bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects for the development of Georgia's trade with the European Union
Authors: Veshapidze Shota , Megreladze Giorgi
Published: November 2024

The article focuses on the impact of Georgia obtaining EU candidate status on its international trade. The interest in this topic stems from the fact that Georgia's acquisition of candidate status marks a significant step towards integration with the European Union. Many people directly associate Georgia's development with integration into the European family and expect that along with this integration, welfare in Georgia will significantly improve. Therefore, we consider it important to investigate the potential impact of obtaining EU candidate status on Georgia's foreign trade.
The aim of the research is to determine the effects of obtaining candidate status, how it will impact Georgia, and how the situation of Georgia's foreign trade will change. The research subject is the assessment and analysis of the effects arising from the acquisition of candidate status, the analysis of positive and negative events that Georgia may face, and the opportunities and challenges that Georgia will encounter. The object of the research is the relationship between the European Union and Georgia and the regional influence that current events may have.
Among the methods used in the study, it should be noted the general scientific methods of analysis and synthesis, induction and deduction, as well as the method of systematic research.The research has practical significance in terms of creating favorable conditions for the long-term development of economic cooperation between Georgia and the European Union.
Keywords: European Union, Georgia, candidate status, strategic partnership, foreign trade.
Legal and Practical Aspects of Cartel Detection and Prevent
Authors: Basiashvili Davit , Fetelava Slava
Published: November 2024

The work deals with the practical aspects of cartels, both the legal regulation of actions restricting competition and their detection and prevention. Emphasis is placed on the role and importance of competition law in assessing the total economic damage caused by the disregard of competition law by economic agents in the relevant markets and the concerted actions of cartels. The discussion for horizontal (agreement/concerted action between competing economic agents operating in the same product market) and vertical (agreement/concerted action between non-competing economic agents operating in different product markets) cartels is carried out. It is also mentioned that the agreement between the competing economic agents, on the one hand, can reduce, eliminate, or strengthen the competition. However, on the other hand, individual agreements can increase the effectiveness of competition. As for vertical agreements, such an anti-competitive act may occur when a dominant producer/service economic agent offers products/services under preferential conditions to a participating seller/service-receiving economic agent, while discriminating against other economic agents. However, it is also a fact that such an action creates a risk of restriction of competition only if the parties to the agreement (separately or taken together) occupy a dominant position and have market power.In the research, an important place is given to international and local legal mechanisms for detecting cartels, and advanced foreign and Georgian practices are presented in this regard. Finally, the conclusion is made that, in order to detect and prevent concerted actions, the provisions included in the competition law in force in Georgia today (detection and prevention of cartels as actions restricting competition) are in full compliance with advanced international practice and, first of all, with similar norms of the EU countries. However, it is also clear that in the background of the development of contemporary digital technologies, when the specifics of the work of many companies are rapidly changing, which diversifies the ways of making concerted commercial strategic decisions - making the issues of detection and detection of concerted actions by competition agencies even more noteworthy. In this direction, the enforcement institutions of the competition of Georgia, as The Agency of Competition and Consumer Protection of Georgia as well as the supervisory bodies of the regulated sector (enforcing the competition legislation in the regulated sector) will have to make more efforts.
Keywords: Cartel, Agreement, Terms of Trade, Restriction of Competition, Sanction, Pricing Algorithm, Agency, Regulated Sector, Business Environment
Lagomorph ladders: Assessing a multi-host community and potential for spillover of rabbit hemorrhagic disease at Great Sand Dunes National Park and Preserve (revised)
Authors: Peralta Airy , Ray Chris , Peralta Airy , Ray Chris
Published: November 2024

Rabbit hemorrhagic disease virus type 2 (RHDV2) has caused dramatic declines in rabbits and hares on several continents, with cascading effects on local ecology. Recent mortalities have been reported for several rabbit and hare species in the United States, suggesting broad susceptibility of lagomorphs. If this susceptibility extends to the American pika (Ochotona princeps), the most cold-adapted lagomorph, it could compound climate-mediated threats to this species. Due to climate change, American pikas are predicted to experience significant upslope range retraction during this century. Using an analogy borrowed from wildfire scenarios, other lagomorph species occurring at lower and mid-elevations could act as ?ladder fuels? to wick RHDV2 into high-elevation pika populations. To address this concern, we investigated spatial patterns of habitat use by pikas and other lagomorphs in Great Sand Dunes National Park and Preserve (GRSA), which borders several counties that have reported RHDV2.

In 2022, we surveyed 115 plots from a spatially balanced sample of pika habitats in the park, including 48 legacy plots from a pika survey conducted in 2010-2012. Pika detections at the plot level were paired with topographic and environmental indices to estimate minimum habitat occupancy and determine its covariates. Leporid (rabbit and hare) detections at these same plots were used to model presence using similar covariates and correcting for imperfect detection. Our best-supported models of pika and leporid presence were then used to estimate the probability of contact between these taxa within the park.

Our mean estimate of pika habitat occupancy was at least 95% during 2022 in GRSA, slightly higher than in 2010-2012, and effects of elevation and precipitation on pika occupancy were as expected from the previous study. Leporid presence at these same plots was 48% after correcting for imperfect detection. The best model of leporid presence supported a negative effect of elevation, in agreement with other studies of these taxa. The best pika and leporid models also included a positive effect of incoming solar radiation.

