bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infantile Acropustulosis and Granuloma Gluteale Infantum
Authors: Esterly Nancy B. 
Published: December 2021

INFANTILE ACROPUSTULOSIS
In 1979, two reports, published simultaneously in the Archives of Dermatology, described a new cutaneous disorder, infantile acropustulosis.1,2 The authors of these papers indicated that patients with this eruption had been discussed at national dermatology meetings as early as 1976, although no studies had previously been documented in the literature. Both the presentations at meetings and the written descriptions evoked instant recognition of this entity by pediatric dermatologists, many of whom recalled the frustration of caring for such an infant whose eruption defied diagnosis and effective management.
Clinical Findings
Infantile acropustulosis is truly a disorder of infancy with onset usually between 2 and 10 months of age. However, both Kahn and Rywlin1 and Lucky and McGuire3 described infants purported to have lesions at birth. Despite the paucity of reported cases of infantile acropustulosis, the collected experience has suggested that black males have a predisposition for this eruption, although affected infants of both sexes and all races have been identified.
The lesions of this disorder are quite characteristic, demonstrating a rapid sequence of morphologic changes as they evolve. Early lesions are discrete, 1- to 2-mm erythematous papules, which became vesiculopustular within 24 hours (Fig 1, top left) and subsequently crust prior to healing.
Neonatal Hyperammonemia
Authors: Donn Steven M. , Banagale Raul C. 
Published: December 2021

Neonatal hyperammonemia is a life-threatening complication of several conditions seen in the newborn infant (Table 1). Some of these disorders are potentially reversible; others are amenable to long-term therapy if early diagnosis and aggressive management in the neonatal period can prevent the catastrophic neurologic deterioration that accompanies massive hyperammonemia.
Normal plasma ammonia concentrations for both term and preterm infants vary according to different laboratories and methods, from 50 to 150 µg/dl,1 but values greater than 75 µg/dl in the term infant and 150 µg/dl in the preterm infant are considered abnormal and should be investigated. Most of the neonatal hyperammonemic conditions produce ammonia concentrations that are several-fold greater than normal, so small interlaboratory differences are less important.
INCIDENCE
The true incidence of hyperammonemic conditions in the general population is not known. Many infants probably die before a diagnosis is made. Ornithine transcarbamylase deficiency and argininosuccinate lyase deficiency are the two most common of the five urea cycle defects, with the frequency of argininosuccinate aciduria estimated to be 1/70,000.2 When all of the disorders are taken together, the incidence approaches 1/30,000 births. The increased awareness of transient neonatal hyperammonemia in recent years has led to an increase in diagnosis, and, in our experience, it is more common than the inherited urea cycle enzyme defects.
Wilms' Tumor and Neuroblastoma in Children
Authors: D'Angio Giulio J. 
Published: December 2021

Major advances have been made in the understanding and management of the malignant diseases of childhood. More than 50% of children with cancer can now be expected to survive five or more years; a few decades ago, most of these patients died within 1 year. These good results have been obtained through the use of combined-modality therapy; that is, the conjoined use of surgery, radiation therapy, and multiple-agent chemotherapy. Wilms' tumor provides a spectacular example (Fig 1). Although achieving higher cure rates, combined-modality treatment is often rigorous, and has its associated early and late complications. The goals of modern pediatric oncology reflect both of these facts. Higher cure rates continue to be sought, but there is a growing recognition that not all patients need maximum treatment. Therapy can now be modulated according to well-defined prognostic factors for most of the malignant conditions. In that way, the most aggressive therapies are reserved for those at highest risk, while those with a good prognosis can be managed less intensively. The objectives of modern management, then, are to cure most patients while at the same time minimizing, as much as possible, the associated deleterious late consequences of successful treatment.
wilms' tumor and neuroblastoma serve as good examples to demonstrate the above points.
Pandémia és különleges jogrend Magyarországon
Authors: Ungvári Álmos , Sabjanics István 
Published: December 2021

