Clinical cases of pulmonary tuberculosis as a result of TNF antagonist therapy

През последните 12 години антагонистите на TNF са били успешно използвани за лечение на много пациенти страдащи от хронични възпалителни заболявания. Това лечение увеличава риска от туберкулоза до 25 пъти. Дължи се на факта, че TNF и TNF-рецепторите играят важна роля в медиирането на имунния отговор при остри и хронични възпаления. Ето защо всички пациенти, на които предстои подобно лечение трябва да бъдат подложени на стриктна оценка за изключване на активна и латентна туберкулозна инфекция. През 2010 г. беше публикуван консенсус на TBNET, озаглавен „Рискът от туберкулоза, свързан с лечение с TNF антагонисти`.В изложението са представени два случая на белодробна туберкулоза, които са наблюдавани в хода на провеждано лечение с TNF антагонисти при болни с доказани възпалителни заболявания на червата.During the past 12 years TNF antagonists have been successfully used for the treatment of many patients suffering from chronic inflammatory diseases. This treatment increases the risk of tuberculosis up to 25 times. This is due to the fact that TNF and TNF-receptors play an important role in mediating the immune response in acute and chronic inflammation. Therefore all patients undergoing such treatment should be subject to rigorous assessment to exclude active and latent tuberculosis infection. In 2010 a TBNET consensus was published entitled "The risk of tuberculosis related to TNF therapies." In this article we present two cases of pulmonary tuberculosis, which were observed in the course of an ongoing treatment with TNF antagonists in patients with proven inflammatory bowel disease

Što na početku prvoga razreda učenici znaju i mogu iz područja matematike – je li to važno ili nije?

The determination of the levels of mathematical knowledge and skills is of essential importance when planning and organizing any form of work with students as well as in the process of creating mathematics curriculum. A question emerges: What kind of mathematical knowledge and skills are children equipped with when entering the first grade of primary school? In the Republic of Macedonia, written mathematics testing of children at this age (approximately 6 years) is not conducted. At the national level there are no data on this issue. At the beginning of the school year 2011/2012 a research study was conducted in primary schools in the Republic of Macedonia, based on a previous research conducted in the Netherlands. The results on five of the given problems are discussed and compared with the results obtained from similar studies conducted previously in other European countries. Another question consequently emerges: Does the national mathematics curriculum for the first grade give full credit to children\u27s actual mathematics competences and does it provide optimal conditions for their further advancement?Određivanje razina matematičkog znanja i vještina od ključne je važnosti prilikom planiranja i organiziranja rada s učenicima, kao i prilikom stvaranja kurikula iz područja matematike. Pitanje koje se postavlja jest: Kakvo znanje i vještine iz matematike posjeduju učenici na početku prvog razreda osnovne škole? U Republici Makedoniji ne provode se pismeni testovi iz matematike za šestogodišnjake. Na nacionalnoj razini ne postoje podatci povezani s tom problematikom. Na početku šk. god. 2011./2012. u Republici Makedoniji provedeno je istraživanje u osnovnim školama koje se oslanja na istraživanje u Nizozemskoj. Provedena je analiza rezultata i njihova usporedba s rezultatima sličnih istraživanja u europskim zemljama. Na kraju istraživanja postavlja se pitanje: Uzima li nacionalni kurikul za matematiku za prvi razred u obzir u potpunosti matematičku kompetenciju djece i pruža li im optimalne uvjete za daljnji napredak

Viral load and lymphocyte subpopulations in newly diagnosed patients with chronic Hepatitis B

INTRODUCTION: The immune response against Hepatitis B virus (HBV) represents a key factor for infection outcome. However, the relation between viral replication and host immune reactivity is still a matter of investigation. AIM: To investigate whether the cellular immune response of newly diagnosed treatment naïve chronic hepatitis B (CHB) patients may be influenced by the replicative status of HBV.MATERIALS AND METHODS: A total of 45 (17 female and 28 male) newly diagnosed untreated CHB patients aged 42.48±13.19 years (19÷71 years) were enrolled in this study. The patients were divided in two groups according to the viral load: >0÷≤104 copies/ml (n=25) and >10 4÷<108 copies/ml (n=17). Flowcytometric immunophenotyping was performed for evaluation of the cellular immunity. Serum HBV DNA load was assessed by quantitative real-time polymerase chain reaction.RESULTS: Similar alterations were observed in both patients` groups in comparison with healthy controls which could be summarized as follows: decreased total T cells (CD3+) due to low helper-inducer (CD3+CD4+) and suppressor-cytotoxic (CD3+CD8+) subpopulations; reduced effector cytotoxic (CD8+CD11b-; CD8+CD28+) and activated (CD3+HLA-DR+, CD8+CD38+) T-cell subsets; increased CD57+CD8- cells; elevated percentage of B lymphocytes. No significant differences in the studied immune parameters were detected between both patients` groups except the significantly elevated CD4/CD8 ratio in individuals with higher in comparison to those with lower HBV DNA levels.CONCLUSION: Alterations in the cellular immune repertoire of CHB patients were observed resulting mainly in significantly decreased T-cell subpopulations, particularly those with effector cell immune phenotype regardless of the viral load