Finally, we used our best models of pika habitat occupancy and leporid presence within the park to map the potential for areas of contact and RHDV2 transmission between these taxa. Our results indicate some potential for contact within subalpine forests, Specifically in the northern half of the park near the lower reach of the Sand Creek Trail and in the far south just north of California Peak.
DFT and EPR Study of Spin Excitations in Oxidized Thiophene-Based Conjugated Oligomers
Authors: Victor Krinichnyi
Published: November 2024

Comparison of data obtained using the density functional theory (DFT) and electron paramagnetic resonance (EPR) method made it possible to establish the composition and state of spin charge carries in the poly(3, 4-ethylenedioxythiophene) (PEDOT) and poly(3-alkylthiophene) (P3AT) oligomers. The coexistence of several polarons on the P3AT chain, the properties of which are governed by the structure of the substituents, is identified. All terms of the spin Hamiltonians of different oligomers were obtained, and their high-resolution EPR spectra were calculated. The structure of the P3AT substituents is shown to influence the polaron spin state and hyperfine interaction with its own microenvironment. The prospects of the approaches used in the work to develop electronic and spintronic elements with spin-controlled parameters are shown.
Semantic Segmentation Based on Geometric Calibration Using AI and AR in Health Care
Authors: Ganesan G. , Poonkuntran S.
Published: November 2024

In the medical field, medical imaging is essential for precise diagnosis, treatment planning, and condition monitoring. The goal of this work is to improve the field of healthcare imaging by investigating the complementary applications of augmented reality (AR) and artificial intelligence (AI) in semantic segmentation. More precise identification and delineation of anatomical structures and abnormalities in medical images is made possible by AI-driven semantic segmentation, opening the door to more precise diagnosis and treatment plans. Modern AI algorithms are employed in the suggested methodology to perform semantic segmentation in a variety of medical imaging modalities, including ultrasound, CT, and MRI scans. The detection of anomalies such as tumours, irregularities in organs, and neurological disorders is made easier by these algorithms. The foundation for integrating augmented reality technologies into the healthcare ecosystem is provided by the segmented medical images. AR enhances the interaction and visualization of segmented medical data in the context of healthcare. Real-time augmented reality overlays help surgeons by improving surgical navigation and precision. Additionally, AR apps help with medical education by offering professionals and students alike an immersive learning environment. AR provides interactive visualizations to help patients understand their medical conditions when they are going for therapy and rehabilitation. The difficulties in integrating these technologies in the healthcare industry are discussed in this paper, with a focus on the significance of data privacy, regulatory compliance, and easy integration with current healthcare systems. The successful deployment of AI technologies necessitates interdisciplinary collaboration among AI developers, healthcare professionals, and AR specialists to ensure compliance with ethical, legal, and clinical standards mandated in the healthcare domain. The proposed Segmentation mask is redefined with geometric calibration and used with U-Net for image segmentation. The segmentation is experimented on Cityscapes and PASCAL VOC 2012 datasets. The experimental results show that proposed semantic segmentation based on geometric calibration yields more accuracy than its counterparts.
Optimal Design of an Off-Grid Solar Energy System Integrated with a Diesel Generator for Urban Areas in Pakistan
Authors: Kashif Muhammad , Iqbal M. Tariq , Jamil Mohsin
Published: November 2024

The growing energy demand in Pakistan, coupled with the challenges posed by reliance on imported fossil fuels, necessitates the exploration of alternative energy solutions. This study presents the design and techno-economic analysis of an off-grid hybrid energy system tailored for a residential neighborhood in Karachi, Pakistan. The system integrates individual solar energy solutions for seven housles, supplemented by a shared diesel generator to ensure a reliable power supply, particularly during load-shedding and grid outages. The study utilizes HOMER Pro software to model and optimize various configurations, taking into account local solar insolation levels and seasonal variability in energy demands. The optimized system includes photovoltaic (PV) panels, battery storage, and a shared diesel generator with individual connections and meters, with each house receiving a customized solution based on its specific energy requirements, ranging from 15 kWh/day to 45 kWh/day. The shared diesel generator is designed to reduce the need for large battery banks, thereby minimizing both capital and operational costs. The results demonstrate a cost-effective solution with a Levelized Cost of Energy (LCOE) of $0.2959/kWh and a Net Present Cost (NPC) of $15,562.55 over a 25-year period. This research highlights the potential for implementing such systems in urban areas of Pakistan, offering a sustainable, reliable, and economically viable alternative to conventional energy sources.
Developing Culturally Sensitive Suicide Prevention Programs for Medical Professionals in Indonesia
Authors: Ni Made Nova Indriyani  , Mischa Chantal Adella  , Patricia Wulandari  , Despian Januandri
Published: November 2024

Introduction: Medical professionals in Indonesia experience high levels of stress, increasing their risk for mental health problems and suicidal behavior. Culturally appropriate suicide prevention programs are critical to address this issue. This study aimed to develop and evaluate the feasibility and acceptability of a culturally adapted suicide prevention program for Indonesian medical professionals.
Methods: This mixed-methods study had two phases. Phase 1 involved program development, adapting an existing evidence-based suicide prevention program using a Delphi method with Indonesian mental health experts (n=10) and cultural consultants (n=5). Phase 2 comprised a pilot implementation of the program with 30 medical professionals. Quantitative data on program feasibility (attendance, completion rates) and acceptability (satisfaction surveys, qualitative feedback) were collected and analyzed.
Results: The Delphi method resulted in a culturally adapted program incorporating Indonesian values related to collectivism, family support, religious beliefs, and stigma associated with mental health. Pilot implementation showed high attendance (87%) and program completion rates (93%). Participants expressed high satisfaction with the program's content, cultural relevance, and delivery format. Qualitative feedback emphasized the importance of peer support, spiritual integration, and addressing workplace stressors.
Conclusion: This study provides preliminary evidence for the feasibility and acceptability of a culturally sensitive suicide prevention program for Indonesian medical professionals. Further research is needed to evaluate the program's effectiveness in reducing suicidal ideation and behavior.
On the Margins of the Mining Economy: Occupational Health and Safety in Artisanal Scale Gemstone Mining in the Mwatate-Voi Area, Taita Taveta County, Kenya
Authors: Njumwa John Zollo , Nyame Frank Kwakyi , Ofori Benjamin Dankyira , Ibrahim Kwabina , Makindi Stanley Maingi
Published: November 2024

