Kalcificirani fibrozni tumor rektuma: prikaz slučaja

A calcifying fibrous tumor (CFT) is a benign tumor of unknown etiology. A calcifying fibrous tumor is rare in the intestinal tract. A calcifying fibrous tumor is characterized by hyalinized collagenous fibrous tissue, psammomatous or dystrophic calcification, and focal lymphoplasmacytic infiltrates on histology. Magnetic resonance imaging is the standard method for evaluating the lesions of the rectum, and CFTs should be considered in differentiating the rectal wall tumors. Herein, we report a case of a 68-year-old man with a rectal wall CFT.Kalcificirani fibrozni tumor (CFT) je benigni tumor nepoznate etiologije. CFT u crijevnom traktu je vrlo rijedak. CFT karakterizira prisutnost hijaliniziranog kolagenskog vlaknastog tkiva, psamomatoznih ili distrofičnih kalcifikacija i fokalnih limfoplazmocitnih infiltrata. Prikazujemo slučaj 68-godišnjeg muškaraca s CFT-om u stijenci rektuma. Magnetska rezonancija je korisna metoda za procjenu procesa stijenke rektuma, CFT treba uzeti u obzir u diferencijalnoj dijagnozi tumorskih procesa stijenke rektuma

The Role of MR Imaging and MR Angiography in the Evaluation of Patients with Headache

BACKGROUND: Headache is one of the most common complaint in medical practice and the most often neurological symptom. AIM: The aim of our study was to estimate the frequency of abnormal magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings in patients with non-acute headache without focal neurological abnormalities. MATERIAL AND METHODS: The results of the MRI and MRA were retrospectively analyzed. As major abnormalities, we took into account tumor, stroke, extraaxial collection, Chiari malformations, and vascular pathology (aneurysm and arterial-venous malformation). RESULTS: Two hundred twenty-five patients fulfilled the criteria. Out of 225 patients with median age of 37 (18–85) years, 78% of the patients were female and 22% were male. In total, we found 8.4% of major abnormalities. On MRI head scan without MRA analysis, we found 50.7% of normal finding, 47.1% of minor abnormalities and 2.2% of major abnormalities. On MRA scan, we found we found 52.9% of normal finding, 40.9% of minor abnormalities, and 6.2% of major abnormalities. CONCLUSION: Our study demonstrates a low but important diagnostic yield of MRI and MRA examination for patients with non-acute headache without focal neurological abnormalities

Action of pulsed lasers on titanium target: surface effects

The interaction of lasers with metals has been studied for decades, and has been especially intensified lately, due to the development of new, efficient pulsed lasers. Titanium has a number of excellent properties, making it applicable in various modern technologies. Treatment and processing of titanium is possible with various techniques, and the application of lasers gives a special quality, such as high precision machining or obtaining specific structures on the surface which cannot be generated by other methods. During our research, surface processing of titanium was conducted by various pulsed lasers: nanosecond CO2 laser, picosecond Nd:YAG laser and femtosecond Ti: sapphire laser. In order to find the optimal conditions for surface modification of titanium, the influence of different laser parameters (wavelength, pulse duration, pulse energy, etc.), as well as the influence of the ambient, was examined. The titanium samples were irradiated in different environments, ie. in air, oxygen, nitrogen, carbon dioxide, helium and in vacuum, which affected the chemical composition and morphology of the target surface.SPIG 2022 : 31st Summer School and International Symposium on the Physics of Ionized Gases : Contributed papers and abstracts of invited lectures, topical invited lectures and progress reports; September 5-9,2022, Belgrad

Value of Head CT Scan in the Emergency Department in Patients with Vertigo without Focal Neurological Abnormalities

BACKGROUND: Vertigo is a common symptom and reason for admission to the emergency department (ED). AIM: This research aimed to determine the incidence of clinically significant findings on computed tomography (CT) in patients with vertigo without focal neurological abnormalities in the ED. MATERIAL AND METHODS: The results of the native CT scans in the ED were retrospectively analysed. Exclusion criteria included: focal neurological abnormalities, underlying malignancy, brain metastasis, previous brain operation, headache, fever, nausea, vomiting, head trauma, coagulopathy. As a clinically significant finding, we took into an account tumour, haemorrhage and acute ischemic lesion. 72 patients fulfilled the set criteria, present vertigo, without focal neurological abnormalities. Out of 72 patients with a median age of 62 (23-87) years old, 54% of the patients were female, and 46% were male. RESULTS: Normal CT findings were found in 44 patients (61.1%), 28 patients (38.9%) had pathological findings, out of that number 23 (31.9%) findings were clinically irrelevant and 5 (6.9%) were clinically significant. Out of the 5 clinically significant findings, tumour process was found in 3 (4.2%) patients, haemorrhage was found in 1 (1.4%) patient, and the ischemic lesion was found in 1 (1.4%) patient. Additional evaluation of five clinically significant findings showed a change of initial diagnosis in one case, but the significance of the finding remained the same. CONCLUSION: Our study demonstrates a low diagnostic yield of head CT examination with 6.9% of clinically significant findings in patients with vertigo without focal neurological abnormalities

