Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with ...Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.展开更多
Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can...Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.展开更多
Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality r...Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality rates. Aim: The sporadic nature of carcinosarcomas of the oral cavity, sinonasal tract, larynx, and hypopharynx causes difficulties with the diagnostic and therapeutic approach. Our clinical case is an example of a rare localization of carcinosarcoma, which allows for a detailed examination thereof. Materials and methods: We present a clinical case of a 67-year-old male, admitted to the Otorhinolaryngology Clinic of University Hospital “Sv. Georgi”—Plovdiv, presenting with difficulty swallowing and a lump on the right side of the neck for several months. Computed tomography was performed and a tumor involving the right palatine tonsil was found. The tonsil was surgically removed. The histopathological findings showed a biphasic tumor with epithelial and mesenchymal components—carcinosarcoma. Results: Following monotonsillectomy, the patient was referred to radiotherapy. The local status does not indicate any progression and infiltration into soft tissue. Conclusion: Carcinosarcoma is a malignant mixed tumor with high recurrence, metastasis, and mortality rates. It is difficult to diagnose due to its non-typical location and the need for immunohistochemistry testing, which is not always possible. The therapy for carcinosarcoma of the head and neck is delivered as per protocol for treatment of squamous cell carcinoma due to the absence of a specific one.展开更多
BACKGROUND Russell body gastritis(RBG)is very rare type of chronic inflammation of gastric mucosa.The pathologic hallmark of the disease is Russell bodies(RB)which represent accumulation of eosinophilic cytoplasmic in...BACKGROUND Russell body gastritis(RBG)is very rare type of chronic inflammation of gastric mucosa.The pathologic hallmark of the disease is Russell bodies(RB)which represent accumulation of eosinophilic cytoplasmic inclusions in endoplasmic reticulum of mature plasma cells(Mott cells).Most published cases are associated with Helicobacter pylori(H.pylori)infection because of correlation between plasma cell activation and antigenic stimulation.There are insufficient data about H.pylori-negative RBG and very little is known about the natural course of the disease.CASE SUMMARY A 51-year-old male patient underwent endoscopic screening for mild iron deficiency anemia.Gastroscopy revealed diffuse hyperemia,edema and nodularity of the fundic and corpus mucosa.Due to non-specific endoscopic findings and iron-deficiency anemia our preliminary diagnosis was diffuse type of gastric carcinoma or gastric lymphoma.Biopsy specimens of gastric mucosa showed inflammatory infiltrate rich in Mott cells,consisting entirely of cytoplasmic RB.Absence of nuclear atypia and mitosis of the plasma cells,polyclonal pattern of the Mott cells and negative staining for cytokeratins favored diagnosis of RBG.The patient was treated with proton-pump inhibitor for 8 wk.Long-term clinical and endoscopic surveillance was scheduled.Albeit,there was no improvement in endoscopic features of the gastric mucosa in three consecutive gastroscopies,histopathological findings demonstrated that the chronic inflammatory infiltrate in the fundic mucosa is less pronounced,rich in plasma cells,with almost absent RB and Mott cells.CONCLUSION The prognosis of this entity is uncertain,that is why these patients are subjects of continuous follow up.展开更多
Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic isl...Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.展开更多
BACKGROUND Hospitalized and severely ill coronavirus disease 2019(COVID-19)patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites.Life-threatening bleedi...BACKGROUND Hospitalized and severely ill coronavirus disease 2019(COVID-19)patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites.Life-threatening bleeding complications include spontaneous iliopsoas hematoma,peritoneal bleeding,and extra-abdominal manifestations such as intracranial hemorrhage.CASE SUMMARY Bleeding in the abdominal wall results in less severe complications than seen with iliopsoas hematoma or peritoneal bleeding.In our case series of 9 patients,we present retroperitoneal and abdominal bleeding complications following anticoagulation in hospitalized COVID-19 patients with severe acute respiratory syndrome coronavirus 2 pneumonia.Contrast-enhanced computed tomography(CE-CT)is the best imaging modality for assessing hematoma secondary to anticoagulation and determines the therapeutic approach,whether interventional,surgical,or conservative management.CONCLUSION We present the role of CE-CT for rapid and precise localization of the bleeding site and prognostic counseling.Finally,we provide a brief review of the literature.展开更多
