Zakrzepica żyły wrotnej po zabiegu rękawowej resekcji żołądka u 32-letniej kobiety z otyłością patologiczną

Portal vein thrombosis after laparoscopic procedures is an uncommon complication, but potentially life threating. Possible etiologic factors include venous stasis due to increased intra-abdominal pressure, intraoperative manipulation, or damage to the splanchnic endothelium and systemic thrombophilia states. We describe a case of a 32 year old morbidly obese patient, qualified for surgical treatment of obesity. After a laparoscopic gastric resection — a sleeve gastrectomy — on the 20th day after hospital discharge, the patient was re-admitted to the surgical ward due to uncharacteristic abdominal pain, nausea, vomiting and increased cholestasis indicators. The patient was diagnosed with portal system thrombosis. Following the treatment the patient achieved complete remission of symptoms. Given a growing number of laparoscopic procedures, we may expect an increasing number of similar complications. This condition needs to be considered in patients with unexplained abdominal pain after several laparoscopic procedures.Zakrzepica żyły wrotnej po zabiegach laparoskopowych jest rzadkim powikłaniem, ale potencjalnie zagrażającym życiu. Do rozwoju zakrzepicy predysponują liczne czynniki, jak zastój żylny z powodu zwiększonego ciśnienia w jamie brzusznej, śródoperacyjna manipulacja wewnątrzotrzewnowa, uszkodzenie śródbłonka naczyń trzewnych oraz trombofilią. Opisujemy przypadek 32-letniej pacjentki z patologiczną otyłością zakwalifikowaną do chirurgicznego leczenia otyłości. Po laparoskopowej resekcji rękawowej żołądka, w 20. dniu po wypisie ze szpitala, pacjentka została ponownie przyjęta na oddział chirurgiczny ze względu na nietypowe bóle brzucha, nudności, wymioty i podwyższenie wskaźników cholestazy. U pacjentki stwierdzono zakrzepicę żyły wrotnej. Po wdrożeniu leczenia zachowawczego uzyskano całkowitą remisję objawów. Biorąc pod uwagę rosnącą liczbę zabiegów laparoskopowych, należy spodziewać się zwiększenia częstości występowania podobnych powikłań. Powinno się o tym zawsze pamiętać u pacjentów z niewyjaśnionymi bólami brzucha poddanych procedurom laparoskopowym

Primary hyperparathyroidism

Primary hyperparathyroidism is an endocrine disorder that results in overproduction of parathyroid hormone by overactivated parathyroid gland leading to a significant rise in blood serum calcium. It results in hypercalcaemia, which has a significant impact mainly on the kidneys and bones and results in a variety of signs and symptoms. Primary hyperparathyroidism should be treated because, if left without any therapy, it can lead even to death. Surgery is considered as the best and only successful therapy, with very low risk of recurrence and relatively low complication rate. The aim of this review is to present clinical basis, aetiology, diagnostic possibilities, and treatment opportunities

Triple excitations in Green's function coupled cluster solver for studies of strongly correlated systems in the framework of self-energy embedding theory

Embedding theories became important approaches used for accurate calculations of both molecules and solids. In these theories, a small chosen subset of orbitals is treated with an accurate method, called an impurity solver, capable of describing higher correlation effects. Ideally, such a chosen fragment should contain multiple orbitals responsible for the chemical and physical behavior of the compound. Handing a large number of chosen orbitals presents a very significant challenge for the current generation of solvers used in the physics and chemistry community. Here, we develop a Green's function coupled cluster singles doubles and triples (GFCCSDT) solver that can be used for a quantitative description in both molecules and solids. This solver allows us to treat orbital spaces that are inaccessible to other accurate solvers. At the same time, GFCCSDT maintains high accuracy of the resulting self-energy. Moreover, in conjunction with the GFCCSD solver, it allows us to test the systematic convergence of computational studies. Developing the CC family of solvers paves the road to fully systematic Green's function embedding calculations in solids. In this paper, we focus on the investigation of GFCCSDT self-energies for a strongly correlated problem of SrMnO$_3$ solid. Subsequently, we apply this solver to solid MnO showing that an approximate variant of GFCCSDT is capable of yielding a high accuracy orbital resolved spectral function

Surgical treatment of patients with primary hyperparathyroidism with a risk of hypercalcaemic crisis

Introduction: The objective of the work was to evaluate the effectiveness of surgical treatment in patients with a high risk of hypercalcaemic crisis due to primary hyperparathyroidism (PHPT) and to determine the best time to undergo surgery. Material and methods and Results: Between 2010 and 2019, 627 patients underwent surgery due to PHPT. Sixty-two patients (9.9%) (47 women and 15 men, aged 28–79 years, average 53.7 years) faced the threat of a parathyroid crisis. In these patients, the average parathyroid hormone (PTH) levels were 774.02 pg/mL (95% CI: 203–1246 pg/mL) and ionised calcium (iCa2+) 1.91 mmol/L (95% CI: 1.70–2.2 mmol/L). The PTH postoperative concentration averaged at 37.86 pg/mL (95% CI: 9.91–42.7 pg/mL) and iCa2 + 1.11 mmol/L (95% CI: 1.07–1.21 mmol/L). Bilateral neck exploration was performed in all patients with the removal of the affected parathyroid gland and biopsies of other parts. Histopathological examination revealed adenoma in 42 cases (67.7%), hyperplasia in 16 (25.7%), and parathyroid cancer in four of the patients (6.6%). Comparison of tests before and after surgery showed a statistically significant decrease in PTH (p < 0.001) and iCa (p < 0.001) in blood serum. Conclusions: A developing hypercalcaemic crisis in the course of hyperparathyroidism is an indication for preoperative intensive medical therapy, along with urgent surgical intervention and removal of diseased parathyroid glands. This type of surgery should be performed as soon as possible, even if there are no imaging tests, only based on an assessment of the general condition of the patient and their serum calcium levels