Összefoglaló. A tanulmány a COVID–19 pandémiára adott jogalkotói
lehetőségeket és válaszokat elemzi, külön figyelmet fordítva a vonatkozó hazai
jogfejlődésre. A szerzők elméleti síkon haladva, de gyakorlati példákkal
szemléltetve értelmezik a hazai megoldásokat, amelyeket a pandémiás válság
kezelésére alkalmaztak az államok. Az alkalmazott megoldásoknak kettős
feltételnek kell megfelelniük: a jogállamisági és hatékonysági szempontoknak
egyidejűleg kell érvényesülniük. A demokratikus intézményeknek mindebben aktív
szerepük van, ugyanakkor lényeges a meghozott intézkedések politikai
elfogadottsága is.
Summary. The essay displays the possibilities and answers of the
legislature and the Government of Hungary regarding the COVID-19 pandemic, with
a special focus on the Hungarian constitutional traditions and development. The
essay reaches out from the theoretical for practical reassurance primarily
through solutions used in Hungary and secondarily in other European countries.
Displaying the struggles of solution seeking in Hungary and other European
countries provides a platform for a much-needed comparative approach. These
practices must comply with two conditions: maintaining the rule of law and
effectiveness, both of which have to prevail simultaneously. Like in the case of
the delicate and ever balancing antiterrorist solutions of western democracies,
two very different questions of ‘How can we survive?’ and ‘How can our way of
life prevail in the end?’ must be answered with the same answer. The democratic
institutions have a crucial role, and with that role these institutions have to
be continuously active. In times of grave danger, with a real threat to human
life, an emergency with the possibility of such a devastation that paralyses or
eliminates state and society, the original role of democratic institutions to
serve the people is enhanced. The political acceptance (legitimacy) of the
emergency measures taken during the pandemic can make a great difference, but
the question of legitimacy itself, favorable as it should be, need not be the
most crucial question regarding emergency laws. Introducing emergency
legislation is based on some level of real or anticipated threat. The focus and
only real goal of emergency legislation, by definition, must always be ensuring
the safe return to normal or peacetime legislation. So we can say with
confidence that functioning democratic institutions provide a much better chance
of a safe and timely return to normalcy and leaving pandemic restrictions
behind.
A meningitis carcinomatosa komplex megjelenése
Authors: Orbán-Szigeti Boglárka , Papp Anikó , Kamondi Anita , Szekeres György Tibor 
Published: December 2021

Összefoglaló. Az emlőtumor miatt kezelt, majd gondozott beteget –
több tünetmentes év után – fejfájás, szédülés, ataxia, megváltozott, furcsa
viselkedés, emlékezetzavar és dezorientáció miatt neurológiai, majd
belgyógyászati osztályokon vizsgálták. Az alapos kivizsgálás ellenére a tüneteit
magyarázó organikus eltérést nem igazoltak, ugyanakkor már a kezdetektől
felmerült a szomatizációs tünetképzés lehetősége, ezért pszichiátriai osztályos
felvételére került sor. Az elvégzett vizsgálatok, illetve a klinikai kép
regresszív állapotot valószínűsítettek. Terápiás próbálkozásaink ellenére a
páciens állapota romlott, végül a megismételt neurológiai vizsgálatok meningitis
carcinomatosát igazoltak. Az esettel szemléltetni kívánjuk, hogy a beteg
premorbid működési nívója, személyiségstruktúrája hogyan képes befolyásolni az
ellátószemélyzetet, milyen külső és belső konfliktusokat válthat ki. A
diagnózishoz vezető folyamat bemutatásával fel kívánjuk hívni a figyelmet az
interdiszciplináris együttműködés fontosságára. Orv Hetil. 2021; 162(43):
1744–1748.
Summary. Our patient with known breast cancer in her past medical
history was hospitalized – after several asymptomatic years – for headache,
dizziness, ataxia, changed behaviour and disorientation. Thorough internal and
neurologic investigations did not find any disease underlying her symptoms,
therefore the possibility of somatization disorder was raised. Despite
lege artis therapeutic interventions carried out on the
psychiatry ward, the patient’s condition deteriorated and repeated neurological
examinations eventually revealed carcinomatous meningitis. With this case, we
would like to illustrate how the patient’s premorbid function level and
personality features might influence the attitude and opinion of the health care
personnel, and what kind of external and internal conflicts might be triggered.
By presenting the complexity of the diagnostic work-up, we would like to
emphasize the importance of interdisciplinary cooperation in the interest of our
patients. Orv Hetil. 2021; 162(43): 1744–1748.
Thrombocytagátló és antikoagulációs terápia a szívsebészetben napjainkban
Authors: Tóth Roland , Németh Zoltán , Rashed Aref 
Published: December 2021