Estrogen and progesterone receptor (ER and PR) contents of 40 breastcancer patients were determined with immunofluorescent staining.Thedifferentiation of cancer cells was evaluated on the basis of histological andultr...Estrogen and progesterone receptor (ER and PR) contents of 40 breastcancer patients were determined with immunofluorescent staining.Thedifferentiation of cancer cells was evaluated on the basis of histological andultrastructural changes.It was found that there was a positive correlation of ERand PR contents with the cellular differentiation of breast cancer,and the lattercould be used to estimate the status of hormone receptors.Breast cancer is a malignant disease with heteropathological characteristics.In handling a breast cancerpatient,both the status of hormone receptors and the cellular differentiationshould be considered and the treatment varied with each pa(?)ent.For those witha well-differentiated cancer and rich hormone receptors,endocrine therapy shouldmainly be administered,while for those with a poorly-differentiated cancer and afew hormone receptors,chemotherapy would be of choice.展开更多
The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slig...The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slight abdominal distension and odorless purulent vulvar discharge after unsuccessful medical treatment with enrofloxacine and aglepristone 2 months ago in another clinic. Ultrasonography revealed enlarged uterine horns filled with fluid and blood laboratory analysis showed anaemia and leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. Histopathological and microbiological examination of the uterus revealed the presence of purulent atrophic endometritis caused by Staphylococcus spp. In conclusion, this is a very rare case of endometrial atrophia after chronic uterine inflammation in a ferret.展开更多
The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the...The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic.The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care.Additionally,the adverse effects of any surgery delays and the financial consequences complicate the picture.Therefore,patients’admission during the COVID-19 pandemic should be taken into consideration,as well as preoperative measures.The COVID-19 situation brings particular risk to patients during surgery,where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients.This review discusses the recent factors associated with surgical complications,mortality rates,outcomes,and experience in COVID-19 surgical patients.展开更多
Melatonin, the principal secretory product of the pineal gland, functions as a potent antioxidant and free radical scavenger. Additionally, the antiapoptotic effect of melatonin has been observed both in vivo and in v...Melatonin, the principal secretory product of the pineal gland, functions as a potent antioxidant and free radical scavenger. Additionally, the antiapoptotic effect of melatonin has been observed both in vivo and in vitro. The aim of this study was to investigate the protective effects of melatonin against burn-induced injury in rat liver and whether these changes were associated with oxidative stress and changes in the expression of apoptosis related genes Bcl-2 and Bax. Melatonin (10 mg/kg, i.p.) was applied immediately after 30% of total body surface area (TBSA) burns of male Wistar rats. Malondialdehyde (MDA) as marker of oxidative stress and tumor necrosis factor (TNF-α) as inflammatory marker were assayed by biochemical methods. The hepatic apoptosis related genes Bcl-2 and Bax using light immunоchistochemistry were investigated, too. Hepatic TNF-α and MDA levels were increased significantly following severe burn. Thermal trauma increased the Bax expression without any changes of anti-apoptotic Bcl-2 protein in sinusoidal endothelial cells (SECs) of burn-treated animals compared with the control group animals as well as elevated ratio Bax/Bcl-2 suggesting the susceptibility of these cells to apoptosis. Melatonin significantly decreased the MDA and TNF-α levels in the liver tissue. It decreased also expression of Bax, increased expression of Bcl-2 and reduced Bax/Bcl-2 ratio. In conclusion, experimental data show that melatonin modulates the expression of Bcl-2 family proteins by increasing anti-apoptotic Bcl-2, inhibits apoptosis and restricts the burn-induced damage.展开更多
Background: Rhabdomyolysis (RM) is striate muscle-cell damage with the release of intracellular substances to the circulation—myoglobin, muscular enzymes, potassium, etc., with or without the development of acute ren...Background: Rhabdomyolysis (RM) is striate muscle-cell damage with the release of intracellular substances to the circulation—myoglobin, muscular enzymes, potassium, etc., with or without the development of acute renal injury. RM due to the intake of illicit and controlled substances, including cocaine, amphetamine and its derivates, cannabis, and alcohol abuse is a common cause of acute renal failure in adolescents and adults. Aim: to alert clinicians to the need of early diagnosis and treatment of RM due to the intake of controlled substances and energy drinks. Case Presentation: We describe a 20-year-old male patient with acute renal failure due to rhabdomyolysis after the intake of controlled substances, energy drinks, physical efforts and dehydration. The renal biopsy revealed acute tubular injury. After rehydration, alkalization, temporary dialysis treatment, intravenous corticosteroids and symptomatic treatment the patient restored renal function. Conclusion: RM can be a severe life-threatening complication of the intake of controlled substances combined with strenuous physical activity, energy drinks and dehydration. The described case represents a typical scenario of RM developing secondary to controlled substance abuse in combination with alcohol and strenuous physical activity. The prompt diagnosis and the timely initiation of supportive (rehydration and alkalization) and corticosteroid therapy and the early dialysis lead to fast resolution of renal failure. The clinicians should keep in mind illicit drugs, alcohol and energy drinks and physical efforts as possible triggers of RM and acute kidney injury, especially in young people.展开更多
