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Biomedical subjects

N Mircea

Publications and source records attributed to N Mircea.

At least 19 recordsLinked to original sources
PubMed1996

[Acute nonbiliary and nontraumatic pancreatitis. The diagnostic and treatment characteristics].

Deeper knowledge of the etiopathogenesis of acute pancreatitis and the possibility to estimate the extend and gravity of pancreatic and peripancreatic lesions determined essential fluctuations in treatment evolution. Etiology of nonbiliary and nontraumatic A.P. recognises in the first place alcoholism (20-25% of A.P.) and in the second place less common causes such as: hypercalcemic states, hyperlipidemia (about 5-10% of A.P.). Diagnosis of nonbiliary A.P. leans upon: antecedents of chronic alcoholism, alteration on liver function tests and serum put levels and the results of cholecystocholangiography, abdominal ultrasonography and duodenum tubing. These reveal the absence of gallstones, cholesterolosis or anomalies of papilla of Vater (sphincter of Oddi). A number of 128 patients with acute pancreatitis were admitted to the clinic in the period 1984-1994 from which 48 with a non-biliary and non-traumatic. A complex medical treatment was applied to all patients but only 25 responded favourably, the remaining 23 necessitating surgical intervention, which was effected on de-shocked and re-equilibrated patients, diminishing thus the number or repeat interventions in the complications which may appear in such cases. Thus postoperative mortality fell from 58, 33 to 30, 76.

Adult↗
PubMed1995

[Preliminary results after the transperitoneal laparoscopic treatment of the first 50 inguinal hernias].

The authors are presenting the results of first 50 inguinal hernias treated laparoscopically trough the transperitoneal approach (39 men, 11 women, mean age--42,5 years, 44 uncomplicated and 6 epiploon's incarceration). After the dissection of the hernia's pouch, the parietal defect was covered with Prolène meche in 15 cases, with Marlex in 10 cases and Plastex prosthesis in 25 cases, all of them without fixation. The prosthesis itself was covered with the parietal peritoneum in running suture. The immediate postoperative evolution was good, the patients being able to walk soon after being awake, and without any urinary problems (even in elder patients). The patients left the hospital 24-48 hours after surgery. They were followed-up 2 to 10 months, periodically. The results were good, except 4 patients: 1 case with port-site hematoma (in the right lower quadrant, necessitating open surgery). 2 patients with seromas (vulvar and scrotal) in case of section and abandoning the hernial pouch. 1 patient with prosthesis migration with precocious recidive (24 hours after the operation). We consider the transperitoneal approach as very good in the treatment of uncomplicated and not very large hernias. The easiest and safest technic is that using Prolène prosthesis.

Adult↗
PubMed1990

[Anesthesia at the "Coltzea" Clinical Hospital, a first line hospital during the revolution of the Romanian people].

Anaesthesia and postoperative course of the wounded victims of the romanian revolution in December 1989 at Bucarest are described. The author, a romanian anaesthetist, was an eyewitness of these events. During this four day period, between 21st and 25th December, 97 live wounded were admitted, 75 of them with very serious wounds, and hypovolaemic shock. The remaining 22 had superficial limb wounds. Twenty-one dead wounded were also admitted to hospital. The wounds involved: the head (3), the neck (4), the chest with an opened pleura (3), with closed pleura (8), the abdomen, including the intra-abdominal and retroperitoneal organs, and the pelvis (14), the upper (16) and lower (39) limbs, and minor skin and soft tissue lesions (10). Seventy-five patients were given a general anaesthetic with endotracheal intubation, 12 an intravenous general anaesthetic without intubation; for the remaining 10, a local anaesthetic technique was used. Four patients died during surgery because of extremely serious wounds, incompatible with life, and overwhelming haemorrhage for which surgical haemostasis was impossible. Two other patients died, one 72 h and the other 5 days later, because of severe infection and gangrene. Twenty days after these events, 91 patients still either recovered or were convalescing.

Anesthesia↗
PubMed1985

Ultrarapid induction.

