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Biomedical subjects

N Mircea

Publications and source records attributed to N Mircea.

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

[Critieria of brain death (personal opinions)].

The study reviews the literature dealing with cerebral death and raises some problems, not yet discussed in the literature, such as those in connection with the decerebrated pregnant woman, of which the following ones are stressed: 1. The pregnancy can continue in the decerebrated woman. If the answer is affirmative, development of the pregnancy represents represents a test of particular biological value in assessing the efficiency of ressuscitation therapy; 2. What are the effects of hipoxyia that led to decerebration of the mother on the psychosomatic development of the child, and the possibility to evaluate it in correlation with the age of the pregnancy; 3. What are the effects of prolonged forced ventilation and the artificial feeding on the development of the pregnancy? The study ends with concrete proposals for establishing criteria for cerebral death, stressing the need for an adequate juridical frame for organ transplantation.

Brain Death↗
PubMedDate not supplied

[ Epidemiological and clinical-therapeutical considerations on 500 operated cases of uterine cervix cancer].

AIM: Optimization of the treatment on uterine-cervix neoplasia, in a general surgery department. MATERIAL AND METHOD: Between 1984-1999, in Colţea Surgical Department were operated 746 uterine-cervix cancers. We selected two trials of 250 females, similarly regarding age and stadium. The A trial (250 females) were treated and operated 1984-1989, the study being retrospectively, and the B trial (250 females) treated and operated between 1990-1995, the study being prospectively by introduction of cisplatyn and carboplatyne chemotherapy in the advanced steadies. In the B trial, on registrated many mutations with negative epidemiological implications as: the grow the number of new cases, the diminution of immunity, the abandon of the screening, a possible grow of irradiations (Cernobâl accident), and the belated of presentation to medical consultation. RESULTS: The complex treatment, comparative in two trials, show a grow of lifetime, at 5 years in B trial from 82.1-93.4% in the 1st and 2nd steadies, 50.7-60.4% in the II B study and 12.9-28.5% in the III study. In the IV study the grow of lifetime was under 24 month. CONCLUSIONS: The resumption of the screening. Complexes therapeutical protocols for each study. Widely introduction of polichemotherapy in the advanced steadies.

Adenocarcinoma↗
PubMedDate not supplied

[Considerations on 988 breast cancers].

AIM: Therapy schedule improvement. MATERIAL & METHOD: The study includes 988 patients (which 16 men) with breast cancer who underwent surgery between 1984-1998. Out of them 63.2% were in advanced stages. The patients were divided in 2 homogenous groups: trial A = 520 patients treated between 1984-1991 (in stade: I = 2, II = 240, III = 246, IV = 32) studied retrospectively, and trial B = 468 patients treated between 1992-1998 (in stade I = 3, II = 212, III = 235, IV = 18) studied prospectively. In trial B the complex therapy schedule was improved according to disease's stade, local breast aspect and patient's biological status, straining on neoadjuvant therapy. To the entire group 945 radical mastectomies (95.6%) were performed. Only 628 (63.5%) could be properly followed up. RESULTS: Global 5 years survival rate was 72% (improved from 69% in trial A to 72% in trial B). The survival rate varied according the stage from 100% (stade I), 88% (stade II), to 22% (stade III) and 2% (stade IV). In the advanced states, the local recurrencies at 5 years were of 22% and the methastases of 17%. CONCLUSIONS: The neoadjuvant therapy, selectively applied upon stade and patient improves the 5 year survival rate. Every patient with an advanced breast cancer can benefit of a complex, differentiated and well guided treatment. The adequate operation earn the important role in powering the neoadjuvant and adjuvant therapies. Further results improvement requires restarting the collectivities and high risk persons screening.

Adenocarcinoma↗
PubMedDate not supplied

[Aspects of pulmonary function in states of hyperhydration].

The authors have investigated in 10 young and healthy men the changes occurring in the cardio-respiratory apparatus following the perfusion with non-colloid isotonie volemic solutions. Exploration of volumetry and of pulmonary mechanics have been performed, hemodynamic tests and pulmonary angiograms. The results indicate the development of slight interstitial oedema, without intra-alveolar transsudation or obstructive phenomena in the aerial pathways. The cardio-vascular apparatus shows satisfactory adaptability through central and peripheral mechanisms in conditions of hyperhydration.

Adolescent↗
PubMedDate not supplied

[Malignant hepatoma (clinical, biological and morphological comparisons)].

The authors make an analysis of 8 cases of malignant hepatoma discovered in 20 362 surgical patients between 1965 and 1975. The analysis of these cases allowed to conclude as follows: 1). In the presence of chronic digestive disturbances, or of hepato-splenomegaly, accompanied by progressive deterioration of the general condition of the patient, and of the use of large amounts of analgetic drugs, one should consider more than usually the possibility of hepatic neoplasia. 2). The first element to be considered in the frame of diagnosis of malignant hepatomas should be the morphological one. Of practical value in the diagnostic are the following: hepatic scintigraphy, angiography and bioptic laparotomy. 3). Of the conventional biologic tests (including the immunological tests), evaluation of serum alpha-foetoprotein is the only one with an orientative diagnostic value.

