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BACKGROUND: As coronavirus disease 2019 (COVID-19) has reached pandemic status, authors from the most severely affected countries have reported reduced rates of hospital admissions for patients with acute coronary syndrome (ACS). AIM: The aim of the present study was to investigate the influence of the COVID-19 outbreak on hospital admissions and outcomes in ACS patients in a single high-volume centre in southeastern Europe. METHODS: This retrospective observational study aimed to investigate the number of hospital admissions for ACS, clinical findings at admission, length of hospitalisation, major complications and in-hospital mortality during the COVID-19 outbreak and to compare the data with the same parameters during an equivalent time frame in 2019. For the ST-elevated myocardial infarction (STEMI) subgroup of patients, changes in ischaemic times were analysed as well. RESULTS: There was a significant reduction of 44.3% in the number of patients admitted for ACS during the COVID-19 outbreak when compared with the same period in 2019 (151 vs 271; 95% confidence interval 38.4-50.2, pâ¯<â¯0.01) with a higher mortality rate (13.2% vs 7.2%, pâ¯= 0.03). In 2020, patients with non-ST-elevated myocardial infarction presented more often with acute heart failure (3.3% vs 0.7%, pâ¯= 0.04). During the COVID-19 outbreak, we observed increases in the total ischaemic time (303⯱ 163.4 vs 200.8⯱ 156.8â¯min, pâ¯<â¯0.05) and door-to-balloon time (69.2⯱ 58.4 vs 50.5⯱ 31.3â¯min, pâ¯<â¯0.01) in STEMI patients. CONCLUSIONS: These findings should increase the awareness of morbidity and mortality related to missed or delayed treatment of ACS among the public and the healthcare services.
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BACKGROUND: The most reliable data about arterial variations, which are very important in surgery and radiology, can be obtained from a large series of patients. MATERIALS AND METHODS: We examined angiographic and multislice computerised tomography (MSCT) images in a group of 1,265 patients and in 1 dissected specimen. RESULTS: While in 946 (74.72%) of the patients a normal vascular pattern (type I) was noticed, in the remaining 320 (25.28%) patients variations of the branches of the aortic arch were found, which were classified into types II through VIII and a few subtypes. Type II (2.84%) comprised a common origin of the left commoncarotid and subclavian arteries. Type III (15.56%) was related to an origin of the left subclavian artery from the brachiocephalic trunk. Type IV (0.55%) included the aortic origin of both common carotid and subclavian arteries, with the right subclavian artery having a retroesophageal course. Type V (0.24%) included the same 4 supra-aortic branches, which, however, arose from a double or a right--sided aortic arch. Type VI (3.63%) comprised the aortic origin of the left vertebral artery, type VII (0.24%) the same origin of the right vertebral artery, and type VIII(2.22%) the aortic origin of the thyroideaima artery. A corresponding embryological background and clinical implications of the described aberrant vessels were presented. CONCLUSIONS: In more than one quarter of the cases, the branching pattern of the examined arteries did not follow the classical pattern. Detailed knowledge of aortic branch variations is of great significance in anatomy, embryology, and clinical medicine, especially in radiology and thoracic surgery.
