Acute coronary syndrome in diclofenac sodium-induced type I hypersensitivity reaction : Kounis syndrome

Drug-induced type I hypersensitivity reactions are frequent. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Because of potentially atypical ACS clinical presentations, the ECG is an obligatory diagnostic tool in any allergic reaction. Coronary artery spasm is the pathophysiological basis of ACS, triggered by the action of potent vasoactive mediators (histamine, neutral proteases, arachidonic acid products) released from the cells involved in type I hypersensitivity. Allergic angina and allergic myocardial infarction are referred to as Kounis Syndrome. We describe herein a case of ACS in a patient with registered systemic immediate hypersensitivity reaction which developed following the muscular administration of diclofenac sodium.peer-reviewe

Leptin immunoexpression and innervation in rat interscapular brown adipose tissue of cold-acclimated rats: the effects of L-arginine and L-NAME.

The aim of the present study was to explore the effect of nitric oxide on leptin immunoexpression and innervation in interscapular brown adipose tissue (IBAT) of room- and cold- acclimated rats. Animals acclimated both to room-temperature (22 +/- 1 degrees C) and cold (4 +/- 1 degrees C) were treated with L-arginine, a substrate for nitric oxide synthases (NOSs), or N?-nitro-L-arginine methyl ester (L-NAME), an inhibitor of NOSs, for 45 days. Leptin expression and localization in brown adipocytes was studied by immunohistochemistry, and innervation stained by the Bodian method. Strong leptin immunopositivity was observed in brown adipocytes cytoplasm of all room-acclimated groups, but nuclear leptin positivity was found only in L-NAME treated rats. In cold-acclimated control and L-NAME treated rats leptin immunopositivity was absent, while L-arginine treatment reversed the cold-induced suppression of leptin expression. Comparing to control, L-arginine, and even more L-NAME, at 22 +/- 1 degrees C induced greater innervation. In conclusion, L-arginine treatment changes leptin expression pattern on cold in rat IBAT

Analysis of the factors influencing development of urinary tract infections in patients with spinal cord injuriеs

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Urinary tract infections are still the most frequent complications in patients with spinal cord injury (SCI). The aim of this study was to analyze the factors influencing development of urinary tract infections during rehabilitation in patients with SCI. Methods. This retrospective case/control study including 540 patients with SCI which were rehabilitated in the Clinic for Rehabilitation “Dr Miroslav Zotović” between January 2000 and December 2009. We used patient files and other available medical documentation for obtaining information contained in this study, such as the manner of bladder emptying, the type of neurological disorder of the bladder, the neurological level and completeness of a lesion, the injury etiology, treatment method, secondary complications and associated injuries, kidney and bladder calculosis, age and sex. Results. Out of the total number of patients included in the study, 152 (28.1%) were without urinary tract infections, whereas 388 (71.9%) had urinary tract infections. There were 389 (72%) male and 151 (28%) female patients. The average age of patients without urinary tract infections was 51.0 ± 15.4 years, whereas the mean age of patients with urinary tract infections was 44.3 ± 16.9 years. The results of our study showed that the occurrence of urinary tract infections during rehabilitation in patients with SCIs was associated with the following factors: combined injuries (OR = 3.5), anemia (OR = 5.67), type of the bladder functional disorder (OR = 40–60) and crystals in urine (OR = 7.54). Conclusion. The physicians should take precautions and try to make the early diagnosis and rapid appropriate treatment of urinary tract infections in patients with SCI who also have functional bladder disorder, combined spinal injuries, anemia or urine crystals

Supply chain management maturity assessment: challenges of the enterprises in Serbia

Nowadays competition has been spread to supply chains, instead of individual enterprises. Therefore, beside evaluation of enterprise’s capabilities to manage business processes, it is important to assess capabilities for business process management at supply chain level. The purpose of the research presented in this paper is to point out the necessity of supply chain management maturity in implementation of best practice. Research methodology is based on supply chain management maturity models. Application of the Delphi method enabled usage of maturity model, adapted to the enterprises in Serbia. The value of the research precedes from unique combination of best practice elements for the assessment of supply chain management maturity level. The research results show that best practice elements are not very popular in the enterprises in Serbia. All enterprises are at the second and third maturity level. Bearing in mind that everything has to be improved continually, maturity models, proposed by different authors can be further developed by including certain statistical tools. The original contribution of this paper and its practical implication refer to including statistical tools, hierarchical cluster analysis and correlation, into maturity analysis, thus enabling creation of framework as a road-map for the improvement of supply chain management maturity

First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

Although tuberculosis (TB) is a curable disease, it continues to be one of the leading infections associated with death in the world. Extra-pulmonary TB (EPTB) occurs in approximately 10% of the total cases, presenting with lymph nodes, pleura, bone and genitourinary tract as the most common locations. Genitourinary tuberculosis, the second most common EPTB, is very difficult to diagnose unless there is a high index of suspicion. Isolated TB orchitis or prostatitis without clinical evidence of renal involvement is a rare entity among genitourinary tuberculosis. We presented the first reported case of TB prostatitis and orchitis associated with pulmonary TB and the presence of an acute massive caseous pneumonia in an immunocompetent man. Despite the anti-TB therapy, the patient presented a rapid progression of disease and deterioration of general conditions taking to death, which occurred four days after TB treatment had started. Disseminated TB is a relatively uncommon cause of acute massive caseous pneumonia; however, there should always be suspicion of the disease, since it is a potentially treatable cause. This rare case supports the assertion that TB should be considered as an important differential diagnosis of genitourinary tumors irrespective of evidence of active TB elsewhere in the body

