Anatomical parameters of the acetabulum in heavy vehicle operators

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. It has been suggested that long-term exposure by heavy vehicle operators to whole-body vibration (WBV) may be related to an increased risk of pathological changes in the anatomical parameters of the hip. The aim of this study was to explore the difference in anatomical parameters of acetabulum in drivers of heavy vehicles (experimental group; n=60) and subjects who have not been exposed to WBV (control group; n=60). The anteroposterior radiographic view of the hips was used to measure the following parameters: the vertical centre edge (VCE), the ‘horizontal toit externe’ angle (HTE), the neck shaft angle (NSA) and the acetabular depth (AD). Compared with the control group, the mean VCE angle values and AD were significantly lower, while the average HTE and NSA values were significantly higher in the experimental group. This study supports the hypothesis that exposure to whole-body vibration during operation of a vehicle causes an increased risk of acetabular dysplasia

Anatomical Parameters of the Acetabulum in Heavy Vehicle Operators

It has been suggested that long-term exposure by heavy vehicle operators to whole-body vibration (WBV) may be related to an increased risk of pathological changes in the anatomical parameters of the hip. The aim of this study was to explore the difference in anatomical parameters of acetabulum in drivers of heavy vehicles (experimental group; n=60) and subjects who have not been exposed to WBV (control group; n=60). The anteroposterior radiographic view of the hips was used to measure the following parameters: the vertical centre edge (VCE), the ‘horizontal toit externe’ angle (HTE), the neck shaft angle (NSA) and the acetabular depth (AD). Compared with the control group, the mean VCE angle values and AD were signifi cantly lower, while the average HTE and NSA values were signifi cantly higher in the experimental group. This study supports the hypothesis that exposure to whole-body vibration during operation of a vehicle causes an increased risk of acetabular dysplasia

Mechanism and clinical importance of respiratory failure induced by anticholinesterases

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Respiratory failure is the predominant cause of death in humans and animals poisoned with anticholinesterases. Organophosphorus and carbamate anticholinesterases inhibit acetylcholinesterase irreversibly and reversibly, respectively. Some of them contain a quaternary atom that makes them lipophobic, limiting their action at the periphery, i.e. outside the central nervous system. They impair respiratory function primarily by inducing a desensitization block of nicotinic receptors in the neuromuscular synapse. Lipophilic anticholinesterases inhibit the acetylcholinesterase both in the brain and in other tissues, including respiratory muscles. Their doses needed for cessation of central respiratory drive are significantly less than doses needed for paralysis of the neuromuscular transmission. Antagonist of muscarinic receptors atropine blocks both the central and peripheral muscarinic receptors and effectively antagonizes the central respiratory depression produced by anticholinesterases. To manage the peripheral nicotinic receptor hyperstimulation phenomena, oximes as acetylcholinesterase reactivators are used. Addition of diazepam is useful for treatment of seizures, since they are cholinergic only in their initial phase and can contribute to the occurrence of central respiratory depression. Possible involvement of central nicotinic receptors as well as the other neurotransmitter systems - glutamatergic, opioidergic - necessitates further research of additional antidotes

Bochdalek hernia in adults – A case report

© 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Introduction. Asymptomatic Bochdalek hernia in adults is a rarity. The aim of this paper is to present a rare case of Bochdalek hernia among adults and to point out to significance of clinical suspicion and important role of imaging techniques in reaching the exact diagnosis of this abnormality. Case report. A patient, aged 68 years, came to the Clinic of Pulmonology complaining of constant dyspnea, coughing and fatigue. Computed tomography (CT) findings were dominated by the large rear right diaphragmatic hernia with the hernial sac that reached the carina trachea and urged the principal bronchi. The stomach, duodenum and proximal part of jejunal winds, as well as a greater amount of omental and mesenteric adipose tissue were localized in hernial sac. Radiography of gastroduodenum showed: entry of the esophagus into the cardia was in the level of the right main bronchus. Stomach was mainly located in the chest (cardia, upper corpus half - to the level of the right main bronchus). Operation was indicated. First, we made right thoracotomy and the hernia sac was separated from the right lung and then we performed median laparotomy and the contents of the hernia sac were returned to the abdominal cavity; diaphragm defect was reconstructed with prolen mesh. Conclusion. We presented a rare case of right sided Bochdalek hernia which was discovered at late age and surgically treated with success