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Aorta Torácica/anatomia & histologia , Aorta Torácica/diagnóstico por imagem , Idoso , Angiografia/métodos , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: The objective of the study was to determine the concentration of matrix metalloproteinase 9 (MMP-9) and changes in the presence of periodontopathogens in the gingival crevicular fluid before and after tooth preparation with the subgingival and equigingival finish line position. PATIENTS AND METHODS: The clinical prospective study included 20 subjects with an indication for upper canine preparation, with the subgingival (group 1) and equigingival finish line (group 2). Samples were taken in four observation intervals: 5 minutes before (control samples), as well as 15 minutes, 24 and 72 hours after tooth preparation (experimental samples). Measurement of MMP-9 was done using Enzyme-linked Immunosorbent Assay (ELISA). The presence of bacteria in the gingival fluid was proven by the Polymerase chain reaction (PCR) analysis. RESULTS: The MMP-9 values did not differ statistically significantly between the groups (p=0.524). The MMP-9 values showed a statistically significant difference in the given observation period (p<0.001) with a significant linear increase in values (p<0.001). A significant quadratic trend recorded a decrease in the MMP-9 values 15 minutes after preparation, and an increase 24 hours after preparation, without a significant difference in the interaction between groups (p=0.392). After preparation, a significant difference in the presence of periodontopathogens was confirmed, i.e., a decrease in the presence of Prevotella intermedia (p=0.025) and Tannerella forsythia (p=0.016) in group 1, and an increase in the presence of Aggregatibacter actinomycetemcomitans in both groups (p=0.029, p=0.026). CONCLUSIONS: The study is a good basis for determining the influence of tooth preparation on gingival inflammation, with therapeutic (choice of preparation technique) and preventive significance regarding the protection of the periodontal tissue from possible iatrogenic damage.
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Líquido do Sulco Gengival , Metaloproteinase 9 da Matriz , Humanos , Líquido do Sulco Gengival/metabolismo , Metaloproteinase 9 da Matriz/análise , Estudos Prospectivos , Metaloproteinase 8 da Matriz/análise , Metaloproteinase 8 da Matriz/metabolismoRESUMO
INTRODUCTION: We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors and the mortality rate in COVID-19 patients with bacterial infections. METHODS: This retrospective observational study evaluated medical records of 7249 randomly selected patients with COVID-19 admitted to three clinical centres between 1st January 2021 and 16th February 2022. A total of 6478 COVID-19 patients met the eligibility criteria for analysis. RESULTS: The mean age of the patients with SARS-CoV-2 and bacterial infections was 68.6 ± 15.5 years (range: 24-94 years). The majority of patients (68.7%) were older than 65 years. The prevalence of bacterial infections among hospitalized COVID-19 patients was 12.9%, most of them being hospital-acquired (11.5%). Bloodstream (37.7%) and respiratory tract infections (25.6%) were the most common bacterial infections. Klebsiella pneumoniae and Acinetobacter baumannii caused 25.2% and 23.6% of all bacterial infections, respectively. Carbapenem-resistance in Enterobacterales, A. baumannii and Pseudomonas aeruginosa were 71.3%, 93.8% and 69.1%, respectively. Age >60 years and infections caused by ≥3 pathogens were significantly more prevalent among deceased patients compared with survivors (P<0.05). Furthermore, 95% of patients who were intubated developed ventilator-associated pneumonia. The overall in-hospital mortality rate of patients with SARS-CoV-2 and bacterial infections was 51.6%, while 91.7% of patients who required invasive mechanical ventilation died. CONCLUSIONS: Our results reveal a striking association between healthcare-associated bacterial infections as an important complication of COVID-19 and fatal outcomes.
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Infecções Bacterianas , COVID-19 , Infecção Hospitalar , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , SARS-CoV-2 , Infecção Hospitalar/microbiologia , Infecções Bacterianas/microbiologia , Bactérias , Atenção à Saúde , Estudos Retrospectivos , Antibacterianos/farmacologia , Antibacterianos/uso terapêuticoRESUMO
Spontaneous coronary artery dissection (SCAD), although in the majority of cases presents as an acute coronary syndrome (ACS), has different pathophysiology from atherosclerosis that influences specific angiography findings and enables most patients to be solved by optimal medical therapy rather than percutaneous coronary intervention (PCI). Therefore, accurate diagnosis is essential for adequate treatment of each patient as management of SCAD differs from that of ACS of atherosclerotic aetiology. So far, invasive coronary angiography remains the most important diagnostic tool in suspected SCAD. However, there are ambiguous cases that can mimic SCAD. In this review, the authors summarize current knowledge about the diagnostic algorithms, particularly angiographic features of SCAD, pitfalls of angiography, and the role of intracoronary imaging in the context of SCAD diagnosis. Finally, apart from the pathognomonic angiographic features of SCAD that are thoroughly discussed in this review, the authors focus on obscure angiography findings and findings that can mimic SCAD as well. Differential diagnosis and the timely recognition of SCAD are crucial as there are differences in the acute and long-term management of SCAD and other causes of ACS.
