bluuebunny/crossref_metadata_2025 huggingface dataset:
Faktor Yang Menunjang Kualitas Pengadaan Barang Dan Jasa Pemerintah
Authors: Prihanto Hendi , Usmar Usmar
Published: April 2022

Penelitian ini bertujuan untuk menguji dan manganalisis teori yang menunjang pengaruh kualitas pengadaan barang dan jasa (PBJ) yang ditinjau dari perspektif pendidikan latihan (diklat), pengalaman kerja pegawai, dan sistem pengendaliian internal pemerintah terhadap kualitas pengadaan barang atau jasa pemerintah.  Populasi dan sampel dalam penelitian terdiri dari staf pusdiklat, auditor internal, pejabat pengadaan barang dan jasa, dan pejabat pembuat komitmen (PPK) dari kementerian yang diperoleh sampel sejumlah 119 dari keseluruhan sample sebanyak 144 yang didistribusikan kepada responden dengan teknik pengambilan secara acak berdasarkan kesempatan yang diperoleh untuk mengisi kueisoner. Uji hipotesis t dan regresi berganda linear dilakukan setelah melalui pengujian kualitas data instrumen (validitas dan reliabilitas) melalui alat bantu SPSS terpenuhi.  Hasil penelitian menyatakan bahwa pendidikan latihan (diklat) dan pengalaman kerja tidak berpengaruh secara signifikan terhadap kualitas PBJ, sedangkan sistem pengendalian internal berpengaruh secara signifikan terhadap kualitas PBJ.  Keterbatasan penelitian terdapat pada jumlah sampel yang hanya mewakili persepsi pada kementerian yang diambil sebagai sampel dan kurang mampu untuk mewakili dan menyimpulkan keadaan pada daerah dan wilayah sample yang lain. Konsistensi dari skala persepsi yang diberikan responden terkadang memiliki jawaban yang tidak stabil.
Pengaruh Corporate Governance, Profitabilitas, Ukuran Perusahaan, Leverage, Dan Kualitas Audit Terhadap Penghindaran Pajak Pada Perusahaan Manufaktur Pada Tahun 2014
Authors: Mayasari Mayasari , Al-Musfiroh Hamnah
Published: April 2022

The goal of this study is to determine the effect of institutional ownership, profitability, firm size, leverage and audit quality towards the tax evasion. In order to find out the influence between two or more variables, the study uses the descriptive and the causal associative approaches. The sixty six manufacturing companies (basic industry and chemical sector) registered in the 2014 Indonesian Stock Exchange (BEI) become the population in this study, and the purposive sampling is conducted to take the 39 samples of the study. The result shows two things. The first outcome demonstrates that the institutional ownership, profitability, leverage, and audit quality do not possess significant influence towards the tax evasion whilst the second one shows that the firm size has the significant influence towards the tax evasion.
PERANCANGAN SISTEM PENDAFTARAN BENGKEL UNTUK PELAYANAN HOME SERVICE BERBASIS WEBSITE
Authors: Nurmiati Siti , Hafidz Giffari Al
Published: April 2022

Perkembangan teknologi sangat pesat dan pemanfaatan dengan adanya perkembangan teknologi dapat dilihat sebagai salah satu jawaban yang tepat untuk mengatasi berbagai permasalahan yang ada di berbagai bidang, dalam hal ini pada sistem pemesanan jasa perbengkelan. Salah satu pemanfaatan dengan membangun sebuah sistem pemesanan jasa yang ter komputasi diantaranya untuk memudahkan pelanggan dalam melakukan kegiatan pemesanan jasa terhadap kendaraan maupun pihak bengkel dalam melakukan penjadwalan dengan baik. Penelitian ini bertujuan untuk merancang suatu sistem pendaftaran bengkel untuk pelayanan homeservice berbasis website. Perancangan sistem pendaftaran pada bengkel ini diharapkan mampu untuk memudahkan pelanggan dalam menemukan bengkel atau ingin menggunakan layanan homeservice sehingga pelanggan tidak perlu keluar rumah. Pemodelan aplikasi direncanakan menggunakan bahasa menampilkan Unified Modeling Language (UML), bahasa pemrograman yang digunakan adalah PHP dan menggunakan MySQL sebagai database, XAMPP sebagai server lokal. Teknik pengembangan produk yang digunakan adalah model strategi. Konsekuensi dari tinjauan ini merencanakan kerangka kerja reservasi studio, layanan homeservice dan fitur konsultasi yang diharapkan mampu untuk mengatasi permasalahan pelanggan untuk mencari tahu masalah terhadap kendaraan atau mencari bengkel terdekat dari tempat tinggal, sehingga akan menghemat waktu dan biaya.
SISTEM INFORMASI PENJADWALAN TAMU PADA PUSAT PELATIHAN PEGAWAI APARATUR SIPIL NEGARA KEMENTERIAN DESA PEMBANGUNAN DAERAH TERTINGGAL DAN TRANSMIGRASI
Authors: Karim Luthfi , Purwandari Nuraini
Published: April 2022

