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The aim of this study was to describe the effectiveness of the vaccines (Tozinameran and Sputnik V), administered on a convenience sample of healthcare workers, and also to describe the relationship between the levels of neutralizing antibodies (NAbs) and the type of vaccine used, as well as their association with incident cases during follow-up.

The term 'malnutrition' is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is an association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.

Introduction: Although more than 100 operative procedures have been described for the treatment of patellar instability, there is no single universally successful procedure. For the most patients with lateral patellar instability medial patellofemoral ligament (MPFL) reefing is recommended. When we perform MPFL reefing we are not aware of the quality and strength of the MPFL tissue. In the presence of recurrent patellar instability,the quality and strength of MPFL tissue is often compromised and it disturbs patellar stability after MPFL reefing. Biomedicine development,recognizing the ligament healing process show us that autologous blood products, particularly PRP can enhance healing in soft tissue injuries. Purpose: The purpose of this study was to determine the potential effect of Plasma preparation rich in growth factorson patellar stability after MPFL reefing. Material and methods: Plasma preparationrich in growth factors was produced from a unit of autologous whole blood using Arthrex ACP double syringe system.Platelet gel was prepared by adding bovine thrombin and 10% solution of calcium chloride.The platelet gel was applied locally into the place where suturing of the MPFL was performed. In this prospective, randomized and double blindstudy12 patients were included:6 patients in the PG group who received platelet gel and 6 patients in the control group who were not treated with platelet gel. Patellar stability was evaluated before surgery and 3 months after surgery with Axial stress radiographs. Results: The calculated 3 month improvement was 12.67 ± 2.51 in the control group and 17.33 ± 1.52 in the PG group, (p=0.064).Although there was greater improvement in patellar stability in PG group comparing to the control group, the difference was not statistically significant (p>0.05).The main reason for this was probably the small number of patients included in the study. Conclusion: Results showed that growth factors from the plasma preparation rich in growth factorshave positive effect on patellar stability after MPFL reefing.We believe that they stimulate and accelerate physiological healing and reparative tissue processes in ligament healing. More studies should be made, including more patients, if we want to get more relevant results.

Background: After intracerebral hemorrhage cysteinyl leukotrienes (C4, D4, E4) are synthetisized in the contact brain parenchyma-extravasated blood and participate in producing of edema formation. The study aim is a 5-days follow up (admittance/3th day/5th day) of urinary cysteinyl leukotrienes, hematoma and edema volume in patients with primary spontaneous supratentorial intracerebral hemorrhage and to determine the relationship: edema/haematoma and edema/leukotrienes. Methods: An enzyme immunoassay for leukotrienes measuring in the urine samples from 62 patients with hemorrhage during the first 5 days (admittance/3th day/5th day) and 80 health controls is used. Hematoma and edema volume is visualised and measured by computed-tomography. Results: Admission values of leukotrienes were significantly higher in the hemorrhagic patients (min = 268.61; max = 5787.36; mean = 1842.20 ± 1413.19 pg/ml/mg creatinine) versus control subjects (min = 297.8; max = 1684.2; mean = 918.6 ± 332) (p < 0.001). Significant leukotrienes excretion dynamism (mean: 1842.20 ± 1413.19; 1181.54 ± 906.16; 982.30 ± 774.24 pg/ml/mg creatinine) is found in hemorrhagic patients during5 day-follow up (admittance/3th day for p 0.05). The edema (mean: 12.86 ± 13.52; 22.38 ± 21.10; 28.45 ± 29.41 cm3 ) showed very high significance (p < 0.001). At admitance and on the 5th day nonsignificant positive correlation (r = 0.4; p > 0.05) of moderate strength is found between edema and hematoma; and significant positive correlation (r = 0.6; p < 0.05) of moderate to high strength at the 3th day. Between leukotrienes and edema, the coefficient of correlation r = - 0.1 (p > 0.05) at admittance, r = - 0.05 (p > 0. 05) on the 3th day (nonexistence of linear correlation, the sign minus presents their tendency for the opposite movement in their values) and r = 0.2 (p > 0.05) on the 5th day are found (positive linear nonsignificant correlation of slight strength). Conclusion: Significant urinary leukotrienes excretion (a brain capacity for significant leukotreienes synthesis) and significant edema progression versus constant haematoma are found. The edema size followed the hematoma size of moderate extent. The edema showed an inverse dependence of the leukotrienes (a tendency for opposite movement of their values), the high leukotrienes values at admittance bring to greater edema volume on the third/the fifth day, respectively. Elevated cysteinyl leukotrienes synthesis and the elevated edema could point to cause-effective relationship between them establishing the leukotrienes as an edema promotive-factor in intracerebral haemorrhage.

