bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical follow up after Focused Assessment with Sonography for Trauma Exam in Blunt Abdominal Trauma
Authors: Deepak Tolia  , Jitesh Tolia
Published: October 2022

Introduction: Blunt injury sustained from a blunt force may be related to motor vehicle accidents, falls, blows or crush injuries from animals, blunt objects or assailants. FAST is a low cost and portable method for evaluating BAT. It provides reasonable accuracy and has a high negative and positive predictive value for diagnosis of intraperitoneal injuries. Hence the aim of the study was to determine a relationship between the findings in focussed assessment with sonography in trauma and clinical outcome.Materials and Methods: A total of 80 patients who underwent FAST were included in the study. A prospective analytical study was carried over 2 year’s duration. The FAST findings were recorded and clinical follow up for seven days.Result: There were more male patients with blunt injury abdomen than female patients. Most common age group was between 20 to 39 years. The most common cause of BAT was RTA fallowed by falls. Out of 80 patients with BAT in our study, 29.2% patients were FAST positive and 70.8% patients were FAST negative. Discussion and Conclusion: On fallow up patient with negative FAST had fewer falls in hemoglobin and hematocrit compared to the patient with positive FAST. It concluded that FAST scan is a predictor of clinical outcome in BAT. It was concluded that FAST is a better diagnostic modality in ruling in than ruling out a patient with blunt abdominal trauma.
Biomedical Waste Management at Health Care Facilities in Chikkaballapur District: A Situational Analysis
Authors: Ishfaq Nazir Butt  , Babitha Rajan  , Arjunan Isaac  , Radhika K
Published: October 2022

Background: It has been almost two decades since the implementation of biomedical waste management (BMWM) rules in India, but most Indian hospitals are yet to achieve the desired standards for BMWM practices. Hence, we intended to study the status of BMWM in healthcare facilities(HCFs) of Chikkaballapura district. Methods: A cross-sectional study was conducted in Chikkaballapura district among all 67 HCFs i.e. 46 HCFs in the private sector and 21 HCFs in the government sector. A pre-tested questionnaire was used to collect information on micro level process of healthcare waste management. Results: Segregation practices were not followed as per BMWM Rules. In private HCFs, segregation efficiency score was very poor in 23(50%) out of 46 HCFs, poor in 21(45.6%) out of 46 HCFs, and satisfactory in only 3(6.5%) out of 46 HCFs. In government HCFs, segregation efficiency score was very poor in 5(23.8%) out of 21 HCFs, poor in 12(57.1%) out of 21 HCFs, and satisfactory in only 4(19.0%) out of 21 HCFs. Conclusion: The micro-level BMWM process at the HCF under the private and government sector was found to be very poor especially the segregation practices.
Effect of Smoking on D-dimer Level at COVID-19 Patients
Authors: Lara Balasim Al-Dahy  , Fatimah A. Abed
Published: October 2022

Background: COVID-19 are a type of virus. There are many different kinds, and some cause disease. COVID-19 identified in 2019, SARS-CoV-2. It attaches to cells there, begins to multiply and moves into lung tissue . D-dimer is one of the protein fragments produced when a blood clot gets dissolved in the body. It is normally undetectable or detectable at a very low level unless the body is forming and breaking down blood clots.Objective of the Study: It’s show effect of smoking on D-dimer level in COVID-19 patients.Materials and Methods: The current study done in Al-Yarmook Teaching Hospital, was included 20 cases of smoking COVID-19 patients and 20 cases of non smoking COVID-19 patients, all of subject’s age were 40-60 years . This study depend on collect of plasma sample used sodium citrate tubes by Elisa method to measure D-dimer level in all cases.Results: This study shows significant elevation of D-dimer in smoking COVID-19 group compare with non smoking COVID-19 group.Conclusion: The current study demonstrate effect of smoking on D-dimer level in COVID-19 patients
Surgical versus Non-Surgical Management in Fibroid Uterus: A Prospective Observational Study
Authors: Madhusudan H Gadhvi  , Bhavesh M Nayak  , Rahul L Patel
Published: October 2022

Background and Aim: Uterine fibroid is the benign condition, known to occur more during reproductive period of women. It is mainly caused due to increased level of estrogen & progesterone & peptide growth. Current management strategies mainly involve surgical interventions, but choice of treatment is guided by patient’s age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomyMaterial and Methods: It is the prospective observational study conducted in patients of department of Obstetrics and Gynecology at tertiary care hospital for the duration of one and half year. The treatment prognosis and outcome was measured in the symptomatic relief in patients, increase in quality of life, decrease in size of fibroid present, requirement of blood transfusion, definitive length of stay in the hospital and successful pregnancy after the line of management. Results: Of the total 60 patients diagnosed with fibroid uterus, there were 20 patients with fibroid size less than 8 cm and in 40 patients the size of fibroid was more than or equal to 8 cm. Among the 32 patients treated with medical line of management, 10 patients were treated with tablet ulipristal acetate 5 mg od for 3 months. Amongst the 28 patients treated surgically, in 7 patients myomectomy was done, 2 patients underwent vaginal hysterectomy, in 2 patient’s laparoscopic assisted vaginal hysterectomy done (LAVH) and 17 patients underwent total abdominal hysterectomy (TAH).Conclusion: The choice of treatment must be individualized to the women’s need and her clinical presentation. Medical line of management is best for patients in younger age group, small size fibroid, desire for future fertility. In medical line of management, ulipristal and mifepristone have better outcomes.
Trichloroethylene-induced Cellular Damage was Associated with Significant changes in the Concentrations of Caspase-3 and Glutathione in human lymphocytes
Authors: Malinee Pongsavee  , Rajnikant Mishra
Published: October 2022

