bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary Study On Potential Antimicrobial Activity Of Honey From Egricayir Plateau, Turkey
Authors: Tokbas Habip , Turhan Mahir
Published: December 2024

Egricayir honey named after the Egricayir Plateau in Mersin, Turkey is rare and is said to have a healing effect by the local people. This preliminary and first-ever study on honey from the Plateau aims to investigate the claim through total antimicrobial activity (TA). Thirty honey samples were collected twice from the Plateau in early July and late August 2023, and then TA was determined through the use of the phenol equivalence test. Samples had a homogeneous TA distribution and each had a TA>10, lower limit for therapeutic potency. Of the samples, 28% had a therapeutically beneficial potency (10≤TA<20) and 72% had a therapeutically high potency (TA≥20). On average, the TA of the honey samples was 21 falling into the category of therapeutically high potency. The findings imply that the honey from the Egricayır Plateou is a good candidate for further therapeutic tests and geographical indication.
Advances in CT Coronary Angiography-Derived Plaque Analysis for Comprehensive Assessment of Ischemic Heart Disease
Authors: Cozac Dan-Alexandru , Lassandro Eleonora , Savo Maria Teresa , Cordoni Gabriele , Tansella Donatella , Motta Raffaella , Pergola Valeria
Published: December 2024

Coronary computed tomography angiography (CCTA) has emerged as a pivotal non-invasive imaging modality for detailed assessment of coronary anatomy and plaque characteristics, playing a significant role in diagnosing and managing ischemic heart disease (IHD). Traditional approaches, such as the Segment Stenosis Score, Segment Involvement Score, and Leaman score, offer semi-quantitative evaluations of plaque burden. However, they are limited by their inability to quantify plaque volume precisely. Recent advancements in CCTA software have enabled more accurate, quantitative assessments that strongly correlate with invasive methods like intravascular ultrasonography and optical coherence tomography. These software tools also allow for detailed plaque characterization, categorizing plaques by composition and identifying high-risk features that may predict future cardiovascular events. The emerging photon-counting CT technique further enhances plaque analysis by individually measuring photons to assess plaque structure. Additionally, perfusion CT offers a functional imaging approach to evaluate myocardial blood flow, complementing CCTA by detecting microcirculatory dysfunction and providing insights into myocardial tissue, especially in fibrosis cases. The peri-coronary Fat Attenuation Index (pFAI), a 3D tool analyzing peri-coronary fat, has emerged as a significant prognostic marker, improving risk stratification in IHD. The evaluation of pFAI, particularly in patients with non-obstructive coronary disease, provides valuable information on inflammation and cardiovascular risk, making it a critical component of comprehensive IHD assessment. The advancement of CCTA-derived plaque analysis represents a significant change in cardiovascular imaging, enhancing diagnostic precision and risk assessment. As precision medicine advances, the integration of CCTA plaque analysis is set to transform the treatment of complex cardiovascular diseases.
Review of the arm alternative arterial access sites for percutaneous interventions
Authors: Ungureanu Claudiu , Dumitrascu Silviu , Achim Alexandru , Bentakhou Elias , Haine Steven EF
Published: December 2024

Percutaneous coronary interventions (PCI) traditionally rely on transradial access (TRA), but alternative arm vascular access sites are gaining importance due to the need to preserve radial arteries for future procedures and to overcome challenges like radial artery occlusion (RAO), tortuosity, or their small vessel size. Additionally, secondary or bailout options become critical when both radial and femoral access are not feasible. This review explores distal radial access (DRA), transulnar access (TUA), and transbrachial access (TBA) as alternatives.

DRA offers reduced RAO rates, maintains antegrade blood flow in hand during both the procedure and hemostasis, and enhances patient comfort, but it requires ultrasound guidance for optimal success. TUA is particularly useful when the radial artery is unsuitable, though it may involve higher access site crossover and technical challenges. TBA, allowing for larger sheath sizes, is ideal for peripheral vascular disease cases but carries a higher risk of complications such as bleeding and nerve injury.

These alternative access sites provide essential bailout options in complex scenarios, offering tailored solutions for cases where radial or femoral access is not viable. They enable operators to manage anatomical or procedural challenges while reducing vascular complications and improving patient outcomes.

This article aims to extensively describe DRA, TUA, and TBA, addressing their benefits, challenges, and providing technical tips and tricks for successful use. Percutaneous repeat interventions will be necessary to perform alternative vascular access routes safely and effectively to ensure better outcomes and procedural success.
Occupational carpal tunnel syndrome: clinical insights from a case report
Authors: Dinescu Venera Cristina , Bica Marius , Vasile Ramona Constantina , Dinescu Sorin Nicolae , Burada Emilia , Bunescu Marius , Ruscu Mihai Andrei , Rotaru-Zavaleanu Alexandra Daniela
Published: December 2024

Carpal Tunnel Syndrome (CTS) has emerged as a growing health concern among workers involved in occupations requiring repetitive and precision-based activities. Within the framework of the modern industrial economy, many professions encompass these characteristics, contributing to a notable prevalence of CTS across various occupational sectors. The impact of CTS extends beyond reduced workplace productivity, significantly impairing the quality of life of affected individuals and imposing economic challenges on both employees and employers.

