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Imaging
Authors: Emanuele Muscogiuri, Marco Di Girolamo, Chiara De Dominicis, Andrea Pisano, Claudia Palmisano, Giuseppe Muscogiuri, and Andrea Laghi

Abstract

Pulmonary embolism (PE) is a condition due to blood clots obstructing pulmonary arteries, often related to deep venous thrombosis (DVT). PE can be responsible for acute and even life-threatening clinical situations and it may also lead to chronic sequelae such as chronic thromboembolic pulmonary hypertension (CTEPH). Signs and symptoms associated to PE may overlap those of many other diseases (e.g. chest pain, dyspnea, etc.), therefore an accurate clinical evaluation is mandatory before referring the patient to the most appropriate imaging technique. Pulmonary angiography (PA) has been traditionally considered the gold standard regarding the diagnosis of PE and it is also useful regarding the treatment of said condition. However, PA is an invasive technique, implying all the known risks concerning endovascular procedures. Nowadays, computed tomography angiography (CTA) is considered the imaging technique of choice regarding the diagnosis of PE. This technique is readily-available in most centers and it is able to provide high resolution images, although it implies the administration of ionizing radiations and iodinated contrast medium. Conventional CTA has further been improved with the use of ECG-gated protocols, aimed to reduce motion artifacts due to heartbeat and to evaluate other causes of sudden onset chest pain. Moreover, another interesting technique is dual energy computed tomography (DECT), which allows to elaborate iodine maps, allowing to detect areas of hypoperfusion due to the presence of emboli in pulmonary arteries. This review is aimed to describe the main findings related to PE with an emphasis on CTA, also discussing technical aspects concerning image acquisition protocol.

Open access

Az adhézió stabilizálódásának meghatározása a korai posztoperatív időszakban patkány modellen

Adhesion stabilization in the early postoperative period in a rat model

Magyar Sebészet
Authors: Györgyi Szabó, Daniella Fehér, Krisztina Juhos, Mohamed Gamal Eldin, Gabriella Arató, Domokos Csukás, József Sándor, and Andrea Ferencz

Összefoglaló. Bevezetés: Az adhézióképződés egy komplex eseménysor, amely olyan sejtes és molekuláris folyamatok következménye, ahol a normál esettől eltérően az adhéziógenezist támogató történések dominálnak az adhéziólízissel szemben. Kiváltásában szerepet játszik többek között a szöveti sérülés, vérzés, szöveti deszikkáció, illetve a gyulladásos folyamatok. Mivel az adhézió jelenléte számos negatív szövődménnyel járhat, elsődleges cél a kialakulásának megakadályozása. Számos prevenciós célpontja van a folyamatnak, azonban a terápia sok esetben csak közvetlenül a beavatkozás után történik.

A jelen tanulmányban egy adhéziós kísérleti patkány modellt mutatunk be, ahol az adhézió stabilizálódási időszakának megismerése a cél. Minden állaton ugyanaz a műtéti beavatkozás történt, szöveti sérülés, kisebb vérzés és szöveti deszikkáció előidézésével, különbség csak a reoperációk, mintavételek időpontjában volt. 1–7. posztoperatív napon makroszkóposan és szövettanilag értékeltük a kialakult adhéziók típusát, az összetapadó szöveteket, az adhézió stabilitását.

Megállapítottuk, hogy a stabilizálódás egy több napig tartó folyamat, a 4. posztoperatív napig az instabil és mérsékelten stabil adhéziók domináltak. Ennek ismerete lehetővé teszi a terápiás ablak kibővítését, a korai posztoperatív időszakban célzottan, a legmegfelelőbb időszakot kiválasztva, esetleg a kezelések kombinálásával még hatékonyabbá tehető az adhézióprevenció.

Summary. Introduction: Adhesion formation is a complex series of events that results from cellular and molecular processes where, in contrast to the normal case, events that support adhesion genesis dominate over adhesion lysis. Tissue injury, haemorrhage, tissue desiccation and inflammatory processes, among others, play a role in its induction. Since the presence of adhesions can be associated with a number of negative complications, the primary aim is to prevent their development. There are several preventive targets for the process, but in many cases therapy is only provided immediately after the procedure.

In this study, we present an experimental rat model of adhesion, where the aim is to understand the stabilization period of adhesion. All animals underwent the same surgical procedure, inducing tissue injury, minor haemorrhage and tissue desiccation, differing only in the timing of reoperations and sampling. On postoperative days 1–7, we assessed macroscopically and histopathologically the type of adhesions formed, the adhesive tissue, the stability of the adhesion.

