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Introduction. Upper digestive tract endoscopy remains the gold-standard for detecting esophageal or gastric varices and assessment of bleeding risk, but this method is invasive. The aim of the study was to identify non-invasive factors that could be incorporated into an algorithm for estimating the risk of variceal bleeding.

This study investigates the relationship between periodontal disease and vitamin D deficiency by correlating clinical periodontal parameters with serum levels of vitamin D; (2) Methods: Data from the literature and the periodontal status of two patients diagnosed with both periodontal disease and vitamin D deficiency were evaluated. Clinical parameters were measured, including plaque index, bleeding on probing, and bone resorption (%). Serum levels of vitamin D were also analyzed. Additionally, the patients underwent initial periodontal treatment to improve the periodontal status; (3) Results: Both patients exhibited advanced periodontal disease with elevated clinical parameters and significant bone resorption. Serum levels of vitamin D were below normal; (4) Conclusions: The findings suggest a significant association between vitamin D deficiency and periodontal disease severity. Low serum levels of vitamin D may exacerbate periodontal tissue destruction and bone resorption. Early detection and management of vitamin D deficiency could play a crucial role in preventing and treating periodontal disease. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic skin condition that can significantly impact the quality of life of those affected. As an autoimmune disease, it can lead to itchy, painful, and scaly patches on the skin. Although various treatments, including topical creams, phototherapy, and systemic medications, are currently available, they may not always offer effective relief and can have side effects. Researchers have thus been exploring the potential benefits of non-psychoactive compounds such as CBD, found in Cannabis sativa plants, for treating psoriasis. CBD treatment may reduce inflammation, oxidative stress, itching, abnormal proliferation of keratinocytes, and may increase hydration. This review aims to provide an overview of the existing literature on the potential uses of CBD for psoriasis treatment. [ABSTRACT FROM AUTHOR]

Quantifying traffic congestion is a critical task for transportation planning and research. Numerous metrics have been developed, mainly focusing on changes in vehicle speeds, their extents, and travel time. In this study, new metrics are presented using the Hägerstrand's space-time cube that has been studied from time geography perspectives since the 1960s. Particularly, the product of distance and time, i.e., distanceTime, is proposed as a base metric to measure traffic congestion amounts. Using the base metric such as mileHours, metrics of weighted congestion and normalized congestion amounts were also developed. New metrics were applied to six metropolitan areas and their vicinities in the United States (Atlanta, Chicago, Washington, D.C. and Baltimore, Dallas and Fort Worth, Los Angeles, and New York), and congestion amounts were calculated and compared. The Google Traffic Layer API was used to obtain traffic congestion datasets for six months (April–September 2022), and GIS (geographic information systems) was used for delineating road features and traffic intensity levels. Among the six areas, New York and its vicinity showed the largest congestion when only heavy congestion was used. Los Angeles and its vicinity showed the largest congestion when all congestion levels were considered. This study shows that the proposed metrics are very effective in summarizing traffic amounts and broadly applicable for further analyses of traffic congestion phenomena by associating various other factors, such as weekdays, months, or gas prices. The new metrics developed in this research may help transportation researchers and practitioners by providing them with a set of metrics applicable to summarizing congestion amounts by synthesizing congestion intensity, extent, and duration. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) refers to chronic conditions with a low mortality but high disability. The multisystemic nature of these diseases can explain the appearance of some extraintestinal manifestations, including liver damage. Abnormal liver biochemical tests can be identified in approximately one third of patients with IBD and chronic liver disease in 5% of them. Among the liver diseases associated with IBD are primary sclerosing cholangitis, cholelithiasis, fatty liver disease, hepatic amyloidosis, granulomatous hepatitis, drug-induced liver injury, venous thromboembolism, primary biliary cholangitis, IgG4-related cholangiopathy, autoimmune hepatitis, liver abscesses or the reactivation of viral hepatitis. The most common disease is primary sclerosing cholangitis, a condition diagnosed especially in patients with ulcerative colitis. The progress registered in recent years in the therapeutic management of IBD has not eliminated the risk of drug-induced liver disease. Additionally, the immunosuppression encountered in these patients increases the risk of opportunistic infections, including the reactivation of viral hepatitis. Currently, one of the concerns consists of establishing an efficiency and safety profile of the use of direct-acting antiviral agents (DAA) among patients with hepatitis C and IBD. Early diagnosis and optimal treatment of liver complications can improve the prognoses of these patients. [ABSTRACT FROM AUTHOR]

Among the most compelling applications of Augmented Reality are spatially registered tutorials. The effort of creating such instructions remains one of the obstacles precluding a wider use. We propose a system that is capable of extracting 3D instructions in a completely model-free manner from demonstrations, based on volumetric changes. The instructions are visualised later in an interactive Augmented Reality guidance application, on a mobile head-mounted display. We enable a technology that can be used by anyone in an ad-hoc tabletop setup for assemblies with rigid components. [ABSTRACT FROM AUTHOR]

