bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Electrokinetic Properties of Magnetite – Silica Core – Shell Nanoparticles
Authors: Utkin Yu. A. , Sha Minggong
Published: September 2021

In this work, the electrokinetic properties of Fe3O4 nanoparticles modified with various alkoxysilanes (tetraethoxysilane and 3-aminopropyltriethoxysilane) in various media were investigated. The determined values of the zeta potential of the Fe3O4/SiO2 samples indicate the complete coverage of nanoparticles with a tetraethoxysilane shell, as well as in the case of the Fe3O4/aminopropyltriethoxysilane. The data obtained on the zeta-potentials of modified nanoparticles with various ligands make it possible to predict the efficiency of subsequent functionalization by target molecules. A decisive role in the study of surface properties is played by cleaning from low molecular weight impurities that can screen the surface of nanoparticles or bind with an indifferent electrolyte. Thus, dispersion on a magnetic stirrer leads to an increase in the sorption capacity of the sample in comparison with ultrasonic dispersion, which causes irreversible destruction of the core-shell nanoparticle structure due to an increase in temperature and pressure in the cavities. This opens the prospective for practical application of modified nanoparticles for creation of tailored composite materials.
The Phonosemantics of the Sibilant Sounds of the Arabic and English Languages
Authors: Qudissya Asst Prof Nafila Sabri
Published: September 2021

Understanding the general meaning of phonemes and their combinations helps to guess the
meaning of unknown words intuitively. The aim of this paper is to examine a group of Arabic
as well as English phoneme combinations as examples to prove they have some specific
common meaning, a so-called DNA that can be traced in all given words. Thus, a group of
selected words were chosen from the Holy Qur'an whose language represents the Classical
Arabic variety. It has been assumed that the relationship between phonemes and what they
signify is non-arbitrary. It is determined that certain consonant combinations retain their
meanings. Thus, upon closer examination, words that are not similar to one another but which
have identical consonant phonemes combinations bear an element of meaning which is absent
in words not containing such combinations.
Modeling of the relationship between the Earth population growth and the electric energy production processes
Authors:   Branch of the National Research University ", Kavchenkov Valeriy P. ,   MPEI",   in Smolensk, Kavchenkova Elena V. ,   Independent Distribution Grid Company Electric Grid Smolensk LLC, Chernenkov Ivan D. ,   National Research University "MPEI"
Published: September 2021

The actual problem of an adequate mathematical description of the world development global processes trends is studied on the example of the Earth population growth and the production (consumption) of the electric energy. Various models used to describe the past, present and future of the various processes in nature, technology and economics are considered. It is shown that these processes are well described by the equations obtained during solving differential models with exponentially growth rates decaying in time. These models take into account the currently accepted doctrine of sustainable development of the world system using energy saving technologies, preserving environmental safety and using renewable energy sources. The similarity of the studied global processes and the possibility of their description by one criterion equation are established. At the same time their dynamics is characterized by different speeds. The first period is characterized by a rapid growth. After the inflection point the growth rates slow down but the volumes increase significantly and a gradual saturation occurs. The influence of the model parameters on the character of the studied processes on the phase plane is estimated which significantly simplifies their analysis. It is shown that the process of the world population growth passed the inflection point in 1990 and is 29 years ahead of the world electricity production growth. But the growth rates of electricity production and its consumption per capita are significantly higher. Thus, new mathematical models are proposed to describe the dynamic series of the Earth population growth, world production and electric energy consumption per capita. The obtained mathematical models have been in good agreement with statistical data for 60 years since 1960 and have high values of the determination coefficient. The studied processes prediction for the long-term period up to 2050 was made with their help. The results of the prediction do not contradict the results of other authoritative studies using the global processes inertial development model.
Simulation of the movement of the supporting leg of an exoskeleton with two links of variable length in 3D
Authors:   Branch of the National Research University ", Blinov Alexander О. ,   MPEI",   in Smolensk, Borisov Andrey V. ,   Branch of the National Research University "MPEI" in Smolensk, Konchina Larisa V. ,   The Branch of National Research University MPEI in Smolensk, Kulikova Marina G. ,   The Branch of National Research University MPEI in Smolensk, Maslova Ksenia S. ,   The Branch of National Research University MPEI in Smolensk
Published: September 2021