Összefoglaló. Egy szívműtét tervezésekor és a perioperatív
időszakban egyaránt kiemelkedő jelentősége van a megfelelő thrombocytagátló és
antikoaguláns kezelés alkalmazásának. Írásunk célja összefoglalni és ismertetni
a jelenleg érvényes nemzetközi ajánlásokat és a jelentős tanulmányok
eredményeit, összpontosítva a Magyarországon alkalmazásban lévő gyakorlatra. A
bizonyítékokon alapuló iránymutatások alábbi, legújabb adatai döntően a European
Association for Cardio-Thoracic Surgery és a European Society of Cardiology
ajánlásaira épülnek, ezeket kiegészítettük az American College of Cardiology, az
American Heart Association és a Society of Thoracic Surgeons útmutatásaival,
végül egyes témákban hozzáfűztük az elmúlt időszak meghatározó tanulmányainak
főbb eredményeit. Cikkünkben érintjük a mono- és kettős thrombocytagátló,
továbbá az oralis antikoaguláns kezelés szerepkörét, beleértve az új típusú
thrombocytagátló és oralis antikoaguláns gyógyszereket, valamint az áthidaló
terápia fontosságát az antikoagulálásban, a különböző típusú beültetett
szívbillentyűk esetén betartandó antikoagulálási ajánlásokat, valamint kitérünk
a perioperatív pitvarfibrilláció, a posztoperatív thrombosisprofilaxis és a
vérzésveszély esetén történő gyógyszeres kezelés témájára. Figyelembe veendő,
hogy a jelen információk folyamatos frissítésen mennek keresztül, a lenti
javaslatok csupán a jelen helyzetet mutatják be. Orv Hetil. 2021; 162(48):
1910–1919.
Summary. The use of appropriate antiplatelet and anticoagulant
therapy has got an outstanding role both in the planning of cardiac surgery and
also during the perioperative period. The aim of our paper is to summarize and
present the current international recommendations and the results of significant
studies, focusing on the current practice in Hungary. The following informations
are based on the evidence-based guidelines and recommendations of the European
Association for Cardio-Thoracic Surgery and the European Society of Cardiology,
supplemented by guidelines from the American College of Cardiology, the American
Heart Association and the Society of Thoracic Surgeons, finally we added some
topics from the main results of major studies of the last years. In this paper,
we discuss the role of mono- and dual anti-platelet and oral anticoagulant
therapy, including the mechanism of novel antiplatelet and oral anticoagulant
drugs, the importance of bridging therapy in anticoagulation, postoperative
thrombosis prophylaxis and the medication practice in the case of bleeding risk.
It should be noted that though the present information has been recently
updated, the suggestions below only illustrate the current state of evidence.
Orv Hetil. 2021; 162(48): 1910–1919.
Ankle range of motion and dynamic balance in recreational Sepak Takraw players with and without ankle injury - a comparative study
Authors: Zhi Xin Jessica Phan , Krishnan Vasanthi Rajkumar , Purushothaman Vinosh Kumar , Nadzalan Ali Md. 
Published: December 2021

Background and Study Aim. Sepak Takraw (ST) is considered Malaysia's national sport, and the nature of this sport requires players to be sufficiently acrobatic. Therefore, players were expected to jump and regain their balance, challenging their dynamic balance (DB). Nonetheless, range of motion (ROM) is closely related to balance. Hence, this study aimed to compare recreational ST players' ankle ROM and DB differences with and without ankle injuries.
Material and Methods. The cross-sectional study in which 30 participants were assigned purposively according to players with an ankle injury (n=15) and without ankle injury (n=15) based on the position statement of the International Ankle Consortium (IAC). One time ankle Range of Motion and Dynamic balance was measured using a universal goniometer and Star Excursion Balance Test (SEBT), respectively, for both groups.
Results. Independent T-test was performed to identify the significant differences (p<0.05) of SEBT and ROM between the non-injured leg and injured leg within the injured group to the non-injured group. Ankle eversion and dorsiflexion between the injured and non-injured groups did not show any significant difference with p=0.35 & p=0.53, respectively. As for SEBT, only posteromedial and medial of the injured leg did not show a significant difference p>0.05. All other ankles ROM and the SEBT score demonstrated a statistically significant difference p<0.05.
Conclusions. ROM and DB training/rehabilitation should be incorporated to all the injured group ST sports players regardless of which leg is affected to optimize ankle function and the game performance.
Glutathione-dependent system in the blood of gastric cancer patients with various tumor histotypes and prevalence of the disease
Authors: Goroshinskaya I. A. , Surikova E. I. , Frantsiyants E. M. , Nemashkalova L. A. , Kachesova P. S. , Medvedeva D. E. , Maslov A. A. 
Published: December 2021

