Idiopathic polyhydramnios and fetal gender.

OBJECTIVES: To determine the relationship between idiopathic polyhydramnios and fetal gender in the absence of fetal or maternal abnormalities. METHODS: This was a retrospective population-based register study. 295 women with singleton pregnancies complicated by idiopathic polyhydramnios (amniotic fluid index (AFI) higher than 24 cm) who were delivered at our institution from January 2002 till December 2012 were included. Only pregnancies with an uncomplicated outcome were accepted in this study. The incidence of the male to female fetuses was compared with the one in the general population. RESULTS: Among pregnancies complicated by idiopathic polyhydramnios, the following gender distribution was found: 72.9% male and 37.1% female. The distribution in the general population was 51.5% female and 48.5% male. The mean AFI was significantly increased in male fetuses (p < 0.001). The increased AFI did not correlate with gestation age, fetal head circumference or estimated fetal weight. CONCLUSIONS: Idiopathic polyhydramnios is more frequent in male normal fetuses than in female ones.

[Macular pigmentary epiteliopathy]. / Epiteliopatie pigmentara maculara.

This issue presents the case of a patient which present bilateral macular pigmentary epitheliopathy.

[Our attitude in esophageal and gastric post-caustic lesions]. / Atitudinea noastra în leziunile esofagiene si/sau gastrice post caustice.

The authors present the experience of the surgery section in patients treatment with oesophagian or gastric lesions after caustic substances ingestion. From a group of 70 patients who were treated in a conservative way (with medicines and dilatations) 60 of them returned to the surgery for nourishment gastrostomy. In two cases, the oesophagian and gastric lesions was established preoperations trough radiologic examination and in thirteen cases the lesions were found intraoperation. The adopted attitude is exemplified presenting a case. Under a general anaesthesia is done a limited resection (about 3 cm) with termino-terminal anastomosis of the stenosed antral area keeping the vascular arches of the little and big gastric curvature. A minimal a la Gavriliu gastrostomy is mounted on the vertical area of the little curvature. Through the gastrostomy (Petzzer) probe is put a tube of perfusor to the first jejununal ansa. In the first 48 hours the Petzeer is used for the gastric drainage in the perfusor probe for feeding. After 48 hours the jejununal probe is taken away and the gastrostomic feeding begins. After six mouths from the caustic ingestion 25 patients come back again for oesophagian reconstruction. For 24 patients the Gavriliu I, II proceeding is applied and for a case it is used the small intestine ansa. They lost 3 patients (2 with gastric tube and 1 with intestinal ansa). The evolution in 24 years time was very good.

[Oncological emergencies in the emergency department]. / Urgente oncologice în departamentul de urgenta.

AIMS: to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. MATERIAL AND METHODS: we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iasi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED. RESULTS: 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications. CONCLUSION: 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with neoplasia and those with high-suspicion neoplasia first diagnosed in the ED.

[Congenital ocular malformations encountered in structural and numerical chromosomal anomalies]. / Malformatii congenitale oculare întîlnite în unele anomalii cromozomiale structurale si numerice.

The paper reports on a study of 32 cases of new-born children who presented various ocular congenital anomalies, studied by karyotype. The genetic investigation was performed for identifying the risk factors.

[Current possibilities of optimizing emergency tetanus immunization]. / Posibilitati actuale de optimizare a imunizarii antitetanice de urgenta.

Retrospective analysis of the tetanus cases, admitted over a six year period, shows the high risks involved by the insufficient immunoprotection. The failure of emergency immunization, with its effects on the incidence and evolution of the disease, may be accounted for by : the difficulty in establishing the vaccination past history, probable decrease of protection with time due to basal immunization, inconstant response to the booster dose, immunodepressive side effects, the drawbacks of antitoxic serum. With reference to their own experience and the published data concerning the methods applied for obtaining a more rapid response to anatoxin and possible optimizing of the protective titre concurrent with the incubation period of tetanus. Experimental investigations have demonstrated the superiority of repeated, multifocal inoculations for obtaining an earlier antitoxic immunity.