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Introduction: Hydatidosis is one of the most critical parasitic zoonotic diseases worldwide. Lungs are the second most common site of the disease. Aim: This study aimed to evaluate the clinical presentation, diagnosis, radiological findings, surgical treatment and post-operative complications of pulmonary hydatid cyst in patients referred to the Second Surgery Clinic at St George University Hospital in Plovdiv, Bulgaria. Materials and methods: From January 2014 to December 2022, 69 patients were operated on due to pulmonary hydatidosis in the Clinic of Thoracic and Abdominal Surgery at St George University Hospital in Plovdiv, Bulgaria. Demographic data of the patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and surgical procedures and post-operative complications were recorded. Results: Pulmonary hydatidosis was confirmed for 69 (46 male and 23 female) patients. The average age of the study group was 31.59±19.49 years. In 29 of the tested patients, specific antibodies of the IgG class to Echinococcus granulosus were positive, and 23 patients showed negative results. The leading symptom was non-productive cough followed by shortness of breath, chest pain, fever, productive cough; rash was reported in one patient. 91.3% of the cases presented with a typical X-ray image and in 8.7% it was atypical. It turned out that 66.7% of patients with an atypical X-ray findings developed complications in the postoperative period. Right lung was affected in 50.7% of the cases. The average size of the echinococcal cyst was 7.43±3.23 cm. Statistical analysis revealed a correlation between the size of the hydatid cyst and the length of the postoperative period. Dissemination in other organs was found in 16 of the patients. No statistically significant differences were reported in the patients with dissemination, regarding the size of the primary hydatid cyst, complications and duration of the postoperative period. The preferred methods of approach were thoracotomy and VATS. The most commonly performed surgical technique was echinococcectomy and capitonnage a modo Delbet followed by two lobectomies and one wedge resection. The mean postoperative period was 7.00±2.81 days. In 12 of the analyzed patients, complications occurred in the postoperative period, and mortality was reported in one patient. Conclusion: Pulmonary echinococcosis remains a significant health issue in many countries worldwide including Bulgaria. With a prolonged silent period, it is usually diagnosed when clinical symptoms as cough, dyspnea, chest pain and fever start manifesting. Plain chest radiography remains the basic imaging method for initial diagnosis while ELISA test has limited diagnostic accuracy in cases of pulmonary hydatidosis. Irrelevant to surgical approach, Delbet’s capitonnage procedure is associated with good postoperative results and low complication rates.

Aim: This study aimed at identifying factors that worsen the prognosis of diabetic foot, one of the most common complications seen in patients with diabetes. Materials and patients: The sample included 230 patients treated in the Department of Surgery at Kaspela University Hospital in Plovdiv, Bulgaria, between January 2016 and May 2022. Of them, 55.65% were men, and 44.35% were women. The age of the patients ranged from 18 to 77 years, with a mean age of 44.4±14.7 years. Results: Diabetic foot patients of grade ≥4 were 1.8 times more likely to be amputated than the rest of the patients (AOR=1.6; 95% CI: 1.504, 4.683). The utilization of inappropriate antibiotics was associated with a 9.47-fold increased risk of amputation (p

Introduction: Osteoarthritis is a prevalent degenerative joint disorder associated with pain and functional impairment. Curcumin, a natural anti-inflammatory compound, has garnered attention for its potential therapeutic benefits in osteoarthritis management. Aim: This study aimed to investigate the correlations between curcumin use, patient characteristics, medication use, and changes in health outcomes among osteoarthritis patients. The primary hypothesis was that curcumin use would correlate with positive changes in health metrics. Materials and methods: A cohort of 60 osteoarthritis patients was enrolled in this observational study and divided into 4 groups according to the type of osteoarthritis. Patient selection criteria included a diagnosis of osteoarthritis and consent for curcumin supplementation. The primary outcome variable was changes in health metrics measured across three visits. Body mass index, nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol use were also recorded. Correlation analysis and paired t-tests were employed to examine the relationships between variables and changes in health metrics. Results: Correlation analyses revealed a weak negative correlation between BMI and changes between ‘Visit 1’ and ‘Visit 2’ (r=−0.09). NSAIDs use exhibited a weak positive correlation with changes during this period (r=0.17), while paracetamol use displayed weak correlations (r=−0.05) with changes. Statistically significant changes were observed between ‘Visit 1’ and ‘Visit 2’ (mean change =−5.93, p