A two-link model of exoskeleton with variable-length links for supporting the lower limbs of the human musculoskeletal system is proposed in the article. The researched model differs from the existing ones by the variable-length links, and by the angle calculation method. While in the existing models, the angles are calculated from the regular direction – from vertical, or from horizontal, – in the proposed research they are calculated between the links. As for practical exoskeleton implementation, the proposed method of angle calculation is appropriate to the actual working conditions of the electrical motors with the reduction gears installed in the hinges, which change the angles between the links. The construction of a variable-length exoskeleton link consists of two absolutely solid weighty sections located at both ends of the link and one weightless section between them in the center of the link. In the weightless section, there is a drive that creates a control longitudinal force, which realizes the increase or decrease in the length of the link in the required manner and provides the necessary maintenance of the length of the link when the person moves in the exoskeleton. The links are connected to each other using spherical hinges. Drives are installed in each hinge, creating control torques, which provide a relative rotational movement of the links. The jointly controlling longitudinal forces and moments realize the maintenance of the posture or the movement of the link in the required manner and, in relation to the exoskeleton, the repetition of the basic biomechanical properties of the human musculoskeletal system. The mathematical model in the form of the system of Lagrange differential equations of the second kind is obtained. The obtained mathematical model is examined for existence and uniqueness of the Cauchy solution. The kinematic trajectory of the link motion has been synthesized, which simulates the anthropomorphic movement of the supporting leg during the single-support phase of movement, and the control actions required for its implementation has been found. The significance of the results obtained in the process of modeling lies in the ability to create active exoskeletons, prostheses in medicine, anthropomorphic robots, and spacesuits that take into account the biomechanical features of the functioning of the human musculoskeletal system.
Algorithms and soft for adapting the knowledge base of project management information systems
Authors:   Branch of the National Research University ", Chernovalova Margarita V. ,   MPEI",   in Smolensk, Kakatunova Tatyana V. ,   Branch of the National Research University "MPEI" in Smolensk, Volkova Irina V. ,   The Branch of National Research University MPEI in Smolensk, Vlasova Ekaterina A. ,   Synergy University
Published: September 2021

The effectiveness of design solutions largely depends on the promptness of processing a large amount of data from various sources, which determines the feasibility of using information decision support systems (IDSS) in the field of project management. The peculiarities of information processes in project management greatly complicate or even make it impossible to implement in practice methods for constructing analytical, as well as probabilistic and statistical dependencies between the characteristics of the modeled project management system and the indicators of its internal and external environment. In this regard, as an algorithmic support for IDSS for project management, it is promising to use precedent methods for analyzing information based on knowledge about similar situations previously observed in the practice of project management, and representing knowledge in the form of ontologies. Analysis of practical situations in the field of project management makes it possible to substantiate the expediency of organizing a monitoring procedure for the IDSS knowledge base, based on the results of which decisions on its adaptation are made. The article proposes the main ways of this adaptation: changing the structure and basic elements (first of all, concepts) of ontologies; clarification of the structure of the description of current situations and, therefore, precedents. The developed algorithm for monitoring the IDSS knowledge base on project management for the analysis and identification of typical situations of the feasibility of changing it is described. The algorithm is distinguished by the possibility of developing recommendations on the modification of ontologies based on a fuzzy classification of search results and using precedents relevant to current situations. A procedure is proposed for changing the structure of the description of precedents, taking into account the results of assessing the indices of the fuzzy correspondence of the characteristics of the existing precedents to the characteristics of the project being implemented. A description of a computer program that implements the proposed algorithm and its components, as well as the results of its application are given.
Modeling of educational processes based on neuro-fuzzy temporal Petri nets
Authors:   Branch of the National Research University ", Borisov Vadim V. ,   MPEI",   in Smolensk, Misnik Anton Е. ,   Inter-state Educational Institution of Higher Education "Belarusian-Russian University", Prakapenka Siarhei А. ,   National Research University "MPEI", Kutuzov Viktor V. ,   Inter-state Educational Institution of Higher Education "Belarusian-Russian University", Zakharchenkov Konstantin V. ,   Inter-state Educational Institution of Higher Education "Belarusian-Russian University"
Published: September 2021

The article is devoted to the implementation of a method for modeling processes in complex educational systems based on the proposed variety of neuro-fuzzy temporal Petri nets. The article considers educational systems of the level of higher educational institutions, which, of course, belong to the class of complex systems. The need for a method, models and modeling tools is dictated by the fact that modern educational processes require constant modernization, due to the constantly growing volumes of information, changes in legislation, stricter requirements for specialists, rapid development of technologies, constant discoveries in various fields, as well as the influence of external factors. Requirements for the tools for modeling processes in complex systems are formulated, the use of Petri nets as the basis of such models is substantiated. The existing educational processes are considered on the example of the cycle of training in the master's program of the Belarusian-Russian University. The model of educational and information-analytical learning processes in the master's program based on the neuro-fuzzy temporal Petri net is presented. The proposed method allows to increase the flexibility of the choice of individual trajectories of training in the master's program, the effectiveness of elective disciplines and to make the transition to an integrated approach in the preparation of undergraduates. The proposed method can also be used as a basis for monitoring the state and control of information and analytical processes in educational systems. An approach to the construction of software-instrumental environment for the design and modification of information-analytical processes is described, aimed, among other things, at bridging the semantic gap between experts, architects and developers of information-analytical processes. A subsystem for the formation of a neuro-fuzzy temporal model of processes within the framework of a software-instrumental environment is considered.
Cognitive modelling application to business model choice justify of an economic organization
Authors:   Branch of the National Research University ", Fomchenkova Larisa V. ,   MPEI",   in Smolensk, Fomchenkov Vladimir P. ,   Branch of the National Research University "MPEI" in Smolensk
Published: September 2021

