[Acute myocardial infarction and cardiogenic shock in patient with COVID-19].

The conditions of the pandemic caused by the novel coronavirus infection (COVID-19) are associated with overloading intensive care units, conversion of hospitals, and changes in routing of patients with acute cardiovascular pathology. At the same time, medical practice is still challenged to provide medical care to patients with acute coronary syndrome (ACS). Patients with COVID-19 and acute myocardial infarction (AMI) are at a higher risk of death while the incidence of this combination of diseases will be growing. This article describes a case of diagnosis and treatment of COVID-19 in a 69-year-old patient who was urgently hospitalized with cardiogenic shock associated with ACS, electrocardiographic signs of complete left bundle branch block, and left ventricular ejection fraction of 19 %. Coronary angiography with stenting was successfully performed in the conditions of extracorporeal membrane oxygenation. The patient received long-term intensive therapy in the intensive care unit followed by symptomatic treatment in the cardiac surgery unit. The patient's condition gradually improved and he was discharged from the hospital on the 56th day. The strategy of intensive care and active follow-up helped saving life of the patient with COVID-19 and AMI.

Impact of placenta previa with placenta accreta spectrum disorder on fetal growth.

OBJECTIVES: To evaluate fetal growth in pregnancies complicated by placenta previa with or without placenta accreta spectrum (PAS) disorder, compared with in pregnancies with a low-lying placenta. METHODS: This was a multicenter retrospective cohort study of singleton pregnancies complicated by placenta previa with or without PAS disorder, for which maternal characteristics, ultrasound-estimated fetal weight and birth weight were available. Four maternal-fetal medicine units participated in data collection of diagnosis, treatment and outcome. The control group comprised singleton pregnancies with a low-lying placenta (0.5-2 cm from the internal os). The diagnosis of PAS and depth of invasion were confirmed at delivery using both a predefined clinical grading score and histopathological examination. For comparison of pregnancy characteristics and fetal growth parameters, the study groups were matched for smoking status, ethnic origin, fetal sex and gestational age at delivery. RESULTS: The study included 82 women with placenta previa with PAS disorder, subdivided into adherent (n = 35) and invasive (n = 47) PAS subgroups, and 146 women with placenta previa without PAS disorder. There were 64 controls with a low-lying placenta. There was no significant difference in the incidence of small-for-gestational age (SGA) (birth weight ≤ 10th percentile) and large-for-gestational age (LGA) (birth weight ≥ 90th  percentile) between the study groups. Median gestational age at diagnosis was significantly lower in pregnancies with placenta previa without PAS disorder than in the low-lying placenta group (P = 0.002). No significant difference was found between pregnancies complicated by placenta previa with PAS disorder and those without for any of the variables. Median estimated fetal weight percentile was significantly lower in the adherent compared with the invasive previa-PAS subgroup (P = 0.047). Actual birth weight percentile at delivery did not differ significantly between the subgroups (P = 0.804). CONCLUSIONS: No difference was seen in fetal growth in pregnancies complicated by placenta previa with PAS disorder compared with those without and compared with those with a low-lying placenta. There was also no increased incidence of either SGA or LGA neonates in pregnancies with placenta previa and PAS disorder compared with those with placenta previa with spontaneous separation of the placenta at birth. Adverse neonatal outcome in pregnancies complicated by placenta previa and PAS disorder is linked to premature delivery and not to impaired fetal growth. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Unusual sensory innervation of the dorsal hand and why we should bear this variation in mind.

Detailed knowledge of the anatomy and different variations of the superficial branch of the radial nerve could be of great importance not only to anatomists but also to clinicians. A predominant radial nerve supply to the dorsum of the hand is rare. Herein, we present an unusual case of unilateral sensory innervation of the dorsal hand found during routine anatomical dissection of a 72-year-old at death male Caucasian cadaver. We also present a brief discussion of the reported variation and emphasize its potential clinical implications.

Variant origin of three main coronary ostia from the right sinus of Valsalva: report of a rare case.

Observing anomalies in the origin of the coronary arteries is a rare but recognised scenario during coronarography. All the major coronary arteries originating from the right sinus of Valsalva is an extremely rare anomaly, its reported incidence being 0.008% in angiographic studies. Most coronary artery variations are benign and are therefore found accidentally or postmortem. However, some anomalies in the origin of the coronary arteries are associated with myocardial ischaemia and a higher risk of sudden cardiac death. Herein, we report a sporadic case of anomalous origin of the coronary arteries, in which the right coronary artery, anterior interventricular artery and left circumflex artery arise separately from the right sinus of Valsalva, each originating from a separate ostium. Regardless of their low incidence rate, coronary artery anomalies can cause serious technical challenges during coronary angiography and percutaneous interventions because of the unusual location and course of the artery. Echocardiography, computed tomography, and magnetic resonance imaging can be useful in such cases.