System penjadwalan tamu pada Pusat Pelatihan Pegawai Aparatur Sipil Negara Kementerian Desa PDT masih manual, termaksud dengan pengelolaan datanya. Penelitian ini bertujuan untuk memberikan kemudahan dalam melakukan proses penjadwalan tamu dengan cara mengisi form digital pada website tanpa mengisikan identitas serta data lainnya secara manual. Sehingga system tersebut dapat menyimpan data dengan baik atas pengelolaan terstruktur. Dalam penelitian ilmiah ini, menggunakan tahapan metodologi Web Development Life Cycle. Website Aplikasi Pelayanan Tamu Digital telah berhasil dibuat dan telah dilakukan uji coba. Uji coba tersebut mendapatkan hasil yang baik. Berdasarkan pembahasan yang dilakukan pada bab sebelumnya dapat diambil kesimpulan bahwa website ini dapat mempermudah user dalam melakukan proses pengisian data dan penjadwalan Pusat Pelatihan Pegawai Aparatur Sipil Negara Kementerian Desa PDT.
PENERAPAN ALGORITMA GENETIKA DALAM MENGATASI JADWAL MENGAJAR YANG BENTROK PADA PROGRAM STUDI INFORMATIKA IBI KOSGORO 1957 JAKARTA INDONESIA
Authors: Firmansyah Boy , Permana Dwi Sidik , Evianti Natalia , Wihandar Asep Mulyana , Kurniawan Ari
Published: April 2022

Menjadwalkan jadwal mengajar di kampus dilakukan untuk mendukung, mempercepat, dan meningkatkan kualitas kampus. Penjadwalan mata kuliah pada umumnya berfungsi sebagai kegiatan dalam meningkatkan kualitas pengajaran dosen dan mahasiswa dalam melihat kedisiplinan dalam kegiatan kinerja kampus. Seiring dengan bertambahnya jadwal perkuliahan yang menuntut ketelitian secara tepat dan cepat dalam pengolahan datanya juga menjadikan efisien waktu. Selama ini pengelolaan data penjadwalan mata kuliah di IBI Kosgoro 1957 Jakarta masih sering terjadi ketidaksesuaian jadwal sampai terjadinya jadwal yang bentrok karena cukup banyak jadwal kesediaan mengajar dosen yang tidak terukur. Untuk itu dirasa perlu untuk merancang aplikasi penjadwalan mata kuliah yang dirancang agar berfungsi untuk membantu Ketua Program Studi dalam penjadwalan mata kuliah di IBI Kosgoro 1957 Jakarta dengan menggunakan PHP dan MYSQL. Algoritma genetika dipilih sebagai pemrosesan jadwal karena diharapkan dapat membantu proses penjadwalan mata kuliah Ketika admin memasukkan jadwal sesuai tahun ajaran kemudian diolah untuk memastikan tidak ada jadwal yang bentrok.
ANALISIS SEMIOTIK TIGA FOTO ESSAY PEKAN INI PADA SURAT KABAR KOMPAS
Authors: Elisabet Hamboer Maria Jashinta , Pranawukir Iswahyu
Published: April 2022

The main problem of this research is, how to know the hidden meaning of photo essay from social and psychological aspects. The purpose of this research itself is to find out the hidden meanings in the essay photo, apart from what is visible. This study uses a qualitative descriptive method, which is a method that aims to provide as accurate a picture as possible of the characteristics of an individual, the characteristics of a group or individual society as well as to find out and examine the characteristics of interest. With the data analysis technique, namely the semiotic analysis model used by Roland Barthes (1990), namely, analyzing the sign. In this model, the main idea is focused on the two-stage significance (two order signification). Data collection was obtained through literature study accompanied by interviews with a photography. The results of this study indicate that in the photo essay there is a hidden meaning from a social and psychological perspective.
KOMUNIKASI TRANSENDENTAL MASYARAKAT ADAT BUTON DALAM MENGEKSPRESIKAN RASA SYUKUR PANEN RAYA TAHUNAN
Authors: Alamsyah Alamsyah
Published: April 2022

The aims of study are to find out the historical relations of tutura Siotapina, the implementation process, the meaning behind it, the transcendental communication in it, and the potential of tourist destination. The subject is the traditional community of Wasuamba as the main.By using descriptive qualitative method and participatory observation data in the ethnographic paradigm of communication, the conclusions are obtained:The meanings of tutura Siotapina are the harmonization with God, others and nature. The core message is forest conservation with all its historical values.Transcendental communication is from the message of ancestral spirit, a message to continue in preserving the forest as the key to prosperity. Transcendental communication is a human consciousness as a real self (full of limitations), symbolic (cultural) and imaginary (imagination of the Almighty).
Pengelolaan Kesan Simbolik Presiden Jokowi
Authors: Sukma Agus Hitopa
Published: April 2022

The purpose of research was to find out the management of President Jokowi's leadership communication in terms of managing the symbolic impression displayed in the one-year period of his governance with Vice President Ma'ruf Amin. The research approach uses cultural studies, with the method of studying the literature of media content, especially political opinions. The results showed that during one government, judging by the management of symbolic impressions, President Jokowi more presents himself as an organizer and entrepreneur, so that it does not stand out too prominently the formal aspects of protocol presidency in his daily acts. The leadership challenge is urban geopolitics, namely the co-optation of the city area into a source of legitimacy opposition. This challenge developed into a latent issue of binary opposition that attacked the identity of the President. The post-truth era news phenomenon contributes to the threat of government legitimacy in cyberspace. In the field of education, the element of character building is still weak in the realm of implementation, so the course of government for one year is shown many breakthroughs, but often colored controversially.
IMPLEMENTASI KOMUNIKASI PEMASARAN TERPADU SAMSUNG INDONESIA DALAM MEMPROMOSIKAN PRODUK TELEPON CERDAS
Authors: Imam Faizal
Published: April 2022