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OBJECTIVE: The aim of this study was to determine any differences in oxidative stress and inflammation parameters in COPD patients treated with either N-acetyl cysteine (NAC) alone or with NAC in combination with propolis (NACP). PATIENTS AND METHODS: Forty COPD patients in the exacerbation phase were enrolled into the study and were treated with either NAC (NAC group; n=20) or NACP (NACP group; n=20) twice daily for one month. Redox status was determined by measuring superoxide anion (O2.-), advanced oxidation protein products (AOPP), total oxidative status (TOS), prooxidative-antioxidant balance (PAB), malondialdehyde (MDA), ischemia modified albumin (IMA) and several other antioxidant markers: superoxide dismutase (SOD), paraoxonase 1 (PON1), total sulfhydryl groups (SHG) and total antioxidant status (TAS). Interleukins 6, 8 and 17 were measured as markers of inflammatory status. RESULTS: Both groups had similar socio-demographic and clinical characteristics. After treatment significantly higher SHG [0.446 (0.395-0.516) vs. 0.292 (0.270-0.325), p<0.001] and significantly lower TOS - 50.6 [49.7-53.4 vs. 73.2 (50.9-84.6), p<0.05] - and IMA [0.650 (0.629-0.682) vs. 0.709 (0.667-0.756), p<0.05] - were found in the NACP group compared to the NAC group. Factorial analysis indicated a larger oxidative stress-inflammatory load in the NAC group after treatment. CONCLUSIONS: From an oxidative stress and inflammatory status perspective, treatment with NACP was more successful than with NAC. The inclusion of propolis into therapy for COPD patients, especially those in the exacerbation phase, could prove beneficial.
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Própole , Doença Pulmonar Obstrutiva Crônica , Acetilcisteína/uso terapêutico , Antioxidantes/metabolismo , Antioxidantes/uso terapêutico , Arildialquilfosfatase/metabolismo , Biomarcadores/metabolismo , Humanos , Oxirredução , Estresse Oxidativo , Própole/metabolismo , Própole/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Albumina Sérica/metabolismoRESUMO
OBJECTIVE: Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) accelerate the progressive impairment of lung function and general health. Together with maintenance therapy for chronic obstructive pulmonary disease (COPD), N-acetylcysteine (NAC) and natural propolis have demonstrated pharmacological properties that address crucial pathophysiological processes underlying COPD and may prevent AECOPDs. This study aims at responding to dose-dependent efficacy and safety concerns regarding a propolis-NAC combination for the reduction of COPD exacerbation rates. PATIENTS AND METHODS: This was a single-center, randomized, double-blind, phase IV trial with three treatment arms: Placebo and two active substance groups, one (AS-600) received 600 mg of NAC + 80 mg of propolis while the other (AS-1,200) received 1,200 mg of NAC + 160 mg of propolis. Following an AECOPD, frequent-exacerbation phenotype patients (n=46) were assigned a once-daily three-month therapy with the study drug and one year follow-up. The primary endpoint was the COPD exacerbation incidence rate during the follow-up period as a measure of dose-dependent efficacy of NAC-propolis combination compared to placebo. RESULTS: There was a statistically significant difference in the AECOPD incidence rate: 52.6% in patients that received placebo, 15.4% that received AS-600 and only 7.1% that received AS-1,200 (Fisher's exact test, p = 0.013). Compared to placebo, AECOPD frequency was significantly lower only in AS-1,200 (p=0.009). Compared to placebo, the relative risk for exacerbation was 0.29 in AS-600 and 0.13 in AS-1,200. No adverse events related to the treatment were reported. CONCLUSIONS: Oral combination of natural propolis with NAC confirmed formulation efficiency with a favorable safety profile. Our results need to be confirmed by larger clinical trials.
