bluuebunny/crossref_metadata_2025 huggingface dataset:
3193 The First Case of Hepatocellular Carcinoma in Male Patient Arising From Resolved Hepatitis B After Seroconversion Without Liver Cirrhosis in Indonesia
Authors: Bestari Muhammad Begawan , Palungkun Ivonne Golda , Abdurachman Siti Aminah
Published: October 2019

INTRODUCTION:

Approximately 18 million people chronically infected with Hepatitis B Virus (HBV) in Indonesia. HBV is a major contributor for the development of hepatocellular carcinoma (HCC). The therapy endpoint for chronic HBV is HBsAg seroclearance or seroconversion. However, in small percentage, HCC can still develop even after seroconversion. This is the first case of such occurrence reported in Indonesia.

CASE DESCRIPTION/METHODS:

A 57-years old male with abdominal pain on right upper quadrant was diagnosed with chronic HBV infection 9 years ago by serologic marker HBsAg 3688 IU/mL, HBeAg (+), anti HBeAg (−), HBV DNA 2.57 × 107 IU/mL, AST 560 IU/L, ALT 440 IU/L, and fasting glucose level 92 mg/dL. After entecavir therapy for 6 years HBV DNA clearance and HBeAg seroconversion were achieved, however HBsAg persisted at 19.66 IU/mL. The treatment then switched to PegIFN α-2a 180 mg for 1 year. The patient reached HBsAg seroclearance at the end of treatment with normal abdominal ultrasound (US) and hepatic elastography of 5.6 kPa. Three months later he developed anti HBsAg 14 mIU/mL. The patient was loss to follow up for 2 years, until current symptoms appeared with serologic markers HBsAg (−), anti HBsAg 121.5 mIU/mL, HBeAg (−), anti HBeAg (+), anti HBcAg (+), HBV DNA (−), anti HCV (−) and AFP 1.93 IU/mL. US suggestive HCC in right lobe and CT scan suggestive of HCC with multiple nodules on both lobes, minimal ascites and portal vein thrombus. Liver biopsy revealed columnar cells arranged in irregular tubular pattern, with nuclear polymorphism, coarse chromatin and presence of mitotic activity. Stroma consisted of fibrous collagen bands, with infiltration of inflammatory cells. No family history of HCC nor habitual alcohol intake identified.

DISCUSSION:

This patient with Hepatitis B has achieved HBsAg seroclearance and seroconversion without cirrhosis. Unfortunately, covalently closes circular DNA (cccDNA) was not identified because the examination was not commercially available, thus it may still persist intrahepatically and may further develop to HCC. Study done by Kuang et al. in 2016 identified the risk factor for developing HCC after HBsAg seroclearance were cirrhosis, male, age >50, and possibly family history of HCC. We suggest Asian descent is more susceptible to develop HCC even after seroconversion, since the incidence is higher in Asian race. Further demographic study is required to confirm this statement to narrow down the surveillance criteria.
3204 Abdominal Pain From the Sahara: An Atypical Source for a Common Complaint
Authors: Narasimha Shruthi , Robinson Katherine
Published: October 2019

INTRODUCTION:

Chest and abdominal pain are staple symptoms that plague the emergency room and the differential that it poses is vast and can sometimes be misleading. The more common cardiac and gastrointestinal causes are well known and can easily be discerned but every once in a while, an unlikely source emerges and urges clinicians to think outside the box.

CASE DESCRIPTION/METHODS:

This case looks at the story of a 61-year-old recently immigrated Ethiopian male with a history of diabetes mellitus and hypertension who presented with a twenty one day history of intermittent chest and abdominal pain. His initial troponins were negative and his electrocardiography showed no ischemia. Due to his historical risk factors, he was admitted and an echocardiogram and stress test were done but no ischemic changes were noted. Although troponins and images were negative, labs showed eosinophilia and due to recent travel to Ethiopia, additional stool workup was initiated after he started to complain with concurrent symptoms of nausea. Gastroenterology weighed in by performing an endoscopy that showed mild erosive gastropathy but benign biopsies. Lab results came back positive for the strongyloides antibody and the ova and parasite culture showed some strongyloides larvae. Infectious disease advised two doses of ivermectin and patient reported improvement through his hospital course and was eventually discharged.

DISCUSSION:

Strongyloides is a helminthic parasite that is usually shed in human feces and the larvae in the stool find their way through the skin of another host and eventually deposit themselves in the small bowel until they are ready to shed their new larvae into the feces; thereby restarting the cycle. Though the disease may be more common in third world areas, it only affects a fraction of patients in the United States. Per the Center for Disease Control, small studies showed that it affected 0 to 6.1% of people tested in the United States. Most patients present with cutaneous, gastrointestinal, or pulmonary findings but cardiac complaints are rare. His eosinophilia helped prompt further investigation and eventually brought forth a formal diagnosis. However common or mundane a symptom may be, every clinical picture is unique and should be evaluated thoroughly with a wide differential. Had his disease been misdiagnosed, it could have lead to a hyperinfection syndrome and may have caused sepsis and even death. Thus, whether a patient is in suburbia or the Sahara, it is vital to keep a broad differential.
3207 An Unusual Metastatic Location of Colorectal Cancer
Authors: Rojas Patricia Guzman , Gonzaga Ernesto Robalino , Oharriz Juan
Published: October 2019

INTRODUCTION:

Malignant neoplasms of the small bowel are rare, and mostly found as metastatic lesions from other neoplasms like lung cancer, renal cell carcinoma, breast cancer and melanomas. CRC is the 3rd cause of death associated to malignancies, and mostly metastasizes to liver, lung, and peritoneum. Duodenum as site of metastasis is rarely reported, reason why there is no specific prevalence of this entity and by 2017, there were less than cases reported in the literature.

