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Intracranial surgical interventions and spontaneous intracerebral hemorrhages challange neuroanesthesia and neurocritical care. First, the brain is the most sensitive organ to tissue hypoxia in the case of severe intraoperative bleedings and, second, a growing hemorrhage within the closed intracranial space may result in a ciritcal elevation of intracranial pressure resulting in an imminent life danger. The authors summerize the potential treatment strategies during neuroanesthesia and neurocritical care. Perioperative organ-specific optimalization of hemoglobin concentration, thrombocyte count and fibrinogen concentrations are key elements in elective neurosurgical interventions. Prior antithrombotic and anticoagulant treatment may indicate targeted pharmacological optimalization and treatment that should be based on laboratory diagnosis. In intracerebral hemorrhages, treatment strategy should be based on the etiology and laboratory diagnostics and targeted pharmacological treatment is preferable. Orv Hetil. 2020; 161(37) 1574-1578.Worldwide, the prevalence of anemia is high, and iron deficiency anemia is the fifth most common disorder according to the study called "Global burden of disease". It can be attributed to a number of factors, complex pathomechanisms, and etiology is highly variable in terms of age, gender, and geographical distribution. The prevalence of anemia increases with age. Demographic change and the aging of the population are now faster than in previous decades, posing major challenges to societies and health systems. The mean prevalence of anemia in the elderly is 17%, but significantly higher among nursing-home (47%) and hospitalized elderly (40%). The cause is usually multifactorial and often, due to comorbidities, several mechanisms are involved at the same time. The prevalence of preoperative anemia was higher (35%) than the prevalence of anemia in the general population, and evidence showed an unfavorable effect on postoperative morbidity and mortality. Timely identification and correction is a multidisciplinary task and a shared responsibility for both Patient Blood Management program and improving the patients' life expectancy. Orv Hetil. 2020; 161(37) 1569-1573.The perioperative Patient Blood Management (in Hungary National Blood Donation and Blood Saving Program) is an individualized clinical practice based on a multidisciplinary consensus with a comprehensive and complex approach. It supports the rational and judicious utilization of blood products and abolishes irrational transfusion policy. Its practical implementation is based upon three pillars 1. anemia management without transfusion, if possible; restrictive transfusion strategy; 2. minimization of blood loss; 3. enhancement of anemia tolerance. Early detection, clarification of etiology and appropriate treatment are the most important tools for the management of preoperative anemia before surgeries with a high risk of bleeding. Minimization of blood loss can be achieved by identifying patients with congenital or acquired bleeding disorders, preparing them appropriately for surgery, discontinuing anticoagulants and antiplatelet drugs for a sufficient time in the preoperative phase of surgery and reversing thn interest. Orv Hetil. 2020; 161(37) 1554-1568.Human red blood cell concentrate and platelet suspension are unstable preparations, therefore, they are not part of the international pharmaceutical market for biological and economic reasons. Consequently, they cannot be replaced by external sources. Human allogeneic erythrocyte and platelet preparations should therefore be considered as part of the common national wealth. The amount of transfused red blood cell concentrate has been declining in countries with advanced health systems in recent years. The changes were initially driven by the spread of the concept and practice of liberal and restrictive transfusion triggers. A complex, thoughtful system of perioperative blood utilization, the Patient Blood Management has later emerged, and a paradigm shift in the delivery of life-threatening perioperative bleeding has developed. At the same time, clinical practitioners are facing a new challenge of reducing willingness to donate blood worldwide. The rationalization of the use of human red blood cell concentrate and platelet suspension is essential in Hungary. As a health care measure, the currently rigidly earmarked financial resources available for allogeneic preparations and stable factor concentrates for the treatment of life-threatening haemorrhages need to be changed to be interoperable. The perioperative blood use could additionally be reduced by the widespread dissemination of the Patient Blood Management requiring complex coordinated educational interdisciplinary and logistical work. Orv Hetil. mTOR inhibitor 2020; 161(37) 1545-1553.The aim of this study was to investigate the variability of the slope of the pelvis in different dog breeds and the correlation between pelvic slope and femoral subluxation. The sacrum-pelvis angle (SPA), the angulation between the sacrum and the axis of the ilium was created to represent the differences in the slope of the pelvis on lateral pelvic radiographs. The Norberg angle (NA) was used to quantify the femoral subluxation on hip-extended radiographs. Archived standard ventrodorsal hip radiographs and lateral lumbosacral radiographs of the same dogs were retrieved and a single observer measured the SPA and the NA in each case. A total of 180 dogs from six different breeds were sampled. The SPA varied between 40° and 71.5° and the NA between 71.2° and 113.9°. The findings indicated that there are significant individual and interbreed variations in the slope of the pelvis. However, no significant relationship between the slope of the pelvis and femoral subluxation could be identified.Newcastle disease virus (NDV) remains a constant threat to the poultry industry even with intensive vaccination programmes. In the present study, 40 samples were collected from farms showing high mortalities in some Egyptian governorates between 2016 and 2018. Tracheal samples were collected for virus isolation and confirmed by real-time RT-PCR. Molecular characterisation was performed by sequencing, followed by phylogenetic analysis of the novel sequences. Histopathological and immunohistochemical examinations were performed on different organs from NDV-infected broilers. The phylogenetic analysis revealed that the NDV isolates from different areas of Egypt were genetically closely related and all belonged to genotype VII. The histopathological hallmarks included haemorrhagic tracheitis, interstitial pneumonia with syncytia formation, haemorrhagic proventriculitis, necrotising pancreatitis, pan-lymphoid depletion, non-suppurative encephalitis and nephritis. Immunological detection of NDV antigen clarified the widespread presence of viral antigen in different organs with severe lesions.
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