We report 250 rapid induction anesthesias performed for the purpose of preventing regurgitation and vomiting in patients with full stomach. The anesthetic technique includes administration of morphine 20 mg and droperidol 5 mg intravenously 10-15 minutes before induction, a voluntary air hyperventilation at the anesthetist's command, during which induction drugs are introduced and an induction with a mixture containing suxamethonium 2 mg/kg and thiopentone 1.4 mg/kg, administered within 1-2 seconds. Eighteen seconds after the onset of injection the loss of lid reflex is observed followed 7 seconds later by masseter muscle relaxation. Within the following 5-10 seconds intubation is carried out in full fasciculation process, before cardia relaxation. With this technique, a mean intubation time of 35 seconds is achieved. The interval of maximum regurgitation risk is lowered to 15 seconds, so that ventilation by mask and cricoid pressure are no more necessary. The technique is indicated in the young and vigorous adult and contraindicated in the old and tainted patient, in coronary patients, in those with low heart output and slowing of circulation.

Adolescent↗
PubMed1984

Stress ulcers in intensive care (etiology, symptomatology and therapy).

The authors present a group of 48 patients with stress ulcers (36 men, 13 women) average age 56.2 years. The analysis of the cases allowed to establish, for the first time in medical literature, a correlation between the etiology, the symptomatology and the moment of onset of the haemorrhage, with important practical implications in the adoption of a treatment regime. These considerations permitted us to delineate four categories of stress ulcers: The first category included stress ulcers caused by a cerebral lesion and manifested through cerebral hypertension. The upper digestive haemorrhage occurred within 24-48 h after the aggression and required the correction of the cerebral hypertension and of the anaemia. The second category comprised stress ulcers brought about by a hypovolaemic shock through myocardial infarction, burns, frost-bite and multiple traumas. Haemorrhage in the upper digestive tract appeared within 3-6 days after the moment of aggression and required surgical control unless it was caused by myocardial infarction. The third category was represented by post-operative stress ulcers. These forms occurred usually late, between the eighth and the thirty-seventh day after the aggression, and were due to the super-imposition of the septicaemia on the post-aggressive systemic reaction. The chief aim of treatment here was the surgical control of infection. The fourth category encompassed the stress ulcers occurring after protracted coma, especially in patients with ventilatory assistance. In these conditions, the ulcers of the digestive tract and the consequent haemorrhage represented terminal elements of irreversible diseases, in which no treatment was effective.

Adult↗
PubMed1982

Risk of pulmonary complications in surgical patients.

The pulmonary complications in a group of more than 20 000 surgical patients between 1971 and 1980 were examined, as well as the pulmonary state of 100 surgical patients who died within 10 days of operation. The factors related to the patient's constitutions, nature of the surgical disease, operation and anaesthesia. Equal and homogeneous groups were considered in respect of each factor which were analyzed retrospectively from 1980 to 1971. The mean frequency of pulmonary complications in the Department of General Surgery was 12%. The main risk factors of pulmonary complications were: the duration beyond 4 h of the operation (59%), age over 70 years (48%), obesity (35%). They were followed in decreasing order by sepsis, hypovolemia and particular sites of operation. Severe pulmonary complications, bronchopneumonia, pneumonia and thromboembolism contribute to mortality.

Abdomen↗
PubMed1982

[Subarachnoid anesthesia with pethidine].

The authors present their experience about spinal anesthesia with pethidine as the sole medication. 713 patients whose mean age was 56.5 years received 1 mg . kg-1 of pethidine in 50 p. 100 aqueous solution administered by subarachnoid route. Indications were surgical procedures involving upper and lower abdomen, perineum and lower limbs. The set up of anesthesia is quite similar to those obtained with local anesthetics. Sensitivity disappears during the first three minutes in the area below the puncture site and in the following two or three minutes areflexia and paralysis is noted. The duration of the motor and sensory block is 90 to 120 minutes. Recovery appears to be in a reverse order. Spinal anaesthesia with pethidine exhibit the following characteristics: --sensory and motor blockade with minimal adverse reactions giving good and very good results in more than 90 per cent of cases, when involving perineum and lower limbs; --the most frequent adverse effect is a syndrome including hypotension, bradycardia and hypoxemia, appearing 20 to 30 minutes after injection, reversal is easily obtained by administration of pressure drugs and artificial ventilation. Neither delayed respiratory depression nor neurologic damage were noted; --a long lasting post-operative analgesia. In conclusion, this work demonstrates that: --1 mg . kg-1 of pethidine administered by subdural route realize a complete spinal anesthesia including motor, sensory and sympathetic blockade allowing surgical procedures in good conditions of security; --increasing the dosage of pethidine over 1 mg . kg-1 is not wise in order to avoid the occurrence of adverse side effects such as hypotension, bradycardia and bradypnaea; --this technic is only indicated for surgery in perineum and lower limbs.