Respiratory muscle training induces additional stress and training load in well-trained triathletes—randomized controlled trial

Background: Respiratory muscle training (RMT) has been investigated in the context of improved athletic performance and pulmonary function. However, psychophysiological costs of RMT remain understudied. Voluntary isocapnic hyperpnoea (VIH) and inspiratory pressure threshold loading (IPTL) are widely applied RMT methods. The main purposes of this study were to assess whether RMT induces additional load on well-trained triathletes and determine differences in RMT-induced load between sexes and applied methods.Materials and Methods: 16 well-trained triathletes (n = 16, 56% males) underwent 6 weeks of VIH or IPTL program with progressive overload. Blood markers, subjective measures, cardiac indices, near-infrared spectroscopy indices, inspiratory muscle fatigue, and RMT-induced training load were monitored pre-, in and post-sessions. We used multiple ANOVA to investigate effects of sex, training method, and time on measured parameters.Results: There were significant interactions for acid-base balance (p = 0.04 for sex, p < 0.001 for method), partial carbon dioxide pressure (p = 0.03 for sex, p < 0.001 for method), bicarbonate (p = 0.01 for method), lactate (p < 0.001 for method), RMT-induced training load (p = 0.001 for method for single session, p = 0.03 for method per week), average heart rate (p = 0.03 for sex), maximum heart rate (p = 0.02 for sex), intercostales muscle oxygenation (p = 0.007 for testing week), and intercostales muscle oxygenation recovery (p = 0.003 for testing week and p = 0.007 for method).Conclusion: We found that RMT induced additional load in well-trained triathletes. Elicited changes in monitored variables depend on sex and training method. VIH significantly increased subjective training load measures. IPTL was associated with disbalance in blood gasometry, increase in lactate, and reports of headaches and dizziness. Both methods should be applied with consideration in high-performance settings

Iron inactivation by Sporobolomyces ruberrimus and its potential role in plant metal stress protection : an in vitro study

The endophytic Basidiomycete Sporobolomyces ruberrimus protects its host Arabidopsis arenosa against metal toxicity. Plants inoculated with the fungus yielded more biomass and exhibited significantly fewer stress symptoms in medium mimicking mine dump conditions (medium supplemented with excess of Fe, Zn and Cd). Aside from fine-tuning plant metal homeostasis, the fungus was capable of precipitating Fe in the medium, most likely limiting host exposure to metal toxicity. The precipitated residue was identified by Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-Ray Diffraction (XRD) and electron microscopy (SEM/TEM) with energy dispersive X-Ray analysis (EDX/SAED) techniques. The performed analyses revealed that the fungus transforms iron into amorphous (oxy)hydroxides and phosphates and immobilizes them in the form of a precipitate changing Fe behaviour in the MSR medium. Moreover, the complexation of free Fe ions by fungi could be obtained by biomolecules such as lipids, proteins, or biosynthesized redox-active molecules

Overview of the software architecture and data flow for the J-PET tomography device

Modern TOF-PET scanner systems require high-speed computing resources for efficient data processing, monitoring and image reconstruction. In this article, we present the data flow and software architecture for the novel TOF-PET scanner developed by the J-PET Collaboration. We discuss the data acquisition system, reconstruction framework and image reconstruction software. Also, the concept of computing outside hospitals in the remote centers such as Świerk Computing Centre in Poland is presented

Sampling FEE and trigger-less DAQ for the J-PET scanner

In this paper, we present a complete Data Acquisition System (DAQ) together with the readout mechanisms for the J-PET tomography scanner. In general, detector readout chain is constructed out of Front-End Electronics (FEE) measurement devices such as Time-to-Digital or Analog-to-Digital Converters (TDCs or ADCs), data collectors and storage. We have developed a system capable for maintaining continuous readout of digitized data without preliminary selection. Such operation mode results in up to 8 Gbps data stream, therefore, it is required to introduce a dedicated module for on-line event building and feature extraction. The Central Controller Module, equipped with Xilinx Zynq SoC and 16 optical transceivers, serves as such true real time computing facility. Our solution for the continuous data recording (trigger-less) is a novel approach in such detector systems and assures that most of the information is preserved on the storage for further, high-level processing. Signal discrimination applies a unique method of using LVDS buffers located in the FPGA fabric

Time calibration of the J-PET detector

The Jagiellonian Positron Emission Tomograph (J-PET) project carried out in the Institute of Physics of the Jagiellonian University is focused on construction and tests of the first prototype of PET scanner for medical diagnostic which allows for the simultaneous 3D imaging of the whole human body using organic scintillators. The J-PET prototype consists of 192 scintillator strips forming three cylindrical layers which are optimized for the detection of photons from the electron-positron annihilation with high time- and high angular-resolutions. In this article we present time calibration and synchronization of the whole J-PET detection system by irradiating each single detection module with a 22Na source and a small detector providing common reference time for synchronization of all the modules

Preliminary studies of J-PET detector spatial resolution

The J-PET detector, based on long plastic scintillator strips, was recently constructed at the Jagiellonian University. It consists of 192 modules axially arranged into three layers, read out from both sides by digital constant-threshold front-end electronics. This work presents preliminary results of measurements of the spatial resolution of the J-PET tomograph performed with ²²Na source placed at selected position inside the detector chamber