This article considers the urgent scientific and practical task of developing analytical tools to justify the choice and transformation of a business model for an economic organization in a rapidly changing business environment. The mathematical apparatus of cognitive modelling is proposed to use to solve this problem, which makes it possible, based on the analysis of cause- effect relationships between the most significant conditions and factors affecting the economic efficiency and competitiveness of doing business, to improve the reasonableness and reduce the subjectivity of the decisions made by its owners and top managers. An algorithm to justify the choice of a business model for an organization based on the construction and analysis of fuzzy cognitive maps (FCM) of business models is proposed. A common list of business factors (concepts) and a set of causality relations between each pair of concepts has been defined, and a basic FCM of the business model is developed as the basis for constructing FCM models of specific businesses. An example of the application of the developed toolkit in a strategic analysis of the conditions and factors of an organization undertaking the production of furniture, carried out to justify a change in competitive strategy and the associated transformation of the business model, is considered. The analysis has been performed using specialized cognitive modelling software developed at the department of information technologies in economics and management, branch of the National Research University Moscow Power Engineering Institute in Smolensk. The proposed toolkit improves methods and algorithms for intelligent decision-making support in the management of economic and social objects and can find practical application in the strategic management of commercial organizations in various fields, as well as be used by professional consultants in the preparation of recommendations for business model change.
Detecting Extremists Online: Examining Online Posting Behaviors of Violent and Non-Violent Right-Wing Extremists
Authors: Scrivens Ryan , Chermak Steven M. , Freilich Joshua D. , Wojciechowski Thomas W. , Frank Richard
Published: September 2021

Like most of us, violent extremists often leave a digital footprint behind. Researchers, practitioners, and policymakers raise questions about whether violent individuals can be identified online prior to their attacks offline based on their online posting behaviors. Despite ongoing concerns, few empirically grounded analyses have identified which online users have engaged in violent extremism offline and then assessed their digital footprints, and fewer analyses have identified differences in posting behaviors of those who share extreme ideological beliefs but are violent or non-violent in the offline world. This policy note highlights the importance of both identifying and examining the online behaviors of violent and non-violent extremists in preventing and countering violent extremism (P/CVE) and provides researchers, practitioners, and policymakers with a number of recommendations for detecting and analyzing the online behaviors of violent and non-violent extremists in the future.
Gamma Knife Stereotactic Radiosurgery (GKS) for the treatment of Vestibular Schwannomas (VS)
Authors:   Department of Neurosurgery, „Bagdasar-Arseni“ University Hospital, Bucharest, Romania, PERIN R. , MOHAN A. ,   Department of Neurosurgery, Bihor County University Hospital, Oradea, Romania, MOISA H. ,   Department of Neurosurgery, Sanador Medical Center Hospital, Bucharest, Romania; Department of  Neurosurgery, „Carol Davila“ University School of Medicine and Pharmacy, Bucharest, Romania, CIUREA A.V. ,   Department of Neurosurgery, Sanador Medical Center Hospital, Bucharest, Romania; Department of  Neurosurgery, „Carol Davila“ University School of Medicine and Pharmacy, Bucharest, Romania
Published: September 2021

Introduction. Vestibular schwannomas (VS) or acoustic neuromas (AN) (as they are known to neurosurgeons) are benign tumors which originate at the junction between central nervous system myelin and peripheral nervous system myelin – an area known as the Obersteiner-Redlich area. Acoustic neuromas represent a special pathologic entity for neurosurgeons due to their important symptoms which need to be adressed as soon as possible and due to the secondary disfunctions which may appear if the tumors are not treated appropriately. Materials and methods. The study below presents the experience of the authors regarding the use of stereotactic radiosurgery for the treatment of acoustic neuromas. The authors focus on a population of 231 patients diagnosed and treated for VS over a period of 10 years at the „Bagdasar-Arseni“ University Hospital in Bucharest. This study compares the impact of Gamma Knife Surgery when performed alone or in association with open microneurosurgery. The authors assessed patients with tumors ranging between 0.25 and 14 cm3 in volume. Gamma Knife Surgery is used successfully to treat VS, both independantly or in association with open microsurgery. Results. The major complications of the treatment are represented by lack of response to treatment (less than 1% of patients) and cerebral edema (16.4% of patients). Conclusions. Given its multiple advantages, stereotactic radiosurgery is right now the tip of the spear regarding the therapeutical means available for VS. When the tumors met in daily practice are larger than the therapeutical resources of the devices used for Gamma Knife Surgery an open microsurgical approach may be attempted followed by stereotactic iradiation of the remnant tumor. Given the large number of successes reported in the literature and the small number of complications but also the ever progressing technology used to improve Gamma Knife devices, the authors consider stereotactic radiosurgery to be a very good solution for the treatment of VS. Furthermore, the improvement potential this technique has grants it the potential to improve standard of treatment for acoustic neuromas and the quality of life in patients with this disease.
Efficacy and safety of ultrasound-guided brachial plexus blocks for upper limb surgery
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, UNGUREANU Raluca ,   Clinica ATI, Spitalul Clinic de Urgenţă, Bucureşti, MIREA Liliana ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti,   Clinica ATI, Spitalul Clinic de Urgenţă, Bucureşti, GRINŢESCU Ioana ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti,   Clinica ATI, Spitalul Clinic de Urgenţă, Bucureşti, TULBURE Dan ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti,   Institutul Clinic „Fundeni“, Bucureşti, POPESCU Gheorghe ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti,   Clinica Ortopedie, Spitalul Clinic de Urgenţă, Bucureşti
Published: September 2021

