Prisutnost bakterije helicobacter pylori u želucu i sluznici grkljana kod bolesnika s karcinomom grkljana

Helicobacter (H.) pylori is the cause of one of the most common chronic bacterial infections in humans. Risk factors for the development of laryngeal cancer are cigarette smoke, alcohol, and human papillomavirus. Several papers report on H. pylori isolated in tooth plaque, saliva, middle ear and sinuses. Many articles describe the presence of H. pylori in laryngeal cancer cases, however, without noting the possible source of infection, i.e. stomach or oral cavity. The aim of this study was to determine which patients and to what extent simultaneously developed H. pylori colonization in the stomach and the larynx. Prospective examinations were performed in 51 patients with laryngeal squamous cell carcinoma. The study group included patients with laryngeal squamous cell carcinoma histopathologically confirmed by two independent pathologists. The patients underwent fiber esophagogastroduodenoscopy with tumor tissue biopsy. Laryngeal and gastric biopsies were examined by histologic staining technique for histopathologic detection of H. pylori and with DNA analyses using the standardized fluorescent ABI Helicobacter plus-minus PCR assay. Laryngeal carcinoma patients showed positive H. pylori test results simultaneously in the laryngeal and stomach areas, implying H. pylori transmission from the stomach to the laryngeal area. In addition, H. pylori positive test results along with negative H. pylori results in the stomach region were also recorded, suggesting a possible bacteria migration from the oral cavity. In conclusion, H. pylori was found in the area of laryngeal carcinoma, and its migration appeared likely to occur both upwards (from the stomach to the mouth) and downwards (from the oral cavity to the stomach).Helicobacter (H.) pylori uzročnik je jedne od najčešćih kroničnih bakterijskih infekcija u ljudskoj populaciji, prisutne u svim zemljama u svijetu. Incidencija infekcije bakterijom H. pylori teško se može izravno utvrditi, jer akutna infekcija ima vrlo malo karakterističnih simptoma ili ih uopće nema. Planocelularni karcinom je najčešći karcinom grkljana koji čini 95% svih karcinoma grkljana. U čimbenike rizika za razvoj karcinoma grkljana ubrajaju se cigaretni dim i alkohol te infekcija humanim papilomavirusima. H. pylori je dokazan kao jedan od uzročnika karcinoma grkljana, ali nigdje nije jasno opisan rezervoar te bakterije s obzirom na to da je u nekoliko članaka dokazano nepostojanje bakterije H. pylori u zdravoj sluznici grkljana. Svrha našega rada bila je ispitati istodobnu prisutnost bakterije H. pylori u karcinomu grkljana i želucu. Kod 51 bolesnika s karcinomom grkljana učinjena je ezofagogastroskopija s uzimanjem uzoraka sluznice iz antruma i korpusa želuca te iz područja karcinoma grkljana za analizu na H. pylori pomoću lančane reakcije polimeraze i patohistološkom metodom. U tkivu karcinoma grkljana dobiveni su pozitivni rezultati testova na H. pylori istodobno s pozitivnim testom na H. pylori u području želuca, što upućuje na migraciju bakterije iz želuca u područje grkljana. U određenom broju ispitanika dobiveni su pozitivni rezultati testova na H. pylori u području karcinoma grkljana s negativnim testom na H. pylori u sluznici želuca, što upućuje na moguću migraciju bakterije iz usne šupljine. Iz nalaza se može zaključiti da je H. pylori prisutan u području karcinoma grkljana te da je njegov prijenos moguć i uzlaznim i silaznim putem iz usne šupljine i želuca

Primary malignant fibrous histiocytoma of the heart with skeletal muscles metastases

Malignant fibrous histiocytoma is an extremely rare primary malignant tumor of the heart. It is usually diagnosed when it is locally aggressive or has already metastasized. The prognosis is poor with an average survival time of one year. We report a case of recurrent left atrial malignant fibrous histiocytoma initially misdiagnosed as myxoma. The patient underwent repeated surgical resections followed by chemotherapy. Despite adjuvant chemotherapy, 18 months after initial diagnosis, definitive tumor relapse in left atrium was diagnosed. This is the 48th case of primary cardiac fibrous malignant histiocytoma reported in the literature

Integrating Energy and Environmental Management in Wood Furniture Industry

As energy costs continue to rise, industrial plants (even those of energy nonintensive industries such as furniture industry) need effective way to reduce the amount of energy they consume. Besides, there are a number of economic and environmental reasons why a company should consider environmental management initiatives. This paper provides a detailed guideline for implementing joint energy and environmental management system in wood furniture industrial company. It covers in detail all essential aspects of the system: initial system assessment, organization, policy development, energy and environmental auditing, action plan development, system promotion, checking system performance, and management review

