[Major accidents in general anesthesia in elective and emergency surgery].
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Biomedical subjects
Publications and source records attributed to C Constantinescu.
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Over the last 20 years a total of 45 cases with digestive fistulae of various origins have been hospitalized in the Surgery Clinic of the "Caritas" Hospital. In this paper a group of 21 cases with gastro-duodenal and anastomotic fistulae are considered, for the solution of which re-interventions were necessary. The authors present a procedure for temporary decompression of the duodenum, according to an original technique. The method allows to recover the digestive segment involved by healing of the fistulae in satisfactory conditions. The technical simplicity of the procedure is stressed, as well as the possibilities for postoperative radiological control, the strictly extraperitoneal traject of the tube, all representing qualities which give the technique considerable credit.
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The authors make a retrospective analysis of 95 cases of acute pancreatitis hospitalized between 1975 and 1979. In 3,8% of all the cases the acute pancreatitis was associated with hyperlipoproteinemia. The study of the 4 patients involved revealed the primary origin of hyperlipoproteinemia as a result of alimentary abuse in 3 of the cases. In a fourth case the increased serum lipoproteins were due to prolonged use of contraceptives. From the clinical viewpoint, pancreatitis associated with hyperlipoproteinemia was more severe, with signs of shock and collapse, respiratory failure, high serum nitrogen an hyperglycemia. The blood and the serum had a lactescent aspect, with a thick layer of chylomicrons. The serum and blood values for lipids were higher than 4000 mg%. The increase in the amount of lipids was especially due to high triglycerides values. From the anatomopathologic viewpoint the 4 patients presented as acute cases of cholecysto-pancreatitis with major and extensive haemorrhagic necrosis which involved almost the entire pancreas. The evolution of the four patients was difficult. Two of the patients recovered after a long hospitalization, and had definitive sequels - insulin-dependent diabetes. The other two patients died following septic complications (bronchopneumonia and visceral gangrene), and hypovolemia due to upper digestive haemorrhage.
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Hyperimmune polyclonal sera were obtained in order to use them as capture and detecting antibodies in rapid diagnostic of influenza A and B viruses by ELISA. The test shown 100% specificity. The sensitivity in directly detection of influenza viruses in human samples compared of influenza isolations was 49,25% for type A and 53,33% for type B. The sensitivity was increased after 48 hours from inoculation of human samples in cell culture-86,75% for type A detection and 80,0% for type B detection from supernatant mammalian tissue culture (MDCK).
114 children with acute respiratory infections were investigated to detect the viral etiological agents. The following methods were used: the direct immunofluorescence technique for the rapid diagnosis from tracheobronchial aspirates and the serological reactions--hemaglutinoinhibition and complement fixation reaction--to determine the increase of antibodies titres. Of 55.2% respiratory infections with a viral etiology, 60.3% represent acute infections of the lower respiratory tract. Due to the influenza epidemic reported between October 1996 and February 1997 (with a higher number of cases than in the last 5 years), most viral respiratory infections were caused by influenza viruses (57.14%). The direct immunofluorescence technique proved to be sensitive and specific in detecting the viral etiological agents which caused respiratory infections. Thus, using this technique, a positive diagnosis was made in 68.2% of cases, of which 49.2% were positive by the hemagglutination and complement fixation reactions, too. The test specificity could have been higher if the pathological products had been prelevated within the first three days after the onset of the disease.
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