Nutraceuticals and Skin Cancer: Exploring Potential Preventive and Adjunctive Strategies

A nutraceutical is any food-derived supplement that has a medical benefit in preventing illness and promoting health. Unhealthy life style is associated with increased risk of non�communicable diseases. Current treatment options such as chemotherapy, radiotherapy and surgery, induce unwanted side effects, compromising patient’s quality of life. Therefore, there has been an increased global interest in the use of dietary supplements and traditional herbal medicines for treatment of cancer. Nutraceuticals can be classified by several criteria: by food source, mechanism of action, chemical nature and specific benefit for health. This review aims to explore the relationship between nutraceuticals and skin cancer, highlighting potential preventive strategies and their adjunctive role in conventional treatment approaches. A PubMed search was performed using the common and scientific names of frequently advertised nutraceuticals along with the terms “non-melanoma skin cancer,” or “basal cell carcinoma” or “squamous cell carcinoma,” or “melanoma.” Results: The rates of skin cancer are continuously rising, and the estimated health care costs are mounting, which increases the need of promotion of healthy lifestyle, and scientific focusing on the role of diet and nutrition in cancer prevention. Cancer has a multifactorial etiology with causes found in genetic mutations, infection/inflammation, poor eating habits, exposure to radiation, work stress, and/or intake of toxins. UV radiation is typified as a “complete carcinogen” because it is both a mutagen and a non-specific damaging agent. UV is connected to the three most common types of skin cancer, basal cell carcinoma, squamous cell carcinoma and melanoma. UV promotes formation of photodimers in the genome and causes mutations by generating reactive oxygen species (ROS). It is becoming increasingly evident that ROS play an important role in carcinogenesis by malignant transformation of cells and perpetuating other steps of carcinoma development and spreading. Food sources used as nutraceuticals can be categorised as: dietary fibre, prebiotics, probiotics, polyunsaturated fatty acids, minerals, amino acids and peptides, carotenoids, vitamins, phytochemicals and spices. The need for alternative and less toxic therapies for skin carcinoma is clear. The role of nutraceuticals in skin cancer is: antioxidant protection, photoprotection, anti-inflammatory effect and immune modulation. Nutraceuticals present an intriguing topic in skin cancer prevention and management. Their potential as adjunctive therapies and their ability to provide antioxidant protection, photoprotection, anti-inflammatory effects and immune modulation warrant further investigation. While the field of nutraceuticals and skin cancer is promising, a comprehensive approach that combines sun protection measures, conventional treatments, and evidence-based nutraceutical interventions is crucial for optimal skin health and cancer prevention

Kвантитативно одредување на калпротектин во асцит кај пациенти со спонтан бактериски перитонитис

Spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis is a newly developed, spontaneous bacterial infection of sterile ascites fluid, in the absence of intraabdominal sources of infection or malignancy. The most sensitive indicator of diagnosis is when the polymorphonuclear cell count (PMNC) is ≥250 in 1 ml ascites fluid (manual microscopic or automated counting) and/or when a bacterial strain is isolated in microbiological culture. The objectives of our pilot study were to determine the concentration of calprotectin in ascites in patients with SBP and non-SBP with BíœHLMANN Quantum Blue®Reader, whether there was a significant difference between the average values "‹"‹of Turcotte-Pugh II and MELD score and to determine average values for CRP serum and ascites in the studied groups. Materials and methods. This prospective analytical observational pilot study included 30 patients with liver cirrhosis and ascites, divided into two groups, SBP and non-SBP. The quantitative measurement of calprotectin in ascites was performed with the Quantum Blue Calprotectin Ascites (LF-ASC25) test. The test is designed to selectively measure calprotectin antigen (MRP8/14) with direct sandwich immunoassay. The ascites samples were diluted with Chase Buffer 1:5 and after 12 minutes incubation at room temperature, the test line signal intensity and the control line were quantitated with BíœHLMANN Quantum Blue®Reader. The collected data were processed using the SPSS 23 statistical software for Windows. Results. In our study the average value of calprotectin in patients with SBP was 1.4 µg/mL. The lowest value of calprotectin in the study group was recorded in one patient at 0.61 µg/mL, while the highest value was 1.81 µg/mL in four patients. The results showed higher values "‹"‹of calprotectin in ascites in patients with alcoholic liver disease compared to other etiologies. Refractive ascites was reported in 60.0% of the subjects and only one patient (6.7%)was reported with Klepsiella pneumoniae in the microbiological analysis of ascites. According to the Child-Turcotte-PughII classification, all patients in the study group were class C, while the mean MELD score was 29.8±6.14. The difference between the average values of CRP in serum and ascites in patients with SBP was statistically significant compared to non-SBP. Conclusion. The quantitative determination of calprotectin in ascites by the Quantum Blue Calprotectin Ascites (LF-ASC25) assay can be used as an alternative to the determination of PMNC in ascites. SBP occurs in patients with severe hepatic dysfunction calculated according to the Child-Pugh II score and the MELD score. Serum and ascites C-reactive protein values were not significantly elevated in patients with SBP, but were significantly different from non-SBP patients.Спонтаниот бактериски перитонитис (СБП) кај пациентите со црнодробна цироза е новонастаната, спонтана бактериска инфекција на стерилна асцитна течност, во отсуство на интраабдоминални извори на инфекција или малигнитет. Најсензитивен показател за поставување на дијагнозата е бројот на полиморфонуклеарни клетки (ПМНК) ≥250 во 1 мл асцитна течност (рачно микроскопско или автоматизирано пребројување) и/или кога во микробиолошката култура биде изолиран еден бактериски вид. Цел на трудот е да се одреди концентрацијата на калпротектин во асцит кај пациентите со СБП и не-СБП, да се споредат просечните вредности на Turcotte-Pugh II и MELD скорот кај пациентите со СБП и не-СБП  и просечните вредности на C-реактивниот протеин во серум и во асцит во испитуваните групи. Материјали и методи. Во оваа проспективно-аналитичко-опсервациска пилот студија беа вклучени 30 пациенти со црнодробна цироза и асцит, поделени во две групи, СБП и не-СБП. Квантитативното мерење на калпротектин во асцит се вршеше  со тестот Quantum Blue Calprotectin Ascites (LF-ASC25). Тестот е дизајниран за селективно мерење на антигенот на калпротектинот (MRP8/14) со директен сендвич имуноесеј. Примероците од асцитот се разредуваа со  Chase Buffer во однос 1:5 и по 12 минути инкубација на собна температура,  интензитетот на сигналот на линијата за тестирање и контролната линија се мереа квантитативно со BÜHLMANN Quantum Blue®Reader. Собраните податоци се обработија со помош на статистичкиот програм SPSS 23 за Windows. Резултати. Во нашата студија просечната вредност на калпротектин кај пациентите со СБП изнесуваше 1,4 μg/mL. Најниската вредност на калпротектин во испитуваната група беше регистрирана кај еден пациент со вредност од 0,61 μg/mL,  додека највисока вредност од 1,81μg/mL кај четири пациенти. Резултатите покажаа повисоки вредности на калпротектин во асцит кај пациентите со алкохолна болест на црниот дроб во споредба со останатите етиологии. Рефракторен асцит се регистрира кај 60,0% од испитаниците, а само кај еден пациент (6,7%) се регистрира Klepsiella pneumoniae во  микробиолошката анализа на асцитот. Според Child-Turcotte-PughII класификација сите пациенти од испитуваната група беа класа C, додека просечната вредност на MELD скорот изнесуваше 29,8±6,14. Разликата помеѓу просечните вредности наC-реактивниот протеин во серум и во асцит кај пациентите со СБП  беше статистички сигнификантна во споредба со не-СБП.  Заклучок. Kвантитативното одредување на калпротектинот во асцит со тестот Quantum Blue Calprotectin Ascites(LF-ASC25) може да се користи како алтернатива наполиморфонуклеарните клетки (ПМНК) во асцит. СБП се јавува кај пациенти со сериозна црнодробна дисфункција пресметана според Child-Pugh II скорот и MELD скорот. Вредноста на C-реaктивниот протеин во серум и во асцит кај пациентите со СБП немаше високи вредности ,но сепак беше утврдена сигнификантна разлика во споредба со пациентите со не-СБП

