Introduction: Non-muscle-invasive bladder cancer (NMIBC) is usually effectively treated with transurethral resection (TUR), most often followed by intravesical instillation of bacillus Calmette-Guérin (BCG) or intravesical chemotherapy. Although the precise mechanism of BCG immunotherapy is still unclear, a local immune response is presumed. However, a number of severe side effects and complications are related to intravesical immunotherapy. AIM: Aim of this report is to present rare case of the renal granulomatous disease in a patient previously treated with intravesical instillation of BCG immunotherapy, following TURBT. In addition, we performed review of previously reported cases of renal granulomas following intravesical BCG immunotherapy. Case report: A 79-year-old man was presented to Urology Clinic due to clinically verified tumor of the urinary bladder. After transurethral resection of bladder tumor, histopathological analysis revealed the diagnosis of papillary urothelial high-grade pT1 carcinoma. Intravesical BCG immunotherapy was initiated, according to protocol currently used in our institution. Upon completion of therapy with BCG, we re-examined the patient and, using ultrasound, found a change in the right kidney, resembling moth bites not seen on CT scan before TURBT. Additionally, CT-guided core-needle biopsy of the affected kidney was performed, and the specimen was sent for histopathological analysis, which revealed chronic necrotizing granulomatous inflammation. Antituberculotic therapy was initiated for 6 months. Upon completion of antituberculotic therapy, control CT-scan was performed at follow-up, indicating regression of changes on the right kidney. Conclusion: This case report emphasizes the importance of consistent implementation of follow-up protocol and the identification of lesions during the asymptomatic period and enables the proper treatment of the disease. To reduce the incidence of adverse effects of BCG treatment for bladder tumors, an individualized approach is needed.
The development of science is essential when it comes to the development of society, while the mathematics necessary for the development of science. The fact that the children are all clearer, more capable and versatile, and their mathematical knowledge smaller and worse, motivated me to this research.How would our society be better you need to choose talented and creative young people who will represent the same company. One way of selecting children, and choosing the best are just competitions. In this work, attention will be focused on additional classes and competitions of teaching mathematics, as well as their importance in the education and development of children in schools.When it comes to gifted students, one of the main events where they can demonstrate their knowledge and skills are the competition.The overall objective of this research is to determine the extent to which the additional classes represented in schools and how many students go to additional classes and competitions in mathematics.The study included 103 primary school students in the municipality of Ilijaš. The results obtained in this study mostly on the representation of additional teaching of mathematics in schools or with, a small number of students. Because the necessary mathematical talent, the will and desire to learn mathematics. Viewed from the perspective that the disciples mathematics not so favorite subject, these are the expected results.
Given the growing number of older people, society as a whole should ideally provide a higher quality of life (QoL) for its ageing citizens through the concept of personalised ageing. Information and communication technologies (ICT) are subject to constant and rapid development, and can contribute to the goal of an improved QoL for older adults. In order to utilise future ICT solutions as a part of an age-friendly smart environment that helps achieve personalised ageing with an increased QoL, one must first determine whether the existing ICT solutions are satisfying the needs of older people. In order to accomplish that, this study contributes in three ways. First, it proposes a framework for the QoL of older adults, in order to provide a systematic review of the state-of-the-art literature and patents in this field. The second contribution is the finding that selected ICT solutions covered by articles and patents are intended for older adults and are validated by them. The third contribution of the study are the six recommendations that are derived from the review of the literature and the patents which would help move the agenda concerning the QoL of older people and personalised ageing with the use of ICT solutions forward.
Many traditional remedies represent potential candidates for integration with modern medical practice, but credible data on their activities are often scarce. For the first time, the anti-virulence potential and the safety for human use of the ethanol extracts of two medicinal plants, Persicaria maculosa (PEM) and Bistorta officinalis (BIO), have been addressed. Ethanol extracts of both plants exhibited anti-virulence activity against the medically important opportunistic pathogen Pseudomonas aeruginosa. At the subinhibitory concentration of 50 µg/mL, the extracts demonstrated a maximal inhibitory effect (approx. 50%) against biofilm formation, the highest reduction of pyocyanin production (47% for PEM and 59% for BIO) and completely halted the swarming motility of P. aeruginosa. Both extracts demonstrated better anti-quorum sensing and antibiofilm activities, and a better ability to interfere with LasR receptor, than the tested dominant extracts’ constituents. The bioactive concentrations of the extracts were not toxic in the zebrafish model system. This study represents an initial step towards the integration of P. maculosa and B. officinalis for use in the treatment of Pseudomonas infections.