Leiomyosarcoma of the inferior vena cava extending into the right atrium and ventricle

Aim: The aim is to present a case of rare malignant tumor, leiomyosarcoma of the inferior vena cava (IVC) with the involvement of the liver and intravascular extension into the right atrium and ventricle. Case report: 50-year-old male patient presented to the Emergency Department with upper abdominal pain and meteorism during the past month, without any medical history of chronic illness. After physical exam and blood test, abdominal ultrasonography was preformed which verified an expansive liver formation. Transthoracic echocardiography showed a large echogenic mobile mass extending from the IVC into the right atrium and ventricle, a differential diagnosis tumor or thrombi. Abdominal computer tomography showed a large hyperdense avascular mass with central necrosis in the left liver lobe, thrombosis of portal vein and filling defect of the inferior vena cava from the hepatic veins to the right atrium and ventricle. After taking biopsy, histochemical and immunohistochemical analysis confirmed a diagnosis of leiomyosarcoma. Considering the findings of computer tomography and echocardiographic characteristics of described mass into the right atrium and ventricle we concluded that it is probably a leiomyosarcoma of IVC with intravascular extension. Taking into account the pathohistological diagnosis, the stage of disease at the time of diagnosis, the laboratory and ultrasonography signs of liver disfunction the Expert Consilium concluded that operative or any active treatment is not indicated. Conclusion: Leiomyosarcoma of the inferior vena cava is malignant mesenchymal tumor, with low incidence and prevalence. Occurrence of this tumor in the III segment of the inferior vena cava by Kulazlat classification is especially rare. It is important to note that it is a possible and uncommon differential diagnosis of a right atrium tumor1-3

Frequency of Ventricular Premature Beats and Ventricular Tachycardia in STEMI Treated with Fibrinolytics

To determine in acute myocardial infarction with an ST elevation (STEMI) treated with fibrinolytics frequency of ventricular premature beats (VPBs) and ventricular tachycardia (VT) according to the damaged area and residual cardiac function. With anterolateral infarction with ejection fraction (EF)<45%, incidence of VPBs<10/h was statistically significantly reduced (p<0.001) while incidence of VPBs10/h as well as VPBs in a pair and VT was increased (p< 0.001). With anteroseptal infarction with EF<45%, incidence of VPBs<10/h was statistically reduced (p=0.06) and incidence of VPBs>10/h, VPBs in a pair and VT was increased (p=0.06). With inferior and inferoposterior infarction with EF<45%, incidence of VPBs<10/h was reduced and incidence of VPBs10/h, VPBs in a pair and VT was increased. However, such difference was not statistically significant. Along with reduced residual cardiac function, one can also expect increase in frequency of VPBs and VT in all forms of STEMI regardless the area of damage. Such frequency is significant with all forms of anterior infarction, that is to say, slightly more with anterolateral infarction in relation to anteroseptal one. However, with inferior and inferoposterior infarction this frequency of VPBs i VT is not significant

INFLAMMATORY BOWEL DISEASE AND KIDNEY– IS THERE A CONNECTION?