Artisanal gemstone mining in Kenya provides income and livelihoods to many locals in Taita Taveta County. However, little is known about the occupational safety and health issues encountered in this activity. This study investigated major occupational health and safety issues associated with artisanal gemstone mining using a variety of methods including key informant interviews, administration of questionnaires to mineworkers and direct observations at mining sites. Out of ninety-five (95) miners surveyed at ten (10) mining sites, sixty-eight (68) (71.6 %) had suffered injuries resulting in absence from work for days up to over a month. The major injury type was contusions (73.5 %). The main cause of injuries was tools/machinery handling (92.6 %). Only about twenty-seven (27) miners (28.4 %) used safety gear at work while twenty-nine (29) (30.5 %) had received any form of safety training. This study suggests that miners generally lack basic knowledge and education on the mitigation of occupational hazards associated with their work and basic tools/equipment for use in gemstone mining. Provision of education on and/or adequate enforcement of occupational health and safety regulations by relevant government agencies would improve the knowledge of miners on how to minimize occupational hazards
High Gradient Magnetic Fields Generated in Events on the 230 kV Electric Power Transmission Infrastructure: Human Exposure Analysis and Risk
Authors: Rojas Fabian Ricardo , Guerra Gerardo , Rivera Sergio
Published: November 2024

This work presents a process for analyzing human exposure to high-gradient magnetic fields based on protection models for patients undergoing magnetic resonance examinations developed by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). A series of events presented in the electrical energy transmission infrastructure is taken, with typical currents and front times, a case of extreme failure is added, and results are presented. Subsequently, with a classic lightning signal, compliance with the exposure to this type of field in the right-of-way strip of a transmission line is verified and validated in the event of a hypothetical atmospheric discharge impact event. Finally, a simulation is implemented with space discretization techniques, establishing the signal resulting from the magnetic field generated as a function of time. The exposure is evaluated using the presented model. Only in one of the analysis cases was it found that the perception threshold is exceeded at distances less than 0.6 cm, virtually a situation in which the worker has contact with the down conductor. With the results obtained and the cases analyzed, it is concluded that failures of this type do not generate significant exposure to high-gradient magnetic fields and do not exceed the determined perception thresholds.
Improving Visual Object Detection using General UFIR Filtering
Authors: Pale-Ramon Eli G. , Morales-Mendoza Luis J. , Ibarra-Manzano Oscar G. , Vázquez-Bautista Rene Fabián , Ortega-Contreras Jorge A. , Shmaliy Yuriy S.
Published: November 2024

Object detection is a fundamental task in computer vision, which involves the identification and localization of objects within image frames or video sequences. The problem is complicated by large variations in the video camera bounding box, which can be thought of as colored measurement noise (CMN). In this paper, we use the general unbiased finite impulse response (GUFIR) approach to improve detection performance under CMN. The results are compared to the general Kalman filter (GKF) and two detection methods: “Faster-RCNN” and “Tensorflow PASCAL Visual Object Classes (VOC)”. Experimental testing is carried out using the benchmark data ”Car4”. It is shown that GUFIR significantly improves the detection accuracy and demonstrates the properties of the effective tool for visual object tracking.
Quantitative proteomics analysis reveals the pathogenesis of obstructed defecation syndrome caused by abnormal expression of dystrophin
Authors: Li Wen-Zhe , Xiong Yu , Wang Tian-Kun , Chen Yan-Yan , Wan Song-Lin , Li Lu-Yao , Xu Meng , Tong Jing-Jing , Qian Qun , Jiang Cong-Qing , Liu Wei-Cheng
Published: November 2024

BACKGROUND

Obstructed defecation syndrome (ODS) represents the most prevalent form of chronic constipation, affecting a diverse patient population, leading to numerous complications, and imposing a significant burden on healthcare resources. Most ODS patients have insufficient rectal propulsion, but the exact mechanism underlying the pathogenesis of ODS remains unclear.

AIM

To explore the molecular mechanism underlying the pathogenesis of ODS.

METHODS

A total of 30 pairs of rectal samples were collected from patients with ODS (ODS group) or grade IV prolapsed hemorrhoids without constipation (control group) for quantitative proteomic and bioinformatic analysis. Subsequently, 50 pairs of paraffin-embedded rectal specimens were selected for immunohistochemistry and immunofluorescence studies to validate the analysis results. Human intestinal smooth cell contractile function experiments and electrophysiological experiments were conducted to verify the physiological functions of target proteins. Cellular ultrastructure was detected using transmission electron microscopy.

RESULTS

In comparison to the control group, the expression level of dystrophin (DMD) in rectal specimens from ODS patients was markedly reduced. This finding was corroborated using immunohistochemistry and immunofluorescence techniques. The diminished expression of DMD compromised the contractile function of intestinal smooth muscle cells. At the molecular level, nucleoporin protein 153 and L-type voltage-gated calcium channel were found to be overexpressed in intestinal smooth muscle cells exhibiting downregulated DMD expression. Electrophysiological experiments confirmed an excessive influx of calcium ions into these cells. Moreover, vacuolar-like structures which may be associated with excessive calcium influx were observed in the cells by transmission electron microscopy.