The ongoing growth of artificial intelligence (AI) involves virtually every aspect of oncologic care in medicine. Although AI is in its infancy, it has shown great promise in the diagnosis of oncologic urological conditions. This paper aims to explore the expanding role of artificial intelligence in the histopathological diagnosis in urological oncology. We conducted a focused review of the literature on AI in urological oncology, searching PubMed and Google Scholar for recent advancements in histopathological diagnosis using AI. Various keyword combinations were used to find relevant sources published before April 2nd, 2024. We approached this article by focusing on the impact of AI on common urological malignancies by incorporating the use of different AI algorithms. We targeted the capabilities of AI’s potential in aiding urologists and pathologists in histological cancer diagnosis. Promising results suggest AI can enhance diagnosis and personalized patient care, yet further refinements are needed before widespread hospital adoption. AI is transforming urological oncology by improving histopathological diagnosis and patient care. This review highlights AI’s advancements in diagnosing prostate, renal cell, and bladder cancer. It is anticipated that as AI becomes more integrated into clinical practice, it will have a greater influence on diagnosis and improve patient outcomes.

Bouveret’s syndrome (BS) represents an exceedingly rare clinical entity characterized by gastric outlet obstruction induced by a gallstone passing through a cholecystoduodenal, cholecystogastric or choledochoduodenal fistula and impacting in the duodenum or pylorus. Endoscopy is the preferred first-line therapy. It has a favorable safety profile, but requires high level of expertise to achieve stone clearance. We report here the case of a 75-year-old Caucasian male who presented with vomiting and upper gastrointestinal bleeding and was diagnosed with BS by upper endoscopy. A single session stone extraction utilizing mechanical lithotripsy and laser lithotripsy was executed. Complete clearance of the duodenum and gallbladder was achieved, extracting successfully all fragments larger than 5 mm. The rarity of BS and its non-specific presentation makes it largely overlooked leading commonly to delayed diagnosis, which results in a high mortality rate of 12-30%. Computer tomography is the diagnostic method of choice. Upper endoscopy can establish the presence of obstruction, but fails to visualize a stone in up to 1/3 of the cases. Management is either endoscopic or surgical. Endoscopic treatment has a good safety profile (mortality 1.6% vs. 17.5-25% for surgery) but poor success rate – 43% vs. 94.1%. To achieve higher success rate, more advanced techniques are required such as mechanical or laser lithotripsy. Laser lithotripsy is a feasible option for endoscopic treatment of BS, but the duration of the procedure might be an issue in frail patients.

Abstract Background A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor. Case report A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods. Conclusion The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.

Introduction. Biliary obstruction is a common manifestation of biliopancreatic malignancies, and its relief is an essential part of the treatment algorithm. Currently, there are three techniques to manage malignant biliary obstruction—endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic biliary drainage (PTBD), and endoscopic ultrasound-guided biliary drainage (EUS-BD). ERCP has been adopted as a first-line treatment modality but EUS-BD is gradually emerging as a viable alternative. The aim of the current article is to assess the clinical outcomes of the three nonsurgical biliary drainage procedures. Materials and methods. A total of 102 consecutive patients with unresectable biliopancreatic malignancy inducing biliary obstruction and subjected to palliative treatment by means of ERCP, EUS-BD, or PTBD were retrospectively included in the study. Results. No difference in clinical and technical success of the procedures was found: ERCP—97.2% technical; 88.9% clinical; PTBD—94.4% technical, 72.2% clinical; EUS-BD—90% technical; 83.3% clinical. Adverse events (AEs) and reinterventions were significantly more common in PTBD (38.9% and 52.8%) and ERCP (27.9% and 25%) compared to EUS-BD (10% and 3.3%). Total duration of hospital stay and number of hospitalizations were lower in the EUS-BD compared to PTBD and ERCP groups. Conclusions. In the presence of adequate expertise, EUS-BD may be superior to PTBD and ERCP in achieving and sustaining biliary drainage in the setting of unresectable malignancy.