Improving the aged population’s health is a complex goal that requires a multifactorial approach and the knowledge of etiopathogenic factors. Osteoarthritis is the most common joint disease and the second leading cause of disability in people over the age of 50, which has a substantial economic impact and turns into a real social and public health problem. Although it manifested in less than 30% of the older population, pathological changes in the articular cartilage are founded in all deaths over 65 years. That is why we consider primary prophylaxis an important goal for the disease. This minireview presents etiological factors as genetic predisposition, age, body mass index, sex, bone density and the pathogenic degradation of articular cartilage. This includes two aspects of evolution, the progressive degradation of the articular cartilage and the reparative reaction of the subchondral bone. In conclusion, knowing these mechanisms are the first step in managing degenerative joint pathology. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic immunologic disease involving inflammation that can target internal organs, the skin, and joints. The peak incidence occurs between the age of 30 and 40 years, which overlaps with the typical reproductive period of women. Because of comorbidities that can accompany psoriasis, including metabolic syndrome, cardiovascular involvement, and major depressive disorders, the condition is a complex one. The role of hormones during pregnancy in the lesion dynamics of psoriasis is unclear, and it is important to resolve the implications of this pathology during pregnancy are. Furthermore, treating pregnant women who have psoriasis represents a challenge as most drugs generally prescribed for this pathology are contraindicated in pregnancy because of teratogenic effects. This review covers the state of the art in psoriasis associated with pregnancy. Careful pregnancy monitoring in moderate-to-severe psoriasis vulgaris is required given the high risk of related complications in pregnancy, including pregnancy-induced hypertensive disorders, low birth weight for gestational age, and gestational diabetes. Topical corticosteroids are safe during pregnancy but effective only for localised forms of psoriasis. Monoclonal antibodies targeting cytokines specifically upregulated in psoriasis, such as ustekinumab (IL-12/23 inhibitor), secukinumab (IL-17 inhibitor) can be effective for the severe form of psoriasis during pregnancy. A multidisciplinary team must choose optimal treatment, taking into account fetal and maternal risks and benefits. [ABSTRACT FROM AUTHOR]

In adults, developmental dysplasia of the hip (DDH) represents a spectrum of disorders. It is commonly found in women in routine orthopedic practice. Hip dysplasia is a leading precursor of joint laxity; when untreated, it can contribute to chronic modifications, such as thickening of the pulvinar and ligamentum teres (which can also elongate), hypertrophy of the transverse acetabular ligament, and osteoarthritis. DDH is presumed to be associated with alterations in pelvic morphology that may affect vaginal birth by the reduction in the transverse diameter of the pelvic inlet or outlet. Here, we provide an overview of the current knowledge of pregnancy-associated DDH. We primarily focused on how a surgical DDH treatment might influence the pelvic shape and size and the effects on the mechanism of birth. We presented the female pelvis from the standpoint of bone and ligament morphology relative to a pelvic osteotomy. Then, we described whether the pregnancy was impacted by previous surgical DDH treatments, performed from infancy to adulthood. In conclusion, hip dysplasia is not associated with high-risk complications during pregnancy or with increased difficulty in vaginal delivery [ABSTRACT FROM AUTHOR]

Group B of streptococcal infection is responsible for maternal and fetal morbidity and mortality. Fetal consequences of streptococcal B infection may lead to puerperal sepsis, meningitis, encephalitis or pneumonia. Long-term consequences may determine neurological sequelae and mental disabilities, and very rare are reported cases for the late death of the child. Maternal consequences of streptococcal B infection are endometritis and sepsis. Universal screening and antibioprophylaxy during labour are safe and effective. But, systematic intrapartum prophylaxis for carriers of SGB does not appear to have effects on long-term complications. Also, systematic cultures in neonates do not appear to detect antenatally all carriers of streptococcus B. Herein, we present the particularity of streptococcal infection in pregnancy that may contribute to further strategy. Better laboratory tests for identifying serotypes, genotypes and phenotypes must be available, significantly to differentiate between dtreptococcal high- and low-risk regarding materno-fetal consequences.Immunization remains a promising way to eradicate this infection. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine has emerged as a critical technology to mitigate SARS-CoV-2 infection. We aim in this work to explore how general practitioners (GPs) perceived the use of telemedicine, recently recognized and reimbursed by the Public Health Insurance House (PHIH) for primary care (PC) provision. Methods: A cross-sectional study was performed in 2020 in one county of Romania using an anonymous questionnaire that assessed physicians' perceptions regarding teleconsultation, reliability in tele-decision, remote pathology management, pregnant women's surveillance, patients' satisfaction with telemedicine, the need for its further reimbursement. Bivariate correlation was used to measure associations between the investigated issues. Results: More than a quarter of GPs (28.6%) found it easier to address patients' healthcare needs remotely, while 60.7% considered time-consuming teleconsultations compared to face-to-face visits. Tele-diagnostic uncertainty was expressed by 64.3% of physicians, and a quarter were confident in tele-decisions. Almost half of GPs (43%) observed patients' satisfaction with tele-visits, while half said patients encountered difficulties using technology. A large percentage of doctors (62.5%) perceived that patients felt as well treated by virtual as in-person visit and 91.1% suggested post-pandemic reimbursement. The results of the bivariate correlation showed that physicians who perceived positive patient feedback on telemedicine were more supportive of subsequent reimbursement. Conclusion: This study showed the GPs' positive perception of the use of telemedicine. Its adoption in PC has shed light on the shadows of the pandemic. The time-consuming nature of teleconsultations, uncertainty in tele-decisions, patients' difficulties in using technology were seen as shadows of telecare. However, most of the GPs surveyed agreed with the need for further reimbursement. Future work should focus on innovative solutions for integrating telemedicine as complementary form of PC, the need for telemedicine-based training for GPs to improve capacity building, and patients' perceptions of virtual care, helping to build trust and satisfaction. [ABSTRACT FROM AUTHOR]