Penelitian ini bertujuan untuk mengetahui implementasi komunikasi pemasaran terpadu Samsung Indonesia dalam mempromosikan produk telepon cerdas ditinjau dengan konsep komunikasi pemasaran terpadu sebagai promosi. Metode yang digunakan adalah kualitatif dengan konsep komunikasi pemasaran terpadu yang merupakan proses perpaduan elemen komunikasi menjadi satu kesatuan dengan tujuan memberi gambaran komunikasi pemasaran terpadu diimplementasikan. Temuan menunjukkan Samsung Indonesia telah menggunakan konsep komunikasi pemasaran terpadu sebagai metode promosi produk telepon cerdas. Hal ini dapat dilihat dari strategi yang digunakan mengandung unsur yang ada pada konsep komunikasi pemasaran terpadu serta mengintegrasikan pesan untuk menjadi suatu pola komunikasi yang efektif. Kesimpulannya implementasi Samsung Indonesia dalam mempromosikan produk telepon cerdas memiliki keefektifan
IDENTITAS MAHASISWA UHAMKA DALAM MEDIA PEMBELAJARAN DARING
Authors: Setiawati Titin , Agustini Vilya Dwi
Published: April 2022

Fokus penelitian ini adalah menganalisis penggunaan identitas mahasiswa dalam media pembelajaran daring. Penelitian ini menggunakan metode penelitian kuantitatif deskriptif. Data dikumpulkan melalui kuesioner yang diisi oleh 366 mahasiswa aktif Universitas Muhammadiyah Prof Dr Hamka dari berbagai angkatan yang merupakan pengguna media pembelajaran daring, baik media pembelajaran daring resmi dari kampus (Online Learning Uhamka, biasa disebut OLU) maupun media pembelajaran daring lain. Kajian ini menemukan bahwa dalam media pembelajaran daring resmi dari kampus mahasiswa memiliki kecenderungan lebih besar untuk menggunakan nama asli sebagai identitas, sementara dalam media pembelajaran daring yang bukan merupakan media pembelajaran daring resmi dari kampus kecenderungan untuk menggunakan nama asli lebih kecil, tetapi berbanding terbalik, pada penggunaan photo, penggunaan photo diri asli memiliki kecenderungan lebih kecil pada media pembelajaran resmi dari kampus dibanding media pembelajaran daring lain.
PENGARUH PENGGUNAAN TELEPON CERDAS (SMARTPHONE) TERHADAP INTERAKSI MASYARAKAT LANGSUNG DI MASA PANDEMI WARGA DUKUH KAPOHAN KARANGANYAR
Authors: Mawardiningsih Wahjoe , Mediantara Yogi
Published: April 2022

Smartphone ikut andil menciptakan interaksi yang berbeda dengan interaksi langsung. Masa pandemi yang telah berlangsung hampir dua tahun ini, smarthphone berperan besar untuk memperlancar interaksi dalam masyarakat karena adanya kebijakan untuk menjaga jarak kontak fisik. Namun ada hal tertentu, terkadang membuat masyarakat tetap harus melakukan interaksi langsung dalam masa new normal ini. Maka penelitian ini bertujuan untuk mengetahui pengaruh penggunaan smartphone terhadap interaksi masyarakat secara langsung pada masa pandemi ini pada warga masyarakat dukuh Kapohan Karanganyar. Guna mengetahui hasil penelitian, peneliti menganalisa data-data yang diperoleh melalui sebaran angket atau kuesioner, dengan menggunakan metodologi penelitian kuantitatif, dengan menerapkan teknik analisis data regresi linier sederhana. Maka diperoleh hasil penelitian yang menunjukkan adanya penggunaan smartphone berpengaruh positif terhadap interaksi masyarakat langsung di masa pandemi ini bagi warga dukuh Kapohan Karanganyar, meski kecil. Hasil ini disimpulkan berdasarkan persamaan hasil analisis regresi linier sederhana, diketahui bahwa koefisien regresi dari variabel penggunaan smartphone berpengaruh positif terhadap interaksi masyarakat langsung di masa pandemi warga dukuh Kapohan Karanganyar, bernilai positif.
MANAJEMEN KOMUNIKASI POLITIK PARTAI GOLKAR PADA PANGGUNG AGREGASI KEBIJAKAN OMNIBUS LAW
Authors: Alamsyah Alamsyah , Misnan Misnan
Published: April 2022

Tujuan penelitian adalah ingin mengetahui manajemen komunikasi politik Partai Golkar pada panggung agregasi kepentingan partai-partai politik pendukung pemerintahan dalam menyukseskan kebijakan omnibus law. Metode penelitian yang digunakan adalah deskriptif kualitatif melalui tradisi fenomenologi. Strategi komunikasi politik Partai Golkar diimplementasikan dalam 3 panggung, yakni panggung belakang, panggung tengah dan panggung depan (model dramaturgis Goffman). Pada panggung belakang, komunikasi politik dilakukan saat momentum konsolidasi partai, sehingga dukungan seluruh kader dapat dipersatukan. Pada panggung tengah, komunikator Partai Golkar mampu meyakinkan seluruh partai koalisi pendukung pemerintah, bahwa omnibus law merupakan solusi utama mengatasi masalah lambannya pertumbuhan ekonomi dan peluang kerja, sehingga harus diputuskan secepatnya. Adapun di panggung depan, komunikator politik Partai Golkar banyak melakukan dialog dengan berbagai lapisan publik, melalui berbagai saluran komunikasi massa.
Trends in World Military Expenditure, 2021
Authors: Lopes da Silva Diego , Tian Nan , Béraud-Sudreau Lucie , Marksteiner Alexandra , Liang Xiao
Published: April 2022