Target silencing of disease-associated B-lymphocytes by chimeric molecules in SCID model of pristane-induced autoimmunity.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the generation of autoantibodies against a diverse array of self-antigens. The B cells producing immunoglobulin G (IgG) antibodies to double-stranded DNA appear to play a main role in the disease progression. Their specific elimination is a reasonable mechanism for effective therapy of SLE. The presently used approaches for silencing autoreactive disease-associated B cells are nonspecific and more precise therapies are needed. We have previously constructed a chimeric protein molecule consisting of several DNA-mimotope peptides coupled to a rat monoclonal anti-mouse CD32 (FcγRIIb) antibody. The mineral oil pristane induces a lupus-like syndrome in non-autoimmune mice leading to the development of glomerulonephritis and lupus-associated autoantibodies. In the present paper, using a pristane-induced autoimmune model in SCID mice, we analyzed the ability of the chimeric antibody to suppress selectively the autoreactive B lymphocytes by cross-linking B-cell surface immunoglobulin receptors with the inhibitory IgG FcγRIIb receptors. Treatment with DNA-like chimeric molecules inhibited B- and T-cell proliferation, restricted the number of anti-DNA antibody-producing cells and suppressed the generation of IgG anti-DNA antibodies. In contrast, phosphate buffered saline (PBS)-injected control mice experienced an increase of disease-associated antibody levels and developed glomerulonephritis similar to pristane-treated donor Balb/c mice.

Identifying radon priority areas and dwellings with radon exceedances in Bulgaria using stored CD/DVDs.

The implementation of the 2013/59/EURATOM directive in the part related to radon exposure imposes challenges for radon measurement methodology and radon survey design. Among them is the need to have estimates (preferably direct) of the annual average radon concentrations, which can be directly compared to the recommended reference levels. On this basis, the surveys should make possible the identification of dwellings with indoor radon above the reference levels and "radon priority areas" where significant proportion of the dwellings falls in this category. The performance of the CD/DVD method for radon measurements as a tool to address these issues is presented. A recent large scale field study based on the CD/DVD method that was carried out in the suburb area of Sofia, Bulgaria is described. Part of the studied area was affected in the past by the uranium mining and milling industry. In total 462 disks (CDs and DVDs) taken from 335 private dwellings from 10 districts in the region were analyzed. The results revealed the large heterogeneity in radon distribution in the area, with the percentage of dwellings with a 222Rn level above 300 Bq m-3 ranking from about 7% to 74%. The district of Yana, for which this percent was 74, was identified as the area of highest radon priority in the region. The paper also discusses how prompt identification of dwellings with radon above the reference level by CD/DVDs can be incorporated within an integrated approach to the radon problem. Within this approach the radon hazard is identified shortly after the stakeholder's decision to test, which allows fast solution of the problem without waiting the long (and usually demotivating) one-year period needed for direct results by the commonly used prospective methods.

Utilising laboratory experiments as a first step to introduce primary sludge hydrolysis in full-scale.

Laboratory experiments have been utilised as a tool to determine the possible yield of soluble COD and VFAs from settled influent and preprecipitated sludge at Klagshamn wastewater treatment plant and to determine the degradability of the organic matter. The release of ammonium and orthophosphate from the hydrolysed sludge has been estimated. It is possible to produce soluble organic matter of good quality from settled influent and preprecipitated sludge at Klagshamn WWTP. Denitrification rates of 3.1 mg NO3-N/(g VSS x h) were found for the hydrolysate in laboratory tests. Owing to the low phosphate concentrations in the hydrolysate from preprecipitated sludge, it shows a potential for postdenitrification despite stringent phosphorus outlet demands. Calculations based on data gained from the laboratory experiments show that about 50% of the external carbon source used today can be saved with minor changes in the plant operation except that the hydrolysis has to be established. Based on these findings, full-scale experiments with internal hydrolysis in the primary clarifiers were scheduled in one of the two lines at Klagshamn WWTP for the summer of 2007.

RADON-222 IN SOIL-GAS MEASUREMENTS BY COMPACT DISCS. COMPARISON TO DIFFUSION CHAMBER MEASUREMENTS.

This work presents the results from simultaneous measurements of 222Rn in soil-gas by compact discs (CDs) and diffusion chambers. The measurements were performed in three terrains with high, medium and low 222Rn-in-soil-gas concentrations. Good correlations between the CD measurements and the reference diffusion chamber measurements are observed. The results indicate that it is important to apply temperature correction in the CD measurements, in order to account for the actual temperature during the exposure of the CDs in the soil.

