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ABSTRACT: Carotid-cavernous fistulas (CCF) are vascular malformations characterized by an aberrant shunt between one or more sources of arterial inflow and the cavernous sinus (CS). They are subdivided into direct and indirect fistulas. This last one, called dural CCF involve dural fistulous connections between branches of the internal carotid artery or the external carotid artery. When conventional routes are not eligible, surgical exposure of the vein is the only access to the fistula. We present the case of a patient successfully treated for right sided dural CCF, by a hybrid approach. Furthermore, through a literature review, we analyze the possible risks and benefits associated with this approach.

This analysis of 238U, 226Ra and 210Pb transfer factors from the soil to the leaves of different native broadleaf trees at sites previously modified by uranium presence and at the site of background radioactivity levels, was conducted using data from a few available studies from the literature. The broadleaf tree species Quercus ilex, Quercus suber, Eucalyptus camaldulensis, Quercus pyrenaica, Quercus ilex rotundifolia, Populus sp. and Eucalyptus botryoides Sm. at the affected sites and Tilia spp. and Aesculus hippocastanum L. at the back ground site were in cluded in the study regardless of the deciduous or evergreen origins of the leaves. In the papers cited here, data about basic soil parameters: pH, total Ca [gkg-1], sand [%], and silt + clay [%] fractions were also available. All the collected data of activity concentration [Bqkg-1] dry weight in the soil (n=14) which was in the range: 22-6606 for 238U, 38-7700 for 226Ra, and 37-7500 for 210Pb, and the tree leaves in the range: 2.7-137.6 for 238U (n=10), 2.6-134.2 for 226Ra (n=14), and 27-77.2 for 210Pb (n=14), indicated that it was normally distributed after log-transformation. The present study was conducted under the hypothesis that biological differences between the examined broadleaf tree species have a lesser influence on the transfer factors of the investigated radionuclides from soil to tree leaves compared to the impact of the soil parameters and radionuclides activity concentrations in the soil. Consequently, it was examined whether 238U, 226Ra, and 210Pb soil-to-leaves transfer factor values for average broadleaf species could be predicted statistically in the first approximation based on their activity concentration in the soil and at least one basic soil parameter using multiple linear regression.

Dual antiplatelet therapy (clopidogrel and acetylsalicylic acid) is a standard for the embolization of planned intracranial aneurysms with CNS stent due to the possibility of stent thrombus formation. All anti-aggregation drugs, including those listed, have bleeding as a side effect. Three patients with aneurysm had an elevated response to antiplatelet therapy with clopidogrel, which was confirmed by a multiplate test on the "VerifyNow" system. After reducing the dose of clopidogrel or after interrupting it, with the introduction of low molecular weight heparin for the duration of five days, aneurysms were successfully resolved by intracranial implantation of the stent. Perioperative angiograms and postoperative CT angiograms have verified hematomas at the place of punction of the femoral artery. Bleeding was resolved by the femoral artery suture by a vascular surgeon. All patients were discharged home without further complications and with dual antiplatelet therapy. By measuring the platelet function in vitro, the degree of inhibition of platelet activity achieved by the action of the drug can be assessed. A specific test can identify those patients who are highly responsive to the drug with increased platelet reactivity and the possibility of increased risk of bleeding. Our suggestion is to reduce the dosage of clopidogrel or to leave it out for 24 hours with preventive doses of low molecular weight heparin or to change the strategy of treatment of intracranial aneurysm, i.e. avoiding implantation of CNS stent.

(1) Background: Laryngeal surgery due to carcinoma leads to significant tissue disruption, cellular injury, and inflammation. This leads to increased levels of reactive oxygen species (ROS), causing oxidative damage that can influence quality of life (QOL) and recovery and complicate the postoperative course. The aim of this study was to compare how postoperative quality of life and surgical complication occurrence interacted with the biomarker levels of oxidative stress (malondialdehyde, MDA; superoxide dismutase, SOD; glutathione peroxidase 1, GPX1; and catalase, CAT) and inflammation (interleukin 1, IL-1; interleukin 6, IL-6; C-reactive protein, CRP) in patients treated with conservative and radical laryngeal surgery. (2) Methods: The study included 56 patients who underwent surgical treatment for laryngeal cancer. Blood samples were collected to analyze oxidative stress and inflammation parameters before surgery and on the first and seventh days postoperatively. Serum concentrations of MDA, SOD, GPX, CAT, IL-1, IL-6, and CRP were measured using coated enzyme-linked immunosorbent assay (ELISA) kits. EORTC QLQ-H&H43 questionnaire was used to measure the QOL of patients. (3) Results and Conclusions: T stage, pain intensity, and the extent of the surgical procedure were established as significant predictive factors for QOL in multivariate analysis. There was a significant positive correlation between surgical complication occurrence and preoperative values of GPX and MDA, but significant predictors of surgical complication occurrence on the 7th postoperative day were SOD and MDA values (p < 0.05). [ABSTRACT FROM AUTHOR]