In 2021 world military expenditure surpassed the two trillion US dollar mark for the first time, reaching $2113 billion. Global spending in 2021 was 0.7 per cent higher than in 2020 and 12 per cent higher than in 2012. The economic effects of the Covid-19 pandemic have not ended the continuous upward trend in world military expenditure seen since 2015. As a result of the strong economic recovery across the globe in 2021, world military spending as a share of world gross domestic product—the global military burden—reached 2.2 per cent, down from 2.3 per cent in 2020. Average military spending as a share of government expenditure in 2021 remained the same as in 2020, at 5.9 per cent. This Fact Sheet presents regional and national military expenditure data for 2021 and highlights trends over the decade 2012–21. The data comes from the updated SIPRI Military Expenditure Database, which provides military spending data by country for the years 1949–2021.
Evolution of mortality rates in ST elevation myocardial infarction
Authors: Munteanu Alice E. , Calcan Cristina M. , Florescu Irina
Published: April 2022

The purpose of this paper is to provide information about mortality rate in patients undergoing primary angioplasty for STEMI. Cardiovascular diseases lead to one third of the deaths worldwide, surpassing the mortality rate produced by neoplasia, acute respiratory failure and diabetes mellitus all together. In the world, approximately 17 million die annually because of cardiovascular disease and every 5 seconds one is suffering from a myocardial infarction. In 2010, in our country was implemented a national program (RO-STEMI) to offer rapid interventional treatment for patients with STEMI, aligned to ESC Guidelines. At the beginning only small parts of the patients were transferred to the hospital in charge for STEMI, so, we chose to study patients from the second year of the program and from last year. We made a retrospective study, including patients with STEMI that reached our hospital for primary angioplasty in the first 12h after the debut of the symptoms, aiming to make a parallel between the in-hospital mortality rates at maximum one month after the primary PCI. In order to be included, the patients must present ST elevation and another 1 out of 3 criteria (clinical, echocardiographic and biological changes suggestive for myocardial infarction). The main target was to evaluate the evolution of early mortality rates post primary PCI after the changes in the ESC Guidelines and the progresses in the medical field. A secondary target was to correlate mortality rates with the presence of comorbidities or risk factors.
Occipital radionecrosis and neuroplasticity in astrocytoma
Authors:   ,,Dr. Carol Davila’’ Central Military Emergency University Hospital, Al Ain Educational Zone, Carol Davila University of Medicine and Pharmacy, European Academy of Neurology, European Brain Council (https://www.braincouncil.eu/),, European Cooperation in Science and Technology, National Council for Development and Innovation, Titu Maiorescu University, Faculty of Medicine, Sirbu Carmen A. , Sirbu Octavian M. , Bastian Alexandra E.
Published: April 2022

Background: Late-delayed complications after radiotherapy (RT) results from an imbalance between cell lesions and the protective capacities of the CNS. Temozolomide (TMZ) after RT may represent a potent radiosensitizing regimen. Although radionecrosis (RN) of the anterior visual pathway has been documented, in our opinion this is the first report of reversible visual field loss associated with occipital lobe radionecrosis. Case observation: We report a patient who suffered a left lateral homonymous hemianopia one year after radiochemotherapy (RCT) for an infiltrative low grade fibrillary astrocytoma. The visual field deficit was completely reversible after one month. Visual field defects have been described after the use of conventional external beam therapy for lesions near the anterior visual pathway. The cortex is relatively spared after RT. Conclusions: Given the new scientific data, we suppose that neuroplasticity may play a role in the reversibility of visual field deficit. At this time there is no proven treatment of radionecrosis. Homonymous hemianopia caused by occipital lesions are attributable to vascular disease and tumors, but take into account radiation effects. The risk of neurogenic visual loss must be factored into the decision to irradiate the whole brain.
Association of rare disease and acute intoxication – case report
Authors: Macovei Radu A. , Tincu Radu C. , Tudosie Mihail S.
Published: April 2022

Benzodiazepine overdose has various clinical manifestation, mainly regarding the central nervous system (CNS), cardiac and respiratory side effects, but rarely results in significant morbidity and mortality. Acute benzodiazepine poisoning results in dizziness, ataxia, nystagmus, dysarthria, hypoxia, hypothermia, bradycardia, hypotension, apnea, pulmonary aspiration, respiratory depression, coma, cardiopulmonary arrest and death. Anyway, deep nonresponsive coma should be investigated for additional etiologies. On the other hand, human transmissible prion disease has a fatal outcome with no specific treatment.
History of medicine on the border between philosophy and science
Authors: Radu Mirela
Published: April 2022