The Influence of Resection Size and Pringle Maneuver on Operating Time and Intraoperative Bleeding in Patients with Colorectal Metastases in the Liver

BACKGROUND: The extent of the resection, whether clamped or non-clamping resection is factor that influences the operating time and intraoperative bleeding, the development of modern techniques for vascular control and resection, and determine of lesser blood loss, morbidity, and mortality. AIM: The aim of this study was to determine the experience of General and Hepatobiliary Surgery Clinic at Aleksandrovska Hospital Sofia, Republic of Bulgaria in the treatment of patients with colorectal metastases in the liver and to compare literature reports on the influence of the extent of resection and Pringle maneuver (IPM) on operating time and perioperative bleeding. MATERIALS AND METHODS: This retrospective study covers the time period from January 01, 2006, until December 31, 2015. A total of 239 patients were included, from which: 179 patients were treated with radical surgery, 5 with palliative intervention, and 55 were subjected on operability exploration. RESULTS: The use of the IPM for vascular control insignificantly influenced the prolonged operative time, while intraoperative blood loss was significantly lower in patients with Pringle <15 min. There was no association between IPM and resection type, while intraoperative blood loss and operating time were significantly greater in patients with major resection. CONCLUSION: Resection size is directly proportional to operating time and perioperative blood loss, but it does not significantly influence perioperative morbidity. The IPM does not influence operating time, while blood loss is significantly lower in the group of patients with Pringle <15 min

Šareni filološki stručak: Zbornik u čast profesorici Željki Fink Arsovski

Ovaj zbornik radova nastao je u čast profesorici Željki Fink Arsovski povodom njezina 70. rođendana, kao znak zahvalnosti za sve što je za radnog vijeka učinila za struku, kako na domaćem tako i na međunarodnom planu, za svoje studente, kolege i suradnike. Knjiga se sastoji od dvadeset i devet radova, od kojih su dvadeset i četiri dvostruko recenzirane znanstvene studije podijeljene u četiri cjeline: Frazeološki stručak, Paremiološki stručak, Književno-jezikoslovni cvijetak, Književni stručak. Na samome početku donosi se životopis slavljenice te ukupni popis njezinih radova. Nakon biografije i bibliografije knjiga zapravo započinje Prigodnim stručkom koji broji tri „obljetnički intonirana“ rada. Cjelina pod naslovom Frazeološki stručak okuplja sedamnaest tekstova na različite  frazeološke teme. U metodološkom smislu riječ je o različitim pristupima, što cjelinu čini znanstveno aktualnom, zanimljivom i poučnom. Drugu cjelinu pod naslovom Paremiološki stručak čine tri teksta posvećena poslovicama. Treća