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Biomedical subjects

O Alexiu

Publications and source records attributed to O Alexiu.

At least 19 recordsLinked to original sources
PubMed1975

Gastro-intestinal haemorrhage from peptic ulcer. An evaluation of bloodless transfusion and early surgery.

Over a 3-year-period 72 patients with upper digestive tract haemorrhage due to peptic ulcer were transfused exclusively with isotonic sodium chloride and glucose solutions in equal quantities. The results are compared with 69 patients treated previously in whom conventional blood transfusion regimes had been used. Transfusion therapy was combined with emergency surgery involving vagotomy and draininage, with surgical haemostasis in situ. There were no significant differences between the two groups with regard to anaesthesia, surgery and post-operative managemement. Apart from anemia, there were less early and late complications in the group not receiving blood. The amount of crystalloid solutions administered varied between 7000 ml and 19,000 ml causing a diuresis of 1000 ml to 5300 ml within the first 24 hours. The use of this transfusion regime for haemodynamic re-equilibration in upper gastro-intestinal haemorrhage due to ulcer, in cases in which haemostasis can be obtained with certainty by emergency surgery, allows transfusion of stored blood and colloid solutions to be avoided and emergency surgery to be safely undertaken at the earliest moment. The severe acute anaemia which is caused appears to create no special problems.

Adolescent↗
PubMedDate not supplied

[Upper digestive hemorrhages of ulcerous nature (management and experience)].

A number of 135 cases were examined, presenting with superior digestive hemorrhage of ulcerative origin. The analysis of the cases was made by two comparable groups. In the first one of the groups the volemic re-equillibration was based on the administration of blood and surgery was carried out, in principle, on a "cold" condition. In the second group volemic re-equillibration was achieved exclusively with isotonic non-colloidal volemic solutions that were administered before, during and after surgery (0.9% NaCl solution and 5 g% glucose solution in equal amounts). Surgery was performed as an emergency and vagotomy was made, as well as surgical hemostasis. The results obtained have allowed for the conclusion that, by providing efficient surgical hemostasis and volemic re-equillibration with isotonic non-colloidal solutions blood transfusion and its untoward side-effects can be avoided.

Adolescent↗
PubMedDate not supplied

[Gastric consequences of toxicoseptic agression].

This study is concerned with gastro-secretory and motor answers. It was carried out in two groups of patients and the results obtained were compared. The following aspects were noted: a. the control group was represented by 10 patients that had been exposed to anesthesic-surgical aggression; b. the second group was formed by 20 patients with toxico-septic syndrome of various etiologies and in different stages of evolution; - secretory and motor gastric disturbances take on an evolutive dynamic character, according to the clinico-biological phase of the syndrome; in the acute stage absolute hypersection is noted, as well as from the viewpoint of the rate, of hydrochloric acid, and gastric hypomotility; in the chronic stage there is acid hyposecretion both insulin- and histamine-resistant and in 30% of the cases there is anachlorhydria; to the general-metabolic phase of inversion corresponds, at the gastric level; a return to normal of the motility and of the acid gastric secretion.

Anesthesia↗
PubMedDate not supplied

[Ulcer recurrence after vagotomy].

In the author's statistics concerning vagotomy with simple gastric draining, performed for gastric ulcers and duodenal ulcers (a number of 556 total abdominal vagotomies, 196 selective gastric vagotomies, 179 selective high vagotomies), ulcerous recidives occured 23 times (2,4%). The authors conclude on the following aspects: -- ulcerous recidives occur more frequently following classical, selective gastric vagotomy; -- the diagnosis of ulcerous recidive is difficult and it should be based on clinical and para-clinical explorations, as well as on "test-therapy"; -- the efficiency of iterative vagotomy raises the problem of the incomplete vagotomy in the etiology of the recidivating ulcers.

Adolescent↗
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

[Anatomical bases of incomplete vagotomy].

The results are presented, of an intraoperative anatomical study concerning the variable disposition of the vagal nerves in the abdominal section of the oesophagus. This study was carried out in a large number of patients with ulcers in which vagotomy was performed. All the patients were followed and in all periodical controls were made after surgery in view of detecting possible ulcerative relapses. The authors conclude that the negative results of vagotomy are due to the fact that this is usually incomplete. The study demonstrated the existence of many variants of the anatomical disposition of the vagal nerves at the level of the abdominal oesophagus, which the authors synthesize in a practical scheme which is available to any surgeon. The risk of an incomplete vagotomy is the highest when the patient presents an anatomical variant with a large number of branches.

Humans↗