Successful isolation of Helicobacter pylori after prolonged incubation: A case report of prolonged incubation for H. pylori

The culture of Helicobacter pylori from a gastric biopsy is the “gold standard” in the diagnosis of H. pylori infection. However, the primary isolation of H. pylori from gastric biopsies is rather demanding. The duration of incubation for the isolation of H. pylori has been recommended to be five to seven days: in the present case, we found that a prolonged incubation period allowed the successful isolation of H. pylori from a patient with ulcus ventriculi. Biopsies were placed directly into transport medium and processed for culture within two hours. On day 14, one suspected H. pylori-like colony appeared on one of the plates. The isolate was confirmed to be H. pylori based on its typical colony morphology, negative Gram stain, and positive urease, catalase and oxidase tests. The isolate, requiring 14 days recovery, later exhibited the normal growth characteristics of H. pylori strains, indicating its unusually long incubation requirement was a temporary predicament

Analysis of the grade of esophagitis, chromendoscopical and histological findings of esophagus in patients with gastroesophageal reflux disease before and after the therapy

Background/Aim. The symptoms of gastroesophageal reflux desease (GERD) are among the most common complaints for which patients are indicated for visiting gastroenterologist. It occurs as a result of the effect made by gastric reflux contents that moves into the esophagus. The prevalence of all forms of GERD is 40%. The aim of this study was to analyze the grade of esophagitis, chromendoscopical and histological findings of esophagus in patients with GERD before and after the therapy. Methods. A prospective study included 90 patients with symptoms of GERD, divided into 2 groups depending on whether they had endoscopic signs of gastroezophageal reflux (group ERD), or not (group NERD). All the patients had esophagogastroduodenoscopy, chromoendoscopy staining, test for Helicobacter pylori and histological findings of the esophagus. In the patients with Helicobacter pylori infection eradication therapy was done. Results. Esophagitis-B level was present in most of the patients. Among the groups, roughly the same number responded to positive findings on chromoendoscopy. After the therapy, chromoendoscopy was significantly negative in both groups of the patients comparing to chromoendoscopy before the therapy (p = 0.00001). Multiplication and elongation of papilla, basal cell hyperplasia, vascular dilatation, increasing of mitotic activity and the presence of polymorphonuclear leukocyte cells were statistically more frequent histological findings in the group ERB compared to the group NERB. After the therapy, the patients in both groups had statistically less histological findings of appropriate esophageal parameters. Conclusion. Chromoendoscopy combined with the standard endoscopy increases the sensitivity and specificity for reflux disease. Histology in the reflux disease is associated with endoscopic and clinical findings so that the localization of taking biopsies and histological criteria of pathohistological changes must be clearly defined. Multiplication and elongation of papilla, basal cell hyperplasia and the presence of polymorphonuclear leukocytes are the most relevant criteria in the diagnosis NERD

Inovativni pristupi u nastavi harmonije kao deo reforme u srednjem i visokom muzičkom vaspitanju i obrazovanju

In the educational system of the Republic of Serbia, subjects Harmony and Harmony with harmonic analysis are taught in high music schools and institutions of high education. The subject Harmony, which is closely professional, is taught in all departments, starting from the second year of high music school. The established methodological syllabus of this subject includes theoretical lectures, practical harmonization (completing harmonic tasks and practical harmonization on an instrument) and harmonic dictation. The subject Harmony with harmonic analysis is complemented with the analytical dimension in high music education and the permanent contact of students with music literature by authors from different style epochs. Doctoral dissertation under the name Innovative approaches in teaching Harmony as a part of the reform of middle and high music education is comprised of a theoretical and methodological section. The descriptive method is applied in this dissertation, taking into account the nature of this research, as well as methods of pedagogical document analysis and theoretical analysis. The theoretical section elaborates the important terms, music education on all levels and reformation processes of middle and high music education. The subject Harmony, which is of high significance in the music education process of future educationalists, theoreticians, conductors, composers, musicologists, ethnomusicologists and artists, has altered its name, content, character, its place in school documents, course books, and the education and development of students. Considering the basic goal of this dissertation – introducing the innovative approaches in teaching subjects Harmony and Harmony with harmonic analysis, two approaches emerged that would make these subjects more creative and more related to other music disciplines. The first group of innovative processes encompasses pedagogical renovations as an idea of creating something new without much change, in continuity with what preceded, in practical harmonization on an instrument. The dissertation offers parts that contribute to obtaining the desired results – free and creative practical harmonization on an instrument that represents a way to a higher level of development of a young person – to artistry. The results of this theoretical research imply the necessity for introduction of these innovative approaches with the goal of modernization and improving the quality of the teaching process in music education. The importance of using the characteristic cadence processes from the structure of protestant chorals by J. S. Bach is emphasized in this context as the second group of innovative approaches

