Synchronous primary ovarian endometrioid carcinoma and poorly differentiated endometrial stromal sarcoma

Introduction: The presence of two concomitant genital malignant tumours is a rare phenomenon with an incidence of 0.7%. They are typically localised in the uterus and ovary, and approximately 50% are identical endometrioid - endometrioid histological type. In the presence of two different histological types of tumours, diagnosis is easier, but because of the small number of reported cases, there are no precise data on their clinical course. Generally, women with synchronous endometrial and ovarian tumours have a better prognosis and are more frequently younger, obese, multiparous and in menopause compared with women who have metastatic ovarian cancer or endometrial cancer. Case Report: In this work, we present a 53-year-old woman who contacted a gynaecologist because of irregular uterine haemorrhaging. The gynaecological exam revealed a tumour protruding through the cervical canal. The biopsy with initial histopathological diagnosis and additional ECHO and CT evaluations indicated the presence of a cervical tumour spreading over the uterus and both uterine adnexa. After surgical intervention, macroscopic and microscopic analyses of the postoperative material showed the simultaneous presence of two different malignancies, ovarian endometrioid carcinoma and poorly differentiated endometrial stromal sarcoma, which infiltrated all layers of the uterus, cervix and both fallopian tubes. Conclusion: The prognosis of synchronous tumours of the ovary and the uterus is primarily dependent on the stage and histological type of each tumour. Because of the rather small number of reported cases, a large part of this phenomenon remains unknown. Our report is the first description of the synchronous occurrence of endometrial ovarian carcinoma and uterine stromal sarcoma

Revealing the Supply Chain 4.0 Potential within the European Automotive Industry

With the rapid advancements in Information and Communication Technologies (ICT) and the widespread enthusiasm of both theoreticians and practitioners, the broader transition to Industry 4.0 (I4.0) in major industries appears imminent. This empirical study analyzes business data from 1140 automotive companies operating in Europe, utilizing various business intelligence platforms and employing decision tree analytics to establish connections between enablers, drivers, company size, and financial resources. The goal is to identify persistent barriers hindering the rational transition to Industry 4.0. The findings reveal an uneven transformation within the industry nexus. While larger companies possess the financial means to allocate collective intelligence, technical resources, and drive necessary for fulfilling I4.0 requirements, smaller members of the nexus lag behind despite their enthusiasm and intent. This imbalanced evolution poses a threat to the comprehensive transformation required for realizing all the benefits of Industry 4.0 within the sector. The primary discovery indicates that small to medium-sized enterprises do not exhibit the same rates of Industry 4.0 adoption, a lag highly correlated with their available financial and human resources for digital transition. The decision tree proposed in this study offers guidelines for achieving an Industry 4.0-compliant nexus. Given its diversity and substantial global impact, the case study from the automotive industry proves intriguing and may later be generalized to other sectors. The study’s outcome could empower engineering managers and researchers to implement, execute, and assess the impact of digital strategies based on the financial capabilities of industrial institutions

Foreign body extraction through the rigid bronchoscopy

Introduction. Foreign body aspiration into tracheobronchial tree represents an urgent condition at high level of risk. Etiology is different, and this condition is typical for all ages with highest incidence in pediatric population. Case report. A successful foreign body removal (partial denture) in a 34-year old man was presented. Radiography and computerized tomography of the chest showed a foreign body localized at the level of the right bronchus including the right middle lobe bronchus. By the use of rigid bronchoscopy, a foreign body was visualized and mobilized from the segmental bronchus in the first act, and then completely extracted. Conclusion. Efficient diagnostics and extraction are imperative for the aspirated foreign body preventing life-threatening complications

Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review

The aim of this study was to establish an evidence-based guideline for the antibiotic treatment of Corynebacterium striatum infections. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with systemic inflammatory response syndrome, harboring C. striatum isolated from body fluids or tissues in which it is not normally present. C. striatum had to be identified as the only causative agent of the invasive infection, and its isolation from blood, body fluids or tissues had to be confirmed by one of the more advanced diagnostic methods (biochemical methods, mass spectrometry and/or gene sequencing). This systematic review included 42 studies that analyzed 85 individual cases with various invasive infections caused by C. striatum. More than one isolate of C. striatum exhibited 100% susceptibility to vancomycin, linezolid, teicoplanin, piperacillin-tazobactam, amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this bacterium showed a high degree of resistance to fluoroquinolones, to the majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in almost 20% of the patients included in this study. Gene sequencing methods should be the gold standard for the identification of C. striatum, while MALDI-TOF and the Vitek system can be used as alternative methods. Vancomycin should be used as the antibiotic of choice for the treatment of C. striatum infections, in monotherapy or in combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin or daptomycin may be used in severe infections, while amoxicillin-clavulanate may be used to treat mild infections caused by C. striatum

Factors associated with fetal growth restriction and small for gestational age newborns