Introduction. The use of ultrasound (US) for brachial plexus block has increased enthusiasm because the anesthesiologist can visualize anatomy, needle placement, and local anesthetic spread during locoregional anesthesia. The objectives of this prospective study was to evaluate the efficacy and the safety of ultrasound guided brachial plexus block comparative with traditional method of neurostimulation. Material and methods. In this randomized controlled clinical trial we included patients over 18 years old with upper limb surgery and who benefit of brachial plexus block (axillary, interscalenic or combined blocks). After monitoring and sedation, the patients randomly received ultrasound-guided (62 pts.) or neuro stimulation (63 pts.) brachial plexus block with ropivacaine 0.5%. We recorded data about: block success rate, sensitive and motor block onset time, block performance time, immediate and late complications events, patient’s satisfaction rate. The results were statistically analyzed, with significance assumed at p<0.05. Results. Block success rate with ultrasound guidance was very high (93.5% in US group and 84% in NS group). The patients of US group received less volume of local anesthetic (20.89 ± 3.9 ml vs. 43 ± 5.1 ml in NS group, p < 0.05). The performance time, needle punctures, sensory and motor onset time was significant reduced in US group. In the NS group we recorded 2 local anesthetic systemic toxicity (minor-moderate neurologic symptoms) with complete recovery and none in US group. We recorded less paresthesia during block performance and vascular puncture due to US guidance (p<0.05). Patient acceptance with locoregional anesthesia is good, even patients experience more discomfort during neurostimulation technique. Conclusions. The results of this study suggest that both techniques of execution of brachial plexus block are adequate for upper limb surgery but US guidance provides significant benefits for patients in terms of efficacy and safety.
Prevalence of metabolic syndrome within hypertensive population and the risk of developing atherosclerotic cardiovascular diseases
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“ Bucureşti, BEJAN Gabriel Cristian , MATEI Dumitru ,   Universitatea de Medicină şi Farmacie „Carol Davila“ Bucureşti, IANCU Adela ,   Universitatea de Medicină şi Farmacie „Carol Davila“ Bucureşti
Published: September 2021

Metabolic syndrome, also called insulin resistance syndrome or excess of catecholamines, is represented by several cardiometabolic factors that result in increased incidence of cardiovascular disease and type 2 diabetes. Due to sedentary lifestyle and hypercaloric food, with a high percent of saturated fats and carbohydrates, that characterize modern lifestyle of the population, especially in urban areas, the prevalence of metabolic syndrome recorded an ascending slope that makes it a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, with age between 48 and 83 years, in whom we determined the prevalence of metabolic syndrome and cardiovascular disease. The survey results showed an increased prevalence of metabolic syndrome, considering that we related to a hypertensive population, and an increased risk of non-fatal atherosclerotic cardiovascular diseases in men and fatal cardiovascular events in next 10 years especially for women.
Surgical approach of complex cases of uterine fibromatosis – three case reports and literature review
Authors:   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest, IOSIFESCU Razvan , GINGHINA Octav ,   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest, MUNTEANU Rubin ,   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest, GIDEA Clarisa ,   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest, SPANU Andrada ,   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest, CALIN Camelia ,   „Sf. Ioan“ Emergency Clinical Hospital, Intensive Care Unit, Bucharest, IORDACHE Nicolae ,   „Sf. Ioan“ Emergency Clinical Hospital, General Surgery, Bucharest
Published: September 2021

The main challenges of benign uterine surgery are fertility preservation, choosing the optimal approach (open or minimally invasive) and the management of complications. Conventional laparoscopy is the main technique used for laparoscopic hysterectomy for benign indications. We present three cases of complex patients with uterine fibromatosis, along with a literature review over the continually regressing limits of the laparoscopic approach of uterine pathology.
The genetic factors of hereditary thrombophilia and their implication in spontaneous abortion
Authors:   Spitalul Clinic Municipal „Dr. Gavril Curteanu“, Oradea, KOZMA Kinga ,   Facultatea de Medicină şi Farmacie, Universitatea din Oradea, JURCA Claudia ,   Spitalul Clinic Municipal „Dr. Gavril Curteanu“, Oradea,   Facultatea de Medicină şi Farmacie, Universitatea din Oradea, BEMBEA Marius ,   Spitalul Clinic Municipal „Dr. Gavril Curteanu“, Oradea,   Facultatea de Medicină şi Farmacie, Universitatea din Oradea
Published: September 2021