CONCLUSION

Decreased DMD expression in intestinal smooth muscle may upregulate L-type voltage-gated calcium channel expression, leading to excessive calcium influx which may cause a decrease in rectal propulsion, thereby contributing to the pathogenesis of ODS.
Early detection and intervention in diabetic gastroparesis: Role of body surface gastric mapping
Authors: Mori Hideki
Published: November 2024

Diabetic gastrointestinal neuropathy is a diabetes-related complication, associated with a complex interplay of hyperglycemic damage, autoimmune responses, oxidative stress, gastrointestinal hormones, and vascular insufficiency. Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to “the point of no return”. Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.
Insights and future directions in studying intestinal microbiota post-transjugular intrahepatic portosystemic shunt for hepatitis B virus-related portal hypertension
Authors: Tong Hong-Xuan , Ye Yang
Published: November 2024

The gut microbiota (GM) plays a major role in the progression and treatment response of liver diseases, with diverse compositions based on different etiologies. In China, hepatitis B virus (HBV) infection is the leading cause of cirrhosis and affects the GM composition in patients with cirrhosis-related portal hypertension (PH). However, a few studies have been conducted on GM alterations after transjugular intrahepatic portosystemic shunt (TIPS) in patients with HBV-related PH. A recent study investigated the changes in the GM in these patients after TIPS. This study found an increase in potentially pathogenic bacteria and a decrease in beneficial bacteria post-TIPS, particularly in patients with hepatic encephalopathy (HE), indicating the potential role of the GM in HE prediction and management post-TIPS. Nevertheless, the study had several limitations, including a small sample size, limited follow-up, a single time point for sample collection, and inadequate analysis of the correlation between intestinal flora, HBV infection status, and clinical parameters. Future research should address these limitations by expanding the sample size, prolonging the follow-up duration, collecting samples at multiple time points, and conducting comprehensive analyses to confirm the findings and evaluate the effectiveness of individualized microbiome-based therapies.
Value Added Tax and The Financial Viability of Supermarkets in Laikipia County
Authors: Wariara Joyce , Kirima Nteere Dr. Kennedy , Maina Dr. Justus
Published: November 2024

Purpose: Value added Tax imposes financial burdens on retail businesses such as supermarkets forcing some of these supermarkets to fail in complying with the tax regulations and some even shutting down. The study looked at the effect of value added tax on the financial viability of supermarkets in Laikipia county. Methodology: The study adopted a descriptive research design. Questionnaires were used to collect data from the respondents. The data was analysed and presented in frequency tables. To analyse the relationship between financial viability of supermarkets and value added tax, correlation and regression analysis were used. Findings: The study concluded that there exists a strong relationship between Value Added Tax and the financial viability of supermarkets in Laikipia County.
The Effect of Harmonious Passion and Workload on The Performance of State Administrative Court Apparatus in Banda Aceh Mediated by Work Motivation
Authors: Syahputra Muhammad Danil , Adam Muhammad , Kesuma T. Meldi
Published: November 2024

This study aims to influence harmonious passion and workload on the State Administrative Court (SAC) apparatus performance, mediated by work motivation. Research data were collected by distributing questionnaires to 68 apparatus at the SAC of Banda Aceh city. Data were measured using a Likert scale that offers five alternative responses. Data were tested using SPSS, SEM-PLS, and Sobel calculator. The results of descriptive testing prove that harmonious passion, workload, work motivation, and Apparatus performance are good. Direct impact testing proves that positively harmonious passion and workload affect work motivation significantly. Furthermore, positively harmonious passion and work motivation affect Apparatus performance significantly, but workload does not have a significant effect on Apparatus performance. Indirect impact testing proves that positively work motivation significantly and partially mediates the harmonious passion effect on Apparatus performance, and positively work motivation significantly and fully mediates the workload effect on Apparatus performance.
The Influence of Perceived Risk and Perceived Value on Customer Loyalty with Customer Satisfaction as A Mediator for E-Commerce Users in Banda Aceh City
Authors: Safitri Rizka , J. Makruf Jasman , Utami Sorayanti
Published: November 2024

In this study, we aimed to explore how perceived risk and perceived value impact customer loyalty, with customer satisfaction serving as an intermediary factor. We gathered data from 170 participants through online surveys and measured the variables using 17 indicators. Our analytical tools included SPSS, AMOS, and the Sobel calculator. Upon analysis, we found that 4 hypotheses were rejected while 3 were accepted. It was observed that perceived risk has a positive but insignificant effect on satisfaction, and a negative and insignificant effect on loyalty. On the other hand, perceived value was found to have a significant positive influence on satisfaction, but an insignificant effect on loyalty. Furthermore, satisfaction was shown to have a significant positive impact on loyalty. Interestingly, we found that satisfaction could mediate the relationship between perceived value and loyalty but not between perceived risk and loyalty. Our results confirm that customer loyalty among e-commerce users is influenced by perceived value and customer satisfaction.
Aproximación al conocimiento de las estructuras de almacenaje en el asentamiento semiurbano de la Antigua Ciudad de Quilmes (Tucumán-Argentina)
Authors: Galarza Lorena Marcela , Dip Alejandra Belén , Peña Monné José Luis , Sampietro Maria Marta
Published: November 2024