This study presents the case of a 43-year-old female textile assembler, highlighting the risk factors contributing to the onset of the condition, the individualized therapeutic interventions employed, and the long-term progression of the disease. The analysis further investigates effective occupational management strategies aimed at minimizing the burden of CTS. Postoperative management revealed several complications, leading to work-related disability with substantial economic and social ramifications for both the employee and the employer. This case emphasizes the critical need for comprehensive strategies to address the occupational risks and consequences associated with CTS.
Occupational domains and age at onset of lung cancer diagnosis
Authors: Mandanach Cristina , Mateș Dana , Jinga Viorel , Oțelea Marina Ruxandra
Published: December 2024

Introduction
Occupational cancer is a major public health issue and continuous efforts are developed all around the world to find better solutions to decrease this prevalence. This is important in particular for the persons diagnosed earlier, as they might have different prognosis and health-related quality of life.

Objectives
The main objective of the study is to present the prevalence of the early diagnosed lung cancer in different activity domains and possible factors associated to a younger age recognition.

Methods
This is a secondary analysis of data collected during the ROMCAN project (reference/acknowledgements). From the whole data-base we have received only anonymized data concerning lung cancer. Age, gender, level of education, occupational domain, smoking, personal medical history, family history of cancer was included in the analysis. Based on the distribution of age in the whole sample, we considered the early diagnosis any diagnosis before 56 years of old; the others were considered the control group. Among the demographic factors only education seems to be of influence (χ2=31.24, p< 0.001). Family history was more prevalent in the earlier diagnosed group (OR=1.4, p=0.009). In terms of occupational domains, the highest prevalence at younger age was in the leather industry (57.14%), trade services (42.22%), extractive industry (34.62%) wood and furniture (34.48%) domains.

Conclusions
Occupational exposure to carcinogens contributes to the early development of lung cancer but other elements (smoking, socio-economic level, comorbidities), have also a significant role. Based on these results, awareness related to lung cancer in extractive, leather, wood manufactures and trade should be re-in forced.
Perfluoroalkylated substances – an endocrine disruptor with reprotoxic effects
Authors: Coșleacără Cătălina-Elena
Published: December 2024

This Perfluoroalkylated substances (PFAS) are persistent organic pollutants. They are subject to restriction to specific production and uses according to the Stockholm Convention 2009, implemented also by the Romanian Government in 2012. The main concerns related to PFAS are the effects on the reproductive system, affecting fertility and the development of the fetus. PFAS can pass through the placenta and in the breast milk and can affect the development of the newborns. Therefore, the possible occupational exposures need to be assessed for couples who want to become parents and before the decision to return to work of a breastfeeding mother is taken. It is also important to identify this exposure, as PFAS and they have other negative effects on health, such as the carcinogenic and the endocrine disrupting ones.

This article reviews the main sources of exposure to PFAS, the means of regulating their use in the European Union and the effects on the reproductive system in people exposed to PFAS. It also describes the occupations in which this exposure exists and the studies on the effects of this exposure in workers.
Food intake and profession – principles of healthy food
Authors: Colonescu Radu Marek , Lazureanu Camelia Pompilia , Popescu Florina Georgeta
Published: December 2024

Healthy nutrition is essential for maintaining workers' health and enhancing work productivity. This paper explores the principles of a healthy nutrition, emphasizing the relationship between dietary requirements and occupational demands.

The daily energy requirement depends on the intensity of the physical activity, being double for forestry workers compared to office workers. The consumed energy during a professional activity can be estimated through metabolic equivalents (METs).

The protein intake maintains muscle mass and protects against certain occupational toxins. Ensuring the optimal energy support requires the avoidance of carbohydrates with a high glycemic index (which disrupt glycemic balance and decrease work capacity) and introduction of slow-absorbing carbohydrates. Lipids provide a concentrated caloric support, particularly useful for intense physical labour (miners, farmers).

Micronutrients (vitamins and minerals) support musculoskeletal integrity, cognitive function, and immune resilience, especially in occupations involving physical or neuropsychological stress. Proper hydration is equally crucial for maintaining physical and cognitive capacities, with water requirements depending on the caloric expenditure and environmental conditions.

This paper provides a new perspective regarding the dual relationship between nutrition and work: occupational demands influence dietary needs, while dietary quality impacts work capacity and health. Knowing and applying the basic principles of healthy eating according to the professional activity and exposure is essential for maximizing workplace performance and employee well-being.
The Rationality of advertising an Analysis of rational, emotional, integrative and mechanistic advertising
Authors: Cardaş-Răduța Dan-Laurențiu
Published: December 2024