Thrombophilia is an abnormality of blood coagulation which correlates with a hypercoaguable state. Hereditary thrombophilia is a genetic disorder with heterogeneous etiology, produced by mutations described in almost all coagulation factors. The hereditary transmission is autosomal dominant in most cases with variable penetrance. The combination of polymorphisms in the involved genes in the coagulation process is a high risk factor for the clinical manifestations of thrombophilia. The clinical consequences of hereditary thrombophilia (cardiovascular and cerebral thrombosis, spontaneous abortion, preeclampsia, abruptio placentae, intrauterine growth retardation) are correlated in a manner not yet fully known to the type and number of mutations.
Toxic thyroid adenoma – case presentation and general considerations
Authors:   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, GHEMIGIAN A. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, POPESCU I. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, PETROVA E. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, GHEMIGIAN M. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti
Published: September 2021

Toxic thyroid adenoma is the third leading cause of hyperthyroidism (following Graves-Basedow disease and toxic multinodular goiter). It consists in the presence of a single nodule that autonomously produces thyroid hormones, causing – in time – outlining of characteristic clinical picture of hyperthyroidism. Paraclinical diagnosis involves thyroid hormones assesment and thyroid ultrasound and scintigraphy that show characteristic changes. There are several treatment options and, with correct management, the prognosis is very good.
Up-to-date review reporting the technological details of devices used in the management of neurogenic bladder in post spinal cord injury patients
Authors: SPINU Aura , DAIA Cristina ,   „Bagdasar-Arseni“ Teaching Emergency Hospital, Bucharest, Romania,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, HARAS Monica ,   „Bagdasar-Arseni“ Teaching Emergency Hospital, Bucharest, Romania,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, ANGHELESCU Aurelian ,   „Bagdasar-Arseni“ Teaching Emergency Hospital, Bucharest, Romania,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, ONOSE Gelu ,   „Bagdasar-Arseni“ Teaching Emergency Hospital, Bucharest, Romania,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest
Published: September 2021

In the past years, a major cause of invalidity and death in post spinal cord injury (SCI) patients with neurogenic bladder (NB) was the renal failure. Since our ability to manage the dysfunction of NB has improved, the morbidity/mortality in these individuals significantly decreased. The aims in NB management are to protect the upper and lower urinary tract and to improve the quality of life (QoL) of these individuals. The insertion and removal of the catheter many times a day, to empty the bladder is called intermittent catheterization and it is considered the „gold standard“ in the NB management. Nowadays, there are available many types of catheters, materials and techniques: non-coated catheters, gel-coated catheters, hydrophilic catheters, glycerine based catheters. The choice of a catheter should be made on an individual analyse, according to gender, age, level of injury, functional status, urethral sensibility, or the circumstances the IC is needed (so, a patient may need a type of catheter at home and another one outside).
Economic analysis of medical management applied to left colectomy with anastomosis
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, PANŢU H. Basca , DUMITRESCU D. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, BORCAN R. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, TROTEA T. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, ŞAVLOVSCHI C. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti
Published: September 2021

The occurrence of left colon neoplasm is increasing and, despite the continuous improvement of the surgical treatment, the death rate consequent to this disease has remained constant these last few years. (1) The economically efficient medical management is currently a general concern worldwide and – in this context – the cost analysis is an important step forward in the joint eff ort to reach medical economic efficiency. (2)
Cephalalgia classification
Authors:   Institutul Naţional de Neurologie şi Boli Neurovasculare Bucureşti, TOADER Corneliu , TOADER Mioriţa ,   Spitalul de Copii „Grigore Alexandrescu“ Bucureşti, DRĂGHICI Mircea ,   Dentirad Hospital, Ploieşt, OPREA Alina ,   Spitalul de Copii „Grigore Alexandrescu“ Bucureşti, ŞERBĂNICĂ Andreea ,   Spitalul de Copii „Grigore Alexandrescu“ Bucureşti, NEACŞU Daniela ,   Spitalul de Copii „Grigore Alexandrescu“ Bucureşti, VIVISENCO Iolanda ,   Spitalul de Copii „Grigore Alexandrescu“ Bucureşti
Published: September 2021