Mood disorders in later life and challenges of care in general/family medicine

Poremećaji raspoloženja se tradicionalno smatraju problemom adolescentne i mlađe odrasle dobi. Novije spoznaje stavljaju naglasak na poremećaje raspoloženja u starijoj životnoj dobi zbog njihovog devastirajućeg učinka na zdravlje i funkcionalnu sposobnost starijih osoba. Ipak, te poremećaje, uključujući i one najčešće, kao što je generalizirani anksiozni poremećaj i depresija velikih depresivnih epizoda, obiteljski doktori često ne prepoznaju. Glavni razlozi su česti komorbiditet sa somatskim stanjima i kognitivnim poremećajima te shvaćanje pacijenata da su mentalni poremećaji normalan dio procesa starenja. Probir osoba starih 60 i više godina na anksiozne poremećaje i depresiju pomoću standardiziranih upitnika, prilagođenih za primjenu u starijoj populaciji, mogao bi biti koristan za poboljšanje prepoznavanja tih poremećaja. Postavljanje konačne dijagnoze bi se trebalo temeljiti na primjeni dijagnostičkih kriterija koje preporučuju najnovije DSM i ICD klasifikacije te detaljnom postupku kliničke evaluacije, a na osnovi intervjua s pacijentom ili njegovim skrbnikom. Iako se obiteljskim doktorima nalaze na raspolaganju djelotvorni lijekovi za liječenje poremećaja raspoloženja, njihova primjena u osoba starije dobi može biti ograničena zbog povećanog rizika od interakcija među lijekovima i neželjenih reakcija na lijekove. Psihosocijalne intervencije su od posebnog značaja u toj populacijskoj skupini, ali nema dovoljno dokaza o tome koji postupak kome primijeniti. Način kako poboljšati skrb za osobe starije dobi s poremećajima raspoloženja u općoj/obiteljskoj medicini bi bio putem intenziviranja istraživanja, s ciljem stjecanja boljih dokaza, te putem davanja veće pozornosti praktičnoj edukaciji obiteljskih doktora iz područja psihijatrije, kao i putem strategija usmjerenih na povećanje svjesnosti javnosti o poremećajima raspoloženja u starijoj životnoj dobi i načinu njihove prezentacije.Mood disorders have been traditionally considered a problem of adolescenthood and early adulthood. Recent findings are pointing to mood disorders in later life due to their devastating effects on health and functional capabilities of older adults. However, those disorders, including those most common such as generalized anxiety disorder and major depressive disorder, are frequently unrecognised by family doctors. Main reasons for that are frequent comorbidities with medical conditions and cognitive disorders and patients’ treating mental disorders as normal aspects of aging. Screening 60 years old patients and older for anxiety and depression by standardised questionnaires, adapted for the use in older population, could be helpful in improving recognition rates. Definite diagnosis should combine the latest update of the DSM or the ICD classification criteria and a thorough clinical evaluation based on responses drown from a patient or a caregiver. Although effective medications for mood disorders are available to family doctors, their application in older adults may be compromised by the increased risk of medication interaction and adverse reaction. Psychosocial interventions are particularly important in this population group but evidence is insufficient regarding who should receive which treatment. The way of improving management of mood disorders in older adults, in family medicine, would be by intensifying research, in order to gain more evidence. More attention should be given to formal psychiatric training of family doctors, as well as to the strategies aimed at increasing the public awareness of mood disorders in later life and their modes of presentation

Applicability of TEA CO2 laser-based LIBS for the analysis of geological samples in air at atmospheric pressure

In this work, we present a study of the plasma generated by transversely excited atmospheric (TEA) CO 2 laser irradiation of a basalt sample. The plasma was induced in air at atmospheric pressure. For acquisition of emission spectra a time-integrated spatially resolved detection system was used. The excitation temperature was evaluated by the Boltzmann's plot method for selected Fe II spectral lines in the wavelength range 256-263 nm. The electron number density was determined from the Stark broadening of two iron lines, and results from both lines were identical within the experimental error. Signal to noise (SNR), ratio and limits of detection (LOD) for several elements were evaluated and compared to the results obtained using Nd:YAG laser and time-resolved LIBS measurements.Proceedings of the XI Belarusian-Serbian Symposium "Physics and Diagnostics of Laboratory and Astrophysical Plasmas" (РDР-11), December 15-19, Minsk, Belaru

Contrast-induced nephropathy in patients with acute coronary syndrom after percutaneus coronary angiography and intervention