Adolescent↗
PubMed1975

Gastro-intestinal haemorrhage from peptic ulcer. An evaluation of bloodless transfusion and early surgery.

Over a 3-year-period 72 patients with upper digestive tract haemorrhage due to peptic ulcer were transfused exclusively with isotonic sodium chloride and glucose solutions in equal quantities. The results are compared with 69 patients treated previously in whom conventional blood transfusion regimes had been used. Transfusion therapy was combined with emergency surgery involving vagotomy and draininage, with surgical haemostasis in situ. There were no significant differences between the two groups with regard to anaesthesia, surgery and post-operative managemement. Apart from anemia, there were less early and late complications in the group not receiving blood. The amount of crystalloid solutions administered varied between 7000 ml and 19,000 ml causing a diuresis of 1000 ml to 5300 ml within the first 24 hours. The use of this transfusion regime for haemodynamic re-equilibration in upper gastro-intestinal haemorrhage due to ulcer, in cases in which haemostasis can be obtained with certainty by emergency surgery, allows transfusion of stored blood and colloid solutions to be avoided and emergency surgery to be safely undertaken at the earliest moment. The severe acute anaemia which is caused appears to create no special problems.

Adolescent↗
PubMedDate not supplied

[Upper digestive hemorrhages of ulcerous nature (management and experience)].

A number of 135 cases were examined, presenting with superior digestive hemorrhage of ulcerative origin. The analysis of the cases was made by two comparable groups. In the first one of the groups the volemic re-equillibration was based on the administration of blood and surgery was carried out, in principle, on a "cold" condition. In the second group volemic re-equillibration was achieved exclusively with isotonic non-colloidal volemic solutions that were administered before, during and after surgery (0.9% NaCl solution and 5 g% glucose solution in equal amounts). Surgery was performed as an emergency and vagotomy was made, as well as surgical hemostasis. The results obtained have allowed for the conclusion that, by providing efficient surgical hemostasis and volemic re-equillibration with isotonic non-colloidal solutions blood transfusion and its untoward side-effects can be avoided.

Adolescent↗
PubMedDate not supplied

[Gastric consequences of toxicoseptic agression].

This study is concerned with gastro-secretory and motor answers. It was carried out in two groups of patients and the results obtained were compared. The following aspects were noted: a. the control group was represented by 10 patients that had been exposed to anesthesic-surgical aggression; b. the second group was formed by 20 patients with toxico-septic syndrome of various etiologies and in different stages of evolution; - secretory and motor gastric disturbances take on an evolutive dynamic character, according to the clinico-biological phase of the syndrome; in the acute stage absolute hypersection is noted, as well as from the viewpoint of the rate, of hydrochloric acid, and gastric hypomotility; in the chronic stage there is acid hyposecretion both insulin- and histamine-resistant and in 30% of the cases there is anachlorhydria; to the general-metabolic phase of inversion corresponds, at the gastric level; a return to normal of the motility and of the acid gastric secretion.

Anesthesia↗
PubMedDate not supplied

[General anesthesia in endoscopic examination of the digestive tract].

The authors made an analysis of 165 general anesthesias applied in the digestive fibroendoscopy and they establish the technology and the indications of this method, as follows: 1) uncooperative patient (in this category should be included children, psychopaths, mentally deficient subjects and a certain category of neurotics); 2) when difficult endofibroscopies are to be expected, during which therapeutic procedures are highly probable, such as resection of polyps, coagulation of bleeding surfaces etc.; 3) lack of tolerance to local anesthetics; 4) optimal instruction conditions should be provided for the beginner anesthesist; 5) the authors recommend that all such anesthesies should be carried out in hospital only. They also suggest as the most reliable technique the intra-venous general anesthesia and the oro-tracheal intubation of the patient.

Anesthesia, General↗