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CNAA / Theses / 2004 / July /

Medical and surgical treatment optimization in children with acute septico-purulent diseases


Author: Mohammed Abu Helal
Degree:doctor of medicine
Speciality: 14.00.35 - Infantine Surgery
Year:2004
Scientific adviser: Eva Gudumac
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.27
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 7 July, 2004
Approved by NCAA on the 14 October, 2004

Abstract

Adobe PDF document0.41 Mb / in romanian

Summary

The group of 107 children with acute septico-purulent diseases (generalized peritonitis, hematogenous osteomyelitis, necrotizing pneumonia) treated conservatively and surgically in the National Scientific and Practical Center of Pediatric Surgery “Natalia Gheorghiu” during 2001- 2003 period of time. This study group was compared with control homogenous group of 100 children selected by stratificated randomization from 216 children with similar septico-purulent diseases, examined and treated traditionally in the same clinic during 1999-2001 period of time.

The exploration methods included: clinical examination, laboratory tests, imaging methods, microbiologic exam, special biochemical tests (for the endogenous intoxication evaluation – dynamic plasmatic concentration of the medium molecular mass peptides and necrotic substances; for the evaluation of septico-purulent process stage – acute faze reactants – C reactive protein, haptoglobine and ceruloplasmine; for nespesific reactivity assessment / complementary factors C3 and C4).

The obtained results allowed to evaluate the endogenous intoxication severity, the acute faze reaction and the systemic inflammatory response in different septico-purulent diseases which made possible elaboration of a medical and surgical management, well differentiated and individualized in dependence of clinical form, age, biologic state. The application of this management allowed recovering of majority patients, reducing the mortality up to 1,9%.