Objective. The purpose of the study is the inventory of isolated pathogens from the patients treated in the General Surgery Department of the Baia Mare Emergency County Hospital, the associated treatment, the postoperative mortality and the related costs. Materials and methods. All positive cultures from samples collected in 2017 from patients hospitalized in general surgery department (surgical wound, peritoneal fluid, sputum, urine, stool, hemoculture, tegument) were selected. From the patient files, the type of surgical procedures performed, duration of hospitalization, costs related to their hospitalization, antibiotic therapy and postoperative progression was retained. Results. A number of 411 patients were diagnosticated with infections (11.47% of all patients hospitalized in 2017) and 686 bacteriaidentified. There were 149 infections with E. coli (36.3%), 87 with Coagulase-negative staphylococcus (21.2%), 78 with Enterococcus (19%), 67 with Streptococcus viridans (16.3%) and 58 with methicillin-sensitive Staphylococcus (14.1%). Most deaths were associated with Escherichia coli infection -22 patients (56.4% of the patients infected with this bacterium, p = 0.01), and out of all the germs, Acinetobacter baumannii was the only one found more frequently in healthcare-associated infections compared to communityacquired infections (17 vs. 6).The average length of hospital stay in patients with infections was 10.9 days compared to the average length of stay of all the patients in 2017 which was 5.6 days. Mortality was 9.7% in patients with infections, compared with a general mortality of 4.8% in 2017.Certain risk factors, such as anemia, prolong the length of hospitalization and increase the risk of death . Conclusions. The most common infections treated in the General Surgery Department were those communityacquired. The most common deaths were reported in patients infected with E. coli, Enterococcus, Candida and Acinetobacter. Stricter isolation of patients infected with Acinetobacter baumannii is required. The association of anemia in the patients hospitalized with infections significantly increases the risk of death and prolongs the duration of hospitalization.
Introduction. The SARS-CoV-2 pandemic has profoundly affected health systems by relocating resources, enforcing restrictive measures and burdening health care workers. The study aims to assess the changes in the treatment and the evolution of cancer patients in a county in Romania, with a population of over a half million inhabitants. Patients and method. Patients with breast, gastric, colorectal, and lung cancer were studied over a two-year period: 14 months before the onset of the pandemic and 10 months after its beginning. The number of new cases of cancer, the number of chemotherapy and radiotherapy sessions, the number of surgeries and deaths from these four types of cancer were recorded. Results. During the pandemic, fewer chemotherapy sessions were administered for all cancers (p<0.0001). The number of radiotherapy sessions for breast (p<0.007) and colorectal cancer (p<0.002) increased by banning patients from going to university hospitals and decreased for lung cancer (p<0.03) which has symptoms similar to those of the SARS-CoV-2 virus. Conclusions. Cancer patients had limited access to chemotherapy. Their diagnosis and treatment were included in the same category as non-lifethreatening diseases. Testing, quarantine and travel limitation were not accompanied by additional safe medical services for the oncological patients. The death rate is inconclusive because the time since the onset of the pandemic is shorter than the natural evolution of the types of cancers studied.
Background: The indications of splenectomy and its ways to perform are today well coded. Recognizing the risks of fulminant infections and discoveries in the field of surgical techniques, in anesthesia but also in hematology and oncology, have reduced morbidity and mortality rate after total or partial splenectomy, regardless of the disease for which it was indicated. Case Presentation: The article aims to present two cases of splenectomy performed in special conditions: spleen lesion operated laparoscopically in child and splenectomy in case of extreme splenomegaly, with the revision of the specialized literature. Conclusion: Laparoscopic splenomectomy is feasible in case of splenic trauma, provided that the condition of the patient is stable and a well-trained team and high-performance medical equipment are available. In the case of splenomegaly, the adhesions and the branching of the spleen vessels make the difference between easy and difficult splenectomy.
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