cjelina, Književno-jezikoslovni cvijetak, broji samo jedan rad kojemu u ovoj knjizi pripada posebno mjesto zbog hibridnosti metodološkog pristupa analiziranoj građi. Studija O hrvatskome slogu, slogovanju i slogovniku (Kratak uvod u slogoslovlje) Josipa Užarevića doprinos je slogovanju, a njezina posebnost leži u pokazivanju i dokazivanju da je  slog, iako jezikoslovni problem, itekako povezan s pjesničkim ritmom (stopom, metrikom). Četvrta cjelina, naslovljena Književni stručak, obuhvaća tri priloga u kojima se donose analize i prezentacije ruskih književnih djela. Zbornik radova završava cjelinom Studentski stručak. Riječ je o dva „cvijetka“, točnije  o dva govora studenata Linde Jurković i Nikole Kušćera koja su oni u ime svojih kolega  studenata poklonili profesorici Fink na okruglome stolu „Frazeološki kotač i dalje se vrti…“ održanome 16. studenoga 2018. godine na Filozofskome fakultetu Sveučilišta u Zagrebu.Ovaj zbornik radova nastao je u čast profesorici Željki Fink Arsovski povodom njezina 70. rođendana, kao znak zahvalnosti za sve što je za radnog vijeka učinila za struku, kako na domaćem tako i na međunarodnom planu, za svoje studente, kolege i suradnike. Knjiga se sastoji od dvadeset i devet radova, od kojih su dvadeset i četiri dvostruko recenzirane znanstvene studije podijeljene u četiri cjeline: Frazeološki stručak, Paremiološki stručak, Književno-jezikoslovni cvijetak, Književni stručak. Na samome početku donosi se životopis slavljenice te ukupni popis njezinih radova. Nakon biografije i bibliografije knjiga zapravo započinje Prigodnim stručkom koji broji tri „obljetnički intonirana“ rada. Cjelina pod naslovom Frazeološki stručak okuplja sedamnaest tekstova na različite  frazeološke teme. U metodološkom smislu riječ je o različitim pristupima, što cjelinu čini znanstveno aktualnom, zanimljivom i poučnom. Drugu cjelinu pod naslovom Paremiološki stručak čine tri teksta posvećena poslovicama. Treća cjelina, Književno-jezikoslovni cvijetak, broji samo jedan rad kojemu u ovoj knjizi pripada posebno mjesto zbog hibridnosti metodološkog pristupa analiziranoj građi. Studija O hrvatskome slogu, slogovanju i slogovniku (Kratak uvod u slogoslovlje) Josipa Užarevića doprinos je slogovanju, a njezina posebnost leži u pokazivanju i dokazivanju da je  slog, iako jezikoslovni problem, itekako povezan s pjesničkim ritmom (stopom, metrikom). Četvrta cjelina, naslovljena Književni stručak, obuhvaća tri priloga u kojima se donose analize i prezentacije ruskih književnih djela. Zbornik radova završava cjelinom Studentski stručak. Riječ je o dva „cvijetka“, točnije  o dva govora studenata Linde Jurković i Nikole Kušćera koja su oni u ime svojih kolega  studenata poklonili profesorici Fink na okruglome stolu „Frazeološki kotač i dalje se vrti…“ održanome 16. studenoga 2018. godine na Filozofskome fakultetu Sveučilišta u Zagrebu