Trichloroethylene (TCE) is a volatile organic compound that is widely used in industries and potential source of environmental contamination. The aims of this study were focused on the effects of TCE on cellular viability and evaluation of critical markers like caspase-3 and glutathione (GSH) in human lymphocytes. The experiments were studied in thirty volunteers. The TCE concentrations of 0.002, 0.004, 0.008, 0.016 and 0.032 mM/L were treated in human lymphocytes for 48 h. Lymphocytes were cultured and effect of TCE on viability of lymphocytes was studied by MTT assay. The expression of caspase-3 in TCE treated lymphocytes was studied by ELISA and the concentration of glutathione in TCE treated lymphocytes was studied by colorimetric technique. The results showed that, in the experimental groups at various TCE concentrations had lower cellular viability than the control group (p<0.05). The caspase-3 concentration was increased when TCE concentration increased (p<0.05). The glutathione concentration was decreased when TCE concentration increased (p<0.05). It is indicated that TCE effected on cellular viability. The expression of caspase-3 enzyme and glutathione concentrations were changed by TCE toxicity in lymphocytes.
Relationship Between Agenesis of Third Molars Skeletal Malocclusion
Authors: Pratik Rupakar  , Jignesh Maheswari  , Indira Palalam Janakan  , Foram Patel  , Darshan Dudhat  , Sanjay Yadav
Published: October 2022

Background and Aim: Among the agenesis of permanent teeth the most affected tooth is the third molar Mandibularthird molar is an unusual tooth characterized by considerable variability in formation, timing, variation in crownand root morphology and not infrequently, by agenesis. Our aim of this study is to find the frequency of thirdmolar agenesis as well as correlation of skeletal malocclusion and third molar agenesis.Material and Methods: A total of 594 patients (242 males, 352 females) aged between 11 and 25 years were reviewedretrospectively. A tooth was considered developmentally missing when there was no evidence of surgical toothextraction, when there was no any sign of tooth crown mineralization or crypt development with radiolucencyon panoramic radiographs. Patients were divided into five groups according to agenesis of third molars: Patient’sskeletal malocclusion was determined by SNA, SNB and ANB angles as well as Wit’s appraisal and divided intoclass I, II, III malocclusion.Results: Third Molar Agenesis was more common in maxilla than in mandible. Third Molar Agenesis was morecommon in females than males. Significant association was observed between Molar tooth agenesis and Gender.Highest number was observed in females at only 1 third molar was missing followed by 2 third molar missing.Prevalence of third-molar agenesis was more in skeletal class III malocclusion followed by class II and I and it wassignificant statistically.(p≤0.05).Conclusion: Third molar agenesis was most commonly observed in maxillary arch than in mandibular arch andmore common in skeletal Class III followed by Class I and Class II. It was also observed that Third Molar Agenesiswas more common in females than males. Significant association was observed between Molar tooth agenesis andGender.
Cyber Crime and Role of Law Enforcement to Tackle Online Crime in Jammu and Kashmir
Authors: Tahir ul Gani Mir  , Aasif Hussain Sheikh
Published: October 2022

Since the inception of the computer the cybercrime cases have been reported by and large. However, with easilyaccessible internet services, lawlessness has gained momentum across the world. The infractions are enacted indiverse forms like banking frauds, hacking, online piracy, stealing of IPRs, match-fixing, etc. This review providescomprehensive insights into the cyber crimes across Jammu and Kashmir with illustrations of the copiousnumber of reported crimes. An inclusive and extensive description of criminality in the modern world makes thisreview indispensable and significant. The numbers presented in the review are precisely unerring and easy tounderstand. From fake news reporting to social media craziness this review vastly touches the necessary aspectsof the cybercrime doldrums.
Impact of Covid-19 Pandemic on Mental Health of Health Care Workers from a Tertiary Care Teaching Hospital of Northern India: A Cross-Sectional Study
Authors: Adarshjot Kaur Toor  , Preeti Padda  , Jasleen Kaur  , Sanjeev Mahajan
Published: October 2022