Background: After intracerebral hemorrhage cysteinyl leukotrienes (C4, D4, E4) are synthetisized in the contact brain parenchyma-extravasated blood and participate in producing of edema formation. The study aim is a 5-days follow up (admittance/3thday/5thday) of urinary cysteinyl leukotrienes, hematoma and edema volume in patients with primary spontaneous supratentorial intracerebral hemorrhage and to determine the relationship: edema/haematoma and edema/leuko trienes. Methods: An enzyme immunoassay for leukotrienes measuring in the urine samples from 62 patients with hemorrhage during the first 5 days ( admittance/3thday/5thday) and 80 health controls is used. Hematoma and edema volume is visualised and measured by computed-tomography. Results: Admission values of leukotrienes were significantly higher in the hemorrhagic patients (min =268.61; max = 5787.36; mean = 1842.20 ± 1413.19 pg/ml/mg creatinine) versus control subjects (min =297.8; max = 1684.2; mean = 918.6 ± 332) (p < 0.001). Significant leukotrienes excretion dynamism (mean:1842.20 ± 1413.19; 1181.54 ± 906.16; 982.30 ± 774.24pg/ml/mg creatinine) is found in hemorrhagic patients during 5 day-follow up (admittance/3thday for p < 0.001; the 3thday/5thday for p < 0.05). The followed hematoma volume (mean: 13.05 ± 14.49; 13.13 ± 14.66; 12.99 ±14.73 cm3) for all three periods of examination did not show significance (p > 0.05). The edema (mean: 12.86 ±13.52; 22.38 ± 21.10; 28.45 ± 29.41 cm3) showed very high significance (p < 0.001). At admitance and on the 5th day nonsignificant positive correlation (r = 0.4; p >0.05) of moderate strength is found between edema and hematoma; and significant positive correlation (r = 0.6; p < 0.05) of moderate to high strength at the 3thday. Between leukotrienes and edema, the coefficient of correlation r = – 0.1 (p > 0.05) at admittance, r = – 0.05 (p >0.05) on the 3th day (nonexistence of linear correlation, the sign minus presents their tendency for the opposite movement in their values) and r = 0.2 (p > 0.05) on the 5thday are found (positive linear nonsignificant correlation of slight strength). Conclusion: Significant urinary leukotrienes excretion (a brain capacity for significant leukotrienes synthesis) and significant edema progression versus constant haematoma are found. The edema size followed the hematoma size of moderate extent. The edema showed an inverse dependence of the leukotrienes (atendency for opposite movement of their values), the high leukotrienes values at admittance bring to greater edema volume on the third/the fifth day, respectively. Elevated cysteinyl leukotrienes synthesis and the elevated edema could point to cause-effective relationship between them establishing the leukotrienes as an edema promotive-factor in intracerebral haemorrhage.

Background and objectives: The main aim of this study is to prove the association of seizure types with the MRI findings of the brain (etiological factor). Also, to prove which type of lesion is mostly represented in which age-group, and with which type of seizure. Methods: A total of 100 patients with symptomatic epilepsy, aged from 16 to 80 years, were hospitalized at the Neurology Clinic or in its Outpatient Unit, in the period from 2009 to 2012. They were neurologically examined and the seizure type registered. All patients underwent MRI of the brain. Results: (56%) men and 44 (44%) women were examined. The represented type of epileptic seizures were 41.0% with SPC + CPC, followed by 15.0% GTCC, and 14.0% CPC with secondary generalization, 12,0% CPC, 10,0% SPC and 8.0% with absences. The epileptic lesions of 25.0% were hippocampal sclerosis, 20.0% post-traumatic injuries, 19.0%, post-vascular and brain tumours, and the lowest percentage of 17.0% with post-infectious lesions. Conclusions: Post-traumatic lesions occur more frequently in the elderly population with the accent on the male, while hippocampal sclerosis occurs in the adolescent and younger population with higher frequency in the female. [ABSTRACT FROM AUTHOR]

One of the essential characteristics of intracerebral haemorrhages (ICH) is the occurrence of brain oedema (BE). Matrix metalloproteinase-9 (MMP-9) belongs to the family of proteolytic enzymes connected with zinc, which in brain bleeding or a stroke can induce matrix proteolyse into the neurovascular unit, and increase the BE. The aim of the study was to determine the MMP-9 values in serum, and to assess the degree of correlation with neurological deficit in patients with acute, primary and supratentorial ICH. Materials: The study was prospective and included 62 patients with ICH. The neurological deficit of the patients was evaluated by the National Institute Health Stroke Scale (NIHSS). Serum MMP-9 level was determined by enzyme-linked immune sorbent assay (ELISA). Patients were evaluated in three phases: 1st, 3rd and 7th day following the ICH. Results: The mean age of the patients was 64.5 ± 9.4. Within the follow-up period, there was a significant rise of the NIHSS score in the first three days: 11.48 ± 3.7; 13.21 ± 3.78, and a significant rise of serum MMP-9, with greatest values in the third day: 134.7 ± 26.1 ng/ml (p = 0.000). There was a positive, significant correlation (r = 0.886, p = 0.000) between the serum MMP-9 concentration and the NIHSS score. Conclusion: Our study showed that in the first three days of ICH, serum MMP-9 values were rising as well as the neurological deficit and the BE. Determination and evaluation of the MMP-9 in serum is an easy, non-invasive, routine laboratory procedure for the detection and follow-up of BE, and also determines further therapeutic strategy as well as prognosis in these patients. [ABSTRACT FROM AUTHOR]