Demographic characteristics and functional outcomes in patients with traumatic and nontraumatic spinal cord injuries

Background/Aim. Spinal cord injuries (SCI) could be associated with a significant functional impairment in the areas of mobility, self-care, bowel and bladder emptying and sexuality. The aim of this study was to compare demographic characteristics and functional outcomes of nontraumatic and traumatic spinal cord injury patients. Methods. This study was designed as retrospective case series study. A detailed medical history including sex, age, mode of trauma, and clinical and radiological examination was taken for all patients. Hospital records were used to classify the patients according to the following: mechanism of injury, neurological level of injury, functional outcomes, associated injuries, method of treatment, secondary complications and length of stay. The following clinical scores were measured in the patients: American Spinal Injury Association standards (CASTA), Functional Independence Measure (FIM), and Modified Aschworth score (MAS). Results. Out of totally 441 patients with spinal cord injury, 279 were traumatic patients (TSCI) and 162 nontraumatic patients (NTSCI); 322 men and 119 women. The mean age of the patients was 46.1 ± 19.9 years. Traumatic and nontraumatic populations showed several significant differences with regard to age, level and severity of lesion. When adjusted for these factors patients with traumatic injuries showed a significantly lower FIM score at admission and significantly better improvement in the FIM score at discharge. The two populations were discharged with similar functional outcome. Conclusions. The NTSCI patients in our study were younger, more frequently female, with less complications before rehabilitation and less frequently treated operatively than the TSCI patients. Hospital rehabilitation of the TSCI patients was longer than that of the NTSCI patients, but their functional gain from admission was also higher, so at discharge. Traumatic and nontraumatic spinal cord lesion patients achieved similar results in regard to neurological and functional status

Pokazatelji aktivne bezbednosti poljoprivrednih vozila

In this paper the problems of the agricultural vehicle active safety are discussed. The parameters of active safety are defined with respect to vehicle stability and controllability. In this sense a vehicle train model has been developed to study system response. The yaw rates of the two vehicle units, tractor and trailer, then, the sideslip angle of tractor and articulation angle tractor – trailer at step steering input is determined. The results are presented and discussed as base to development of the vehicle safety assessment criterion.U ovom radu su diskutovani problemi aktivne bezbednosti poljoprivrednih vozila. Parametri aktivne bezbednosti su definisani sa aspekta stabilnosti i upravljivosti vozila. U ovom smislu, razvijen je model sprega vozila za proučavanje odgovora sistema. Određene su ugaone brzine zaokretanja dva spregnuta vozila, traktora i prikolice, zatim, ugao skretanja traktora, i ugao između prikolice i traktora, pri naglom zaokretanju točka upravljača. Rezultati su prikazani i diskutovani kao baza za razvoj kriterijuma procene aktivne bezbednosti vozila

Uticaj karakteristika terena na oscilacije traktora

In this paper the problems of tractor vibration excited from terrain unevenness are considered. For simulation investigation a modular vibration model of tractor system is developed. A experimental platform for measurement of tire vibration parameters, stiffness and damping, as support to simulation investigation, is used. As ilustrative examples are presented and discused the experimental results of tire characteristics and simulate resultes of tractor vibration for two load states and three form of terrain excitation.U ovom radu su razmotreni problemi oscilacija traktora prouzrokovane neravninama terena. Za simulaciona istraživanja razvijen je modularni model traktorskog sistema. Eksperimentalna platforma je korišćena za merenje oscilatornih parametara guma, krutosti i prigušenja, koji su potrebni za simulaciona istraživanja. Kao ilustrativni primeri prikazani su i diskutovani eksperimentalni rezultati karakteristika guma i simulirani rezultati oscilacija traktora za dva stanja opterećenja i tri oblika pobude od terena

Targeting the superoxide/nitric oxide ratio by L-arginine and SOD mimic in diabetic rat skin

AbstractSetting the correct ratio of superoxide anion (O2•-) and nitric oxide (•NO) radicals seems to be crucial in restoring disrupted redox signaling in diabetic skin and improvement of •NO physiological action for prevention and treatment of skin injuries in diabetes. In this study we examined the effects of L-arginine and manganese(II)-pentaazamacrocyclic superoxide dismutase (SOD) mimic – M40403 in diabetic rat skin. Following induction of diabetes by alloxan (blood glucose level ≥12 mMol l −1) non-diabetic and diabetic male Mill Hill hybrid hooded rats were divided into three subgroups: (i) control, and receiving: (ii) L-arginine, (iii) M40403. Treatment of diabetic animals started after diabetes induction and lasted for 7 days. Compared to control, lower cutaneous immuno-expression of endothelial NO synthase (eNOS), heme oxygenase 1 (HO1), manganese SOD (MnSOD) and glutathione peroxidase (GSH-Px), in parallel with increased NFE2-related factor 2 (Nrf2) and nitrotyrosine levels characterized diabeti..