Given that several opinions have emerged in the literature over time according to which advertising addresses the irrational side of the public, this study aims to demonstrate that there is rationality even in types of advertising that at first glance do not target the consumers’ rationality: emotional, mechanistic and integrative advertising. The study also aims to identify what types of rationality exist in these types of advertising, with reference to the Weberian theory of rationality, from which it focuses on instrumental rationality and value rationality. The main results of the research show that beyond the emotional impact that advertising has, the public is looking for rational objectives to purchase a product. These objectives are linked to the audience’s values and its need to adapt to the demands of society. The study also shows that all types of advertising can be rationalised, as audiences do not automatically react to ‚irrational’ messages but decide on the basis of reasoning. Advertisers know this game of rationality and irrationality and use it frequently.
The Role of Festivals and Cultural Events in Promoting Social Inclusion: Examining Local Public Policy Documents in Romania
Authors: Mureșan Raluca
Published: December 2024

This study aims to investigate whether festivals and cultural events are considered by the cities that host them as a means to achieve social inclusion goals. We analyzed public policy documents related to urban development strategies and the allocation of non-reimbursable funds for festivals and cultural events in five Romanian cities: Sibiu, Cluj-Napoca, Sfântu Gheorghe, Miercurea Ciuc, and Alba Iulia, in order to identify to what extent city municipalities consider that festivals can play a role in promoting social inclusion and the importance of the social dimension when considering applications for financial support for cultural festivals. The selected cities are top five in a ranking of the cultural vitality of Romanian cities, published in 2022, which shows a very high polarity at a territorial level, with a concentration in the central part of the country. Thus, we investigated which public policy objectives festivals are associated with and to what extent the social dimension is relevant for obtaining financial support. The results showed that the link between culture and social inclusion is insufficiently explored in terms of how public authorities could encourage greater social inclusion through public policies supporting festivals.
Magic, witchcraft and popular culture: Political and religious reasoning
Authors: Dragoman Dragoș
Published: December 2024

The witch trials that mark the West European society during the 17th century is by no means a religious affair. Run by public secular judges, and not by the ecclesiastical tribunals, those judicial inquiries unravel the tight alliance between state and church in their common effort of consolidating their authority. Weakened by the Reformation movement, the Catholic church found in the new type of absolutist monarchy the much awaited support for the revival of the faith. By working hand in hand, the two institutions made the needed effort to put both religious faith and the political legitimacy on a rational basis. By centralizing the political power, the newly born modern bureaucracy was making an effort to destroy localism, regional autonomy, as well as fighting paganism, superstition, rural mythology and oral traditions. By helping the Church in rationalizing the faith, the modern bureaucracy was paving the way for the rationalization of the overall human existence, which will culminate with the European modern anti-religious natural science.
Chinese Intellectual Thought in Early Qing Dynasty: The Contributions of Gu Yanwu
Authors: Vereș Diana-Elena
Published: December 2024

Seventeenth-century China was a period of profound upheaval and transformation, marked most prominently by the fall of the Ming Dynasty and the establishment of the Qing Dynasty in 1644, following the entry of Manchu troops into Beijing. This transition not only redefined the political landscape but also generated a deep cultural and moral crisis within Chinese society. The ascension of a foreign ruling class of Manchu origin was met with resistance and unease among the Han Chinese, who struggled to reconcile the loss of the Ming with the legitimacy of the new rulers. This era of uncertainty and disruption challenged long-standing intellectual and social norms, prompting a reevaluation of cultural identity, governance, and moral principles. Among these figures, Gu Yanwu (1613–1682) stands out as a pivotal thinker who sought to address the intellectual stagnation of his time. His critique of Neo-Confucianism was especially significant, as he rejected its overreliance on abstract metaphysical speculation, which he deemed detached from the practical realities of governance and everyday life. Instead, Gu Yanwu advocated for a return to classical Confucian principles, emphasizing empirical study, moral integrity, and practical application of knowledge. This article examines Gu Yanwu’s contributions to Chinese thought, leaving a lasting impact on the trajectory of Chinese scholarship and philosophy in the early Qing period.
The Concealed Behavior regarding the Communication of Information in Judicial and Security System
Authors: Văcaru-Sora Mihai-Ștefan
Published: December 2024

Human behavior manifests in everyday life. In certain contexts, driven by fears or the need to conceal a certain attitude they have adopted, people are prone to distort reality. In this way, both the national security system and the legal system are subjected to risk.

The principle of seeking the truth is a cornerstone of both of these systems. In this regard, the article aims to present the ways in which we can prevent and avoid the emergence of such behavior that could threaten the optimal functioning of professionals within the system.

The concept of “dissimulation” is encountered in both systems, but it has different meanings. While dissimulation in the context of national security is used to protect the state’s interests, often employed in espionage, counter-espionage and military operations to hide critical information or real intentions from enemies, in the legal context, dissimulation can undermine the integrity of justice and public trust in the legal system. It is important to note that both domains analyze and counteract such tactics to ensure security and fairness.
Gods and Idols. Representations and Symbolizations of the Divinity in Religions of Ancient Israel. Aniconism – per visibilia ad invisibilia (IIb /2.1)
Authors: Grozea Lucian
Published: December 2024

The present study explores the history and stratified literary formation of the biblical narrative concerning the legendary patriarch Jacob. It also examines a „conceptual invariant”, Bethel, a term linguistically expressed in various idioms, signifying a connection to a shared spirituality, particularly within the Ancient Near Eastern context, characterized by diffusionism and acculturation.
Beyond bindis, bhajis, bangles and bhangra
Authors: Bagchi Suparna
Published: December 2024

