bluuebunny/crossref_metadata_2025 huggingface dataset:
P-14 A case of Paget's disease of bone presenting at early stages of life
Authors: Öner Hatice , Yavuz Dilek Gogas
Published: January 2024

Paget's disease of bone is the metabolic bone disease that affects 2-4% of individuals over age 55 in European nations. The disease may be asymptomatic and can be detected incidentally through x-rays or biochemical tests conducted for another condition. It can also manifest as bone pain, deformity, fracture, Here, we present a case of Paget's bone disease that manifested at a young age.

A 47-year-old female was referred to an endocrinology outpatient clinic due to a nonfunctional pituitary gland microadenoma. She has had constant pain in the right thigh region for the past two years, and no fractures have ever been reported. During the physical examination, the patient's right femur was sensitive to palpation. The results of the standard laboratory test were as follows: Creatinine: 0.61 mg/dl (0-1.2 mg/dl), Albumin: 50 g/L (35-52 g/L), Calcium: 9.8 mg/dl (8.8-10.6 mg/dl), Phosphorus: 4.2 mg/dl (2.6-4.5 mg/dl), PTH (Parathyroid Hormone): 33 ng/L (15-65 ng/L), Alkaline Phosphatase: 524 U/L (33-98 U/L) and 25-OH vitamin D is 43.7 mcg/L.

A bone scintigraphy was performed due to the patient's elevated alkaline phosphatase levels and bone pain. The scintigraphy revealed elevated osteoblastic activity in a sclerotic lesion expanding the right femoral cortex, and the results were reported in accordance with Paget's disease. A biopsy of the right femur lesion was performed due to the patient's young age and to rule out other diagnosis such as osteosarcoma or bone metastases. The pathology results revealed thickened and distinct cement lines along with calcified bone fragments, consistent with Paget's disease. The patient was administered 5 mg of IV zoledronic acid, and the alkaline phosphatase level was determined to be 123 U/L (Reference Range: 33-98) at the one-month control following treatment. Paget's disease can be diagnosed in young people. Therefore, it is important to take into account even a slight increase in ALP levels that is linked to early radiological abnormalities.
P-18 Dent's Disease as a rare cause of rickets
Authors: Akçay Seçkin , Kapan Ece , Yavuz Dilek
Published: January 2024

Introduction

Dent's disease is a rare recessive X-linked disorder characterized by hypophosphatemia, hematuria, proteinuria, hypercalciuria, nephrocalcinosis, and progressive renal failure. The majority of cases are caused by mutations in the CLCN5 or OCRL genes. The primary mechanisms of rickets in Dent's disease are a deficiency in phosphate absorption in the proximal tubules of the kidney and an increase in urinary calcium excretion. In order to draw attention to this rare disease, we present a patient diagnosed with Dent's disease while being evaluated for hypophosphatemic rickets.

Clinical Case

A 23-year-old male patient with Dent's disease was referred to an adult endocrinology clinic for follow-up after a CLCN5 mutation was identified during an examination for hypophosphatemic rickets and proteinuria at the age of three. Since the age of 18, he has been diagnosed with chronic kidney disease. At the age of 19, he has a history of hospitalization for osteomyelitis. No history of fracture. In his family history, both of his parents were cousins, that have short stature and Dent's disease mutation was found to be heterozygous. Both cousins had hypophosphatemic rickets diagnosis. On physical examination, he was mobile, 155 cm tall, weighed 55 kilograms, had bilateral genu valgum, and other system examinations revealed no pathology. The patient was taking 500 mg of phosphate three times per day in addition to 0.5 microgram of calcitriol. In laboratory evaluation, creatinine was 3.11 mg/ dL, GFR was 26 ml/min, PTH was 118 pg/mL, ALP was 82 IU/ml, phosphorus was 3.44 mg/ dL, and calcium was 10 mg/dL. 24-hour urine calcium: 195 mg/day; osteocalcin: 188 ng/mL; beta-crosslaps: 2 ng/mL. It was determined to be high-turnover chronic kidney disease-bone disorder. Urinary ultrasonography showed bilateral kidney diameters decreased and parenchymal thickness thinned, bilateral kidney echoes increased, and bilateral medullary nephrocalcinosis with high echogenicity and calcifications. Cataract and basal ganglia calcification were not detected.

Dual Energy X-Ray Absorbsiometry evaluation revealed that the L1-L4 BMD: 0.915 gr/cm2 Z score: -1.1 and the femoral neck BMD: 0.614 gr/cm2 Z score: -3.1 were lower than anticipated for age.

The patient's calcitriol dosage was reduced to three times per week after PTH suppression. Since the serum ALP concentration was normal, the oral phosphorus dose was not altered. A limited sodium diet was suggested for the patient. The patient with bilateral nephrocalcinosis was referred to the nephrology clinic for further evaluation.

Conclusion

Patients diagnosed with rickets should also be mindful of Dent's disease, which must be closely monitored alongside nephrology.Figure 1.Bilateral knee radiograph of the patient
P-25 Unusual cause for spontaneous hypoglycemia: Hirata's Disease in Iraqi patient
Authors: Khudhair Mahmood Shakir , Altaee Gelal Abidali , Sabri Khalid Abdulhussain
Published: January 2024

Introduction

Hirata's Disease, is a rare condition characterized by episodes of spontaneous hypoglycemia associated with hyperinsulinemia with positive insulin autoantibodies. Hypoglycemia is common in patients with diabetes mellitus especially those who are taking insulin therapy or insulin secretogogues oral medications but spontaneous hypoglycemia is rare and there is no clear figures about those patients in Iraq.

We receive a lot of persons claim to have hypoglycemia but most of them fail to fulfill the Whipple triad.