The focus of this article is on the biography and medical activity of Gisela Januszewska (née Rosenfeld) in Austro-Hungarian (AH) occupied Bosnia and Herzegovina (BH) between 1899 and 1912. Rosenfeld, later Januszewska and then Kuhn(ová) by marriage, was the fifth of a total of nine official female physicians who were employed by the AH administration to improve the health and hygienic conditions among Bosnian and Bosnian Muslim women. In 1893, Gisela Kuhn moved from Brno, Moravia to Switzerland to pursue her medical studies; she was awarded her Doctorate in Medicine (MD) from the University of Zurich in 1898. In the same year, she took up her first position as a local health insurance doctor for women and children in Remscheid but was prohibited from practising in the German Empire. In 1899, she successfully applied to the AH authorities for the newly established position of a female health officer in Banjaluka and began working there in July 1899. She lost her civil service status upon marrying her colleague, Dr Wladislaw Januszewski, in 1900 but carried out her previously officially assigned tasks as a private physician. In 1903, she was employed as a 'woman doctor for women' at the newly established municipal outpatient clinic in Banjaluka. Upon her husband's retirement in 1912, the couple left BH and settled in Graz, Styria. After, World War I Januszewska ran a general medical practice in Graz until 1935 and worked as a health insurance-gynaecologist until 1933. She received several AH and Austrian awards and medals for her merits as a physician and a volunteer for humanitarian organisations. Upon Austria's annexation to Nazi Germany 1938, however, she was classified a Jew and was deported to Theresienstadt concentration camp (Terezín, Bohemia), where she died in 1943. CONCLUSION: Gisela Januszewska, née Rosenfeld (1867-1943) viewed her medical practice as a social medicine mission which she put into practice as a 'woman doctor for woman' in Banjaluka, BH (1899-1912) and Graz, Austria (1919-1935).
Analysis of 4G/5G polymorphisms of PAI-1 gene in interaction with other genetic and external risk factors that induce development of venous thromboembolism can be used for risk assessment for development of venous thromboembolism. Research was conducted on 202 examinees of both genders, older than 18, from north-eastern Bosnia. Experimental group included 100 examinees with diagnosed DVT and 101 examinees who until the sampling procedure did not have diagnosed DVT. In DVT group, following genotype frequencies were determined: 27% of examinees had a normal genotype 5G/5G, 68% are heterozygotes and 5% are mutated homozygotes 4G/4G. In the control group, frequencies of 4G/5G polymorphisms of PAI-1 gene were: 42.6% of examinees have 5G/5G genotype, 55.4% are heterozygotes 4G/5G and 2% are 4G/4G genotype. Obtained results support the hypothesis that PAI-1 in interaction with other genetic and external risk factors probably induces the development of venous thromboembolism.
This article aims to improve spectrum efficiency (SE) for the unmanned aerial vehicle (UAV)-relayed cellular uplinks, through distinguishing both line-of-sight (LoS) and non-LoS (NLoS) links. Meanwhile, aiming to accommodate the air-to-ground (A2G) cooperative nonorthogonal multiple access (NOMA)-based cellular users (CUs) with a high energy efficiency (EE), a joint resource allocation (RA) problem is further considered for the UAV and the CUs. To solve the problem, first, an access-priority-based receiver determination (RD) method is derived. According to the RD result, the heuristic user association (UA) strategies are given. Then, based on the UA result, transmission powers of the CUs and the UAV are initialized based on their quality-of-service (QoS) demands. Furthermore, the subchannels are assigned to the associated CUs and the UAV with the reweighted message-passing algorithm. Finally, the transmission power of the CUs and the UAV is jointly fine-tuned with the proposed access control schemes. Compared with the traditional orthogonal frequency-division multiple access (OFDMA) scheme and the traditional ground-to-ground (G2G) NOMA scheme, simulation results confirm that the UAV-aided NOMA with the proposed joint RA scheme yields better performances in terms of the SE, the EE, and the access ratio of the CUs.