CASE DESCRIPTION/METHODS:

We present a 52 yo man with a PMH of stage IIIB colon cancer s/p right hemicolectomy and chemotherapy, currently on remission. He had a recent normal colonoscopy 6 months prior this admission. The patient is admitted to the hospital complaining of abdominal discomfort, nausea, non-bloody vomiting, weight loss and melena for the past 2 weeks. His vital signs were stable. Laboratory results showed a hemoglobin of 6.6 g/dL and for this reason one pack of red blood cells was transfused. An EGD showed an ulcerated lesion on the duodenum (Figure 1). Biopsies were taken and these showed invasive, moderately differentiated adenocarcinoma. PET scan was done showing extensive metastatic liver and duodenal disease (Figure 2). The patient was referred to oncology for initiation of treatment with chemo and radiotherapy.

DISCUSSION:

Malignant tumors of the small intestine are very rare and involve only 1-2% of all gastrointestinal neoplasms. Metastasis from CRC has an unclear mechanism but is thought to be secondary to lymphatic spread or direct contact. Given its slow growth rate, duodenal tumors usually remain asymptomatic at onset. However, later in the course of the disease, the reported manifestations are melena, abdominal pain, and small bowel obstruction symptoms. Diagnosis is made through EGD and radiological studies. There is no stablished treatment, but surgery has been reported to be curative in some cases. Adjuvant chemotherapy can be used as a palliative option and survival rates have been reported to be 23% in 5 years. We report this case due to its rarity, since CRC tumors hardly metastasize to the duodenum. Furthermore, we would like to encourage expanding the research about treatment modalities, in order to improve prognosis in this entity.
3210 Aortoenteric Fistula—Rare, Deadly and Obscure
Authors: Harris Adam , Vemulapalli Roopa , Harris Samar , Greenan Garrett , Philip Justin
Published: October 2019

INTRODUCTION:

Small-bowel bleeding comprises a majority of obscure gastrointestinal bleeding, and is caused by various diseases. For its diagnosis, history-taking, physical examination, diagnostic testing such as cross-sectional imaging, followed by videocapsule endoscopy and deep enteroscopy are all used according to the severity of hemorrhage and patient condition.

CASE DESCRIPTION/METHODS:

A 74 year old male with an open AAA repair, CKD stage 3, diverticulosis, and ongoing overt obscure GI bleeding × 1.5 years s/p segmental small bowel resection was admitted for an episode of rectal bleeding with hemodynamic instability. He had innumerable upper endoscopies, colonoscopies, video capsule endoscopies and intraop enteroscopy with no clear etiology and had gotten over 70 units of packed RBCs. Records revealed He underwent repeat endoscopy and colonoscopy, but a video capsule endoscopy showed active bleeding in the sigmoid likely from diverticulosis and venous ectasias seen on CTA. He underwent sigmoid resection but bleeding recurred. He then underwent a provoked angiography which was normal. He continued to have bleeding episodes which was characterized by large volume hematochezia and hemodynamic instability. After extensive discussion he underwent a loop ileostomy to determine exact source of his bleeding (small bowel versus colon). Unfortunately 24 hours after surgery, he became unresponsive and developed large volume hematemesis which led to his demise. An autopsy was performed and showed a secondary aortoenteric fistula. This is perhaps one of the only are reported cases of AEF presenting as an obscure GI bleed.

DISCUSSION:

Development of an aortoenteric fistula (AEF) is a devastating and life-threatening condition, which is as difficult to diagnose as it is to treat. Fortunately, it is rare, most commonly seen as a delayed complication of aortic reconstruction. Two types are recognized: primary and secondary. Primary fistulas occur de novo between the aorta and bowel, most commonly duodenum. Secondary fistulas occur between an aortic graft and segment of bowel. Diagnosis of AEF requires a high index of suspicion in patients who present with either signs of infection or gastrointestinal hemorrhage.
3212 Weight Loss Due to Chronic Mesenteric Ischemia
Authors: Ullah Waqas , Mehmood Asif , Rashid Mamoon Ur , Zafar Yousaf , Shafiq Muhammad , Hurarirah Abu
Published: October 2019

INTRODUCTION:

Chronic Mesenteric Ischemia, also known as abdominal angina, is an uncommon condition defined by a state of attenuated blood circulation in the mesenteric vasculature affecting one or more abdominal viscera, and is more common in the female and elderly populations.

CASE DESCRIPTION/METHODS:

An 81-year-old woman presented with low blood pressure, she had a six month history of alternating constipation and diarrhea and lost 40 pounds. She appeared cachectic and abdominal examination revealed a bruit on auscultation, positive bowel sounds. Her blood work was unremarkable. Computed Tomography Angiography (CTA) of abdomen/pelvis showed chronic occlusion of the proximal celiac axis and proximal superior mesenteric artery. The distal portions of the vessels were reconstituted through large inferior mesenteric artery collaterals. CTA also revealed chronic occlusion of the proximal celiac axis and proximal superior mesenteric artery with reconstitution of the distal portions of the vessels via large inferior mesenteric artery collaterals. Patient was provided gentle hydration with intravenous fluids, and symptomatically treated with ondansetron and proton pump inhibitor. After the confirmation of diagnosis of mesenteric ischemia by CTA, cardiology was taken on board and patient underwent successful mesenteric artery bypass surgery.