AbstractObjectives: To assess the prevalence of depression, anxiety and stress (DAS) and post-traumatic stress disorder (PTSD)among health care workersMethods: The present study was conducted over a period of six months (June 2020-November 2020) during which mentalhealth status of health care workers was assessed using semi-structured self-reporting study tool which included twostandardized and validated tools (DASS-21 and IES-R). Sociodemographic profile and occupational history were alsorecorded. Health care workers of all categories who gave a written informed consent were recruited using non probabilityconvenience sampling technique. Minimum sample size required was this study was calculated to be 440, using 4PQ/L2 where, power was assumed to be 80%, absolute precision of 5%, and P as 50%, after adding non-response rate of 10%.Data was compiled and analyzed using EpiInfo07 software.Results: Out of a total of 822 participants included in the study, 12%,13% and 16% were found to have symptoms ofdepression, anxiety, and stress with the odds being higher in females. The prevalence of PTSD was 18%. Those witheducation above intermediate and directly involved in COVID 19 related work and patient care were found to be at higherrisk of depression, anxiety, stress and posttraumatic stress disorder.Conclusions: There is a need for a psychological support system for health care workers along with appropriateadministrative action to ensure shift rotation, rest and appropriate working hours. Further, in-depth knowledge ofprevention and control of the disease is necessary.
“I AM MENTALLY HEALTHY, SO I CAN CHOOSE WELL.” QUARTER-LIFE CRISIS AND POSITIVE MENTAL HEALTH IN STUDENTS
Authors: Herdian Herdian , Wijaya Dzikria Afifah Primala
Published: October 2022

The transition from adolescence to adulthood is marked by psychosocial and other psychological changes. Quarter-life crisis is a symptom that appears during the transition period. We examined how quarter-life crisis impacts mental health using a convenience sampling technique. A total of 459 students, 18 to 25 years old, filled out questionnaires distributed online. The data measurement tool used quarter-life crisis and positive mental health scales adjusted into Indonesian form. The results show a significant negative correlation (R = -0.437; p <  .001) between quarter-life crisis and positive mental health in students. The regression analysis shows an impact of quarter-life crisis on positive mental health of 19%, which is relatively small. The implications of our research results are discussed.
An Assessment of Character building in light of National Professional Standards of Public Sector Teachers at Primary Level in District Peshawar
Authors: Khan Rahim
Published: October 2022

The main objective of the study was to assess the teaching practices of the public sector primary school teachers in light of the national professional standards (NPS) approved by the Ministry of Education (MoE) on 23rd February 2009 in collaboration with the financial support of the USAID. The program was named as STEP which stands for strengthening Teacher Education Program. The study was delimited to only 3rd standard, being related to character building. For data collection, a criteria based Rubric was constructed. Data was collected from 360 public sector primary school teachers of District Peshawar. Collected Data, for selected standard, was analyzed through mean score. Findings of the study showed that majority of the teachers didn’t perform as per investigated Standard. So, it was recommended that Education department should chalk out a widespread program for the training and supervision of public sector primary school teachers regarding Character building of students.
Evidence-based guideline recommendations for physiotherapy in Parkinson's disease: a systematic review
Authors:   Brandenburg University of Technology, Scheffler Bettina , Bremer Alexander , Kopkow Christian
Published: October 2022

Review question / Objective: The aim of the systematic review is to identify and analyse physiotherapeutic guideline recommendations for people with idiopathic Parkinson's syndrome (IPS). In particular, the quality with which the guidelines were developed and the extent to which the internationally existing recommendations for the physiotherapeutic field of action are consistent with regard to their level as well as the precision of the recommendation are considered. Eligibility criteria: Restrictions will be applied with regard to language (English, German) and publication Date (prior 5 years).The following documents will be excluded:- Guidelines without recommendations of physiotherapeutic interventions- Guidelines recommending healthy lifestyles or including physical activity in general - Guidelines recommending physiotherapy in general - Recommendations on pharmacological, surgical, complementary interventions or non-invasive brain stimulation.
Diagnostic Value of Combination of Biomarkers for Malignant Pleural Mesothelioma：Systematic Review and Meta-Analysis
Authors:   Landzhou University Second Hospital, Zhu Mucheng , Lu Zhenhua , Guo Hao , Gu Xiaoting , Wei Defang , Zhang Zhengyi
Published: October 2022

Review question / Objective: Tumor biomarkers have become increasingly attractive due to their non-invasive properties and relatively inexpensive nature for early diagnosis of Malignant pleural mesothelioma (MPM) .Many scholars have published studies on DNA and protein as biomarkers for early diagnosis of MPM, which might be a new breakthrough. A new meta-analysis is necessary to compare the accuracy of combination of three kinds of DNA and three kinds of proteins. Condition being studied: XAs the previous studies have a certain controversy about DNA as a biomarker of MPM, we conducted a systematic search using EMBASE, PubMed and Cochrane Library to identify relevant studies from the inception to October 2021. we used QUADAS-2 for Quality Assessment to Diagnostic Accuracy Studies to evaluate the quality of eligible studies. We used Stata 15.0 and Review Manager 5.4 software to perform the meta-analysis to compare the accuracy of combination of three kinds of DNA and three kinds of proteins.
Validity and reliability of the Wolf Motor Function Test -WMFT in patients with Cerebrovascular disease: Scoping review
Authors:   Fundación Universitaria María Cano (FUMC), Roldán-González Elizabeth , Robledo-Castro Carolina , Lerma-Castaño Piedad Rocío , Hurtado-Otero María Luisa
Published: October 2022