The role of storage strategies throughout history is unquestionable. The old city of Quilmes offers features that indicate a possible emphasis placed on the construction of structures oriented to that end. The objectives of this research are: (1) to carry out the first systematic survey of the semi-urban system of the Old City of Quilmes; (2) differentiate between structures of diverse function through morphological clues; (3) identify and record structures traditionally associated with storage; and (4) estimate the area occupied by the aforementioned structures and their volumetric capacity. For this, a non-invasive geoarchaeological approach is proposed through the use of remote sensors and digital models, accompanied by statistical analysis. The set of information has made it possible to establish that the structures similar to storage use would cover a total area estimated at 26,146 m2 with an estimated volume of 43,761 m3 and probably contributed to improving food security during the period of indigenous resistance (1535-1667). This constitutes the first systematic approach to this subject.
Genel Cerrahi Bakışıyla Safra Kesesi
Authors: Gökdere Osman Gökhan , Gülmez Rifat Mert , Karaca İsa , Acar Serdar , Özdemir Abdulselam , Güven Mustafa , Kulu Abdül Rıdvan , Yeşilyurt Değercan , Unutmaz M.Emin , Tatlısu Ezgi , Yeni Mustafa , Arslan Ramazan Serdar , Binici Serhat , Manoğlu Berke , Bağ Yusuf Murat , Süleyman Marlen , Kaya Ahmet , Bulut Aziz , Uludağ Gökhan , Altıner Saygın , Büyükkasap Ahmet Çağrı , Adalı Mert , Kaycı Yunus , Yavuz Burak , As Abdullah , Keğin Murat , Kale Halim , İşler Ali , Kızılkaya Erhan , Aydın İshak , Çoğal İbrahim , Sarıkaya Seyyit Muhsin , Oruç Mustafa , Akgün Can , Sarı Ahmet Can , Özalp Ali Hikmet , Özgehan Gülay , Uçar Mehmet , Gün Mustafa , Avcı Mehmet Alperen , Yeşil Sarsmaz Hayrunnisa
Published: November 2024

Tıp Tarihinde Safra Kesesi
Osman Gökhan GÖKDERE
Safra Kesesi Anatomisi
Rifat Mert GÜLMEZ
Safra Kesesi ve Safra Fizyolojisi
İsa KARACA
Safra Kesesi Hastalıklarına Genel Bakış
Serdar ACAR
Safra Kesesi Hastalıklarında Tanı Yöntemleri
Abdulselam ÖZDEMİR
Mustafa GÜVEN
Kolelitiazis
Abdül Rıdvan KULU
Safra Kesesi Hastalığında Semptomlar
Değercan YEŞİLYURT
Safra Taşı Risk Faktörleri ve Korunma Yöntemleri
M.Emin UNUTMAZ
Safra Kesesi Hastalıkları ve Beslenme
Ezgi TATLISU
Akut Kolesistit
Mustafa YENİ
Akalküloz Kolesistit
Ramazan Serdar ARSLAN
Kronik Kolesistit
Serhat BİNİCİ
Mirizzi Sendromu
Berke MANOĞLU
Biliyer Diskinezi
Yusuf Murat BAĞ
Marlen SÜLEYMAN
Safra Kesesi Cerrahisi Öncesinde Hastanın Preoperatif Değerlendirilmesi
Ahmet KAYA
Safra Kesesi Cerrahisi Öncesi Hazırlık
Aziz BULUT
Robotik Kolesistektomi
Gökhan ULUDAĞ
Saygın ALTINER
Ahmet Çağrı BÜYÜKKASAP
Açık Kolesistektomi
Mert ADALI
Hamilelikte Safra Kesesi Hastalıklarına Yaklaşım
Yunus KAYCI
Burak YAVUZ
Yaşlılarda Safra Kesesi Hastalıklarına Yaklaşım
Abdullah AS
Çocuklarda Safra Kesesi Hastalıklarına Yaklaşım
Murat KEĞİN
Siroz ve Karaciğer Hastalıklarında Safra Kesesi Hastalıklarına Yaklaşım
Halim KALE
Kolesistektomi Sonrası Beslenme
Ali İŞLER
Postkolesistekomi Sendromu
Erhan KIZILKAYA
Kolesistektomi Komplikasyonları
İshak AYDIN
İbrahim ÇOĞAL
Safra Kesesi Histolojisi & Embriyolojisi: Güncel Literatür Taraması
Hayrunnisa YEŞİL SARSMAZ
İatrojenik Safra Yolu Yaralanmalarına Yaklaşım
Seyyit Muhsin SARIKAYA
Perkütan Kolesistostomi
Mustafa ORUÇ
Obezite Cerrahisi ve Safra Kesesi
Can AKGÜN Ahmet Can SARI
Safra Kesesi Hastalıklarında Patoloji
Ali Hikmet ÖZALP
Zor Kolesistektomiler
Burak YAVUZ Yunus KAYCI
Ne Zaman Açığa Dönelim
Gülay ÖZGEHAN
Sils Kolesistektomi (Single İncision Laparoscopic Surgery)
Mehmet UÇAR
Safra Kesesi Polipleri / Porselen Kese ve Diğer Özellikli Durumlar
Mustafa GÜN Mehmet Alperen AVCI
Principles and Techniques of Apnoea Resuscitation: The Critical Importance of Prompt and Effective Intervention in Managing Respiratory Distress in Neonates - A Review
Authors: Badamasi S , Ihebuzo N.G. , Kuma-Udah K.I , Obichere J.C
Published: November 2024

Neonatal apnea, characterized by pauses in breathing lasting more than 20 seconds, is common in preterm infants due to immature respiratory control mechanisms, posing risks such as hypoxemia and bradycardia, which can impact neurological development. This review underscores the critical need for prompt and effective intervention, ranging from non-invasive techniques like tactile stimulation to advanced methods such as positive pressure ventilation and endotracheal intubation. Despite progress, research gaps remain in optimizing non-pharmacological and pharmacological treatments, highlighting the necessity for standardized training, updated guidelines, and multidisciplinary approaches. Continuous monitoring, post-event reflection, and ongoing research are essential to improve outcomes for these vulnerable patients.
TROMBOSE EM PRÓTESE BIOLÓGICA MITRAL ASSOCIADA DISFUNÇÃO VALVAR SEVERA EM VIGÊNCIA DE ANTICOAGULAÇÃO ORAL
Authors: Simões Cristiano , Santos Bayeh André Eduardo dos , Hoshino Rafael Yudi Scalia Cunha , Faria Ricardo Alves Ribeiro de , Gardenghi Giulliano , Rezende Ana Carolina Vasconcellos de , Themudo Lesley Ferreira Rodrigues , Campos Dayse Elisabeth , Oliveira e Silva Ricardo Curado de , Rezende Valéria Tatyane de , Balestra Luciana Fernandes
Published: November 2024