DISCUSSION:

Chronic Mesenteric ischemia is a rare condition but can lead to considerable malnutrition and weight loss, and have fatal consequences such as bowel infarction, necrosis, perforation, sepsis and death. Timely diagnosis is associated with a better prognosis, which can be done with imaging or invasive angiography (gold standard).
3213 Giant Gastric Heterotopia (GH) in the Duodenal Bulb (DB): A Possible Cause of Gastric Outlet Obstruction (GOO)
Authors: Gil Arcelia Guerson , Singh Vikram , Timsar Ali Kazerouni , Brandt Lawrence
Published: October 2019

INTRODUCTION:

The presence of gastric mucosa within the DB usually is an incidental finding during endoscopy and is seen in up to 8.9% of cases. While GH usually produces no symptoms, our patient presented with symptoms of GOO, which we attributed to the large size of the GH lesion, occupying >50% of the DB. This case of DH merits attention due to its uncommon appearance and presentation.

CASE DESCRIPTION/METHODS:

A 47-year-old woman with a history of insulin-dependent diabetes mellitus presented with abdominal pain, nausea, and post-prandial emesis for 1 year. Physical exam was normal, without a sucussion splash or post-prandial abdominal distention. Hematologic testing showed a Hb 9.8 mg/Dl. Other labs, including basic metabolic panel and liver biochemical tests, were normal. Abdominal CT without IV contrast was non-diagnostic. EGD identified a single polyp in the DB measuring 1.5 cm × 2 cm (Figure 1). Additionally, there was a more distal, irregular, cratered mass in the duodenum that was surrounded by a “carpet” of mucosal nodularity consistent with the appearance of Brunner's gland hyperplasia (BGH) (Figure 2). Both areas were biopsied. The pathology of the polyp showed gastric heterotopia (Figure 3) and the cratered mass showed peptic duodenitis.

DISCUSSION:

GH is seen throughout the adult GI tract but most commonly in the duodenum, with an incidence of 0.5% to 8.9%.
1
In most cases, GH causes no symptoms and is undiagnosed. When symptomatic, GH may cause abdominal pain from mucosal irritation secondary to the release of hydrochloric acid from parietal cells. Rarely, as in our patient, obstructive symptoms may be present.
2
For symptomatic patients, proton pump inhibitors (PPIs) are the cornerstone of treatment as they help to decrease acid secretion and, therefore, mucosal irritation. After EGD, our patient was started on a PPI and rapidly had symptomatic improvement. We suspect that her abdominal pain resolved due to decreased acidity within the DB, and that obstructive symptoms improved secondary to decreased inflammation within the DB. We present this case as a rare example of GOO caused by GH.
3228 The Tale of Two Tumors: Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm Masquerading as Gastric Outlet Obstruction
Authors: Zafar Yousaf , Albawaliz Anas , Elkafrawy Ahmed A. , Mahmoudi Tahar
Published: October 2019

INTRODUCTION:

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) are tumors with two distinct neuroendocrine and non-neuroendocrine cell origins with each component comprising at least 30% of the entire neoplasm. These are rare tumors that have been reported in different parts of the digestive tract. We report the case of MiNEN identified in the duodenum of a patient who presented with gastric outlet obstruction.

CASE DESCRIPTION/METHODS:

A 61-year-old African American male with past medical history significant for stage 2 prostate adenocarcinoma (in remission) and alcohol induced cirrhosis who presented with abdominal pain, intractable nausea and vomiting for one week and concomitant weight loss over the past few months. He was tachycardic and normotensive on presentation. Physical examination was remarkable for gastric splash without notable abdominal distention. A Computed Tomography of the abdomen showed focal thickening in the duodenum near the ampulla. An esophagogastroduodenoscopy was remarkable for a periampullary, protruding and fungating mass in the second part of the duodenum that was biopsied and confirmed to be adenocarcinoma. The endoscope could not traverse beyond the identified lesion. Patient underwent Whipple procedure and intra-operative biopsy revealed invasive well-differentiated intra-ampullary adenocarcinoma, arising in intraductal papillary mucinous neoplasm, in addition to a well-differentiated neuroendocrine tumor in the second part of the duodenum. Post-operative course was complicated by upper gastrointestinal bleeding from anastomotic site, hepatorenal syndrome, abdominal compartment syndrome and acute hypoxic respiratory failure. Due to poor prognosis and worsening condition family elected to pursue comfort care and the patient passed away.

DISCUSSION:

The occurrence of MiNEN is rare and to our knowledge this is the first case to present as gastric outlet obstruction. Biopsies are needed to confirm diagnosis and surgical intervention is mainstay for management.
3239 Gastric Outlet Obstruction in Setting of Acute Cholecystitis With Duodenal Lipoma
Authors: Dalal Kunal , Chaaya Adib
Published: October 2019

INTRODUCTION:

Gastric outlet obstruction (GOO) overall incidence has declined after improved treatment of its benign etiologies. The only remote association between GOO and acute cholecystitis is through Bouveret syndrome, which is characterized by a gallstone ileus in setting of a bilioenteric fistula. Duodenal lipomas are very rare, and literature review reveals only 39 cases reported specifically in the second portion of the duodenum. This is the first reported case of GOO occurring in setting of severe acute cholecystitis and duodenal lipomas, with complete resolution after treatment of the acute cholecystitis.

CASE DESCRIPTION/METHODS:

A 71 year-old male presented for an unrestrained motor vehicle crash with multiple fractures including left femur fracture requiring surgical intervention. CT on admission showed mild gastric distention, 1.2 cm calcified cholelith. One week postoperatively, he complained of new onset right upper quadrant pain, with subsequent nausea and non bloody emesis. His physical exam was positive for Murphy's sign. His vitals showed tachycardia. His labwork revealed increasing leukocytosis from 13K to 43K with concerns for sepsis. Liver chemistries were WNL, except elevated alkaline phosphatase 171. Repeat imaging demonstrated new findings of acute cholecystitis, duodenal wall thickening, duodenal lipomas, and gastric distention with fluid suggesting gastric outlet obstruction, presumably secondary to the inflammatory process. The patient had nasogastric tube decompression with 2.6 liter output, followed by emergent percutaneous cholecystostomy tube. The patient gastrointestinal symptoms, gastric distention, and leukocytosis significantly improved. Then two days later, EGD was notable for LA Grade D esophagitis and two large duodenal lipomas the in second portion.

