Validation of the Romanian translation of the ABC-V (Assessment of Burden in Chronic Venous Disease) questionnaire.

The objective of this study was a psychometric evaluation of the Romanian translated version of ABC-V (Assessment of Burden in Chronic ­ Venous Disease) questionnaire in patients with uncomplicated varicose disease of lower limbs. All components of the questionnaire were translated from the English version into the Romanian language and after that backwards, discussed, adopted and pre-tested. Evaluation of the final version of the translated questionnaire demonstrated acceptable results: missed questions in 3% of forms, no ceiling effect and low floor effect, good split-half reliability (rs = 0.61,p < 0.01) and significant correlation between test and re-tests cores (rs = 0.86, p < 0.01). There was no significant influence of age and sex upon average ABC-V scores. Study results support the application of ABC-V questionnaire for assessing the severity of chronic venous disease as well as for quantitative evaluation of patient satisfaction and health status improvement after varicose vein treatment in the Romanian-speaking population.

Extraluminal venous interruption for free-floating thrombus in the deep veins of lower limbs.

The free-floating thrombus (FFT) represents a particular form of deep vein thrombosis with extremely high potential of fatal pulmonary embolism. The purpose of the study was to evaluate the early results of aggressive surgical approach to FFT. During the period 2005-2008 years FFT was diagnosed in 13 patients. Demographic characteristics of patients: medium age--54.7 years, male--76.9%, significant comorbidity--5 (38.5%) cases. Localization of FFT: superficial femoral vein (SFV)--5 (38.5%), common femoral vein (CFV)--4 (30.7%), external iliac vein (EIV)--2 (15.4%), inferior cava vein (ICV)--2 (15.4%). Manifestations of previous pulmonary embolism were documented preoperatively in 3 (23.1%) cases. The following emergency surgical procedures were performed: ligation--3 (23.1%) or plication--2 (15.4%) of SFV; plication of CFV--5 (38.5%) patients, combined in 4 cases with partial thrombectomy (free-floating part of thrombus); plication of common iliac vein--1 (7.6%); plication of ICV--2 (15.4%) cases. Primary or recurrent cases of clinically significant pulmonary embolism were not detected in the postoperative period. The accumulated experience of surgical management of patients with FFT reveals the important role of deep vein ligation/plication in prevention of fatal pulmonary embolism.

[Prevention of recurrent varicose veins after surgery caused by phenomenon of neovascularization].

The aim of study was to evaluate the effectiveness of surgical "barrier techniques" in prevention of phenomenon of inguinal neovascularization in patients with varicose veins of lower limbs. There were 68 patients (80 limbs) treated with flush ligation of saphenofemoral junction, stripping of great saphenous vein and avulsion of varicosities. Patients were divided in three groups: I (no "barrier techniques")--40 limbs; II (anatomical barrier)--20 limbs and III (synthetic barrier)--20 limbs. Duplex ultrasound was performed at interval of 24 months postoperatively. Signs of neovascularization were found more frequently in group I--22.5% of limbs vs 7.5% of limbs in patients with utilization of "barrier techniques". There were types B1, B2a and B2b of neovascularization only, according to Fischer classification. We conclude that use of a "barrier techniques", either anatomic or synthetic, is associated with a decreased incidence of neovascularization at the level of the saphenofemoral junction compared with a control group.

Surgical treatment of severe chronic venous insufficiency caused by pulsatile varicose veins in a patient with tricuspid regurgitation.

A case of severe chronic venous insufficiency caused by pulsatile varicose veins in a 46-year-old man with tricuspid regurgitation is presented. Active venous leg ulcer complicated with recurrent venous bleeding and inefficacy of conservative management serve as indications for surgical treatment. This case demonstrates the possibility of radical surgical correction of pathological venous reflux by means of saphenofemoral ligation, foam sclerotherapy and subfascial endoscopic perforator surgery.

Primary retroperitoneal mucinous cystadenoma. A case report and brief review of the literature.

Retroperitoneal mucinous cystadenomas are extremely rare tumors found exclusively in women. An additional case of retroperitoneal mucinous cystadenoma histologically confirmed in a 41-year- old woman is reported herein. Computed tomographic (CT) scanning showed a cystic mass, 21 x 16 cm in size, in the right retroperitoneal space. Removal of the cystic tumor was performed without any other additional procedures, and further histological diagnosis was confirmed as primary mucinous cystadenoma of borderline type. Histologic findings suggested that the tumor developed from mucinous metaplasia of the coelomic mesothelium. Clinicopathological features, diagnostic findings, therapeutic options and the outcome are analyzed in this paper having reviewed the cases reported in world literature.

[Key problems of the pathogenesis of infection]. / Kliuchevye voprosy patogeneza sepsisa.

The authors analyse the results of clinico-immunological studies in 452 patients with various forms of pyogenic surgical infection; 292 of the patients had surgical sepsis. It is proved that the condition of the primary and secondary purulent foci determines the course of the wound process and the occurrence and progress of sepsis. Radical surgical debridement of the wound leads to early optimization of the condition of the immune system and creates conditions for effective immunologic correction and intensive therapy.

[Immunocorrection with pentaglobin in wound infection and burn disease]. / Immunokorrektsiia pentaglobinom pri ranevoi infektsii i ozhogovoi bolezni.

Patients with wound infections and extended burns were treated with pentaglobin (Biotest-Pharma), a serum preparation containing high concentrations of immunoglobulin M. The use of the preparation at early stages after surgical operations in the patients with wound infections or at the beginning of active surgical treatment of the patients with burns decreased the terms of the body temperature normalization as well as normalization of the immunological, hematological and biochemical indices. The most pronounced efficacy of pentaglobin was observed in the patients with severe microbial toxemia. A scheme for pathogenetic immunocorrection of wound infections and burns was developed. It is based on simultaneous recording of intensity of immunological responses in peripheral blood and intensity of protective reactions in wound tissues.

[Sandoglobulin immunocorrection in trauma]. / Immunokorrektsiia sandoglobulinom pri travme.

Twenty one patients with the long-term compression syndrome (LCS) and 12 patients with burns treated with sandoglobulin in combination with antibacterial therapy were followed up. The control groups included 14 and 18 patients, respectively. All the patients had wound infections. Increased or lowered respiratory burst of peripheral blood neutrophils and lowered contents of active T-lymphocytes were detected in the majority of the patients. The patients had also an increased respiratory burst of tissue homogenate in the primary focus. Sandoglobulin decreased the periods of normalization of the immunological indices, body temperature and leukogram shifts to the right. The most pronounced effect of the drug was recorded before radical operations, i.e. in the presence of acute microbial toxemia or in patients with severe and extended burns. The procedure of immunological monitoring developed by the authors rapidly estimates the indications to the use of sandoglobulin alone or in combination with other immunomodulators.

[Clinical and laboratory effect of leukinferon in purulent infections]. / Kliniko-laboratornyi éffekt leikinferona pri gnoinoi infektsii.

Clinical trials of human leukocytic alpha-interferon for injections, leukinferon were performed in 51 patients with different forms of surgical purulent infections. It was shown that leukinferon lowered the terms of normalization of body's temperature, leukocytosis, respiratory neutrophilic outbreak and levels of active T-lymphocytes. The same was observed when leukinferon was used prophylactically in cardiosurgical patients. The effect of leukinferon depended on the level of radical operations on primary purulent foci and severity of the patient's state. Leukinferon had immunomodulatory properties and mainly influenced the system of neutrophilic phagocytes. The action was lymphocyte-mediated. The rapid effect of leukinferon makes it necessary to recommend it for treatment of patients with purulent infections as an agent of urgent immunomodulation.