Although endogenous hyperinsulinemic hypoglycemia especially insulinoma is very rare condition, it is still concern for endocrinologist in patients presented with presumed hypoglycemia.

Clinical Case

A 43 year old female presented with frequent fainting attacks over several weeks. She has no past medical history a part of localized areas of vertigo for which she received no systematic treatment. Initial medical evaluation was unremarkable but with documented hypoglycemia below 40 mg/dl. She has normal heart, brain, kidney, liver, thyroid and adrenal function. She has multiple emergency admissions treatment with glucose infusion. She gains more weight as she eats more to avoid hypoglycemia.

Her specific lab during the attack shows high serum insulin level (141.10 mIU/ml) with high C-peptide 18.55 ng/ml

Work up for insulinoma shows normal MRI abdomen, normal endoscopic ultrasound and negative PET Gallium 68 scan.

There are no previous reports of Insulin autoimmune syndrome in Iraq. The insulin autoantibodies in this patient were very high (more than 300.00 U/ml) which highly suggestive of this syndrome after excluding other factors that may cause elevation of these autoantibodies.

Patient condition persist for about eight months and was advised for small multiple meals and diazoxide was not used much because it is not available in Iraq widely. Her condition resolved spontaneously after one year with dietary modifications.

Conclusion

Hirata syndrome is very rare but important cause of spontaneous hypoglycemia that should not be ignored. Up to our knowledge this is the first documented case in Iraq.
P-29 Metformin poisoning without lactic acidosis: Case report
Authors: Bivol Elena , Dumitraș Tatiana , Sîrbu Felicia , Gușanu Olesea , Vieru Daniela
Published: January 2024

Introduction

Metformin is the most widely used oral antidiabetic, which belongs to the biguanide pharmacological group. Metformin-associated lactic acidosis (MALA) is a rare event with an incidence of approximately 19 cases per 100,000 patient-years. The risk of developing lactic acidosis, when taking metformin is enhanced by several factors such as: age > 65 years; concomitant diseases that have the ability to induce hypoxemia (chronic renal failure, congestive heart failure, cardiogenic shock, severe lung disease, sepsis, advanced liver disease, history of lactic acidosis); an excessive alcohol consumption; an administration of iodinated contrast agents.

Clinical Case

A 46-year-old man was urgently admitted with the following symptoms: drowsiness, repeated vomiting, lethargy, dizziness. The symptoms started after he administered outpatient and at own initiative 50 tablets of metformin, each tablet contains a dose of 500 mg (total dose 25g). Concomitant pathologies: diagnosed with Type 2 Diabetes for 8 years; Toxic liver cirrhosis, compensated Child-Pugh A (recently diagnosed); hypertension; CKD G3aA2 KDIGO. The patient's condition at admission was assessed as extremely serious, Glasgow scale - 11 points, mild hypertension, tachycardia, tachypnea. The paraclinical investigations revealed the presence of metabolic acidosis, but with lactate <5 mmol/l; the progressive renal dysfunction with creatinine values in the first 24 hours up to 1184 µmol/l, urea – 24.5 mmol/l; a severe hypoglycemia - 1.68 mmol/l; a moderate cytolytic syndrome; a cholestatic syndrome, an inflammatory and hepatoprive syndrome; coagulation disorders; a pancreatic dysfunction. In the context of the evident increase of urea and creatinine, the decision was made to initiate the intermittent hemodialysis, a total of 14 sessions were required during hospitalization.

The particularity of this case is represented by the absence of lactic acidosis, despite metformin intoxication with altered neurological status, acute renal failure, developed due to chronic kidney disease, liver cirrhosis of toxic etiology and severe hypoglycemia.

Conclusion

Metformin should be administered with caution in patients with multiple comorbidities. Metformin intoxication can induce lactic acidosis with an increased risk of serious, potentially fatal adverse events. It is essential to identify metformin intoxication as early as possible, with prompt initiation of renal replacement measures and dynamic monitoring of biochemical parameters.
O-17 A case of severe and recurrent hypoglycaemia in a healthy patient
Authors: Samperi Irene , Bima Chiara , Radaelli Piero , Steffanini Mara , Persichetti Agnese , Cozzi Renato , Attanasio Roberto , Ponziani Maria Chantal
Published: January 2024

Introduction

Hypoglycaemia is a challenging condition for the endocrinologist.

Clinical Case

A 75 y/o man was admitted to ER due to severe symptoms of hypoglycaemia (weakness, blurring and sweating). His symptoms improved after eating some food and blood glucose was 50 mg/dL. He was treated with oral glucose and referred to our endocrinology clinic. His personal and family history was uneventful (no endocrine, autoimmune or neoplastic disease, no drug) and he did not complain any other symptoms besides hypoglycaemic ones. When going deeply into his medical history, he reported that back pain had occurred 4 weeks before ER access. His GP had thus prescribed supplements containing alpha lipoic acid (ALA) that he had assumed for 3 weeks and then discontinued for the lack of any benefit. He regarded this information as useless as ALA was “just a supplement”. Furthermore, he reported symptoms as shaking, anxiety, dizziness, sweating, and hunger that occurred 5-7 times per day far from meals and faded after eating.

A diet was prescribed with frequent eatings, high content of fibers and whole foods. He started flash glucose monitoring (FGM) with the alarm for hypoglycaemia set at 70 mg/dL and was trained for the management of hypoglycaemia. The laboratory alerted us due to the results of oral glucose tolerance test (Table 1). Hypoglycaemic episodes after the test were neither reported nor registered by FGM.

The differential diagnosis was among insulinoma, insulin resistance or insulin autoimmune syndrome (Hirata disease). The calculated molar ratio of insulin to C-peptide was 2.68, thus pointing to Hirata disease (to be suspected when the ratio is >1). We opted for watchful waiting while continuing the monitoring.