Aim: This study aimed to construct prognostic mathematical models utilizing multifactorial regression analysis to assess the risk of developing drug-induced neutralizing antibodies in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis treated with tumor necrosis factor alpha blockers. Materials and methods: Over a four-year period, we enrolled 213 patients in this study and divided them into three groups: the rheumatoid arthritis group (n=121), the ankylosing spondylitis group (n=50), and the psoriatic arthritis group (n=42). The study included also a group of healthy controls consisting of 31 healthy subjects who matched the patient groups in age, sex, body mass index, and conditions typical for rheumatology patients. Prognostic mathematical models based on statistically significant factors determined through univariate correlation and regression analyses incorporated patient medical history and serological and immunological data. Results: The study encompassed all 213 patients and 31 healthy controls. Data analysis was conducted at 12 and 24 months after commencing treatment. During this follow-up, the patients exhibited the highest percentage of antidrug antibodies. At 6 months, 6.57% of patients had confirmed neutralizing antibodies, which increased to 12.69% at 12 months and 17.72% at 24 months. Multivariate logistic regression analysis revealed that factors such as age over 55 years, excess weight, smoking, and absence of methotrexate treatment at a dose less than 7.5 mg per week had the highest predictive value. Conclusions: Investigating clinical and biological markers with predictive value for individual patients’ therapeutic responses is a complex task. This complexity arises from the interplay of at least three distinct parameters: the patient’s disease state, drug bioavailability, and pathophysiological changes within the patient’s body, all of which are influenced by various factors.

Introduction: There are numerous imaging modalities available to describe pancreatic parenchyma. None of the broadly accepted diagnostic methods uses elasticity as an indicator of tissue damage. Aim: The aim of the present study was to establish reference values of parenchymal stiffness of normal pancreatic parenchyma through point shear wave elastography. Materials and methods: The design of the study is prospective single-center cohort study. Sixty patients were included in the study. The ultrasound-based point shear wave elastography (pSWE) imaging technique was applied. The mean and median shear wave velocity values of the pancreatic parenchyma in the head, body and tail were calculated. The influence of certain variables on the shear wave velocity (SWV) values was estimated. Results: A reference range for the entire pancreatic parenchyma of 0.66-1.62 m/s and a mean value of 1.17±0.22 m/s were calculated. Apart from age, none of the evaluated factors proved to have statistically significant influence on the obtained results. A measurement success rate of 94.5%, 97.2%, and 95.8% was established for the head, body, and tail of the pancreas, respectively. Transabdominal pSWE could be utilized for assessment of pancreatic parenchyma with high success rate. A mean value of 1.17 m/s was measured which is consistent with the existing literature on the matter. None of the external factors examined in the study, apart from age, was found to have statistically significant influence on the SWV values. Conclusions: The obtained results suggest that pSWE is a highly objective method for evaluating pancreatic parenchyma. Calculated reference range and mean values could be used in future studies to assess the capabilities of the method for differentiating between normal pancreatic parenchyma and diffuse and focal pancreatic disorders.