DISCUSSION:

To our knowledge this is the first documented case of GOO associated with acute cholecystitis in the setting of duodenal lipoma. With our case we concluded the GOO pathophysiology was dependent on the degree of inflammation from cholecystitis causing worsening intraluminal narrowing in relation to the specific location of the lipoma. Given the entities have varying presentations, clinical suspicion should remain high, and diagnosis relies on successful imaging and endoscopic evaluation. Treatment of the underlying acute cholecystitis should be urgent with either percutaneous cholecystostomy tube or cholecystectomy, if feasible. The excision of the benign duodenal lipoma can be made on a case-by-case basis.
3246 Long-Term Survival in a Patient With Recurrent Gastric Cancer With Peritoneal Seeding Undergoing Chemotherapy and Mistletoe Extract Treatment
Authors: Oh Sung Jin , Suh Byoung Jo
Published: October 2019

INTRODUCTION:

Recurrent gastric cancer with peritoneal seeding is associated with poor overall survival. Mistletoe extract has been widely used for complementary cancer therapy such as pancreatic cancer, ovarian cancer, and melanoma which support the quality of life and prolong overall survival. However, the effect of treatment for recurrent gastric cancer remains controversial.

CASE DESCRIPTION/METHODS:

A 71-year-old man with advanced gastric cancer underwent radical total gastrectomy (stage IIIb, T4b N1 M0). Abdominopelvic computed tomography performed 7 months after surgery revealed the increased ascites with an enhanced peritoneal thickening. He was diagnosed with peritoneal seeding and received 2nd line chemotherapy (Irinotecan). However, he was refused the chemotherapy due to side effects after 1 cycle. He starts receiving alternative therapy with Viscum album extract (mistletoe) instead of chemotherapy. Malignant ascites had decreased gradually after mistletoe extract therapy. So we start 3rd line chemotherapy (docetaxel) with mistletoe extract. The patient achieved good health with complete response postoperative 32 months after combination treatment. The patient has survived for 51 months after surgery without disease progression. We report a case of recurrent gastric cancer with peritoneal seeding that was successfully treated by docetaxel monotherapy with long-term mistletoe extract treatment.

DISCUSSION:

Mistletoe extract contributed to the reduction of malignant ascites and improved quality of life during chemotherapy. This case suggests that the synergistic effect of mistletoe extract treatment could be expected when used together with chemotherapy for recurrent gastric cancer.
3248 SIBO and Gastroparesis: Downstream Effects of Diabetes
Authors: Grosch Gretchen , Evans Neil , Jadav Puja
Published: October 2019

INTRODUCTION:

Homeostasis of the GI mucosal environment depends on gut motility and normal gastric acid secretion. The autonomic nervous system plays an important role in these processes. Diabetes has been shown to injure the enteric nervous system, resulting in slowed motility. Gastroparesis and small intestinal bacterial overgrowth are two consequences of the enteric injury associated with diabetes.

CASE DESCRIPTION/METHODS:

A 23-year-old male with type 1 diabetes presented with 6 months of diffuse abdominal pain and diarrhea, which had recently worsened. He noted 4-6 loose bowel movements daily and vomiting after food. He had previously been seen by gastroenterology and had an unremarkable colonoscopy, EGD, and celiac testing. He had been trialed on rifaximin and neomycin, which improved his symptoms for a short period. He tried eluxadoline with little effect. On presentation, he was hemodynamically stable with labs significant only for mildly elevated AST (58 units/L). WBC, ESR, CRP, feces ova and parasites, and C. difficile Ag were all unremarkable. A gastric emptying study revealed moderate (24%) gastroparesis. A right upper quadrant ultrasound was unremarkable. Small intestinal bacterial overgrowth related to gastroparesis was suspected. A trial of rifaximin and metoclopramide improved his symptoms leading to empiric diagnosis of SIBO.

DISCUSSION:

Small intestinal bacterial overgrowth occurs when the normal homeostatic mechanisms that control bacterial populations are in some way disrupted. Frequently, this occurs with decreased gastric acid secretion or dysmotility of the small intestine. The most common symptoms of SIBO include bloating, abdominal discomfort and distention, chronic diarrhea, weight loss, and malabsorption. One proposed theory for SIBO in gastroparesis is the idea that phase 3 migratory motor complexes may be diminished in frequency or altogether absent. While the gold standard for diagnosis requires jejunal aspirate, lactulose and glucose breath testing have been used as indirect measures of SIBO. Multiple studies have been done to analyze the relationship between gastroparesis and SIBO with results showing up to 60-70% of study participants with gastroparesis test positive for SIBO via lactulose breath testing. Once the diagnosis of SIBO has been established, the goal of therapy is to correct the underlying cause, provide nutritional support, and treat overgrowth with a course of antibiotics.
The modern concept of the pathogenesis of pituitary tumors
Authors: Bulatov A. A.
Published: October 2019

Pituitary tumors are a fairly common and often very severe form of neuroendocrine pathology. They make up about 10% of all intracranial tumors detected in clinical practice. They are found at autopsy in 10-20% of cases. Therefore, elucidation of the fundamental mechanisms of the pathogenesis of various types of pituitary tumors, the characteristics of their cellular biology and the development on this basis of effective approaches to their diagnosis, monitoring and treatment are one of the priorities in endocrinology.
Autoimmune polyglandular syndrome of the 1st type in a child of 10 years
Authors: Nikitina I. L. , Astafyeva L. I.
Published: October 2019