Twenty-first-century education as a powerful means of knowledge will possibly be shaped by the emphasis it places on having classrooms that are race-conscious and multicultural. The present article is based on a doctoral study that explores an under-researched area: experiences and understanding of multiculturalism in mainstream primary schools situated in the predominantly White places of Southwest England. The study was underpinned by a sociocultural theoretical framework; data were collected through semi-structured interviews with the adult participants, students’ classroom activities, and documentary analysis of school displays. The article focuses on the data generated from the students’ classroom activities. Findings show differences in knowledge level and access to multicultural education among participants that significantly influenced their perceptions of multiculturalism. The study findings illuminated two key ideas. The first key idea is the powerful role of multicultural education in teaching and learning for not only raising cultural awareness among students across communities but also becoming a mouthpiece of empowerment for students from ethnic minority communities by promoting an equitable school atmosphere of recognition and acceptance for them. Secondly, findings illuminate racialised power positioning that created (un)democratic conditions perpetuating broader societal structural (im)balances within the particular local sociocultural context.
UN and BRICS+ in countering wars and conflicts to eliminate the energy crisis
Authors: Bryndin Evgeniy Grigorievich
Published: December 2024

The 2022 energy crisis has been a major shock to the entire world. The year began with anticipated oil shortages and actual coal shortages, marking the start of the crisis. The environmental agenda shifted focus to prioritizing the security of energy supply, both in terms of ensuring a smooth energy transition and preparing for extreme scenarios. Today, the ongoing energy crisis threatens the normal functioning of society, including fuel for transportation and logistics, electricity for lighting and work, and gas for cooking. The world is currently facing a severe energy crisis, a period of energy shortages and rising prices. This crisis is driven by several factors, including the depletion of non-renewable energy sources like oil. However, the most pressing factor is war. Energy shortages will increase costs for individuals, as many will struggle to meet their basic needs. This will compel people and governments within the UN and BRICS+ to seek solutions for energy conservation. The author argues that the most effective solution to save energy is to address conflicts and wars, and transition to peaceful living.
Fraseología y traducción en el ámbito literario. Análisis de la adaptación al francés de El amigo Melquiades
Authors:   Universidad de Málaga (España), Caballero Artigas Héctor Leví
Published: December 2024

For years, CREC's translation workshops have been working on the publication in French of outstanding works of Spanish literature. In order to solve all translation problems, they start from the total translation, through which all language levels are considered in the translation process. The present study aims to analyze the translation into French of the phraseological units in the theatre piece El amigo Melquiades o por la boca muere el pez (1914) by Carlos Arniches, the last work translated on at the CREC workshop, as well as to verify the effectiveness of the methodology.
De l’ancienne à la nouvelle orthographe du français : le cas de la presse francophone
Authors:   Ostravská univerzita (República Checa), Dedková Iva
Published: December 2024

The article examines the use of traditional and rectified French orthography (1990) in journalistic texts, focusing on the most prevalent type of orthography applied during the period 2014 to 2021. The analysis is based on four sub-corpora created from a large French textual orpus incorporated into the Sketch Engine platform. The study’s findings shed light not only on the predominant graphical variants in the analyzed sub-corpora but also on the potential correlation, or its lack, between these forms and other characteristics such as the frequency in occurrence of selected words, the source country, and the orthographic rules in question. It should be noted that the old orthography remains widely used in this sector, in which the author is not required to follow the rectified orthography
Chanter Renée Vivien au XXIe siècle : réécriture et militantisme dans Treize poèmes, de Pauline Paris
Authors:   Universidad Complutense de Madrid  (España), Marc Isabelle
Published: December 2024

Renée Vivien (London 1877 - Paris 1909) is both a cult author for lesbian communities and a great unknown to the general reading public in France. In recent years, however, her figure has aroused growing interest in the wake of efforts to (re-)discover women authors who have been ignored or erased from French literary history (Planté, 2003). It is in the field of popular music that we find one of the strong gestures aimed at rediscovering Vivien in the form of a book-album Treize poèmes by singer-songwriter Pauline Paris, which sets to music a selection of Vivien's poems, accompanied by illustrations by Élisa Franz. e aim of this article is to analyse this album as a rewriting of Vivien's work within the tradition of lesbian poetry. e article first presents the figure and work of Renée Vivien. en, it examines the musical setting of her poems in the album by Pauline Paris. Finally, it reflects on the situation of LGBTQ+ culture nowadays.
Juegos de rol orientados a la acción para el desarrollo de la interacción oral en francés
Authors:   Universidad del Norte (Colombia), Sorkar Gómez Rajib David
Published: December 2024

