MORPHOFUNCTIONAL STATUS OF INSTRUCTORS OF HIGHER EDUCATIONAL INSTITUTIONS DURING THEIR PEDAGOGICAL ACTIVITIES.

OBJECTIVE: The aim: To research the morphofunctional status of instructors of higher educational institutions of di"erent age groups in the process of their pedagogical activities. PATIENTS AND METHODS: Materials and methods: The research was conducted in the period from 2019 to 2021. The research involved 126 instructor offcers (men) of different age groups: under 30 years of age - 21 people, 31-35 years of age - 27 people, 36-40 years of age - 32 people, 41-45 years of age - 27 people, over 45 years of age - 19 people. Morphofunctional status of the instructor offcers was assessed by the indicators of their height, body weight, lung vital capacity, wrist dynamometry, heart rate, blood pressure and relevant indices. RESULTS: Results: It was found that during the study (2019-2020) the Kettle index, vital index, strength index, Robinson index and duration of recovery processes deteriorated among instructor offcers of all age groups. However, in instructor offcers of 36-40, 41-45 and over 45 years of age most of indices deteriorated reliably (P < 0.05). The values of the studied indices are below average or low in most instructors of all age groups, most instructors are overweight. CONCLUSION: Conclusions: It was found that the level of morphofunctional status of the instructional sta" is insuffcient to perform the tasks of their pedagogical activities. Rationally organized health-improving physical training sessions, taking into account the age group, morphofunctional status of instructors and the time of training sessions during the working day can be an effective way to solve this problem.

Tricobezoar de estómago / Gastric Trichobezoar Rapunzel Syndrome

Trichobezoars are an unusual pathology that appears generally in young adolescents associated with psychiatric disorders. The clinical presentation is very varied. The diagnosis is suspected by the clinical records of teen agers with trichophagia and trichotillomania and the digestive disorders are confirmed by the results of the endoscopy, the same as with images toward the therapeutic management. Undowbtly the treatment is surgical, and continuation with the psychiatric treatment is essential to avoid a recidival of the disease. Bezoar is a concretion formed in the alimentary tract, and according to the substances forming the ball, we find trichobezoar (foodball). The Rapunzel syndrome is an unusual complication of individual bezoar. When the trichobezoar located in the stomach extends through the pylorus into the small intestine and the right colon, is known as Rapunzel syndrome, that is an extremely rare gastric condition in humans. It is a rare form of trichobezoar, occurring in psychiatric patients with the trichobezoar (hairball) located in the stomach. The syndrome is named after the long haired girl Rapunzel in the fairy tale of the brothers Grimm. Most bezoars in teen agers are trichobezoars from swallowed hair. A 28-year-old patient is presented, with abdominal pain and vomiting, on the general physical examination the patient revealed a severe weight loss. Later on, through a gastrostomy, appeared the trichobezoar, being removed with good postsurgical resullts

The influence of experimentally induced endometritis on the PPAR expression profile in the bovine endometrium.

Peroxisome proliferator-activated receptors (PPARs) are ligand-activated transcription factors of the nuclear receptor superfamily. The PPARs activity can be modified e.g. by arachidonic acid metabolites. Escherichia coli (E. coli) is one of the main infectious agent of endometritis in dairy cows. We hypothesized that PPAR expression profile change in the bovine endometrium under the influence of LPS or E. coli. In experiment 1, endometrial explants were obtained post mortem from heifers and incubated without (control) or with LPS for 12, 24, 48, 72 and 96 h. In experiment 2, heifers were intrauterine infused with 0.9% NaCl (control) or with E. coli suspension in 0.9% NaCl. Endometrial biopsies were performed before (0 h) and 12, 24, 48, 72, 96 h after the infusions. In experiment 1, the increase in protein expression was observed for PPARα 48 h, for PPARß/δ 24, 72 and 96 h, whereas for PPARγ 12, 24 and 96 h after LPS treatment relative to the control groups. In experiment 2, the up-regulation in protein expression was observed for PPARα 48 and 72 h, for PPARß/δ 72 and 96 h, for PPARγ1 and PPARγ2 12 and 96 h after the intrauterine infusion with E. coli suspension compared to the control group. Changes in mRNA and protein PPAR expression profile in endometrial explants under the exposure of LPS indicate participation of these nuclear receptors in signal transduction during stimulation with LPS. The patterns of mRNA and protein PPAR expression in endometrial bioptates suggest that during experimentally induced endometritis in vivo, PPARs role may be connected both with enhancement of inflammation as well restoring physiological conditions in uterus.