Patients with type 2 diabetes exhibit higher cardiovascular risk than normal individuals. Optimal blood glucose levels are rarely achieved in diabetic patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a new antidiabetic drug class with multiple metabolic effects. Some trials have evaluated their safety, but it has been recently demonstrated that this new class has cardiovascular benefits, through other mechanisms than glycemic control. The use of GLP-1RAs was associated with a significant reduction of cardiovascular and all-cause mortality, with a safe profile related to pancreatitis or thyroid cancer, as compared with placebo. This review presents the cardiovascular and metabolic benefits of GLP-1 RAs versus placebo, in patients with type 2 diabetes. Semaglutide and liraglutide demonstrated a reduction in cardiovascular events, with similar rates on cardiovascular mortality. Ongoing trials assess the cardiovascular benefits and side effects of dulaglutide treatment. Exenatide and liraglutide demonstrated the decrease of blood pressure values, weight reduction and improvement of dyslipidemia. Liraglutide induced, both in vivo and in vitro, an improvement of blood circulation, increasing the nitric oxide level and inhibiting the adhesion and procoagulant factors. Also, liraglutide demonstrated beneficial effects on cardiac remodeling after myocardial infarction, but more large trials are required. However, the international guidelines recommend using GLP-1 RAs as first-line therapy in type 2 diabetes patients with high cardiovascular risk or as first-line agents in patients intolerant to metformin. [ABSTRACT FROM AUTHOR]

Anticoagulant treatment is necessary in various conditions, with curative or preventive purposes. Until recently, the only oral anticoagulants available have been vitamin K antagonists. To overcome the disadvantages of the antivitamin K oral anticoagulants, new oral anticoagulants (NOACs) have been developed and included in clinical trials. After more than 60 years of using vitamin K antagonists, the introduction of NOACs represent a medical breakthrough, with promising prospects. Due to their promising results and better safety profile, NOACs have become an appealing alternative to vitamin K antagonists in a short period of time. NOACs have been approved for the prevention and treatment of venous thromboembolism and for the prevention of stroke in patients with nonvalvular atrial fibrillation. Starting with postoperative venous thromboprophylaxis after hip replacement surgery, NOACs have been approved also for other clinical situations. Rivaroxaban is the first oral anticoagulant approved to be used in combination with an antiplatelet agent to prevent atherothrombotic events in adults with coronary artery disease and/or peripheral artery disease. However, further investigation is needed to establish which group of patients would benefit most from this medical approach. Furthermore, preliminary studies have shown that NOACs seem to be a reasonable choice of anticoagulation for patients with cancer, but further studies are expected. [ABSTRACT FROM AUTHOR]

Many diseases that affect physical health can also affect mental health. Many of these diseases are studied in terms of quality of life, depression and suicidal behavior. Dermatological disorders, although having a strong impact on the individual's life, are less studied with regard to suicidal behavior. There is a need to approach several dermatological diseases from the perspective of suicidal behavior in order to intervene early with specific treatment or to prevent suicide. Psoriasis, acne, melanoma, atopic dermatitis and urticaria are scarcely studied from the point of view of suicidal behavior. In addition to these diseases, there are others that require attention in terms of suicidal behavior, such as vitiligo or oculocutaneous albinism, most probably due to a small number of people suffering from these diseases, research is almost non-existent in these cases. We want to draw attention to the importance of early detection of suicidal behavior in dermatological practice and to highlight the need for several studies on this subject. [ABSTRACT FROM AUTHOR]

