MULTIDISCIPLINARY MANAGEMENT AND NEUROREHABILITATION OF PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS

Bolesnici s amiotrofi čnom lateralnom sklerozom zahtijevaju kompleksnu skrb i multidisciplinarni pristup, koji je individualno prilagođen potrebama bolesnika. Ciljevi neurorehabilitacije moraju biti prilagođeni stadiju bolesti. U ranom stadiju bolesti potrebno je započeti s fi zikalnom terapijom radi očuvanja i optimiziranja motoričke i respiratorne funkcije. Već u ovom stadiju potrebno je angažirati obitelj bolesnika u provođenju određenih aktivnosti i upoznati ih s prirodom bolesti. U kasnijem tijeku bolesti potrebno je provoditi fi zikalnu terapiju kako bi se spriječile respiratorne komplikacije i kontrakture, te se primijenila adekvatna ortopedska pomagala. Nastupom dizartrije nastaje potreba za evaluacijom akta gutanja i respiratorne funkcije. U početku se primjenjuju određeni manevri a potom nazogastrična sonda i perkutana gastrostoma. Primjenom neinvazivne mehaničke ventilacije i respiratorne fizioterapije može se odgoditi potrebu za traheostomom i invazivnom mehaničkom ventilacijom. Uloga multidisciplinarnog pristupa je pružiti optimalnu medicinsku skrb, olakšati komunikaciju a time poboljšati kvalitetu skrbi i života.Patients with amyotrophic lateral sclerosis require comprehensive care with a multidisciplinary approach, which is individually adjusted to each patient. The goals of neurorehabilitation should be adjusted to the stage of disease. In early stages, physical therapy is focused on preserving and optimizing motor and respiratory function. At this stage, family should be involved to partake in desired activities and be informed regarding the natural course of the disease. In late stages, physical therapy is focused on preventing respiratory complications and contractures, and orthotics may also be recommended. The onset of dysarthria should trigger swallowing and pulmonary function testing. Swallowing maneuvers should be tried at the onset of symptoms, later feeding tubes or percutaneous gastrostomy tube is necessary. Noninvasive mechanical ventilation may delay the need of tracheostomy and invasive mechanical ventilation. The key objectives of multidisciplinary teams are to optimize medical care, facilitate communication, and thus to improve the quality of care and quality of life

Import of non- coniferous wood into the European Union and risk for the forest

Posledice mednarodne trgovine z lesom med celinami in državami so vneseni tujerodni škodljivi organizmi, ki ob ustalitvi v našem okolju nimajo naravnih sovražnikov. Zato se lahko pojavijo v večjih populacijah in povzročajo poškodbe na rastlinah ali celo odmiranje. Pri prenovi zakonodaje na področju zdravja rastlin v EU je Slovenija podpirala preventivni pristop in previdnostno načelo pri trgovanju z rastlinami in rastlinskimi proizvodi iz tretjih držav. Za les listavcev ni dovolj zaščite pri uvozu v EU. Zato je bil pripravljen seznam novih, potencialno nevarnih tujerodnih škodljivih organizmov, ki bi jih morali uvrstiti v seznam karantenskih škodljivih organizmov in tako preprečiti njihov vnos z uvozom lesa gostiteljskih rastlin v EU in tako obvarovati gozdove pred potencialno škodo.The consequences of the international wood trade between the continents and countries are introduced non-native pests, which settle in our environment without natural enemies. Therefore, they can occur in larger populations and cause damages on plants or even their dying off. During the renovation of the EU plant health legislation Slovenia supported the preventive approach and safety principle for the trade of plant and plant products with the third countries. There is not enough protection for the non-coniferous wood at import to the EU. Therefore, a list of the new, potentially dangerous non-native pests has been prepared. These pests should be listed in the list of quarantine pests and thus prevent them from entering through the import of the host plant wood into the EU and thereby protect the forests from the potential damages

Rare Case of Multiple Perirenal, Extra-Adrenal Myelolipoma: Case Report, Current Management Options, and Literature Review

Extra-adrenal myelolipomas are rare, asymptomatic entities, although large tumors may cause local symptoms or hemorrhage. When these lesions occur outside the adrenals in the retroperitoneum, they are radiographically easily confused with both primary and secondary retroperitoneal tumors, which tend to be aggressive. Although myelolipomas are benign and can be managed conservatively, if malignancy is suspected, a surgical procedure is an option. We report a case of a 68-year-old patient with multiple perirenal extra-adrenal myelolipomas. Initial abdominal ultrasound reviled an inhomogeneous mass surrounding the left kidney. Subsequent CT examination of the abdomen showed four separate, extrarenal, well-circumscribed, round-shaped, fat-containing retroperitoneal tumors. Given the significant size of the masses, that compressed major abdominal vessels and the suspicion of liposarcoma, a surgical excision of the lesions was performed. The tumors were easily separated, all surrounding structures were spared, and they were removed completely. Histologically, all masses consisted of hematopoietic and mature fat tissue and the final diagnosis was extra-adrenal myelolipoma. The patient was released from the hospital 7th day after surgery in good condition and at his baseline. Since myelolipomas are, by definition, nonfunctional benign tumors, there was no need for further follow-up. The radiological evaluation and fine needle biopsy are usually sufficient to establish the diagnosis, but in some cases of well-differentiated liposarcoma, the differentiation between myelolipoma and liposarcoma can be challenging. Therefore, considering that myelolipomas and liposarcomas have opposite prognoses, which affects the surgeon’s decision on the extent of surgical procedure and further treatment, we also emphasize the importance of intraoperative assessment of the tumor, both by the surgeon and by intraoperative pathology consultation