Cordyceps sinensis: Genotoxic Potential in Human Peripheral Blood Cells and Antigenotoxic Properties Against Hydrogen Peroxide by Comet Assay.

Context • Cordyceps sinensis (C sinensis) is a well-known, traditional, Chinese medicinal mushroom, valued for its beneficial properties for human health. C sinensis has been reported to have immunomodulatory, anticancer, antiaging, antioxidant and anti-inflammatory activity. Despite potential medicinal benefits, no previously published reports are available about the genotoxicity or antigenotoxicity of C sinensis, as detected by comet assay. Objective • The objective of the study was to evaluate both the genotoxic and antigenotoxic potential of an extract of C sinensis (CS extract) in human peripheral blood cells. Design • The research team designed a pilot study. Setting •The study was conducted at the Center for Biological Research, University of Belgrade, in Belgrade, Serbia. Participants • Participants were 6 healthy individuals (2 males and 4 females), between the ages of 20 and 45 y, recruited on a voluntary basis, who provided heparinized, peripheral blood samples. Intervention • Four concentrations of the CS extract-125 µg/mL, 250 µg/mL, 500 µg/mL, and 1000 µg/mL-were used in the treatment of tested blood cells from the blood samples. Three independent procedures were performed: (1) a genotoxicity assessment, (2) an antigenotoxicity assessment for pretreatment of human cells with the CS extract prior to their exposure to hydrogen peroxide (H2O2) (ie, an evaluation of the benefits of the CS extract as a preventive agent); and (3) posttreatment of human cells with the CS extract after their exposure to H2O2 (ie, an evaluation of the benefits of the CS extract as an interventional agent). Outcome Measures • Cells were graded by eye inspection into 5 classes, depending on the extent of DNA damage, representing: (1) class A-undamaged cells with no tail (<5% damaged DNA); (2) class B-low-level damage (5%-20%); (3) class C-medium-level damage (20%-40%); (4) class D-high-level damage (40%-95%), and (5) class E-total destruction (>95%).Results • The CS extract proved to be nongenotoxic because no induced DNA damage was detected at all tested concentrations. For the antigenotoxicity assessment of the pretreatment with the CS extract, only the 1000-µg/mL concentration showed a significant decrease in the number of cells exhibiting H2O2-induced DNA damage. For the posttreatment, the CS extract exhibited antigenotoxic potential by attenuating H2O2-induced DNA damage at all concentrations tested. The evaluation of repair kinetics showed a decrease in DNA-damaged cells 15 min after the application of the CS extract, reaching a maximum potency after 45 min. Conclusions • The results indicated that C sinensis can be used as a postapplicative agent that counteracts the effect of oxidative stress. The resulting reduction in DNA damage might be related to its scavenging properties and stimulation of DNA repair.

The use of the Alvarado score in the management of right lower quadrant abdominal pain in the adult.

AIM OF THE STUDY: The Alvarado score is a validated test in clinical adult surgery practice which can be helpful in the diagnosis of acute appendicitis. This study aimed to assess the reliability and the reproducibility of this score for patients presenting in the emergency room with acute right lower quadrant abdominal pain. MATERIAL AND METHODS: A prospective monocenter study included all adults who presented in the emergency room with right lower quadrant abdominal pain. The score was calculated by assessing six symptoms and two laboratory values weighted by coefficients. The diagnosis of acute appendicitis was confirmed by the histological examination of the resected appendix. Three groups of patients with high, low, and intermediate scores were defined as described in the literature. RESULTS: Of the 233 patients studied, 174 underwent surgery: three had a normal appendix on histological exam. The statistical analysis of the results showed that a score lower than 4 was significantly associated with the absence of acute appendicitis while a score higher than 6 was significantly associated with acute appendicitis which required surgical care. But a score between 4 and 6 was not discriminant. CONCLUSION: The Alvarado score is a reliable, cheap and reproducible tool for the diagnosis of acute appendicitis in the emergency room; if the score is higher than 6 or lower than 4, there is no need for complementary exams. Patients with a score between 4 and 6, require serial reassessment of physical findings and score over 24 hours and/or complementary diagnostic exam such as ultrasound or CT scan.