Botulinum toxin is a substance produced by Clostridium Botulinum and is responsible for human botulism. This substance is a poison, a neurotoxin, but used in limited quantities it can be a cure for some diseases. It is well connected to a large variety of medical applications. The mechanism of action relies on blocking the acetylcholine at the neuromuscular junction, which blocks the transmission of the nervous impulse with secondary flaccid paralysis. In urology, its role in idiopathic overactive bladder and neurogenic bladder is well known. We performed a thorough review using PubMed and other databases, revising the mechanisms of botulinum toxin action in urologic pathology, treatment procedures and other options. Botulinum toxin is a well-studied substance with a large number of applications in medicine. In urologic pathology, overactive bladder and neurogenic bladder are backed by robust studies that support the therapeutic role of this substance. The toxin has multiple effects, such as inhibition of the nerve growth factor, blocking the bladder sensory afferent pathway and apoptotic effect on the prostate tissue, by inhibiting the substance P, altering the nociceptive pathways. Interstitial cystitis and other rare pathologies show promising results, but further studies are needed. The role of botulinum toxin in benign prostatic hyperplasia is still not elucidated. [ABSTRACT FROM AUTHOR]

Penile carcinoma is a relatively frequent health issue in the developing countries such as Africa, Asia and South America, usually affecting men aged between 50 and 70 years. It is a highly treatable disease in its early stages, but has serious physical and psychological consequences. Usually, penile carcinoma is located in the penile glans, in approximately half the cases, with the most frequent histological type being squamous cell carcinoma with its microscopic subtypes. A large number of risk factors have been reported for this disease, having a multifactorial etiology, HPV infection being one of the most important factors involved in its appearance. Out of the HPV DNA positive genital cancers HPV-16 is the most frequently found type in men, followed by HPV-18. The evolution of penile cancer includes two independent carcinogenic pathways, related or unrelated to HPV infection. There is limited data available in literature regarding HPV-related neoplasia, as well as on the efficacy of vaccination in men, with studies still ongoing. [ABSTRACT FROM AUTHOR]

In the last 50 years, several clinical and epidemiological studies during have shown that increased levels of low-density lipoprotein cholesterol (LDLc) are associated with the development and progression of atherosclerotic lesions. The discovery of β-Hydroxy β-methylglutaryl-CoA reductase inhibitors (statins), that possess LDLc-lowering effects, lead to a true revolution in the prevention and treatment of cardiovascular diseases. Statins remain the cornerstone of LDLc-lowering therapy. Lipid-lowering drugs, such as ezetimibe and bile acid sequestrants, are prescribed either in combination with statins or in monotherapy (in the setting of statin intolerance or contraindications to statins). Microsomal triglyceride transfer protein inhibitors and protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are other drug classes which have been investigated for their potential to decrease LDLc. PCSK9 have been approved for the treatment of hypercholesterolemia and for the secondary prevention of cardiovascular events. The present narrative review discusses the latest (2019) guidelines of the European Atherosclerosis Society/European Society of Cardiology for the management of dyslipidemia, focusing on LDLc-lowering drugs that are either already available on the market or under development. We also consider "whom, when and how" do we treat in terms of LDLc reduction in the daily clinical practice. [ABSTRACT FROM AUTHOR]

THERE ARE A FEW STUDIES WHICH LOOKED INTO THE OVERALL BENEFIT AND LONG TERM OUTCOME OF RADICAL OPEN PROSTATECTOMY VERSUS LAPAROSCOPIC PROSTATECTOMY, THE SECOND PROCEDURE BEING MORE AND MORE POPULAR WITH THE PATIENT BUT ALSO WITH THE UROLOGIST. THE PURPOSE OF THIS ARTICLE IS TO COMPARE THE BENEFITS TO THE PATIENT, THE ADVANTAGES AND DISADVANTAGES BETWEEN THIS TWO PROCEDURES REGARDING THE PROSTATE CANCER. IN MAKING THIS ARTICLE PUBMED DATABASE WAS RESEARCHED AMONG SPECIALTY LITERATURE. [ABSTRACT FROM AUTHOR]

THE PRESENT ARTICLE IS A REVIEW IN THE MODERN MANAGEMENT OF THE RENO-URETERAL CALCULI. SEPARATE REVIEWS OF THE LITERATURE AND GUIDELINES WERE PERFORMED FOR EACH SEGMENT OF THE RENAL SYSTEM, REGARDING ONE OF THE MOST COMMON PATHOLOGY OF THIS SYSTEM: STONES. MOST IMPORTANT, ALL OF THE RECOMMENDATIONS REGARDING THE TREATMENT OF THIS DISEASE WERE BASED ON THE GUIDELINES AND ON EXPERT REVIEW OF THE LITERATURE. WE COMPARED THE TREATMENT OUTCOME AND THE DIFFERENT TYPES OF TREATMENT FOR RENAL AND URETERAL STONES. [ABSTRACT FROM AUTHOR]

