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Arta, înregistrată la Ministerul Justiţiei al Republicii Moldova lanr. Testemiţanu 29, Spitalul Clinic Republican, et. Tipar executat la Tipografia Sirius S.

MD, Chişinău, str.

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Lăpuşneanu, 2 tel. Ion Ababii Preşedinte de onoare al Congresului. Rectorul U. Nicolae Testemiţanu Conf.

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Gabriel M. Iurie Acalovschi, România Prof. Anthony Cunningham, Irlanda Prof. Paolo Pelosi, Italia Comitet local de organizare Dr. Ruslan Baltaga Conf. Adrian Synergy pierdere în greutate bakersfield Conf.

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Mihail Borş Conf. Gheorghe Cazacu Dr. Alexandru Clim Dr. Sergiu Cobiletchi Conf. Alexandru Cornogolub Conf.

Lidia Dolghier Dr. Petr u Gherghelegiu Conf. Nicolae Gurschi Dr. Cornelia Gutu-Bahov Dr. Alexandru Hadjioglo Dr. Onu Grigore Dr. Svetlana Plămădeală Conf. Petru Rusu Dr. Anatol Scripnic Conf. Igor Ştefăneţ Conf. Tatiana Tazlavan Dr. Chisinau, the capital of the republic of Moldova, hosted in August the first International Congress organized by the Moldovan Society of Anesthesiology and Reanimatology. More than physicians took part to this event.

Some 50 foreign speakers contributed to the success of the scientific program. This was indeed a success, so significant that we decided to create a tradition and to have a similar international gathering every two years. We built up a list of new topics, each with a special interest to the anaesthesia community. It reflects the fact that our profession is one with many faces. This time we are interested to discuss matters of interest not only for our future patients, but also for ourselves, for our well being and for the future of Anesthesiology as a profession.

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We are happy to inform you that the quality of presentations is at least at the same scientific level as at our first congress, held in The Moldovan anesthesia progressed immensely during the last few years and this is, in part, due to the assistance we got from our foreign friends and colleagues. All the rest remained as it was! The well known Moldovan hospitality is there and is waiting for you.

The wonderful landscape, the typical synergy pierdere în greutate bakersfield and the famous wine, from so many vineyards spread over all our country are here for you and your colleagues.

In the name of our Moldovan colleagues and of our International Advisory Committee we welcome all of you here in Chisinau, the Moldovan capital and wish you a pleasant stay in our country. Gurman, Professor of Anesthesiology and Critical Care Dragi prieteni, O zicală faimoasă a unui politician zice că odată ce ai un eveniment important deja ai creat o tradiţie. La acest eveniment au participat mai mult de medici.

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Aproximativ 50 de conferentiari străini au contribuit la sucesul programului ştiinţific. Acesta, într-adevăr, a fost un success, atît de semnificativ încît noi am hotărît să creăm o tradiţie şi să organizăm astfel de întîlniri internaţionale la fiecare 2 ani. Astfel, suntem acum, în augustpentru cel de-al doilea Congres Internaţional al Societăţii Anesteziologie Reanimatologie din Republica Moldova.

Am făcut o listă cu tematici noi, fiecare prezentînd un interes special pentru comunitatea de anestezie.

Acesta reflectă faptul că profesia noastră este una cu mai multe faţete. De data aceasta suntem dispuşi să discutăm subiecte de interes nu numai privitor la viitorii noştri pacienţi, dar deasemenea şi subiecte interesante pentru noi, pentru starea noastră de bine şi privitor la viitorul Anesteziologiei ca profesie.

Sumtem bucuroşi să vă informăm că calitatea prezentărilor este cel puţin la acelaşi nivel ştiinţific ca şi la primul congres din Anestezilogia modovenească a făcut un progress imens ultimii cîţiva ani, şi aceasta se datoreşte în parte şi asistenţei de care ne-am bucurta din partea prietenilor şi colegilor din străinătate. Toate celelalte au rămas cum au fost! Binecunoscuta ospitalitate moldovenească vă aşteaptă.

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Peisajul minunat, bucătăria tipică şi faimosul vin din numeroasele podgorii împrăştiate pe întreg teritoriul ţării sunt prezente aici pentru Dumneavoastră şi pentru colegii Dvs. În numele colegilor moldoveni şi al Comitetului Ştiinţific Internaţional vă invităm pe toţi la Chişinău, capitala Republicii Moldova, şi vă urăm un sejur plăcut în ţara noastră. Testemitanu, R. Vă rugăm să purtaţie cusonul la toate sesiunile şi evenimentele sociale.