Abstract: Physicians have represented a long time the main transmitters of knowledge as they were real scholars. If Renaissance promoted the study of the human body anatomy and physiology, the next step made by practitioners of medicine was to spread the enlightenment. That meant the shift of the very purpose of their profession: from passive opposition to ailments towards an active involvement into the lives of the impoverished. In order to change the odds in the battle against diseases, physicians had the great burden to enlarge the cultural horizons of those whose health was in their hands. Therefore, one way of imparting knowledge was by publishing and spreading their attainments to the general public in a comprehensible way. Once people gained awareness of the dangers entailed by bad hygiene, the physicians’ role in society switched towards more cultural realms. At the beginning of the 20th century health care professionals achieved the next step in the becoming of medicine: setting up a new science to link humanities with pure science. In Romania, the main promoters of this new border science were Victor Gomoiu and Valeriu Bologa and they co-opted other intellectuals.
The communication and promotion policies of the medical organizations in the marketing of Romanian healthcare services
Authors: Coculescu Bogdan , Purcărea Victor , Coculescu Elena
Published: April 2022

Abstract: The interdisciplinarity of the marketing department is due to the application of concepts, methods and marketing technics specific both to service and to social marketing. In addition to this fact, the attempt of the social services to satisfy the patient’s needs places the health care domain at the border between social and economic, between profit and non-profit orientation. However a lot of the notions from the marketing field (competition, promotion, strategy, need, supply, cost etc.) acquire new meaning when used for defining the rivalry between the distinct medical organizations, the advance of the health care services, the development and implementation policies in medical marketing, the increasingly acute demand for treatment, the use and the supply of health care services as well as the cost that it requires.. Conclusion: These above described microscopy method can be used to distinguish between benign and malignant thyroid nodules, based on different degree of the capsular collagen fibers orientation.
Medical applications of the GC/MS method in the acute intoxication with dimethoate – clinical case
Authors: Caragea Genica , Tudosie Mihail , Macovei Radu , Danescu Ilenuţa , Ionică Mihai
Published: April 2022

Abstract: Mass spectrometry is a chemical analytical method of determining organic substances by comparing their mass spectrum with mass spectra found in system libraries. In the case of biological products, substances of interest, like organophosphorus compounds, must be separated and identified for rapid and good medical measures (antidotism procedures) in acute intoxication case. A gas chromatograph coupled with a Varian mass spectrometer (GC-MS), was used to develop the application. The proposed objective is presenting the medical applicability in acute organophosphorus compounds intoxication management of the GC/MS method (gas chromatography coupled with mass spectrometry) as a separation and identification method for these compounds and their metabolites in urine samples.
Rare case of Stevens-Johnson-TEN overlap syndrome caused by mycotoxins
Authors: Cobilinschi Cristian , Țincu Radu , Tudosie Mihail , Ghiorghiu Zoie , Macovei Radu A.
Published: April 2022

Abstract: Mushroom poisoning is rarely associated with skin involvement. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions, characterized by extensive necrosis. SJS/TEN overlap includes patients with skin exfoliation between 10 to 30 percent of the body surface area. We report the case of a patient that was assumed to have ingested one type of toxic mushroom within the twelve hours prior to the appearance of skin lesions typical for SJS/TEN overlap syndrome.
Complications of systemic lupus erythematosus: A review
Authors:   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania, Iftimie Georgiana , Pantea Stoian Anca ,   2 University of Medicine  and Pharmacy “Carol  Davila”, Department of  Diabetes and Nutrition,  Bucharest, Romania, Socea Bogdan ,   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania 3 St. Pantelimon Hospital,  Department of General  Surgery, Bucharest,  Romania, Motofei Ion ,   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania 3 St. Pantelimon Hospital,  Department of General  Surgery, Bucharest,  Romania, Marcu Dragoș ,   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania 4 Urology Department,  Central University  Emergency Military  Hospital, Bucharest,  Romania, Costache Raluca S. ,   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania 5 Gastroenterology  Department, Central  University Emergency  Military Hospital,  Bucharest, Romania, Diaconu Camelia ,   1 University of Medicine  and Pharmacy „Carol  Davila”, Bucharest,  Romania. 6 Clinical Emergency  Hospital of Bucharest,  Bucharest, Romania
Published: April 2022

Systemic lupus erythematosus (SLE) is a complex autoimmune condition, which often evolves with severe complications. In SLE, autoantibodies appear, with systemic inflammation and multiple tissue destructions. SLE is the most common form of lupus and is considered more severe than other forms. SLE can affect many parts of the body, including the kidneys, heart, lungs, brain, blood, and skin. Symptoms vary among patients. SLE can follow an unpredictable pattern of remissions (symptoms improve) and flares (symptoms worsen). Renal involvement is one of the most severe complications in SLE patients. The process of depositing the immune complexes in the kidneys could lead to the appearance of lupus nephritis. If the treatment is early and treat-to-target, it can change the course of the renal disease.
Gut microbiota – new insight in colorectal cancer pathogenesis
Authors:   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Pătrășescu Mihăiță , Nuță Petruț ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Costache Raluca S. ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Bucurică Săndica ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Macadon Bogdan ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Balaban Vasile ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Popescu Andrada ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Călin Roxana ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Ioniță Radu Florentina ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest, Jinga Mariana ,   1 Carol Davila University  Emergency Central  Military Hospital,  Bucharest  2   Carol Davila University  of Medicine and  Pharmacy, Faculty of  General Medicine,  Bucharest
Published: April 2022

