The Romanian natural gas market is still in its infancy regarding the manners in which the demand and supply match. We are frequently talking about market liquidity or about its dynamic behavior, without considering the monthly losses of the national natural gas system operator that derive from the very lack of matching the supply and demand. The present article proposes a method of overlaying the two in a manner that is feasible for the Romanian natural gas market of 2017, a method that will encapsulate the usage of OBAs (operational balancing agreements) in correlation with a model of allocating the demand and supply as a restricted all-pairs shortest path problem. Based on authors experience, five main variables will be examined: point-of-entry (location and time), volume, time and location of delivery, as well as other sets of data that are particular to this sector. This article will tackle the area of usability of OBAs between suppliers and the degrees of sustainability that such a model offers for clients, therefore the resilience of the system will be analyzed through an optimized transfer of information and accessibility to assets. Due to the complex nature of demand in energy markets and the different requirements set by clients, in which an energy resource can be requested by different sets of users, we will conceive a model that can be applied for natural gas, but also for electric energy production and industrial clients. The scope of this endeavor is to create a tool that will minimize the monthly losses of the national natural gas system operator, as well as its distributors, by allocating, in a fair and unbiased way, the responsibility of fulfilling the requested demand in a certain time unit.
Aim: The present study aimed at identifying the pattern of patients with critical limb ischemia (CLI) compared with those with peripheral arterial occlusive disease (PAOD).
Materials and methods: A four-year retrospective study was conducted with patients hospitalized in the Second Surgical Clinic at the Emergency County Hospital Cluj-Napoca. The medical charts of patients with PAOD (n=466) and CLI (n=223) were reviewed and data were collected.
Results: The study included 689 patients; mean age 67 years for PAOD patients and 65 years for CLI patients. A significantly higher percentage of patients were male in both groups (79.25%, P < 0.0001). Most of the patients in both groups had received at least a secondary education (P < 0.0001). Most of the subjects in both groups were smokers (>71.30%) with no difference between groups (P = 0.566). No significant differences were found between the groups in comorbidities (diabetes, arterial blood hypertension, cardiac ischemia, rhythm disorders, P > 0.05). There were more CLI patients that were overweight than overweight patients with PAOD (P = 0.0004). High serum cholesterol (>200 mg/dL) and triglycerides (>150 mg/dL) levels were found in the CLI group (P < 0.05). Age was identified as a risk factors for amputation (OR = 1.03, 95%Cl [1.01−1.05], P = 0.0012).
Conclusions: The profile of a patient with critical limb ischemia and peripheral arterial occlusive disease is a 65-67-year-old male smoker with at least a secondary education. The CLI patient is overweight with pathological serum levels of cholesterol and triglycerides.
Introduction. Chondrosarcoma is a malignant tumor of cartilaginous origin representing approximately 20-30% of all bone malignant tumors and occupying the second place in terms of their incidence. It usually affects adults between 40 and 60 years old, but can be encountered at older ages as well.
Materials and methods. We report the case of a 55-year-old male patient who presented to our department with 2 weeks-long right hip pain and partial loss of functionality in right limb. We performed X-rays, magnetic resonance imaging, computed tomography, bone scintigraphy, and angiography, which established the diagnosis of pelvic tumor. Biopsy of the tumor was performed by iliofemoral approach and its result showed moderately differentiated chondrosarcoma. Orthopaedic surgery was performed, with tumoral removal within oncological limits, pelvic reconstruction using acrylic bone cement impregnated with Vancomycin and total hip arthroplasty.
Results were assessed using the Musculoskeletal Tumor Rating Scale and a score of 23 out of 35 was obtained (the higher the better). Postoperative complications consisted in flap-skin necrosis that resolved within 2 months after surgery.
Conclusion. Bone defects repair using antibiotic impregnated cement drastically reduced the rate of postoperative infections, thus decreasing both morbidity and mortality. In spite of technological advancement, long-term prognosis remains reserved in chondrosarcoma, due to its specific aggressivity, resistance to chemo- and radiotherapy and high rate of recurrence.
We live in a noisy world. We constantly undergoing in various types of noise that affect our quality of life. It is well known that noise is not only a problem but also a serious threat to health. The effects, that noise exposure has on health is a public serious problem, and is becoming more acute, which can occur at both, mentally and physically levels