It is well known that air in industrial cities contains a significant amount of dust particles, smoke, and toxic gases. The increased number of vehicles has a direct impact on air quality resulting in the emission of ...It is well known that air in industrial cities contains a significant amount of dust particles, smoke, and toxic gases. The increased number of vehicles has a direct impact on air quality resulting in the emission of exhaust gases, and the increase of dust concentration in air. In this article, we are describing the dust retention ability of plants depending on their leaf structure. Plant species were classified into three groups according to their dust-holding capacities. Dust retaining ability of plant species in conditions of high, average and low dust conditions described.展开更多
The introduction of coronavirus disease-2019(COVID-19)as a global pandemic has contributed to overall morbidity and mortality.With a focus on understanding the immunology and pathophysiology of the disease,these featu...The introduction of coronavirus disease-2019(COVID-19)as a global pandemic has contributed to overall morbidity and mortality.With a focus on understanding the immunology and pathophysiology of the disease,these features can be linked with the respective findings of imaging studies.Thus,the constellation between clinical presentation,histological,laboratory,immunological,and imaging results is crucial for the proper management of patients.The purpose of this article is to examine the role of imaging during the particular stages of severe acute respiratory syndrome coronavirus 2 infection–asymptomatic stage,typical and atypical COVID-19 pneumonia,acute respiratory distress syndrome,multiorgan failure,and thrombosis.The use of imaging methods to assess the severity and duration of changes is crucial in patients with COVID-19.Radiography and computed tomography are among the methods that allow accurate characterization of changes.展开更多
The coronavirus disease 2019(COVID-19)pandemic profoundly affected the management and treatment of patients with malignancies.Based on the progress reported in the literature,we reviewed the recommendations for treatm...The coronavirus disease 2019(COVID-19)pandemic profoundly affected the management and treatment of patients with malignancies.Based on the progress reported in the literature,we reviewed the recommendations for treatment and vaccination in patients with gastrointestinal stromal tumor(GIST)during COVID-19.We focus on whether there is a risk and what could be the possible effects of vaccinating patients with GIST/cancer.Since the situation is quickly changing,and the health services have been severely disrupted,the diagnosis,treatment and recommendations for vaccination of these patients against COVID-19 are still not updated.The approval of vaccines in the pandemic gave hope that we would soon be able to return to a more normal life.However,the oncology community needs to adapt and provide the most effective treatment and care models for patients with rare cancer,such as GIST.Collecting data on the impact of vaccination in patients with GIST/cancer also will be beneficial in expanding knowledge about the future planning of treatment strategies and optimizing care in the event of a subsequent pandemic.展开更多
基金Supported by The European Union-NextGenerationEU,Through The National Recov-ery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008。
文摘Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No. BG-RRP-2.004-0008-C01。
文摘Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.
文摘Introduction: Carcinosarcoma of the head and neck is a very rare pathology < 1%. This is a mixed tumor with epithelial and mesenchymal components. It is characterized by high recurrence, metastasis, and mortality rates. Aim: The sporadic nature of carcinosarcomas of the oral cavity, sinonasal tract, larynx, and hypopharynx causes difficulties with the diagnostic and therapeutic approach. Our clinical case is an example of a rare localization of carcinosarcoma, which allows for a detailed examination thereof. Materials and methods: We present a clinical case of a 67-year-old male, admitted to the Otorhinolaryngology Clinic of University Hospital “Sv. Georgi”—Plovdiv, presenting with difficulty swallowing and a lump on the right side of the neck for several months. Computed tomography was performed and a tumor involving the right palatine tonsil was found. The tonsil was surgically removed. The histopathological findings showed a biphasic tumor with epithelial and mesenchymal components—carcinosarcoma. Results: Following monotonsillectomy, the patient was referred to radiotherapy. The local status does not indicate any progression and infiltration into soft tissue. Conclusion: Carcinosarcoma is a malignant mixed tumor with high recurrence, metastasis, and mortality rates. It is difficult to diagnose due to its non-typical location and the need for immunohistochemistry testing, which is not always possible. The therapy for carcinosarcoma of the head and neck is delivered as per protocol for treatment of squamous cell carcinoma due to the absence of a specific one.