Pojedini čimbenici rizika imaju manju ili veću ulogu za razvoj kontrastom inducirane nefropatije (KIN). Svrha ovog retrospektivnog istraživanja je doprinijeti razjašnjavanju rizičnih čimbenika i štetnosti kontrastnih sredstava na bubrežnu funkciju nakon perkutane koronarne angiografije i intervencije. Istraživanje je provedeno u Klinici za unutarnje bolesti SKB Mostar, Odjel za invazivnu kardiologiju. U istraživanje je uključeno 235 bolesnika kojima je tijekom 2013. i 2014. godine učinjena perkutana koronarna angiografija i intervencija zbog akutnog koronarnog sindroma. Podaci su prikupljeni iz baze podataka informatičkog bolničkog sustava. Ustanovili samo učestalost KIN-a u 14% bolesnika nakon perkutane koronarne angiografije i intervencije. Kod ispitanika s KIN-om utvrdili smo prosječnu životnu dob od 69,3 ± 12,4 godina kao statistički značajan čimbenik (p < 0,001). Prosječna količina apliciranog kontrastnog sredstva tijekom provedbe perkutane koronarne angiografije i intervencije u ispitanika u kojih je nastao KIN iznosila je 331,8 ± 73,7 ml, što se pokazalo statistički značajno (p < 0,001). Broj bolesnika sa šećernom bolesti unutar skupine bolesnika s KIN-om iznosio je 60,6%, što je statistički značajno (p < 0,001). Ranije dokazana renalna insuficijencija unutar skupine bolesnika s KIN-om iznosila je 51,5%, što je također statistički značajno (p < 0,001). Usporedba koronarnih krvnih žila na kojima je izvršena intervencija u odnosu na pojavu KIN-a nije pokazala statistički značajnu razliku (p = 0,173). Nastanak KIN-a nakon perkutane koronarne angiografije i intervencije češća je pojava u starijih bolesnika, te u onih koji boluju od kroničnih bubrežnih bolesti i od šećerne bolesti. Također postoji povezanost količine apliciranog kontrastnog sredstva i nastanka KIN-a.Some risk factors have a smaller or greater role in developing contrast-induced nephropathy (CIN). The purpose of this retrospective study is to contribute to the clarification of the risk factors and damage of contrast agents to the renal function after percutaneous coronary angiography and intervention. The research was conducted at the University Hospital Mostar, Department of Invasive Cardiology. The study included 235 patients with percutaneous coronary angiography and intervention procedure during 2013-2014 due to acute coronary syndrome. The data was collected from the database of the IT hospital system. We found the incidence of CIN in 14% of patients after percutaneous coronary angiography and intervention. In patients with CIN an average age was 69.3 ± 12.4 years as a statistically significant factor (p < 0.001). The mean amount of applied contrast agent during percutaneous coronary angiography and intervention in subjects with CIN was 331.8 ± 73.7 ml, which was statistically significant (p < 0.001). The number of diabetic patients within the CIN group was 60.6%, which was statistically significant (p < 0.001). Previously demonstrated renal insufficiency within the CIN group was 51.5%, statistically significant (p < 0.001). Comparison of intervention on coronary blood vessels with reference to the appearance of KIN did not show a statistically significant difference (p = 0.173). The emergence of CIN after percutaneous coronary angiography and intervention is more common in older patients, those with chronic kidney disease and diabetes mellitus. There is also a correlation between the amount of applied contrast agent and the CIN after percutaneous coronary angiography and intervention

LIBS Analysis of Geomaterials: Comparative Study of Basalt Plasma Induced by TEA CO 2

We present a study of the plasma generated by transversely excited atmospheric (TEA) CO2 laser irradiation of a basalt sample. The plasma was induced in air at atmospheric pressure. The same sample was also analyzed using a commercial LIBS system based on Nd:YAG laser and time-gated detection. The main plasma parameters, temperature, and electron number density were determined and analytical capabilities of the two systems compared. Despite differences in laser wavelength, pulse duration, applied fluence, and signal detection scheme, the two systems are comparable in terms of element detectability and limits of detection. In both cases, all elements usually present in geological samples were identified. The estimated limits of detection for most elements were below 100 ppm, while for Cu, Cr, and Sr they were around or below 10 ppm. The obtained results led to the conclusion that simple, cost-effective TEA CO2 LIBS system can find applications for geological explorations

The analytical capability of laser induced breakdown spectroscopy (LIBS) based on tea CO2 laser system

This paper gives an overview of analytical capabilities of the laser induced breakdown spectroscopy (LIBS) system, based on Transversely-Excited Atmospheric pressure (TEA) CO2laser, and time-integrated, spatially-resolved detection, for the analysis of solid materials. The developed LIBS system is unique, and differs from the commonly used systems in two respects. The first one is the laser used as an energy source for plasma generation, and the second one is the applied non-gated detection scheme. Various types of materials were analyzed, from metals to biological samples, under different experimental conditions. The obtained results were critically evaluated and compared to the results obtained using commercially available LIBS that comprises Nd:YAG laser and time-gated detection.It was concluded that when it comes to detectability, precision and sensitivity, this simple and cost effective LIBS system may be regarded highly competitive to standard LIBS systems.Physical chemistry 2016 : 13th international conference on fundamental and applied aspects of physical chemistry; Belgrade (Serbia); 26-30 September 2016