Diffusion lengths and partition coefficients of 131mXe and 85Kr in Makrofol N and Makrofol DE polycarbonates.

This work presents the results of an experimental study of the Makrofol® N and Makrofol® DE polycarbonate foils absorption properties of 85Kr and 131mXe. The diffusion lengths of 85Kr and 131mXe in both types of foils are determined. The partition coefficients of 85Kr from air and water and that of 131mXe from air in Makrofol® N are determined. The partition coefficients of 85Kr from water and 131mXe from air in Makrofol® DE are also determined. The parameters are determined for T = 22°C and allow for the full characterization of sorption and desorption of 85Kr and 131mXe in the foils at this temperature. The results from this study highlight the remarkable absorption ability of Makrofol® and especially of the Makrofol® N foil and show that it surpasses the Makrofol DE® foil not only as a Rn absorber, but also as Kr and Xe absorber.

Laboratory facility to create reference radon + thoron atmosphere under dynamic exposure conditions.

Radon (222Rn) and thoron (220Rn) levels in the environment are typically subject to significant random and systematic variations. Creation in the laboratory of reproducible and controlled exposure conditions close to that in the real environment can be useful for testing 222Rn and 220Rn detectors and for research. In this report the design and performance of a novel laboratory facility with such functionality is presented. The facility allows the exposure of detectors under controlled dynamic as well as static activity concentrations of 222Rn and 220Rn (pure and mixed) and temperature. The temperature is measured and regulated within -15 °C ÷ +60 °C by a dedicated programmable thermostat. Different reference activity concentrations in the exposure vessel are made by regulating the flow-rate of the air that flushes 222Rn/220Rn activity from the sources towards the exposure vessel. Reference atmospheres that contain 222Rn, 220Rn or a specified ratio of the two can be created. Pilot experiments that demonstrate the feasibility of the approach are presented. They include follow-up of a pre-defined temperature profile (in the range -5 °C ÷ +35 °C), test of the correspondence between planned and measured 222Rn and 220Rn activity concentrations, follow-up of a pre-defined dynamic profile of 220Rn concentrations and test of the possibility to create mixed 220Rn/222Rn atmospheres (experimentally checked for ratio of the activity concentrations from 0.27 to 4.5). The results from the experimental tests are in agreement with the values obtained by the developed theoretical model. The proposed approach can be used to plan and create stationary and dynamic reference exposure conditions that are close to the real exposure regimes in the environment.

COMPARATIVE STUDY OF RADON AND THORON MEASUREMENTS IN FOUR ROMANIAN SHOW CAVES.

Measurements have been carried out using four types of passive detectors in four of the most popular show caves in Romania. Three types of detectors (RSKS, RadTrak and CD) were used for radon measurements and two (Raduet and CD) for thoron measurement. Activity concentrations in air were measured in the same locations for two seasons, autumn and winter. Measured values for the different caves varied between below detection limit (5 Bq m-3) and 4024 Bq m-3 for radon and from below 10 to 583 Bq m-3 for thoron. The results indicate a very good correlation between RSKS and RadTrak detectors (r = 0.96). The most significant difference between radon concentrations measured with different types of detectors (RSKS and CD) was higher than 150%. The study suggests that the activity concentration of radon in caves, measured using track detectors, could not be influenced by the type of detector used if the microclimate factor is acknowledged.

Determination of (222)Rn absorption properties of polycarbonate foils by liquid scintillation counting. Application to (222)Rn measurements.

This work demonstrates that a Liquid Scintillation Counting (LSC) technique using a Triple to Double Coincidence Ratio counter with extending dead-time is very appropriate for the accurate measurement of (222)Rn activity absorbed in thin polycarbonate foils. It is demonstrated that using a toluene-based LS cocktail, which dissolves polycarbonates, the (222)Rn activity absorbed in thin Makrofol N foil can be determined with a relative standard uncertainty of about 0.7%. A LSC-based application of the methodology for determination of the diffusion length of (222)Rn in thin polycarbonate foils is proposed and the diffusion length of (222)Rn in Makrofol N (38.9±1.3µm) and the partition coefficient of (222)Rn in Makrofol N from air (112±12, at 20°C) and from water (272±17, at 21°C) are determined. Calibration of commercial LS spectrometers for (222)Rn measurements by LSC of thin polycarbonate foils is performed and the minimum detectable activities by this technique are estimated.

Influence of the type of CD case on the track density distribution in CDs exposed to thoron.

