The assessment of microbiological and physicochemical characteristics in drainage waters of the Siriu dam

Based on the balneotherapeutic applications of mineral spring water and particularly sulphurous water, the aim of our research was to study the physicochemical and microbiological parameters of some drainage waters of Siriu dam that showed a strong hydrogen sulphide odour. In addition, due to the corrosive effect of some groups of microorganisms, such as iron-oxidizing bacteria and sulphatereducing bacteria, the present paper also aimed to detect their presence in order to signal the need for some disinfection measures. According to physicochemical analysis, there has been found an external drain that is suitable for use in balneotherapy, presenting a balanced content of mineral elements such as sulphur, calcium, silicon, chlorine and potassium. However, due to the presence of potentially toxic phytoplankton microorganisms such as Microcystis sp. and Phormidium sp. it is necessary to disinfect this water source before using it for any purpose. On the other hand, the identification of both sulphate-reducing bacteria and iron-oxidizing bacteria in the drainage waters of Siriu dam should be considered as an alarm signal as they may lead to bio-corrosion and deterioration of metallic or concrete structures, affecting the integrity of the dam and hydropower constructions.

Permanent External Biliary Catheter: A Difficult Problem Managed by Rescue Technique of Hepaticocholecystogastrostomy

Percutaneous biliary drainage is commonly performed procedure after failure of ERCP in patients with biliary obstruction. Failure to internalization can lead to permanent external catheter. In the present case, problem of external biliary catheter was solved with hepaticocholecystogastrostomy. Guidewire from the external drain site could not be passed across the stricture, instead it was entering in the gall bladder. This was used as an opportunity to internalize the catheter. First EUS guided cholecystogastrostomy was performed, followed by placement of stent between right biliary system and the stomach, through the cholecystogastrostomy stent. This led to drainage of right biliary system into the stomach, and the external catheter could be removed.

Complications of external cerebrospinal fluid drainage in aneurysmal subarachnoid haemorrhage

Background The need for external cerebrospinal fluid (CSF) drains in aneurysmal subarachnoid haemorrhage (aSAH) patients is common and might lead to additional complications. Objective A relation between the presence of an external CSF drain and complication risk is investigated. Methods A prospective complication registry was analysed retrospectively. We included all adult aSAH patients admitted to our academic hospital between January 2016 and January 2018, treated with an external CSF drain. Demographic data, type of external drain used, the severity of the aSAH and complications, up to 30 days after drain placement, were registered. Complications were divided into (1) complications with a direct relation to the external CSF drain and (2) complications that could not be directly related to the use of an external CSF drain referred to as medical complications Results One hundred and forty drains were implanted in 100 aSAH patients. In total, 112 complications occurred in 59 patients. Thirty-six complications were drain related and 76 were medical complications. The most common complication was infection (n = 34). Drain dislodgement occurred 16 times, followed by meningitis (n = 11) and occlusion (n = 9). A Poisson model showed that the mean number of complications raised by 2.9% for each additional day of drainage (95% CI: 0.6–5.3% p = 0.01). Conclusion Complications are common in patients with aneurysmal subarachnoid haemorrhage of which 32% are drain-related. A correlation is present between drainage period and the number of complications. Therefore, reducing drainage period could be a target for further improvement of care.

Surgical Management of a Chronic Neck Abscess in a U.S. Navy Bottlenose Dolphin

Surgical intervention on cetaceans is rarely performed due to challenges including general anesthesia and post-operative wound healing. This report describes the evaluation and treatment of an adult female bottlenose dolphin (Tursiops truncatus) with the US Navy Marine Mammal Program, with a chronic ventral cervical abscess caused by Candida glabrata. Despite aspiration and lavage along with multiple antifungal drugs, the patient developed inspiratory stridor with decreased performance level and surgical treatment was pursued. Under general anesthesia with the dolphin in dorsal recumbency position a 12-cm longitudinal ventral midline neck incision was used for exploration. Intraoperative ultrasound aided the identification of surgical landmarks and the abscess cavity. After adequate drainage and curettage, a closed-suction drain was placed in the surgical site. Retention sutures were used to close the incision and the external drain bulb was secured to a pectoral fin strap. One-year post-op, the dolphin was clinically normal and follow-up imaging showed no significant recurrence of the abscess. This case demonstrates a novel surgical approach of managing abscesses in dolphins, including placement and management of a negative suction drain in a submerged patient. The successful collaboration between veterinary anesthesiology, veterinary medicine, radiology, and general surgery allowed the patient to continue her normal activities as a full-duty service member.

Combined Interventional Radiological and Endoscopical Approach for the Treatment of a Postoperative Biliary Stricture and Fistula

A 43-year old woman was admitted 11 days after open cholecystectomy with a iatrogenic bile duct injury. On admission the patient showed an uncontrolled biliary fistula through an external drain placed at an emergency laparotomy for biliary peritonitis with fever and jaundice. PTC showed a biliary stricture type II (Bismuth). A percutaneous drainage was performed to decompress the biliary system. Three weeks later, percutaneous balloon dilatation of the stricture was performed. However, bile leakage persisted. In a combined transhepatic/ endoscopic procedure, the percutaneous biliary drainage was replaced by a nasobiliary tube. One week later, no stricture was found and the biliary leak was sealed. The patient could be discharged without symptoms or signs of cholestasis. The multidisciplinary management of post-operative biliary fistula is presented, comparing the role of interventional radiology, endoscopy and surgery.

Why Was Specie Scarce in Colonial Economies? An Analysis of the Canadian Currency, 1796–1830

Colonial economies suffered from a scarcity of specie that traditionally has been attributed to a chronic external drain. An analysis of the Canadian currency in the early nineteenth century suggests that the explanation for the specie scarcity lies in the multi-coin monetary standard imposed by the currency laws. Gresham's Law accurately predicts the coins that circulated in Canada, and it is concluded that the colonists suffered from a lack of quality rather than quantity of specie.