Metastatic colorectal cancer presenting with malignant pleural effsion - a self-experience study

INTRODUCTION: Colorectal cancer (CRC) advanced stage (stage IVA) is characterized by distant metastasis in one organ or in one site. The aim of this study is to present a relatively rare localization of CRC dissemi­nation, i.e. pleural metastases clinically presenting with malignant pleural effusion.PATIENTS AND METHODS: A total of 12 patients, 10 males and two females at a mean age of 61.4±13.3 years (range, 39-78 years) with malignant pleural effusion because of CRC were included in this four-year study (2012-2016). Physical examination and Karnofsky performance status score were evaluated. Radio­graphic studies were used to establish pleural effusion. Pleural effusion drainage and pleural fluid cytolog­ical examinations were performed. Patients` survival rate was established.RESULTS: Pleural metastasis developed approximately 1.8±0.7 years after radical operation in all the pa­tients. Patient`s Karnofsky performance status score was ≤50. Pleural effusion evacuation was accomplished by tube thoracostomy in all the patients. The cytological examination established adenocarcinoma cells in the pleural effusion. The mean patient`s survival rate was 3.1±1.9 months.CONCLUSION: This study described a rare localization of CRC metastasis in the pleural cavity character­ized by an extremely low patient`s survival rate. Scr Sci Med 2017; 49(3): 35-3

Optimization of Material Flow in a Manufacturing Company

Bakalárska práca spracováva optimalizáciu materiálového toku vo výrobnej spoločnosti. Práca popisuje, na základe znalosti z odbornej literatúry, materiálový tok, základné pojmy súvisiace s materiálovým tokom, metódy Kanban, Conwip a základné metódy skladovania. V nasledujúcej časti je práca zameraná na analýzu súčasného stavu konkrétneho produktu, možné návrhy optimalizácie a ich dopad z technicko-ekonomického hľadiska.Bachelor thesis handles the optimization of material flow in manufacturing company. This thesis describes, based on knowledge of literature, material flow, basic concepts related to the flow of materials, methods Kanban, Conwip and basic methods of storage. The following section is focused on the analysis of the current state of a particular product, optimization possibilities and their impact on technical and economic point of view.

THE UTILITY OF VIDEO-ASSISTED THORACOSCOPIC SURGERY IN THE MANAGEMENT OF THE FIRST UNCOMPLICATED EPISODE OF PRIMARY SPONTANEOUS PNEUMOTHORAX

Introduction. The option of surgery at the time of the first uncomplicated episode of primary spontaneous pneumothorax is now a matter of debate. The aim of this study is to present the utility of video-assisted thoracoscopic surgery (VATS) in the management of the first uncomplicated episode of primary spontaneous pneumothorax. Marterials and Methods. Twenty-five patients [male – 21 (84 % / p <0,05); mean age – 24,3 (SD – 6,1) years; age range: 17 ÷ 35 years] with the first uncomplicated episode of primary spontaneous pneumothorax were included in this study (from March 2017 to April 2018). The size of pneumothorax was determined by radiological evaluation (thoracic X-ray). Video-assisted thoracoscopic examination of the entire pleural cavity was performed. Resection of blebs (in cases of such operative finding) and partial apical parietal pleurectomy were done. Results. Right-sided pneumothorax was established in 16 (84%) patients. For 10 (40 %) of the patients pneumothorax was determined as a minimal and for the rest of them - as a large. Subpleural blebs were established in 8 of patients. No pathological changes on the lung surface were established for the rest of the cases. The mean hospital stay was 5.5 days with no postoperative complications. Conclusion. The easy access to VATS with no postoperative complications, confirmed in this study, demonstrated the utility of mini-invasive surgery, even in the first episode of uncomplicated primary spontaneous pneumothorax

HYPERLIPIDEMIC ACUTE PANCREATITIS: A CASE-BASED REVIEW

Hypertriglyceridemia is a rare cause of acute pancreatitis (accounts for about 1–7% of all cases of acute pancreatitis in large series). The aim of this publication is to discuss the incidence of hypertriglyceridemia-induced pancreatitis, using a case-based approach. A case of 33-year-old woman with hyperlipidemic acute pancreatitis is presented. The woman was hospitalized due to severe abdominal pain, epigastric tenderness, biochemical and abdominal sonographyc evidences of acute pancreatitis. There was no history of alcohol consumption and biliary disease. The past medical history established hyperlipidemia, treated with diet alone, and diabetes mellitus-type II. Subsequent laboratory investigation revealed marked hypertriglyceridemia. Emergent laparotomy was performed with severe necrotizing pancreatitis as an operative finding. Postoperative treatment was conducted in the intensive care unit. The woman died at the 3th postoperative day. In a case-based approach we present the proposed mechanisms and the severity of hyperlipidemic acute pancreatitis