Purpose of the study. Exploring the erythrocyte glutathione system functioning in patients with gastric cancer in a comparative aspect, depending on tumor histotype and disease prevalence.Patients and methods. The study included 89 patients with gastric cancer, divided into 6 groups depending on the histotype of the tumor. Separately, the results of the study were analyzed in patients with T4 status according to TNM and in patients at stage 4. The content of reduced glutathione and the activity of glutathione-dependent enzymes in the erythrocytes of the patients' blood were studied by conventional spectrophotometric methods. Statistical processing of the results was carried out using the Statistika 6.0 software package according to the Student's t-test and the nonparametric Wilcoxon-Mann-Whitney test for two independent samples.Results. An increase in the content of glutathione was revealed in patients with gastric cancer compared with the group without oncopathology. The maximum increase was observed in patients with low-grade adenocarcinoma - by 42.5 %, while in signet ring cell carcinoma (SRCC) there was only a tendency to increase by 17.8 %. Glutathione reductase activity was decreased in adenocarcinoma by 23.4-26.2 % and did not change in SRCC. The activity of the antioxidant enzymes glutathione peroxidase and glutathione transferase was increased in all groups, and especially in SRCC - by 76 % and 23-29 %, respectively. In patients with the T4 status and at stage IV of the process, a lower activity of the studied glutathione-dependent enzymes was revealed in comparison with all other groups of patients.Conclusions. The data obtained indicate a greater functional potential of the glutathione system in SRCC. A significant increase in glutathione transferase activity at a sufficiently high level of reduced glutathione can contribute to the development of treatment resistance in SRCC patients.
Human resources in a healthcare institution as the management efficacy improvement factor
Authors: Kukurika A. V. 
Published: December 2021

The article analyzes the current HR of the local healthcare organization. There was carried a SWOT-analysis of personnel management has been out, disclosed the main problems of the management system of a medical institution. Development strategies and an algorithm for improving personnel policy are formulated in order to increase the efficiency of management and the quality of medical care to the population.Purpose of the study. Is to analyze the current personnel policy, SWOT-analysis of personnel management, develop a strategies and set of practical recommendations for improving the management system of a public health institution while ensuring high quality medical services to the population.Materials and methods. An analysis of the personnel policy in a phthisiatric institution (Makeevka Municipal TB Dispensary, Donetsk region) was carried out, the heads of the main structural divisions were questioned. The analysis results are structured using the SWOT scale.Results. Based on the results of the sociological survey, the main advantages and disadvantages of personnel policy were identified, a SWOT analysis matrix was drawn up, and strategies for the development of a budgetary healthcare institution were developed. The breakthrough strategy is based on improving the material and technical base, attracting funding and investment, increasing the speed and quality of TB care at the regional level using information technology, while the survival strategy is based on increasing the income of health workers, social protection, improving working conditions and developing personnel motivation systems. The main recommendations include increasing the number of employees, creating a strategy for the formation of qualified personnel, improving the quality of the working environment, creating a favorable psycho-emotional climate, and developing an effective system of incentive payments.Conclusion. The medical industry is in dire need of modernization in order to improve personnel processes, financial, economic and regulatory support. The conducted research and developed recommendations will have a beneficial effect on the achievement of the main strategic goal - improving the health and quality of life of the population of the state.
The effectiveness of liposomal doxorubicin hydrochloride in combination with cyclophosphan in the treatment of breast cancer in an experiment
Authors: Balykova L. A. , Inchina V. I. , Tarasova T. V. , Mosina L. M. , Gvozdikova E. N. , Khaydar D. A. , Myandina G. I. , Ryzhakin S. M. , Saushev I. V. 
Published: December 2021