Review question / Objective: This scoping review aimed to compile the studies that have examined the validity and reliability of the different versions of the Wolf Motor Function Test - WMFT in patients with Cerebrovascular disease. Background: Numerous investigations in rehabilitation have used the WMFT as an instrument for the primary measurement of the results; however, to date, there are no known reviews that have compiled the reliability and validity of the wolf test in its different versions, which is considered of vital importance and constitutes critical information for decision making in the process of evaluation and follow-up of patients with stroke in clinical, academic and research environments.
The Impact of Innovations on the Competitive Balance in the Kontinental Hockey League
Authors:   National Research University – Higher School of Economics, Ugryumov Alexander S. , Barajas Angel ,   National Research University – Higher School of Economics, Kostov Fedor F. ,   Herzen State Pedagogical University of Russia
Published: October 2022

The problem of competitive balance in the sports economy remains relevant and widely discussed both in the scientific community and among representatives of the sports services market around the world. This issue is widely considered in the world scientific literature. At the same time, there are practically no studies devoted to assessing the competitive balance in the leading sports leagues in Russia. The tasks required to achieve this goal are as follows, based on methods for assessing the competitive balance, characterize the innovations made by the top – KHL management and identify new factors that affect the level of competitive balance in the KHL. The study relies on previous works that examine the presence of a competitive balance in leading sports leagues. Including in the NHL, the model of which was used to create the Kontinental Hockey League and is very similar in many respects. This work makes it possible not only to evaluate the effectiveness of decisions made by the league, but also to study the impact innovations KHL policies on organizational results over time. In this article, for the first time, issues of the impact of innovations on competitive balance in hockey leagues until changes and after. Authors conclude that after making major changes to the KHL regulation, in all respects, the level of competitive balance has not changed than before. It means that the well-known and widely used tools for regulating the competitive balance in the sports leagues did not give the expected result in one of the leading sports leagues in Russia.
Analysis of the Competitive Environment in the Electronics Market: the Global Crisis of the Semiconductor Industry and Global Development Trends
Authors:   Synergy University, Trubin Alexander E. , Zubanova Anastasiya E. ,   Orel State University named after I. S. Turgenev, Dorofeev Oleg V. ,   Synergy University, Chanturiia Georgii T. ,   Synergy University, Sorokvashina Yulia S. ,   Orel State University named after I. S. Turgenev
Published: October 2022

The relevance of the study lies in the large-scale and progressive impact of the shortage in the semiconductor market on the key industries of modern electronics production. Currently, the production of microchips shows the highest growth rates, the sphere is directly associated with the fourth industrial revolution, so leading manufacturers are actively seeking either to increase market share or to gain leadership altogether. As a result, competition is intensifying both between individual companies and between countries. The purpose of the study is to determine the degree of influence of the shortage of semiconductors on the final cost of goods based on microchips. The main task is to analyze the dependence of the cost of video cards on the cryptocurrency exchange rate, the growth in demand for the extraction of which is one of the factors that influenced the semiconductor crisis. The article analyzes the current state of the semiconductor industry market, describes the key players, manufactured products by type. The chronology of events that led to the shortage of microchips – the main basis for any modern electronics – has been built. The article describes the main affected industries from the crisis in the semiconductor market, analyzes the consequences in quantitative and qualitative terms. Conclusions are drawn about the global role of cryptocurrency mining in the progressive shortage of microchips. In the course of the study, general scientific methods were applied, such as analysis, synthesis, comparison, as well as special methods (statistical-economic and econometric analysis). A paired linear regression model is constructed to identify the relationship between the Bitcoin exchange rate and the cost of popular video card models. As a result of the study, the relationship between the cryptocurrency exchange rate and the price of video cards was determined, and the stock index of the semiconductor industry was analyzed.
The Phenomenon of Bargaining Power on the Competitive Product Markets
Authors:   Siberian Institute of Management – branch of RANEPA, Knyazeva Irina V. , Zaikin Nikolay N. ,   Laboratory for Economic Analysis and Economic Policy;Siberian Institute of Management – branch of RANEPA
Published: October 2022

