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Navolan D.,Clinical Emergency Municipal Hospital | Ciohat I.,Prenatal Medicine Laboratory | Farcas S.,Genetic Laboratory | Gug C.,Dr Cristina Gug Genetic Laboratory | And 2 more authors.
Timisoara Medical Journal | Year: 2011

Objective: To analyze the risk assessment program for fetal aneuploidies done by the Municipal Clinical Emergency Hospital Timisoara. The primary indicators are: the rate of false positive results and the detection rate. Materials and methods: A triple test determination (AFP, hCG, Free E3) and a fetal morphology ultrasound was performed on 2169 gravidas. The aneuploidy risk was assessed based on a standard mathematical formula including biochemical and ultrasound results. High risk gravidas received amniocentesis and a fetal karyotype in one of the four genetic centers in our area. The antenatal and postnatal diagnosed cases were counted. Results: The age of gravidas was 29.3+/-4.5 years (Mean+/-DS) and the gestational age at the moment of screening was 16.3+/1.1 weeks. 43 gravidas had an age-risk and 49 gravidas a biochemical risk higher than 1:100 while 184 gravidas had an age-risk and 163 gravidas a biochemical risk higher than 1:250. The biochemical risk was adapted based on second trimester ultrasound. In the evaluated cases, we performed 62 amniocentesis, from which 4 were positive: 3 Down syndrome fetuses and 1 Turner syndrome. There were one newborn with Down syndrome (due to poor doctor - patient communication). The rate of false positive cases was 2.85% and the detection rate was 80%. Conclusions: The combined assessment of aneuploidies based on age, biochemical triple test parameters and the second trimester ultrasound remains an applicable method in our system as long as not all gravidas come for screening during the first trimester of pregnancy. Source

Sima L.V.,Victor Babes University of Medicine and Pharmacy Timisoara | Sima A.C.,Clinical Emergency Municipal Hospital
Timisoara Medical Journal | Year: 2011

Introduction: Bariatric surgery is a method of treating morbid obesity which raised more and more interest in the past years. Among all types of intervention, the most frequently used is Roux-en-Y gastric bypass, an intervention both restrictive and malabsorbtive, which leads to best results for weight loss. In Romania, bariatric surgery, and especially Roux-en-Y gastric bypass, is not widely practiced due to poor addressability of patients, both by lack of information, and the poor recommendation from general practitioners and specialists in metabolic diseases. Material and methods: The study group includes 14 patients aged between 18 and 65 years, with BMI above 40 kg/m 2, evaluated before surgery as per the indications for this kind of treatment. The study aims to present the complications that occurred in this group of patients in which Roux-en-Y gastric bypass was performed in the Surgery Department of the City Hospital Timisoara. The surgery was done by xifo-umbilical laparotomy technique, because of the very high costs of laparoscopic approach. Subsequently, patients were followed postoperatively at 1 month, and then every 3 months, up to 2 years. The results were compared to those of the laparoscopic approach described in the literature regarding length of stay, operative time, early and late complications. Results: The only complications found were wound infections and incisional hernias. Conclusions: Introducing some changes in terms of restoring the abdominal wall, there is hope to eliminate these complications. The laparoscopic technique is followed by fewer wound infections and incisional hernias, a greater number of anastomotic leakages and involves higher price, being inaccessible to many patients with morbid obesity. The long term results regarding excess weight loss have proven to be better in gastric bypass performed by laparotomy. Source

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