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M R Diaconescu

Publications and source records attributed to M R Diaconescu.

At least 19 recordsLinked to original sources
PubMed1995

[Secondary hyperparathyroidism].

Secondary (renal) hyperparathyroidism appears in chronic renal failure, sometimes in patients on chronic dialysis. Other causes includes rickets and osteomalacia. These diseases are associated with poor calcium and vitamin D absorbtion from the small bowel. Two patients with chronic renal failure maintained on chronic haemodialysis from two and three years, respectively underwent subtotal parathyroidectomy: removal of three glands and preserving a half of a gland in situ. The diagnosis and surgical indication was made upon clinical (bone pain and severe itching), radiological (demineralisation, ectopic calcifications) and biochemical (hypercalcemia, hyperphosphoremia, increased values of alkaline phosphatases) arguments. Postoperatively the improvement is defined by a return to normal in the clinical, laboratory and radiological parametres. The most appropriate operation for secondary hyperparathyroidism is still unresolved one of two techniques is performed according to the preference of the surgeon: subtotal parathyroidectomy or total parathyroidectomy with autotransplantation of parathyroid fragments into forearm muscle.

Adult↗
PubMed1991

[The hyperfunctional thyroid nodule].

Authors report their experience of 22 years regarding 284 patients with hyperfunctional thyroidal nodules (279 operated), representing 12.4% of the 2,289 cases of thyroidal (875 hyperthyroid) diseases treated during this period. The diagnosis was established on the basis of the confrontation of the anamnestic symptomatology and of that found at the clinical examination--which confirmed the pure character of thyrotoxicosis by showing the presence of a thyroidal nodule--with the study of the global glandular function and the scintigram, completed with dynamic tests. Among the typical clinical and scintigraphic, usually severe, forms (with cardiothyreosis) may be distinguished asymptomatic or atypical forms (with dissociated or intermittent manifestations). The treatment of the toxic thyroidal adenoma is surgical, except some contraindications of a general order. The surgical treatment is aimed at achieving the permanent cure of the disease, without sequelae or functional and/or morphological relapses. The subtotal lobectomy (210 cases) is preferred as an exeresis procedure to the enucleoresection (45 cases). In most operated cases (93%) the immediate clinical and biological results were favourable.

Adolescent↗
PubMedDate not supplied

[Prevention and therapy of postoperative thyrotoxic crisis].

Out of a group of 361 patients with various anatomo-clinical forms of hyperthyroidia--of which 328 had underwent surgery--hospitalized in the Surgical Clinic from Jassy between 1965 and 1974, a total of 17 observations are analised, from the clinical and the therapeutical viewpoint, that showed postoperative thyreotoxicosis crisis. The fact is stressed that the prophylaxis of the crisis is dominated by the principle that no case of hyperthyroidia should be operated on before it has been perfectly balanced from the endocrinological viewpoint. The complex treatment of the cases that are presented included a symptomatic component to which were associated oxygen therapy, tonics, vitamins, hepatotrop preparations, eventually antibiotics. The results obtained--complete recovery in all the cases--can be compared with the best from the literature.

Adolescent↗
PubMedDate not supplied

Management of perineal impalement injuries.

Between 1975 and 1990, 18 cases of sphincter and pelvic floor injuries, of which 7 isolated and 11 part of severe polytraumas, were treated. Thirteen cases benefited from primary repair. Colostomy was required in 9 cases due to the complexity of lesions, in other 5 cases the wounds drainage and colostomy were undertaken. Secondary repair was done after 2-6 months. The functional results in 11 patients indicate a good continence in 6 of 7 cases with primary repair. The results of secondary repair are satisfactory.

Adolescent↗
PubMedDate not supplied

[Choristomas].

The authors present 21 cases of aberrant pancreas with gastric and duodenal location (heterotopias under the shape of inclusions, nodules or true adenomas) included besides the rare cases of adenoma developed from Brunner and Lieberkühn glands in the "choristomas" category. Asymptomatic or with clinical phenomena and complications "borrowed" from the associated peptic ulcers (15 cases) the diagnosis of pancreatic heterotopias is usually an interoperatory or even histopathological surprise, the X-ray examination with the classical image "in cocard" and the endoscopy being rarely evocative. The surgical treatment is generally conservative and is dominated by the presence or lack of the concomitant peptic ulcer.

Adult↗
PubMedDate not supplied

[The "cold" thyroid nodule].

The main problem posed by an (apparent) solitary thyroid nodule is cancer identification, present in about 10% of the nodules excised surgically. This percent might increase to 25-30% in the cold scintigraphic nodules. Therefore, a combination of all the methods for nodule assessment is necessary: anamnesis, physical examination, functional tests, therapeutic test with tyrosine and thyroid imaging, but mainly the intensive active exploration including puncture-biopsy with a fine needle and exeresis with extemporaneous and paraffin morphological checking. Starting from a two decades' experience of a group of endocrinologists, surgeons, anatomo-pathologists and specialists in nuclear medicine, in 2,289 thyropathies operated--of whom 1691 (poly)nodular goitres and 1,190 non-capturing nodules--the authors suggest an investigation algorithm for achieving a differentiated surgery in terms of the pre- and intraoperative morphological findings. This attitude permitted both the improvement of the surgeries of thyroid cancers and the exeresis of benign nodules under low-risk surgical conditions or avoidance of a "non-necessary" surgery.

Biopsy↗
PubMedDate not supplied

[Isolated traumatic lesions of the abdominal wall musculature].

Six cases of isolated traumatic lesions of the abdominal wall muscles (2 ruptures of the right abdominal muscle and 4 of the anterolateral muscles) are reported. The presence of a "fixed" hematoma or even of a true subcutaneous eventration, the case history (for finding out the injury mechanism or unusual muscular effort), the X-ray examination of the abdomen and especially the ultrasonography can establish the diagnosis. The treatment of this lesion is usually conservative, surgery (performed in 3 cases) being indicated only in those ruptures with large parietal defects or hematomas or in case of diagnostic doubts.

Abdominal Muscles↗
PubMedDate not supplied

[Hepatic abscesses].

The authors analyse 16 cases of hepatic abscesses recorded in a 10-year interval. The difficulties in assessing the etiology and diagnosis, as well as in indicating an effective treatment are discussed. The clinical aspects and investigation methods, among which scintigraphy, arteriography and especially echotomography are extremely useful in making the diagnosis and in localizing the collection, are reviewed. The bacteriological examination revealed the presence of various organisms in 14 patients, the examined specimen of pus being negative in the remainder of 2 cases. The treatment was surgical in most of the cases (15) consisting in an abdominal approach or posterolateral with rib resection (1 case) and drainage. In 3 cases the intervention was extended to cholelithiasis which was the underlying cause of the abscess. The ultrasound-guided transparietohepatic drainage was performed in 2 cases. No death was recorded.

Adolescent↗