The oldest medical ailment – cephalalgia – has been attributed various etiologies throughout time. The high incidence along with the fact that every person (disregarding age and sex) can experience a case of physiologic or pathologic cephalalgia have contributed to the elaboration of molecular, immunological, fundamental, clinical, paraclinical and radiological research studies. The data resulted created the possibility of identifying new etiologies for cephalalgia and establishing innovative evaluation techniques. The authors aim at presenting the international classification of cephalalgia used not only by clinicians but also by researchers. In addition we want to outline the fact that our colleagues should explain to their patients the fact that cephalalgi has numerous causes.
The surgical treatment of thoracic metastases in ovarian cancer
Authors:   Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania, SAVESCU Alice , BALESCU Irina ,   „Ponderas“ Hospital, Bucharest, Romania, BACALBASA Nicolae ,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania
Published: September 2021

Ovarian cancer still represents one of the most aggressive malignancies affecting women worldwide. Unfortunately many patients are still diagnosed in an advanced stage of the disease when distal metastases are already present. When it comes to thoracic involvement in advanced stage ovarian cancer, this may develop via peritoneal, hematogenous and lymphatic route. This is a literature review of the most commonly seen involvements in ovarian cancer and of the most appropriate surgical procedures which might be performed in order to increase the rate of complete cytoreduction.
Diabetes mellitus: present by historical perspective
Authors:   Institutul Naţional de Diabet, Nutriţie şi Boli Metabolice „N.C. Paulescu“, Bucureşt, IONESCU-TÎRGOVIŞTE Constantin
Published: September 2021

Diabetes mellitus has been known from antic period, due to the sweet taste of the urine of this patients. The modern era of diabetes started in 1815 with the discovery made by the French chemist Eugène Chevreul, who found that the sweet substance from the diabetic urine was the same with the grapes sugar. At this point, the study of diabetes has had aproached several succesive objectivs: the development of chemical methods from determination of urinary and blood glucose and its physiological signification (A. Bouchardat, Claude Bernard); the discovery of the organ involved in diabetes (E. Lancereaux, P. Langerhans, von Mering and Minkowsky, E. Laguèsse); indirectly demonstration of the presence of a pancreatic antidiabetic substance, produced possible in the Langerhans islets (E. Hédon, E. Gley, G.L. Zuelzer), the discovery of antidiabetic hormone and full description of its metabolic functions (N.C. Paulescu); purification of the pancreatic extract by J. B. Collip and it’s utilization in diabetes treatment by J. MacLeod, F.G. Banting and C.H. Best; in an unprecedental hurry, the 1923 Nobel Prize for the physiological and experimental discovery of insulin (in fact made by Paulescu) and for its clinical application (in fact due to the purification of the pancreatic extract made by J. B. Collip), without factual reasons the Nobel Prize was awarded to Banting and MacLeod.
Maternal mortality in Romania in 2013
Authors:   Spitalul Clinic „Nicolae Malaxa“, Bucureşti, GARDESCU Marrie Jeanne , MATEI Alexandru ,   Spitalul Clinic „Nicolae Malaxa“, Bucureşti, EDU Antoine ,   Spitalul Clinic „Nicolae Malaxa“, Bucureşti, NANU Dimitrie ,   Clinica de Obstetrică-Ginecologie „Bucur“, Bucureşti
Published: September 2021

The maternal mortality continues to be a concern for both the medical organizations and for the factors responsible with the identification of causes and with the disposal of this matter. Although the recorded tendency of the maternal mortality in Romania has been decreasing in the last years, it still remains at a high level compared to the average recorded in the geographical zone we are situated in.
Preoperative management in Hirschsprung’s congenital megacolon
Authors:   Spitalul Clinic de Urgenţe pentru Copii „Grigore Alexandrescu“, Bucureşti, TUDORACHE Simona-Gabriela ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, CHIRIAC-BABEI Cătălin ,   Spitalul Clinic de Urgenţe pentru Copii „Grigore Alexandrescu“, Bucureşti,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, PĂTRĂNCUŞ Toli ,   Spitalul Clinic de Urgenţe pentru Copii „Grigore Alexandrescu“, Bucureşti,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, NICULESCU Laura ,   Spitalul Clinic de Urgenţe pentru Copii „Grigore Alexandrescu“, Bucureşti
Published: September 2021