The focus of the study is the new format of Russian as a foreign language textbook - digital, or digitalized. The relevance of the research is determined by the need to create such textbooks due to the changed audience for which they are intended - the generations of so-called millennials and postmillennials, who acquire new information through imagery, speed, technical capabilities. The aim of the research is to analyze a digitalized Russian language textbook for a Slovak secondary school (gymnasium) from the point of view of its conceptual framework, technical features, and design. On the material of the Russian language textbook for Slovak secondary schools “Meetings with Russia. Today” (E. Kollárová et al.) where new technologies are used, the authors analyze a nationally oriented digital textbook, which is an element of Russian-language education in Slovakia. The methods of research include the analysis of theoretical and educational literature, the method of linguodidactic analysis, comparative and descriptive methods. The authors argue that the conceptual foundations of digital textbooks - cognitivism, constructivism, and behaviorism - are aimed at the rational selection of culturally relevant educational content and the construction of a communicatively directed methodological component. Modern technical capabilities allow to include in these textbooks a variety of video, audio, television, and other authentic materials, creating a sense of “living” reality. It is concluded that the main advantages of the new form of the textbook are not only its technical capabilities, but also more effective implementation of its cultural and communicative orientation, as well as eduction (education combined with upbringing,). The problem points of the textbook are the lack of linguistic (lexical, grammatical, phonetic) exercises, as well as the lack of the minimal vocabulary. The effective interaction of the three components - digitalization, edutainment, and cultural orientation - while relying on the language system - determine the prospects of digital textbooks.

The development of the Gleason grading system has proven to be an irreplaceable tool in prostate cancer diagnostics within urology. Despite the advancements and developments in diagnostics, there remains a discrepancy in the grading process among even the most experienced pathologists. AI algorithms have demonstrated potential in detecting cancer and assigning Gleason grades, offering a solution to the issue of significant variability among pathologists’ evaluations. Our paper explores the evolving role of AI in prostate cancer histopathology, with a key focus on outcomes and the reliability of various AI algorithms for Gleason pattern assessment. We conducted a non-systematic review of the published literature to examine the role of artificial intelligence in Gleason pattern diagnostics. The PubMed and Google Scholar databases were searched to gather pertinent information about recent advancements in artificial intelligence and their impact on Gleason patterns. We found that AI algorithms are increasingly being used to identify Gleason patterns in prostate cancer, with recent studies showing promising advancements that surpass traditional diagnostic methods. These findings highlight AI’s potential to be integrated into clinical practice, enhancing pathologists’ workflows and improving patient outcomes. The inter-observer variability in Gleason grading has seen an improvement in efficiency with the implementation of AI. Pathologists using AI have reported successful outcomes, demonstrating its effectiveness as a supplementary tool. While some refinements are still needed before AI can be fully implemented in clinical practice, its positive impact is anticipated soon.

Prostate cancer is the second most common neoplasia and fifth-leading cause of cancer death in men worldwide. Electromagnetic and magnetic fields have been classified as possible human carcinogens, but current understanding of molecular and cellular pathways involved is very limited. Effects due to extremely low magnetic/hypomagnetic fields (LMF) are furthermore poorly understood. Extracellular vesicles (EVs) are crucial mediators of cellular communication with multifaceted roles in cancer progression, including via transport and uptake of various protein and microRNA (miRNA) EV-cargoes. miRNAs regulate gene expression and are implicated in cancer-related processes such as proliferation, metastasis, and chemoresistance. This study investigated the effects of LMF exposure (20 nT) by magnetic shielding on the prostate cancer cell line PC3 compared to the prostate epithelial cell line PNT2 under short-term (4 h) conditions. We examined EV profiles following a 4 h LMF exposure alongside associated functional enrichment KEGG and GO pathways for the EV proteomes. The 4 h LMF exposure significantly reduced cellular EV release and modified PC3 EV cargoes to a more inflammatory and metastatic profile, with 16 Disease Pathways and 95 Human Phenotypes associated specifically with the LMF-treated PC3 EV proteomes. These included cancerous, metabolic, blood, skin, cardiac and skeletal Disease Pathways, as well as pain and developmental disorders. In the normal PNT2 cells, less EV protein cargo was observed following LMF exposure compared with cells not exposed to LMF, and fewer associated functional enrichment pathways were identified. This pointed to some differences in various cellular functions, ageing, defence responses, oxidative stress, and disease phenotypes, including respiratory, digestive, immune, and developmental pathways. Furthermore, we analysed alterations in matrix metalloproteinases (MMPs) and miRNAs linked to metastasis, as this is crucial in cancer aggressiveness. The 4 h LMF exposure caused a significant increase in MMP2 and MMP9, as well as in onco-miRs miR-155, miR-210, miR-21, but a significant reduction in tumour-suppressor miRs (miR-200c and miR-126) in the metastatic PC3 cells, compared with normal PNT2 cells. In addition, 4 h LMF exposure significantly induced cellular invasion of PC3 cells. Overall, our findings suggest that changes in magnetic field exposures modulate EV-mediated and miR-regulatory processes in PCa metastasis, providing a basis for exploring novel therapeutic strategies.

