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Biomedical subjects

I Acalovschi

Publications and source records attributed to I Acalovschi.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Cortical blindness after subclavian vein catheterization.

The occurrence of air embolism with neurologic complications during the insertion of central venous catheters is well known, but the development of a cortical blindness has not been stress. The case of a woman patient is described, who, after the puncturing of the subclavian vein, developed a state of confusion and transient left hemiplegia, followed by the loss of sight. Blindness was associated with normal pupilary light reflexes and no observable changes in the fundi, features identifying it as cortical. Possible pathogenetic mechanisms are discussed.

Aged↗
PubMedDate not supplied

[Emergency operations in colorectal cancer].

In a group of 161 patients subjected to emergency surgery of rectocolonic cancers with occlusive (111 cases), hemorrhagic (39 cases) or perforating (11 cases) complications, the authors analyze the immediate therapeutic results, as a function of the complication form and the surgical method used in emergency (primary colectomy, serial surgeries, palliative surgeries). Emergency colectomy (55 cases) performed deliberately in strictly selected cases or as the unique possible choice, was followed by immediate good results (the lowest rate of surgical morbidity and mortality) in comparison with the serial surgeries (cumulative morbidity and mortality). The paper discusses the indications of the proximal colectomy and of Hartman's surgery in primary emergency colectomies. Serial surgeries (secondary colectomy--30 cases) are mainly indicated in the complicated cancers of the left colon, in the patients with resectable tumours, but with critical biological state or with insufficiently prepared colon. Palliative surgeries (colostomies, internal derivations) used in patients with nonresectable tumours were followed by the highest surgical mortality, a consequence of the biological substrate weakened by disease and complications. The data reported show the necessity of a selective tactical behaviour in the emergency surgery of rectocolonic cancer and plead for the primary urgent colectomy in the patients meeting certain general and local conditions. Likewise, they point to the importance of discovering rectocolonic cancer in an early stage, before the appearance of complications requiring the emergency surgery.

Colectomy↗
PubMedDate not supplied

[Hemodynamic reaction in the ultrarapid induction and protection realized with fentanyl].

The hemodynamic response caused by the orthotracheal intubation and also the fentanyl-induced protection were determined in the patients with ultrarapid anesthetic induction. 60 patients were randomly distributed in 3 groups, each of 30 patients: group I, control, with sequential induction, group II, with ultrarapid induction, and group III with ultrarapid induction protected by fentanyl administration. In the patients in the groups II and III the hydrocortisone in the blood, taken 1 minute before induction and 3 minutes after intubation was dosed radioimmunologically. Measurement of the hemodynamic constants showed the increase of the systolic and diastolic AT, and of the pulse during laryngoscopy and in the first two minutes after intubation in all the patients investigated. The hemodynamic response was stronger in the lot with rapid induction, with important differences in comparison with the group with sequential induction. In the IIIrd group, the previous injection with fentanyl, 5 mcg/kg led to a less intense hemodynamic response to laryngoscopy and intubation, close to that of the control group. Likewise, the injection of the anesthetic was followed by an important decrease in the plasmatic hydrocortisone in comparison with the preinduction values.

Adult↗
PubMedDate not supplied

[The effect of fentanyl as an adjuvant to etomidate and thiopental on the hemodynamic response to the induction of anesthesia and endotracheal intubation].

The hemodynamic modifications during anesthesia induction with etomidat or thiopentalum, with and without pretreatment with fentanyl, were studied in 60 ASA I-II patients. The patients were randomly divided into six subgroups, as a function of the induction agent (etomidat, 0.15 mg/kg, or thiopentalum, 3 mg/kg) and of the pretreatment used (fentanyl, 5 micrograms/kg, or 0.9% 1 ml/kg saline solution). Systolic, diastolic ATs and pulse were followed and measured during induction and after tracheal intubation. During induction the presence or absence of the thoracic rigidity, after fentanyl administration, and also the appearance of myoclonias and of local pain after etomidat injection were noted. Measurement of hemodynamic constants showed, in the control subgroups unprotected by fentanyl, that AT and pulse frequency increase following laryngoscopy and intubation irrespective of the induction agent used. Association of thiopentalum with fentanyl influenced partially tachycardia and postintubation hypertension. Administration of 5 micrograms/kg fentanyl prevented the SAT and pulse modifications but not the DAT variation. Association of 10 micrograms/kg fentanyl ensured a complete protective effect versus the tracheal intubation but, it led, first, to a SAT decrease by intensification of the myocardial depressing effect of the barbiturate. On the other hand, use of fentanyl as induction adjuvant with etomidat ensured the blockage of the pressure response to intubation, with hemodynamic stability during anesthesia induction, irrespective of the dose of fentanyl injected. Thoracic rigidity and the side effects generated by etomidate were absent.

Anesthesia, General↗
PubMedDate not supplied

[Effectiveness of sympathoadrenergic blocking in prevention of postoperative acute pancreatitis].

The role of the vascular factor (namely hypoperfusion) in the onset of pancreatic necrosis is a well-established fact. In the present study an analysis is made of the efficiency of drug blocking of alpha and beta adreno-receptors in the prophylaxis of acute postoperative pancreatitis, following surgery of the Oddi sphincter. Compared with a control group of 301 papillo-sphincterotomies performed in a previous period the application of adrenergic blocking in 127 patients in whom interventions were performed on the Oddi sphincter led to a significant reduction in both morbidity and mortality through acute postoperative pancreatitis, from 5 to 2,3%, and from 1,3 to 0,7% respectively.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

[Intragastric administration of norartrinal in hemorrhage caused by rupture of esophageal varices].

In 20 patients with g hepatic cirrhosis hospitalized for upper digestive haemorrhage by rupture of oesophageal varices, the intragastric administration of norartrinal in amounts of 4-40 mg/24 h achieved definitive haemostasis in 7 cases and temporary haemostasis (with prolonged survival) in another 6 cases. The overall mortality was 80%. In three of the 7 patients in which haemorrhage was completely arrested death occurred as a result of hepatic failure. The large amounts of Norartrinal administered (up to 120 mg total dose) were well tolerated and did not have haemodynamic side-effects, or renal side-effects. The results obtained, and especially the easy method used for administration of the drug recommend this method as an alternative of the vasopressin treatment.

Administration, Oral↗