A Double Rarity: Lost intravascular Catheter Guidewire in Persistent Left Superior Vena Cava and Coronary Sinus - A Case Report

Benjamin Palić,1,2 Marija Goluža Sesar,3 Kristina Galić,3 Gojko Bogdan,4 Zrinko Prskalo1 1Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 2Department of Pathophysiology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina; 3Department of Pulmonology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 4Department of Radiology, University Clinical Hospital Mostar, Mostar, Bosnia and HerzegovinaCorrespondence: Benjamin Palić, Department of Internal Medicine, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina, Email [email protected]: Guidewire loss is a rare complication of central venous catheterization. A 65-year-old male was hospitalized in a high-dependency unit for exacerbation of chronic obstructive pulmonary disease, pneumonia, erythrocytosis, and clinical signs of heart failure. Upon admission, after an unsuccessful right jugular approach, a left jugular central venous catheter was placed. The next day, chest radiography revealed the catheter located in the left parasternal region, with suspected retention of the guidewire, visually confirmed by the presence of its proximal end inside the catheter. The left parasternal location of the catheter and the typical projection of the guidewire in the coronary sinus, later confirmed by echocardiography, raised suspicion of a persistent left superior vena cava (PLSVC). Agitated saline injected into the left antecubital vein confirmed bubble entry from the coronary sinus into the right atrium. After clamping the guidewire, the catheter was carefully retrieved along with the guidewire without any complications. This is the first reported case of guidewire retention in PLSVC and coronary sinus. It underscores the potential causes of guidewire loss and advocates preventive measures to avoid this potentially fatal complication.Keywords: intraoperative complication, central venous catheter, persistent left superior vena cava, congestive heart failure, chronic obstructive lung diseas

TECHNOLOGICAL AND TECHNICAL FACTORS AND ECONOMIC RESULTS OF SEED CORN PRODUCTION

Istraživanja su provedena tijekom 2009. godine na površinama Poljoprivrednog instituta Osijek. Na parceli 10,80 ha istraženi su tehnološki činitelji i ekonomski rezultati, praćeni su i evidentirani agrotehnički zahvati i organizacija uzgoja sjemenskog kukuruza. Na temelju izračunatih normi i izrađene tehnološke karte ukupne proizvodnje, utvrđen je utrošak od 16 sati rada strojeva i 64 sati rada ljudi po hektaru. Ukupni troškovi iznosili su 13.234,80 kn ha-1, a vrijednost ostvarene proizvodnje (prinos od 2,72 t ha-1) uz poticaj od 4.800,00 kn ha-1 iznosila je 21.139,80 kn ha-1. Proizvodnost rada iznosila je 42,55 kg zrna po satu ljudi, te utrošak od 23,70 sati rada ljudi po toni zrna. Ostvarena je dobit u iznosu od 7.905,00 kn ha-1. Koeficijent ekonomičnosti proizvodnje iznosi 1,59 iz čega je vidljivo da je proizvodnja sjemenskog kukuruza bila ekonomična, a na 100 kn uloženih u proizvodnju ostvareno je 30,70 kuna dobiti.The research was carried out during 2009 on the arable land owned by the Agricultural Institute in Osijek. Technological factors and economic results, agrotechnical procedures and organization of seed corn production were monitored on the total area of 10.80 ha. Based on the calculated norms and technology plans of overall production, it was determined that there were 16 hours of machine work and 64 hours of labor invested per one hectare. Total costs were 13,234.80 HRK per ha-1, and the production value (as of the yield of 2.72 t per ha-1) with state subsidies of 4,800.00 HRK per ha-1 amounted to 21,139.80 HRK per ha-1. Working productivity was 42.55 kg of grain per one hour of labour, and 23.70 hours of labour were invested per one ton of grain. Profit was 7,905.00 HRK per ha-1. Coefficient of production efficiency was 1.59, which indicated that production of seed corn was cost-effective, and a profit of 30.70 HRK was made per 100.00 HRK invested in production

Community-acquired pneumonia

Introduction: Community-acquired pneumonia (CAP) today, as well as a few decades ago, is a current medical problem considering the incidence and the mortality rate of the population, despite the availability of new and powerful antimicrobials and vaccines effectiveness. Objective: Analysis of outpatients diagnosed with pneumoniae, determination of the most common risk factors for their development, analysis of the success of outpatients' treatments and complications. Methods: Medical exams of 38 patients were analyzed. Each case is chosen by following previously prepared protocol, including patients with respiratory symptoms and infectious syndrome, positive auscultatory findings on the lungs which are radiologicaly confirmed and laboratory treated (SE, Le, FBC, the first and the tenth day of the therapy). Demographic data and associated illnesses, as well as a severity assessment of the illness, were made at the first medical examination, when pneumonia was suspected. Results: In the period from 01.11.2014 to 01.05.2015, there were 33 diagnosed pneumoniae. Associated illnesses, in population older than 65 years, were present in 92.85% of patients and some of them had two or three comorbidities. CRB65 proved itself as a good parameter in assessment of the disease severity for both groups. Applied antibiotic therapy proved to be effective in 80% of patients. There is no significant difference in pneumonia presentation with regards to gender and age. In data proccessing, descriptive statistics methods and no parameter x2 test were used for statistical significance assessment. Conclusion: All patients with clear indications should be hospitalized, but large percentage of patients can be treated in outpatints' facilities, with good patient cooperation. Also vaccination, as an available resource, seems to have not received a significant place in our environment

Utjecaj hijaluronske kiseline, kalcijeva hidroksida i dentinskih adheziva na odontoblaste i fibroblaste štakora

The aim of this study was to investigate the effects and efficiency of pulp capping preparations based on hyaluronic acid, calcium hydroxide, and dentin adhesive on the pulp tissue of Sprague-Dawley rats. The rats were killed and extracted teeth sectioned transversely through the pulp. The slices were placed in a RPMI 1640 cell culture medium supplemented with 10 % foetal calf serum. During 14 days of cultivation cultures were treated with preparations that contained hyaluronic acid (Gengigel Prof®), and calcium hydroxide (ApexCal®), or with dentin adhesive (Excite®). Cellularity and viability of fibroblasts and odontoblasts was analysed using a haemocytometer. Hyaluronic acid proved most efficient and the least toxic for direct pulp capping. Even though calcium hydroxide and dentin adhesive demonstrated a higher degree of cytotoxicity, their effects were still acceptable in terms of biocompatibility.Cilj ovog rada bio je istražiti djelovanje preparata na bazi hijaluronske kiseline i kalcijeva hidroksida te dentinskog adheziva na pulpno tkivo Sprague-Dawley štakora u svrhu procjene učinkovitosti navedenih materijala kod direktnog prekrivanja pulpe. Izvađeni zubi transverzalno su podijeljeni kroz pulpu. Naresci su uzgajani u RPMI 1640 staničnom mediju obogaćenom s 10 % fetalnoga telećeg seruma u plastičnim bočicama za staničnu kulturu. Kulture su tijekom 14 dana tretirane preparatima s hijaluronskom kiselinom (Gengigel Prof®), kalcijevim hidroksidom (ApexCal®) i dentinskim adhezivom (Excite®). Nakon 14 dana pristupilo se analizi staničnosti i vijabilnosti s pomoću hemocitometra. Iako su preparati na bazi kalcijeva hidroksida i dentinski adheziv pokazali nešto viši stupanj citotoksičnosti, dobiveni su rezultati u granicama biokompatibilnosti. Primjena preparata na bazi hijaluronske kiseline postigla je najbolje rezultate te se ovaj materijal pokazao najboljim za direktno prekrivanje pulpe između tri ispitivana preparata