Two weeks later the pending results became available: TSH 1.69 mU/L, HbA1c 5.2%, serum cortisol 14.8 μg/dL, ACTH 18.2 pg/mL, anti-endogenous insulin antibodies 5.8 U/ml (nv <2.4), normal values of transaminases, lipase, and amylase.

The patient reported adherence to the diet, two symptomatic hypoglycaemias (in the afternoon, when he couldn't have the snack) as well as asymptomatic FGM alarms once daily, usually early in the morning.

We advised to add a snack before bedtime to shorten the fasting period. At the 3-month follow-up he had had no further hypoglycaemias, blood glucose was normal and anti-endogenous insulin antibodies were negative.

Conclusion

Hypoglycaemia can be a life-threatening condition and differential diagnosis is crucial. It is important to consider even rare conditions, such as Hirata syndrome that can be triggered by several factors and medications, the most common being ALA. Complete medical history is mandatory and tight follow-up essential. Most cases, as the one reported, resolve with a correct diet after the withdrawal of supplements.Table 1.Oral Glucose Tolerance Test
P-46 Panhypopituitarism in a patient with Acute Myeloid Leukemia
Authors: Cakir Ilkay , Evren Bahri , Arslan Oyku
Published: January 2024

Introduction

Panhypopituitarism with acute myeloid leukemia (AML) is a very rare condition. Few cases reported in the literature have been generally associated with poor prognosis.

Clinical Case

Here we present A 57-year-old female patient with AML-M2. In the first year of her follow-up, she was diagnosed with central diabetes insipidus (DI)- Arginine vasopressin deficiency, when she was referred to the endocrinology clinic with complaints of fatigue, polydipsia and polyuria. Hypopituitarism was found following further investigations including pituitary hormones (Table 1). Magnetic resonance imaging (MRI) of the pituitary gland revealed a a heterogeneous contrasting lesion of approximately 15×11×21 mm, which is isointense with gray matter. Pituitary stalk was observed thickened. Differentiation between lymphocytic hypophysitis and macroadenoma could not be made (Figure 1). Visual field examination was normal. When clinical, laboratory and radiological findings were evaluated together, panhypopituitarism was considered and empirical treatment was started including prednisolone 5 mg daily, levothyroxine 75 mcg daily, and Desmopressin acetate hydrate (DDAVP) 0.600 twice daily without performing a fluid restriction test.

The patient had relocated because of social reasons. She applied to another endocrinology out-patient clinic for follow-up controls and reported that she first reduced the desmopressin to half dose and then stopped because she felt amelioration of symptomes. Her urine output during this admission amounted to 2 liters/day without receiving desmopressin. Laboratory workup also supported recovery of DI - Arginine vasopressin deficiency (Table 1). Since basal cortisol values were found to be within normal limits, steroid was also reduced and discontinued, but the need of replacement for hypothyroidism continued. In the control pituitary MRI, the changes of pituitary gland and stalk observed in the prior imaging was seen disappeared (Figure 1).

Although the patient did not receive any specific treatment for hypophysitis other than AML treatment, clinical and radiological improvement was observed. She is still doing well on levothyroxine treatment. Cytarabine (ara-c) and idarubicin, hematopoietic stem cell transplantation and venetoclax treatments were applied for AML, respectively and the patient was considered as remission. Resolution of hypophysitis may be associated with remission of AML.Figure 1.Pituitary MRI at diagnosis and follow-up  Table 1.Laboratory findings of the patient at baseline and follow-up
P-53 Resistant macroprolactinoma
Authors: Berkovskaya Marina , Grigoriev Andrey
Published: January 2024

Introduction

Dopamine agonists (DAs) are considered to be the mainstay treatment for prolactinomas. Primary DA-resistance has been reported in approximately 20–30% of the patients on bromocriptine, and in around 10% of those on cabergoline. The DA-resistance is usually defined as a failure to achieve normal prolactin levels on maximally tolerated doses of DAs for at least 3-6 months and failure to achieve 30-50% reduction in tumor size in case of macroprolactinoma.

Most of resistant prolactinomas have shown to be large and/or invasive tumors. We present a clinical case of microprolactinoma, resistant to cabergoline.

Clinical Case

A 21-year old woman reported of a 2-year history of amenorrhea. Primary examination revealed hyperprolactinemia up to 361 ng/ml (bioactive prolactin 256 ng/ml). MR imaging with contrast enhancement showed the ovoid microadenoma in the right half of the adenohypophysis up to 10 mm without invasion to cavernous sinus (Figure 1). Hormone tests excluded the overproduction of ACTH, GH and TSH by the tumor (Table 1), and revealed no signs of hypopituitarism. The patient was prescribed cabergoline (0.5 mg per week), which was followed by the initial decrease of prolactin level to 116 ng/ml. However, subsequent increase of cabergoline dose up to 4,5 mg per week did not lead to further prolactin decrease and normoprolactinemia and there was no resumption of menstrual function. On the follow-up MR images (6 months after the first one) no dynamics was revealed: the tumor was up to 10 mm in size without invasive spreading to cavernous sinus or chiasm.

