Reabilitarea cardiaca Dr. Tase

amtsibiu.ro

Background. Ischemic colitis is very rare in our country; there are difficulties in diagnosis and surgical treatment, and the late diagnosis in advanced cases causes a high rate of fatalities. Case. A 73-year old woman was presented with melena, diffuse abdominal pain, nausea and vomiting. Laboratory evaluation revealed a WBC of 20,900/mm 3 , blood glucose level of 194 mg/dl, without other abnormalities. Plain abdominal radiography and abdominal ultrasound were normal. Emergency exploratory laparotomy revealed a rubbery hard colon, without the normal aspect of haustrations, feeling like a parenchimatous organ, from the left colic angle to the recto-sigmoid junction. The dissection of the origin of the inferior mesenteric artery proved its complete thrombosis. We performed a left colectomy with terminal colostomy on the transverse colon. Postoperative course was uneventful. Nine months after the first operation, we restored the continuity of the digestive tract by a colo-rectal anastomosis, without any problems.

Zenodo (CERN European Organization for Nuclear Research), 2022

Îmbunătățirea calității actului medical este una dintre sarcinile importante ale medicinei legale, care se realizează inclusiv prin elucidarea cazurilor de divergențe dintre diagnosticul clinic și cel medico-legal. Cu toate că posibilitățile tehnice ale medicinei contemporane sunt enorme, în cadrul autopsiilor se identifică greșeli de diagnosticare într-un număr considerabil de cazuri; mai mult ca atât, frecvența acestora a crescut în ultimele decenii. În cadrul prezentului studiu neam propus să evaluăm circumstanțele organizatorice, medicale și sociale de apariție a divergențelor pentru a elucida impactul lor asupra calității actului de diagnosticare ca parte componentă a asistenței medicale. Cercetarea reprezintă un studiu analitic retrospectiv făcut în baza analizei a 152 de constatări și expertize medico-legale primare privind cadavrele persoanelor decedate în staționar și documentele medicale ale acestora executate în secțiile teritoriale ale Centrului de Medicină Legală în perioada 2009-2013. Analiza a evidențiat profilul pacientului cu risc sporit de stabilire a divergenței dintre diagnosticul clinic și cel medico-legal: internat în mod urgent, imediat sau până la o zi după debutul bolii/traumei, în perioada de iarnă, în zilele de luni și vineri, între orele 17:00 și 23:00, pe motivul unei traume accidentale, fiind în stare generală gravă sau foarte gravă, bărbat cu vârsta între 18 și 75 de ani care s-a aflat în staționar până la o săptămână. Cuvinte-cheie: traume mecanice, divergență dintre diagnosticuri, calitatea asistenței medicale, greșeală de diagnosticare. HEALTH SERVICES FROM THE PERSPECTIVE OF DIAGNOSTIC MISTAKES IN LETHAL MECHANICAL TRAUMA Improving of medical care quality is one of the important tasks of legal medicine, which is achieved inclusively by discovering discrepancies between clinical and medico-legal diagnosis. Although the technical possibilities of contemporary medicine are enormous, diagnostic mistakes are identified in a considerable number of autopsies; moreover, their frequency has increased in recent decades. The present study aimed to assess the organizational, medical and social circumstances of identified discrepancies in order to establish their impact on the quality of diagnosing as a part of medical care. The study is a retrospective-analytical one. It is based on the analysis of 152 primary medico-legal examinations regarding cadavers of patients deceased in hospitals and their medical documents conducted within the Center of Forensic Medicine between 2009 and 2013. The following profile of a patient with an increased risk of discrepancy between clinical and medico-legal diagnosis was observed: urgently hospitalized, immediately or up to one day after the beginning of disease/trauma, during the winter period, on Mondays or Fridays, between 5 p.m. and 11 p.m., due to an accidental trauma, being in a serious or severe general condition, a man aged between 18 and 75 years, who stays in hospital up to a week.

Medic.ro, 2017

Quality assurance in primary health care is a concern of all states in Europe. In order to have quality, a whole range of elements must be integrated with health policy. Furthermore, professional organizations can contribute to define standards and models of good medical practice. Finally, medical practices and primary care service providers will have the tools to organize their activity, and the quality of services can be truly measured.