The study of light-emitting defects in silicon created by ion implantation has gained renewed interest with the development of quantum optical devices. Improving techniques for creating and optimizing these defects remains a major focus. This work presents a comprehensive analysis of a photoluminescence line at a wavelength of 1240 nm (1 eV) caused by defects arising from the ion irradiation of the SiO2/Si system and subsequent thermal annealing. It is assumed that this emission is due to the formation of defect complexes WM with trigonal symmetry similar to the well-known W-centers. A distinctive feature of these defects is their thermal resistance up to temperatures of 800 °C and less pronounced temperature quenching compared to the W-line. The difference in the properties of these defect centers and W-centers can be explained by their different defect environments, resulting from the larger spatial separation between vacancies and interstitial atoms diffusing from the irradiated layer. This, in turn, is associated with the difference in the distribution of primary radiation defects during irradiation of the SiO2/Si system and silicon not covered with a SiO2 film. The patterns of changes in the WM line depending on various factors, such as the thickness of the SiO2 film, type of conductivity and impurity concentration in the original silicon, irradiation parameters, and annealing regimes, is studied and explained in detail. These findings demonstrate the benefits of this new approach when compared to previous methods. [ABSTRACT FROM AUTHOR]

The objective of the article is the correspondence of individual and typological features of the student to the chosen direction, which promotes successful adaptation to study at the university and readiness for future professional activity. The aim is to reveal psychological features of personality of students: doctors, engineers, and jurists. Materials and methods are the following: 180 students of 1-3 year (17-25 years old): future doctors (n=80), jurists (n=50), and engineers (n=50). We studied the psychological characteristics of personality. The program «Mini-mult» of the medical diagnostic hardware and software complex «Biomysh Research» («Neurolab», Russia) was used. The statistical analysis was performed by parametric method using the Student's t-test. The results are the following: students of different specialties have intergroup and individual differences in neurodynamic and cognitive functions. The most significant difference was found on scales 1, 2, 6, 7 (??0.05-0.01). The personality pattern of students (future doctors and jurists) has a «peak», three-phase pattern, and no reliable differences between the contrasting ones. The average psychological profile of the personality of students, future engineers is «linear», all its indicators are between 45T and 55T. Such profile is found in persons referred to the concordant norm. Conclusions are the following: students of all studied groups are characterized by high openness and desire to present themselves in a more favorable light on indicators of three evaluation scales (L, F, K). The psychological profiles of doctors and jurists are similar. Contrasting «peaks» are on scales of hysteria, paranoia and schizoidity. It testifies to constant dissatisfaction and indomitable aspiration to the set goal. Determination, flexibility of behavior with low level of anxiety, and confidence in decision making are inherent in future doctors and jurists. Engineering students are confident, satisfied with themselves and their surroundings, sociable, optimistic, and cheerful. However, their level of anxiety is higher than the level of jurists. It is recommended to create a system of organizational and pedagogical conditions for the formation and development of «western components of professional mobility» for students of various specialties.

Urachal adenocarcinomas, constituting 10 % of bladder adenocarcinomas, pose a significant challenge with limited literature. A 43-year-old male presented with haematuria and abdominal pain, leading to surgical intervention for a 13 cm pelvic tumor. Histopathology identified an intestinal-type primary urachal adenocarcinoma, staged as IIIA, no recurrence on follow-up. Early detection is crucial for improved outcomes in these rare malignancies. While surgery remains the primary treatment, outcomes vary, emphasizing the need for research on standardized protocols. Enhanced awareness and interdisciplinary collaboration are vital for effective management. Comprehensive guidelines are essential for optimizing patient prognoses in urachal adenocarcinomas.