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Própole , Doença Pulmonar Obstrutiva Crônica , Acetilcisteína/efeitos adversos , Progressão da Doença , Método Duplo-Cego , Humanos , Própole/uso terapêuticoRESUMO
Cardiovascular disease is one of the leading causes of death worldwide, and has been associated with many environmental risk factors. Recent evidence has indicated the involvement of pathogens such as viruses as causative agents, and specifically identified the coxsackievirus B serogroup as the leading culprit. Not only has coxsackievirus B3 (CB3) been identified from patients with cardiovascular disease, but also infection of mice with CB3 strains can reproduce human clinical heart disease in rodents. Several mechanisms have been proposed in an attempt to distinguish between pathology mediated by direct viral destruction of cardiac muscle cells or by the virus-induced immune response directed at infected myocytes or at 'mimicked' epitopes shared between viral and cardiac antigens. To distinguish between these mechanisms, we infected a unique mouse that diminishes the extent of infection and spread of the virus, but allows complete immunity to the virus. Transgenic mice expressing interferon-gamma in their pancreatic beta cells failed to develop CB-3-induced myocarditis. This work challenges the idea of the function of the immune response and 'molecular mimicry' in the CB-3-induced autoimmune myocarditis model, and instead favors the idea of virus-mediated damage. These results emphasize the benefit of reducing the level of viremia early during infection, thereby reducing the incidence of virus-mediated heart damage and autoimmunity.
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Infecções por Coxsackievirus/imunologia , Enterovirus Humano B/imunologia , Interferon gama/imunologia , Miocardite/imunologia , Pâncreas/imunologia , Animais , Autoanticorpos/imunologia , Infecções por Coxsackievirus/patologia , Infecções por Coxsackievirus/virologia , Modelos Animais de Doenças , Expressão Gênica , Células HeLa , Coração/virologia , Humanos , Interferon gama/biossíntese , Interferon gama/genética , Camundongos , Camundongos Endogâmicos NOD , Camundongos Transgênicos , Miocardite/patologia , Miocardite/virologia , Miocárdio/imunologia , Miocárdio/metabolismo , Miocárdio/patologia , Miosinas/imunologia , Pâncreas/metabolismo , Pâncreas/patologiaRESUMO
We report on three cases of symptomatic transmission of the L-Zagreb mumps vaccine virus from three vaccinated children to five adult contacts. The five contact cases were parents of the vaccinated children and presented with parotitis and in one case also with aseptic meningitis. The etiology of the contacts' illness was determined by viral culture, genomic sequencing, serology and epidemiological linking. Two of the vaccinated children developed vaccine associated parotitis as an adverse event three weeks following immunization. Symptoms in contact cases developed five to seven weeks after the vaccination of the children. The five contact cases, as well as the three children with adverse events recovered completely. The children had been vaccinated with MMR vaccine produced by the Institute of Immunology Zagreb, each of them with a different lot. One of the possible explanations for these adverse events is that the very low levels of wild mumps virus circulation in the last decade, combined with waning immunity in those who received one dose of vaccine or suffered from mumps in childhood, resulted in susceptible young adults and that this unique epidemiological situation allows us to detect horizontal transmission of mumps vaccine virus.
