Wound infections with multi-drug resistant bacteria.

INTRODUCTION: Wound infections remain a public health problem, despite the progress made on improving surgical techniques and antibiotic prophylaxis application. Misuse of antibiotics to prevent bacterial infections leads to increased bacterial resistance and their dissemination. MATERIAL AND METHODS: The study refers to 470 samples taken from wound infections of which only multi-drug resistant strains were selected for study, using two special culture mediums (Metistaph-2 for methicillin-resistant staphylococci and ESBLs-Agar for extended-spectrum betalactamases secreting bacteria). Sensitivity of these strains was tested using the diffusion method. RESULTS: Of all studied samples, a rate of 27.6 bacterial strains showed multi-drug resistance. Among them stood primarily Staphylococcus aureus; both MRSA strains and ESBL Gram negative bacteria studied showed high resistance to aminoglycosides, quinolones, third generation cephalosporins and low to fourth generation cephalosporins. No vancomycin resitant nor vancomycin-intermediate Staphylococcus aureus strains were isolated. CONCLUSIONS: Knowing the antibiotic resistance is very useful in antibiotic "cycling"application, avoiding this way the emergence of increased resistant strains.

[Subconjunctival nodule with Dirofilaria repens]. / Nodul subconjunctival cu Dirofilaria repens.

Dirofilaria repens infection, a zoonotic illness, is rarely seen in humans; it is more frequently met over the endemic areas of the Southern Europe and Sri Lanka. The authors report a case of dirofilaria conjunctivae in a 27 year old woman from Craiova; such infections are hardly to be found in our country. Our patient presented a mobile, bulbar, subconjunctival tumoral formation which was surgically removed; immature Dirofilaria repens was revealed into it. Case particularity was that the patient had not visited any of the endemic areas. Environmental changes with global warming can lead to some new unspecific diseases in our country.

[Oculo-orbital manifestations of paranasal sinus diseases]. / Manifestari oculo-orbitare în afectiuni sinusale.

PURPOSE: The paper is a study of the oculo-orbital affections established by the sinusal lesions. METHODS: The study is retrospective for five years and it is affected by the patients with ocular and orbital affections hospitalized in Ophthalmological Clinic. Were used the sheets of the patients and a collaboration with ORL Clinica, where the sinusal affections were surgical cured. RESULTS: The ocular lesions caused by the sinusal inflammations were: acute uveitis, orbital cellulitis, unilateral exophthalmia without obvious inflammatory signs. The oculo-orbital signs were missing with oculo/sinusal treatment. CONCLUSIONS: Without treatment, the inflammatory or tumoral affections of the paranasal sinus, established oculo-orbital complications and the patients request the first time the oculist. It is necessary a collaboration between the ORL--ist and the oculist physician for of these cases.

[Changes in the vascular wall in the conjunctiva of patients with diabetes mellitus]. / Modificari ale peretelui vascular în conjunctiva bolnavilor cu diabet zaharat.

Venous capillary wall in type II diabetic patients' conjunctiva was examined. The study was performed on conjunctiva fragments removed from diabetic patients during the operation of senile cataract. The fragments were fixed in Lillie's solution then studied by using optical microscopy with usual but histochemical stainings, too. Conjunctiva fragments removed from patients of the same age, being operated by senile cataract and one conjunctiva from ten years old patient were examined by using the same techniques as they could be compared. Computer determinations of the external and internal diameter of the same capillary in all three groups were performed. Venous capillary wall thickening by type IV collagen hyperproduction in all the aged patients was noted. This kind of thickening is more revealed in aged diabetic person. Type I-III collagen presence in the capillary wall of the diabetic patients was noted, too. The average value of the differential between the external and internal diameter was increased in the diabetic patients with diabetic retinopathy. Venous capillary wall thickening in the diabetic patients is due to the basal membrana both by means of the type IV collagen hyperproduction and presence of the I-III collagen, too.

[The role of the sympathetic system in ocular pathology]. / Rolul simpaticului în patologia oculara.

Neurovegetative system consist of preganglionar fibre from neural tube and postganglionar from neural crest. We examined 13 patients with Fuchs' syndrome. The first sign was heterochromia, followed by keratic precipitates, pathological cataract and finally secondary glaucoma. The cause of Fuchs' syndrome was the damage of superior cervical ganglion. We studied 4 cases of Claude Bernard Horner's syndrome through damages of preganglionar sympathetic system, in 3 cases because of laterocervical neoplasia and in the last case through brachial plexus damages.

[Hemorrhagic glaucoma]. / Glaucomul hemoragic.

The hemorrhagic glaucoma defines a clinical syndrome which recognizes as a frequent symptoms the hemorrhagic element, and from the morphopathological point of view the presence of some neoformation vessels at the level of the iris and camerular angle. 22 clinical observations of hemorrhagic glaucoma which appeared during one year are analyzed. It is shown that the new vessels appear as a reaction of the tissues hypoxemia and especially to alon of the oxygen pressure that determines the increase of the vessels. Also in the hemorrhagic glaucoma appears a deficiency of the venous reaction which determines a deficiency of the venous flow. The new vessels appear because of the hypoxemia and acid lactic accumulation only as the presence of a vital iridian tissue, because the new vessels do not appear in necrotic tissues.