Taking into account the resistance to cabergoline, young age and pregnancy planning, the patient underwent transnasal debulking of the tumor. A week after the operation, normalization of prolactin level was noted, and there were no any signs of hypopituitarism. Within a month after operation, the patient reported of resumption of regular menstrual cycle. r4 months later the woman got pregnant. The pregnancy proceeded without complications and ended in timely delivery.Figure 1.MR image of pituitary microadenoma (contrast enhanced)  Table 1.Primary hormone examination
P-80 A rare case of papillary thyroid carcinoma within a mature cystic ovarian teratoma
Authors: Tekin Selin , Ünlütürk Uğur
Published: January 2024

Introduction

Mature teratoma is the most common ovarian germ cell neoplasm. Teratomas can contain various tissue groups, such as skin, hair, and thyroid tissue. Teratomas in which more than 50% of the tumor tissue is composed of thyroid tissue are defined as Struma Ovarii. Malignant transformation of Struma Ovarii has been reported at a rate of 0.5-5%, most commonly presenting as thyroid papillary and follicular carcinomas. Metastasis is observed in 5% of malignant cases.

Clinical Case

A 45-year-old female with a history of Hashimoto's thyroiditis presented in July 2022 with complaints of abdominal pain. Abdominal contrast-enhanced tomography revealed a hypo dense lesion 5 cm in diameter the right adnexal region, and in the magnetic resonance images 5 cm mass was observed in the right adnexal area. Serum Ca-125 level was 212 U/mL (0-35) at admission. Due to high suspicion of malignancy ovarian cystectomy has been performed. Pathology of specimen revealed a 0.5 cm thyroid papillary carcinoma with follicular variant in infiltrative features but no lymphovascular invasion. Subsequently, the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy due to the unverifiable risk of malignancy. Pathological examination showed no malignancy. The patient presented to our clinic in June 2023, neck ultrasound revealed a 13×12 mm heterogeneous hypoechoic thyroid nodule with thick and thin septations and occasional internal vascularity in the left thyroid lobe. Fine-needle aspiration biopsy of the thyroid was performed, and cytology results were reported as benign. The serum thyroglobulin level was found to be 83.7 ng/mL. In terms of the treatment plan, BRAF and K-RAS gene analysis was planned based on the pathology preparations. The patient will be evaluated for total thyroidectomy/radioactive iodine ablation/no treatment based on the results. Follow-up is ongoing, and test results are awaited.

Conclusion

Malignant transformation of mature teratoma is rare and thyroid papillary carcinoma being the most frequently seen malignancy. There is no consensus on treatment and follow-up, but it is recommended to classify patients based on their risks and consider options such as total thyroidectomy/radioactive iodine ablation/no treatment for follow-up. Literature suggests the need for guidelines and treatment algorithms for the management of malignant struma ovarii. Some authors recommend whole-body iodine scanning in determining risk and follow-up, asserting that iodine-based treatment and follow-up methods would be meaningless without thyroidectomy. There is also an approach advocating for only salpingo-oophorectomy in low-risk patients and subsequent follow-up. Thus, a consensus on guidelines and treatment algorithms for malignant struma ovarii is needed.
Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma
Authors: Alaimo Laura , Endo Yutaka , Catalano Giovanni , Ruzzenente Andrea , Aldrighetti Luca , Weiss Matthew , Bauer Todd W. , Alexandrescu Sorin , Poultsides George A. , Maithel Shishir K. , Marques Hugo P. , Martel Guillaume , Pulitano Carlo , Shen Feng , Cauchy François , Koerkamp Bas Groot , Endo Itaru , Kitago Minoru , Pawlik Timothy M.
Published: January 2024

Introduction

Benchmarking in surgery has been proposed as a means to compare results across institutions to establish best practices. We sought to define benchmark values for hepatectomy for intrahepatic cholangiocarcinoma (ICC) across an international population.

Methods

Patients who underwent liver resection for ICC between 1990 and 2020 were identified from an international database, including 14 Eastern and Western institutions. Patients operated on at high-volume centers who had no preoperative jaundice, ASA class <3, body mass index <35 km/m2, without need for bile duct or vascular resection were chosen as the benchmark group.

Results

Among 1193 patients who underwent curative-intent hepatectomy for ICC, 600 (50.3%) were included in the benchmark group. Among benchmark patients, median age was 58.0 years (interquartile range [IQR] 49.0–67.0), only 28 (4.7%) patients received neoadjuvant therapy, and most patients had a minor resection (n = 499, 83.2%). Benchmark values included ≥3 lymph nodes retrieved when lymphadenectomy was performed, blood loss ≤600 mL, perioperative blood transfusion rate ≤42.9%, and operative time ≤339 min. The postoperative benchmark values included TOO achievement ≥59.3%, positive resection margin ≤27.5%, 30-day readmission ≤3.6%, Clavien-Dindo III or more complications ≤14.3%, and 90-day mortality ≤4.8%, as well as hospital stay ≤14 days.

Conclusions

Benchmark cutoffs targeting short-term perioperative outcomes can help to facilitate comparisons across hospitals performing liver resection for ICC, assess inter-institutional variation, and identify the highest-performing centers to improve surgical and oncologic outcomes.
Προηγμένοι απεικονιστικοί παραμετρικοί δείκτες μαγνητικής τομογραφίας καρδιάς (CMR), κατά την αξιολόγηση ασθενών με σημαντική στένωση αορτικής βαλβίδας και ασθενών με μυοκαρδιοπάθεια
Authors: Λάμα Νίκη
Published: January 2024