Abstract Background Ankylosing spondylitis (AS) and Behçet's disease (BD) are distinct inflammatory disorders, but their coexistence is a rare clinical entity. This case sheds light on managing this complex scenario with Janus kinase (JAK) inhibitors. Case Presentation A 42‐year‐old woman presented with a decade‐long history of lower back pain, nocturnal spinal discomfort, recurrent eye issues, oral and genital ulcers, hearing loss, pus formation in the left eye, and abdominal pain. Multidisciplinary consultations and diagnostic tests confirmed AS (HLA‐B27 positivity and sacroiliitis) and BD (HLA‐B51). Elevated acute‐phase markers were observed. Conclusion This case fulfills diagnostic criteria for both AS and BD, emphasizing their coexistence. Notably, treatment with upadacitinib exhibited promising efficacy, underscoring its potential as a therapeutic option in patients with contraindications for conventional treatments. Our findings illuminate the intricate management of patients presenting with these two diverse systemic conditions and advocate for further exploration of JAK inhibitors in similar cases.

Understanding the mechanisms responsible for the origin, evolution, and failure of pingos with explosive gas emissions and the formation of craters in the Arctic permafrost requires comprehensive studies in the context of fluid dynamic processes. Properly choosing modeling methods for the joint interpretation of geophysical results and analytical data on core samples from suitable sites are prerequisites for predicting pending pingo failure hazards. We suggest an optimal theoretically grounded workflow for such studies, in a site where pingo collapse induced gas blowout and crater formation in the Yamal Peninsula. The site was chosen with reference to the classification of periglacial landforms and their relation to the local deformation pattern, according to deciphered satellite images and reconnaissance geophysical surveys. The deciphered satellite images and combined geophysical data from the site reveal a pattern of periglacial landforms matching the structural framework with uplifted stable permafrost blocks (polygons) bounded by eroded fractured zones (lineaments). Greater percentages of landforms associated with permafrost degradation fall within the lineaments. Resistivity anomalies beneath pingo-like mounds presumably trace deeply rooted fluid conduits. This distribution can be explained in terms of fluid dynamics. N–E and W–E faults, and especially their junctions with N–W structures, are potentially the most widely open conduits for gas and water which migrate into shallow sediments in the modern stress field of N–S (or rather NEN) extension and cause a warming effect on permafrost. The results obtained with a new workflow and joint interpretation of remote sensing, geophysical, and analytical data from the site of explosive gas emission in the Yamal Peninsula confirm the advantages of the suggested approach and its applicability for future integrated fluid dynamics research.

ABSTRACTEpizootiologists recurrently encounter symbionts and pathobionts in the haemolymph (blood equivalent) of shellfish. One such group is the dinoflagellate genus Hematodinium, which contains several species that cause debilitating disease in decapod crustaceans. The shore crab Carcinus maenas acts as a mobile reservoir of microparasites, including Hematodinium sp., thereby posing a risk to other co-located commercially important species, e.g. velvet crabs (Necora puber). Despite the widespread prevalence and documented seasonality of Hematodinium infection dynamics, there is a knowledge gap regarding host-pathogen antibiosis, namely, how Hematodinium avoids the host’s immune defences. Herein, we interrogated the haemolymph of Hematodinium-positive and Hematodinium-negative crabs for extracellular vesicle (EV) profiles (a proxy for cellular communication), alongside proteomic signatures for post-translational citrullination/deimination performed by arginine deiminases, which can infer a pathologic state. Circulating EV numbers in parasitized crab haemolymph were reduced significantly, accompanied by smaller EV modal size profiles (albeit non-significantly) when compared to Hematodinium-negative controls. Differences were observed for citrullinated/deiminated target proteins in the haemolymph between the parasitized and control crabs, with fewer hits identified overall in the former. Three deiminated proteins specific to parasitized crab haemolymph were actin, Down syndrome cell adhesion molecule (DSCAM), and nitric oxide synthase – factors that contribute to innate immunity. We report, for the first time, Hematodinium sp. could interfere with EV biogenesis, and that protein deimination is a putative mechanism of immune-modulation in crustacean-Hematodinium interactions.