In clinical practice, the greatest difficulties for diagnosis are polyendocrinopathies. Of these, polyendocrine syndromes are the least studied, in which the functions of several peripheral endocrine glands are initially impaired. The main cause of this pathology are autoimmune lesions [5, 6].
Unravelling efficient applications of agriculturally important microorganisms for alleviation of induced inter-cellular oxidative stress in crops
Authors: KESWANI Chetan , DILNASHIN Hagera , BIRLA Hareram , SINGH S.P.
Published: October 2019

Abiotic stresses like high temperature, cold, freezing, drought, salinity, flooding or oxidizing agents cause significant loss in the crop yield and quality. Abiotic stresses cause reactive oxygen species (ROS) production such as singlet oxygen (1O2), hydrogen peroxide (H2O2), superoxide radical (O2•−), hydroxyl radical (OH-), etc., that leads to a significant reduction of crop yield. A major source of ROS production in plants through aerobic metabolism is chloroplast, mitochondria, and peroxisome. The tripartite interactions involving Trichoderma- Phytopathogen-Host have received less attention in contrast to the plant–antagonist, plant–pathogen or pathogen–antagonist interactions. This article explores the possibilities of employing thermotolerant strains of agriculturally important microorganisms (AIMs) for alleviating the oxidative stress induced due heat stress in crops by modulating oxidative and defense network of the host.
Population fluctuations of the pistachio twig borer, Kermania pistaciella Amsel, 1964 (Lep.: Oinophylidae) using delta pheromone trap
Authors: FAKHRI Najmeh , ABBASIPOUR Habib
Published: October 2019

Population fluctuations of adult insects of pistachio twig borer, Kermania pistaciella Amsel were studied using delta pheromone traps and sampling from 2016-2017 in Kashan pistachio orchards. Delta type traps baited with sex pheromones were hung in pistachio orchards (‘Akbari’) at 20 lures per one hectare and the numbers of captured male insects were counted every three days. Kermania pistaciella males have begun to attract the traps from 18th March and 8th April in the first and second year, respectively and this trend continued to 31st April and 4th May and flight period of about 42 days in the first year and the second year that lasted 27 days. First, peak and end of each catch insects occurred on 18 March, 8-21 April and 31 April in the first year and on 8 March, 23-26 April and 4 May in the second year, respectively. There was no association in the first year and a weak positive association in the second year of study between the average daily temperature and the number of K. pistaciella moths captured in pheromone traps. It seems that moths capture was different because of the weather conditions of these orchards was different in two consecutive years.
Medidas de protección respiratoria de tuberculosis en personal de salud: revisión integrativa
Authors: Muñoz Sánchez Alba Idaly , Antolinez Figueroa Carolina
Published: October 2019

Introducción: los trabajadores de la salud (TS) son vulnerables a la infección por tuberculosis. Se suma el desconocimiento de los TS de las medidas de protección respiratoria que puede aumentar el riesgo individual de adquirir tuberculosis en instituciones de salud. Objetivo: describir la producción de literatura científica en las bases de datos científicas sobre las medidas de protección respiratoria de la infección tuberculosa durante el periodo 2012-2018. Síntesis de contenido: revisión integrativa a través de: formulación de la pregunta de investigación, recolección de datos, evaluación, análisis e interpretación de datos y presentación de los resultados. 45 artículos cumplieron con los criterios de inclusión. Las características predominantes de los estudios fueron: año 2017 con mayor número de publicaciones, en el continente de África, la metodología de estudio cuantitativo cuasiexperimental. En los estudios se identificaron las características del respirador N95 y la mascarilla quirúrgica, los conocimientos, actitudes y prácticas de las medidas de protección respiratoria y programas educativos. Conclusiones: se evidenció que el respirador N95 es la medida de protección individual más eficiente para el control de la infección tuberculosa en los TS. También se identificó la necesidad del diseño de programas educativos sobre las medidas de protección de la infección tuberculosa.
THE REVIEW ON THE MONOGRAPH
Authors: Kevbrin Boris F. , Pisachkin Vladimir A.
Published: October 2019

The article is devoted to the consideration of the ideas of creatology in the development of the theory of discoveries and inventions.
Mortgage of land by nobles in the state noble land bank in the Kazan province in the late XIX – early XX centuries
Authors: Bogatyrev Eduard D.
Published: October 2019

Introduction. The abolition of serfdom confronted Russian landowner nobles with a new reality, when the possibility of using the resource potential of extremely cheap labor of serfs was firstly limited, and then completely disappeared. At the same time, it is necessary to take into account the presence of a significant part of the nobleman’s debts, as a result of which almost a quarter of them did not receive redemption payments that went to pay off the debt. In these conditions, many nobles were in a situation of lack of funds. The main source of finding these funds for the local nobility were operations with the land, its sale or pledge. In this situation, the nobility was extremely interested in obtaining a long-term loan secured by land. This led to the emergence of land banks, the largest of which was the State Noble Land Bank, which carried out mortgage lending to nobles on favorable terms. His activity was of great importance for the development of the noble economy in the new conditions. Materials and Methods. The study is based on the analysis of mainly statistical materials reflecting the activities of the State Noble Land Bank. A study of the regional characteristics of his activities reveals the features of the main trends in the development of noble land ownership in certain areas of the Russian Empire. In the research process, comparative-historical, systemic, quantitative, statistical methods and complex analysis were used. Results. During the analysis of statistical data on the territory of the Kazan province, the reasons were identified that prompted the nobles to pledge their estates and caused the emergence of land banks, reflects the performance indicators of the State Noble Land Bank with the identification of train specifics. It was revealed that the preferential terms of credit provided to the nobles allowed him to become a major player in this area and receive the lion’s share of transactions on the issuance of loans secured by noble estates. Discussion and Conclusions. As a result, this led to the fact that by the beginning of the 20th century, the most of the land belonging to the nobility of the Kazan province was mortgaged precisely in the State Noble Land Bank. His activity allowed the nobles to less loss and to solve the problems arising in the new economic conditions. But, despite the measures taken by the government to support noble land ownership, a significant part of the nobles could not overcome them and was forced to sell their land. At the same time, in general, the Kazan province during the reviewed period had the lowest rate of reduction of noble land ownership.
Preparation and characterizations of plasticized PMMA/PVC/Mg(ClO4)2 electrolytes
Authors: Tham Do Quang , Mai Tran Thi , Hoang Thai , Dung Nguyen Thi Kim , Tung Nguyen Quang , Thang Dam Xuan , Linh Nguyen Thi Dieu , Huyen Lai Thi , Cong Do Van , Huynh Mai Duc , Thai Nguyen Thi
Published: October 2019