Vă rugăm să încărcaţi prezentarea Dvoastră în unul din computerele oferite cu cel puţin 1 oră înainte de sesiunea în care este programată. Opening of the industrial exhibition - 29 August These patients can also be classified regarding their acute and chronic illness of the neurological pathology. The metabolic and physiologic functional alterations show a complex cascade. The metabolic aspect depends basically on the underlying disease process and stress is one of the most important causes and in the presence of neurosurgery the metabolic response becomes much more profound.

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Differences regarding their pathology and its location contribute to the severity. However there are similarities during the chronic period of the different diseases, the acute period stress response depends mostly to the severity of the illness.

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Some patients besides their neurological disease do pronounce systemic disorders such as organ failures which diverse the metabolic changes activating nutritional demand in a different way and influencing negatively the morbidity and mortality rates. The common seen metabolic aspects are hyperglycemia which reflects the severity and the outcome, altered gastrointestinal functions as intolerance and delayed gastric emptying and depressed immunity during the acute phase response.

Recuperarea Termică A Petrolului Din Zăcăminte [PDF|TXT]

The organism is governed by central nervous system CNS and its homeostasis is established by the hypothalamus and the brain stem. Most of the neurological pathologies affect the CNS and sometimes a very small injury in one of these important vital areas may contributes severely the outcome with a hypermetabolic clinical symptoms.

All the pathological alterations of the organism generates primary a stress response via the brain and its network. But when the brain itself is affected it might not have the same ability to respond metabolically in the same way depending on the involved cerebral region. Abnormal counterregulatory responses might be seen with the malfunction of the hypothalamus leaving the brain stem on its own.

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Besides axonal injuries CNS pathologies contribute also CSF biochemistry and cerebral blood flow leading to important clinical symptoms like high heat gain or low heat loss fever, hypoxia, hypercarbia, intense hypocarbia, fluid and electrolytes imbalance, hyperglycemia. Heat loss is promoted by the control system activating a cholinergic neuronal system in the medial anterior hypothalamus which projects via relays in the brain stem and anterolateral grey matter of the spinal cord to cholinergic sympathetic nerve fibres making dilation of the skin vessels in the trunk and eccrine sweating.

While heat gain is promoted by the control centre activating and adrenergic neuronal centre in the medial posterior hypothalamus.

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By similar medullary and spinal cord relays, it activates the sympathetic adrenergic neurons to conserve heat by causing vasoconstriction of skin and mucosal vessels, and piloerection. Nutrients are the key generator of heat via thermogenesis diet induced thermonegesis and makes an important role for the nutritional support evaluation. Over-feeding which will give raise to iatrogenic thermogenesis may cause an increase in body temperature in patients who have sustained the stress of the acute illness.

The lower nutrient-induced thermogenesis and more positive energy balance, indicates a more efficient utilisation of nutrients. Some aminoacides like leucine and glycine are thermogenic not dependant upon the route of administration.

Over-feeding must be avoided in neurological patients. The metabolic response of the neurological patient is closely related to the pathology location and the clinical evolution of the disease. Studies have shown a pronounced hypermetabolism and hypercatabolism. There is marked increase in protein turnover, protein stores are broken, excess in urinary N excretion, excessive levels of counterregulatory hormones, significant increase in glucose utilization, gluconeogenesis.

In elderly patients suffering from cerebrovasvular accidents CVA there is no increase in resting energy expenditure REE and is generally less because of decreased activity and muscular tone subsequent to the CVA. It has been described many equations for the measurements of the requirement of caloric intake.

Measuring a patient energy requirement at least once by indirect calorimetry is important, because the degree of metabolism predicts how easily a patient will synergy pierdere în greutate bakersfield underfed or overfed. Particularly surveys of nutritional support have reported discripancies between a prescribed intake and actual delivery in ICU.

Enteral nutrition should be preferred within the tolerability and of the gastrointestinal tract. Less risk of hyperglycemia, low risk of infection and low cost are the advantages of enteral nutrition. Nutrition is not an exact science and what we must considered the most is realability on clinical experience accepting the individualized tailored nutrition regimes. There is no sufficient data to support a treatment standart, but ASPEN and ESPEN clinical guidelines are the best tools as recommendations for the metabolic and nutritional benefits of the patients.

References 1. Over-feeding as a cause of fever in intensive care patients. Clin Nutr ; Sakaue, M. Nutrient-induced thermogenesisi NIT following amino acid infusion. Clinical Nutrition ; Ireton-Jones, C.

Klinik Nütrisyon Istanbul Rapp, R. Specific problems associated with enteral nutrition in patients with head injury Clin Nutr ;12 suppl 1 : Dimopoulou, I. Hypothalamic-pituitary disfunction in critically ill patients with traumatic and non traumatic brain injury Inten Care Med synergy pierdere în greutate bakersfield Lones, N. Implementating nutrition guidelines in the critical care setting.