The emergence of network retailers and corporate associative structures in some industries, which became the largest buyers or initiators of market processes, began to form the buyer’s market power or bargaining power of the buyer that became the object of a broader study and confirmed its relevance. The realization of bargaining power on the part of the consumer does not always manifest itself in the system of economic interactions as an action that violates competition, but often is identified as a mechanism of business strategies or a form of implementation of marketing competitive practices. There are types of markets and market situations in which bargaining power is essentially the central link of the transaction, regulating prices, volumes, contract terms and distribution of benefits. The purpose of the study is to consider the phenomenon of bargaining power, since the consequences of its manifestations form long-term losses for both the seller and the market as a whole. To achieve this goal, it is necessary to solve several tasks: to conduct a theoretical analysis of the concept of “bargaining power”, to determine the difference between bargaining power and market power and to identify factors affecting the formation and development of bargaining power. This article focuses on the study of the evolution of theoretical thought in the field of disclosure of the phenomenon of bargaining power. Foreign sources give some understanding of the subject of bargaining power, but the question of factors, research schools and evaluation indicators still remains open. Based on the available bibliographic content, the article presents a comprehensive analysis of the category of “bargaining power” in various conditions of interaction of agents, the established scientific directions of its study. The systematized factors influencing the negotiating power and the vectors of their impact reflect the accumulated author’s opinion of different research views. The article reflects the criteria characteristics of the manifestation of bargaining power in the market. Understanding the essence of the phenomenon under study can be useful for expanding the field of market analysis in cases of antimonopoly proceedings, preventing anticompetitive actions, forming an antimonopoly compliance system and preventing antimonopoly risks.
Assessment of the Reasons for the Termination of Company's Operations in a Pandemic 2021
Authors:   Ulyanovsk State University, Pinkovetskaia Iuliia S.
Published: October 2022

The relevance of studying the problem of entrepreneurs leaving their business has increased significantly in recent years due to the fact that under the influence of the consequences of the COVID-19 pandemic, this process has significantly accelerated. Therefore, one of the possible reasons for the termination of entrepreneurial activity starting in 2020 is the negative consequences of the pandemic, along with other possible positive and negative options for leaving the business. The purpose of the study was to assess the opinion of entrepreneurs who have ceased their activities about the reasons for this according to the results of surveys conducted in a number of countries in 2021. The objectives of the study were: formation of a database of initial data reflecting the opinions of retired entrepreneurs about the reasons for this; development of mathematical models describing the distribution of empirical data across different countries; evaluation of the values of indicators characterizing the exit from business for positive reasons, as well as negative reasons related and unrelated to the pandemic. The initial data were the results of a survey of entrepreneurs in 47 countries during the work on the Global Entrepreneurship Monitoring project. An assessment of four indicators characterizing the positive and negative reasons for the termination of their activities by entrepreneurs was carried out. Empirical data modeling based on the development of normal distribution density functions was used to evaluate the indicators. It is proved that the majority (58.1%) of all entrepreneurs who stopped their activities did so for negative reasons, but not related to the COVID-19 pandemic. It is proved that almost a quarter (23.7%) of all entrepreneurs who stopped their business were forced to do so due to the negative consequences of the pandemic. It is shown that only one in six entrepreneurs who stopped their activities had positive reasons for leaving their business in 2021. The obtained results make a significant contribution to the existing knowledge about the reasons for the termination of entrepreneurial activity in modern national economies.
Disambiguation of visual stimuli correlates with activity in bilateral medial temporal lobe structures
Authors:   Synergon Consulting, Bucharest, Romania, Cirneci Dragos , Preoteasa Florentin ,   Euromedic Fundeni, Bucharest, Romania, Constantinescu Sorin ,   Center for Diagnostic and Treatment “Victor Babes”, Bucharest, Romania, Marian Stelian ,   Synergon Consulting, Bucharest, Romania, Tarta-Arsene Eugen ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: October 2022

We are organisms adapted to recognize patterns around us in order to avoid ambiguity and indecision and there are inter-individual differences at this level. Ambiguity can be studied in the context of the decision making process, problem solving, perception of images or text comprehension. The purpose of our study is to investigate with fMRI the neural correlates of inter-individual differences related with healthy people’s performance of ambiguous images perception using a modified form of Snowy Pictures Task. We found a significant positive correlation between performance in disambiguating the pictures and bilateral activation of entorhinal cortex, perirhinal cortex and hippocampus (Pearson chi square = 3,86, df = 1, p < 0.05, N = 22). It is documented that tasks having a higher level of ambiguity seem to take place gradually on the ventral visual circuit axis, from occipital and occipito-temporal cortices to perirhinal cortex and finally hippocampus. Other studies revealed that hippocampus is also a key structure in modulating anxiety so our results raise the hypothesis that anxiety, at least in some situations, could be triggered by an inability of hippocampus to manage ambiguous situations.
19-year-old female with abdominal pain
Authors:   Department of Neurology, Colentina Clinical Hospital, Bucharest, Romania, Buraga Ioan ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Dobrescu Adrian-Florin ,   Department of Neurology, Colentina Clinical Hospital, Bucharest, Romania
Published: October 2022

Porphyria is a group of at least 8 diseases that differ greatly between them. Common feature of these diseases is the accumulation in the body of porphyrins or porphyrin precursors, due to defects of specific enzymes in the biosynthesis of hem. Many symptoms of porphyria are nonspecific and therefore the diagnosis is often delayed. Laboratory tests can confirm or exclude the diagnosis of porphyria. However, certain diagnosis requires demonstration of specific enzyme deficiency. The presented case demonstrates the difficulty in diagnosis of acute intermittent porphyria (AIP) in a young woman without a history of significant pathology.
Bourneville tuberous sclerosis - a case report
Authors:   Clinical Emergency Hospital, Galati, Romania, Lungu Mihaela , Ursoiu Alina ,   Clinical Emergency Hospital, Galati, Romania, Lefter Mihaela ,   Clinical Emergency Hospital, Galati, Romania
Published: October 2022

