Colorectal anastomosis dehiscence following radical surgical operation for rectal carcinoma

Background/Aim. Colorectal cancer (CRC) is one of the biggest health problems of modern humanity, especially in highly developed countries. In Serbia about 3,200 patients suffer from CRC, out of whom about 1,100 patients suffer from rectal cancer (RC), while about 2,100 patients suffer from other colon segments cancer. The aim of the study was to show the incidence genesis of one of the possible early postoperative complications regarding dehiscence of the colorectal anastomosis (CRA) with a group of patients suffering from RC and operated by using sphincter-saving procedures, in the period from 1993 to 2007, and then to compare the incidence genesis of these complications with those in the published series of the reporting colorectal institutions. Methods. The research included 242 patients radically operated on for RC in a 15-year period using some of sphincter-saving procedures following by a careful analysis of the symptoms of subclinical dehyscencias not solved with the reintervention as well as of the clinically evidented dehyscencias mostly solved by reoperation. Results. With 22 (9.1%) patients in the first 10 postoperative days there were early postoperative symptoms of CRA dehiscence. In 6 (2.47%) of the patients there were subclinical signs of raised body temperature, less quantity of feces content, and after the conservative treatment they ended in spontaneous process of rehabilitation. In 16 (6.61%) patients there was clinically evidented anastomosis dehiscence followed by abundant drainage of feces content, signs of local peritonitis, pelvic sepsis, so we had to undertake surgical intervention. Conclusion. Comparing the results of a few tenths of published studies with our results we proved that performing and operative technique of colorectal anastomosis in the patients suffered and radically surgically treated for RC, is quite adequate with the operative technique in reporting world institutions that are engaged in surgical treatment of RC

Razvoj Hodžkinovog limfoma u ileocekalnoj regiji pacijenta sa transplantiranim bubregom na dugoročnoj imunosupresivnoj terapiji - prikaz slučaja

Following solid organ transplantation, the patient's management includes the provision of immunosuppressive therapy to the recipient. All kidney transplant recipients require lifelong immunosuppression. Regardless the improving survival following solid organ transplantation, post-transplant complications such as the development of malignancy due to immunosuppression remain to be an issue. One of the most common malignancies encountered in the post-solid organ transplant is lymphoproliferative disorder likely developed as a consequence of immunosuppression. We report a case of plasma cell type lymphoma in the ileocecal region of a 45-year-old male kidney transplant patient who was on a tacrolimus-based regimen for ten years. Although literature data indicate differently localized lymphoma as an adverse reaction to the long term use of tacrolimus, to our knowledge, this is the first described case of lymphoma in the ileocecal region. Serious adverse drug reactions and potential toxicity of tacrolimus emphasize the importance of finding the optimal balance between effective drug concentration and the risk associated with its use.Nakon transplantacije organa, pacijenti primaoci organa se stavljaju na režim imunosupresivne terapije, a u primalaca bubrega ta terapija je doživotna. Bez obzira na poboljšanje preživljavanja nakon transplantacije organa, brojne su komplikacije koje se mogu javiti nakon transplantacije, a razvoj maligniteta usled imunosupresije nastavlja da bude značajan problem. Jedan od najčešćih tipova maligniteta koji se sreće kod ovakvih pacijenata je limfoproliferativni poremećaj koji se verovatno razvija kao posledica pomenute imunosupresije. Opisan je slučaj limfoma u ileocekalnoj regiji u 45-godišnjeg muškarca sa transplantiranim bubregom, koji je bio na imunosupresivnoj terapiji zasnovanoj na takrolimusu, tokom 10 godina. Literaturni podaci ukazuju na drugačiju lokalizaciju limfoma kao neželjene reakcije nakon dugoročnog korišćenja takrolimusa, pa je prema našim saznanjima, ovo jedinstven slučaj razvoja limfoma u ileocekalnoj regiji. Ozbiljne neželjene reakcije i toksični potencijal takrolimusa naglašavaju značaj pronalaženja optimalnog balansa između efektivne koncentracije leka i rizika vezanih za njegovu upotrebu

With food to health : proceedings of the 10th International scientific and professional conference

Proceedings contains 13 original scientific papers, 10 professional papers and 2 review papers which were presented at "10th International Scientific and Professional Conference WITH FOOD TO HEALTH", organised in following sections: Nutrition, Dietetics and diet therapy, Functional food and food supplemnents, Food safety, Food analysis, Production of safe food and food with added nutritional value

The Blazar TXS 0506+056 Associated with a High-energy Neutrino: Insights into Extragalactic Jets and Cosmic-Ray Acceleration

A neutrino with energy of ∼290 TeV, IceCube-170922A, was detected in coincidence with the BL Lac object TXS 0506+056 during enhanced gamma-ray activity, with chance coincidence being rejected at ∼ 3σ level. We monitored the object in the very-high-energy (VHE) band with the MAGIC telescopes for ∼41 hours from 1.3 to 40.4 days after the neutrino detection. Day-timescale variability is clearly resolved. We interpret the quasi-simultaneous neutrino and broadband electromagnetic observations with a novel one-zone lepto-hadronic model, based on interactions of electrons and protons co-accelerated in the jet with external photons originating from a slow-moving plasma sheath surrounding the faster jet spine. We can reproduce the multiwavelength spectra of TXS 0506+056 with neutrino rate and energy compatible with IceCube-170922A, and with plausible values for the jet power of ∼ 10^45 − 4×10^46 erg s^{; ; ; −1}; ; ; . The steep spectrum observed by MAGIC is concordant with internal γγ absorption above ∼100 GeV entailed by photohadronic production of a ∼290 TeV neutrino, corroborating a genuine connection between the multi-messenger signals. In contrast to previous predictions of predominantly hadronic emission from neutrino sources, the gamma-rays can be mostly ascribed to inverse Compton up-scattering of external photons by accelerated electrons. The X-ray and VHE bands provide crucial constraints on the emission from both accelerated electrons and protons. We infer that the maximum energy of protons in the jet co-moving frame can be in the range ∼ 10^14 to 10^18 eV