Cilj ove studije bio je ispitati imaju li bolesnici s upalnom bolesti crijeva u nekoj mjeri promjene na bubregu. Štoviše, ispitivali smo odnosi li se ta povezanost na aktivnu bolest crijeva. U ovoj presječnoj studiji okupili smo od rujna 2012. do rujna 2013. godine 50 bolesnika srednje dobi od 47,1±16,5 godina s dijagnozom upalne bolesti crijeva postavljenom na osnovi anamneze, endoskopskih, histoloških i radioloških nalaza. Aktivnost bolesti procjenjivali smo indeksom aktivnosti ulceroznog kolitisa (UC activity index, UCAI) i indeksom za Crohnovu bolest (Crohn’s disease index, CDAI). Bilo je 38% bolesnika s ulcertivnim kolitisom (UK) i 62% bolesnika s Crohnovom bolešću (CB). Učestalost abnormalne albuminurije bila je 21,1% u bolesnika s UK i 29% u onih s CB. Nađena je visoka negativna korelacija između trajanja bolesti crijeva i 24-h albuminurije u bolesnika s UK, kao i visoka korelacija između odnosa albumin-kreatinin (ACR) i zbira UCAI u bolesnika s UK, ali te korelacije nisu bile statistički značajne, vjerojatno zbog malog broja bolesnika s UK. S druge strane, procijenjena stopa glomerularne filtracije (estimated glomerular filtration rate, eGFR) pokazala negativnu korelaciju s aktivnošću bolesti u bolesnika s CB (r=-0,569; p=0,05), dok nije bilo statistički značajne korelacije između UK i eGFR (r=0,343; p=NS). Zaključujemo da je abnormalna albuminurija dosta česta u bolesnika s upalnom bolesti crijeva. Čini se da bolesnici s tom bolešću imaju do neke mjere oštećenje glomerula, pretežito oni s CB. Da se istraži ta povezanost potrebne su zajedničke prospektivne studije gastroenterologa i nefrologa.The aim of the present study was to investigate whether patients with inflammatory bowel disease (IBD) have some degree of renal involvement. Furthermore, we investigated whether this connection is related to active bowel disease. In this cross-sectional study, 50 patients diagnosed with IBD, mean age 47.1±16.5 years, were recruited from September 2012 to September 2013. The diagnosis of IBD was based on clinical history, endoscopic, histological and radiological findings. Disease activity was assessed using the UC activity indeks (UCAI) for ulcerative colitis (UC) and Crohn’s disease activity index (CDAI) for Crohn’s disease (CD). There were 38% of UC patients and 62% of CD patients. The prevalence of abnormal albuminuria in UC and CD patients was 21.1% and 29%, respectively. There was a high negative correlation between duration of bowel disease and 24-h albuminuria in UC patients, as well as a high correlation between albumin-creatinine ratio (ACR) and UCAI score in UC patients, but these correlations were not statistically significant, probably due to the small number of UC patients. On the other hand, estimated glomerular filtration rate (eGFR) showed negative correlation with disease activity in CD patients (r=-0.569; p=0.05), while there was no statistically significant correlation between active UC and eGFR (r=0.343; p=NS). In conclusion, abnormal albuminuria is quite frequent in patients with IBD. It seems that patients with IBD have some degree of glomerular damage, mainly those with CD. Collaborative, prospective studies conducted by gastroenterologists and nephrologists are needed to investigate this association

Eighteen years of heart transplantation: a single center experience

The best option for the treatment of a failing heart is heart transplantation. The transplantation program at the University Hospital Center Rebro Zagreb started in 1988. To the best of our knowledge this is the first retrospective study on cardiac transplantation in Croatia looking into survival following heart transplantation. Between 1988 and 2006, we performed 81 heart transplantations at the University Hospital Center Rebro Zagreb. Our study focused on the last ten years after establishment of the Department of cardiac surgery as a separate institution. There were thirteen different hospitals throughout Croatia, which contributed to the donor network. Average age of the heart recipient was 48+/-11.8 years (range 14-72), and average age of the heart donor was 34+/-10.7 years (range 14-56). There were more women among the heart donors (34%) then among the heart recipients (18%). During the first ten years, from 1988-1998, the average number of cardiac transplantations was 3 per year In the period from 1998-2006, average number of cardiac transplantations increased to 6 per year. The average thirty-day mortality for the last nine years was 27%. It declined from 30% and 40% in 1998 and 1999, respectively down to 0% in the last two years. Average age of the patients who died was 50+/-6.5years (range 44-62) and did not significantly differ from those who survived. The donor network has grown up to fourteen different hospitals throughout Croatia. The limiting factor in cardiac transplant surgery is the number of available donors. Therefore in attempt to form a good transplant program it is crucial to form an efficient donor network. The number of performed cardiac transplantations is expected to rise until it reaches the number of available donors. With advances in operative technique and postoperative management--immunosuppressive therapy we have observed a remarkable drop in the early operative mortality in the studied period

REVIEW OF EXISTING ENERGY MANAGEMENT STANDARDS AND POSSIBILITIES FOR ITS INTRODUCTION IN SERBIA

Until recent times, energy management practices primarily consisted in replacing inefficient equipment and then using any number of methods to estimate obtained savings. Experience shows that positive effects of energy efficient improvements were decreased over time. There have been significant efforts over the last decade to define appropriate standards and best practices and implement the consistent energy management system to increase and maintain the energy savings. The knowledge gained from thousands of energy efficient projects is driving a transition from traditional tactical practice (one-time "build and forget" projects) to energy management strategies proposed and endorsed by a number of international organizations. The current status of internationally developed energy management standards, including an analysis of their shared features and differences is presented in this paper. The purpose of the analysis is to describe the current state of "best practices" for this emerging area of energy efficiency policymaking in order to study the possibility of implementation of energy management standards in Serbia and to estimate the effects and the potential for energy saving that would be made by its implementation