The current action research aims to assess the impact of action-oriented role-playing tasks on the interactional competence and perceptions of FLE students. Initially, the interactional proficiency of 37 university students is evaluated. Based on these findings, a pedagogical intervention is designed and implemented to enhance and evaluate interactional competence. Following its execution, an assessment is conducted to measure progress, supplemented by surveys and focus groups to uncover student perspectives. Results indicate a positive evolution in interactional competence, notably in pragmatic and sociolinguistic domains. Additionally, students express satisfaction and highlight their progress thanks to the innovative nature of the intervention.
Saisir l’intime ou la quête du moi artiste dans Souvenirs dormants de Patrick Modiano
Authors:   Université Chouaib Doukkali (Marruecos), Rida Zgani Mohammed
Published: December 2024

This article examines the notion of the intimate in Patrick Modiano. The latter approaches intimacy through the prism of memory, highlighting fleeting memories and their impact on the quest for the artistic self. The analysis will be based on a multidisciplinary and comparative approach to Modiano’s work, Souvenirs dormants. It is about approaching Modiano’s characters as incomplete reflections of the soul of the author-narrator, in a self-reflexive story where he explores his own existence through his protagonists. It will be a question of putting our finger on the Modianesque exploration of the mnemonic universes, the very ones which govern the creation of his work to come.
Grill&Gulasz, czyli o nazwach imprez kulinarnych
Authors: Przymuszała Lidia , Świtała-Trybek Dorota
Published: December 2024

Culinary tourism (part of a broader phenomenon called cultural tourism) has become extremely fashionable in recent years. It is closely related to culinary events organised on various occasions – accompanying other events or constituting the goal of a culinary trip in itself. An incentive to participate in them and a kind of trademark are the various names of these events, sometimes extremely original, testifying to the immense creativity of the organisers. The object of observation in this contribution are the names of culinary events belonging – according to Artur Gałkowski’s proposal – to ideational chrematonyms. The names of this  subcategory of socioideonyms have not been sufficiently developed yet, so they have become the subject of research. Accordingly, the aim of this article is a formal and semantic analysis of these names, a discussion of the motivation behind the presented onyms,and an indication of their functions. The research basis for the observations made are 165 names of culinary events, organised periodically in the years 2019-2023 in three voivodeships: Silesia, Lower Silesia and Opole. The analysis of the material shows that multi-word constructions consisting of elements such as: a component  identifying the project (e.g. festiwal [festival], święto [celebration], warsztaty [workshop]), specifying its nature (e.g. wodzionki [of Wodzionka soup], smaków [of flavours], maszketówi [of Silesian sweets]), locating event (e.g. w Lyskach [in Lyski], w Bagieńcu [in Bagieniec]) are very characteristic of this type of names. The basic naming model can be supplemented with various variant components. Onyms of this category, apart from their primary informative function, also play marketing, persuasive and promotional roles.
The Vision and Inception of the Legal Aid Clinic at SMU School of Law
Authors: Kearney Amy
Published: December 2024

This paper examines the impetus behind the creation of the SMU Clinic and analyzes how the clinic actually worked in its early years and whether the clinic accomplished its objectives. I wrote this paper during my last semester of law school while participating in the SMU Clinic as a student attorney. While researching this paper, I had the pleasure of speaking with some of the first student attorneys that participated in the SMU Clinic, many of whom went on to practice law for decades afterwards. I greatly enjoyed hearing their perspectives, and love that I was able to similarly provide legal services to members of the Dallas community through my work with the SMU Clinic.
Introdução
Authors: Hernandez Maria-Elena , Figaro Roseli , Tixier Florian
Published: December 2024

Introdução
Correspondants à l’étranger. Introduction
Authors: Leal-Adghirni Zélia , Pinson Guillaume , Ruellan Denis
Published: December 2024

Correspondants à l’étranger. Introduction
Questioning the Norms of Journalism Researchers. Introduction
Authors: Le Cam Florence , Pereira Fabio
Published: December 2024

Questioning the Norms of Journalism Researchers Introduction
L’éditorial et le débat public. Introduction
Authors: Demers François
Published: December 2024

L’éditorial et le débat public. Introduction
Seguimento após inserção de dispositivo intrauterino de cobre no pós-parto imediato
Authors: Paes Camila Dilellis Quaresma , Fadel Anna Paula Maneschy , Campos Ana Carla Araújo
Published: December 2024

Objetivo: Descrever o seguimento das pacientes que inseriram DIU de cobre no pós-parto imediato no período de janeiro a dezembro de 2020. Métodos: Trata-se de um estudo observacional, descritivo, analítico, retrospectivo no qual foram analisados durante um ano os prontuários das pacientes que realizaram a inserção do DIU de cobre no pós-parto imediato e foram encaminhadas para o ambulatório de planejamento familiar. Resultados: Foram incluídas 363 mulheres, onde 71% estavam na faixa etária de 18 a 34 anos e 57% realizaram a inserção após cesárea. A grande maioria das pacientes (80,2%) já possuíam gestações anteriores. De forma alarmante, um total de 55,4% da amostra não realizou acompanhamento, 19% solicitaram a remoção do DIU de cobre e apenas 8,2% mantiveram o uso do método por mais de um ano. Nos retornos a maioria das paciente se demostraram assintomática e as principais queixas foram corrimento vaginal, alteração de fluxo mesntrual e dor pélvica. A taxa de gravidez observada foi de 1,7%, maior do que o esperado para o método. Conclusão: Conclui-se que as pacientes tiveram um seguimento precário demonstrando diversas fragilidades no programa apesar da importância da disponibilização de métodos anticoncepcionais de longa duração no Sistema Único de Saúde.
Impactos sistêmicos do uso off-label da semaglutida
Authors: Porto Gabriela Ingrácio , Davesac Caroline Laimer , Freitas Carolina Carlesso de , Lima Débora Fontenele de Sá , Barella Fabiely , Medeiros Helena de Britto Hoenisch , Orça Lara Carolina Duarte , Góes Luiz Eduardo de Costa , Guimarães Natália Ferrão , Alves Gabriel Cabeda Spalding
Published: December 2024