Cercetări Arheologice, 2012

A major real estate development required a rescue archaeology intervention in the very downtown Bucharest, mainly between February and June 1996. A large section, 75 long and about 3 m large was made in the street, mostly mechanically, just in the front of the National History Museum. The archaeological rescue digging documented 12 rooms belonging to a large inn, built by a famous Ruler of the Romanian Country (Ţara Românească), Constantin Brâncoveanu, in the last decade of the XVIIlh century. This kind of inn, of Oriental inspiration, is typical for the passage from Late Middle Age to Modem times, and is, in fact, a complex project including hosting areas, enclosure for animals, large storehouses, but usually churches also. Flourishing in towns with a certain demographic growth, but with a very poor communication means, like Bucharest, the inns were supposed to gather all goods needed by community in five months of cold and wet weather, when the road network was impracticable. The inn functioned about 160 years, until around 1860, the internai spaces being frequently restored, up to 7 times. Despite the fact that the landlord was unique, for its entire existence, a comparison between the type of internai rehabilitation operations proved that the initiative was lefi on tenants, the sequence type offloors (wood, bricks or vegetal cover) being unrepeatable. The use ofthe spaces-when proved by micromorphological study-is also distinctive, either cooking area, workshops connected with open fire, or even stables for sheep, for some relatively short episodes. Those 12 rooms are placed on the western wing of the building, on the main facade, facing a major street-Podul Mogoşoaiei-studied in the southem end of the archaeological section. The public road was made of wooden boards supported by wooden pillars buried under the walking levei, similarly with a bridge, from which the street took its name ("pod" meaning bridge). This type of public street, made entirely of wood, is documented in wet lowlands, where stone is not available, like Timişoara (western Romania). The history of the place begins during the late XV 1 h century, for which deep buried huts were discovered. For the mid XVIlh century a new type ofhouse was in use, made ofwood, relatively large and with cellars, typical for aristocracy. In the XVIIlh century this strip of land was no more a constructive area, a little cemetery being discovered in the southem part of the trench. The layers dated between the cellar-houses and the inn are first in which fragments of bricks and mortar were recorded, probably from buildings in proximity. Regarding the political history of the Romanian countries, it might be surprising that from our discoveries Ottoman co ins are missing. W e found instead some Turkish pipes, a good witness of adopting an oriental lifestyle. This paper also presents the main results of the sedimentological and micromorphological study performed on Constantin Vodă Inn archaeological site. The field study firstly considered in the analysis of the sedimentary successions observed on the main stratigraphic profiles and the identification of the different types of units. The main diagnostic criteria observed in the field at the macroscopic leveitexture, structure, color, nature of constituents, homogeneity and degree of compaction-allowed establishing a typology of sedimentary facies necessary for the interpretation in terms of mechanisms of formation, in order to identify human activities and post-abandon transformations of the accurnulated deposits. Thus, different types of construction and arrangement units, occupation units and natural accumulations were recognized. Micromorphological analysis, at the microscopic scale, brings detailed information on the sedimentary units and thus contributes to a better interpretation of the archaeological levels. Extraordinary information provided by this study is the identification of sferulites, structures indicating the presence of the domestic animals (Ovis/Capra) in spaces fitted out with a wooden floor. The palinological expertise-the first ever done in an archaeological site from Bucharest-revealed a predominance of a ruderal vegetation, followed by hydrophilic vegetation and lowlands trees, but not cereals, explained by the position is in the middle of the medieval town.

Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2006

Un moment crucial în dezvoltarea chirurgiei hepatice şi a transplantului românesc îl reprezintă introducerea transplantului de fi cat în România. Primul transplant hepatic (TH) cu supravieţuire a fost realizat în România în Centrul de Chirurgie Generală şi Transplant Hepatic din Institutul Clinic Fundeni în aprilie 2000. Experienţe preliminare au constituit subiectele unor studii anterioare [1,2]. Lucrarea de faţă analizează experienţa acumulată din anul 2000 până în luna aprilie 2006 în TH ortotopic cu fi cat întreg de la donator decedat la pacienţi adulţi (THO). Material şi metode: În perioada aprilie 2000-aprilie 2006 în Centrul de Chirurgie Generală şi Transplant Hepatic din Institutul Clinic Fundeni au fost realizate 45 de TH cu fi cat întreg de la donator decedat la pacienţi adulţi. Datele generale ale seriei sunt prezentate în tab. 1. Tabelul 1 Datele generale ale pacienţilor cu THO Raport Femei/Bărbaţi 20/25 Vârsta 19-57 ani Media vârstei 45 ani

Editura Universitară Ion Mincu eBooks, 2022

Materialele publicate în paginile acestui volum (ediție bilingvă) reprezintă rezultatele cercetării desfășurate în cadrul proiectului SCHOLAR ARCHITECT-Perfecționarea și creșterea calității științifice în învățământul de arhitectură (2020). The materials published in this volume (bilingual edition) represent the results of the research developed within the framework of the project SCHOLAR ARCHITECT-Improving the quality of research and teaching in architectural education (2020).

2012

To determine the effects of isotonic volume overload on cardiac autonomic function and hemodynamic parameters in patients scheduled for spinal anesthesia which benefi ciated of pre-anesthetic hydration. Iin all patients, initially, before starting the pre-anesthetic volume loading, there where a state of cardiac hyper-sympathicotonia. First 10-15 minutes after starting fl uid administration, both sympathetic and parasympathetic cardiac tonuses increase. At the end of hydration, after all liquid volume was administered (10-15 ml/kg), vegetative sympathetic cardiac tonus was signifi catively reduced, meanwhile parasympathetic cardiac tonus was reduced non-signifi catively, being higher than that registered before pre-anesthetic hydration. Hemodynamic indices (TAs, TAd, MAP) increase progressively during volume expansion, meanwhile the pulse reduces progressively with hydration.Isotonic volume loading in pre-anesthesia is associated with reduced spectral component of LF, this refl ecting decreased sympathetic modulation on the heart and increased spectral component HF-refl ecting increased parasympathetic (vagal) modulation on the heart. This can be explained by arterial-cardiac barorefl ex coupling, which is manifested hemodinamically by progressive increase of TAs, TAd, MAP, and progressive reduction of heart rate.

DOAJ (DOAJ: Directory of Open Access Journals), 2007

2014

Rezumat: Relaţia dintre afectarea renală şi patologia cardiovasculară este o problemă bine documentată în prezent în cadrul conceptului "ax cord-rinichi". La pacienţii coronarieni, disfuncţia renală acută apare cu o incidenţă cuprinsă între 9 şi 19%.(1) Din punct de vedere al statusului funcţiei renale preexistente-status cu importanţă prognostică deosebită, aceasta se poate instala la pacienţii cu funcţie renală normală sau cu insuficienţă renală. În studiul nostru dorim să caracterizăm profilul pacienților printr-un studiu analitic, observaţional, retrospectiv de tip cohortă pe un lot de pacienţi internaţi în intervalul 01.01.2012-01.03.2012 în Clinica de Cardiologie a Spitalului Clinic Judeţean de Urgenţă Sibiu, asociat cu un studiu descriptiv al acestui lot. Acest studiu este util pentru a stabili existenţa unei relaţii între infarctul miocardic acut şi disfuncţia renală .