文摘BACKGROUND Russell body gastritis(RBG)is very rare type of chronic inflammation of gastric mucosa.The pathologic hallmark of the disease is Russell bodies(RB)which represent accumulation of eosinophilic cytoplasmic inclusions in endoplasmic reticulum of mature plasma cells(Mott cells).Most published cases are associated with Helicobacter pylori(H.pylori)infection because of correlation between plasma cell activation and antigenic stimulation.There are insufficient data about H.pylori-negative RBG and very little is known about the natural course of the disease.CASE SUMMARY A 51-year-old male patient underwent endoscopic screening for mild iron deficiency anemia.Gastroscopy revealed diffuse hyperemia,edema and nodularity of the fundic and corpus mucosa.Due to non-specific endoscopic findings and iron-deficiency anemia our preliminary diagnosis was diffuse type of gastric carcinoma or gastric lymphoma.Biopsy specimens of gastric mucosa showed inflammatory infiltrate rich in Mott cells,consisting entirely of cytoplasmic RB.Absence of nuclear atypia and mitosis of the plasma cells,polyclonal pattern of the Mott cells and negative staining for cytokeratins favored diagnosis of RBG.The patient was treated with proton-pump inhibitor for 8 wk.Long-term clinical and endoscopic surveillance was scheduled.Albeit,there was no improvement in endoscopic features of the gastric mucosa in three consecutive gastroscopies,histopathological findings demonstrated that the chronic inflammatory infiltrate in the fundic mucosa is less pronounced,rich in plasma cells,with almost absent RB and Mott cells.CONCLUSION The prognosis of this entity is uncertain,that is why these patients are subjects of continuous follow up.
基金Supported by European Union-NextGenerationEU,through The National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008-C01.
文摘Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.
文摘BACKGROUND Hospitalized and severely ill coronavirus disease 2019(COVID-19)patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites.Life-threatening bleeding complications include spontaneous iliopsoas hematoma,peritoneal bleeding,and extra-abdominal manifestations such as intracranial hemorrhage.CASE SUMMARY Bleeding in the abdominal wall results in less severe complications than seen with iliopsoas hematoma or peritoneal bleeding.In our case series of 9 patients,we present retroperitoneal and abdominal bleeding complications following anticoagulation in hospitalized COVID-19 patients with severe acute respiratory syndrome coronavirus 2 pneumonia.Contrast-enhanced computed tomography(CE-CT)is the best imaging modality for assessing hematoma secondary to anticoagulation and determines the therapeutic approach,whether interventional,surgical,or conservative management.CONCLUSION We present the role of CE-CT for rapid and precise localization of the bleeding site and prognostic counseling.Finally,we provide a brief review of the literature.
文摘Estrogen and progesterone receptor (ER and PR) contents of 40 breastcancer patients were determined with immunofluorescent staining.Thedifferentiation of cancer cells was evaluated on the basis of histological andultrastructural changes.It was found that there was a positive correlation of ERand PR contents with the cellular differentiation of breast cancer,and the lattercould be used to estimate the status of hormone receptors.Breast cancer is a malignant disease with heteropathological characteristics.In handling a breast cancerpatient,both the status of hormone receptors and the cellular differentiationshould be considered and the treatment varied with each pa(?)ent.For those witha well-differentiated cancer and rich hormone receptors,endocrine therapy shouldmainly be administered,while for those with a poorly-differentiated cancer and afew hormone receptors,chemotherapy would be of choice.
文摘The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slight abdominal distension and odorless purulent vulvar discharge after unsuccessful medical treatment with enrofloxacine and aglepristone 2 months ago in another clinic. Ultrasonography revealed enlarged uterine horns filled with fluid and blood laboratory analysis showed anaemia and leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. Histopathological and microbiological examination of the uterus revealed the presence of purulent atrophic endometritis caused by Staphylococcus spp. In conclusion, this is a very rare case of endometrial atrophia after chronic uterine inflammation in a ferret.
文摘The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic.The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care.Additionally,the adverse effects of any surgery delays and the financial consequences complicate the picture.Therefore,patients’admission during the COVID-19 pandemic should be taken into consideration,as well as preoperative measures.The COVID-19 situation brings particular risk to patients during surgery,where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients.This review discusses the recent factors associated with surgical complications,mortality rates,outcomes,and experience in COVID-19 surgical patients.