Adolescent↗
PubMedDate not supplied

[Treatment for spontaneous pneumothorax].

The present study refers to 67 cases of spontaneous pneumothorax admitted to intensive care unit. Symptomatic therapy and treatment of the pneumothorax is efficient. Minimal thoracotomy with continuous aspiration drainage indicated in severe pneumothorax and relapses after exsufflation, was considered the basic procedure in the symptomatic treatment.

Adult↗
PubMedDate not supplied

[The value of non-specific general therapy of shock caused by acute pancreatitis].

The shock in general, including that of acute pancreatitis, presents, according to our conception, as an energetic disease involving primarily the cell (by the intensive catabolic processes induced by the pancreatic lesion) and secondarily the most peripheral and mobile sector, that of the hemodynamic compartment. There is no etiological treatment of pancreatitis (the exceptions are very rare), and this is the reason for which we adopt a conservative attitude, and medical treatment, in the acute stage of the disease. The basic treatment of the shock of acute pancreatitis is considered to be the re-establishment of the circulatory volume with the aid of non-colloidal isotonic solutions that are given in large amounts (8-17 liters in a 24-hour period) under continuous perfusion. This technique is called hyperhydration or transrenal dialysis. Making use of this technique in the treatment of shock occurring in the course of acute pancreatitis the death-rate recorded was as low as 2,3% and the number of complications was very low.

Acute Disease↗
PubMedDate not supplied

[Primary exertion thrombophlebitis of the upper extremities: clinical and therapeutic aspects].

The authors present 4 cases of "effort" thrombophlebitis of the upper limb that were diagnosed both clinically and thrombophlebographically, and in whom classical therapy was applied: total rest, anticoagulants, elevation of the limb. All the cases had sequels of variable intensity, and in 2 of the patients Roos' transaxillary route was used which revealed a double anterior scalenus muscle insertion, and compressive fibro-sclerous tissue. The pathogeny of the affection makes mandatory the removal of extrinsic or intrinsic factors which may generate a new thrombosis or vascular and neurologic sequels.

Adult↗
PubMedDate not supplied

[Anesthesiologic aspects of surgical interventions in patients with liver diseases].

The authors review the anesthesiology problems in hepatic patients on the one hand, and on the other hand they present their personal experience in anesthesia of patients with jaundice, upper digestive haemorrhage and hepatic coma. The conclusions of the study are the following: 1. The major hepatic functions which can interfere with anesthetic drugs and techniques are related to changes in the hepatic blood flow, the synthesis of proteins, homeostasis of carbohydrates, and especially the metabolization of medicinal drugs. 2. Hepatic patients presenting with jaundice, upper digestive haemorrhage, and hepatic coma raise special problems concerning preoperative preparations and anesthetic technique. Considering the risk factors which occur in the patient with jaundice denutrition, hypoalbuminemia and partially angiocholitis can be corrected by medical means. Hemostasis on hepatic patients with upper digestive haemorrhage is the most difficult problem, and also very controversial. There are not, at present, either infallible solutions or arguments in favor of hemostatic techniques (by compression, endoscopic haemostasis, or surgical hemostasis). The comatose patient is usually the final evolutive stage of the hepatic disease, and the mortality in this category of patients, indifferent of the therapy, is higher than 80%.

Anesthesia↗
PubMedDate not supplied

[Nongynecologic abdominal emergencies during pregnancy].

The paper reports on the authors' experience in the surgical emergency of a special category of patients: pregnant women with acute affections requiring surgery. The clinical aspects, sometimes deceptive, diagnosis difficulties and tactile and technical surgical attitudes are presented in detail.

Abdomen, Acute↗
PubMedDate not supplied

[Intra-anesthetic hypothermia].

Oesophageal temperature was recorded after induction of anesthesia, and further, at one, two and three hours. Temperature in the operation hall was continuously monitored. In relation to the temperature in the operating hall the effects on the patient were of three kinds: 1. operating halls with low temperatures (under 21 degrees C) where all the patients become hypothermic; 2. operating halls with an intermediate temperature (21-24 degrees C), where 67% of the patients remain normothermic; 3. operating halls with high temperatures (above 24 degrees C) where all the patients remain normothermic, although these temperatures are uncomfortable for the medical personnel, and increase the septic risk of the patient. When the oesophageal temperature of the patients falls by 0.5 degrees C chills will occur in 40% of the patients. Thermal falls of less than 0.5 degrees C will also determine chills but in only 10.5% of the cases. Immediate postanesthesia chills are also recorded in normothermic patients, but there is a direct relationship between the temperature in the operating hall, the degree of hypothermia and the frequency of chills, while the site of the surgery or the duration of the operation have but an unsignificant influence on intra-anesthetic temperature.

Adult↗