Gut microbiota is a superorganism involved in homeostasis and in pathogenesis. Microbiota composition is influenced by several factors such as: type of birth (cesarean or natural), role of age, role of diet. Pathological consequences of certain type of diet (especially western type of diet) may, in fact, be mediated by gut microbiota alteration. Also few studies have investigated the issue of gut microbiota composition in patients suffering of colorectal cancer, several reports notice relevant differences. Certain pathogenic bacteria in gut microbiota have been extensively studied in relation to their role in colorectal cancer. Thus, Fusobacterium nucleatum, which is abundant in colorectal cancer patient’s colon, may initiate the progression from adenoma to adenocarcinoma. A suggested pattern of oncogenesis in colorectal cancer may be represented by this: dysbiosis-inflammation-oncogenesis. A metanalysis that has been published in 2006 concluded a protective role of probiotics in colorectal cancer and in colonic adenoma.
Diagnosis and management of cases with deep infiltrating endometriosis affecting the urinary tract
Authors:   1Department of Obstetrics  and Gynecology, “Carol  Davila” University of  Medicine and Pharmacy,  Bucharest, Romania, “Prof.  Dr.Panait Sârbu” Clinical  Hospital of Obstetrics and  Gynecology, Coroleucă C.B. , Berceanu C. ,   2 University of Medicine  and Pharmacy, Craiova, Brindușe L. ,   3 “Carol Davila” University  of Medicine and Pharmacy,  Bucharest, Romania,  Department of Public  Health and Management, Marcu D. ,   4 Department of Urology,  Central Emergency  University Military Hospital,  “Carol Davila” University of  Medicine and Pharmacy,  Bucharest, Romania, Brătilă Elvira ,   1Department of Obstetrics  and Gynecology, “Carol  Davila” University of  Medicine and Pharmacy,  Bucharest, Romania, “Prof.  Dr.Panait Sârbu” Clinical  Hospital of Obstetrics and  Gynecology
Published: April 2022

Objective: The goal of this paper is to present the management of cases of deep endometriosis that affects the bladder, the ureters and the kidney. Materials and method: In this review we analyzed the sensitivity and specificity of imaging techniques for diagnosing deep infiltrating endometriosis, the optimal surgical technique and the surgical approach. Results: In patients with pelvic endometriosis in advanced stages the urinary tract is frequently involved. Preoperative work-up of patients with deep infiltrating endometriosis is aimed at evaluating the extension of the lesions in order to assess the complexity of the intervention and to choose the optimal approach. Conclusions: Laparoscopic and robotic management of these cases are good therapeutic alternatives. Ultrasound, sonovaginography with gel and MRI are useful imaging techniques for evaluating patients with deep infiltrating endometriois. The surgical management of patients with deep infiltrating endometriosis that involves the urinary tract consists of partial bladder resections, ureterolysis, ureteral resection and anastomosis and ureteral reimplantation.
Death due to a rare posttraumatic complication: fat embolism
Authors:   Bihor County Forensic Service, Oradea, Bihor, Romania, Podila Cristina , Somlea Mihaela ,   County Clinical Emergency Hospital Cluj-Napoca, Clinical Department of Dermatovenerology, Buhas Bogdan ,   County Emergency Hospital of Oradea, Department of Urology, Oradea, Romania, Judea Adrian ,   University of Oradea, Faculty of Medicine and Pharmacy, Department of Morphological Disciplines, Oradea, Romania, Hlescu Andreea ,   Grigore T. Popa University of Medicine and Pharmacy of Iasi, Romania, Department of Legal Medicine, Nicoara Nicolae ,   University of Oradea, Faculty of Medicine and Pharmacy, Department of Morphological Disciplines, Oradea, Romania, Sandoiu Flavia ,   Bihor County Forensic Service, Oradea, Bihor, Romania, Marian Paula ,   University of Oradea, Faculty of Medicine and Pharmacy, Department of Medical Disciplines, Hanganu Bianca ,   5 Grigore T. Popa University of Medicine and Pharmacy of Iasi, Romania, Department of Legal Medicine, Manoilescu Irina ,   Grigore T. Popa University of Medicine and Pharmacy of Iasi,  Romania, Department of Legal Medicine  Institute of Legal Medicine of Iași, Romania
Published: April 2022

Fat embolism is a rare complication of high or medium intensity trauma. It is caused by the formation of fat particles in the territories of small terminal circulation, especially at pulmonary, tegumentary and cerebral levels. The mechanism underlying the fat embolism is described by several different theories in literature. In legal medicine, fat embolism raises many controversies upon the diagnostic certainty of the thanatogenerator mechanism leading to death. The occurrence of fat embolism syndrome followed by death must be properly explained so that the fatality can be adequately framed from a legal point of view. In this paper the authors present three cases in which victims of trauma died due to clinically undiagnosed fat embolism, the diagnosis being established only by postmortem histopathological examination. The authors underline the fact that the diagnosis of fat embolism syndrome, although it is a clinical one, it is often established only during autopsy.
The concept of biological warfare and real biological attacks
Authors:   The Military-Medical Institute, Bucharest, Romania, Eremia Teodora , Gal Ioana ,   The Military-Medical Institute, Bucharest, Romania, Staicu Iulia ,   The Military-Medical Institute, Bucharest, Romania, Tudosie Mihail ,   The Military-Medical Institute, Bucharest, Romania  “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania, Ordeanu Viorel ,   The Military-Medical Institute, Bucharest, Romania  Military Medical Research Center, Bucharest, Romania  “Titu Maiorescu” University, Bucharest, Romania
Published: April 2022