Στόχος: Η μαγνητική τομογραφία καρδιάς (CMR) αποτελεί μια βασική εξέταση, κατά την διαγνωστική προσέγγιση της καρδιακής αμυλοείδωσης (CA). Η εξωκαρδιακή προσβολή είναι συχνή στην νόσο εξ ελαφρών αλύσων (ΑL) και τα ευρήματα της μαγνητικής τομογραφίας μπορεί να βοηθήσουν περαιτέρω, στη διάγνωσή της. Επιδιώξαμε να διερευνήσουμε τη χρησιμότητα των παραμετρικών μετρήσεων του σπληνός, κατά την διενέργεια της μαγνητικής τομογραφίας καρδίας (CMR) για τη διάγνωση της καρδιακής αμυλοείδωσης. Μέθοδος: Τριάντα τέσσερις ασθενείς με AL αμυλοείδωση και τριάντα δύο ασθενείς με σοβαρού βαθμού υπερτροφία της αριστερής κοιλίας, στα πλαίσια στενώσεως της αορτικής βαλβίδας (LVH-AS), οι οποίοι εξετάστηκαν με μαγνητική τομογραφία καρδιάς σε μαγνητικό τομογράφο 3Τ, κατά τη στιγμή της διάγνωσής τους με AL ή LVH-AS αξιολογήθηκαν με χαρτογράφηση T1, T2 (modified Look-Locker inversion recovery), μέτρηση του εξωκυττάριου όγκου (ECV) και μελέτη καθυστερημένης σκιαγραφικής ενίσχυσης μετά την χορήγηση γαδολινίου (LGE) της καρδιάς και του σπληνός. Αποτελέσματα: Η ηλικία, ο δείκτης μάζας της αριστερής κοιλίας, το πάχος τοιχώματος, το κλάσμα εξώθησης και οι διαστάσεις του σπληνός, δεν διέφεραν σημαντικά μεταξύ των ομάδων. Όλοι οι ασθενείς με AL είχαν καρδιακή συμμετοχή. Η χαρτογράφηση Τ1 και Τ2 του σπληνός δεν διέφερε σημαντικά μεταξύ των ομάδων, αλλά οι ασθενείς με AL είχαν υψηλότερη διάμεση τιμή του εξωκυττάριου όγκου (ECV) του απληνός από αυτούς με LVH-AS (AL 46,9%, LVH-AS: 31%, p<0,001) και σημαντικά χαμηλότερο λόγο ανάκτησης βραχείας αναστροφής tau (AL: 1,7, LVH-AS : 2,7, p<0,001), αμφότερες οι μετρήσεις είχαν πολύ καλή διαγνωστική απόδοση, ως προς την διάγνωση της AL αμυλοείδωσης. Εντοπίσαμε 16 ασθενείς με AL και προσβολή σπληνός και 16 χωρίς. Το κλάσμα εξωκυττάριου όγκου (ECV) του σπληνός και η «κανονικοποιημένη» αναλογία σπληνός, που ορίζεται ως η αναλογία μέτρησης του σπληνός προς τον σκελετικό μυ κατά την ακολουθία καθυστερημένης σκιαγραφικής ενίσχυσης (LGE), εμφάνισαν ισχυρή συσχέτιση και είχαν εξαιρετική διαγνωστική απόδοση για τη διάκριση εκείνων με συμμετοχή του σπληνός. Συμπεράσματα: Τα ευρήματά, μας δείχνουν ότι οι παραμετρικές μετρήσεις του σπληνός κατά την διενέργεια της μαγνητικής τομογραφίας καρδίας, μπορούν να αναγνωρίσουν την συμμετοχή του οργάνου, σε ασθενείς με AL και να τους διαφοροδιαγνώσουν από αυτούς χωρίς αμυλοείδωση AL.
Poetry in the Vanguard of Nation-Building and Cultural Ecology
Authors: Talvet Jüri
Published: January 2024

Poetry in the Vanguard of Nation-Building and Cultural Ecology
Fearlessness and Resistance in the Gulag: Estonian Prison Camp Poetry
Authors: Lotman Rebekka
Published: January 2024

During and after the Second World War, over 50,000 Estonians were sent to Soviet prison and forced labour camps. Within these camps, some of the repressed Estonians developed their own subculture – prison camp poetry, secretly written on sheets of paper and also memorised. The poems examined in the article were composed predominantly during the latter half of the 1940s and the 1950s, within various prison camps situated in the Karaganda Region, the Kazakh ASSR (Spassky), the Komi ASSR (Vorkuta, Intalag, and Ukhta), Mordovia (Dubravslag), the Gorki Oblast (Unzhlag) and the far northern camps of Kolyma and Krasnoyarsk Krai (Norilsk). The focus of this article is on the emotional depth of these poems and how they encapsulate feelings of fear and fearlessness, despair and hope, anger and sorrow, vengefulness and loathing. The article demonstrates how not succumbing to fear became a survival strategy within a regime of terror for Estonian Gulag poets, and how poetry provided diverse avenues for exploring this approach. Fear was transformed in various ways: Artur Alliksaar’s poetry confronts the possibility of cataclysm with beauty, while the lyrical selves of Valve Pillesaar, Leenart Üllaste, and Helmut Joonuks chose to shut down their minds. Venda Sõelsepp and Annus Rävälä, on the other hand, replaces his fear with sarcasm, while Enno Piir and Enn Uibo’s poems call for terror to be turned against the system itself.
Adam Mickiewicz in Search of Lithuanian National Identity
Authors: Jurgutienė Aušra
Published: January 2024

