Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Jul 2007
Review[Noninvasive methods of assessing inflammation in bronchial asthma].
Airway inflammation plays a key role in asthma. Among noninvasive methods as tools to study these inflammatory processes and to monitor airways diseases, the sputum analysis is widely used. As well, the analysis of concentrations of nitric oxide (NO) and the analysis of exhaled breath condensate are alternative methods for assessing the airway inflammation. In addition a treatment strategy directed at normalisation of these noninvasive parameters could led to a better control of the disease.
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Rev Med Chir Soc Med Nat Iasi · Apr 2007
[Fibrin-collagen patch (TachoComb) in general surgery. Indications and results].
Adequate hemostasis is an important part of any surgical procedure, by open or minimally-invasive approach. The aim of this study was to evaluate the indications and the effect of absorbable fibrin-collagen patch--FCP (TachoComb). ⋯ The efficacy of FCP in local hemostasis is excellent. The use of FCP decrease the rate of conversions in laparoscopic surgery and is essential for spleen preserving surgery. The use of FCP in the treatment of digestive fistula is inadequate. FCP (TachoComb) is too expansive for some surgical units.
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Pain is a common occurrence for the hospitalized elderly, and may often be under recognized and inadequately managed. Insufficient pain management can lead to the sequelae of emotional distress and depression, delirium, anxiety, sleep disturbances, and physical disabilities, as well as increased health care costs. Effective pain management of the older adult begins with pain assessment using the proper tools. ⋯ Paracetamol is commonly prescribed and may be the drug of choice for mild to moderate postoperative pain. Older adults may enjoy the benefits of Patient-Controlled Analgesia and Patient Controlled Epidural Analgesia in the postoperative period; however, thorough and ongoing teaching must occur to ensure understanding and compliance with the therapy. Treating post-procedure pain in the elderly patient requires an understanding of the normal changes associated with aging and the impact on medications, and multimodal analgesia can be the best approach.
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Rev Med Chir Soc Med Nat Iasi · Oct 2006
Comparative Study[Soliciting a model of a child emergency care unit in road accidents in the year 2005].
This paper describes the specific model of burden due to child road traffic injuries upon the emergency care unit from a university paediatric hospital during 2005 year. A total number of 193 road trauma cases required emergency care to this hospital. Distribution by seasons pointed out the highest number in summer (31.1%) and comparing the observed repartition by seasons with an expected symmetrical repartition there have been obtained significant differences between seasons (p < 0.02). ⋯ The leading non-fatal injuries requiring emergency care as a result of road traffic collisions have been: multiple trauma--166, intracranial injury--128, fractured lower limbs--31, fractured upper limbs--20 cases. Approximately one third of these cases required admission in hospital for complex care, one third have been referred to another hospital (neurosurgery and maxillo-facial clinic) and one third have been discharged after 24 hours of hospitalized monitoring. In conclusion, more road traffic injuries arrived in the emergency care unit of the studied university paediatric hospital during summer without a specific distribution by weekdays, but with a higher probability of being a boy aged 5-9 years, presenting multiple trauma especially intracranial injury and requiring specialised hospital care.
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Mechanical ventilation, a life saving procedure in ARDS aims to optimally ventilate the patient and to avoid at the same time the ventilator induced lung injury (VILI). In ARDS the lung contains a variable portion of collapsed alveoli witch impair the normal oxygenation. ⋯ Multiple recruiting maneuvers are reported in the literature but there is no consensus regarding the optimal one(s), as each maneuver is only partially efficient and has several down falls. While in animal studies theses maneuvers have proved their efficiency and safety, there are not enough humans studies to guide the decision on how, when and which technique should be used.