文摘Melatonin, the principal secretory product of the pineal gland, functions as a potent antioxidant and free radical scavenger. Additionally, the antiapoptotic effect of melatonin has been observed both in vivo and in vitro. The aim of this study was to investigate the protective effects of melatonin against burn-induced injury in rat liver and whether these changes were associated with oxidative stress and changes in the expression of apoptosis related genes Bcl-2 and Bax. Melatonin (10 mg/kg, i.p.) was applied immediately after 30% of total body surface area (TBSA) burns of male Wistar rats. Malondialdehyde (MDA) as marker of oxidative stress and tumor necrosis factor (TNF-α) as inflammatory marker were assayed by biochemical methods. The hepatic apoptosis related genes Bcl-2 and Bax using light immunоchistochemistry were investigated, too. Hepatic TNF-α and MDA levels were increased significantly following severe burn. Thermal trauma increased the Bax expression without any changes of anti-apoptotic Bcl-2 protein in sinusoidal endothelial cells (SECs) of burn-treated animals compared with the control group animals as well as elevated ratio Bax/Bcl-2 suggesting the susceptibility of these cells to apoptosis. Melatonin significantly decreased the MDA and TNF-α levels in the liver tissue. It decreased also expression of Bax, increased expression of Bcl-2 and reduced Bax/Bcl-2 ratio. In conclusion, experimental data show that melatonin modulates the expression of Bcl-2 family proteins by increasing anti-apoptotic Bcl-2, inhibits apoptosis and restricts the burn-induced damage.
文摘Background: Rhabdomyolysis (RM) is striate muscle-cell damage with the release of intracellular substances to the circulation—myoglobin, muscular enzymes, potassium, etc., with or without the development of acute renal injury. RM due to the intake of illicit and controlled substances, including cocaine, amphetamine and its derivates, cannabis, and alcohol abuse is a common cause of acute renal failure in adolescents and adults. Aim: to alert clinicians to the need of early diagnosis and treatment of RM due to the intake of controlled substances and energy drinks. Case Presentation: We describe a 20-year-old male patient with acute renal failure due to rhabdomyolysis after the intake of controlled substances, energy drinks, physical efforts and dehydration. The renal biopsy revealed acute tubular injury. After rehydration, alkalization, temporary dialysis treatment, intravenous corticosteroids and symptomatic treatment the patient restored renal function. Conclusion: RM can be a severe life-threatening complication of the intake of controlled substances combined with strenuous physical activity, energy drinks and dehydration. The described case represents a typical scenario of RM developing secondary to controlled substance abuse in combination with alcohol and strenuous physical activity. The prompt diagnosis and the timely initiation of supportive (rehydration and alkalization) and corticosteroid therapy and the early dialysis lead to fast resolution of renal failure. The clinicians should keep in mind illicit drugs, alcohol and energy drinks and physical efforts as possible triggers of RM and acute kidney injury, especially in young people.
文摘It is well known that air in industrial cities contains a significant amount of dust particles, smoke, and toxic gases. The increased number of vehicles has a direct impact on air quality resulting in the emission of exhaust gases, and the increase of dust concentration in air. In this article, we are describing the dust retention ability of plants depending on their leaf structure. Plant species were classified into three groups according to their dust-holding capacities. Dust retaining ability of plant species in conditions of high, average and low dust conditions described.
文摘The introduction of coronavirus disease-2019(COVID-19)as a global pandemic has contributed to overall morbidity and mortality.With a focus on understanding the immunology and pathophysiology of the disease,these features can be linked with the respective findings of imaging studies.Thus,the constellation between clinical presentation,histological,laboratory,immunological,and imaging results is crucial for the proper management of patients.The purpose of this article is to examine the role of imaging during the particular stages of severe acute respiratory syndrome coronavirus 2 infection–asymptomatic stage,typical and atypical COVID-19 pneumonia,acute respiratory distress syndrome,multiorgan failure,and thrombosis.The use of imaging methods to assess the severity and duration of changes is crucial in patients with COVID-19.Radiography and computed tomography are among the methods that allow accurate characterization of changes.
文摘The coronavirus disease 2019(COVID-19)pandemic profoundly affected the management and treatment of patients with malignancies.Based on the progress reported in the literature,we reviewed the recommendations for treatment and vaccination in patients with gastrointestinal stromal tumor(GIST)during COVID-19.We focus on whether there is a risk and what could be the possible effects of vaccinating patients with GIST/cancer.Since the situation is quickly changing,and the health services have been severely disrupted,the diagnosis,treatment and recommendations for vaccination of these patients against COVID-19 are still not updated.The approval of vaccines in the pandemic gave hope that we would soon be able to return to a more normal life.However,the oncology community needs to adapt and provide the most effective treatment and care models for patients with rare cancer,such as GIST.Collecting data on the impact of vaccination in patients with GIST/cancer also will be beneficial in expanding knowledge about the future planning of treatment strategies and optimizing care in the event of a subsequent pandemic.