A ocorrência de trombo em prótese biológica é rara, mas apresenta desfecho potencialmente fatal quando da obstrução importante da área valvar. Descrevemos o caso de uma paciente de 60 anos que apresentou descompensação cardíaca severa 10 meses após implante de próteses biológicas mitral e aórtica. O ecocardiograma transesofágico (ETE) diagnóstico evidenciou trombo pediculado aderido a músculo papilar do ventrículo esquerdo (VE) e espessamento importante dos folhetos da prótese biológica mitral (PBM) por trombo laminado, com limitação significativa de sua abertura, causando estenose mitral acentuada. Iniciada terapia anticoagulante com heparina de baixo peso molecular (HBPM) com resolução do quadro. Paciente mantém acompanhamento regular com evolução satisfatória nos últimos quatro anos.
SARCOMA SINOVIAL PRIMÁRIO DO TRATO GASTROINTESTINAL
Authors: Silva Alline , Braga Vitória , Rabelo Wanessa , Graciano Izabella , Tredicci Thiago
Published: November 2024

O sarcoma sinovial é uma neoplasia maligna de tecidos moles, tradicionalmente conhecida por seu padrão histológico bifásico e taxa relativamente alta de ocorrência próximo às articulações. Sarcomas sinoviais primários gástricos são extremamente raros3,4. O presente relato apresenta o caso de uma paciente de 58 anos com diagnóstico de Sarcoma Sinovial Bifásico primário do estômago que apresentou evolução satisfatória após o tratamento cirúrgico. A paciente está em acompanhamento em Cirurgia Oncológica no HC-UFG e há 5 anos sem evidências da doença.
PERFIL DOS RECÉM-NASCIDOS SUBMETIDOS A CIRURGIA EM UNIDADE DE TERAPIA INTENSIVA
Authors: Miguel Patrícia de Paula , Afiune Sandra Marcia Ramos Pimentel , Portal Daniela Carvalho , Vieira Carla Amaral , Saidah Tárik Kassem
Published: November 2024

INTRODUÇÃO: As melhorias nos resultados cirúrgicos pediátricos são em parte atribuíveis aos grandes avanços à melhor compreensão da fisiologia neonatal, anestesia pediátrica especializada, cuidados intensivos neonatais, incluindo suporte cardiopulmonar sofisticado, utilização de nutrição parenteral e ajustes no gerenciamento de fluidos, refinamento da técnica cirúrgica e avanços na tecnologia cirúrgica, incluindo opções minimamente invasiva, o que fez diminuir ainda mais a mortalidade operatória em neonatos. OBJETIVO: Analisar o perfil dos pacientes submetidos a cirurgia em unidade de terapia intensiva neonatal. MÉTODO: Estudo transversal retrospectivo analítico com levantamento de todos os casos de cirurgias realizados em recém-nascidos internados na Unidade de Terapia Intensiva Neonatal do Hospital e Maternidade Dona Íris (HMDI). RESULTADOS: Foram analisados 523 prontuários que correspondem à quantidade de pacientes internados na UTI Neonatal do HMDI no ano de 2018 e 2019 e desses 78 foram submetidos a algum tipo de cirurgia correspondendo a 14,9% dos RN. O perfil destes pacientes é de idade gestacional entre 33 a <37 semanas 31(40%), com peso >2500g 35(45%), sexo masculino 45(58%), nascidos por cesárea 49(63%), sem complicações póscirúrgica 41(53%). O tipo de cirúrgica predominante foi a toracostomia com dreno 21 (27%) seguido pela gastroquise 11(14%). Na comparação entre idade gestacional e tipo de cirurgia encontrou-se: < 28 semanas a toracostomia com dreno, 29 a < 32 semanas a toracostomia com dreno e a herniorrafia, 33 a < 37 semanas a gastrosquise, > 38 semanas a toracostomia com dreno. A principal complicação encontrada foi a sepse 17(42%) e o óbito 16 (40%). Vale destacar que houve uma maior ocorrência de óbitos em RN com idade gestacional < 28 semanas 8(50%). Dos pacientes que realizaram cirurgia 20,5% morreram. CONCLUSÕES: O perfil dos pacientes submetidos a cirurgia em UTI neonatal foi de RN do sexo masculino, idade gestacional entre 33 a <37 semanas, com peso >2500g, nascidos por cesárea e sem complicações pós-cirúrgica. A taxa de cirurgias realizadas na UTI neonatal foi de 14,9%. A principal complicação encontrada foi a sepse 42%. Índice de óbito no pós-cirúrgico foi de 20,5%.
UVEÍTE INTERMEDIÁRIA SECUNDÁRIA À COVID-19
Authors: Sobrinho Vinicius Stival Veneziano , Pereira Augusto , Neto Francisco Dias Lucena
Published: November 2024