Electrolyte films based on poly(methyl methacrylate) (PMMA), poly(vinyl chloride) (PVC) were prepared by using casting method with the addition 100 wt.% to 240 wt.% of dioctyl phthalate (DOP), propylene carbonate (PC) as plasticizers and Mg(ClO4)2 as an electrolytic salt. The Fourier infrared spectra (FTIR), tensile, electrical properties, surface morphology of electrolyte films were investigated. The FTIR spectra of plasticized PMMA/PVC blends indicated that there were secondary interactions between plasticizers and PMMA/PVC matrix. There were also molecular interactions between Mg(ClO4)2 and the blends, which indicated that Mg(ClO4)2 was well dissolved and solvated in the blends. Tensile results showed that Mg(ClO4)2 improved the elongation at break and the reduced tensile strength and Young’s modulus of the blends due to this salt can act as an internal lubricant for the blends. The SEM and EDX-mapping micrographs showed the wrinkled surface morphology of the electrolyte film, all raw materials were dispersed regularly into each others at molecular and ionic levels. For the electrolytes containing 10 wt.% of Mg(ClO4)2, the ionic conductivity increased with increasing plasticizer content and achieved in the range of 1.80 × 10-4 - 1.03 × 10-3 (S/cm). For the electrolyte containing 200 wt.% of the plasticizer, the ionic conductivity increased with increasing magnesium salt content and achieved in the range of 2.31 × 10-4 - 4.57 × 10-3 (S/cm).
Kadın Okul Yöneticilerinin Karşılaştıkları Kurumsal Kariyer Engelleri ve Bunları Aşmaya Yönelik Çözüm Yolları
Authors: TÜZEL İŞERİ Emel , ÇALIK Temel
Published: October 2019

Bu çalışmanın amacı,
kadın okul yöneticilerinin karşılaştıkları kurumsal kariyer engellerini, okul yöneticisi kadınların
görüşleri doğrultusunda incelenmek ve karşılaştıkları kurumsal kariyer
engellerini yenmek için hangi yollara başvurduklarını ortaya koymaktır. Araştırmanın çalışma grubunu Ankara ili merkez
ilçelerine bağlı okullarda görev yapmakta olan okul yöneticileri arasından
maksimum çeşitleme yapılarak belirlenen 10 kadın okul müdürü oluşturmaktadır. Araştırmada nitel araştırma
desenlerindenfenomenolojikullanılmıştır.
Araştırma sonucunda kadın okul yöneticililerinin üst yönetimleve özellikle
kadın öğretmenlerle çeşitli sorunlar yaşadıkları ortaya koyulmuştur. Bu
sorunları çözümlemek için ise iletişim kurmaktan mahkeme yoluna gitmeye kadar
uzanan bir çözüm sürecine başvurdukları belirlenmiştir.Katılımcıların tümünün,
kadınların Milli Eğitim Bakanlığı bünyesindeki yönetim kademelerinde temsil
edilme oranlarını yetersiz bulduğu belirlenmiştir.Bu durumun ise sadece kadınların
kendi bireysel çabaları ve isteklilikleri sonucunda ortadan kaldırılabileceğini
belirttikleri ortaya koyulmuştur. Katılımcıların tamamına yakınına göre, Milli
Eğitim Bakanlığı’nda kadınların okul yöneticiliğine seçilmesi sürecinde kadına
yönelik pozitif ayrımcılık işlememekte, tersine erkeklere yönelik pozitif
ayrımcılık bulunmaktadır.
Türkiye ve Azerbaycan Örnekleminde Büyümenin, Enerji ve Dış Ticaret Dinamikleri
Authors: ŞAHİN Güller , KONAK Ali
Published: October 2019

Enerji, ülkelerin büyüme ve
kalkınma aşamalarında başat rol oynayan üretim faktörlerinden birisidir. Ancak,
ülkelerin tamamı üretim sürecinde gerekli olan enerji kaynakları açısından
zengin değildir. Bu durum, ülkelerin başta petrol ve doğal gaz olmak üzere pek
çok enerji kaynağının temini açısından diğer ülkelere bağımlı hale gelmesine
neden olmaktadır. Dolayısıyla, bu bağımlılık enerji ithal edilen diğer ülkelere
önemli bir sermeye transferi anlamına gelmektedir. Böylece üretim faaliyetleri
sonucunda elde edilen gelirlerin önemli bir kısmı enerji ithal edilen ülkelere
aktarılmaktadır.