Šareni filološki stručak: Zbornik u čast profesorici Željki Fink Arsovski

Ovaj zbornik radova nastao je u čast profesorici Željki Fink Arsovski povodom njezina 70. rođendana, kao znak zahvalnosti za sve što je za radnog vijeka učinila za struku, kako na domaćem tako i na međunarodnom planu, za svoje studente, kolege i suradnike. Knjiga se sastoji od dvadeset i devet radova, od kojih su dvadeset i četiri dvostruko recenzirane znanstvene studije podijeljene u četiri cjeline: Frazeološki stručak, Paremiološki stručak, Književno-jezikoslovni cvijetak, Književni stručak. Na samome početku donosi se životopis slavljenice te ukupni popis njezinih radova. Nakon biografije i bibliografije knjiga zapravo započinje Prigodnim stručkom koji broji tri „obljetnički intonirana“ rada. Cjelina pod naslovom Frazeološki stručak okuplja sedamnaest tekstova na različite  frazeološke teme. U metodološkom smislu riječ je o različitim pristupima, što cjelinu čini znanstveno aktualnom, zanimljivom i poučnom. Drugu cjelinu pod naslovom Paremiološki stručak čine tri teksta posvećena poslovicama. Treća cjelina, Književno-jezikoslovni cvijetak, broji samo jedan rad kojemu u ovoj knjizi pripada posebno mjesto zbog hibridnosti metodološkog pristupa analiziranoj građi. Studija O hrvatskome slogu, slogovanju i slogovniku (Kratak uvod u slogoslovlje) Josipa Užarevića doprinos je slogovanju, a njezina posebnost leži u pokazivanju i dokazivanju da je  slog, iako jezikoslovni problem, itekako povezan s pjesničkim ritmom (stopom, metrikom). Četvrta cjelina, naslovljena Književni stručak, obuhvaća tri priloga u kojima se donose analize i prezentacije ruskih književnih djela. Zbornik radova završava cjelinom Studentski stručak. Riječ je o dva „cvijetka“, točnije  o dva govora studenata Linde Jurković i Nikole Kušćera koja su oni u ime svojih kolega  studenata poklonili profesorici Fink na okruglome stolu „Frazeološki kotač i dalje se vrti…“ održanome 16. studenoga 2018. godine na Filozofskome fakultetu Sveučilišta u Zagrebu.Ovaj zbornik radova nastao je u čast profesorici Željki Fink Arsovski povodom njezina 70. rođendana, kao znak zahvalnosti za sve što je za radnog vijeka učinila za struku, kako na domaćem tako i na međunarodnom planu, za svoje studente, kolege i suradnike. Knjiga se sastoji od dvadeset i devet radova, od kojih su dvadeset i četiri dvostruko recenzirane znanstvene studije podijeljene u četiri cjeline: Frazeološki stručak, Paremiološki stručak, Književno-jezikoslovni cvijetak, Književni stručak. Na samome početku donosi se životopis slavljenice te ukupni popis njezinih radova. Nakon biografije i bibliografije knjiga zapravo započinje Prigodnim stručkom koji broji tri „obljetnički intonirana“ rada. Cjelina pod naslovom Frazeološki stručak okuplja sedamnaest tekstova na različite  frazeološke teme. U metodološkom smislu riječ je o različitim pristupima, što cjelinu čini znanstveno aktualnom, zanimljivom i poučnom. Drugu cjelinu pod naslovom Paremiološki stručak čine tri teksta posvećena poslovicama. Treća cjelina, Književno-jezikoslovni cvijetak, broji samo jedan rad kojemu u ovoj knjizi pripada posebno mjesto zbog hibridnosti metodološkog pristupa analiziranoj građi. Studija O hrvatskome slogu, slogovanju i slogovniku (Kratak uvod u slogoslovlje) Josipa Užarevića doprinos je slogovanju, a njezina posebnost leži u pokazivanju i dokazivanju da je  slog, iako jezikoslovni problem, itekako povezan s pjesničkim ritmom (stopom, metrikom). Četvrta cjelina, naslovljena Književni stručak, obuhvaća tri priloga u kojima se donose analize i prezentacije ruskih književnih djela. Zbornik radova završava cjelinom Studentski stručak. Riječ je o dva „cvijetka“, točnije  o dva govora studenata Linde Jurković i Nikole Kušćera koja su oni u ime svojih kolega  studenata poklonili profesorici Fink na okruglome stolu „Frazeološki kotač i dalje se vrti…“ održanome 16. studenoga 2018. godine na Filozofskome fakultetu Sveučilišta u Zagrebu

Psychocutaneous Diseases In Children: Factors That Lead To The Appearance.Review

Introduction:A large number ofdermatoses occur secondarily, the primary cause being of a psychogenic nature. It is important for the dermatologist to be able to distinguish between these conditions and thus to provide adequate therapy for the patient.Factors that lead to the appearance of psychocutaneous problems in children: Two factors that influence the appearance of psychodermatological problems are the existence of a genetic predisposition for emotional instability, and previously experienced trauma.sConclusion:Skin diseases whose basis lies in psychological problems are very often misdiagnosed. Key to the diagnosis is a good relationship with the family and a well-taken history. If a child visits a dermatologist more often with the same or different dermatoses that are prolonged or refractory to therapy, we must always think of the possibility of the existence of another pathology at the basis of the disease.Keywords:Psyhodermatology;Trauma;Stres