Introduction. Hirschsprung’s congenital megacolon is a challenge in terms of diagnosis and a proper treatment plan. If, in terms of the final operation there have been described various techniques and done studies that followed postoperative complications, regarding tracking and treatment previous to the intervention there is little documentation available. Material and methods. The study is retrospective and includes a group of 31 patients diagnosed and treated in the “Grigore Alexandrescu” Children’s Emergency Hospital between 2010-2014. The group of patients was divided into two groups: Group I – patients who underwent diverting stomy before pull through and group II – without diverting stomy, who received preoperative nursing. The main parameters followed were: the frequency rate of enterocolitis and number of hospitalizations before the definitive operation. The second parameter followed is the patients age at the time of the pull through, patients were followed until definitive surgery. Data was collected from the hospital information system – Hippocrates, the clinical charts and the operation room registry of surgery and were processed using SPSS version 22.0. Results. From group I, 10 patients (32.3%) had at least one episode of enterocolitis before definitive surgery, compared with only 3 patients (9.7%) in group II. Analyzing the data, we fi nd that patients in group I have on average 4 more hospitalizations than those in group II. The average length hospitalization was 21 days for group I and 7 days for group II. The age at the time of operation ranged between 2 and 72 months in the whole group, with an average of 8 months for patients in group II and 21 months in the first group. The average duration of observation of the patients was 3 months for group I and 16 months for the second group. Conclusion. In the group with diverting stomy, infectious episodes are more frequent and the number of hospitalizations before the pull through is bigger. If frozen histopathological examination is available one stage pull through is considered the best option, exception beeing when there is an absolute indication for diverting stomy.
Anatomical and functional correlations in feminizing genitoplasty in patients with congenital adrenal hyperplasia
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, ANDRIESCU Mircea ,   Spitalul de Pediatrie MedLife, Bucureşti, TALĂ Sorin ,   Spitalul de Pediatrie MedLife, Bucureşti, ENESCU Dan Mircea ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti,   Spitalul Clinic de Urgenţă pentru Copii „Grigore Alexandrescu“, Bucureşti
Published: September 2021

Objectives. To establish the anatomical and functional correlations which are necessary in feminizing genitoplasty through the study of the specialized literature, following the changes in surgical procedures gained with the improvement of anatomical knowledge. Materials and method. There were studied references from internet database, some with historical importance but representative as evolutionary steps in establishing the current procedures accessed in feminizing surgery. There were searched case reports, reviews, technical presentations, descriptive, retrospective and prospective studies, also book chapters. Results. Of the studied materials have been selected 43 titles, including articles and papers that bring in the fore the importance of the anatomical and functional features present within the studied pathology, making correlations that developed, perfected and refined surgical techniques used in feminizing genitoplasty. Some observations and technical applications have historical value in these days but aspects were reiterated in this study, trying to select some surgical procedures in according with current requirements. Conclusions. Although techniques have gained value thanks to the thorough study of functional anatomy, each surgical stage winning accuracy and functional value, keeping the sensitivity of the genital area through the observance of structures with tactile and erectile importance, there are controversies which are emphasized by the pitiful of long-term outcomes, but also by ethical and deontological implications of this type of treatment. For cases of Congenital Adrenalian Hyperplasia keeping the integrity of the tissue and reproductive function is the main reason which eases the surgical decision.
Kounis syndrome – an unusual etiology of acute myocardial infarction
Authors:   Spitalul Clinic de Urgenţă, Bucureşti, BĂTĂILĂ Vlad , VÎJÎIAC Aura ,   Spitalul Clinic de Urgenţă, Bucureşti, CÂLMÂC Lucian ,   Spitalul Clinic de Urgenţă, Bucureşti, DOROBANŢU Maria ,   Spitalul Clinic de Urgenţă, Bucureşti,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti
Published: September 2021

Kounis syndrome is defined as an association between an acute coronary syndrome and acute systemic allergy involving vasoactive mediators released during the activation of the mast cells. A 79 year old woman arrives at the emergency department with syncope; she was stung by a wasp an hour before symptoms’ onset. Clinical examination was normal, excepet her left upper limb which had important edema. The ECG revealed ST-segment elevation in the inferior leads and negative T waves in the anterior leads. Emergency coronary angiography was performed, which revealed a 40% stenotic plaque on the mid LAD. A conservative approach was decided. The patient received standard anti-ischemic treatment and she was safely discharged after 6 days. We considered this case a Kounis syndrome induced by a wasp sting associated with a silent inferior myocardial infarction.
Brainstem tumor associated with misleading ENT diseases – case presentation
Authors:   Spitalul Clinic de Urgenţă pentru Copii „Grigore Alexandrescu“, Bucureşti, Zamfir-Chiru-ANTON A. , GHEORGHE D.C. ,   Spitalul Clinic de Urgenţă pentru Copii „M.S. Curie“, Bucureşti
Published: September 2021

Vestibular syndromes are less common seen in pediatric practice than in adult pathology. Vestibular testing is not usual in pediatric hospitals. The most usual causes for vertigo in children are usually less investigated. The authors present a rare case of a child with a brainstem tumor presenting concomitant rhinosinusitis symptoms. Vestibular investigation and a thorough history managed to discover the real nature of the clinical signs. Conclusion: vertigo in children needs careful evaluation for precise determination of its cause.
Peripheral artery disease – necessary steps for keeping us walking
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“, București, DIACONU Camelia ,   Clinica de Medicină Internă, Spitalul Clinic de Urgenţă, Bucureşti, CRÎȘMARU Irina ,   Clinica de Medicină Internă, Spitalul Clinic de Urgenţă, Bucureşti, DEDIU Giorgiana ,   Universitatea de Medicină şi Farmacie „Carol Davila“, București, BĂLĂCEANU Alice ,   Universitatea de Medicină şi Farmacie „Carol Davila“, București,   Clinica de Medicină Internă, Spitalul Clinic de Urgenţă „Sf. Ioan“, Bucureşti
Published: September 2021