Objetivo: Analisar impactos sistêmicos no uso off-label da semaglutida. Revisão bibliográfica: A semaglutida, um análogo do GLP-1, foi inicialmente aprovada para o tratamento do diabetes tipo 2. Estudos mostram que, além de reduzir os níveis de glicose, ela promove perda de peso ao induzir saciedade e retardar o esvaziamento gástrico, fatores que diminuem a ingestão calórica. No entanto, o uso off-label para emagrecimento, sem supervisão médica, é uma prática crescente, impulsionada pela rápida perda de peso e pela popularidade do medicamento. Os efeitos adversos mais comuns incluem náuseas, vômitos e risco de colelitíase. Complicações estéticas, como a "Ozempic Face", caracterizada por flacidez e envelhecimento facial, também têm sido relatadas. Considerações finais: Embora a semaglutida demonstre eficácia na perda de peso, a falta de supervisão médica no uso off-label pode acarretar riscos à saúde e efeitos indesejados. Portanto, devido aos riscos, os pacientes devem ser monitorados, e mudanças no estilo de vida devem ser integradas ao tratamento para evitar a recidiva do peso. A popularidade do uso off-label ressalta a necessidade de estudos adicionais para entender melhor os efeitos a longo prazo e para desenvolver diretrizes que orientem o uso seguro e eficaz deste medicamento.
Association of immunosuppressive CD45+CD33+CD14− CD10−HLA-DR−/low neutrophils with poor prognosis in patients with lymphoma and their expansion and activation through STAT3/arginase-1 pathway in vitro
Authors: Xiao Meng , Zhou Ji , Zhang Wanqiu , Ding Yangyang , Guo Jinjing , Liang Xue , Zhu Jinli , Jiao Xunyi , Zhai Zhimin , Wang Huiping
Published: December 2024

Objective:

This study aimed to explore the clinical significance of CD45+CD33+CD14−CD10−HLA-DR−/low neutrophils (Cluster of Differentiation 10 [CD10−] neutrophils) in B-cell non-Hodgkin’s lymphoma (B-NHL). An amplification system of CD10− neutrophils in vitro was constructed using cytokines, and the mechanisms underlying the cytokine-induced expansion and activation of the CD10− neutrophil subpopulation were investigated.

Material and Methods:

We identified a novel suppressive cell population known as CD10− neutrophils in the peripheral blood of patients with B-NHL in different statuses by flow cytometry and found it to be correlated with interleukin-6 levels, T cell counts, and plasma arginase-1 (Arg-1) levels. We then verified the effect of CD10− neutrophil expression on the prognosis of patients with B-NHL. Furthermore, we described a clinically compatible method for generating granulocyte populations rich in CD10− neutrophils using cultures of peripheral blood-isolated neutrophils supplemented with cytokines in vitro. Arg-1 expression was detected in neutrophils before and after induction by cytokines through reverse-transcription polymerase chain reaction, enzyme-linked immunosorbent assay, and flow cytometry. T-cell proliferation and apoptosis were measured by carboxyfluorescein succinimidyl ester assay and Annexin V-Propidium Iodide stains, and induced cells were exposed to Arg-1 inhibitor and ruxolitinib. signal transducer and activator of transcription 3 (STAT3)/Arg-1 signaling was studied mainly by western blot and chromatin immunoprecipitation experiments.

Results:

We established a correlation between high CD10− neutrophil levels and poorer survival outcomes in patients with B-NHL. Moreover, CD10− neutrophils were positively correlated with interleukin (IL)-6, T-reg cells, and plasma Arg-1 levels and negatively correlated with the absolute number of total T cells. Granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor, and IL-6 could all induce the expansion of CD10− neutrophil phenotype cells in vitro, which exhibit typical immature cellular morphology, and the combination of IL-6 and GM-CSF was the most effective. We confirmed that the STAT3/Arg-1 signaling pathway could be a critical mechanism regulating CD10− neutrophil-mediated immunosuppression in vitro.