In the current military-political context, with the Cold War having ended, we find ourselves in full anti-terror war, in which Romania is a direct participant, as a member of N.A.T.O. and the E.U., and the issue of biological warfare and bioterrorism is again highly topical but bearing other valences. There is information that there are still laboratories and plants specializing in the research and manufacture of biological weapons. Most of the results of such research are not intended to be published; however, a number of research guidelines that testify to the trends in the improvement of biological weapons and their means of use can be deduced from the data published by researchers from several research institutes. We believe that the threats posed by bioterrorism are real and that it is mandatory to be prepared at any time to prevent, combat and liquidate the consequences of ""bio-chem"" attacks, respectively the management of the consequences.
Methods of assessing stable coronary artery disease by non-invasive imaging techniques
Authors:   Clinical Emergency Hospital Bucharest, Romania, Voicu Carmen , Nanea Tiberiu ,   Prof. Dr. Th. Burghele” Hospital, Bucharest, Romania
Published: April 2022

Diagnosis of stable coronary artery disease is vital for prognosis, classification and early treatment. Current guidelines show that patients with stable angina who are suspected of CAD need to undergo a certain protocol for classification and further analysis. This review’s aim is to present the most used non-invasive techniques for identification of CAD and to underline the current development of imaging technology and the possible reduction of invasive measures due to non-invasive techniques. Currently, non-invasive techniques used to diagnose stable coronary artery disease have a very high accuracy and newer methods seem to be comparable to the gold-standard. The majority of the methods discussed have an optimal performance for patients with PTP between 15-85%, and the future of diagnosis for these patients seem to involve less invasive measures and less radiation by improving the current devices and by usage of machine-learning algorithms.
Endoscopic eradication of nodular gastric vascular antral ectasia by using band ligation after argon plasma coagulation
Authors:   Carol Davila University Emergency Central Military Hospital,  Bucharest, Romania, Bucurica Sandica , Ailenei Mihaela ,   Carol Davila University Emergency Central Military Hospital, Bucharest, Romania, Jinga Mariana ,   Carol Davila University Emergency Central Military Hospital,  Bucharest, Romania  Carol Davila university of Medicine and Pharmacy, Faculty of  General Medicine, Bucharest, Romania, Ionita Radu Florentina ,   Carol Davila University Emergency Central Military Hospital, Bucharest, Romania,   Titu Maiorescu University, Bucharest, Romania
Published: April 2022

Gastric antral vascular ectasia (GAVE) is an important cause of gastro-intestinal bleeding. The most common clinical presentation of GAVE is chronic occult bleeding that leads to symptomatic iron deficiency anemia, but some cases could present with acute massive bleeding. Frequently, patients are dependent by iron suplimentation, or in severe cases even blood transfusions. Endoscopic therapy is frequently necessary in acute or chronic blood loss. Over the past several years, treatment for GAVE has continued to evolve as the number of available effective therapeutic interventions has increased. These included: YAG laser, argon plasma coagulation (APC), endoscopic band ligation, cryotherapy and surgical anterectomy. Argon plasma coagulation is the most commonly used technique, but has been associated with several complications like sepsis, post-APC bleeding, gastric outlet obstruction and increased incidence of hyperplastic polyps. Endoscopic band ligation (EBL), a mechanical procedure, has been reported in the past years as an effective salvage therapy for GAVE that is refractory to other approaches, or even as the first line treatment. We present a case of nodular GAVE treated succesfully with endoscopic band ligation after unsuccesufull sessions with argon plasma coagulation.
Prioritisation in delivering health services: A military health system example
Authors:   Department of Health and Veterinary Medicine, Gendarmerie General Command, Ankara, Turkey, Demirtas Ünal
Published: April 2022

Objectives: The aim of this study is to use of available resources effectively and efficiently, to determine the situation of recource allocation, priority setting and to offer an insight into future planning in delivery of health services in Turkish Armed Forces (TAF). Study Design: This study was conducted using qualitative focus group method and it is a descriptive and qualitative study. Questions to be asked in the focus group discussions, the location and the time of discussions and the participants was determined by review of the literature. Methods: Focus group interviews lasted between approximately 90-120 minutes, respectively, to each focus group, 9 chief phsycians, 13 doctors /dentists, 6 nurses, 8 health noncommissioned officers, 7 officers, 6 noncommissioned officers and 6 health administrators were attended. Results: The result of focus group discussions; priority settings in military health services must be done and to preventive health care would be prioritised. The military hospitals in Internal Security Operation Area should be strengthened in terms of medical personnel and medical supplies and be full-fledged hospital. There was found that secondary care should be met from civilian hospitals in the other regions. Conclusion: It is evaluated that the study will be contributed to set of priorities in TAF military health services take the investments in the public or private health sectors and operational requirements into consideration, the studies carried out by TAF Medical Command in order to restructure of the military hospitals, to be employed the recources allocated for health services and health personnel graduated from Gulhane Military Medical Academy such as physicians, health noncommissioned officer and nurses in real requirement positions. Keywords: Military hospital, prioritisation, primary health services, focus group, health personnel.
Why cancer/terminal ill diagnosis unsuccessful in India: a qualitative analysis
Authors:   Bhupal Nobles University, Udaipur, India, Vaiphei Suantak , Singh Devendra ,   Bhupal Nobles University, Udaipur, India
Published: April 2022