Purpose of the study. To evaluate the antitumor efficacy of liposomal doxorubicin hydrochloride in combination with tamoxifen in the treatment of breast cancer.Materials and methods. The study included mongrel white rats (n = 30). A model of carcinogenesis (Walker 256 tumors) was created for all animals. Then we divided these rats into 3 equal groups: 1 control group (n = 10) - animals were monitored without treatment; 2 group (n = 10) - animals received neoadjuvant therapy: liposomal doxorubicin hydrochloride + cyclophosphan; 3 group (n = 10) - animals received neoadjuvant therapy with doxorubicin hydrochloride (non-liposomal) and cyclophosphan. Animals of the second and third groups received two cycles of neoadjuvant therapy. All animals were monitored for 1.5 months. We evaluated the effectiveness of antitumor therapy by measuring the size of tumors, the dynamics of their regression, and counting the number of metastases in the lungs. The toxic effects of doxorubicin hydrochloride were assessed by blood parameters: platelet and lymphocyte levels.Results. We recorded a significant inhibition of the growth of tumor nodes in the second group of rats on the 25th day from the start of the experiment compared with the first and third groups: 36004.7, 86112.1 and 38962.4 mm3, respectively. By the end of the 3rd week of the experiment, we also noted the formation of a tumor regression trend in the 2nd and 3rd groups of animals, which was reliably maintained until the end of the observation. At the end of the experiment, the number of metastases in the first group of animals was 3 times more, in the third group almost 1.5 times more than in the second (p < 0.05)Conclusion. The treatment of Walker 256 tumor with liposomal doxorubicin showed better efficacy and safety in comparison with non-liposomal doxorubicin. The tumor volume becomes smaller against the background of neoadjuvant chemotherapy with liposomal doxorubicin hydrochloride compared with its non-liposomal form, while there is no pronounced decrease in platelets and lymphocytes. We also recorded a significantly lower number of lung metastases in animals of the second group compared to other groups.
Improvement of surgical methods for the treatment of spontaneous rupture of the esophagus ­complicated by purulent mediastinitis
Authors: Senichev D V , Sulimanov R A , Sulimanov R R , Spassky E S , Salekhov S A 
Published: December 2021

Aim. To improve surgical treatment outcomes of patients with spontaneous rupture of the esophagus complicated by purulent mediastinitis.
Methods. Over the past 30 years, we have experience in the surgical treatment of 31 patients with spontaneous rupture of the esophagus complicated by purulent mediastinitis. Depending on the tactics and techniques of surgical treatment, we identified two groups of patients. The first group (n=8) consisted of patients operated with conventional techniques: thoracotomy, transpleural mediastinotomy according to Dobromyslov, suturing of the esophagus with drainage of the mediastinum and pleural cavities, blind mediastinal drainage. The second group (n=23) consisted of patients treated with programmed re-thoracotomy. Re-thoracotomy was performed along with the postoperative thoracotomy wounds. The delimited foci of purulent mediastinitis were opened and sanitized (necrotic tissues were excised and removed). Preventive hemostatic methods were used in the area of pressure ulcers from drainage tubes. Replacing and changing the position of the drainage tubes in the mediastinum was a strictly compulsory technique. Pus and necrotic soft tissue that appeared in the thoracotomy wound were subsequently eliminated by a device consisting of two titanium brackets connected by a lock embodied in the form of an oval ring during the wound suturing at the stage of programmed re-thoracotomy. The groups were comparable in age and comorbidities. The average diagnosis of spontaneous esophageal rupture took 3.5 days; the maximum time is 10 days. The statistical significance of differences in immune status indicators was assessed by using the Student's t-test and Pearson's 2 test.
Results. A systematic approach using the tactical and technical surgical techniques developed by us (such as suturing esophageal wall defects regardless of the rupture time, multifunctional nasoesophagogastric tube installation; the imposition of a purse string suture to prevent reflux from the stomach into the esophagus; programmed re-thoracotomy using the method of temporary fixation of the ribs) allowed to reduce the number of complications, such as haemorrhage from the mediastinal vessels, by 3 times, sepsis 1.5 times, mortality almost 2 times.
Conclusion. The introduction of patented techniques allowed to reduce the number of life-threatening complications and mortality in patients with spontaneous rupture of the esophagus complicated by purulent mediastinitis.