Rare case of multiple perirenal, extra-adrenal myelolipoma: case report, current management options, and literature review

Extra-adrenal myelolipomas are rare, asymptomatic entities, although large tumors may cause local symptoms or hemorrhage. When these lesions occur outside the adrenals in the retroperitoneum, they are radiographically easily confused with both primary and secondary retroperitoneal tumors, which tend to be aggressive. Although myelolipomas are benign and can be managed conservatively, if malignancy is suspected, a surgical procedure is an option. We report a case of a 68-year-old patient with multiple perirenal extra-adrenal myelolipomas. Initial abdominal ultrasound reviled an inhomogeneous mass surrounding the left kidney. Subsequent CT examination of the abdomen showed four separate, extrarenal, well-circumscribed, round-shaped, fat-containing retroperitoneal tumors. Given the significant size of the masses, that compressed major abdominal vessels and the suspicion of liposarcoma, a surgical excision of the lesions was performed. The tumors were easily separated, all surrounding structures were spared, and they were removed completely. Histologically, all masses consisted of hematopoietic and mature fat tissue and the final diagnosis was extra-adrenal myelolipoma. The patient was released from the hospital 7th day after surgery in good condition and at his baseline. Since myelolipomas are, by definition, nonfunctional benign tumors, there was no need for further follow-up. The radiological evaluation and fine needle biopsy are usually sufficient to establish the diagnosis, but in some cases of well-differentiated liposarcoma, the differentiation between myelolipoma and liposarcoma can be challenging. Therefore, considering that myelolipomas and liposarcomas have opposite prognoses, which affects the surgeon\u27s decision on the extent of surgical procedure and further treatment, we also emphasize the importance of intraoperative assessment of the tumor, both by the surgeon and by intraoperative pathology consultation

THE RELATIONSHIP BETWEEN THE BIG FIVE PERSONALITY DIMENSIONS AND ACUTE PSYCHOPATHOLOGY: MEDIATING AND MODERATING EFFECTS OF COPING STRATEGIES

Background: Prior research suggests that the Big Five personality dimensions might be associated with coping strategies as well as acute psychopathology. The aim of the present study was to investigate direct and indirect associations between the Big Five personality traits, coping styles, and psychopathological variables. Subjects and methods: Subjects were 1140 adults from various institutions and regions in Hungary. A comprehensive test battery was administered including the Big Five Inventory (BFI), Psychological Immune System Inventory (PISI), and some subscales of the Brief Symptom Inventory (BSI). Several moderation-mediation analyses were conducted using the PROCESS tool in SPSS to test for influence paths. Results: Coping and personality variables jointly accounted for 40% to 50% of variance in psychopathology outcome. Personality dimensions of Extraversion, Conscientiousness and Emotional Stability had strongest predictive values. Emotional Stability had a more direct and unmediated effect, whereas Extraversion and Conscientiousness effects were mediated by the Approach and Self-regulation coping systems. In comparison to personality, coping style was generally a stronger predictor. Conclusions: The findings of this study might add to better understanding of complex pathways leading from broad personality dimensions to coping strategies and psychological (mal)adjustment

The risk of bark and ambrosia beetles associated with imported non-coniferous wood and potential horizontal phytosanitary measures

Many bark and ambrosia beetle species (Coleoptera: Scolytinae and Platypodinae) are known to have spread worldwide in relation to international trade. Concerns have been expressed within the European and Mediterranean Plant Protection Organization (EPPO) about recent introductions of non-indigenous species of these groups. Regulation of the non-coniferous wood trade into many EPPO member countries is currently not sufficient to cover such risks. In 2018-2019, an EPPO study on the risk of bark and ambrosia beetles associated with imported non-coniferous wood was carried out, and the key characteristics contributing to the pest risk from introduced species were determined using expert consensus. This paper summarizes the key findings of the study, which are available in full detail on the EPPO website. The study identified biological and other risk factors and illustrated them with examples from 26 beetle species or groups of species known to be invasive or posing a threat to plant health. These representative species were classified into three categories based on known damage and level of uncertainty. In the present article, factorial discriminant analyses were used to identify features of bark and ambrosia beetle biology associated with damage caused and invasiveness. Based on the information assembled and consideration of the risk factors, it was recommended that in order to prevent the introduction of new bark and ambrosia beetles via non-coniferous wood commodities, horizontal phytosanitary measures should be adopted, irrespective of the host plant species and the origin (i.e., for all genera of non-coniferous woody plants and from all origins). Phytosanitary measures are presented here for various wood commodities