Proportional–integral–derivative (PID) control is the most common control approach used to control active magnetic bearings system, especially in the case of supporting rigid rotors. In the case of flexible rotor support, the most common control is again PID control in combination with notch filters. Other control approaches, known as modern control theory, are still in development process and cannot be commonly found in real life industrial application. Right now, they are mostly used in research applications. In comparison to PID control, PI-D control implies that derivate element is in feedback loop instead in main branch of the system. In this paper, performances of flexible rotor/active magnetic bearing system were investigated in the case of PID and PI-D control, both in combination with notch filters. The performances of the system were analysed using an analysis in time domain by observing system response to step input and in frequency domain by observing a frequency response of sensitivity function.
Introduction: Widespread opinion that penetrating chest injuries are more urgent, in terms of treatment and care, contributed to underestimation of the urgency of blunt chest trauma, which in most cases is treated conservatively. It remains an open question frequency when the injuries of the heart and pericardium are not timely diagnosed and surgically treated. Aim: To demonstrate the importance of well-timed surgical treatment of blunt chest trauma, when coupled with cardiac and pericardial injuries. Methods: At the Thoracic Surgery Clinic of the University Clinical Centre Banja Luka, Bosnia and Herzego vina, during period of 10 years (01.01. 2008 – 31.01.2018.), the total of 66 patients were treated for urgent thoracotomy due to clinically and radiologically unclear findings after blunt chest trauma. In general, diagnostic examinations, apart from laboratory analysis, included radiological imaging and Multi Slice Computed Tomography (MSCT) of the chest, followed by an ultrasound of the heart in cases when sternum was injured or when pericardial tamponade was suspected. Results presented in the study where obtained from the retrospective analysis of patients data. This work presents a retrospective observational cross-sectional study, which results in the assessment of the correctness of a particular diagnostic test. Statistical methods used: descriptive statistics, counting measures (frequencies and percentages), central tendency measures (arithmetic mean), variability measures (standard deviation). Results: Sixty six patients were treated with urgent thoracotomy after a blunt trauma of the chest due to the unclear clinical and radiological finding. In the case of 11 patients (10 men and 1 woman), presenting 16.6% of the total sample, pericardial and cardiac injuries were detected and treated intraoperatively. Further, in the case of the one patient, pericardiotomy and suturing of the right heart chamber where performed, with the creation of a pericardial window. Transthoracic echocardiogram was not used as the primary screening module, but rather as a diagnostic test for patients who had unexplained hypotension and arrhythmia. Radiographs of the chest showed cardiomegaly with or without epicardial fat pad sign suggesting a pericardial effusion. Conclusion: Blunt cardiac and pericardial injuries represent a serious therapeutic problem, which, if not treated properly, result in a high mortality rate. Echocardiography is the primary diagnostic method for initial detection of pericardial effusion. Pericardial fluid first accumulates posterior to the heart, when the patient is examined in the supine position. As the effusion increases, it extends laterally and with large effusions the echo-free space expands to surround the entire heart. The size of the effusion may be graded as small ( echo free spaces in diastole <10 mm, corresponding to approxymately 300 ml), moderate (10-20 mm, corresponding to 500 ml), and large ( >20 mm, corresponding to >700 ml). When the ability of the pericardium to stretch is exceeded by rapid or massive accumulation of fluid, any additional fluid causes the pressure with the pericardial sac. Early recognition, pericardiotomy with pericardial window creation and/or ventricular rupture suture remain the “gold standard” in the treatment of blunt cardiac and pericardial injuries.