Adam Mickiewicz’s multicultural national identity, based on his claim Sum gente lituanus, natione autem polonus, was created over the several centuries that followed the Lithuanian Grand Duchy’s formation of the union with the Polish kingdom. Thus, it is no surprise that his reception in the literatures of these respective countries became so complicated. It was not only the Lithuanians and Poles who strayed into fruitless arguments as to which country could lay more claim to him, but disputes also constantly arose even within the relevant societies: did he belong to their national literature or was he foreign to it? In Lithuania two alternative traditions of reception formed: one faction (Jonas Basanavičius, Jonas Aistis, Faustas Kirša) erased him from Lithuanian culture and national identity, the same way as it treated all of the Polonised Lithuanian nobility; while others (Antanas Baranauskas, Maironis, Motiejus Gustaitis, Sofija Kymantaitė-Čiurlionienė, Vincas Krėvė, Stasys Šalkauskis, Vincas Mykolaitis-Putinas, Julijonas Lindė-Dobilas, Antanas Maceina, Petras Juodelis, Justinas Marcinkevičius, Vytautas Kubilius, etc.), supported a positive reception, honouring him as “a genius of the Lithuanian spirit”. The article will demonstrate the impact of Mickiewicz’s poetry on the conceptions of Lithuanian national identity presented by two Lithuanian cultural philosophers, Šalkauskis and Maceina, and will briefly discuss its more significant variations in Lithuanian romantic and neo-romantic literature. Referencing Mickiewicz’s work reveals qualities of mysticism, syntheticism and Prometheanism in Lithuanian literature and in the concept of national identity itself. The problem of Mickiewicz as foreign to Lithuanians (being foreign in some aspects to Poles as well) and his incompatibility with any notions of ‘purity’ of national identity at this time encourages one to delve into varied regional cultural relationships and the openness and complications of national identity more deeply.
Christian Felix Weiße’s Poetry in Latvian and Estonian Literature
Authors: Mattheus Ave , Daija Pauls
Published: January 2024

The article analyzes the translations of Christian Felix Weiße’s poems in Latvian and Estonian within the context of cultural transfer during the age of Enlightenment. Translations of Weiße’s poems were of great significance because they paved the way for the emergence of secular poetry in both languages. First translations appeared in the 1770s, and others followed in the next decades. While the first Latvian translations were connected to the popular enlightenment efforts of Baltic German pastor Gotthard Friedrich Stender and addressed to the peasant readers, the first Estonian translations were written in the context of experiments with the language and addressed to the Baltic German intellectual elite. First translations that were addressed to Estonian peasants appeared in the early 19th century. The frame of reference of the poems was transformed when they were addressed to peasant reading public: they acquired didactic meaning. At the same time, these translations demonstrated the poetic possibilities of Estonian and Latvian languages. The analysis as a case study reveals the multifaceted influence of German poetry on Estonian and Latvian literary cultures.
Collective Awareness and Lyrical Poetry: The Emergence of Creole Literary Culture in the Archipelago of São Tomé and Príncipe
Authors: Łukaszyk Ewa A.
Published: January 2024

The problem discussed in the article is the emergence of the autonomous literary system on the islands of São Tomé and Príncipe, a former Portuguese slave emporium, as well as coffee and cocoa producing colony. Several concurrent narrations concerning the emergence of the Santomense literary system are presented. One of them accentuates the groundbreaking role of a particular institution, Casa dos Estudantes do Império; other narrations inscribe the literature of the tiny archipelago in a larger system of Portuguese-speaking literature (Lusophony). The author of the present article postulates a radical enlargement of the chronological and cultural perspective, including the legacy of the Angolars (rebellious slaves) and their collective awareness in the genesis of the local literary tradition, in parity with such elements as the legacy of the Portuguese colonizers and free Creole social groups (Forros). It could be a way of overcoming the Eurocentric “chronopolitics” that remained valid also in the postcolonial studies, associating the decolonial processes, on the one hand, with the metropolis as a place where the decolonial thought took shape, and on the other, with the chronology, rhythms, and trends of its literary evolution.
World Literature and Mythology: Guarantees of Freedom of Man and Nation in Sigitas Geda’s Poetry
Authors: Bagdonė Karolina
Published: January 2024

In this article, the author uses the theory of intertextuality (Julia Kristeva, Gérard Genette, Marco Juvan) to analyse reflections on the openness of cultural identity and Europeanness in Sigitas Geda’s (1943–2008) poetry and his commentaries. The objective is to discuss how resistance to Soviet ideology could be constructed in mythological and world-literary contexts. Johann Wolfgang von Goethe’s vision of the universality of World Literature has remained important in Geda’s work. The Lithuanian poet adopted and applied it in his work by creating a mythological foundation as a unifying universal, a synthesis of Lithuanian and various national cultures. In this way, he conveyed a deeper sense of European identity, coming from the intertexts of modern World Literature (especially the poetry of François Villon, Johannes Bobrowski, Rainer Maria Rilke, and Paul Celan). Geda freed the imagination of a reader constrained by the Soviet occupation and directed it towards the universal world.
Characteristics of bulls with different genotypes of the OLR gene according to the productivity of female ancestors
Authors: Lamara Mohammed , Ahmetov Tahir , Tyulkin Sergey , Sadriev Aidar , Zarubezhnova Diana
Published: January 2024

The aim of the research was to assess the origin of Black-and-White breed bulls with different genotypes according to the low-density lipoprotein receptor (OLR1) gene. The object of the study was one sample represented by 58 bulls-producers of black and motley breed belonging to JSC "Head breeding enterprise "Elite" of the Vysokogorsky district of the Republic of Tatarstan. A preliminary assessment of the breeding value of Black-and-White bulls with different genotypes for one of the lipid metabolism marker genes (low-density lipoprotein receptor - OLR1), which are mainly used in insemination of dairy cows bred in the Republic of Tatarstan, is presented. As a result of a molecular genetic study (PCR-RFLP), the animal population was selected by groups, taking into account the genotype at the loci of the OLR1 gene. Evaluation and selection based on indicators of milk productivity of mothers, mothers and fathers of bull mothers showed that producers with AA and AC genotypes of the low-density lipoprotein receptor gene had the greatest breeding significance in terms of milk yield and mass fraction of fat in the milk of female ancestors. Thus, the parental index of bulls with AA and AC genotypes of the OLR1 gene was 9071 kg, 3.90% and 9510 kg, 3.95% in terms of milk content and fat mass, which is slightly higher than in bulls with CC genotype by 817 kg and 1256 kg (P<0.05) of milk, 0.03-0.08% fat, respectively.
AI in Dermatology: Bridging the Gap Between Potential and Practice
Authors: Klarycki Jakub , Tomczyk Karolina , Podgórska Dominika , Sanecki Miłosz , Jurasz Karolina , Chojnacka Natalia , Rzeska Ewa , Cymer Radosław
Published: January 2024