Bu çalışmanın amacı,
1995-2016 dönem aralığı içerisinde Türkiye ve Azerbaycan örnekleminde, enerji
ithalatı ve ihracatı ile dış ticaretin büyüme üzerindeki etkisinin
incelenmesidir. Amaç doğrultusunda GSMH, ihracat, ithalat, enerji ithali ve
ihracı değişkenleri arasındaki ilişki eşbütünleşme, Vektör Hata Düzeltme Modeli
ve nedensellik metodolojileri kullanılarak tahmin edilmiştir. Çözümleme
bulguları, her iki ülke için değişkenler arasında uzun ve kısa dönemli
etkileşimlerin varlığını, ayrıca tek ve/veya çift yönlü nedensellik
ilişkilerini göstermiştir. Temel sonuçlar, tüm değişkenlerin birlikte hareket
ettiğinin; Türkiye ekonomisinde büyüme dinamiğinin daha çok ihracata,
Azerbaycan ekonomisinde ise ithalata dayalı olarak gerçekleştiğinin bilgilerini
vermiştir.
Makroekonomik Göstergeler Üzerinden Uluslararası Para Fonu Küresel Bölge Gruplarının Kompozisyonu
Authors: ÖNALAN Gökhan Oruç
Published: October 2019

1929 yılında yaşanan büyük
buhran sonrasında küresel anlamda finans siteminin sağlıklı işlemesi adına bir
ekonomik işbirliği süreci yaşanmış ve bu doğrultuda Uluslararası Para Fonu
(International Monetary Fund) kurulmuştur. Günümüzde varlığını etkin bir
şekilde sürdüren fon kuruluşundan bugüne üye ülkelere iktisadi başlıklarda
hizmet vermektedir. Uluslararası Para Fonu yayımladığı küresel makroekonomik
görünüm raporlarında dünya ülkelerini, Birleşmiş Milletler Eğitim, Bilim ve
Kültür Organizasyonu (UNESCO) tarafından hazırlanan sınıflandırmayı baz alarak
on dokuz bölge grubu üzerinden değerlendirmektedir. Bu çalışmada da
Uluslararası Para Fonu tarafından hazırlanan bu bölge grupları çeşitli
makroekonomik göstergeler açısından Kümeleme Analizi ile incelenmiş ve
böylelikle bölge gruplarının ekonomik görünümleri bakımından birbirleri ile
benzeşen ve birbirlerinden ayrıştıran yönleri hakkında çıkarsama yapılmıştır.
Soft Power Potentials of European Union and Turkey: A Comparative Analysis
Authors: YILMAZ Ayhan Nuri , KILIÇOĞLU Gökmen
Published: October 2019

The
purpose of this study is to analyze the soft power impact of the European
Union, a supra-national body exerting its power in the economic sphere rather
than in the military field such as nation states, in establishing its inspiring
and appealing exceptional structure and the soft power of Turkey in a
comparative perspective.

For
the purpose of this analysis, the soft power of the EU is examined and
evaluated with a holistic approach besides dwelling on the soft power
activities of the EU’s Big Four, namely Germany, United Kingdom, France and
Italy. We already know that Turkey, as a candidate for EU membership, has been
affected by such activities for a long time. In this respect, the point that
should be inquired is how much the EU is affected from Turkey. That is why we
believe that this study will shed light on the soft power and public diplomacy
dimensions of EU-Turkey relations.
Avrupa Birliği Ülkelerinde Karbon Dioksit Emisyonu Politikaları Başarılı Olabilir mi? Kırılmalı Birim Kök Analizi
Authors: YILDIRIM Selim
Published: October 2019

Avrupa Birliği çevre konusunda
duyarlı bir yaklaşıma sahiptir ve çevre koruma politikaları açısından önemli
adımlar atmaktadır. Avrupa Birliği sera gazı emisyonunu ilişkin olarak 1990
yılına kıyasla  2020’de %20 ve 2030’da
%40 düşüş hedeflemektedir. 2050 hedefi olarak ise Paris Anlaşmasına bağlı
kalarak küresel ısınmayı 2°C'nin altında, tercihen 1.5°C’de tutmak için gerekli
politikaları uygulamayı hedeflemektedir. Bu çalışma sera gazlar içinde CO2‘de
odaklanarak Avrupa Birliğinin sera gazı ile ilgili politikalarda başarılı olup
olamayacağını araştırmaktadır. Bu amaçla yirmi sekiz Avrupa ülkesine ait kişi
başı yıllık CO2 emisyonu serisi kırılmasız, bir kırılmalı ve iki
kırılmalı ADF birim kök testleri ile sınanmıştır. Kırılmalı birim kök testleri
birkaç durum dışında serilerin durağan olduğunu yani politikalar yapısal
değişiklik yaratırsa  CO2
emisyonunu yeni trend etrafında hareket edeceğini; yani politikaların başarılı
olacağı yönünde bulgular ortaya koymuştur.
Material and durability study of a 10-year-old crumb rubber concrete bridge deck in Tianjin, China
Authors: Zhu Han , Duan Fuqiang , Shao Jian-wen , Shi Wanwan , Lin Zhicheng
Published: October 2019

In early August 2006, a crumb rubber concrete (CRC) bridge deck was constructed in a suburb of Tianjin, China. Although small, measuring 24 × 8 × 0·12 m, it was the first instance of the application of a CRC bridge deck reported in public literature. More than 10 years have passed since, and the last inspection of the deck carried out in June 2017 showed that few cracks have developed in the deck surface. Visual inspection of the bottom of the bridge deck showed no sign of stains owing to water leakage. At the same time, six samples were cored from the deck and were evaluated for split strength, density and rubber content. Four cored samples were further scanned by computerised image software to reveal the distribution of rubber crumbs. In March 2019, water permeability and carbonation tests were carried out on the deck as well as on a nearby plain concrete bridge deck. This study reports on these findings and discusses issues such as flexural strength and rubber floating, and provides recommendations for rubber content in crack-controlling CRC mix design. This study concludes that the Tianjin CRC bridge deck is in good condition, that the material properties show little deterioration and that its durability has been sustained.
ФОРМИРОВАНИЕ МЕТОДИКИ ОЦЕНКИ ЭФФЕКТИВНОСТИ ПРОМЫШЛЕННЫХ ПРЕДПРИЯТИЙ, ФУНКЦИОНИРУЮЩИХ НА ТЕРРИТОРИИ ИНДУСТРИАЛЬНЫХ ПАРКОВ
Authors: Симченко Ольга Леонидовна
Published: October 2019