Introduction: There are several evaluation schemes for the results of tendon transfers in case of radial nerve paralysis, and the most logical and commonly used are evaluation schemes that use the range of active joint movements to evaluate the results. Aim: Present an original evaluation scheme for tendon transfer results based on functional wrist and fingers joint movements. The aim of the article is to present the advantages of our own Functional scheme in comparison with other schemes, its simplicity and applicability in the evaluation of all clinical cases of different postoperative outcome of the variables being evaluated, and to present the ease of comparison of the achieved results with other authors who would possibly use our scheme because it minimizes the subjective error of the examiner. The secondary aim is to compare the results of flexor carpi radialis (FCR) vs. flexor carpi ulnaris (FCU) tendon transfers (TT). Methods: The study was conducted as clinical and retrospective. The study included 60 patients with isolated radial nerve palsy operated by two tendon transfer surgical methods (FCR and FCU) over a 10-year period. The evaluation of the results was performed by using Zachary, Neimann-Pertecke, Tajima evaluation schemes, our own Functional Evaluation Scheme as well as subjective patient evaluation. Results: The time elapsed from injury to surgery ranged from 105 to 956 days in case of FCR tendon transfer and from 109 to 712 days in cases of FCU tendon transfer. The overall average age of patients is 36.71 years. A statistically significant difference in values with t -test based on the Functional Evaluation Scheme was found in the variables of ulnar deviation (p=0.000731), extension of the MP fingers joints II-V (p=0.04610) and extension of the MP of the thumb joint (p=0.0475). Evaluation of the total results with t-test (p=0.007532) and with U-test (p=0,00433) showed statistically better FCR tendon transfer results. A statistically significant difference in value measured by the t-test was found in the evaluation of the overall results (p=0.022) with Zachary and Neumann-Pertecke schemes and by the Tajima evaluation Scheme (p=0.042) in favor of better FCR tendon transfer results. With a use of Functional Evaluation Scheme, it is possible to evaluate all the results unlike most available schemes. Conclusion: The functional evaluation scheme is based on the functional joint movements evaluated and incorporating radial and ulnar deviation of the wrist (RD and UD), extension of the metacarpophalangeal (MCP) joint and flexion of the intephalangeal (IP)joint of the thumb in the final evaluation becomes completely original. A functional evaluation scheme is simply applicable for the evaluation of all clinical cases of different postoperative outcome of the variables being evaluated. FCR tendon transfer achieves better results than FCU TT.
Cardiopulmonary exercise monitoring is a valuable method not only for the evaluation of medical health, but also for the assessment of patients with cardiac or pulmonary dysfunction. Spiroergometry provides additional criteria for the assessment of cardiopulmonary efficiency compared to simple ergometry. Maximal oxygen consumption (VO2max) is the most critical variable during spiroergometry. Most submaximal exercise measures provide the heart rate (HR) response to predetermined workloads in equations or nomograms used to predict VO2max. According to previous studies, the heart rate is divided into five fields. In this paper, we are doing a new redistribution of heart rates-to-workloads into seven fields, corresponding to the ergo bar. In other words, an answer is given based on the initial anthropological values of the subjects, when and in which field there will be a mismatch between the lung capacity of the subjects and the power required for that field.
Simple summary Halophytic plants are a promising animal feed source. However, the extreme NaCl2 salt content constraints their use. Excess diet salt adversely affects growth performance and animal’s reproduction worldwide. This review focuses on the impact of high salt intake on growth performance and reproduction ability in animals. Abstract Salinity is a reliable issue of crop productivity loss in the world and in certain tropical and subtropical zones. However, tremendous progress in the genetic improvement of plants for salinity tolerance has been made over several decades. In light of this, halophytic plants can be used as animal feeds and have promising features because they are a good feed resource. However, the main constraint of saline pasture systems is the extreme concentration of NaCl salt in drinking water and forage plants for grazing animals. Ecological reports revealed that excess diet salt causes mortality and morbidity worldwide. Animal fed halophytic forages may have adverse effects on growth performance and reproductive function in males and females due to inducing reductions in hormone regulation, such as testosterone, FSH, LH, and leptin. It was indicated that high salt intake promotes circulating inflammatory factors in the placenta and is associated with adversative effects on pregnancy. This review focuses on the scientific evidence related to the effect of high salt intake on growth performance, spermatogenesis, sperm function, and testicular morphology changes in male animals. In addition, the review will also focus on its effect on some female reproductive features (e.g., ovarian follicle developments, placental indices, and granulosa cell function).
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