Introduction. Mirizzi syndrome (MS) represents a rare clinical entity caused by impaction of one or multiple stones in the infundibulum of the gall bladder or the cystic duct resulting in partial or complete obstruction of the common hepatic or common bile duct (CBD). Though described more than a century ago, MS is still one of the most challenging diseases in the spectrum of biliary pathology. In recent years, endoscopic treatment has become an increasingly popular treatment modality. Patients and methods. Three consecutive patients subjected to cholangioscopy-assisted laser lithotripsy (CA-LL) for postocholecystectomy MS (pMS) were retrospectively evaluated. Case reports. Successful clearance of the cystic duct was achieved in all patients in one or two sessions. One complication in the form of mild cholangitis was observed. Clinical success was 100%. Discussion. According to current research, CA-LL achieves a high rate of ductal clearance and acceptable complication rate in patients with pMS. A 250 µm laser fiber seems to be the optimal choice for CA-LL. Our results suggest that procedure duration is closely associated to the stone size and possibly to the operator experience. In our opinion, upon obtainment of successful ductal clearance and drainage, prophylactic stenting does not improve clinical outcome. Conclusions. Our results demonstrate that CA-LL is a safe and effective treatment for pMS.

Introduction: Descending necrotizing mediastinitis is one of the most lethal forms of acute mediastinitis. It originates from an odontogenic or deep neck infection, which descends to the mediastinum through the fascial planes. It is a rare condition, but mortality rates remain high, especially in the presence of comorbidities or predisposing factors. Delay in diagnosis has been shown to be one of the most important factors for the disease outcome. Therefore, early diagnosis and treatment by a multidisciplinary team are of utmost importance. Case series: Four healthy young males with descending necrotizing mediastinitis were treated at our institution. None of them had any comorbidities, but all of them waited between 3 and 4 days before seeking medical help. Upon their arrival at the hospital, in addition to the presence of a severe neck infection, the presence of mediastinitis was also found. Despite the timely surgical treatment of both the source of the infection and the mediastinitis, three of the four cases had a fatal outcome. Conclusion: We believe that the time factor is of greater importance for the outcome of acute descending mediastinitis than the factors of age and presence of accompanying diseases. Proper and rapid treatment by a multidisciplinary team is essential, even for young and healthy people.

Background and objectives: This review aims to delve into the role of artificial intelligence in medicine. Ulcerative colitis (UC) is a chronic, inflammatory bowel disease (IBD) characterized by superficial mucosal inflammation, rectal bleeding, diarrhoea and abdominal pain. By identifying the challenges inherent in UC diagnosis, we seek to highlight the potential impact of artificial intelligence on enhancing both diagnosis and treatment methodologies for this condition. Method: A targeted, non-systematic review of literature relating to ulcerative colitis was undertaken. The PubMed and Scopus databases were searched to categorize a well-rounded understanding of the field of artificial intelligence and its developing role in the diagnosis and treatment of ulcerative colitis. Articles that were thought to be relevant were included. This paper only included articles published in English. Results: Artificial intelligence (AI) refers to computer algorithms capable of learning, problem solving and decision-making. Throughout our review, we highlighted the role and importance of artificial intelligence in modern medicine, emphasizing its role in diagnosis through AI-assisted endoscopies and histology analysis and its enhancements in the treatment of ulcerative colitis. Despite these advances, AI is still hindered due to its current lack of adaptability to real-world scenarios and its difficulty in widespread data availability, which hinders the growth of AI-led data analysis. Conclusions: When considering the potential of artificial intelligence, its ability to enhance patient care from a diagnostic and therapeutic perspective shows signs of promise. For the true utilization of artificial intelligence, some roadblocks must be addressed. The datasets available to AI may not truly reflect the real-world, which would prevent its impact in all clinical scenarios when dealing with a spectrum of patients with different backgrounds and presenting factors. Considering this, the shift in medical diagnostics and therapeutics is coinciding with evolving technology. With a continuous advancement in artificial intelligence programming and a perpetual surge in patient datasets, these networks can be further enhanced and supplemented with a greater cohort, enabling better outcomes and prediction models for the future of modern medicine.