Introduction. The concept of underactive bladder is relatively new. Currently there is no generally accepted definition of this pathology. Diagnosis depends on urodynamic findings, and symptoms are usually rare and intricated with the symptoms of other urinary pathology. Matherials and methods. This review examines the current literature on underactive bladder regarding pathology, definition, diagnosis, current guidelines, and any further potential medical developments. Conclusions. Underactive bladder is a poorly understood pathologic condition. Only since 2002 has there been any consensus regarding the definition. The diagnosis relies only on urodynamics; clinical diagnosis is a challenge even for a consultant; and treatment does not seem to alleviate much of the suffering. This disease remains underrecognized and undertreated. More research is needed to identify less invasive diagnosis tools and treatment for this pathology. [ABSTRACT FROM AUTHOR]

According to statistical data published in 2019, breast cancer is among the leading causes of death in women worldwide. The serine/threonine kinase (AKT) or protein kinase B (PkB) signaling pathway is activated by phosphorylation processes, which further is associated with cell growth, proliferation, and survival, but also with activation of glucose metabolism. Mutations of the AKT signaling pathway components (especially PI3KCA and PTEN) have been observed in breast cancer patients, which are associated with resistance to hormonal treatment. Many clinical trials are testing the effect of AKT inhibition in order to block the growth and proliferation of breast cancer cells. The purpose of this review is to present the incidence of this neoplastic disease, to describe AKT signaling pathways activation, mutations that occur at its level, and inhibitors that can block this protein kinase. [ABSTRACT FROM AUTHOR]

Prostate cancer is the second most common form of cancer in men in Europe. The primary treatment of this type of cancer is radical prostatectomy, which has shown good oncological results. Radical prostatectomy (open, laparoscopic or robotic) has high success and low morbidity rates in patients with localized prostate cancer. The life expectancy is >10 years after radical prostatectomy. Studies have shown that ~20%-30% of the patients who have undergone radical prostatectomy can develop biochemical recurrence, which is monitored by using the value of the prostate-specific antigen (PSA). In some cases (patients with high-risk prostate cancer), adjuvant therapy after radical prostatectomy, such as radiotherapy or androgen deprivation therapy, can significantly reduce the risk of biochemical recurrence. The optimal management of recurrent disease remains uncertain. Recent literature was systematically reviewed regarding the management of biochemical recurrence and to compare clinical experience in literature studies. [ABSTRACT FROM AUTHOR]

Correlations between alterations in the oral cavity and systemic conditions have been widely reported. A considerable number of gastrointestinal (GI) diseases of varied nature may produce lesions in the hard and soft oral tissues. Among the different types of manifestations of GI, oral lesions represent an important, if not a major component of the manifestation of these diseases. As a consequence, recognition and management of oral lesions accompanying the GI conditions, is mandatory for all clinicians, either gastroenterologists or dentists. The aim of this article is to underline useful data about the most common GI conditions (intestinal bowel diseases (IBD), gastroesophageal reflux, genetic diseases, malabsorption conditions, infections, metastatic tumors) and their link to oral pathology. [ABSTRACT FROM AUTHOR]

Telemedicine ensures remote medical services through technologies that facilitate the interaction between a health professional and patients and offers the possibility of a interdiciplinary consultation between specialists, in order to obtain a diagnosis and treatment plan. It involves secure transmission of medical data and information, through text, sound, images or other forms needed for the prevention, diagnosis, treatment and follow-up of patients. With the help of telemedicine, people from rural areas, with difi cult access to primary care, and those with reduced mobility can benefi t from healthcare services. This paper is a review of the latest data available in the literature regarding telemedicine and the future prespectives in this fi eld in Europe. [ABSTRACT FROM AUTHOR]

The role of the trace elements in humans has increased during the last 20 years. It seems that they play a significant role in maintaining the healthy state of the organism. These minerals are present in small levels, but their role is vital. Although they account for only 0.02% of the total body weight, it has highlighted that they play significant roles, either as active centers of enzymes or as trace bioactive substances. Their excess or deficiency may influence the homeostasis and potentially can lead to several chronic diseases, including cancer. It is already known that certain elements in the free or combined state can be primary causative agents, or risk factors for human cancer. Nevertheless, it is important to underline that the carcinogenic elements are fewer than it was expected in studies. Copper, cobalt, chromium, zinc, selenium, are involved in many biochemical processes supporting life. However, their concentrations may play an important role in developing cancer, by influencing proliferation or apoptosis. Disruption of the balance between free radicals and antioxidants may cause a cellular damage and trigger carcinogenesis. [ABSTRACT FROM AUTHOR]