Peripheral arterial disease (PAD) is a consequence of the atherosclerosis of large arteries located distal to aortic arch. The most common symptom is intermittent claudication. The most commonly used screening tool of BAP in primary care is the ankle-brachial index (ABI), especially recommended for patients older than 70 years or between 50-69 years, if they are diabetics or smokers. Management of PAD include smoking cessation, exercise, treatment with statins, antiplatelet therapy with aspirin and clopidogrel, possibly cilostazol in patients without heart failure. Surgery is recommended for patients who do not respond to drug therapy.
Thyroid cancer
Authors:   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, GHEMIGIAN A. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, BURUIANĂ A. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, PETROVA E. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, POPESCU I. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, GHEMIGIAN M. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti
Published: September 2021

The most common endocrine neoplasia, showing a large increase in incidence in recent decades, thyroid cancer is a disease requiring early diagnosis and appropriate treatment. Thyroid cancer is a heterogeneous entity in terms of cell type origin, degree of differentiation, evolution and prognosis. Forms of epithelial origin, well-differentiated and with good prognosis are, fortunately, most commonly found. Thyroid cancer appears as a solitary node or multinodular goiter. The maximum practical importance is the recognition of clinical features that raise suspicion of malignant nodule, although it is important to note that, often, thyroid carcinoma appears inside of nodules without suspicious clinical features. Although malignant nodules may have certain morphological characters at imaging exploration, fine needle aspiration cytology is the most faithful/reliable method for preoperative differential diagnosis of an nodule. The complex treatment must be adapted to each case to ensure maximum efficiency.
Diabetes secondary to endocrine diseases
Authors:   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, GHEMIGIAN A. ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, POPESCU I. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, PETROVA E. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti, BURUIANĂ A. ,   Institutul Naţional de Endocrinologie „C.I. Parhon“, Bucureşti
Published: September 2021

Diabetes mellitus may occur as a complication of endocrine disorders and it’s name is, according to current classification (American Diabetes Association): „other specific types of diabetes“. This particular endocrine diseases associate sustained and excessive hormonal secretion, which interferes insulin secretion or action. Over time, glucose intolerance and then diabetes occur. Generally, there are middle forms with no ketosis because of the persistence of endogenous insulin secretion. More then that, hyperglycemia is usually reversible with the treatment of the underlying endocrinopathy. Main endocrine diseases that cause diabetes are reviewed.
Sentinel lymph node in early cervical cancer – pros and cons aspects
Authors:   Department of Obstetrics and Gynecology, University Emergency Hospital, Bucharest, Romania, SAVESCU Alice , BALESCU Irina ,   „Ponderas“ Hospital, Bucharest, Romania, BACALBASA Nicolae ,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania
Published: September 2021

Cervical cancer remains an important health problem worldwide responsible for a high number of deaths especially in cases diagnosed in advanced stages. When it comes to patients diagnosed in early stages, they have an improved prognosis with high rates of 5 year overall survival. Due to the fact that one of the most important routes of dissemination remains the lymphatic pattern, studies were focused on determining which cases are more suitable for lymph node dissection even if an early stage of the disease is expected. This is a literature review regarding pros and cons aspects of the utility of sentinel lymph node in early stage cervical cancer.
The impact of modern cardiovascular risk factors associated with metabolic syndrome on long-term outcome
Authors:   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, BEJAN Gabriel Cristian , GHILENCEA Liviu Nicolae ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, IANCU Mihaela Adela ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, BALTĂ Mihaela Daniela ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, MATEI Dumitru ,   Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti
Published: September 2021

Metabolic syndrome is also called insulin resistance syndrome or catecholamine excess syndrome and is a cluster of cardiometabolic factors that result in increased incidence of cardiovascular disease and diabetes type 2. Due to sedentary lifestyle and hypercaloric diet with an increased content of saturated fat and carbohydrates that characterizes modern life style of the population, especially in urban areas, the prevalence of metabolic syndrome is increasing, thus becoming a very topical issue for the medical world. During the years 2013-2014 we conducted an observational study on a sample of 111 hypertensive patients without major cardiovascular events such as myocardial infarction or stroke, aged between 48 and 83 years, who have determined the prevalence of modern cardiovascular risk factors such as hs CRP, serum uric acid, 24-hour proteinuria, serum fibrinogen and the ratio of apo B/apo A1, associated with the metabolic syndrome. The study was conducted separately by gender in the sense that we followed prevalence of these modern risk factors associated with metabolic syndrome in both genders, women and men. We also watched the influence of risk factors related to lifestyle on metabolic syndrome. Finally, we determined the correlation of these factors with the risk of death from cardiovascular disease to observe their influence on the prognosis of metabolic syndrome.