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Transmissão de Doença Infecciosa , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Vírus da Caxumba , Caxumba/transmissão , Adulto , Busca de Comunicante , Croácia , Feminino , Humanos , Programas de Imunização , Lactente , Masculino , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Meningite/virologia , Caxumba/diagnóstico , Caxumba/fisiopatologia , Vírus da Caxumba/imunologia , Parotidite/virologiaRESUMO
BACKGROUND: An association between gestational hypertension (GH) and changes of maternal cardiac function was previously reported. AIM: The study assessed the effect of non-dipping pattern of blood pressure (BP) in GH on haemodynamic function and intrauterine growth restriction (IUGR). METHODS: This study included 126 women (91 with GH and 35 normotensive controls). Based on the BP values measured by ambulatory blood pressure monitoring (ABPM), all hypertensive women were classified in dipper (46 women) or in non-dipper group (45 women). All participants underwent echocardiography and ABPM during the third trimester. RESULTS: Participants with GH and non-dipping pattern had significantly lower velocity of longitudinal systolic function (s') (p<0.0005), and cardiac output index (COi) compared to dippers (p<0.0005) and controls (p=0.002). Diastolic velocities at the mitral valve annulus were also lower in non-dippers e's (non-dippers vs dippers p=0.023; non-dippers vs controls p<0.0005) and e'l (non-dippers vs dippers p=0.048; non-dippers vs controls p<0.0005). There were significant differences in the index of the left ventricle filling pressure E/e' and myocardial mass index between women with GH and controls, but with no significant difference among dippers and non-dippers. Total vascular resistance was increased in non-dipping group compared to normotensives and dippers (p<0.0005). Multivariate regression analysis revealed that the peak night-time diastolic BP, left ventricular mass index and CO index were identified as independent predictors of IUGR. CONCLUSION: Changes in maternal hemodynamics, as well as IUGR, are strongly related to the non-dipping pattern of BP.
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Pressão Sanguínea/fisiologia , Retardo do Crescimento Fetal/fisiopatologia , Hipertensão Induzida pela Gravidez/fisiopatologia , Adulto , Determinação da Pressão Arterial , Débito Cardíaco , Estudos de Casos e Controles , Ecocardiografia , Feminino , Hemodinâmica , Humanos , Gravidez , Resultado da Gravidez , Estudos ProspectivosRESUMO
A higher prevalence of risk factors for venous thromboembolism (VTE) has been found in women with preeclampsia and fetal loss. We investigated whether women with a history of VTE have a higher prevalence of pregnancy-associated complications compared with control subjects. In 395 patients with a history of VTE and in 313 control women, the prevalence of complications during pregnancy and the mean birth weight of viable infants were evaluated. The prevalence of pregnancy-induced hypertension and preeclampsia was higher in patients (5.1% and 3.0%, respectively) compared with control subjects (1.3% each). The odds ratio was 4.13 for pregnancy-induced hypertension (95% CI 1.4 to 12.22, P=0.0058) and 2.43 for preeclampsia (95% CI 0.78 to 7.6, P=0.133). Stillbirth was slightly more frequent in patients (4.3%) than in control subjects (3.2%); the difference was not statistically significant. Miscarriage was equally frequent in patients (21.8%) and control subjects (21.3%). The birth weight of viable infants born to patients was, on average, 109 g lower than that of the infants born to the control subjects (P=0.014) after adjustment for the mother's body mass index. Our study demonstrates that women with a predisposition to VTE have, overall, a good chance for a successful pregnancy outcome. However, the findings from our study support the assumption that a predisposition to venous thrombosis is associated with a higher risk for complications during pregnancy and lower infant birth weight.