Extramedullary involvement of lymph nodes in multiple myeloma

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Myeloma multiplex is a malignant disease of bone marrow plasma cells. It is usually confined to the bone marrow, but in rare cases, patients can develop extramedullary disease. The involvement of lymph nodes is rare and can be a diagnostic challenge. Here, we describe a 36-year-old male patient who presented with abdominal pain and discomfort initially. An abdominal ultrasound followed by computed tomography (CT) revealed retroperitoneal and mesenteric lymph node enlargement. Biopsies of the abdominal lymph node and infiltrated colon showed a plasma cell infiltrate positive for CD79α, CD38, CD138, kappa light chain and VEGF2. Multiple myeloma with extramedullary localization was diagnosed. After six cycles of chemotherapy consisting of doxorubicin, dexamethasone and thalidomide followed by autologous haematopoietic cell transplantation, the patient achieved complete remission. Specifically, a CT scan after therapy showed enlarged lymph nodes in the abdomen, but PET CT scans did not detect any metabolically active foci. Three years after the completion of therapy, the patient remains in remission. This case illustrates a rare presentation of extramedullary myeloma involving the abdominal lymph nodes, which could have been potentially mistaken for a lymphoid malignancy

Extramedullary Involvement of Lymph Nodes in Multiple Myeloma

Myeloma multiplex is a malignant disease of bone marrow plasma cells. It is usually confined to the bone marrow, but in rare cases, patients can develop extramedullary disease. The involvement of lymph nodes is rare and can be a diagnostic challenge. Here, we describe a 36-year-old male patient who presented with abdominal pain and discomfort initially. An abdominal ultrasound followed by computed tomography (CT) revealed retroperitoneal and mesenteric lymph node enlargement. Biopsies of the abdominal lymph node and infiltrated colon showed a plasma cell infiltrate positive for CD79α, CD38, CD138, kappa light chain and VEGF2. Multiple myeloma with extramedullary localization was diagnosed. After six cycles of chemotherapy consisting of doxorubicin, dexamethasone and thalidomide followed by autologous haematopoietic cell transplantation, the patient achieved complete remission. Specifically, a CT scan after therapy showed enlarged lymph nodes in the abdomen, but PET CT scans did not detect any metabolically active foci. Thee years after the completion of therapy, the patient remains in remission. This case illustrates a rare presentation of extramedullary myeloma involving the abdominal lymph nodes, which could have been potentially mistaken for a lymphoid malignancy

Mechanism and Clinical Importance of Respiratory Failure Induced by Anticholinesterases

Respiratory failure is the predominant cause of death in humans and animals poisoned with anticholinesterases. Organophosphorus and carbamate anticholinesterases inhibit acetylcholinesterase irreversibly and reversibly, respectively. Some of them contain a quaternary atom that makes them lipophobic, limiting their action at the periphery, i.e. outside the central nervous system. They impair respiratory function primarily by inducing a desensitization block of nicotinic receptors in the neuromuscular synapse. Lipophilic anticholinesterases inhibit the acetylcholinesterase both in the brain and in other tissues, including respiratory muscles. Their doses needed for cessation of central respiratory drive are significantly less than doses needed for paralysis of the neuromuscular transmission. Antagonist of muscarinic receptors atropine blocks both the central and peripheral muscarinic receptors and effectively antagonizes the central respiratory depression produced by anticholinesterases. To manage the peripheral nicotinic receptor hyperstimulation phenomena, oximes as acetylcholinesterase reactivators are used. Addition of diazepam is useful for treatment of seizures, since they are cholinergic only in their initial phase and can contribute to the occurrence of central respiratory depression. Possible involvement of central nicotinic receptors as well as the other neurotransmitter systems – glutamatergic, opioidergic – necessitates further research of additional antidotes