The increasing of the modern technologies requires the setting up of multiple factories and industries that produce smokes and chemicals, which polluted the air, water, and the environment resulting in putting lives in dreaded conditions. In fact, the coming of the modern era and the modern lifestyle gives birth to numerous deadly diseases like cancer and its related diseases, which increasingly takes the lives of many in the country. The cold-blooded killer ‘cancer’ becomes the major public health concern in India as a whole. Among all the problems existed across the world, the problems or the issues associated with cancer or terminal illness becomes the worldwide phenomenon that produces several unwanted worst experiences. Human polluting the water, soil, and the air continued, and the global burden of cancer affected populations rapidly increasing year after year. Unfortunately, India turns out to be the world most densely cancer populated regions and a cancer hub. The reason behind the rapidly increasing of cancer illness and its mortality rates in India is mainly due to people lack awareness on cancerous factors, no proper preventive measures, and the late detection of the symptoms at the advanced stages when cure is not possible.Thus, concerning the helplessness conditions of the cancer effected people of in general, the current analytical study has been forms with an aim to spread awareness on the cold-blooded killer cancer across the country. Keywords: cancer, terminal illness, awareness, mortality rates, diagnosis.
Pregnancy outcomes in a patient with Fontan circulation for single ventricle congenital heart disease and aberrant praevia placental lobe
Authors:   University Emergency Hospital Bucharest, Romania, Voicu Diana , Munteanu Octavian ,   University Emergency Hospital Bucharest, Romania  2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Sajin Maria ,   University Emergency Hospital Bucharest, Romania, Dumitru Adrian ,   University Emergency Hospital Bucharest, Romania, Darabont Roxana ,   Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Cirstoiu Catalin ,   University Emergency Hospital Bucharest, Romania  2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Cirstoiu Monica ,   University Emergency Hospital Bucharest, Romania  2 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: April 2022

Single ventricle heart (SVH) is a very rare congenital heart disease. However, since the introduction of Fontan's intervention, the survival rate of patients with SVH has been significantly improved, increasing the number of women who may become pregnant in this condition. It has been already reported, in isolated case presentations or in some series of patients, that the pregnacy in the context of SVH and Fontan circulation carries a very high risk for first trimester miscarriage, maternal cardiovascular or obstetric complications and for an increased rate of pre-term birth. Therefore, it is an open field of debate weather or not to allow pregnancy in this category of patients. We are presenting the case of a 22 years old patient who underwent two surgeries for SVH: a Glenn procedure when she was 2 years old and the implantation of a Fontan circuit at the age of 16 years. Since the last surgery she was under permanent internal cardiac stimulation. During the pregnancy the patient was hemodynamically stable, with a normal resting oxygen saturation and a good ejection fraction of the single ventricle. However, the evolution of this patient has become even more challenging due to an aberrant praevia placental lobe. This condition brought her to hospital for several episodes of metrorrhagia and uterine contractions. She delivered at 33 weeks of gestation by emergency Caesarian section with a good evolution until discharge, for mother and the newborn. This case is supporting the opinion that pregnancy can be tolerated without important cardiovascular events in patients with SVH and Fontan circulation, unless heart failure or cardiac arrythmia are associated. Nevertheless, the obstetrical complications remain an important problem in pregnancy overcome of patients with Fontan circulation for SVH that can be superimposed with other unfavorable conditions, like aberrant praevia placental lobe in this case. During the management of such particular clinical settings difficult decisions must be taken, including those addressing the antithrombotic therapy that will be covered in the presentation of this case. Keywords: Pregnancy outcome; Cardiovascular pregnancy complications; Fontan procedure; Delivery, obstetrics.
Management of war-related vascular injuries: A civilian surgeon experience in the treatment of war casualties at a secondary care hospital
Authors:   Department of Cardiovascular Surgery, Inonu University Faculty of Medicine, Malatya, Turkey, Akça Bariș
Published: April 2022

Background: This study presents the management of patients with war-related injuries and early results of vascular injuries treated at a secondary care hospital neighboring to civil war. Methods: Between December 2013-December 2014 ninety-six war-related injury patients evaluated by a single vascular surgeon and participating disciplines according to components of injury in polytrauma patients. Thirty-six patients who underwent vascular surgery were retrospectively registered to the study. Demographics, treatment and early results of patients reviewed. Results: Mean age was 26.69±11.80 (7-66) years and 91.66% (33/36) were males. Injuries were caused by shrapnel wound due to bombing 61.11% (22/36), stab wound 8.33% (3/36), gunshot wound 30.55 % (11/36). The number of patients with polytrauma was 29, seven patients had isolated vascular injury. Among 42 arterial and 31 venous injuries primary suture repair, autologous vein graft interposition and prosthetic graft interposition performed to 20.54% (15), 28.76% (21), 19.17% (14) respectively. Amputation and all-cause mortality were %8.3 (3/36), 13.8% (5/36) respectively. Conclusions: Vascular injury with concomitant trauma is the main issue of war-related injuries. Surgeons should be cautious about patients who were initially deemed not to need surgery for vascular injury and then were found to need it. Repetitive physical examination is very important in case of any suspicion, especially in limited conditions for diagnostic tools like CT angiography. A rapid, careful multidisciplinary evaluation of experienced surgeons for the diagnosis and the treatment priorities in war-related injury patients may lead to increase life and limb salvage rates with a better quality of life. Keywords: vascular system injuries, war-related injuries, mortality, amputation, multiple trauma.