The diagnosis of Bourneville Tuberous Sclerosis – the ”forme fruste” – was established for a sixteen years old teenager, due to some typical cutaneous lesions, of angiofibromas type, which appeared at puberty, lesions suggestive for the diagnosis. The imagery investigations confirmed the existence of brain hamartomas and angiomyolipomas of the kidneys, supporting the diagnosis of Bourneville disease.
An unusual case of seronegative Wegener's granulomatosis: acute pancreatitis at onset, followed by atrio-ventricular block, neurological and kidney involvement
Authors:   Clinical Emergency Hospital, Neurological Clinic I, Targu Mures, Romania, Balasa Rodica ,   Department of Neurology, University of Medicine and Pharmacy, Targu Mures, Romania, Bajko Zoltan ,   Clinical Emergency Hospital, Neurological Clinic I, Targu Mures, Romania,   Department of Neurology, University of Medicine and Pharmacy, Targu Mures, Romania, Balasa Adrian ,   Clinical Emergency Hospital, Neurosurgical Clinic, Targu Mures, Romania, Mocan Simona ,   Pathological Department, County Clinical Emergency Hospital, Targu Mures, Romania, Chebut Octavia ,   Department of Neurology, University of Medicine and Pharmacy, Targu Mures, Romania
Published: October 2022

Wegener’s granulomatosis WG) classically involves the upper respiratory tract, lungs and kidneys. Rarely, it also affects the gastrointestinal tract and heart. Symptomatic conduction defects in WG are quite uncommon and acute pancreatitis is rarely reported as the first presentation. This can result in diagnostic difficulty and may allow a potentially poor outcome. We report a case in which WG started with gastrointestinal tract problems, was suspected after an heart and ear implication and diagnosed after a peripheral facial paresis with repeated negative ANCA test, and a fatal end by renal impairment after 3 months of starting immunosuppression therapy.
Characteristics of patients with atrial fibrillation and history of stroke or transient ischemic attack - some results from the FACTS Database
Authors:   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Popescu Raluca , Dan Gheorghe Andrei ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Colentina University Hospital, Bucharest, Romania, Buzea Adrian ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Colentina University Hospital, Bucharest, Romania
Published: October 2022

Background and purpose. Atrial fibrillation (AF) is the most common arrhythmia in adult population and represents an independent risk factor for stroke with an annual risk for thromboembolic events for chronic fibrillation estimated at three to six percentage. The risk of stroke is five time more frequent in AF patients and the outcome of the ischemic stroke in AF patients is worse than other forms of ischemic stroke. There are few data regarding the specific management and outcome of the 200,000 estimated AF patients in Romania. The aim of the present study (part of the FACTS program) was to determine the characteristics of patients with AF/AFl and their management. In this paper we have analyzed the characteristics of the subgroup of patients with history of stroke or transient ischemic attack (TIA). Methods and results. From March 2011 to April 2012 a total of 3700 patients from 27 sites, ambulatories or hospitals, were enrolled including regions all over the country. Of this cohort 374 patients had documented history of stroke or TIA. Hypertension, sedentary lifestyle, associated diseases (cardiovascular and non-cardiovascular) statistically correlate with history of stroke/TIA. CHADS2 and CHA2DS2Vasc scores had higher values for patients with stroke/TIA. Conclusion. This database (part of the Romanian AF Registry) offers an insight into patient’s characteristics with AF/AFl and stoke/TIA history and provides comprehensive data that will allow a range of evaluation at national level and contribute to better understand the management of AF/AFl in Romania. Next evaluation aims to analyze anticoagulant therapy in patients with AF and especially of those with stroke/TIA history.
Computerized posturography in the diagnosis and treatment of the instability of the elderly
Authors:   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Musat Gabriela ,   ENT Department, “Sfanta Maria” Hospital, Bucharest, Romania
Published: October 2022

Aging of the world’s population is a fact that accounts for the emphasized interest for the pathology of the elderly. The objective of this paper is the evaluation of the utility of computerized posturography in the diagnosis and treatment of the instability in the elderly. The syndrome of instability of the elderly, also called presbyastasis is a pathology that requires increased attention because of the traumatic risks involved, due to the falls. Presbyastasis is difficult to diagnose because there are no functional alterations perceivable at the vestibular examination (no spontaneous nystagmus, no rotatory and caloric tests modifications). Computerized posturography may be used to diagnose the instability syndrome appeared in the elderly. There are modifications at the sensory organization test (SOT) that can be revealed in computerized posturography. The risk of falls can be assessed using special tests. The therapy of the instability syndrome of the elderly is mainly based on vestibular rehabilitation therapy that can be performed using the posturography platform. In conclusion computerized dynamic posturography is a diagnostic as well as a therapeutic tool that can be used for the diagnostic and treatment of age related balance disorders.
Kaleidoscopic nervous system involvement in the setting of a chronic multisystem dysimmune disorder: report of a remarkable case
Authors:   Department of Neurology, Colentina Clinical Hospital – CDPC, Bucharest, Romania, Dumitrescu Laura , Nicolau Adriana ,   Department of Internal Medicine, Colentina Clinical Hospital – CDPC, Bucharest, Romania, Popescu Bogdan O. ,   Department of Neurology, Colentina Clinical Hospital – CDPC, Bucharest, Romania,   School of Medicine, “Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania,   Department of Molecular Medicine, “Victor Babes” National Institute of Pathology, Bucharest, Romania
Published: October 2022