IRRITABLE BOWEL SYNDROME, ANXIETY, DEPRESSION AND PERSONALITY CHARACTERISTICS

Background: Numerous studies have suggested that 54%-100% of patients with IBS may have associated psychiatric illness and personality pathology. This transversal controlled study was realized in order to evaluate anxiety and depression levels, as well as the personality characteristics of patients with IBS and to compare the results obtained with patients with episodes of depression and healthy individuals. Subjects and methods: The experimental group consisted of 30 IBS patients, while two control groups consisted of the same number of inpatients with episodes of depression and healthy individuals from the general population. There were equal number of men and women in the study sample and all subjects were aged between 25 to 65 years. Standard psychometric instruments employed included Hamilton anxiety scale, Zung depression scale, Hamilton depression scale, Minnesota Multiphasic Personality Inventory (MMPI), Eysenck Perosonality Inventory (EPI). Results: The average Hamilton and Zung depression scores were significantly higher in patients with depressive episodes compared with the IBS patients, while the mentioned scores among them were also significantly higher compared with the healthy controls. There were no significant differences between IBS and the group with depressive episodes in the average Hamilton anxiety levels, EPI neuroticism and extraversion levels and MMPI neurotic scales levels (Hs, D, and Hy). The significant differences were observed comparing the IBS patients to healthy individuals. Conclusion: The patients suffering from irritable bowel syndrome who asked for medical help (consulters) because of their intestinal symptoms, presented emotional problems such as depression and anxiety and expressed neurotic personality characteristics

FOLLOW-UP OF BIOCHEMICAL PARAMETERS AND INTENSITY OF OXIDATIVE STRESS IN PATIENTS WITH EXTRAHEPATHIC CHOLESTASIS

In cholestasis, due to impossibility of gall flow into duodenum, there occurs a subsequent return of gall constituents to hepatocytes and circulation. Extrahepatic cholestasis is the result of mechanic obstacle of gall flow through ductus hepaticus, choledochus or papilla Vateri, leading to the occurrence of manifest icterus. In cases leading to liver damage, hydrophobic gall salts and non-conjugated bilirubins have the most important toxic effects.The aim of this study was to follow up the biochemical parameters, enzyme activity AST, ALT, *-GT and AF, bilirubin concentration and albumins, and intensity of oxidative stress in blood plasma in patients with different types of extrahepatic cholestasis.The study included 60 subjects divided into two groups. The first one was control group (30 healthy subjects), while II group involved 30 patients with intraluminar extrahepatic obstruction.Significant increase of enzyme activity of AST, ALT, *-GT and AF in plasma of cholestatic patients was present in comparison to the control group (p< 0,001). The levels of total direct and indirect bilirubin in plasma of cholestatic patients increased (p<0,001) when compared to the control group. The level of albumin in plasma of cholestatic patients significantly decreased in comparison to the control group (p<0,05). The intensity of oxidative stress measured through the levels of malondialdehide (MDA) and carbonyl group concentration in plasma of cholestatic patients increased (p<0,001) when compared to the control group.Significant increase of cholestasis enzyme markers (AST, ALT, *-GT and AF) and bilirubin levels in blood plasma was noticed in patients with extrahepatic cholestasis. Cholestasis leads to significant disorders of synthetic function of the liver that are manifested by decrease of albumin concentration in plasma

Arrangement of a 4Pi microscope for reducing the confocal detection volume with two-photon excitation

The main advantage of two-photon fluorescence confocal microscopy is the low absorption obtained with live tissues at the wavelengths of operation. However, the resolution of two-photon fluorescence confocal microscopes is lower than in the case of one-photon excitation. The 4Pi microscope type C working in two-photon regime, in which the excitation beams are coherently superimposed and, simultaneously, the emitted beams are also coherently added, has shown to be a good solution for increasing the resolution along the optical axis and for reducing the amplitude of the side lobes of the point spread function. However, the resolution in the transverse plane is poorer than in the case of one-photon excitation due to the larger wavelength involved in the two-photon fluorescence process. In this paper we show that a particular arrangement of the 4Pi microscope, referenced as 4Pi0 microscope, is a solution for obtaining a lateral resolution in the two-photon regime similar or even better to that obtained with 4Pi microscopes working in the one-photon excitation regime

Complicated Appendicitis: A Surgical Controversy Concerning Risk Factors, Diagnostic Algorithm and Therapeutic Management

By surgeon’s perspective, complicated appendicitis is defined as perforated appendicitis, periappendicular abscess, gangrenous appendicitis or peritonitis, noted on radiological studies upon hospital admission, operative reports or pathology results of the surgical specimen. Despite that this clinical condition is truly common in everyday surgical routine, its causes and risk factors are still unclear. Some parameters have been associated with complicated appendicitis, like older age, type 2 diabetes, symptoms for longer duration, appendicoliths/fecaliths, delays in surgery after onset of symptoms and after admission. Furthermore, currently, there is no standard diagnostic algorithm for complicated appendicitis. To be specific, radiological findings lack sensitivity, intraoperative assessment may overestimate it while, histopathological examination is regarded as more specific diagnostic method. In addition, the optimal treatment for complicated appendicitis remains controversial between an immediate surgical operation (laparotomy/laparoscopy) or a trial of nonoperative management. Hereby, by reviewing the current literature, we would aim to clarify the risk factors and the diagnostic procedure of complicated appendicitis as well as to compare the operative management with the conservative one according to the type of complicated appendicitis, the success rate and the postoperative complications