Conclusion:

CD10− neutrophils exhibited basic characteristics similar to conventional myeloid-derived suppressor cells. Our observations provide a promising STAT3 or Arg-1 targeting strategy for B-NHL and an important method for generating remarkably amounts of inhibitory granulocyte populations rich in CD10− neutrophils for immunotherapy.
Rapunzel Syndrome with Gastric Perforation: A Rare Case Report in a Three-year-old Child
Authors: Singh Chhavindar , Pandey Vinod Kumar , Pratap Prakhar
Published: December 2024

Rapunzel syndrome is a rare variant of trichobezoar in the stomach extending from the stomach into the small intestine causing a bowel obstruction and commonly associated with an underlying psychiatric disorder. The term comes from a story written by the Grimm brothers in 1812 about Rapunzel who was a long-haired maiden. We hereby, present the case of a 3 years old boy with Rapunzel syndrome due to a very large gastric trichobezoar. An abdominal computed tomography scan showed a heterogeneous mass occupying the whole stomach cavity with extension into the jejunum. A large dense mass of hair extending up to jejunum was removed. Following surgery, psychiatric consultation was sought to prevent recurrence. Trichobezoar as an entity should be considered in the differential diagnosis of abdominal pain and non-tender abdominal mass in young patients. A thorough assessment of psychiatric history is mandatory to address the underlying disease to prevent recurrence.
The Endoscopic Transsphenoidal Technique for Acromegaly: Evaluating Remission
Authors: Randhawa Anmol Singh , Sherpa Tshering Dorjee , Srivastava Anurag , Agrawal Yogesh , Jain Pavan Kumar , Gill Mehakleen , Verma Jitendra Singh , Sharma Bhawani Shanker , Gupta Pankaj , Narola Viraj , Narad Sameer
Published: December 2024

Objectives

The primary strategy for managing acromegaly involves transsphenoidal surgical intervention, with the achievement of post-surgical remission playing a pivotal role in patient prognosis. Factors such as pre-surgery GH (growth hormone) as well as insulin-like growth factor-1 levels, tumour size, invasion into the cavernous sinus and the extent of tumour resection outside the capsule have been recognised as crucial for determining remission outcomes.

Material and Methods

Between January 2017 and April 2023, 89 patients underwent endoscopic transsphenoidal surgery at the Mahatma Gandhi University of Medical Sciences and Technology in Jaipur. The study assessed preoperatively along with postoperative parameters such as overall remission, cavernous sinus invasion, the extent of resection beyond the tumour capsule, resection rates and GH levels before and after surgery. Remission rates were evaluated based on the consensus criteria from 2010.

Results

Of the 89 patients, 79 (88.8%) achieved complete tumour resection. Remission was observed in 70 patients (78.7%), with 61 of 78 patients (78.2%) having larger tumours (macroadenomas), 9 of 11 (81.9%) with smaller tumours (microadenomas), and 7 of 18 (38.9%) with tumours invading the cavernous sinus achieving remission. Remarkably, 68 of 72 patients (82.9%) who had a pseudocapsular resection entered remission. Patients with preoperative GH levels below 20 ng/mL saw an 87.5% remission rate, which dropped to 33.3% for those with levels above 60 ng/mL. The study found strong associations between remission rates and factors such as extra-pseudocapsular resection and cavernous sinus invasion, with a negative correlation to tumour size and volume.

Conclusion

The key determinants of remission include the extent of tumour invasion into the cavernous sinus and the completeness of tumour excision. Achieving optimal remission outcomes requires meticulous surgical removal of the tumour, including any residual fragments, with preoperative as well as postoperative GH levels serving as prognostic indicators of remission success.
BIOCHEMICAL, IMMUNOLOGICAL AND MORPHOLOGICAL CHANGES IN THE LIVER AND LARGE INTESTINE OF RATS AFTER INOCULATION OF DNA/RNA VIRUSES
Authors:   Institute of Biochemistry of Biologically Active Compounds of the NAS of Belarus, Grodno, Belarus, Kuzniatsou A. E. , Tsyrkunov V. M. ,   Grodno State Medical University, Grodno, Belarus, Shuriberko A. V. ,   Institute of Biochemistry of Biologically Active Compounds of the NAS of Belarus, Grodno, Belarus, Ostrovskaya O. B. ,   Grodno State Medical University, Grodno, Belarus, Kerimova S. S. ,   Grodno Regional Clinical Pathological Bureau, Grodno, Belarus, Gorchakova O. V. ,   Grodno State Medical University, Grodno, Belarus
Published: December 2024