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Morte Fetal/epidemiologia , Pré-Eclâmpsia/epidemiologia , Tromboembolia/complicações , Trombose Venosa/complicações , Adolescente , Adulto , Peso ao Nascer , Feminino , Morte Fetal/etiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Pessoa de Meia-Idade , Pré-Eclâmpsia/etiologia , Gravidez , Prevalência , Estudos Retrospectivos , Fatores de Risco , Tromboembolia/diagnóstico , Trombose Venosa/diagnóstico , Trombose Venosa/epidemiologiaRESUMO
INTRODUCTION: Intima-media thickness (IMT) of the carotid artery is a widely accepted parameter for detection and quantification of atherosclerosis. The aim of the study was the evaluation of the impact of changes of IMT on the mortality of patients on hemodialysis. METHODS: The study was organized as a prospective and observational one. Intima-media thickness was determined by ultrasound in 194 patients who were evaluated every year during a three-year period. We analyzed the mortality rate of patients on hemodialysis in relation to their biochemical parameters, demographic and anthropometric characteristics, type of dialysis, smoking habits and statin therapy. RESULTS: Female gender and hemodiafiltration emerged as good predictors of long-term survival. Baseline IMT values were significantly lower than those at the end of the second (p <0.001) and third years of the study (p <0.001). The baseline values positively correlated with uric acid levels (p =0.027) and body mass index (p =0.024), while at the end of the second year, IMT positively correlated with LDL-cholesterol (p =0.037) and triglyceride levels (p =0.018) and body mass index (p =0.045). Patients on hemodiafiltration had significantly higher values for erythrocytes (p =0.047), hemoglobin (p =0.005), creatinine (p =0.048), Kt/V (p =0.026), albumin (p =0.012), LDL-cholesterol (p <0.001), body mass index (p <0.001),and lower IMT values at the end of the first year (p =0.039), compared to patients on bicarbonate hemodialysis. Predictors of death were the duration of hemodialysis (p <0.001), and IMT at the end of the first (p =0.008) and second years of the study (p =0.005). CONCLUSION: Dynamic changes of IMT of the carotid arteries during the first two years were found in our study to be predictors of mortality in patients on hemodialysis. Hippokratia 2015; 19 (2):158-163.
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The morphology of neurons in the magnocellular septal nuclei (medial septal and diagonal band nucleus) were studied in frontal sections of 15 human brains by means of the Golgi method. We classified neurons in the diagonal band nucleus according to their size and morphology into four types: type I--multipolar neurons, type II--fusiform neurons, type III--triangular neurons and type IV--fusiform multipolar neurons. The neurons of the medial septal nucleus we classified into two types: type I--multipolar neurons and type II--fusiform neurons. Our results indicated greater morphological variability of neurons in the human diagonal band nucleus than in the medial septal nucleus.
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Complexo de Golgi/ultraestrutura , Hominidae/anatomia & histologia , Neurônios/citologia , Núcleos Vestibulares/anatomia & histologia , Adulto , Idoso , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Núcleos Vestibulares/citologiaRESUMO
OBJECTIVES: To assess the impact of high body mass index (BMI) on patient-reported outcomes in sarcoidosis patients and healthy persons. METHODS: In this case-control study, we investigated symptoms of fatigue and dyspnoea, health status, BMI and spirometric tests in 184 sarcoidosis patients and the same number of sex- and age-matched healthy subjects. Fatigue was assessed using the fatigue scale (FS), dyspnoea was determined by the baseline dyspnoea index (BDI) and health status was measured using the respiratory-specific St George's Respiratory Questionnaire (SGRQ). RESULTS: There were significantly more subjects with increased BMI (≥25 kg/m(2)) among the sarcoidosis patients than among the healthy volunteers ((2) 37.675, P < 0.01). Sarcoidosis patients also had a greater probability of having a higher BMI (P < 0.01, OR 1.18, 95%CI 1.071.3). We found significantly lower BDI scores and forced expiratory volume in 1 s/forced vital capacity, as well as higher total SGRQ and total FS scores in sarcoidosis patients than in healthy individuals (P < 0.01 for all differences). CONCLUSION: Sarcoidosis significantly reduces patients' health status, both independently and also due to increased BMI. Reduction in BMI may contribute to improved spirometry results and health status of patients with sarcoidosis.