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

What Mathematics School Beginners Know and Can Do – a Matter of Importance or Not

The determination of the levels of mathematical knowledge and skills is of essential importance when planning and organizing any form of work with students as well as in the process of creating mathematics curriculum. A question emerges: What kind of mathematical knowledge and skills are children equipped with when entering the first grade of primary school? In the Republic of Macedonia, written mathematics testing of children at this age (approximately 6 years) is not conducted. At the national level there are no data on this issue. At the beginning of the school year 2011/2012 a research study was conducted in primary schools in the Republic of Macedonia, based on a previous research conducted in the Netherlands. The results on five of the given problems are discussed and compared with the results obtained from similar studies conducted previously in other European countries. Another question consequently emerges: Does the national mathematics curriculum for the first grade give full credit to children’s actual mathematics competences and does it provide optimal conditions for their further advancement

The benefits of kinesitherapy during the period of pregnancy

There are many physical changes to a pregnant woman’s body: the core changes, there is more pressure on the organs and there is increased weight to be carried. All of this in a short period of time often leads to back pain, pelvic pain and urinary incontinence. Our research shows that group training programs designed and delivered by physiotherapists can relieve the most common problems pregnant women have. METHODS USED: Kinesitherapy - treatment by means of movement and based on exercises and medical gymnastics, Starting positions for the kinesitherapy most commonly used are: lying, sitting, kneeling, and rarely standing. Sitting position exercises are used to increase the range of spine’s motion. Exercises usually last for 15 - 20 minutes and are followed by a 15 - minute relaxation. The exercises include the following scheme: starting position, essential exercise, reversion to the starting position and a short rest. Kinesitaping – using cotton tapes to provide support and stability, The advatage of kinesitaping is the lack of invasiveness. With proper plaster application there is a possibility,depending on the woman’s needs, of increasing or decreasing the tension of abdominal rectus muscle and of external and internal oblique muscles. Massage – to relieve muscle tension. During the massage, gentle techniques are applied - stroking, rubbing, gentle pressure , remembering that around lumbosacral area there are situated nerve roots are innervating genital organs. RESULT: Using their knowledge of the pelvic floor, physiotherapists can help teach women how to push effectively during childbirth. Pushing correctly will reduce the chances of pelvic floor trauma and subsequent problems. The primary objective of physiotherapy in pregnancy is to prepare the organism for the increased effort and changes in the organism itself. The aim of the exercises is the reduction or elimination of imbalances and motor coordination. CONCLUSION:Methods and exercises for pregnant women should be chosen with great care, to be sure that the fetus will be provided with the maximum space to move and grow freely. It is worth remembering, that after a cesarean section, there is no need to protect the pelvic floor and perineum, because they were not extended. Working with pregnant patients is the issue that is still not very popular and often overlooked. There is a need to promote all the available methods that would make this period of the women’s life more comfortable and less stressfull

The effect of kinesitherapy on balance and functional independence after ischemic stroke

Purpose: To monitor the effect of kinesitherapy on the functional capabilities of patients after ischemic stroke (IS). Material and methods: We studied 23 patients of average age of 57.1 ± 8.8 years after supratentorial IS, with severity of paresis according to Chedoke-McMaster - 4th stage and disease duration 1.4 ± 0.5 months. For the purpose of the study, functional independence test (FIM) and a Berg balance scale (BBS) were used. The applied kinesitherapy is based on the advanced principles of modern neurorehabilitation: to be individual, intensive and specifically oriented; and the principles of motor learning: task specificity, active patient participation, repetition, adaptation of complexity, feedback and variability / contextual intervention. Results: The study shows that the applied kinesitherapy permanently improves the functional independence, the static and dynamic balance of the patients after IS, and the results are most recognizable in the 1st month of treatment (p <0.001). Conclusion: Applying one-month therapy with specialized therapeutic exercises improves functional capabilities of patients with IS compared to their baseline condition. Key words: kinesitherapy, ischemic stroke, functional capabilitie

Što na početku prvoga razreda učenici znaju i mogu iz područja matematike – je li to važno ili nije?