We found that stabilization was a process lasting several days, with unstable and moderately stable adhesions predominating by postoperative day 4. Knowing this allows to broaden the therapeutic window, targeting the most appropriate period in the early postoperative period, possibly combining treatments, to make adhesion prevention even more effective.

Open access

Bal felső lebenyi adenocarcinoma és pulmonális vénás fejlődési rendellenesség együttes előfordulása

Left upper lobe pulmonary adenocarcinoma with partial anoumalous pulmonary venous connection in the same lobe: Case report

Magyar Sebészet
Authors: Ottó Kovács, Zoltán Szántó, Gábor Vida, and Árpád Juhász

Összefoglaló. Esetismertetés: 60 éves férfibeteg esete kerül bemutatásra jelen közleményben. Operábilis bal felső lebenyi tüdő adenocarcinomája a lebeny rendellenes véna pulmonalis beömlésével (partial anomalous pulmonary venous connection – PAPVC) szövődött. Az aortaív felett a hemiazygos vénába ömlő véna pulmonalis superior a bal véna brachiocephalicába vezette a bal felső lebeny vénás vérét, bal jobb shunt-öt okozva ezzel. A fejlődési rendellenességet egyértelműen csak a műtét során sikerült azonosítani. Az elvégzett bal felső lobektómia mindkét elváltozás definitív megoldását jelentette. Megbeszélés: Jelen közleményünkkel együtt a fellelhető szakirodalomban (PubMed) 32 esetleírás szerepel erről a ritka fejlődési anomáliáról. Ez aláhúzza a preoperatív computer tomográfia (CT) jelentőségét és a mellkassebész szerepét a CT felvételek értékelésében.

Summary. Authors present a case of a 60-year-old male patient with left upper lobe cancer in association with partial anomalous pulmonary venous connection (PAPVC) in the same lobe. The hemiazygous vein joined the left superior pulmonary vein above the aorta in the thorax cavity draining into the left brachiocephalic vein causing left to right shunt flow. PAPVC was clearly identified intraoperatively and left upper lobectomy was performed as definitive solution for both. PAPVC was closed by stapler. To our knowledge 32 operated cases of lung cancer with PAPVC has been described in the literature (PubMed), including our patient.

Restricted access
Acta Veterinaria Hungarica
Authors: Monika Bugno-Poniewierska, Barbara Kij-Mitka, Zenon Podstawski, Bogusława Długosz, Olga Lasek, Patrycja Mrowiec, and Marian Tischner

Abstract

The use of frozen semen lowers the risk of disease transmission, eliminates geographical limitations and supports the implementation of genetic resource protection programs. However, due to the very rare use of frozen semen from Hutsul stallions, their genetic material is not secured in sperm banks, and very little information is available about their semen, including its suitability for cryopreservation, and sperm survival rates after thawing. The aim of this study was to analyse basic parameters such as sperm motility, vitality and morphology in diluted-stored and post-thawed Hutsul semen, using a CASA system. There were no differences in sperm motility (P = 0.3372) or morphology between the groups, although the progressive motility was higher in thawed semen (P = 0.0151), while the sperm vitality was higher in diluted-stored semen (P = 0.00517). This study demonstrates that semen from Hutsul horses is suitable for cryopreservation, thus supporting the creation of a sperm bank as a genetic reserve for representatives of this breed.

Restricted access

Abstract

This article tries to explain the differences in COVID-19 case fatality rate (CFR) in 22 European countries by their type of organization and performance level of their healthcare systems. The CFR is taken here as the most important indicator since it measures the ratio between COVID deaths and COVID cases. In our view, this indicator reflects the true performance of the healthcare system, as this indicator is freed form public health interventions, like testing, lockdowns or social distancing.

Our research is also unique, because it sees the healthcare system in a holistic way and tries to explain the CFR not by individual risk factors, socioeconomic indicators, or partial system parameters, but by using a complex healthcare system classification method adopted from Isabelle Joumard and an overall healthcare system performance index adopted from European Health Consumer Index (EHCI).

The main results are twofold. First, higher EHCI score is related to lower CFR. So, the countries are cumulated basically in two quadrants: High EHCI performers (score 790 and higher) with low CFR (below 1.93%) and low EHCI performers with high COVID CFR. Second, apart from Czech Republic, the V4 countries are not doing very well in fighting COVID. Hungary is the worst, not only from the V4 group, but the worst from the whole list of 22 European countries included in this research. Poland is doing better, but still is high above the median CFR. Slovakia was the second worst from the V4 group. Czech Republic is the best V4 performer and the only country with EHCI score lower than median and CFR also lower than the median.