Objetivo: compartilhar um caso de uveíte intermediária, pós infecção da fase aguda, imunomediada pela SARS-CoV-2, documentando a capacidade de apresentação clínica multiforme desta infecção. Materiais e método: relato de caso, propedêutica armada e exames de imagem, com revisão de literatura bibliográfica. Resultados: Um homem, de 50 anos, com Reação de Cadeia Polimerase (PCR) positivo em swab nasal para SARS-COV-2, 10 dias após isolamento, queixou-se de baixa acuidade visual e embaçamento visual bilateral. Vitreíte em ambos os olhos, 2+/4 em OD e 1+/4+ em OE e haze vítreo foram documentados em retinografia simples. 15 dias após o diagnóstico precoce e o início do tratamento, o paciente evoluiu com melhora de acuidade visual. Na reavaliação da biomicroscopia e fundoscopia, houve melhora do padrão da vitreíte. Conclusões: a paciente negou história médica de doenças crônicas autoimunes, inflamatórias e foi realizada a exclusão de possíveis etiologias através das principais sorologias. A clássica apresentação clínica, diagnóstico precoce e resposta clínica, com redução gradual e resposta satisfatória falam a favor de uma uveíte intermediária. Apresentamos este caso de envolvimento ocular, dias após a uma condição inflamatória sistêmica por COVID ‐ 19, para documentar a extraordinária e multifacetada capacidade de manifestação clínica viral.
SÍFILIS NA GESTAÇÃO E TRANSMISSÃO VERTICAL
Authors: Lima Gomes Mariana Carvalho de , Amaral Waldemar Naves do
Published: November 2024

INTRODUÇÃO: A Sífilis é uma doença causada pela bactéria Treponema Pallidum. Na gestante, se a doença não for diagnosticada e adequadamente tratada, pode chegar até o feto, o contaminando e trazendo repercussões no desenvolvimento fetal. Essa disseminação via hematogênica é chamada de sífilis congênita. A transmissão materno-fetal ocorre com mais frequência com a gestante portadora de sífilis primária e secundária. OBJETIVOS: Identificar a taxa de crescimento de Sífilis no período de 2017 a 2019. MÉTODOS: estudo transversal descritivo retrospectivo RESULTADOS: No presente estudo encontramos 188 pacientes notificadas com sífilis entre os anos de 2017 a 2019, essas pacientes apresentaram idade variando de 15 a 43 anos, com média de 24,6 ± 5,9 anos. O número de casos de Sífilis entre os anos de 2017 a 2019 cresceu 85%. Apesar desse alto crescimento, não foi estatisticamente significativo; p = 0411. No presente estudo, 73,4% das gestantes com sífilis eram da raça parda, 1,6% da raça negra e 7, 4% da raça branca. Das pacientes notificadas, 82,3% residem em zona urbana, 60,6% são solteiras e 47,9% fizeram pré-natal, 34,6% das gestantes notificadas estavam no 3º trimestre. Não houve informação sobre uso de álcool, tabagismo e drogas para serem estudados. Em relação a classificação clínica, 18,6% se encontravam na sífilis primária e 6,9% na sífilis latente. 78,7% das pacientes apresentaram teste treponêmico reagente. 38,3% das gestantes estavam com VDRL ≥ 1/8. O diagnóstico de sífilis congênita foi encontrado em 34,6% dos casos, aborto em 9% dos casos e óbito fetal em 8% de toda a amostra. Sobre o tratamento das gestantes: Penicilina 2,4 milhões em 17,6%, Penicilina 4,8 milhões em 27,1% e Penicilina 7,2 milhões em 12,2%. 7,4% das pacientes receberam outro esquema de tratamento, portanto, considera-se tratamento inadequado. Em relação ao tratamento do parceiro, apenas 12,8% dos parceiros foram comprovadamente tratados. CONCLUSÃO: Das pacientes notificadas no HMDI, a maioria era jovem (média de idade de 24,6 anos), parda, solteira e moradoras de zona urbana.. Em relação ao período da gestação, 17 pacientes estavam no primeiro trimestre, 5 pacientes no segundo trimestre e 65 pacientes no terceiro trimestre. Fizeram pré natal, não havia informação sobre presença ou ausência do pré natal. O número de casos de sífilis entre os anos de 2017 a 2019 cresceu 85%, foram diagnosticados 65 casos de sífilis congênita, 17 casos de aborto e 15 casos de óbito fetal. O tratamento foi realizado em 12,8% dos parceiros, 87,2% das fichas não continham informação sobre tratamento ou não dos parceiros. 107 gestantes receberam tratamento com Penicilina G Benzatina.
SARCOMAS E OUTROS TUMORES NÃO EPITELIAIS DA MAMA
Authors: Sousa André Maroccolo de , Luciano Ana Luíza Fleury , Oliveira Leandro Gonçalves , Corandin Rafael Mazon , Sousa Melo Marcella Segato de , Pinto Sebastião Alves , Sousa Juarez Antônio de
Published: November 2024

As doenças malignas não epiteliais da mama são responsáveis por cerca de 1% de todos os tumores mamários. Os cânceres de mama primários não epiteliais mais comuns são os sarcomas e os linfomas. Dentre os sarcomas, o tumor filodes maligno é o mais comum. O aspecto macroscópico dos sarcomas evidencia tecido de consistência firme de coloração variando de bronze a cinzenta, com áreas macias, císticas e outras hemorrágicas. Histologicamente esses tumores são hipercelulares, proliferação em fuso fibroblásticas, células atípicas altamente anaplásicas e de grau intermediário a alto. A graduação histológica é importante para o tratamento e prognóstico. A disseminação hematogênica é a mais comum e o envolvimento dos linfonodos axilares não é frequente entre os sarcomas. Os locais mais frequentes de metástase são os pulmões, ossos e fígado. O tratamento para os sarcomas primários da mama é a excisão ampla com margens adequadas e livres. A linfadenectomia não é recomendada, a menos que existam linfonodos clinicamente suspeitos. A radioterapia e a quimioterapia podem ser consideradas, mas tem um papel incerto.
TERATOMA IMATURO DO OVÁRIO
Authors: Luciano Ana Luíza Fleury , Sousa André Maroccolo de , Silva Julliano Moraes , Pinto Sebastião Alves , Nóbrega Judas Tadeu Nunes , Sousa Juarez Antônio de
Published: November 2024

