[Incidence of tuberculous infection in Caracal in 2000]. / Incidenta infectiei tuberculoase în municipiul Caracal în anul 2000.

Taking into consideration the informational value of the yearly risk of tuberculous infection as an isolated epidemic indicator which is able to define by itself the present phase and the trends of the tuberculous endemic in a population, we tried to establish its value at the first grade pupils in the city of Caracal by using two methods: 1. the indirect one starting from the prevalence of infection using the A. Lotte formula: YRI = 1.24% +/- 0.45, p = 0.05, s = 0.32, Es = 0.16 (the average level in 1992, 1993, 1994, 1999 and 2000); 2. the direct one, by testing with tuberculin a group of 184 pupils twice at one year's interval. YRI = 2.65% in 1999/2000. By using the student test we demonstrated that the two values are statistically different, without being able to state which one is closer to reality, but irrespective of the chosen value, to reach the present level of yearly tuberculous infection of the western countries we need about ten to twenty years, if we admit that beginning from this moment the annual decrease will be maximal (14%).

[Retrograde cholangiopancreatography (ERCP) and endoscopic sphincteropapillotomy (ES) in the diagnosis and treatment of common bile duct (CBD) lithiasis]. / Colangiopancreatografia retrograda (ERCP) si sfincteropapilotomia endoscopica (ES) in diagnosticul si tratamentul litiazei caii biliare principale (CBP).

The common bile duct (CBD) stones often gives real difficulties of diagnosis and treatment. The ultrasound (US) does not offer in a significant percentage of cases certain diagnostic data, and the unconventional imaging techniques such as computer tomography (CT) are yet less accessible. ERCP appeared in the last period as an optional method for the diagnosis of common bile duct stones, and, moreover, permitted the development of the nonsurgical treatment possibilities. ES and the extraction of stones revealed in this frame as preferable, especially in the high surgical risk cases. This study presents the results of ERCP performed in 547 and the therapeutic value of ES in 284 cases with CBD stones (conclusions of the ERCP and ES used in the clinical practice, in our clinic, in the last three years). In 81.69% cases ES managed the dezobstruction of the CBD, with a frequency of complications of 4.33% and a related mortality rate of 0.78%.

[A periventricular tumor associated with acute kidney failure and bilateral renal cortical necrosis]. / Tumora periventriculara asociata cu insuficienta renala acuta si necroza corticala renala bilaterala.

The authors present a case in which the clinico-evolutive particularity was an association between a periventricular tumour (multiform glioblastoma) and acute renal failure. Considerations are made on clinical signs determined by the neoplastic process (apraxia-agnosia hyperthermia, etc.), and on the disseminated intravascular coagulation syndrome related to the acute renal failure.

Continuous electrocardiographic monitoring during balloon dilatation in achalasia.

Electrocardiographic (ECG) changes in nine patients under continuous ECG monitoring before, during and after balloon dilatation for achalasia were followed; of these, three had ischaemic heart disease (IHD). One or several abnormalities including sinus tachycardia, supraventricular or ventricular ectopic beats, S-T segment depression and T-wave flattening appeared during the procedure; these were more commonly found in patients with IHD. Despite the high incidence of recorded ECG abnormalities, these were transient, and no treatment was needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during balloon dilatation for achalasia, particularly when this procedure is performed in patients with IHD.