Free access

Abstract

The main objective of this paper is to identify the impacts of the COVID-crisis on growth, in particular on growth potential in the European Union (EU), in the context of a broader growth analysis. The quantitative analysis underlying this paper focuses on the financial and economic (“Great”) recession of 2008–2009, the subsequent recovery and the period of the COVID-crisis. We provide a detailed overview of some of the mechanisms of the COVID-crisis on growth.

The COVID-crisis is likely to have a direct impact on the level of potential output. A decrease in investments and labour market hysteresis may have long-lasting effects on potential growth. The former would have a negative impact on productivity. This can lead to increased inequalities and have a negative effect on social cohesion. The future development of divergences among the EU Member States is particularly important. Their possible intensification could disrupt the functioning of the euro area and the internal market.

A lasting source of potential growth in the EU Member States could be productivity growth. Its decisive structural factor is the growth dynamism of total factor productivity (TFP). There are large differences in this area with regard to the level and growth dynamism of performance of the Member States. Narrowing the output gaps vis-à-vis the front-runners through deep structural reforms could be a key factor in raising growth potential. The cleansing effects of crises, which force structural change and resource reallocation, can also create new opportunities for TFP growth.

Open access

Abstract

COVID-19 has been the “hottest” topic in many fields of research during 2020–2021. Our analysis focuses on the publications related to the pandemic in the business and economics area. Using the Web of Science database, the main international research patterns in this field have been analysed. Our research covers less than two years (2020 and part of 2021), but the number of publications is large (more than 1,000) in this limited time span. The publication patterns of the CEE countries have also been examined. Bibliometric and social network analysis was used to assess which countries and institutions published the most during this period. For analysing the main trends in the given field, keyword analysis was performed.

Open access

Abstract

Potential functional food bakery products were developed and characterized based on White Lupin (Lupinus albus cv. Nelly) flour. Analytical properties of the seeds resemble to previously described Lupinus species, with significantly high protein content (45%). The high protein and dietetic fiber content of the seeds makes Lupin flour suitable to develop potential functional food products with high nutritional values. Results of the development of sweet biscuits and salty crackers enriched with Lupin flour are presented. Sensory evaluation of the bakery products was carried out by 15 panelists using the nine points hedonic scale. Heat stability of White Lupin proteins were investigated by gel-electrophoretic analysis, White Lupin proteins are quite stable at 140°C, after 35 min heating the biscuits still contain 69% of the original amount of proteins. Baking conditions were optimized also based on gel-electrophoretic experiments, the optimal baking time was 30 min at 140°C. Gluten-free Lupin-based biscuits and crackers were produced by completely omitting wheat flour from the recipes.

Open access
Imaging
Authors: Hatem Soliman-Aboumarie, Maria Concetta Pastore, Eftychia Galiatsou, Luna Gargani, Nicola Riccardo Pugliese, Giulia Elena Mandoli, Serafina Valente, Ana Hurtado-Doce, Nicholas Lees, and Matteo Cameli

Abstract

In the last years, new trends on patient diagnosis for admission in cardiac intensive care unit (CICU) have been observed, shifting from acute myocardial infarction or acute heart failure to non-cardiac diseases such as sepsis, acute respiratory failure or acute kidney injury. Moreover, thanks to the advances in scientific knowledge and higher availability, there has been increasing use of positive pressure mechanical ventilation which has its implications on the heart. Therefore, there is a growing need for Cardiac intensivists to quickly, noninvasively and repeatedly evaluate various hemodynamic conditions and the response to therapy.

Transthoracic critical care echocardiography (CCE) currently represents an essential tool in CICU, as it is used to evaluate biventricular function and complications following acute coronary syndromes, identify the mechanisms of circulatory failure, acute valvular pathologies, tailoring and titrating intravenous treatment or mechanical circulatory support. This could be completed with trans-esophageal echocardiography (TOE), advanced echocardiography and lung ultrasound to provide a thorough evaluation and monitoring of CICU patients. However, CCE could sometimes be challenging as the acquisition of good-quality images is limited by mechanical ventilation, suboptimal patient position or recent surgery with drains on the chest. Moreover, there are some technical caveats that one should bear in mind while performing CCE in order to optimize its use and avoid misleading findings. The aim of this review is to highlight the key role of CCE, providing an updated overview of its main applications and possible pitfalls in order to facilitate its use in CICU for clinical decision-making.

Open access