A novel approach for retrospective thoron (Rn-220) measurements in buildings was recently proposed. It employs CDs/DVDs as detectors, in which the alpha-tracks formed by thoron's progeny Po-212 are analyzed. Compact disks and DVDs that had been stored in their cases are suitable, because the case provides a fixed and reproducible geometry of the Po-212 source. Since the measurement and calibration procedures involve analysis of different pieces of the disk, it is important to test the homogeneity of the track density over the disk area. This report presents results of such a study, in which disks in different containers were exposed to thoron. In almost all disks, the track density was inhomogeneous, increasing significantly near the holes in the container through which thoron could enter. However, as demonstrated, in disks regularly used and randomly rotated in their containers, the track density is expected to homogenize. It is concluded that the homogeneity of the tracks should be tested in disks exposed to thoron in homes and should be estimated or compensated in calibration exposures.

[Optimization of the composition of granular materials for the preparation of a diazepam-containing suspension]. / Optimierung von Granulatzusammensetzungen zur Anfertigung einer diazepamhaltigen Suspension.

The composition of auxiliary substances in granular material for the preparation of a diazepam containing suspension for veterinary use was studied. By means of an experimental plan regression models of the physico-mechanical parameters of the preparation were developed. Variants of optimized compositions meeting certain demands regarding the bulk volume, the flow angle, the relative sediment height and the viscosity were elaborated in order to choose the most qualified variant which has to guarantee a high quality of the ready-made drug.

[Echographic diagnosis of ovulation in healthy women]. / Ekhografska diagnoza na ovulatsiiata pri zdravi zheni.

Dynamic echographic changes in measures of the uterus, uterine mucosa, ovaries and dominant follicle during normal ovulatory menstrual cycle were established in 16 multiparas and 17 nulliparas. All measures undergo characteristic changes as they increase during follicular phase of the cycle and reach their maximum paraovulatorily. For establishment of ovulation the changes in anterior-posterior size of the uterus, uterine mucosa, diameter of the dominant follicle and qualitative changes, occurring in it, are of the greatest significance. Mathematical models are made, which allow a comparison and prognosis of the changes in the internal genital organs of a woman in respect to the ovulation.

Liquid scintillation counting of polycarbonates: a sensitive technique for measurement of activity concentration of some radioactive noble gases.

This work explores the application of the liquid scintillation counting of polycarbonates for measurement of the activity concentration of radioactive noble gases. Results from experimental studies of the method are presented. Potential applications in the monitoring of radioactive noble gases are discussed.

A high-sensitivity method for the measurement of 222Rn based on liquid scintillation counting of polycarbonate powder.

This work describes a technique for the measurement of 222Rn by absorption in polycarbonate (PC) powder and liquid scintillation counting (LSC). The work is an improvement of the recently proposed method for 222Rn measurements by LSC of exposed PC grains. It is demonstrated that the use of PC powder as a 222Rn sampler improves 13.6 times the sampling efficiency and leads to 6.5 times smaller minimmal detectable activity concentrations (MDAC) compared with the PC grains used so far. For a 40-h exposure of 7.4-g PC powder to 222Rn in air, the MDAC with a RackBeta 1219 LS counter is 62 Bq m(-3) (assuming a 8-h sample counting time and 24-h background time). For the same conditions the estimated 222Rn MDAC with a Quantulus 1220 LS counter is 20 Bq m(-3). The proposed technique is suitable for radon in air and radon in soil-gas measurements.

Logistic of surveys of retrospective radon concentrations by home-stored CDs/DVDs.

Recently, a method for rather precise retrospective (222)Rn measurements, based on home-stored compact disks (CDs)/DVDs, has demonstrated a promising potential for wide application. In Bulgaria, pilot surveys have been initiated based on voluntarily provided CDs/DVDs. The results showed that large-scale surveys could be efficiently organised. However, several problems were identified and are discussed in the report. The first is the relatively small proportion of participants (30-50 %) that actually provided disks. Other addressed topics include the compatibility between results of different disks from one place, the accuracy of dating CDs/DVDs and the possibility for individual a posteriori calibration of each disk. The possibility to follow year-to-year variations by disks of different age is also discussed.

Determination of the diffusion coefficient and solubility of radon in plastics.

This paper describes a method for determination of the diffusion coefficient and the solubility of radon in plastics. The method is based on the absorption and desorption of radon in plastics. Firstly, plastic specimens are exposed for controlled time to referent (222)Rn concentrations. After exposure, the activity of the specimens is followed by HPGe gamma spectrometry. Using the mathematical algorithm described in this report and the decrease of activity as a function of time, the diffusion coefficient can be determined. In addition, if the referent (222)Rn concentration during the exposure is known, the solubility of radon can be determined. The algorithm has been experimentally applied for different plastics. The results show that this approach allows the specified quantities to be determined with a rather high accuracy-depending on the quality of the counting equipment, it can be better than 10 %.