[Hepatoid adenocarcinoma of the stomach. A case report]. / Adénocarcinome hépatoïde de l'estomac. A propos d'un cas.

Hepatoid adenocarcinoma of the stomach is a very rare tumor with a poor prognosis. Lymph nodes involvement and/or liver metastases are frequently observed. Diagnosis should be pointed out if elevated serum level of alpha-fetoprotein (AFP) is detected with gastric tumor. Histologically, the tumor is an adenocarcinoma of intestinal type including foci of hepatoïd differenciation. Immunohistochemistry is positive for alpha-1-antitrypsin and alpha-1-antichymotripsin, and for AFP. We report a case of a 66 year-old man presenting an advanced stage of hepatoid adenocarcinoma of the stomach, treated by gastrectomy followed by chemotherapy. The patient died four months after the surgery because of progressing liver metastatic disease.

[Primary hydatid cyst of the thyroid, an unusual localisation of hydatidosis]. / Kyste hydatique primitif de la thyroïde, une localisation inhabituelle de l'hydatidose.

INTRODUCTION: Echinococcus granulosus, responsible for hydatidosis, most often lodges in the liver and lungs, but is found in other organs of the body in 10% of cases. CASE: A painless, left cervical tumefaction suddenly developed in a 28-year-old Portuguese man. After thyroid lobectomy with isthmusectomy, the pathology findings led to the diagnosis of hydatidosis. DISCUSSION: The thyroid is a rare location for a hydatid cyst. Diagnosis can be difficult and fine-needle aspiration cytology is not usually helpful. Treatment requires surgical excision, and administration of benzimidazole derivatives to prevent recurrence.

Tumores neuro-endocrinos del intestino / Neuroendocrine tumors of the small intestine

Los tumores carcinoides son neoplasias poco frecuentes en el tubo digetivo y que se desarrollan a partir de las células que forman el sistema APUD o neuroendocrinas. El objetivo es analizar la nueva nomenclatura, la incidencia en el aparato digetivo, la presentación clínica, diagnóstico y tratamiento quirúrgico

Tumores neuro-endocrinos del intestino / Neuroendocrine tumors of the small intestine

Los tumores carcinoides son neoplasias poco frecuentes en el tubo digetivo y que se desarrollan a partir de las células que forman el sistema APUD o neuroendocrinas. El objetivo es analizar la nueva nomenclatura, la incidencia en el aparato digetivo, la presentación clínica, diagnóstico y tratamiento quirúrgico

Endoscopic sphincterotomy prior to laparoscopic cholecystectomy for the treatment of cholelithiasis.

BACKGROUND: We performed this study to assess the outcome of endoscopic retrograde cholangiography (ERC) before laparoscopic cholecystectomy (LC) for symptomatic gallbladder and suspected duct stones. METHODS: We performed prospective study of 310 patients with symptomatic gallstones and suspected choledocholithiasis managed by preoperative ERC with endoscopic extraction (ESE) and LC. The presence of one or more of the following criteria at hospital admission led to preoperative ERC because of suspected choledocholithiasis: jaundice for more than 72 h, ultrasonography measurement of the common bile duct > 8 mm, cholestasis, and acute biliary pancreatitis. RESULTS: ERC for suspected choledocholithiasis was performed in 310 patients. The rate of successful cannulation for ERC was 96.8%. Duct stones were found in 86%. Twelve patients had impacted duct stones cleared at open common duct exploration. The failure rate of ERC was 4.5%, and the rate of unnecessary ERC was 13.5%. LC was performed in 298 of 310 patients. Morbidity rates were 2.2% and 1.5% after ESE and LC, respectively. CONCLUSION: A total of 95.5% of patients with symptomatic gallbladder and ductal stones could be successfully managed by ERC prior to LC with a low morbidity rate.