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Obesidade/complicações , Sarcoidose Pulmonar/complicações , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Dispneia/etiologia , Fadiga/etiologia , Feminino , Volume Expiratório Forçado , Nível de Saúde , Humanos , Imunossupressores/uso terapêutico , Modelos Logísticos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/diagnóstico , Razão de Chances , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , Sarcoidose Pulmonar/diagnóstico , Sarcoidose Pulmonar/tratamento farmacológico , Sarcoidose Pulmonar/fisiopatologia , Sérvia , Espirometria , Inquéritos e Questionários , Capacidade VitalRESUMO
PURPOSE: To analyze the clinical pattern of ocular toxoplasmosis (OT) in a referral centre in Serbia. PATIENTS AND METHODS: The medical records of consecutive patients admitted for OT to the single referral centre for uveitis in Serbia between 2006 and 2010 were retrospectively analyzed. OT was diagnosed on the basis of typical fundus lesions and positive serology for Toxoplasma. RESULTS: In a total of 457 uveitis patients, OT was the third leading cause, with 59 patients (12.9%). Most OT cases (73%) were monocular. An active primary retinal lesion was observed in 36% and recurrent OT in 64% patients. Localization of lesions was central/paracentral (44%), juxtapapillar (27%), peripheral (19%), and multifocal (10%). Other ocular manifestations of inflammation included vitritis (44%), anterior uveitis (19%), and retinal vasculitis (10%). Complications included choroidal neovascularization in two and exudative retinal detachment with cataract, glaucoma, and cystoid macular oedema in one patient each. The detection of Toxoplasma-specific IgM antibodies in a single patient indicates a low rate of OT concomitant with acute infection. After treatment, the mean best-corrected visual acuity (BCVA) increased significantly. However, 14 (24%) patients ended up legally blind in the affected eye, of which 2 (3%) with bilateral blindness, all with a very poor BCVA (0.047 ± 0.055) at presentation. Visual impairment and treatment outcome were both associated with central localization of lesions (P<0.0001 and P=0.006, respectively). CONCLUSION: OT is a significant cause of posterior uveitis in Serbia. Patients should be aware of the recurring nature of OT and react immediately if symptoms occur.
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Toxoplasmose Ocular/epidemiologia , Adulto , Anticorpos Antiprotozoários/sangue , Antiprotozoários/uso terapêutico , Neovascularização de Coroide/epidemiologia , Neovascularização de Coroide/imunologia , Neovascularização de Coroide/parasitologia , Ensaio de Imunoadsorção Enzimática , Feminino , Angiofluoresceinografia , Glaucoma/epidemiologia , Glaucoma/imunologia , Glaucoma/parasitologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/imunologia , Descolamento Retiniano/parasitologia , Estudos Retrospectivos , Sérvia/epidemiologia , Tomografia de Coerência Óptica , Toxoplasma/imunologia , Toxoplasmose Ocular/imunologia , Toxoplasmose Ocular/parasitologia , Uveíte/epidemiologia , Uveíte/imunologia , Uveíte/parasitologia , Acuidade Visual/fisiologiaRESUMO
Measurements of air quality in the territory of Bor (Serbia) were performed at the sampling sites in the urban-industrial, suburban and rural area during the 2003-2008 period. A high level of arsenic (As) concentration in suspended particulate matter (PM) is of a predominantly industrial origin. The major source of pollution is the copper smelter which is situated in the close vicinity of the urban area of Bor. The ambient level of PM and As is influenced by meteorological parameters as well as the remoteness from the copper smelter. Continual exceedances of the annual limit value (LV) for As (6 ng m(-3)) were recorded at the sampling sites in the urban-industrial and suburban area. Maximum annual As concentrations were recorded at Town Park (46.5 ng m(-3)) in 2004, Institute (95.4 ng m(-3)) in 2004 and Jugopetrol (74.5 ng m(-3)) in 2003. In the past 15 years not a single mean annual As concentration recorded at the sampling sites Town Park, Institute and Jugopetrol has been within the LV. When the average annual and maximum monthly As concentrations are compared, it can be concluded that the level of pollution is higher in the urban-industrial and suburban areas than in the rural area.
