Aim To emphasize the importance of early recognition, diagnostic processing and emergent surgical treatment of spontaneous spinal epidural hematoma (SSEH). Methods A 39-year-old female presented with sudden onset of severe pain between the shoulder blades followed by paraparesis and alerted sensibility in the lower extremities. An hour later she developed paraplegia with sensory deficits below ThIV level, absence of patellar reflex, ankle jerk reflex and sphincter dysfunction. Results Magnetic resonance imaging (MRI) demonstrated acute extensive epidural mass of thoracic spinal segments (ThI-ThIII). The patient underwent emergent decompressive laminectomy ThI-ThIII with epidural hematoma evacuation within 24 hours of symptoms onset. After the surgical treatment, because of suspicion on spinal arteriovenous malformation, complete diagnostic evaluation with spinal angiography was done and no form of vascular malformation was found. Idiopathic SSEH was diagnosed. Two months later the patient reached complete neurological improvement. Conclusion The SSEH is a rare condition that should be kept in mind in patients presenting with neurological deficit and a sudden onset of back pain like it was in our case. For early diagnosis, immediate MRI is essential. Prompt surgical decompression such as laminectomy is an absolute surgical indication widely accepted for patients with progressive neurological deficit. The SSEH should be considered as one of the important differential diagnoses in patients who have developed acute myelopathy.

Introduction: Uveitis as extra-articular manifestation of juvenile idiopathic arthritis (JIA) is present in 20% of children with the persistent form, in 30% with the extended oligoarticular form, while it is present in psoriatic and polyarticular rheumatoid factor (RF) negative arthritis in 10% and 14%, respectively. Aim: The aim of the study was to evaluate the frequency of uveitis and its complications in children with JIA. Material and Methods: A retrospective study was conducted with an analysis of the medical records of children with JIA who were treated for the last 5 years. The analysis included the following: the child’s age and sex, age at onset of arthritis, of uveitis, complications, RF values and antinuclear antibodies (ANA). Results: The study included 97 children with JIA: in 14 (14.4%) uveitis was observed; the most common form of JIA was the oligoarticular extended form (6/14), oligoarticular persistent form was observed in 5 children, while 3 children with uveitis had polyarticular RF negative JIA. The age of arthritis onset was lower in children with uveitis (4.7 vs 8.2 years); ANA positivity was more common in children with JIA and uveitis (64% vs 41%). Uveitis was the first manifestation of the disease for 2 children; 28.6% of children had clinically asymptomatic uveitis, while 42.4% of children developed uveitis within 4 years from the JIA onset. 8/14 children developed uveitis complications: 3 cases of synechia, 2 band keratopathy, 2 cataracta, 1 glaucoma. Conclusion: Uveitis as significantly present manifestation of JIA requires to timely recognize, treat, monitor children in order to prevent complications.

Aim To investigate the relationship between recovered hepatitis B infection with appearance of toxic propylthiouracil (PTU) hepatitis and point out the growing importance of the use of drugs in the development of hepatitis. Methods A case of a 45-year-old female patient with suspicion of acute viral hepatitis who had polypragmasy of drugs in the last ten years, due to the polymorphism of symptoms/illnesses (diabetes mellitus, depression, hypertension, hypothyroidism) was presented. Results A female patient had hyperthyroidism after resolved viral hepatitis B with HBsAg seroconversion (HBsAg negative, antiHBs positive). PTU had the greatest potential for hepatotoxicity of all administered drugs. After corticosteroid therapy there was a significant improvement in liver function tests. In the course of the disease there was no change of hepatitis markers and exacerbations of hepatitis B. Conclusion Clinical practice should comprehensively monitor the effects of the intricate and tight connection between drugs, liver and endocrine system in order to better resolve all manifestations, complications and worsening of one or another organic system.

Aim To define direct anatomical relations of the sphenoidal (alae minores), ethmoidal sinuses and optic nerve, with an emphasis on determining the effect of age on pneumatisation and dehiscence. Methods This retrospective, descriptive study involved 60 consecutive patients: 30 patients younger than 30 and30 patients older than 60 years of age. All patients underwent computerized tomography(CT). The relationship of the optic nerve and the sphenoidal and ethmoidal sinuses was classified. The presence of dehiscence in the bone structures, forming the optic canal, was checked. Dehiscence was defined as absence of visible bone density located between the sinus and the optic nerve. Protrusion of the optic nerve into the sphenoidal sinus was defined as optic nerve surrounded by pneumatised space. Results The most common type of relation between the optic nerve and sphenoidal sinus was type I, where the optic nerve was immediately adjacent to the lateral or superior wall of the sphenoidal sinus, without impression on the sinus wall. Dehiscence was documented in 15 (25%) cases, it was more common in older patients (8, 27%) than in younger ones (7, 23%). The pneumatisation processes were more frequent in patients over 60 (5, 17%) than in those younger than 30 years (4, 13%). Conclusion Surgeons and ophthalmologists should be aware of high frequency of dehiscence of sphenoidal sinus walls when treating adult patients in our population, especially when evaluating risks and complications of surgical procedures or when diagnosing inflammatory or tumorous processes in the close vicinity of posterior paranasal sinuses.

Integrated fruit production (IFP) is an economical, high-quality fruit production which prioritizes ecologically acceptable means of production, which minimize side-effects aiming to increase environment conservation and human health. Following the market demands and increasing production standards, integrated production imposes itself, which is to enable lucrativeness, market competition and ecological acceptability of agricultural products. Introducing and implementing multi-criteria model of decision-making is based on DEXi method (multi-attribute analysis). This method makes selection of the most adequate fruit sort for initiating fruit production. This model of decision-making is based on opinions of experts from the Feld of integrated production. The main criterion in evaluating IFP according to DEXi and expert system are: economic, technological, ecological and socio-political. The result of multi-criteria expert system DEXi have shown that the plum fruit sort yields the best results according to integrated production concept and can be recommended as the first planting alternative. The second alternative recommends apple while the third one recommends pear.

Neste trabalho efetuamos um estudo sistematico das propriedades estruturais e eletronicas da hidroxiapatita (HA), atraves da teoria funcional de densidade (DFT) usando o codigo – CASTEP. Os resultados obtidos atraves da tecnica de aproximacao GGA – PBE demonstraram em termos das propriedades estruturais uma diferenca maxima de 13.4 % entre o valor teorico e experimental, enquanto o volume calculado com estes valores foi V = 529,58 A 3 .