Целью настоящего исследования является разработка оптимальной методики для решения задач оценки эффективности деятельности промышленных предприятий-резидентов индустриальных парков на основе анализа среды функционирования (АСФ). Обсуждение: для этого осуществляется обзор существующих подходов к оценке эффективности деятельности промышленных предприятий на основе различных отечественных и зарубежных источников, а также приводятся доводы о целесообразности применения данной методики. В теоретической части содержатся постановка проблемы, описание теоретической концепции исследования, раскрываются основные методологические положения. Результаты: автором определены минимальные требования к оценке эффективности промышленных предприятий методом АСФ, представлен примерный набор входных и выходных параметров, оказывающий наибольшее влияние на производственный процесс, а также составлен алгоритм, позволяющий получить объективную оценку эффективности промышленных предприятий, функционирующих на территории индустриальных парков по рассматриваемым параметрам.
The Origin of Management Ideas in Sociology in Chinese Society at the Turn of the 19th and 20th Centuries
Authors: Kremnyov Evgeny
Published: October 2019

n the beginning of the 20th century, China faced the need to look for new ways of development and, like other countries, turned towards the resources provided by social sciences in the attempt to comprehend and interpret this experience. This article reviews and analyzes Chinese sociological thought of the turn of the 19th and 20th centuries, focusing on management issues. The subject of this work is the genesis of management ideas in sociology in Chinese society. The material for the study comprises the works of thinkers, publicists, and political figures of that time who set themselves the task of applying sociological theories to the development of the country. The main problem discussed in the article is the ratio of Western and native Chinese views and ideas in sociological approaches to the study of managerial processes in China. The analysis of materials from that time shows three different tendencies in the formation of management ideas in sociology; identifying the prerequisites for a new science to be used in traditional ideas about management, demonstrating the predominance of Western science over Chinese traditional sciences, and the attempts at synthesizing the first two tendencies. The conclusion of the article is that, by the time of the fall of the Qing Dynasty in 1911, the nascent management ideas in sociology in China were a heterogeneous fusion of Western and traditional Chinese concepts, and was closely related to other sciences such as political science, sociology, philosophy, etc. During this period, traditional ideas that were largely distinguished by speculation and ideology bore the function of an ideological “shield” to preserve the integrity of the Chinese nation in the context of the growing influence of Western powers on Chinese society.
1968, o ano que ainda não começou - Comentário ao filme Mourir à trente ans, de Romain Goupil
Authors: Figueiredo Virginia De Araujo
Published: October 2019

Resumo: O texto que se segue é um comentário ao filme de Romain Goupil, Morrer aos trinta anos, e tece algumas considerações sobre o Maio de 1968 na França. Além disso, instigada pelo organizador da Mostra, Pedro Rena, tentei estabelecer um paralelo entre o Maio francês e as manifestações de 2013 no Brasil, cujas consequências talvez ainda estejam repercutindo até hoje, no Brasil pós-eleições de 2018.Palavras-chave: Maio 68 na França; Manifestações de 2013 no Brasil; Goupil; Arte; Política.Abstract: This text is a commentary on Romain Goupil’s film Mourir à trente ans, and aim to consider some events of May 1968 in France. In addition, instigated by Pedro Rena, the Seminar’s organizer, I tried to establish a parallel between the French May and the manifestations of 2013 in Brazil, whose consequences may still be reverberating to this day in Brazil after the 2018 elections.Keywords: May 68; Manifestations 2013 in Brazil; Goupil; Art; Politics.
What’s that in the right atrium?
Authors: Wang Tom Kai Ming , Van Pelt Niels
Published: October 2019

We present an interesting case of a middle-aged male patient with recent diagnosis of diffuse large B-cell lymphoma, who underwent a staging CT scan that revealed hypoattenuated lesions in the right atrium initially suspicious of thrombi. They were not evidence on transthoracic echocardiography, but the transesophageal echocardiogram showed a large mobile mass infiltrating and extending the right atrium, interatrial septum and aortic root. This case further illustrates the excellent sensitivity and specificity of transesophageal echocardiography for intracardiac masses but also the importance of multimodality cardiac imaging to reach a diagnosis and guide management.
Is there a Role for Genetics in Cardiac Calcification?
Authors: Hellman Urban , Mörner Stellan , Henein Michael
Published: October 2019

Calcific coronary artery disease (CCAD) may cause abnormal myocardial perfusion and hence generalized ischaemia, despite potential discrepancy in its expression pattern compared to the well-known atherosclerotic disease which raises questions about the exact pathophysiology of coronary calcification and whether there is a genetic aetiology for it.  In a pilot study we studied three candidate genes, ENPP1, ABCC6 and NTE5 which may predispose to coronary arterial or valvular calcification. We studied 65 patients with CCAD and 5 patients with calcific aortic valve disease (CAVD).  Five DNA variants potentially affecting protein function were found in six patients. Our findings support genetic variants might influence the development of CCAD and CAVD, however, segregation in the families must first be performed to ascertain any damaging effect of these variants. The search for direct causative genetic variants in coronary artery and aortic valve calcification must be broadened with other genes.