Hereditary angioedema (HAE): a case report and literature overview

Recognition of the unique clinical and immunological characteristics of the rare causes of Hereditary angioedema (HAE) is important in order to obtain proper and timely diagnosis and treatment of the patient. Hereditary angioedema is a rare disease with great heterogeneity of symptoms like edema of the skin, gastrointestinal mucosa and larynx or pharynx. The changes are spontaneously withdrawn in 12 to 72 hours. Hereditary angioedema is autosomal-dominant but can occur spontaneously in a healthy family without clinical manifestations or immune defects. Based on the mechanism of occurrence, it is conventionally classified as angioedema mediated by mastocytic degranulation, bradykinin or idiopathic, while in terms of clinical and pathophysiological manifestation it is divided into acquired and congenital or congenital angioedema with or without urticaria.Three types of HAE are described. The most frequent is type I, which is a result from a mutations in the SERPING 1 gene, they cause hereditary angioedema type I and type II. The SERPING 1 gene provides instructions for creating C1 inhibitory protein, which is important for controlling inflammation. C1 inhibitory protein leads to blockage of the activity of certain proteins that lead to inflammation. Mutations that cause hereditary angioedema type I lead to decreased levels of C1 in the blood, deficiency of the complement C1 inhibitor. Without an adequate level of functional C1 inhibitor, excessive amounts of a protein fragment called bradykinin are generated. Bradycin causes inflammation due to the increased elimination of fluid through the walls of blood vessels in the body's tissues. Excessive accumulation of fluid in body tissues causes episodes of swelling observed in individuals with inherited angioedema type I and type II. Case presentation: A 25-year old woman who was first diagnosed with Oedema Quincke, of the face, after an insect bite, when she was 9 years old. Since then, almost every month, swelling of the arms or legs occurs before the menstrual cycle, and swelling of the hands also occurs when blood is drawn from the finger, while several times a year there is swelling in the facial region. The patient was brought for the first time as an emergency to the Department of Dermatovenereology at the Clinical Hospital Stip with pronounced circuscribed edema of the face without erythema and without a feeling of itching and pain that appeared 3-4 hours before admission. Due to the frequent occurrence of swelling in the facial region, immunochemical analyzes have been performed. The analysis showed a reduced level of C1 inhibitor esterase 0.0365g / l (0.18-0.39) and the results are in favor of HAE typ I. The patient was treated few times with isogroup plasma 2x220 ml and within 24 hours the edema receded, later she was included in the program for patients with HAE, with parenteral inhibitor of C1 esterase, ie with amp. Beriner. Keywords: hereditary angioedema; case report; C1 inhibitor esterase

Patient with intracranial hemorrhage and arteriovenous malformation detected with transcranial color duplex sonography – case report

Abstract Introduction: Transcranial color duplex sonography represents a non-invasive diagnostically method which allows visualization of the brain arteries on the basis of the skull through color-coding of the flow rate. The arteries of the Willis’ circle (circulus arteriosus cerebri) can be identified through their anatomic localization in relation to brain stem structures and by determining the direction of flow. During examination the ultrasound beam passes through natural cranial openings, or windows, which are areas of the cranium where the bone is the thinnest (transtemporal, tansorbital and transoccipital windows). During hemodynamic analysis on the Doppler wave, the following basic parameters are analyzed: systolic speed peak, median speed, spectral distribution of the frequencies, direction of flow, Doppler indexes (index of pulsation and index of asymmetry). Goal: The goal is to show the diagnostic application of transcranial color duplex sonography in detection of morphologic and hemodynamic changes of the intracranial arteries in patients with stroke. Material and methods: We represent 62-year old patient who has been hospitalized due to acute paralysis of the left limbs, slurred speech and headache. Neurological examination on admission: left-sided hemiplegia, dysarthria, headache. At admission a CT was made with finding clearly limited hyperdense change – intracerebral hemorrhage with perifocal edema without evident mass effect on the adjacent brain structures. A neurosurgeon was consulted who said that there are no indications for operation. Significant information: history of CVI before 18 years, with left limbs weaknesses (no medical documentation). Transcranial color duplex sonography was made whit detected area of mixed arterial and venous signal, with increased flow rate and turbulence through transtemporal sonographic window. Because of that a CT angiography of the intracranial blood vessels was indicated which found an pial arteriovenous malformation with big nidus and dilated and tortuous vein which flows to v. Galeni. Arteriovenous malformation receives blood through the right a. cerebri media, right a. carotis posterior and also cross-filling through the left a. carotis interna and aa. comunicantes anterior. Results: On discharge improved neurological condition, patient was with residual left sided hemiparesis and discreet dysarthria – mRS score 3. Discussion: Transcranial color duplex sonography is a non invasive method of evaluation of intracranial blood flow, especially in patients with stroke. It helps if selection is made for patients that should undergo additional invasive radiological tests such as CT angiography. Key words: arteriovenous malformation, transcranial color duplex sonograph