INTRODUCTION. HUMAN PAPILLOMAVIRUS (HPV) IS A VIRAL INFECTION WHICH GENERATES EPITHELIAL TUMOURS OF THE MUCOUS MEMBRANES AND SKIN ESPECIALLY WARTS. THE DIMENSIONS OF THE WARTS COULD VARY AMONG INDIVIDUALS FROM A FEW MILLIMETRES TO A CONSIDERABLE SIZE BEING CALLED GIANT CONDYLOMA ACUMINATUM (GCA). THIS GIANT CONDYLOMA ACUMINATUM WAS FIRST DESCRIBED BY BUSCHKE AND LÖWENSTEIN IN 1925 ON PENILE FORESKIN, NOWADAYS KNOWN AS BUSCHKE -- LOWENSTEIN TUMOUR (BLT). MATERIAL AND METHODS. THE PURPOSE OF THIS PAPER IS TO REVIEW THE AVAILABLE DATA REGARDING THE ETIOPATHOGENY OF BLT DIAGNOSIS AND NEW LINES OF TREATMENT. WE USED PUBMED AND SCOPUS DATABASES FOR REVIEWS AND FULL ARTICLES. CONCLUSIONS. BUSCHKE -- LOWENSTEIN IS A RARE DISEASE CAUSED BY INFECTION WITH HPV, ESPECIALLY ASSOCIATED WITH "SEMI -- MALIGNANT " VERRUCOUS CARCINOMA OR SQUAMOUS CELL CARCINOMA. COINFECTION WITH HIV ENHANCE THE ONCOGENIC ABILITY OF HPV, BUT THE ONCOGENIC PROCESS IS SLOW, SO AN EARLY REMOVAL OF THE LESION WHEN NOTICED BY THE PATIENT IS USEFUL TO PREVENT A GCA. PRE-EXPOSURE AND POST-EXPOSURE VACCINES ARE VERY IMPORTANT IN PREVENTING BLT AND REDUCING THE VIRAL LOAD IN THE INFECTED. [ABSTRACT FROM AUTHOR]

Breast milk is recommended as an optimal and exclusive source of early nutrition for all infants from birth to at least 6 months of age. Despite all the benefits of breastfeeding, there are situations where breastfeeding is contraindicated. There are differences of opinion regarding the contraindications of breastfeeding, the current research bringing more knowledge in this area. It is important to know the differences of opinion for the correct approach of the breastfeeding patient. [ABSTRACT FROM AUTHOR]

Pheochromocytoma is a neuroendocrine tumor characterized by the excessive production of catecholamines (epinephrine, norepinephrine, and dopamine). The diagnosis is suspected due to hypertensive paroxysms, associated with vegetative phenomena, due to the catecholaminergic hypersecretion. Diagnosis involves biochemical tests that reveal elevated levels of catecholamine metabolites (metanephrine and normetanephrine). Functional imaging, such as 123I-metaiodobenzylguanidine scintigraphy (123I-MIBG), has increased specificity in identifying the catecholamine-producing tumor and its metastases. The gold-standard treatment for patients with pheochromocytoma is represented by the surgical removal of the tumor. Before surgical resection, it is important to optimize blood pressure and intravascular volume in order to avoid negative hemodynamic events. [ABSTRACT FROM AUTHOR]

The role of beta-adrenergic receptor antagonists in cardiovascular therapy has been the subject of various studies over time, these agents representing one of the oldest class of drugs used for the treatment of cardiovascular diseases. Although beta-blockers have been excluded from guidelines as the first-line therapy in essential hypertension, they remain the first choice in patients with heart failure, coronary artery disease, and atrial fibrillation. In this article, we review the major clinical evidence for the use of beta-blockers in cardiovascular diseases. Several trials have demonstrated that beta-blockers reduce mortality in patients with heart failure with a reduced ejection fraction. Also, beta-blockers have beneficial properties in patients with heart failure with preserved ejection fraction. Guidelines recommend beta-blockers for the relief of symptoms in cases of angina pectoris and for the control of the ventricular rate in cases of atrial fibrillation. Also, beta-blockers have numerous benefits in hypertensive patients with diabetes mellitus. In conclusion, betablockers are an important class of cardiovascular drugs, reducing the mortality and morbidity rates in patients with cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Vitamin D has antimicrobial and immunomodulatory activities playing an essential role as an adjuvant treatment to reduce the incidence and severity of various conditions, including influenza and recurrent respiratory infections. Vitamin D insufficiency and deficiency are reported by many countries, especially in the elderly population, requiring intervention by vitamin D supplementation even before the onset of the COVID-19 pandemic. From the beginning of the pandemic, it was considered that vitamin D has a role in preventing and treating COVID-19. The few available studies show a perspective of vitamin D therapy in preventing and early treatment of SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

An essential aspect of human health is sleep. Sleep, among others, interacts with the immune system, plays a role in restoring the body's energy, healing and brain function. Insomnia is often noticed in medical practice, is considered a public health problem. Acute sleep deprivation can alter cognitive performance, and chronic sleep deprivation can lead to disease development. Lack of sleep affects all major systems in the human body, and the major changes that occur in chronic insomnia have been associated with many conditions such as type 2 diabetes, cardiovascular disease, asthma, thyroid disease and gastroesophageal reflux disease. [ABSTRACT FROM AUTHOR]