Rationalization of Production Processes in the Company

Diplomová práca sa zaoberá racionalizáciou výrobných procesov v podniku Honeywell Safety Products Partizanske s.r.o.. Cieľom práce je zmapovať súčasný stav procesov, ktoré úzko súvisia s výrobnou činnosťou, nájsť príčiny rozporov týchto procesov a snažiť sa ich minimalizovať pripadne eliminovať. S pomocou niekoľkých návrhov, následného vyhodnotenia a výberu vhodného návrhu môže byť nájdený rozpor cielene odstránený. Tieto návrhy sú podrobené ekonomickej analýze a možnému prínosu pre podnik. Ekonomické hľadisko prispieva k lepšiemu rozhodovaniu pre výber vhodného návrhu a jeho následnej implementácii v hore uvedenom podniku.The diploma thesis focuses on rationalization of manufacturing processes in company Honeywell Safety Products Partizanske s.r.o.. Main target is to track actual state of processes, which are connected to manufacturing activity, search for reasons of collisions and try to minimize or eliminate them. By designing of multiple optimization solutions, evaluating of data and after applying best-fitted solution can be collision eliminated on purpose. These solutions are exposed to economic analyse and possible share with Company. Economic perspective can help to easier identify which of solution could have bigger impact after implementation to support prosperity of mentioned company.

Right-sided pneumothorax in a patient with chronic obstructive pulmonary disease and tuberculosis-affected left lung: a case report

Introduction: A spontaneous pneumothorax occurring in a patient with underlying lung pathology is classified as a secondary spontaneous pneumothorax (SSP). Its main cause is the chronic obstructive pulmonary disease (COPD), more rarely - a tuberculosis infection (TB). Untreated TB could lead to carnification of a part or the whole lung.Case report: A 35-year-old female patient was admitted with complaints of sudden right chest pain and severe dyspnea. The physical examination showed retracted and deformed left chest part, missing breathing sounds in the left and weakened breathing in the right. Chest CT revealed partial right-sided pneumothorax, bullous changes of the right lung and carnification of the whole left lung. Right thoracocentesis was performed. The postoperative period was uneventful. The chest drain was removed on the fifth day. After more detailed examinations the patient was diagnosed with COPD and TB and was transferred to the Department of Pulmonology and Phthisiatry for further treatment.Conclusion: In a patient who has two advanced and complicated lung diseases at the same time (COPD and TB), a spontaneous pneumothorax, even partial, is a life-threatening condition and requires special consideration and urgent therapeutic measures

THE MOST COMMONLY IDENTIFIED CAUSE OF PERIOPERATIVE HYPERSENSITIVITY REACTIONS

Introduction. Perioperative anaphylaxis is a clinical condition that range from mild symptoms to life-threatening reactions. There is a geographic difference in the most frequent identified cause of perioperative drug hypersensitivity reactions. However, data from national surveys are lacking. The aim of this study was to evaluate the cause of perioperative drug hypersensitivity reactions among patients with a history of perioperative anaphylaxis. Materials and Methods. A total number of 195 patients [68(34.87%) men; mean age 57 years; SD 40.8; age range 10-79] with a history of perioperative anaphylaxis were included. All patients were referred in a specialized allergy centre for evaluation within at least six weeks of hypersensitivity reaction during anesthesia. Allergy evaluation included a detailed medical history, review of perioperative medical records and skin testing for all drugs and products administered during the anesthesia. Skin testing was performed with nonirritating concentrations. If the skin prick test was negative, intradermal test was performed, when available. Results: A culprit drug, defined as a positive skin test, was identified in 115(58.97%) patients. A total number of 111 patients had allergy to one agent and 4 – to two. The most common agents indentified were neuromuscular blocking agents (NMBAs)– 68 positive skin tests in 61 (53.04%) patients. Reactions were as followed: pipecuronium -25(36.76%), rocuronium - 25(36.76%), suxamethonium - 13(19.12%), atracurium -5 (7.35%). Four patients had allergy to two NMBAs. Other identified agents were: fentanyl 10(8.7%), ketamine 13(11.3%), midazolam 11(9.57%), propofol 18 (16.65%), latex 2(1.74%). Conclusions: The leading causes of perioperative anaphylaxis in our study population were NMBAs. More data from multicenter national surveys should be collected in future