Malignant pleural effusions in lung cancer: the condition during the disease

Introduction: Malignant pleural effusions are common pathology in clinical practice in patients with malignant disease .Malignant pleural effusion represents 40% of chronic pleural effusion and is the leading cause of recurrent pleural effusion, which has an additional impact on morbidity in patients with malignant disease. Lung cancer is the predominant cause of malignant pleural effusion confirmed by more research series. Primary lung cancer associated with malignant pleural effusion is metastatic disease (7-th edition of TNM classification of lung cancer at the American Cancer Committee). Primary lung cancer associated with malignant pleural effusion further increases the morbidity of these patients reducing therapeutic options and affect survival (a median survival of less than 4 months).Pleural metastases originating from bronchogenic origin appear relatively early in the disease unlike other primary visceral tumors and is sufficient reason to determine the incidence of pleural effusions among different histological types of primary lung cancer and the condition of the malignant pleural effusion in different histopathological types of lung cancer during the course of disease. Material and methods: The study is a retrospective study in which data from 800 patients (35-75 years old) with primary lung cancer classified according to the recommendations of the WHO were processed over a period of three years from 2010 to 2013 at the Clinic of Oncology and Radiotherapy. The study included all patients with the presence of malignant pleural effusion associated with primary lung cancer regardless of the time of occurrence of pleural effusion. Data from patients for the purposes of the study were evaluated by the following parameters: Incidence of pleural effusion in evaluated lung cancer patients; Development of pleural effusion in certain histopathological types of lung cancer and Condition of the malignant pleural effusion in different histopathological types of lung cancer during the course of disease. Results: Research has shown that malignant pleural effusion associated with primary lung cancer appeared in 193 patients/28.1%. The right lung malignant pleural effusion appeared with 54.4% of the total number of pleural effusions, and left with 43.5%, and 10.9% of the difference was statistically significant. The right lung showed no statistically significant trend in the separate histopathological type development pleural effusion, while only adenocarcinoma in the left lung showed a tendency to develop pleural effusion for 20.6% more than squamous cell carcinoma. In the right lung 59% of the effusions persisted,14.3% withdrew and 6.7% progressed, while 63.1% of the effusions in the left lung persisted,16.7% withdrew, 6% progressed during disease. In the right lung there wasn’t difference in the condition of pleural effusion between different histological types, but in the left lung adenocarcinoma effusions withdrew as much as they progressed during the disease (13,6%) and squamous cell carcinoma effusions didn’t progress. Discussion: Pleural effusions in lung cancer are a major problem (appearing in 28%) given that they mostly persist during illness regardless of histological type which increases the problem in the treatment and in survival of those patients. Keywords lung cancer, malignant pleural effusio

Viability of L. casei during fermentation in soymilk and freeze-dried soymilk; effect of cryoprotectant, rehydration and storage temperature

The aim of the work was to investigate the behaviour of L. casei and the effect of sorbitol on its viability during fermentation in soymilk drink. Values for pH, ranging from 6.82 to 3.42 in the soymilk drink without sorbitol and from 6.74 to 3.41 in the drink with sorbitol were noted during 72 h of fermentation at 25oC. The corresponding values for titratable acidity ranged from 0.071% to 0.758% and from 0.073% to 0.761%, respectively. Soymilk was found to support the growth of L. casei with improvement in viability for 0.24 log at the end of fermentation when sorbitol was added. Survival of L. casei and the effectiveness of sorbitol in improving viability during freeze-drying, subsequent rehydration and during a 5-week period of storage under different temperatures were also investigated. After freeze-drying, L. casei exhibited a survival percent of approximately 46%. Sorbitol improved the viability of L. casei by 0.51 log immediately after freeze-drying and by 1.30 log and 0.47 log during five weeks of storage at 25oC and 4oC, respectively. Further study revealed that the freeze-dried fermented soymilk rehydrated at 45oC was optimum for the recovery of L. casei with improvement in recovery for 0.68 log when sorbitol was added. A higher percent of survival was noted when the dried soymilk was stored at 4oC than at 25oC with improved viability at the end of 5 weeks storage for approximately 6 log for drinks with and without sorbitol. Fermented dried soymilk with sorbitol afforded significant tolerance of L. casei to acid stress. Generally, a stable probiotic diary product was prepared in which the concentration of L. casei remained above therapeutic level of 107 cfu/ml