Background: Recent biochemical advances have led to inexpensive, time-efficient production of massive volumes of raw genomic data. Traditional machine learning approaches to genome annotation typically rely on large amounts of labeled data. The process of labeling data can be expensive, as it requires domain knowledge and expert involvement. Semi-supervised learning approaches that can make use of unlabeled data, in addition to small amounts of labeled data, can help reduce the costs associated with labeling. In this context, we focus on the problem of predicting splice sites in a genome using semi-supervised learning approaches. This is a challenging problem, due to the highly imbalanced distribution of the data, i.e., small number of splice sites as compared to the number of non-splice sites. To address this challenge, we propose to use ensembles of semi-supervised classifiers, specifically self-training and co-training classifiers. Results: Our experiments on five highly imbalanced splice site datasets, with positive to negative ratios of 1-to-99, showed that the ensemble-based semi-supervised approaches represent a good choice, even when the amount of labeled data consists of less than 1% of all training data. In particular, we found that ensembles of co-training and self-training classifiers that dynamically balance the set of labeled instances during the semi-supervised iterations show improvements over the corresponding supervised ensemble baselines. Conclusions: In the presence of limited amounts of labeled data, ensemble-based semi-supervised approaches can successfully leverage the unlabeled data to enhance supervised ensembles learned from highly imbalanced data distributions. Given that such distributions are common for many biological sequence classification problems, our work can be seen as a stepping stone towards more sophisticated ensemble-based approaches to biological sequence annotation in a semi-supervised framework. [ABSTRACT FROM AUTHOR]

Cu(II) is a naturally occurring microelement, essential for many biochemical pathways but its excess causes serious toxicological problems. This study evaluates the ability of heat pretreated commercial instant dry baker's yeast Saccharomyces cerevisiae (HPIBY) to remove Cu(II) ions from aqueous solutions. The importance of the biosorbent properties in the adsorption process was examined by scanning electron microscopy/energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy, differential scanning calorimetry/thermogravimetric analysis, and zeta potential analysis. In order to establish the optimum operating parameters, the influence of pH, biosorbent dosage, and initial metal concentration was investigated. The equilibrium adsorption data were analyzed by using Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich adsorption models. The desorption efficiency and the regeneration potential of the HPIBY were evaluated by performing successive biosorption/desorption cycles. The monolayer adsorption capacity ( Qm) determined from Langmuir model was 19.53 mg g−1. The maximum removal efficiency, 71.12% was obtained at pH 4.5, for a biosorbent dosage of 0.5% w/v and an initial metal concentration of 50 mg L−1. The zeta potential results suggested that the heat pretreatment enhanced the quantity of organic functional groups with negative charge present on the biosorbent cell walls. The physicochemical characteristics of the biosorbent after metal adsorption and the isotherm data suggested that Cu(II) immobilization by the HPIBY was simultaneously accomplished via electrostatic interactions and chemisorption. [ABSTRACT FROM AUTHOR]

Vaccinations during pregnancy can protect the mother from several infections, thus blocking vertical transmission. Furthermore, through passive antibody transfer, the newborn can be protected against some infections in the first months of life until their own vaccination regimen is initiated and completed at the appropriate age. Pregnancy can be considered a high-risk condition that increases vulnerability to infectious diseases with potentially unfavorable evolution. We present the current knowledge on vaccination during pregnancy in Europe as a useful information source for different health workers involved in prenatal care. Many European countries implement vaccination policies specifically designed for pregnant women, but there is great heterogeneity among programs. Recommendations on vaccination during pregnancy must be based on current high-quality scientific data. The decisions must be made for each individual case, depending on the associated conditions or special circumstances, with a concomitant assessment of the potential benefits and risks to both the pregnant patient and the fetus. Many vaccines are well-tolerated in pregnant women, with no clinically meaningful injection site reactions, systemic symptoms, or vaccine-related serious adverse events. [ABSTRACT FROM AUTHOR]

Anaphylactic reactions during pregnancy can range from subjective cutaneous symptoms to anaphylaxis and lethal anaphylactic shock. The fetal and maternal outcomes are unpredictable. This study is the first systematic review of the clinical presentation of severe anaphylaxis in pregnancy as defined by the World Allergy Organization to determine maternal and fetal outcomes. We searched PubMed, the Web of Science, and Scopus databases for articles published between 1 January 1985 and 15 April 2021 using the following terms (((anaphylactic shock) AND (pregnancy)) OR ((anaphylaxis) AND (pregnancy))). In 42 studies involving 47 patients, 36.17% of patients were 31–35 years old, and 74.47% of cases occurred peripartum, mostly during cesarean section. Accurate diagnosis with valid and reliable outcome measures was reported for 71.74% of cases. Twenty-two allergens were identified: antibiotics (penicillins and cephalosporins), anesthetic drugs (suxamethonium, mepivacaine), latex, oxytocin, sodium and sucrose iron, laminaria, misoprostol, rubber from Foley catheter, oral phytomenadione, ranitidine, chamomile, and ant sting. Two cases of maternal death related to latex and intravenous iron sucrose, and six infants with neurological disease were reported, mostly related to antibiotics. This review of the currently available literature shows that favorable outcomes are attainable with a high degree of observation, multidisciplinary cooperation, and rapid treatment. [ABSTRACT FROM AUTHOR]

