоной правого бедра, осложненной тяжелым ендотоксикозом и профузным кровотечением из магистрального сосуда, на фоне скомпромитированого соматического статуса (наркомания) изначально очень высок. Основная роль в развитие синдрома отводится инфекции, профузному кровотечению, метаболическим нарушениям, массивной гемотрансфузии, иммунодефициту. В большенстве случаев респираторный дисстрес синдром (ОРДС) является самой тяжелой формой дыхательной недостаточности, определяющей развитие общего состояния больного

Острый респираторный дистресс-синдром вызванный свищeм

IMSP Spitalul Clinic Republican, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“Rezumat ARDS (Acute Respiratory Distress Syndrome) reprezintă forma cea mai severă de insufi ciență respiratorie hipoxemică și una din marile provocări terapeutice pentru specialistul de anestezie-terapie intensivă, cu costuri fabuloase, eforturi enorme, deseori cu evoluție letală ARDS (Acute Respiratory Distress Syndrome) is the most severe form of hypoxemic respiratory failure and one of the great therapeutic challenges for anesthesia-intensive care specialist, with fabulous costs, enormous efforts, often with lethal development.ОРДС (острый респираторный дистресс-синдром) является наиболее тяжелой формой гипоксической дыхательной недостаточности и одной из самых важных проблем в интенсивной терапии, с большими затратами, огромными усилиями, часто со смертельным исходом.ARDS (Acute Respiratory Distress Syndrome) is the most severe form of hypoxemic respiratory failure and one of the great therapeutic challenges for anesthesia-intensive care specialist, with fabulous costs, enormous efforts, often with lethal development

Moderate permissive hypercapnia, induced during general anesthesia and its effects on acid-base balance: prospective, comparative study

Catedra de anesteziologie şi reanimatologie nr. 1 „Valeriu Ghereg”, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Spitalul Clinic Municipal „Sfânta Treime”, Chişinău, Republica Moldova, Catedra de anesteziologie şi reanimatologie nr. 2, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaRezumat Introducere. Capnia este responsabilă de o serie de efecte fiziologice, cu impact clinic important. Ventilarea pulmonară artificială, pe durata anesteziei generale, poate asigura, separat, atât oxigenarea, cât și nivelul de CO2 din sânge. Hipercapnia moderată a fost asociată cu o trezire mai rapidă, cu bronhodilatare, cu reducerea riscului de infecţie de plagă; totodată, hipercapnia a fost asociată cu acidoză respiratorie, vasoconstricţie pulmonară hipoxică, creșterea presiunii intracerebrale. Nu a fost studiat, deocamdată, impactul hipercapniei moderate, induse intraanestezic, asupra echilibrului acido-bazic.Abstract Introduction. Capnia is responsible for several physiological effects, with important clinical impact. Mechanical ventilation during general anesthesia can separately assure both oxygenation and blood levels of CO2. Moderate hypercapnia was associated with a faster wake up, bronchodilation, reduced risk of wound infection; at the same time, hypercapnia was associated with respiratory acidosis, hypoxic pulmonary vasoconstriction and a rise in intracranial pressure. The impact of moderate hypercapnia, induced during anesthesia, on acid-base balance has not been studied yet

Острый респираторный дистресс-синдром вызванный свищeм

Acute respiratory disease caused by biliobronchical file (Clinical case)ARDS (Acute Respiratory Distress Syndrome) reprezintă forma cea mai severă de insufi ciență respiratorie hipoxemică și una din marile provocări terapeutice pentru specialistul de anestezie-terapie intensivă, cu costuri fabuloase, eforturi enorme, deseori cu evoluție letalăОстрый респираторный дистресс-синдром вызванный свищe

Выбор метода обезболивания у беременных женщин с раком шейки матки

USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaThe choice of method of analgesia at the stages of surgical intervention (Caesarean operation and Wertheim) reasoning minimal impact on the fetus and the survival of anesthetics and drugs. The evidence of minimal impact on fetus and its survival on anesthetic drugs administered to mother, determines the choice of method of analgesia at the stages of surgery (C section and Wertheim). Therefore, at the stage of radical onco-gynecological.Выбор метода обезболивания на этапах хирургического вмешательства (операция кесарево сечения и Вертхейм) аргументирован минимальным воздействием на плод и его выживаемость анестетиков и наркотических средств, вводимых матери. На этапе радикальной онкогинекологической операции позволяет достичь адекватного обезболивания

Электроанальгезия, применяемая при дискогенной радикулопатии нижней конечности

USMF Nicolae Testemiţanu, Spitalul Clinic Municipal Sfânta Treime, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaImproving all monitoring parameters allows us to assume that the mild frequency electroanalgesia applied at discogenic radiculopathy, of lower extremity promissess to be an effective treatment for pain.Улучшение всех мониторизированных параметров позволяет считать что электроанальгезия средней частоты, применяемая при дискогенной радикулопатии нижней конечности, является эффективным методом лечения болевого синдрома