O teratoma imaturo de ovário consiste em um tumor formado por tecidos dos três folhetos germinativos: ectoderme, mesoderme e endoderme, contendo estruturas imaturas ou embrionárias. Trata-se de tumor incomum e compreende menos de 1% dos tumores ovarianos, sendo o segundo tumor de células germinativas mais comum. Essa neoplasia é mais comum nas primeiras três décadas de vida das mulheres. Pode apresentar com massa pélvica, ou na forma de sangramento uterino anormal ou dor pélvica. O diagnóstico precoce associado à terapêutica imediata e o seguimento rigoroso são imprescindíveis para o desfecho favorável a longo prazo, principalmente em relação a preservação do futuro reprodutivo da paciente. O presente relato de caso apresenta uma paciente de 24 anos com massa volumosa em ovário esquerdo com infiltração omental, a qual foi submetida a estudos anatomopatológico e imuno-histoquímico que evidenciaram um teratoma imaturo do ovário.
USO DE BLOOD PATCH PARA MANEJO DE CEFALEIA PÓS-PUNÇÃO DURAL EM PACIENTE PEDIÁTRICO
Authors: Gonçalves Filho Saulo , Abreu Luciana Hahmann , Oliveira Figueiredo Marco Túlio José de , Fraga Wesley Sidney Garcia , Elmiro Gustavo Siqueira , Gardenghi Giulliano
Published: November 2024

As técnicas anestésicas neuroaxiais são difundidas em pacientes de todas as faixas etárias para os mais diversos tipos de cirurgias. Trata-se de uma técnica extremamente eficiente para analgesia, como é o caso da peridural. Devendo-se considerar que a correta execução e o conhecimento das possíveis complicações minimizam os erros, mas não os anulam. A cefaleia pós-punção dural (CPPD) é uma complicação da perfuração da dura-máter, em que no caso da peridural, trata-se de um acidente de punção. Embora seja mais comum em mulheres jovens, afeta também outros pacientes, incluindo a população pediátrica. Neste artigo, relatamos o caso de uma criança que apresentou CPPD e evoluiu com melhora clínica satisfatória após ser submetida ao blood patch.
PREVALÊNCIA E TRATAMENTO DA DOR CRÔNICA EM IDOSOS BRASILEIROS COM OSTEOARTROSE
Authors: Assis Angela , Freitas Jaqueline , Emiliano Robson
Published: November 2024

Introdução: A osteoartrose é o desgaste articular, pode evoluir com depósitos de osteófitos marginais, e está diretamente relacionada ao processo de envelhecimento. O tratamento da dor é norteado pelos fatores etiológicos, que direciona ao tratamento conservador, medicamentoso, cirúrgico ou combinados. Objetivo: Analisar a literatura brasileira, recente e gratuita, a fim de promover reflexões sobre a temática. Nortear fisioterapeutas em suas práticas de atendimento sobre os impactos dos tratamentos na OA, na intenção de otimizar e potencializar os efeitos da fisioterapia. Metodologia: Foi realizada uma revisão integrativa da literatura onde a pergunta norteadora foi: Qual a prevalência e tratamento da dor crônica em idosos brasileiros com OA? Realizou-se a busca on-line dos artigos nas plataformas online, no período de outubro de 2021 a fevereiro de 2022. Resultados: Inicialmente o total de artigos encontrados nas plataformas foi de n=498, sendo excluídos n=492 por não atenderem os critérios de inclusão. Após a leitura minuciosa dos estudos, n=6 artigos foram incluídos para análise e discussão, constando tratamentos para OA cirúrgico e conservador. Conclusão: Os tratamentos para a OA têm efeito positivo para a dor crônica. A prevalência da dor crônica em idosos brasileiros com OA é alta, sobretudo em idosas com sobrepeso, porém as produções científicas brasileiras não são tão satisfatórias em termos de quantidade e qualidade.
PERFIL EPIDEMIOLÓGICO E CLÍNICO-FUNCIONAL DE PACIENTES VÍTIMAS DE TRAUMATISMO CRANIOENCEFÁLICO
Authors: Sá Amanda Moraes de , Araújo Mariely Leonardo , Gardenghi Giulliano , Spadoni Marcos Fernando Tweedie , Souza Júnior José Roberto de , Souza Pereira Letícia de
Published: November 2024

Objetivo: O objetivo foi avaliar o perfil epidemiológico e clínico-funcional dos pacientes vítimas de TCE atendidos em um hospital público de referência em atendimento ao trauma em Goiânia. Métodos: É um estudo transversal analítico realizado em um hospital referência em trauma entre março a julho de 2021. Foram avaliados pacientes internados nas enfermarias, advindos da Unidade de Terapia Intensiva ou emergência, que se enquadraram nos critérios de elegibilidade da pesquisa. Foram coletadas informações dos prontuários eletrônicos e aplicadas a Escala de Coma de Glasgow, o Montreal Cognitive Assessment, a escala Medida de Independência Funcional e o Medical Research Council. Resultados: A amostra foi composta por 70 indivíduos, sendo 58% homens, com média de idade de 40,40 (±15,41) anos. Os finais de semana corresponderam aos dias de maiores ocorrências e internações, a principal causa de TCE foi o acidente motociclístico e o uso de álcool esteve associado em 41,5% dos casos. O diagnóstico de TCE leve foi o mais frequente e foram identificados déficit cognitivo e prejuízo na independência funcional. Conclusões: As maiores vítimas de TCE atendidas em um hospital referência em trauma do estado de Goiás são homens em idade produtiva envolvidos em acidentes motociclísticos sob a influência do uso de álcool. Predominou-se lesões de grau leve e identificou-se que as maiores repercussões funcionais dos indivíduos foram na cognição e na independência para desempenhar as atividades diárias do dia-a-dia.