ON SOME SOCIAL CHARACTERISTICS OF THE DECEASED IN TRAFFIC ACCIDENTS WOMEN IN PLOVDIV REGION OF REPUBLIC OF BULGARIA

In the recent years there is an increase of road traffic and with it – an increase in the number of road accidents. Parallel to that there is an increase in the number of women injured in road accidents. OBJECTIVE: The objective of the present work is to study the dynamics of female mortality in road crashes, the social image and role of victims in road accidents. MATERIALS AND METHODS: the subject of the survey was the women, who died in traffic accidents in Plovdiv region for the period between 2000 and 2014, registered and autopsied at the department of Forensic Medicine at the St. George University Multi-Profile Hospital for Active Treatment in Plovdiv. For processing of the results the historical, statistical and graphical analysis were used. RESULTS: The research includes 323 women, who died in road accidents in Plovdiv region between 2000 and 2014. The dynamics of female mortality during the period is wavy and irregular with a tendency to decrease in recent years. 72,85±4,93% of them live in the cities of Plovdiv region and 22,68±4,65% in the villages. Most of the deceased women are over 65 years old /33,23±5,23%/ and young people aged 19 to 44 /31,63±5,16%/. The majority of the deceased women are pedestrians (43.45 ± 5.49%) and passengers in the motor vehicles (41.85 ± 5.47%). CONCLUSION: Traffic accidents continue to be a serious threat to the lives of older women, pedestrians and traveling young women

COMPARATIVE REVIEW OF MEAT QUALITY OF SOME CYPRINID SPECIES IN SERBIA

Šaranke predstavljaju dominantne vrste u ribnjacima Republike Srbije. Šaranke su dobar izvor nezasićenih masnih kiselina, koje su veoma važne u pravilnoj prehrani ljudi. Obzirom da se u postojećim podacima o kakvoći mesa šaranskih vrsta u Republici Srbiji rijetko navodi uzrast riba, način hranidbe kao i ostali čimbenici koji imaju značajan utjecaj na rezultate, postojeći podaci o kakvoći mesa ovih vrsta riba, smatraju se jako varijabilni. Uzorci dvogodišnjih šaranki, tj. šarana (Cyprinus carpio L.), amura (Ctenopharyngodon idella) i bijelih glavaša (Hypophthalmichthus molitrix), uzeti su s ribnjaka Ečka (Republika Serbia), gdje se proizvodnja temeljila na hranidbi kompletnim krmnim smjesama. Riblja hrana je sadržavala 25% sirovih proteina, bez dodatka animalnih komponenata. Analize kemijskog kao i masnokiselinskog sastava navedenih riba izvršene su u Institutu za higijenu i tehnologiju mesa (Beograd, Srbija). Sadržaj vlage, proteina, masti i ukupnog kolesterola u ispitivanim uzorcima statistički su se značajno razlikovali između vrsta (p<0,01). Ukupna količina zasićenih masnih kiselina bila je najviša kod bijelog glavaša (33%), a najniža kod šarana (27,15%), u odnosu na ukupan sadržaj masnih kiselina. U filetima amura i bijelog glavaša nije postojala statistički značajna razlika u sadržaju zasićenih masnih kiselina, dok je značajnost uočena između “kineskog kompleksa riba” i šarana (p<0,01). Ukupan postotak mononezasićenih masnih kiselina bio je najniži kod šarana (28,79 %), a najviši kod bijelog glavaša (37%) (p<0,01). Šaran je imao najviši (44,08%), dok je bijeli glavaš imao najniži (30%) postotak polinezasićenih masnih kiselina, u odnosu na ukupan sadržaj masnih kiselina (p<0,01). Iz naših rezultata istraživanja zaključilo se da, kemijski sastav, kao i masnokiselinski profil, u značajnoj mjeri ovise o vrsti ribe te da dobivene vrijednosti variraju između različitih vrsta riba, ali su svi parametri kod ispitanih vrsta veoma povoljni. Stoga su šaranke poželjne za svakodnevnu konzumaciju.Cyprinids are the dominant fish in ponds in Serbia. Existing data of its meat quality are highly variable, since fish age, diet and other factors that have a significant impact on the results have been rarely mentioned. Samples of two-year old common carp, grass carp and silver carp were taken from the same pond (Ečka, Republic of Serbia) where production was carried out with complete feed mixtures with 25% crude protein which did not contain animal components. Analyses were performed at the Institute of Meat Hygiene and Technology. Moisture content, protein, fat and total cholesterol in the examined fish were statistically significantly different between species (p<0.01). The total amount of saturated fatty acids in relation to total fatty acid content was the highest in silver carp (33%) and the lowest in common carp (27.15%). There was no statistically significant difference in the content of saturated fatty acids in grass carp and silver carp fillets, but a significant difference was found between "Chinese carps" and common carp (p<0.01). The total percentage of monounsaturated fatty acids was the lowest in common carp (28.79%) and the highest in silver carp (37%) (p<0.01). Carp had the highest (44.08%), while silver carp had the lowest (30%) percentage of polyunsaturated fatty acids in relation to the total fatty acid content (p<0.01). Carp fish are good sources of unsaturated fatty acids which are important for proper nutrition. Chemical composition and fatty acid profile significantly depend on fish species. Obtained values vary greatly between different fish species, but all tested parameters are favorable and so the inclusion of cyprinid fish is recommended in people’s daily diet