Artificial intelligence has been rapidly penetrating every element of our lives for quite some time. However, its presence in health care has remained elusive. This is particularly apparent in the field of dermatology, where, given the characteristics of this discipline of medicine, it would seems that its presence should be abundant. Malignant skin lesions are still high in the statistics in terms of cancer mortality while being one of the easiest to treat when diagnosed early. There are many reasons why artificial intelligence is not used in daily practice as an aid for cancers detection. However the most important one is the ongoing insufficient quality of the algorithms, which, despite great results in laboratory settings, do not produce good enough outcomes in clinical settings. Other important reasons are that people still distrust and fear artificial intelligence and simply the legal lack of adaptation of countries to its lawful and safe use. Despite the work of scientists and legislators the road to seeing artificial intelligence as a helping tool for dermatologists on a daily basis is still very long and requires the attention of scientists and the whole medical community.
ADHD in adults in a nutshell
Authors: Rzeska Ewa , Jurasz Karolina , Podgórska Dominika , Sanecki Miłosz , Tomczyk Karolina , Chojnacka Natalia , Klarycki Jakub , Cymer Radosław
Published: January 2024

ADHD (attention-deficit hyperactivity disorder), primarily only considered as a childhood condition, remains an underdiagnosed condition that also affects adult patients. High comorbidity and similarities to different psychiatric disorders impedes the diagnosis.  Despite this, it is important for medical practitioners to detect ADHD symptoms and implement proper treatment to enhance patients’ life quality. Treatment should be multimodal and involve both behavioral therapy and pharmacotherapy.
Bieg z przeszkodami: Autoportret w pękającym zwierciadle
Authors: Tatarowski Konrad W.
Published: January 2024

Autobiografia, którą oddaję do rąk Czytelników, jest tekstem wieloskładnikowym. Pierwszoosobowa narracja wzbogacona jest o wplecione w nią relacje i reportaże z różnych dramatycznych wydarzeń (jak na przykład „Branka” na Poligonie Drawskim czy pobicie internowanych w Kwidzynie), wiersze i krótkie opowiadania, korespondencję, fragmenty wcześniejszych publikacji, a także fragmenty esbeckich raportów na mój temat z akt przechowywanych w Instytucie Pamięci Narodowej. Czytelnik znajdzie tu też szereg krótkich szkiców portretowych ludzi, których poznałem w czasie swojej życiowej wędrówki – od okresu młodości, poprzez okres emigracyjny w Los Angeles i w Monachium, aż po lata ostatnie, spędzone w Polsce. Fragment Słowa wstępnego
Epilog sprawy Jana Andrzeja Morsztyna w 1683 roku
Authors: Kietliński Grzegorz
Published: January 2024

THE EPILOGUE OF JAN ANDRZEJ MORSZTYN’S CASE IN 1683This article is devoted to the epilogue of diplomatic endeavours of Jan Andrzej Morsztyn in 1683. In that year, the Polish-Lithuanian monarch, Jan III. Sobieski, preparing military campaign to save Vienna from Turks, aimed to change state foreign policy. This change was to involve breaking relations with France and establishing an alliance with Austria. In the king’s opinion, there was a serious opponent to this change – a long-time leaver of the French faction and the Great Crown Treasurer (podskarbi) Jan Andrzej Morsztyn. The monarch decided to eliminate the faction through a plot aimed at bringing Morsztyn to the parliamentary court. In response to the attempts of the king, Morsztyn intensified his political activity, in particular, international contacts in the years 1681-1683. This activity delayed the monarch’s accusation, yet in 1683 Morsztyn was accused of mismanagement of finances and betrayal of the country seeking to dethronize Jan Sobieski. In effect, he was forced to leave Poland and spent the last 10 years of his life in France.
Pod fałszywym sztandarem „naszej cywilizacji” w obronie Zachodu
Authors: Gaul Jerzy
Published: January 2024

UNDER THE FALSE BANNER OF “OUR CIVILIZATION” IN DEFENSE OF THE WEST: SUCCESSFUL MYSTIFICATION OF ADOLF HITLER, FALSE HOPES OF PIŁSUDSKI’S SUPPORTERS (1933-1935)For Adolf Hitler, the most important goal was to build the power of the Third Reich and expand the armed forces necessary to implement his plans to fight communism, solve the Jewish question and gain living space in the East. The peace on the eastern border sought by Hitler could be the basis for an agreement with Józef Piłsudski, who sought to normalize relations with his western neighbor due to the danger from Soviet Russia. For Poland, aspiring to the role of defender of Western civilization and a bulwark against Russia and Eastern influences, it was necessary to stick to the values of the West, even though the Second Polish Republic, heading towards authoritarianism, deteriorated its relations with Western countries. After gaining power, Adolf Hitler began building a totalitarian state, consistently destroying the achievements of Western civilization in Germany. Aware of Poland’s desire to play the role of a bastion of Western civilization in the East, he used camouflage, falsely presenting himself as its defender, and called for a joint defense of the West against communism and Asian civilization. Hitler’s maneuver was facilitated by the fact that J. Beck and other Piłsudski supporters, unlike Piłsudski, used interests rather than values in international politics. Poland lost in the confrontation with Hitler because, contrary to its efforts and hopes for a policy of neutrality towards totalitarian states with an openly anti-Western and anti-civilization face, it did not gain the loyalty of its allies or the gratitude of its enemies.
Effect of Aboveground Aqueous Extracts of Anthemis Cotula on the Growth and Development of Certain Important Crops
Authors: Dar Mushtaq Ahmad , Zomba Disket , Singh Rishikesh , Kaur Shalinder , Batish Daizy R.
Published: January 2024