Background. Neurological manifestations are not an unusual expression of multisystem dysimmune disorders, some etiopathogenic correlations being more common than others. We report here four distinct patterns of recurrent central nervous system (CNS) involvement and neuromuscular junction dysfunction occurring in an autoimmune chronic disease. Our patient presented diagnosis clues suggestive for systemic lupus erythematosus, antiphospholipid syndrome and Sjögren’s syndrome along with clinical findings highly characteristic for two primary vasculitis (i.e. Churg-Strauss syndrome and Behçet’s disease) and an increased susceptibility to infections. To our knowledge no similar case has been described previously. Case presentation. The patient is a Caucasian female of current age 26. Her neurological condition evolved over the last 6 years in a relapsing-remitting manner with recurrent cerebral venous system thrombosis/thrombophlebitis, recurrent myelopathy consistent with acute transverse myelitis, recurrent encephalopathy manifested as psychosis, recurrent pancerebellar syndrome and recent onset myasthenic syndrome. In spite of reaching life-threatening illness severity several times, following each one of the disease flare-ups the patient eventually showed a complete clinical resolution with therapy, as a peculiar and unexpected feature of her repeated CNS autoimmune attacks. Conclusion. When facing a complex and atypical immune disorder involving CNS one should remain cautious in labeling it. In such beyond-guidelines cases several treatment approaches should be tried and reevaluation of different organ involvement is a must.
Preexisting neurologic disorder triggered by anesthesia?
Authors:   Department of Anesthesiology and Intensive Care, Colentina Hospital, Bucharest, Romania, Buraga Ioana , Buraga Ioan ,   Department of Neurology, Colentina Hospital, Bucharest, Romania, Buraga Magda ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: October 2022

Neurologic deficits appearing after various anesthetic techniques are not always caused by these procedures, also some are attributed to them. Neuraxial blocks – spinal, more often than epidural – have been associated with the postoperative relapse of multiple sclerosis, although the evidence is not strong. The mechanism is unknown but it is speculated that the disease makes the spinal cord more susceptible to the neurotoxic effects of local anesthetics. We present the case of 42-years-old female, scheduled for ureteroscopy for ureteric calculi under spinal anesthesia. Postoperatively she developed various neurological symptoms that together with the paraclinical findings led to the diagnosis of multiple sclerosis.
Subcortical Band Heterotopia Syndrome in children - comparison of two case reports
Authors:   Department of Pediatric Neurology, “Dr. Victor Gomoiu” Children’s Hospital, Bucharest, Romania, Nita Smaranda , Sandu Magdalena ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Teleanu Raluca ,   Department of Pediatric Neurology, “Dr. Victor Gomoiu” Children’s Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: October 2022

This article aims to present the cases of two pediatric patients with Subcortical Band Heterotopia, monitored in our clinic over a period of one year with respect to seizure frequency and cognitive as well as behavioral evolution. While one of the patients was born at 32 weeks and had a delay in reaching the normal developmental milestones, the second patient had no significant history of psychomotor delay. Both patients showed epileptic seizures, one of them evolving to intractable epilepsy, mild cognitive decline and behavioral problems, while the other presented a wide seizure-free interval and no cognitive impairment. Finally, we would like to emphasize that in a child with epilepsy and psychomotor delay, with an evocative EEG, cortical development disorders should be considered and magnetic resonance imaging (MRI) should be carried out.
Vasoreactivity testing in pulmonary hypertension associated with congenital heart disease
Authors: Shmalts A. A. , Gorbachevsky S. V. , Martynyuk T. V. , Nakonechnikov S. N.
Published: October 2022

In December, 2021 at the IXth All-Russian Congress «Pulmonary Hypertension 2021» the first Eurasian guidelines for the diagnosis and treatment of pulmonary hypertension associated with congenital heart disease in adults were approved. The expert group discussed many contentious issues, including the need for diagnostic tests for vasoreactivity. Invasive registration of the reaction of the pulmonary vessels to vasodilators – a vasoreactivity testing – in idiopathic, hereditary and drug- and toxin-induced pulmonary arterial hypertension (PAH) is used to determine indications for calcium antagonist therapy, in PAH associated with uncorrected congenital heart disease (CHD) in children – to determine the indications for surgical treatment. The use of a vasoreactivity testing to assess the operability of adult patients with congenital heart disease is inappropriate. An overview of the performance technique, specific pulmonary vasodilators and criteria for evaluating the test for vasoreactivity in various subgroups of PH associated with CHD is given.
Features of myocardial damage at COVID-19
Authors: Hamidov S. H. , Obrezan A. G. , Lobanova P. S. , Azarenko S. V.
Published: October 2022

