Development of integrative bioethics in the Mediterranean area of South-East Europe.

With regards to its origin, foundation and development, bioethics is a relatively new discipline, scientific and theoretical field, where different and even contradicting definition models and methodological patterns of its formation and application meet. In some philosophical orientations, bioethics is considered to be a sub-discipline of applied ethics as a traditional philosophical discipline. Yet in biomedical and other sciences, bioethics is designated as a specialist scientific discipline, or a sort of a new medical ethics.

[Splenorrhaphy and partial splenectomy as an alternative to splenectomy in trauma--overview].

For many year splenectomy was considered to be the only possible surgical treatment for all laceration of the spleen, whether resulting from abdominal contusion or not. Such factors have led to changes in practical attitudes to splenic lacerations but it would seem that indications for a conservative approach must be based upon the underlaying condition and the precise nature of the lesions. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems.

[Perforation of the small intestine as a sequela of blunt injuries of the abdomen during a 12-year period].

The paper presents 44 cases of small intestine perforation caused by blunt abdominal trauma in a period of 12 years. 34 patients were men and 10 were women. The patients were aged from 10 to 82 years which gives an average age of 39 years.

[Permanent decrease in immune function in patients with splenectomy for trauma].

The authors describe the peripheral blood analyses in patients splenectomized for trauma in consideration on the concentration of the immunoglobulins total complement CH50 levels, T and B lymphocyte populations and compare this with the control group. The levels of the IgM were significantly decreased (p0.001) in splenectomised while the levels of the IgA and IgG were significantly increased (for IgA - p0.

[Fatal postsplenectomy sepsis (OPSI syndrome)].

The cases of postsplenectomy sepsis are described at the Clinical Hospital Centre Split. Overwhelming postsplenectomy infection is a unique clinical entity distinguishable from other infections. It may occur during the lifetime of any asplenic patient.

[Epidemiologic aspects of splenic injuries observed from 1958 to 1988 in our department].

The authors have reviewed the frequency of the patients with splenic injuries treated on the Surgical clinics of the Clinical Hospital Centre "Firule" Split in period from 1958 to 1988. The distribution of the splenic injuries in consideration to age, sex such as the lethality inside this group is shown.

[Injuries of the diaphragm examined from 1976 to 1988].

The authors review 28 patients with the diaphragmal injury treated at the Surgical Clinic of the Clinical hospital centre "Firule" Split in the period from 1976 to 1988. The distribution of the injuries in consideration of age and sex, the most frequent lesions of the organs connected with the diaphragmal injury, number of the patients in different years as the structure inside this group of the patients is shown.

[Injuries of the pancreas].

At the Surgical Clinic of the University Hospital Center "Firule" Split in the period from 1977-1987. years were treated 12 patients with injuries of the pancreas. That is 4% of all abdominal injuries treated in those 11 years.

[Rupture of the retroperitoneal duodenum due to blunt abdominal trauma].

We are reported eight patients after blunt abdominal trauma with rupture of retroperitoneal part of the duodenum, with etiology of injury and with their surgical treatment. We emphasized diagnostic troubles and great mortality in the cases of missed duodenal rupture in the preoperative and in the intraoperative time. The result of successful therapy depend of quick recognizing of the retroperitoneal part of the duodenum and of the operation treatment.

[Retroperitoneal hematoma as a consequence of blunt abdominal injury].

In our examination we have used clinical material of 448 cases treated in our clinics for blunt abdominal trauma in period from 1976. to 1988. with special care on the group of 172 patients in who the retroperitoneal haematoma was founded.

[Injuries of the urinary bladder].

The authors analyse 32 patients with injuries of the urinary bladder treated in Clinical Hospital Centre "Firule" in the period from 1976 to 1988 (Figure No 1). There were: 10 contusions of the bladder (31%), 5 extraperitoneal ruptures (16%), 16 intraperitoneal ruptures (50%), and 1 combined extra and intraperitoneal rupture (3%). The isolated injuries of the bladder are rare.