The naturally occurring compounds ecdysterone and turkesterone, which are present in plants, including Rhaponticum carthamoides Willd. (Iljin), Spinacia oleracea L., Chenopodium quinoa Willd., and Ajuga turkestanica (Regel) Briq, are widely recognized due to their possible advantages for both general health and athletic performance. The current review investigates the beneficial biological effects of ecdysterone and turkesterone in nutrition, highlighting their roles not only in enhancing athletic performance but also in the management of various health problems. Plant-based diets, associated with various health benefits and environmental sustainability, often include sources rich in phytoecdysteroids. However, the therapeutic potential of phytoecdysteroid-rich extracts extends beyond sports nutrition, with promising applications in treating chronic fatigue, cardiovascular diseases, and neurodegenerative disorders.

Tanacetum parthenium L. (Asteraceae) is a perennial herbaceous plant with a long-standing historical use in traditional medicine. Recently Tanacetum parthenium L. essential oil has been associated with a promising potential for future applications in the pharmaceutical industry, in the cosmetics industry, and in agriculture. Investigations on the essential oil (EO) have indicated antimicrobial, antioxidant, and repellent activity. The present study aimed to evaluate the chemical composition of Bulgarian T. parthenium essential oil from two different regions, to compare the results to those reported previously in the literature, and to point out some of its future applications. The essential oils of the air-dried flowering aerial parts were obtained by hydrodistillation using a Clevenger-type apparatus. The chemical composition was evaluated using gas chromatography with mass spectrometry (GC-MS). It was established that the oxygenated monoterpenes were the predominant terpene class, followed by the monoterpene hydrocarbons. Significant qualitative and quantitative differences between both samples were revealed. Camphor (50.90%), camphene (16.12%), and bornyl acetate (6.05%) were the major constituents in the feverfew EO from the western Rhodope Mountains, while in the EO from the central Balkan mountains camphor (45.54%), trans-chrysanthenyl acetate (13.87%), and camphene (13.03%) were the most abundant components.

Background: The aim of this review is to explore the role of artificial intelligence in the diagnosis of colorectal cancer, how it impacts CRC morbidity and mortality, and why its role in clinical medicine is limited. Methods: A targeted, non-systematic review of the published literature relating to colorectal cancer diagnosis was performed with PubMed databases that were scouted to help provide a more defined understanding of the recent advances regarding artificial intelligence and their impact on colorectal-related morbidity and mortality. Articles were included if deemed relevant and including information associated with the keywords. Results: The advancements in artificial intelligence have been significant in facilitating an earlier diagnosis of CRC. In this review, we focused on evaluating genomic biomarkers, the integration of instruments with artificial intelligence, MR and hyperspectral imaging, and the architecture of neural networks. We found that these neural networks seem practical and yield positive results in initial testing. Furthermore, we explored the use of deep-learning-based majority voting methods, such as bag of words and PAHLI, in improving diagnostic accuracy in colorectal cancer detection. Alongside this, the autonomous and expansive learning ability of artificial intelligence, coupled with its ability to extract increasingly complex features from images or videos without human reliance, highlight its impact in the diagnostic sector. Despite this, as most of the research involves a small sample of patients, a diversification of patient data is needed to enhance cohort stratification for a more sensitive and specific neural model. We also examined the successful application of artificial intelligence in predicting microsatellite instability, showcasing its potential in stratifying patients for targeted therapies. Conclusions: Since its commencement in colorectal cancer, artificial intelligence has revealed a multitude of functionalities and augmentations in the diagnostic sector of CRC. Given its early implementation, its clinical application remains a fair way away, but with steady research dedicated to improving neural architecture and expanding its applicational range, there is hope that these advanced neural software could directly impact the early diagnosis of CRC. The true promise of artificial intelligence, extending beyond the medical sector, lies in its potential to significantly influence the future landscape of CRC’s morbidity and mortality.