The aspects of the clinical evolution of malnutrition in early childhood

Introduction: Hypotrophy - a chronic disorder of nutrition caused by protein and energy starvation. According to the statistics provided by the WHO, the child mortality is mostly determined by acute respiratory diseases, diarrheal diseases and perinatal factors in equal proportions (approximately 19%). Every second child who suffered and died from these diseases was diagnosed with hypotrophy. Aim: The research of the hypotrophy course with varying degrees of manifestation taking into account the duration of the disease and comorbidities. To identify the most common malnutrition’s causes and nutritional errors that caused the hypotrophy. Methods and materials: A retrospective analysis of clinical and paraclinical examination data of 50 children suffering from hypotrophy treated at the Clinical Republican Hospital for Children ‘E.Cotsaga during 2010 - 2011 was carried out. The researchers used the software ‘WHO Anthro’ to establish the nutritional status of the researched children (the ‘WHO Anthro’ software for PC, version 3, 2009 - software designed for the assessment of the worldwide growth and development of children. Geneva, WHO, 2009 - http://www.who.int/childgrowth/software/ru/). Results and discussions: The average age of children was 10 ±7, 3 months. The research concentrated upon the study of second and third degree hypotrophy. The anamnesis has shown that 9 children (18%) were breastfed, 18 children (36%) were fed replacement products (11 children (22%) were fed partially adopted mixtures, 7 children (14%) were fed unadapted mixtures (whole cow’s milk), 15 children (30%) mixed-fed. Approximately 40% of children were mixed-fed on NAN lactose-free mixtures, Alfare, Nutrilac/Nutrilon, Maliutka (Малютка). Approximately 24% of children suffered from exogenous hypotrophy development while as a manifestation of endogenous factors, the hypotrophy was marked in the case of 18% of children; 58% of children suffered from hypotrophy caused by violations of nutrition types (unadapted milk mixtures, flour products’ excess, and lactose intolerance). Conclusions: Main causes of hypotrophy diagnosed among researched children were gastrointestinal diseases (gastroduodenitis, enterolitis) with the development of the secondary malabsorbtion syndrome as well as prenatal facts (congenital malformations, prematurity and cystic fibrosis). The most frequent diet errors were early transition of children to mixed and artificial feeding using whole cow’s milk and flour products. A number of breast-fed children were diagnosed with a lactase deficiency

Spleen injure treatment early and late results analysis

Catedra Chirurgie Generală, Semiologie USMF “N.Testemiţanu”Most cases of spleen injuries require splenectomy which may result in multiple early and late postoperative complications. The goal of this work isthe comparative analysis of the treatment results and the assessment of the quality-of-life index in the case of patients who undergone splenectomy compared to the patients who undergone organ-preserving operations and nonoperative treatment methods. Intervenţia chirurgicală de elecţie în leziunile lienale mai continuă şi până în prezent a fi splenectomia, care induce cu sine multiple complicaţii postoperatorii atât în perioadele precoce cît şi la distanţă. Scopul lucrăriia fost efectuarea unui studiu comparativ asupra rezultatelor tratamentului şi a calităţii vieţii între grupele de pacienţi splenectomizaţi comparativ cu cei ce au beneficiatde tratament organo-menajantsau non-operator

Contemporary treatment of hiatal hernia and gastroesophageal reflux disease

Catedra Chirurgie Generală, Semiologie USMF “N.Testemițanu”The Gastroesophageal Reflux Disease (GERD) is the primary concern for the XXI century gastroenterology due to the hereinafter mentioned facts:GERD ranks among the most common gastrointestinal diseases among mature population; 10% of global population suffers from GERD, fact which caused the appearance of the term ‘Gastroesophageal Reflux’ in the 10-th edition of the International Classification of Diseases. Boala de Reflux Gastroesofagian (BRGE) pentru gastroenterologia secolului XXI reprezintă preocuparea primordială din mai multe considerente. Enumerîndu-le, vom menționa următoarele momente:BRGE ocupă locul celei mai des întîlnite maladii gastrointestinale în rîndul populației mature sau 10% la nivelul populației globale, fapt ce a indus apariția noțiunii de Reflux Gastroesofagian în a 10-a ediție a Clasificării Internaționale a Maladiilor

Contemporary treatment of hiatal hernia and gastroesophageal reflux disease

Introduction: The Gastroesophageal Reflux Disease (GERD) is the primary concern for the XXI century gastroenterology due to the hereinafter mentioned facts: • GERD ranks among the most common gastrointestinal diseases among mature population; 10% of global population suffers from GERD, fact which caused the appearance of the term ‘Gastroesophageal Reflux’ in the 10th edition of the International Classification of Diseases. • GERD requires a long-lasting antacid medication (min 3-6 months) and frequently repeated treatment courses inducing a high treatment cost. • Patients suffering from GERD are exposed to the high risk of morphohistological inflammatory, metaplasia and cancer complications (Reflux Esophagitis, Esofag Barrette, Esophagial Adenocarcinoma). Goal: Optimisation of contemporary individualized treatment of HH and GERD. Objectives: • Research of drug treatment schemes to elucidate the most efficient treatment schemes in curing the GERD depending on its evolution • Research and description of indications, methodology and short-term results of laparoscopic surgeries performed under GERD treatment by comparing the efficiency and gaps created by the implemented technologies. • Research of endoscopic methodology of GERD surgery to elucidate strengths and gaps among the short- and long-term results. Materials and methods: The authors highlighted the principles of the GERD treatment basing on data received after the retrospective, descriptive and monocentric study performed at the Municipal Clinical Hospital Nr. 1, Chisinau, Republic of Moldova, during 2010 - 2012. The authors have studied medical records of a group of 30 patients hospitalized according to the schedule into the section ‘Aseptic Surgery’ being diagnosed with GERD and HH. Results: • Medical treatment: Is implemented step by step (step up/down) depending on the clinical and paraclinical evolution, is long-lasting (2-6 months) with disease’s relapse in 87-90% of cases at 12 months after the cessation of the treatment, PPI appear to be the most efficient causing 61% of clinical resolution cases compared to 41% in H2 blockers’ case. • The endoscopic treatment: is poorly studied with short term results (12 months) that shows the reduction of the ER in 62% cases and healing in 40%. The abandoning of the PPI post operative treatment in 87% of cases. Is a bridge between the drug treatment and the laparoscopic one of the GERD. • The surgery tactics could be applied in only 10% of the total number of GER patients who face at least several conditions: HH and GER symptoms, complications (ER, EB, AE, SDH), the conservative treatment failed or appeared to be impossible, too young age (being an asset in the choice of the therapeutical technique). Conclusions: The study of the GERD modern treatment methods, both drug and surgery, has concluded that a patient who suffers from GERD needs an individual approach taking into consideration the stage and the evolution of the disease to deal successfully with it