Introduction: Modern health care implies the continuous development of human resources and the application of pharmacoeconomic analyzes during the introduction of new methods of treatment in medicine. Aim: The aim of the paper is to compare and analyze: 1) the number of: operated patients, provided anesthesia services, hospital days in ICU and surgery interventions; 2) distribution of anesthetic services: general anesthesia, local anesthesia and anesthesia procedures and 3) the values of direct costs of anesthesiology and reanimatology, in 2006 and 2015 in order to propose measures of rationalization and savings of funds. Methods: This paper is part of an academic IV phase study, conducted at the Clinical Center of Serbia (CCS) with the permission of the Ethical Committee of the Medical Faculty of the University of Belgrade (470 / IV7) and harmonized with the European Union Directive. Direct costs of anesthesiological services of the Center for Anesthesiology and Reanimatology, by department of anesthesia in the maternal surgical clinics of the Clinical Center of Serbia in Belgrade, during 2006 and 2015, are included and analyzed. The subjects were all anesthetized patients, both sexes, children and adults. The numeric data is processed by Microsoft Office Excel 2003 and SPSS for Windows. For the analysis of the statistical significance of the number of patients, anesthesiologic services, hospital days in Intensive Care Units and surgical procedures was used Wilcox test. In order to analyze the percentage distribution of funds in the category of direct costs (personal costs, drugs, materials, analyzes and medical equipment), in 2015 compared to 2006 was used the hi-square matching test. Results: There is a statistically significant difference in the frequency of service categories within the scope of services in 2015 compared to 2006 (p

This paper presents a study of the profile distribution of available micronutrients Fe, Mn, Cu and Zn and radionuclide 137Cs in cultivated soil at the experimental field "Radmilovac" (property of Agricultural Faculty, Belgrade University) in the vicinity of Vinĉa Institute of Nuclear Sciences. The soil belongs to the anthrosol class of anthropogenic soils according to FAO (2006). At first, the deep plowing was performed while preparing soil for planting peach trees followed by cultivation of soil for 12 years. All agricultural treatments at the experimental field ceased for three years. After that period, soil sampling was carried out. Contents of DTPA-extracted Fe, Mn, Cu and Zn were in the range of (mg kg-1): 5.8-41.6; 9.2-34.2; 1-7.6 and 0.2-1.3, respectively. Detected activity concentration (Bq kg-1) for 137Cs ranged from 1.8 to 35. It was noticed that distribution patterns of 137Cs radionuclide and available Cu and Zn along soil depth were very similar and they were analyzed by simple linear regression; mutual affinity for the soil organic matter might affect their distribution in soil. Contents of available Fe and Mn exhibited different, more constant distribution within a soil horizon.

The study of spatial distribution of activity concentration of 238U, 226Ra, 210Pb, 232Th, 40K, and 137Cs radionuclides in the surface soil samples (n = 42) collected in the vicinity of four coal-fired power plants in Serbia is presented. Radioactivity measurements in soils performed by gamma-ray spectrometry showed values [Bqkg-1] in the range: 15-117 for 238U, 21-115 for 226Ra, 33-65 for 210Pb, 20-69 for 232Th, 324-736 for 40K, and 2-59 for 137Cs. Surface soil radio-activity that could have resulted from deposition of radionuclides from airborne discharges or resuspension of ash from disposal sites showed no enhanced levels. It was found that variation of soil textural properties, pH values, and carbonate content influenced activity levels of natural radionuclides while radiocesium activities were associated with soil organic matter content. Modification of some soil properties was observed in the immediate vicinity (

Introduction. Dural carotid cavernous fistula is acquired, relatively rare, condition comprising of numerous smallcaliber meningeal arterial branches, draining directly into cavernous sinus. Endovascular therapy is the treatment of choice, preferably by a transvenous approach. In the case of inaccessible inferior petrosal sinus, other alternative routes are considered. We presented a case of dural carotid cavernous fistula completely occluded with Guglielmi detachable coils, using a transvenous approach through facial and superior ophthalmic vein. Case report. A 62-year-old man was referred with a gradual worsening proptosis, red eye, and decreased visual acuity, on the right side. Digital subtraction angiography revealed the presence of a right dural carotid cavernous fistula, predominantly supplied from dural branches of the right internal carotid artery siphon, with minimal contribution from the right middle meningeal artery and contralateral dural branches of the left internal carotid artery siphon. The fistula was drainaged through the dilated superior ophthalmic vein, and via the facial to the internal jugular vein. There was neither pacification of pterygoid and petrous sinuses, nor cortical venous reflux. Endovascular treatment was performed by a transvenous approach. A guiding catheter was placed in the right facial vein. A microcatheter was advanced through the dilated angular and superior ophthalmic vein, and its tip positioned into the right cavernous sinus. Coils were deployed, until a complete angiographic occlusion of the fistula had been achieved. The patient experienced rapid improvement in the symptoms, with complete normalization of his condition one month after the treatment. Conclusion. Coil embolization of dural carotid cavernous fistula by transvenous catheterization, through the facial and superior ophthalmic vein, can be considered as safe and effective treatment option in the presence of marked anterior drainage.

Distribution of natural gamma-emitting radionuclides 238U and 40K were determined in the soil profiles from the peach-trees field on experimental farm Radmilovac, southeast Belgrade. Internal soil morphology has been changed in 1992. when soil rigosol type with deep Ap-horizon (0-80 cm) has been formed by special treatment of parent soil, chernozem type. Gamma-spectrometry method is applied in measurement of radionuclide activities in soil samples by using hyperpure coaxial gamma-ray detector, Canberra type. Investigation results has been shown that the natural activity contents obtained in the experiment are within the range of normal background activity according to UNSCEAR (2000) and that radionuclide activity decreased in the plant root zone. .

The effect of the density of environmental samples on the counting efficiency of Ge detectors used in gamma-spectrometry was studied. The dependence εff(ρ) was determined for two HPGe detectors (relative efficiencies 18% and 20%) using five radioactive standard reference materials (silicone resins, epoxy resin, milk powder, soil) with different matrix densities (0.45-1.22 g/cm3) in Marinelli beakers (V = 500 cm3). The dependence of efficiency vs. density was found to be linear and the regression parameters for energies in the range of 60-2000 keV were determined, too. The effect of variation in density on the counting efficiency of Ge detectors is dominant in the range of lower energies (60-600 keV) and de creases with energies in the higher energy range.