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Arsênio/análise , Resíduos Industriais/análise , Material Particulado/análise , Poluentes Atmosféricos/análise , Cidades , Cobre/análise , Monitoramento Ambiental/métodos , Metalurgia , SérviaAssuntos
Adenoma de Ducto Biliar/epidemiologia , Carcinoma Hepatocelular/epidemiologia , Neoplasias Hepáticas/epidemiologia , Adenoma de Ducto Biliar/diagnóstico , Adulto , Carcinoma Hepatocelular/diagnóstico , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , IugosláviaRESUMO
Neurocysticercosis is a clinical form of parasitic infection caused by Taenia solium. Therapy is recommended only for the symptomatic form of illness and whether to apply conservative and/or surgical treatment, depends on the localization of the infection in the nerve tissue, the number of cysts and symptoms of the infection. Conservative therapy (drug therapy and supportive therapy) is the therapy of choice for majority of patients, while Albendazole has proved better than Praziquantel in many clinical trials. The recommended dose of Albendazole is 10-15 mg/kg/24h during 8-28 days, whereas for Praziquantel it is 50 mg/kg/24h in three divided doses during 15 days. It is considered that combined therapy of Albendazole and Dexamethasone has better effects because of increased serum concentration of Albendazole metabolites. Implantation of intraventricular shunt and/or removal of cysts are surgical procedures in management of neurocysticercosis. Combined conservative and surgical treatment is most often applied in extraparenchymal forms and those parenchymal forms of neurocysticercosis in which symptoms persist despite antihelmintic therapy, while cysts are accessible for surgical treatment.
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Neurocisticercose/terapia , Humanos , Neurocisticercose/diagnósticoRESUMO
The caecum in man as a part of the large colon (intestinum crassum) differs morphologically and topographically from the caecum of domestic mammals. The caecum in domestic mammals differs not only from the human caecum but also comparatively morphologically and topographically among the domestic mammals. The appendix vermiformis does not exist in domestic mammals, which represents the main difference between the human caecum and that of domestic mammals. There are certainly some differences in the physiological function of the caecum in man and the caecum in domestic mammals, which are carnivores, omnivores, omnivores and herbivores.
Assuntos
Ceco/anatomia & histologia , Mamíferos/anatomia & histologia , Adulto , Idoso , Anatomia Comparada , Animais , Apêndice/anatomia & histologia , Búfalos , Gatos , Bovinos , Colo/anatomia & histologia , Cães , Cabras , Cavalos , Humanos , Masculino , Pessoa de Meia-Idade , Ovinos , SuínosRESUMO
The knowledge of the topographical relationship of some body structures was one of our aims in the study of the position and topography of the ulnar nerve in the lower third of the upper arm and the elbow region. The elbow region, because of its close relation to the ulnar nerve, especially the relation to the medial epicondyle of the humerus and the nerve, may explain some injuries of the nerve trunk. In this region the anterior dislocation of the ulnar nerve may occur, as well. We studied 60 specimens of the foetuses, newborn infants and adult persons of both sexes, by using macro and micro dissection. Almost in all cases (96.7%) the ulnar nerve passed from the upper arm to the forearm through the bony-fibrous opening ("the elbow tunnel") on the posterior side of the elbow. The anterior wall of the tunnel was sulcus n. ulnaris, while its posterior-medial wall was a strong, fibrous arch-shaped band that connected olecranon and the tip of the medial epicondyle. In the majority of cases (75%) this fibrous arc was thick and strong, high, and did not reach the top of the medial epicondyle. Thus it prevented the anterior dislocation of the ulnar nerve in the elbow flexion. Rarely (21.7%) this fibrous are was situated lower, even 15 mm below the medial epicondyle top. This disposition could favour the anterior dislocation of the ulnar nerve. Only rarely (3.3%) the ulnar nerve passed in front of the medial epicondyle.