Biomedical subjects

D Stoica

Publications and source records attributed to D Stoica.

5 recordsLinked to original sources

PubMed1998

Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers.

OBJECTIVE: To contain a nosocomial outbreak of vancomycin-resistant Enterococcus (VRE). DESIGN: Intervention study, with comparison of incidence rates before and after intervention to assess whether changes in incidence followed the intervention and were greater than expected based on trends observed before the intervention. SETTING: A 343-bed acute-care hospital serving a predominantly elderly population referred from nursing homes, as well as patients admitted from the community. METHODS: Interventions strategies were tested on three high-risk nursing stations. These included enhanced environmental sanitation; intensive staff retraining in Universal Precautions, body substance isolation, and proper use of gloves; and the use of tympanic thermometers to avoid possible rectal or oral VRE transmission during temperature taking. RESULTS: Nosocomial VRE infections were reduced by 48% 9 months after switching to tympanic thermometers; incidence of Clostridium difficile infections also was reduced. As a result, tympanic thermometers were introduced facilitywide; additional observation for 20 months showed a risk reduction of 60% for VRE and 40% for C difficile. CONCLUSION: Cross-transmission of VRE and C difficile during temperature taking may result in bowel colonization, placing the patient at increased risk for infection. This risk may be reduced by the use of tympanic thermometers.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Splenohepatoplasty in the treatment of hepatic cirrhosis].

The authors review the patho-physiologic arguments that have determined Bénichoux to recommend spleno-hepatoplasty in the treatment of hepatic cirrhosis, and present a group of 7 personal observations in which they have tested this type of intervention. The technique employed is described, as well as the follow-up of the cases that had a favourable evolution. In one of the observations differences between the samples obtained by bioptic puncture before the intervention and those obtained at one and two years after surgery, have demonstrated a marked reduction in the intensity of inflammatory reactions, as well as evident reparation processes in the hepatocytes. The authors consider the intervention as a new type of therapy, allowing for re-vascularization of the ischaemic hepatic tissue, as well as for a slow porto-caval derivation with remarkable results for the cirrhotic patients.

Adolescent↗

PubMedDate not supplied

[Morphological and enzymatic studies of the supratumoral distended colonic loop in colorectal cancers (therapeutic aspects)].

The authors carried out experimental and clinical studies in an attempt to explain the causes leading to anastomotic dehiscences, a major complication of exeresis surgery of the left colon and of the rectum. In this view they have performed in dogs incomplete stenoses at the level of the sigmoid and also made parallel studies of the morphological and histochemical changes occuring in the supra-stenosis colon wall, with those of the supra-tumoral colon wall found in human colo-rectal carcinomas, in the "sub-occlusion" stage. Histological alterations are presented, characterized by marked edema in all the layers of the wall, leading to evidently hampered colon vascularization. From the enzymological viewpoint there was noted an intensive phosphatasic and ATP-ase reaction in all the layers of the colon wall. These studies led to the conclusion that it is necessary to evaluate the degree and the duration of the supra-tumoral colic distension before a decision is taken to carry out primary colectomy or rectal resection (single-step procedure), and not to avoid the practice of a seriated intervention when necessary. The reversibility of the lesions noted by the authors allows for the possibility to perform a resection after the colic wall to be anastomosed has returned to an almost normal condition, thus avoiding the dehiscence of the sutures.

Adenosine Triphosphatases↗

PubMedDate not supplied

High levels of plasma von Willebrand factor in hyperthyroidism.

Both von Willebrand factor antigen and activity tested as ristocetin cofactor, were found to be increased in the 20 patients with hyperthyroidism, while changes detected on the 10 hypothyroid patients did not significantly differ from the mean values recorded in 19 healthy control subjects. It is considered that the high levels of endothelia-derived plasma von Willebrand factor in hyperthyroidism is the result of a long-standing stimulation of vascular endothelial cells by either a direct effect of thyroid hormones or by an excessive adrenergic activity. The present findings represent an important limitation in interpreting raised levels of plasma von Willebrand factor as a marker of endothelial injury or in terms of a thrombotic tendency.

Adult↗

PubMedDate not supplied

[Benign hepatic tumors].

A total of 30 cases are presented, of benign hepatic tumours. As a result of the confrontation of data from the literature with the personal experience of the authors has evidenced the diagnostic difficulties in patients with benign hepatic tumors, especially because these can be erroneously considered as either malignant tumours or as liver cirrhosis. The clinical and the para-clinical pictures are not suggestive in all the cases, and the necessity arises of histopathologic confirmation which can be achieved by puncture and cytologic examination, or by intra-surgery biopsy. This is particularly useful because some of the benign hepatic tumours may benefit from a radical surgical treatment.

Adenocarcinoma↗