Actualităţi în nutriţia pacientului critic

Catedra Anesteziologie şi Reanimatologie Nr. 2, USMF “Nicolae Testemiţanu” din Republica Moldova, Congresul II Internaţional al Societăţii Anesteziologie Reanimatologie din Republica Moldova 27-30 august 200

TeSeR – Technology for Self-Removal – Status of a Horizon 2020 project to ensure the Post-Mission-Disposal of any future spacecraft

No abstract available

New electroactive polymers structures

Ces travaux de thèse se veulent exploratoires et visent à proposer d’une part une nouvelle approche hybride piézoélectrique-polymère pour le développement de récupérateur d’énergie et d’autre part à développer des méthodes d’actionnement destinée au contrôle de forme structurelle. L’utilisation de polymères diélectriques dans les dispositifs de récupération d’énergie permet de concilier une densité énergétique élevée avec une faible rigidité et une simplicité de mise en œuvre. L’approche hybride proposée dans le cadre de ces travaux permet de s’affranchir de la source de polarisation externe en la substituant par un dispositif piézoélectrique apte à générer, sous l’action d’une contrainte mécanique, le champ électrique nécessaire au fonctionnement du dispositif. L’optimisation du transfert d’énergie entre deux systèmes supposé quelconque a d’abord été généralisée. Les travaux ont ensuite été orientés vers l’investigation de la faisabilité de l’approche hybride piezo-polymère. Les performances des dispositifs hybrides ont été évaluées expérimentalement et comparées à celles obtenues avec des récupérateurs piézoélectriques simples et avec des récupérateurs polymères à polarisation externe. Il est montré que l’utilisation d’un dispositif hybride permet de concilier les qualités des deux approches simples, à savoir la faculté d’initier le processus de conversion d’énergie grâce au champ électrique généré par l’élément piézoélectrique et d’exploiter la haute densité d’énergie des polymères. La deuxième partie de ces travaux porte sur l’utilisation de matériaux électroactifs comme dispositifs d’actionnement destinés au contrôle de forme de structures minces. L’application finale visée ici est le développement de matériau de type peau active. Différents types de polymères ont d’abord été testés et leur performances ont été comparées avec des modèles théoriques spécifiquement développés. Des structures originales ont été proposées pour solutionner certains problèmes liés à l’actionnement par polymères diélectriques. Des prototypes simples ont permis de valider le principe du contrôle de forme des structures à l’aide de polymères diélectriques.Dielectric polymers have seen their importance grow in the field of electroactive materials because of their undeniable advantages, particularly for potential applications such as energy harvesting, actuation or sensors. The work done in this thesis is exploratory and aims primarily to provide on one hand a new piezoelectric-polymer hybrid approach for the development of energy harvesting systems and secondly to develop operating methods shape control of structures using electroactive polymers. The use of dielectric polymers in energy harvesting devices reconciles a high energy density with low rigidity and simplicity of integration. The main problem which is characteristic of such devices is that they necessarily require the use of an external bias high voltage supply (> 1kV) to achieve significant energy densities. The hybrid approach proposed in the context of this work eliminates this source of external energy by using a piezoelectric device capable of generating, under the action of a mechanical stress, the electric field required to operate the device. The problem of optimization of energy transfer between any two systems was also studied. The work was then directed towards the investigation of the feasibility of the piezo-polymer hybrid approach. Various configurations have been proposed and evaluated in order to deduce their optimal parameters. The performance of hybrid devices was experimentally evaluated and compared with that obtained with simple piezoelectric or electrostatic (using polymers) systems. The second part of this work focuses on the use of electroactive materials as actuators for shape control of thin structures. The final application aimed here is the development of an active skin type material allowing reconfiguration of orbiting satellite antennas. Different types of polymers were first tested and their performance has been compared with the theoretical models developed specifically in this context. Original structures have been proposed to solve some problems related to the actuation using dielectric polymers. Simple prototypes have validated the principle of the structural shape control. If their use brings undeniable advantages over conventional operating techniques, the fact remains that certain specific characteristics of electroactive polymers limit their performance. For example, the square law characteristic of the electroactive polymer control requires the use of particular geometries in order to obtain a symmetrical two-way displacement. This fact complicates the control of such actuators but allows in the end to add new features. Thus the use of a sectored network of polymer actuator is required to obtain a symmetrical movement on a single type of structure blocked blocked-beam, but allows to consider different deformation profiles. Other similar problems have been addressed using different original structures