Anthemis cotula (Asteraceae) is a dominant invader in the agroecosystems in Kashmir Himalaya, India. However, the extent of its allelopathic effects on different crops Is particularly unknown. The present study evaluated the allelopathic potential of aboveground extract (0.5 to 4% concentration) of A. cotula on the growth performance of four important crops (viz. Avena fatua, Oryza sativa, Triticum aestivum and Vigna radiata) in a laboratory bioassay. In addition, pH, electrical conductivity (EC) and total phenolic content (TPC) of the extracts were also measured. In this study, the extracts (0.5% to 4% concentration) of aboveground part of A. cotula significantly (P<0.05) affected the growth characteristics of the test plants in a dose-dependent manner. Radicle length, coleoptile / plumule length, dry weight, and chlorophyll content of the test plants were found to be reduced by 30–77% with the increasing extract concentration. Moreover, the responses observed were species-specific, where O. sativa was found to be most sensitive whereas T. aestivum reflected relatively less reduction in different growth parameters in response to the aboveground extracts. Besides pH, EC and TPC contents also showed significant (P<0.05) variation with the increasing concentration of the extract. Correlation analysis revealed a positive relationship between pH and the plant growth responses whereas negative relationships were observed between EC and TPC with growth parameters, particularly dry weight and chlorophyll content of different plant species. Based on the observations of the study, it can be inferred that A. cotula has substantial phytotoxic effects on the agricultural crops, especially O. sativa and A. fatua, by the leachation of potent allelochemicals.
Novel Fungal Co-Culture Technique for Enhanced Bioconversion of Agro-Industrial Waste to Amylase
Authors: Maddimadugu Raja Reddy , Panyam Suresh Yadav , Battala Venkata Siva Prasad , Adiboyina Swarnalatha , Ramanna Gari Subhosh Chandra Muni
Published: January 2024

Global strategies for management of solid waste occasionally lead to the environmental pollution. Now a days environmental friendly methods to valorize this waste are more demand to reduce the global warming. Solid-state fermentation (SSF) which is a potential waste recycling method to convert these solid wastes into value-added products by microbial population. In the present study, SSF was carried out using four substrates namely castor husk, rice husk, groundnut fodder, sugarcane bagasse and saw dust for the selection of renewable and chief substrate for the industrial production of amylase enzyme. We used two indigenous strains i.e., Aspergillus protuberus and Aspergillus unguis. Maximum production of α-amylase 1.614 U/g of substrate and 0.958 U/g of substrate on 2nd day of incubation in rice husk respectively. Groundnut waste (0.847 U/g of substrate) and castor husk (0.692 U/g of substrate) were also showed highest production of glucoamylase on 1st day and 2nd day of incubation in SSF. Further, prominent increase in the production of α-amylase (12 U/ml) and glucoamylase (3 U/ml) and extra cellular secretion of protein (20 mg/ml) was noticed in co-culture system on 2nd day of incubation in submerged fermentation (SmF).
Studies on Air Borne Fungi of Tea Seed Orchard at Gaya Ganga Tea Estate of Darjeeling District, West Bengal
Authors: Ghosh Chandra , Mukherjee Suvojeet , Sultana Saini , Das Priyanka , Chettri Vivek , Debnath Sukumar
Published: January 2024

Air borne microorganisms obtaining tremendous interest as they play a significant role in the plant, animal and human health. Studies on aerobiology can help to recognize the resources, take-off, passive deposition and impaction of these microorganisms on the plant life. So far, no work has been reported on the air spora of the seed orchards of tea garden. This work aimed to observe flowering period and the diversity of air mycoflora prevalent in six biclonal tea seed orchards (TS: 569, TS: 491, TS: 557, TS: 520, TS: 463 and TS: 462). A total five species were recorded. Penicillium sp is found to be dominant over the other recorded species. The maximum population of mycoflora (CFU 1580/M3) was recorded under TS: 569 and the lowest (CFU 180/M3) under TS: 463. Air mycoflora fluctuated under TS: 491, TS: 557, TS: 520 and TS: 462 and were CFU/M3 740, 540, 340 and 380 respectively.
Biological Control for Solanum melongena L. in Sustainable Agriculture.
Authors: Thomas Smitha , Mathew Lizzy
Published: January 2024

The environment and ecosystem were disrupted by the extensive use of fertilizers and pesticides which are harmful to humans and animals. Nature unfolds a biological response to overcome the different types of hazardous agrochemicals, in the form of microorganisms which have the efficiency to encourage plant growth without disturbing the environment. We conducted a biological approach to control phytopathogenic agents by plant growth-promoting rhizobacteria (PGPR), capable of restraining the devastation by phytopathogen. Pseudomonads can cling to soil particles, motile, prototrophic, and antibiotic synthesis along with the production of hydrolytic enzymes. Pseudomonas fluorescens extracted from the soils of Kerala were subjected to the identification of genes that have the phytostumillatory effect. These bacteria were immobilized using sodium alginate beads and applied to the soil where Solanum melongena (L.) was planted and the growth was compared with plants treated with cyanobacteria Spirulina platensis and NPK. The plants treated with PGPR showed high potential in growth-promoting characters when compared to cyanobacteria and NPK. P. fluorescens is an intense bio-agent to use in the field of agriculture because of its multifaceted utility.