Anaphylaxis is an unpredictable systemic hypersensitivity reaction and constitutes a high risk of maternal and fetal morbidity and mortality when occurring during pregnancy. Currently, the acute management of anaphylaxis is based on clinical parameters. A total serum tryptase is only used to support an accurate diagnosis. There is a need to detect other biomarkers to further assess high-risk patients in obstetrics. Our objective is to present biomarkers in this complex interdisciplinary approach beyond obstetrician and anaesthetic management. Candidate biomarkers derive either from mediators involved in immunopathogenesis or upcoming molecules from systems biology and proteomics. Serum tryptase is determined by singleplex immunoassay method and is important in the evaluation of anaphylactic mast cell degranulation but also in the assessment of other risk factors for anaphylaxis such as systemic mastocytosis. Another category of biomarkers investigates the IgE-mediated sensitization to triggers potentially involved in the etiology of anaphylaxis in pregnant women, using singleplex or multiplex immunoassays. These in vitro tests with natural extracts from foods, venoms, latex or drugs, as well as with molecular allergen components, are useful because in vivo allergy tests cannot be performed on pregnant women in such a major medical emergency due to their additional potential risk of anaphylaxis. [ABSTRACT FROM AUTHOR]

Infertility is generally defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. premature ovarian failure (POF) is a cause of female infertility, being estimated to affect 1% of the general population. This condition represents a loss of hormonal and germinative activity of the ovaries due to a lack in the number of active follicles in women under 40 years old. Regenerative medicine represents a complex therapeutic option and it consists of technologies such as the use of stem cells, tissue engineering, and gene therapy alone or in different combinations. Although the boundaries of regenerative medicine are not clearly outlined at present, this paper is aiming to review its possibility of treatment in the future in what concerns POF, focusing more on the use of stem cell therapy. Stem cell therapy could be a feasible therapeutic approach for POF as the cells can be easily obtained. However, additional clinical studies are needed because until now the majority of the literature focuses on animal models for the evaluation of the role of stem cells on treating POF. Additionally, the platelet-rich plasma (PRP) approach for POF should be kept in mind as it was shown to be useful in the regeneration of multiple types of tissue. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory condition with genetic, immunological, and metabolic etiology. The link between psoriasis and diabetes mellitus has been shown in genetic predisposition, environmental influences, inflammatory pathways, and insulin resistance, resulting in end-organ damage in both conditions. Because comorbidities often accompany psoriasis, the therapeutic management of the disease must also take into consideration the comorbidities. Given that metformin's therapeutic role in psoriasis is not yet fully elucidated, we raised the question of whether metformin is a viable alternative for the treatment of psoriasis. We conducted this scoping review by searching for evidence in PubMed, Cochrane, and Scopus databases, and we used an extension for scoping reviews (PRISMA-ScR). Current evidence suggests that metformin is safe to use in psoriasis. Studies have shown an excellent therapeutic response to metformin in patients with psoriasis and comorbidities such as diabetes, metabolic syndrome, and obesity. There is no clear evidence supporting metformin monotherapy in patients with psoriasis without comorbidities. There is a need to further evaluate metformin in larger clinical trials, as a therapy in psoriasis. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) has a growing prevalence in recent years. Its association with cardiovascular disease has been intensively studied, and certain correlations have been identified. The connection between these two entities has lately aroused interest regarding therapeutic management. In order to find the best therapeutic options, a detailed understanding of the pathophysiology that links (NAFLD) to cardiovascular comorbidities is needed. This review focuses on the pathogenic mechanisms that are behind these two diseases and on the therapeutic management available at this time. [ABSTRACT FROM AUTHOR]

The impact of sleep disorders (SDs) on patients with chronic liver diseases (CLD) is tremendous. SDs are frequently encountered among these patients and interfere with their quality of life. This review aims to present the data available so far about the prevalence, phenotypes, and proposed pathophysiological mechanisms of SDs in CLD. Moreover, we proposed to search the literature regarding the most reliable methods to assess SDs and the possible therapeutic options in patients with CLD. The main results of this review show that when it comes to prevalence, the percentages reported vary widely between studies performed among populations from the USA or Europe and those coming from Asian countries. Furthermore, it has been proven that SDs may also be present in the absence of neurocognitive disorders attributable to hepatic encephalopathy (HE), which contradicts traditional suppositions where SDs were considered part of the clinical scenario of HE. Currently, there are no specific recommendations or protocols to assess SDs in CLD patients and data about the therapeutic management are limited. Taking into consideration their impact, a protocol for diagnosing and managing SDs should be developed and included in the daily practice of hepatologists. [ABSTRACT FROM AUTHOR]