[Jejunostomy for enteral feeding in surgery. Technical contribution and experience]. / Yeyunostomía de alimentación en cirugía. Contribución técnica y experiencia.

UNLABELLED: The necessity to maintain the nutritional integrity in patients subjected to major surgery of the superior digestive tract has been broadly accepted. The enteral nutrition for yeyunostomy is accepted as more physiologic, sure and effective than the parenteral one. MATERIALS AND METHOD: 171 yeyunostomies were indicated in: 151 patients with malignant neoplasm of the superior digestive tract, 15 with infected pancreatic necrosis, 3 bile-duodenum-pancreatic traumatisms and in 1 stenosis for gastroesophagic reflux. Depending on the pathological type, a yeyunostomy using the Witzell technique was carried out with either local or general anesthesia at a 15 to 20 cm. of the Treitz angle. To facilitate the fixation of the catheter and to avoid the stenosis of the jejunum we have incorporated, as an original technical detail, the proximal serous section with cold scalpel in about 4 cm, that is to say in the sector to be tunneled. RESULTS: There was not mortality in relation to the yeyunostomy. Among the minor complications we emphasize the abdominal distension, colic pain and diarrhea, situations that were reverted, controlling the debit and the feeding characteristics. This approach could be maintained for period of 2 months and in some cases at home. CONCLUSIONS: We emphasize the great importance of the enteral feeding for yeyunostomy, for its of easy handling, security and low cost that, together with the suggested technical detail, has allowed us to obtain a deeding road almost without inherent complications.

Yeyunostomía de alimentación en cirugía. Contribución técnica y experiencia. / [Jejunostomy for enteral feeding in surgery. Technical contribution and experience]

The necessity to maintain the nutritional integrity in patients subjected to major surgery of the superior digestive tract has been broadly accepted. The enteral nutrition for yeyunostomy is accepted as more physiologic, sure and effective than the parenteral one. MATERIALS AND METHOD: 171 yeyunostomies were indicated in: 151 patients with malignant neoplasm of the superior digestive tract, 15 with infected pancreatic necrosis, 3 bile-duodenum-pancreatic traumatisms and in 1 stenosis for gastroesophagic reflux. Depending on the pathological type, a yeyunostomy using the Witzell technique was carried out with either local or general anesthesia at a 15 to 20 cm. of the Treitz angle. To facilitate the fixation of the catheter and to avoid the stenosis of the jejunum we have incorporated, as an original technical detail, the proximal serous section with cold scalpel in about 4 cm, that is to say in the sector to be tunneled. RESULTS: There was not mortality in relation to the yeyunostomy. Among the minor complications we emphasize the abdominal distension, colic pain and diarrhea, situations that were reverted, controlling the debit and the feeding characteristics. This approach could be maintained for period of 2 months and in some cases at home. CONCLUSIONS: We emphasize the great importance of the enteral feeding for yeyunostomy, for its of easy handling, security and low cost that, together with the suggested technical detail, has allowed us to obtain a deeding road almost without inherent complications.

[Zenker diverticulum: therapeutic approach]. / Diverticulo de Zenker: conducta terapéutica.

BACKGROUND: Pharyngoesophageal or Zenker diverticula are a few frequent pathology that could represent between 1 and 3% of the patients with dysphagia and their physiopathology even at present is scarcity clear. OBJECTIVE: Therapeutic procedures results about this pathology were analyzed. SETTING: Caraffa and Sucre Clinic. DESIGN: Retrospective observational study. METHOD: It analyzed 13 patients operated by Zenker diverticula 9 of which were male and 4 were female sex with an average age of 55.6 years. Dysphagia occurred in 100% of the cases. Besides clinical finding the diagnosis was made evident by esophageal X-ray with contrast medium and endoscopy. Diverticulectomy by one stage through a left cervicotomy was the surgical procedure of choice. RESULTS: There was no surgical mortality. Related with morbility 2 patients presented fistulas managed medically and in other 2 patients abscesses of surgical wound occurred. The follow-up was carried on 6 months, 4 and 7 years respectively without relapses and with a good posterior evolution. CONCLUSIONS: Based on our short experience and the results attained we think the treatment of Zenker or pharyngoesophageal diverticulum by diverticulectomy through a left cervicotomy is safe and effective procedure to control this pathology.