Background. A characteristic feature of tumor diseases associated with viruses is a long latent period lasting several years. Objective. To monitor biochemical, immunological and morphological changes in the liver and large intestine after inoculation of Wistar rats with DNA/RNA viruses. Material and methods. The goal was realized on 52 adult male Wistar rats (average initial weight 210.1±14.9 g), on a standard diet and free access to food and water, by inoculating the abdominal cavity with DNA/RNA viruses. The monitoring of biochemical, immunological and morphological parameters reflecting the condition of the liver and large intestine was carried out 30, 112 and 224 days after the introduction of the genetic material of the viruses. Results. The monitoring of laboratory and morphological parameters after inoculation of DNA/RNA viruses into the animals showed that within 30-224 days there occur noticeable changes in biochemical, immunological and morphological parameters characterizing the processes of apoptosis acceleration and cell cycle disruption in the liver and large intestine. Biochemical markers of damage to the liver and large intestine after inoculation of animals with DNA/RNA are the values of AST, ALT, ALP, LDH, urea, creatinine, bilirubin, albumin, cholesterol as well as those of microelements – magnesium, phosphorus, iron, calcium (p<0,05). A dependence was established between the change in the concentration of antibodies to cell cycle proteins (bcl-2, p53, pRb1, NF1) and the duration of exposure to viral DNA/RNA. Morphological signs of liver damage due to inoculation of DNA/RNA viruses are: the presence of neutrophils and eosinophils in the sinusoids, protein granular degeneration and polymorphism of hepatocyte nuclei; in the intestinal tissue - infiltration with plasma cells, eosinophils and lymphocytes with the presence of multiple lymphoid follicles at various levels of the lamina propria and muscular plate with lymphoid hyperplasia, eosinophilic accumulations without degranulation with penetration into the surface epithelium and into the muscular lamina of the mucosa (eosinophilic colitis). Conclusion. Significant changes in liver tissue and intestinal tissue occur when DNA of EBV, CMV, HSV type 1/2 and HBV is introduced into the animal body. Probable signs of pre-oncogenic transformation are: the presence of infiltrating neutrophils in the sinusoids of the liver and that of lymphoid hyperplasia in the wall of the large intestine.
PATHOMORPHOLOGICAL CHANGES ASSESSMENT IN EXPERIMENTAL DESTRUCTIVE PANCREATITIS IN RATS
Authors:   Grodno State Medical University, Grodno, Belarus, Masyukevich A. I.
Published: December 2024

Background. Acute pancreatitis remains to be a challenge in emergency abdominal surgery. Severe forms of the disease have a number of complications associated with high mortality. There is a need for a thorough study of the pathogenesis of acute pancreatitis and its adequate pathomorphological assessment, first of all, in an experiment for the purpose of testing new therapeutic approaches. Objective. To assess pathomorphological changes in the pancreas and its surrounding tissues in experimental acute destructive pancreatitis (ADP) and to identify 4 categories of changes most specific for destructive pancreatitis. Material and methods. The experiment was performed on 54 rats. A special table was developed that includes 4 categories of pathomorphological changes and parameter assessment tool based on the visual analogue principle (VAP). Further statistical processing of data between the studied groups was performed. Results. Control group 1 is characterized by the absence of mortality and minimal pathomorphological changes, reflecting the response of the pancreas to the surgery. Group 2 is characterized by minimal mortality (16.67%), moderately increased indexes of necrosis, of circulatory disorders, of inflammation (up to the fourth day) as well as that of repair (by the eighth day), these parameters corresponding to ADP of moderate severity. In group 3, there is a high mortality rate (66.66%), a high index of necrosis with slight indexes of circulatory disorders and of inflammation (on the fourth day), as well as a low repair index (on the eighth day). This group is characterized by severe ADP. Conclusion. Administration of 10% detergent solution results in ADP of moderate severity. Administration of a 20% detergent solution causes severe ADP. The proposed table of pathomorphological assessment alongside with the mortality rate allow us to assess the severity of experimental acute destructive pancreatitis in rats.
CONGENITAL VIRAL HEPATITIS A WITH A FATAL OUTCOME
Authors:   Grodno State Medical University, Grodno, Belarus, Prokopchik N. I. , Tsyrkunov V. M. ,   Grodno State Medical University, Grodno, Belarus, Khvorik N. V. ,   Grodno State Medical University, Grodno, Belarus, Lupachik E. I. ,   Grodno Regional Clinical Pathology Bureau, Grodno, Belarus
Published: December 2024

Background. Intrauterine HAV transmission and congenital hepatitis A (HA) are rarely reported. Most infants born to mothers with HAV infection are uninfected and have normal transaminase levels. According to the literature, lethal outcomes with congenital HA have either not been recorded or are a rare occurrence. Objective. To present a description of a clinical case of acute HA in a pregnant woman and congenital HA in a fetus with a fatal outcome in the newborn. Material and methods. A diabetic female patient who suffered an icteric form of acute HA at the gestational age of 25-29 weeks and underwent cesarean delivery at the gestational age of 36 weeks (253 days) due to fetal indications. An analysis of patient’s clinical, laboratory as well as instrumental findings was carried out. Autopsy data of a newborn child died due to congenital HA were studied. Results. It was established that during acute moderate HA course in the pregnant woman with diabetes-related microangiopathy and polyneuropathy there occurred transplacental HAV infection of the fetus with the development of congenital HA. Morphologically, hepatitis was characterized by predominance of alterative changes in hepatocytes, as well as pronounced intralobular cholestasis, exudation and proliferation being moderately expressed. Conclusion. Diabetes mellitus contributed both to HAV infection, the development of acute HA in the woman in the second trimester of pregnancy, and damage to the fetus by HAV infection. The causes of the child’s death were severe asphyxia due to diabetic embryo- and fetopathy, placental disorders and multiple organ failure due to the abovementioned diseases, acute liver failure, intrahepatic cholestasis caused by congenital acute HA.