The determination of the levels of mathematical knowledge and skills is of essential importance when planning and organizing any form of work with students as well as in the process of creating mathematics curriculum. A question emerges: What kind of mathematical knowledge and skills are children equipped with when entering the first grade of primary school? In the Republic of Macedonia, written mathematics testing of children at this age (approximately 6 years) is not conducted. At the national level there are no data on this issue. At the beginning of the school year 2011/2012 a research study was conducted in primary schools in the Republic of Macedonia, based on a previous research conducted in the Netherlands. The results on five of the given problems are discussed and compared with the results obtained from similar studies conducted previously in other European countries. Another question consequently emerges: Does the national mathematics curriculum for the first grade give full credit to children\u27s actual mathematics competences and does it provide optimal conditions for their further advancement?Određivanje razina matematičkog znanja i vještina od ključne je važnosti prilikom planiranja i organiziranja rada s učenicima, kao i prilikom stvaranja kurikula iz područja matematike. Pitanje koje se postavlja jest: Kakvo znanje i vještine iz matematike posjeduju učenici na početku prvog razreda osnovne škole? U Republici Makedoniji ne provode se pismeni testovi iz matematike za šestogodišnjake. Na nacionalnoj razini ne postoje podatci povezani s tom problematikom. Na početku šk. god. 2011./2012. u Republici Makedoniji provedeno je istraživanje u osnovnim školama koje se oslanja na istraživanje u Nizozemskoj. Provedena je analiza rezultata i njihova usporedba s rezultatima sličnih istraživanja u europskim zemljama. Na kraju istraživanja postavlja se pitanje: Uzima li nacionalni kurikul za matematiku za prvi razred u obzir u potpunosti matematičku kompetenciju djece i pruža li im optimalne uvjete za daljnji napredak

Treatment of lower back pain during the period of pregnancy

The aim of the study is understanding the effect of kinesitherapy make the lower back pain rarer and milder during the period of pregnancy. Materials and methods: Twenty-five healthy women without any diseases and obesity were examined in the third trimester of pregnancy. The level of pain was being examined is on the VAS scale. Safety techniques for the unborn baby have been used, such as: exercises and gentle stretching of the muscles of the lumbar region, exercises for proper posture, prenatal massage to relax the muscles and improve flexibility. Results: The application of these techniques over a 2-week period in this study of these women resulted in a decrease in lumbar pain, with a significance level of changes of p <0.05 and losing the sensation of muscle tightness in the lumbar region. Conclusion: Our study confirms that exercise and kinesitherapy are one of the most effective remedies during pregnancy. Keywords: pregnancy, lowerback pain, kinesitherap

Perinatal Outcome in Gestational Diabetes Melitus Vs Normoglycemic Women

Introduction: Gestational Diabetes Mellitus (GDM) is glucose intolerance diagnosed for the first time in pregnancy. It may lead to potentially serious short term and longterm complications for both mother and fetus or newborn. Material and Methods: Prospective study was conducted at the University clinic for gynecology and obstetrics, Skopje for the period of one year. 100 pregnant women in the second trimester which performed oral glucose tolerance test (75g OGTT) were evaluated. The study included 50 women with GDM and control group of 50 women with negative OGTT at the same gestational age, parity and maternal age. Gestational weight gain, blood pressure and urine analysis for proteinuria were recorded monthly. Patients with GDM were more often followed according to the clinical protocol. Maternal and neonatal data was collected after birth from medical records during discharge from the clinic. The perinatal outcome of pregnant women with or without GDM was analysed. Results: There was a significant difference in BMI between the women with GDM and normoglycemic women. Hypertensive disorders of pregnancy, preterm labour and delivery by caesarean section were significantly more often in GDM pregnancies vs control group. Respiratory distress, hypoglycemia, pH <25, lower Apgar score in the first minute and admission in the neonatal intensive care unit was significantly more often in the neonates from mothers with GDM vs controls. Conclusion: Many parameters of the perinatal outcome were significantly associated with GDM in our study. Adequate treatment can achieve better maternal and neonatal outcome