Objectives: To identify risk factors that contribute to the occurrence of fetal growth restriction (FGR) and small for gestational age (SGA) and quantify the strength of their impact. Material and methods: This study was designed as a retrospective-prospective observational cohort study conducted on pregnant women at the Clinic for Gynecology and Obstetrics at the University Clinical Centre Kragujevac, Serbia. We measured the intrauterine degree of fetal development through the estimated fetal weight (EFW) on ultrasound examination, which was calculated using Hadlock’s formula 3. Fetuses whose EFW was below the 10th percentile on the World Health Organization (WHO) fetal growth charts adjusted for gender and gestational age were classified as FGR fetuses, while newborns weighing less than the 10th percentile were considered SGA. Results: The study included 320 pregnant women with an average age of 30.3 ± 5.5 years who gave birth to 332 newborns. The results of univariate and multivariate stepwise backward conditional binary logistic regression showed that the occurrence of FGR during the second trimester was more likely in pregnant women with lower body height and proteinuria. The risk factors for the occurrence of FGR during the third trimester were lower body height and proteinuria, while iron supplementation had a protective effect. SGA newborns were more common in pregnant women who were shorter, had proteinuria, used corticosteroids, or smoked during pregnancy. Conclusions: Clinicians should pay special attention to pregnant women with lower body height, proteinuria, who smoke and use corticosteroids in order to prevent FGR and SGA

Case Report Uterus Didelphys: Report of a Puerperal Torsion and a Review of the Literature

A 29-year-old Para 2 was admitted to the emergency department with increasing lower abdominal pain. The patient had undergone an uncomplicated elective repeat caesarean section 7 days before being admitted to the emergency department. An emergency laparotomy revealed a uterus didelphys with a torsion of one of the uteri

Pyrrolizidine alkaloids from seven wild-growing Senecio species in Serbia and Montenegro

The genus Senecio (family Asteraceae) is one of the largest in the world. It comprises about 1100 species which are the rich source of pyrrolizidine alkaloids. Plants containing pyrrolizidine alkaloids are among the most important sources of human and animal exposure to plant toxins and carcinogens. The pyrrolizidine alkaloids of seven Senecio species (S. erucifolius, S. othonnae, S. wagneri, S. subalpinus, S. carpathicus, S. paludosus and S. rupestris) were studied. Fourteen alkaloids were isolated and their structures determined from spectroscopic data (1H- and 13C-NMR, IR and MS). Five of them were identified in S. erucifolius, four in S. othonnae, two in S. wagneri, four in S. subalpinus, two in S. carpathicus, three in S. paludosus and three in S. rupestris. Seven pyrrolizidine alkaloids were found for the first time in particular species. The results have chemotaxonomic importance. The cytotoxic activity and antimicrobial activity of some alkaloids were also studied

Kounis Syndrome Associated With the Use of Diclofenac

BACKGROUND: Diclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac. METHODS: Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index. RESULTS: Twenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) reported a previous reaction to diclofenac. Reported time from the used dose of diclofenac to onset of the first reaction symptoms ranged from immediately to 5 hours. Diclofenac caused both type I and type II Kounis syndrome, with the presence of various cardiovascular, gastrointestinal, dermatologic, and respiratory signs and symptoms. Most patients experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]). The most frequently reported finding on electrocardiogram was ST-segment elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary vessels in 9 patients (45.0%), with some pathologic findings in 8 patients (40.0%). CONCLUSION: Clinicians should be aware that Kounis syndrome may be an adverse effect of diclofenac. Prompt recognition and withdrawal of the drug, with treatment of both allergic and cardiac symptoms simultaneously, is important

The impact of cardiovascular drugs on the efficacy of local anesthesia in dentistry

© 2016, PALACKY UNIV. All rights reserved. Background and Aim. Drugs used chronically by patients with diseases of the cardiovascular system (group C of the ATC classification) may act on adrenergic receptors and/or certain ion channels, which gives them the potential to interact with the action of local dental anesthetics. The aim of the study was to investigate the effect of systemically administered chronic cardiovascular medication (oral route) on the efficacy of intraoral local anesthesia in patients with diseases of the cardiovascular system. Patients and Methods. This was a prospective cohort study which analyzed the efficacy of local terminal anesthesia (onset of anesthesia, duration anesthetized area) in the upper jaw of 70 patients: 40 patients on medication for cardiovascular system disorders and 30 patients who were not using these drugs (the control group). The following cardiovascular drugs were used: beta blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, vasodilatators, diuretics, angiotensin receptor blockers, antiarrhythmics, statins and alfa blockers. Results. The onset of anesthesia on the vestibular side was faster in those taking cardiovascular drugs (40.50±19.87 s) than the control patients (58.93±31.07 s; P = 0.004) and duration of anesthesia on this side was shorter. Although the difference was not significant, it was evident that on vestibular and palatal side the anesthetized area was more rapidly reduced in the patients taking cardiovascular drugs. The duration of cardiovascular therapy also had a significant impact on the anesthetized area. Conclusion. Drugs acting on cardiovascular system may influence the effect of local anesthetics used in dentistry, possibly through interaction with autonomic receptors and ion channels

A new ecologically friendly process for the synthesis of selective flotation reagents

A new ecologically friendly synthesis of N-alkyl-O-ethylthioncarbamates from ethyl dixanthogenates, waste material from the xanthate production plant, and monoalkylamines has been performed in this work. Structure determination of the synthesized compounds and also corresponding intermediates has been performed by IR, 1H-NMR and MS spectrometric methods. Residual dixanthogenates and thioncarbamates in waste water have been done by the gas chromatographic method and corresponding standard curve. It was confirmed that the reaction product was not present in water, while the concentration of dixanthogenates has been determined to be under the maximum contamination limit