This work is devoted to a literature review of published articles, where studies are focused on studying the frequency, structure of complications of cardiovascular diseases in patients with COVID-19, that occurred in vivo and post-mortem: myocarditis, myocardial damage, AMI, and other thrombotic events. Some studies also provide comparative data on COVID-19+ and COVID-19- patients, complication patterns, and mortality rates. The results of the studied materials shows that, the frequency of cardiac complications and the number of deaths are significantly more common in patients with concomitant diseases such as arterial hypertension, diabetes mellitus, obesity, CKD, arrhythmias. Patients over 60 years of age are at increased risk of a severe course of the disease, this is due to the fact that these individuals have concomitant chronic diseases that are decompensated due to an acute infectious process, reducing the adaptive capabilities of the organism, and lead to a deterioration in survival rates.
Cardiac structural and functional changes in ischemia-reperfusion injury of myocardium
Authors: Gelis L. G. , Miadzvedzeva A. A. , Shibeko N. A. , Kurganovich S. A. , Haidzel I. K. , Gevorkyan T. T.
Published: October 2022

The aim is to study the effect of microvascular reperfusion injury (RI) of myocardium on structural and functional changes of heart in patients with acute coronary syndrome with ST segment elevation (STE-ACS) and endovascular revascularization.   Materials and Methods. The study included 146 patients with STE-ACS (mean age 54 ± 10 years, 89 % men). Depending on the presence of microvascular RI, according to CMR, performed on 5 ± 3 days after myocardial infarction, patients were divided into groups: the first group included 73 patients (50 %) with microvasculature lesions, the second group consisted of 73 patients (50 %) without microvasculature lesions. All patients underwent endovascular myocardial revascularization within 12 hours of symptoms onset. The assessment of structural and functional parameters of heart was performed by CMR with contrast enhancement on 5 ± 3, 30 and 90 days, by echocardiography on 1-2 days, 1, 6 and 12 months after myocardial infarction.   Results. In our study microvascular RI was accompanied by a significant size of infarction, a high transmurality index (TI), a large size of edema and a low myocardial salvage index, was associated with LV dilatation, a decrease in  global and local myocardial contractility during the 12 months post-infarction period (p < 0.05). The risk of developing pathological remodeling of left ventricle with microvascular RI size >1.2 % of LV mass is OR=6.25, 95 % CI 2.25–17.35 (p < 0.001), myonecrosis size on day 5 ± 3 of MI >11.7 % of LV mass (OR=10.1, 95 % CI 4.72–21.69, p < 0.001), TI > 64.3 (OR=5.63, 95 % CI 2.37–13.39, p < 0.001), edema size >24.7 % of LV mass (OR = 2.33, 95 % CI 1.09–4.97, p < 0.02).   Conclusion. Microvascular RI of myocardium is associated with pathological remodeling of the left ventricle.
A Study on the Influence of Residents' Association Leadership and Organizational Culture on Organizational Performance
Authors:   National Association of Korean Local Government Studies, Ha Tae-Young
Published: October 2022

According to the flow of times, livelihood autonomy centered on residents is strengthened, and the necessity for existence of residents' association to solve various local problems by themselves, to raise awareness of democratic participation, and to revitalize local autonomy is emerging. The residents' association is a representative organization for residents' autonomy and a public-private cooperative organization for Eup, Myeon, and Dong.
Residents' associations perform various tasks such as matters necessary for harmony and development of residents in the Eup, Myeon, and Dong, matters concerning the handling of affairs entrusted by local governments, and other matters entrusted by relevant laws, ordinances, or rules. Of the 3,500 Eup, Myeon, and Dong, there were 47 local residents' associations in 2017, but the number increased to 1,013 in 2021.
This thesis conducted a study on leadership of an organization named the Residents' Association, organizational culture, and organizational performance. This study investigated the situation for organization of residents' association and derived its implications through empirical analysis(Residents' Association Leaders n=125).
The empirical analysis results are as follows.
Firstly, in the leadership of residents' association(structure-led type, considerate type) and organizational culture(rational culture, hierarchical culture, development culture, consensus culture) of the residents' association, structural-led leadership had a significant positive (+) influence on rational culture, considerate-typed leadership had a significant positive (+) influence on rational culture, developmental culture, and consensus culture.
Secondly, in organizational culture(rational culture, hierarchical culture, developmental culture, consensus culture) and organizational performance(non-financial performance, financial performance), rational culture and consensus culture had a significant positive (+) influence on non-financial performance and rational culture had a significant positive (+) influence on financial performance.
Lastly, in the leadership(structural-led type, considerate type) and organizational performance(non-financial performance, financial performance), structural-led leadership had a significant positive (+) influence on financial performance, and considerate type had a significant positive influence on financial performance.
Currently, studies on residents' associations are insufficient, and there are no studies on leadership of residents' associations, organizational culture, and organizational performance. The history of studies on Residents' Associations, which started in 2013, is as short as 10 years. Therefore, a lot of studies and interests are needed to develop local residents' association in the future.