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Biomedical subjects

G Popa

Publications and source records attributed to G Popa.

At least 109 records · Page 6Linked to original sources

[Reoperations on the extrahepatic bile ducts after surgery of the common bile duct or its indirect drainage].

An analysis is made of 80 re-interventions on the extra-hepatic biliary pathways in patients who had underwent one or more surgical interventions on the main biliary pathway. The cases have been classified according to the type of the initial intervention as follows: re-interventions following cholecystectomy, choledocotomy and Kehr drainage, following sphincterotomy, and following internal and external biliary derivations. An analysis is made of the causes of re-interventions, and of the increased risk due to severe complications which are at the origin of high morbidity and mortality rates. Particular stress is laid on the necessity for a correct diagnosis, as well as a complete one for the first intervention on the biliary pathways, which will allow to make an adequate choice for a second surgical solution.

Adult↗

[The dumping syndrome. Surgical treatment].

Data are presented, from the specialized literature, in connection with the frequency of the dumping syndrome, and the methods for its correction. An analysis is made of indications and of surgical methods used for the correction of this syndrome in a total of 74 patients of which 32 were operated. Preference was given to sub-diaphragmatic troncular vagotomy and to re-positioning of the duodenum with efferent loop, or by gastro-duodenal interpositioning of a segment of jejunal loop in an-iso-peristaltic position. The results of these interventions are, as a rule, favourable, but some disturbances may occur, dependent on the development of peri-visceritis, loop dysfunction, or duodenal dysfunction, as well as gastro-oestrophageal reflux.

Adult↗

Stroke and hypertension. Antihypertensive therapy withdrawal.

The effect of antihypertensive therapy withdrawal in acute ischaemic stroke patients was assessed in order to establish possible correlations between blood pressure values and the modified Rankin Scale (mRS) outcome. One hundred and twelve consecutive patients with acute ischaemic stroke and hypertension were treated with relatively similar regimen. Seventy-two hours following the onset of stroke, systolic blood pressure decreased to < or = 180 mmHg in 110 patients. Antihypertensive therapy was randomly discontinued in 59 patients. Clinical outcome and mortality were compared in patients with and without antihypertensive therapy withdrawal, no statistically significant differences (p > 0.05) between the two groups being found. Statistically significant positive correlations (p < 0.05) between mRS outcome and the decrease of systolic and diastolic blood pressure values were in patients treated with anticoagulant and antihypertensive therapy. Statistically significant negative correlations (p < 0.05) between mRS outcome and low levels of diastolic blood pressure were noted in patients who discontinued antihypertensive therapy. Our findings emphasize the need to associate antihypertensive and anticoagulant therapy in acute ischaemic stroke patients with hypertension. Spontaneous decrease of diastolic blood pressure values showed poor outcome. The management of hypertension associated with acute ischaemic stroke should be reconsidered.

Aged↗

Acetazolamide therapy evaluation in haemorrhagic stroke.

The influence of acetazolamide in patients with hemorrhagic stroke was assessed in 54 patients in comparison with the influence of other therapies in 68 patients included in a control group. Modified Rankin Scale and mortality rate were evaluated at three different moments: onset, 72 hours and control (3 weeks-one month from the onset). A better outcome was seen when acetazolamide was given. Mortality rate was significantly lower in the group of acetazolamide. This therapy may be safely used in haemorrhagic stroke, especially when hydrocephalus is associated.

Acetazolamide↗

Hypertension in acute ischaemic stroke: to treat or not to treat.

The reasons for not treating hypertension could be the risk of reducing cerebral blood flow (CBF) which may induce additional cerebral damage in the so-called ischaemic "penumbra". Hypertensive patients have altered autoregulation. A severe hypertension (over 230/120 mmHg) may lead to further damage by cerebral edema which asks for antihypertensive therapy. An antihypertensive therapy was applied in 81 patients within the 72 hours interval from acute ischaemic stroke (AIS) onset. In 42 patients, the antihypertensive treatment was discontinued after the 72-hour interval (the therapy with nifedipine in daily doses of 10-20 mg was not considered as hypotensive). We compared as end points: the survival, death, modified Rankin Scale (mRS). There were no statistically significant differences between end points of patients who discontinued (group C) and those who maintained (group T) the antihypertensive therapy. The mean value of blood pressure was higher in patients who maintained antihypertensive therapy (p < 0.001 for systolic blood pressure (BP); p = 0.001593 for diastolic blood pressure). The mean value of age in patients in whom antihypertensive therapy was discontinued was higher than that found in patients who maintained antihypertensive therapy (p < 0.05).

Acute Disease↗