[Amplifying right colectomy: place in the treatment of obstructive proximal left colon cancer]. / Colectomía derecha ampliada. Lugar en el tratamiento del cáncer de colon izquierdo proximal obstructivo.

The results obtained about nineteen (19) patients operated by left colon cancer with variable grade obstruction have been analysed. Seventeen (17) patients operated due to obstructive left colon cancer situated: five (5) in distal transverse colon, other five (5) at splenic flexure and seven (7) in proximal descending colon but three of them with right synchronic neoplasias. The remaining two (2) that showed a cancer located at splenic flexure and the other one in proximal descending colon were reoperated three weeks later than a transverse colostomy had been performed owing to an obstructive condition. One patient had to be reoperated because a generalised peritonitis from a fistula with partial disruption on end to end ileo-colic anastomosis. Exteriorization of both ends was carried out with favourable evolution and subsequent reanastomosis. An exteriorized patient by splenic flexure cancer also had to be drained ten days later for a retroperitoneal abscess through a percutaneous puncture and a lesion grade 1 in lower pole of spleen was resolved with electrofulguration. No patient has showed invalidating diarrhea and all themselves have been stabilised with two or three stools daily about two month after surgery. Amplifying right colectomy is a safe procedure with low surgical morbimortality and take privileged place in the treatment of the patients undergoing synchronical neoplasias and/or carcinomas associated with polyps, specially in all those cases when a variable grade of obstruction have occurred.

Diverticulo de Zenker: conducta terapéutica. / [Zenker diverticulum: therapeutic approach]

BACKGROUND: Pharyngoesophageal or Zenker diverticula are a few frequent pathology that could represent between 1 and 3

of the patients with dysphagia and their physiopathology even at present is scarcity clear. OBJECTIVE: Therapeutic procedures results about this pathology were analyzed. SETTING: Caraffa and Sucre Clinic. DESIGN: Retrospective observational study. METHOD: It analyzed 13 patients operated by Zenker diverticula 9 of which were male and 4 were female sex with an average age of 55.6 years. Dysphagia occurred in 100

of the cases. Besides clinical finding the diagnosis was made evident by esophageal X-ray with contrast medium and endoscopy. Diverticulectomy by one stage through a left cervicotomy was the surgical procedure of choice. RESULTS: There was no surgical mortality. Related with morbility 2 patients presented fistulas managed medically and in other 2 patients abscesses of surgical wound occurred. The follow-up was carried on 6 months, 4 and 7 years respectively without relapses and with a good posterior evolution. CONCLUSIONS: Based on our short experience and the results attained we think the treatment of Zenker or pharyngoesophageal diverticulum by diverticulectomy through a left cervicotomy is safe and effective procedure to control this pathology.

[Congenital pancreatic cyst]. / Quistes malformativos del páncreas.

A case of a congenital cyst of the pancreas occurring in an adult woman and successfully treated by resection, is reported. The presence of cylindrical epithelium in the cystic cavity, the high amylase contents of the cyst and the ERCP examination made the diagnosis.

[Experimental peritonitis: sequential bacteriologic study of the lymph and blood]. / Peritonitis experimental: estudio bacteriológico secuencial en linfa y sangre.

In 7 dogs with fecal peritonitis, induced by incision of the cecum, and in the same number of control animals the thoracic duct was cannulized at the neck level together with a femoral vein for the purpose of sequential study of the routes of bacterial dissemination. The findings show: a) rapid appearance of germs in lymph and then in blood in animals with peritonitis, b) a progressive increase in the number of species isolated in each sample, and c) that the lymphatic flow and drainage of bacterias lasted throughout the 12 hours that the experiment lasted. The microbes isolated in lymph and blood were related to the flora of the intestinal segment where the infection originated, with development of a large number of anaerobic species.