Articles

Chronic infection with the hepatitis C virus (HCV) is estimated to affect 58 million people worldwide and around 700,000 individuals in Brazil. Various non-invasive markers of hepatic fibrosis have been proposed, such as transient hepatic elastography (THE) using FibroScan®. However, the reliability of the performance, by operators in the training phase is undetermined, which hinders its applicability in clinical practice. Objectives: The present study aimed to evaluate the impact of training an inexperienced operator to perform the examinations using FibroScan® in patients with chronic hepatitis C. Specifically, the frequency of unreliable results throughout the training was assessed. Methods: This is a cross-sectional study with retrospective data collection including compensated chronic hepatitis C patients who underwent the examinations using FibroScan® between March 2014 and December 2016, performed by two researchers. Included patients were divided into two groups based on the operator's experience in the examination: the Experienced Examiner (EE) group and the Examiner in Training (ET) group, with the latter divided into two phases: phase 1, consisting of the first 100 examinations, and phase 2, comprising subsequent examinations. For the reliability analysis, parameters such as success rate (SR), interquartile range (IQR) to median (Md) ratio (IQR/Md), and reliability criteria of Castéra, et al. and Boursier, et al. were used. Results: Between March 2014 and December 2016, 771 adult HCV-infected individuals were evaluated and divided into EE group (n = 161), ET phase 1 (n = 100), and ET phase 2 (n = 158), showing similar demographic, clinical, and laboratory characteristics. SR and IQR/Md ratios were similar among EE, ET phase 1, and ET phase 2 groups. The proportion of reliable results was comparable in all three groups, using Castéra, et al. reliability criteria (92.5%, 92.0%, and 97.5%, respectively) and Boursier, et al. criteria (96.9%, 95.0%, and 98.1%, respectively). Conclusion: A short training period (up to 100 examinations) seems to be sufficient for them to have good clinical applicability in the hands of an operator with initial experience in the method

Introduction: Childhood obesity is one of the current themes of medical research, being considered not so much a multidimensional condition but primarily a real problem of worldwide interest.The aim of our randomized study was to evaluate and compare the effects of physical exercise associated with an educational program on clinical-functional status in overweight and obese children.Material and method: Participants were children hospitalized, through the emergency service, in the Pediatric Department, Craiova Municipal Clinical Hospital, between June and November 2023. 93 overweight and obese children, aged between 2 and 16 years, were evaluated (clinical, paraclinical and functional) by a multidisciplinary team and randomized into the control group (group C – 63 children) and the study group (group S – 30 children). After the resolution of the acute digestive or respiratory disease, the children in group S underwent a program to restore their functional status, based on educational measures (following the 5-2-1-0 rule) and physical exercises, for 12 weeks. Anthropometric data were measured (height, weight, body mass index); physical performance wasevaluated by gait analysis (we used the BTS G – WALK / BTS G – SENSOR 2 system, BTS Bioengineering Corp, Italy) with the determination of four parameters – the Timed Up-and-Go (TUG) test, the symmetry index, the walking test six minutes (6 MWT) and walking cadence or average cadence (steps/min) in both groups of children.The results were obtained by analyzing the differences in values obtained in the two moments T1 (initial) and T2 (after three months). The proportion of girls and boys was approximately equal within obesity class in each study group. Although we did not obtain statistically significant differences between the monitored parameters, between the two groups, for the two evaluation moments, the children in Group S had a clearly favorable evolution for physical performance parameters, whose average value was improved in T2. Anthropometric data did not change.Conclusion: The present study confirms the effectiveness of the multimodal (educational-kinetic) program for the physical performance of overweight/obese children. The sustained running of the program at home, with the involvement of the family and the school environment, is essential for the well-being of these children, with a favorable impact on the quality of life later.

Background: Sinonasal myxomas are exceptionally rare benign tumors in pediatric patients. This report presents the case of a 4-year-old boy diagnosed with a sinonasal myxoma extending into the right orbit.Case presentation: The patient’s clinical presentation included moderate-angle esotropia and ocular torticollis. Advanced imaging revealed an expansile lesion in the right posterior ethmoid cavity with orbital involvement. The differential diagnosis considered included malignancies such as rhabdomyosarcoma and lymphoma, as well as benign neoplasms and inflammatory changes. A biopsy confirmed the diagnosis of sinonasal myxoma. The patient underwent a wide local resection performed by a multidisciplinary team, leading to a confirmed histopathological diagnosis of sinonasal myxoma.Conclusion: This case highlights the diagnostic challenges and the importance of thorough clinical and radiologic evaluation in pediatric patients with unusual ocular symptoms. The report underscores the need for a multidisciplinary approach in managing rare neoplasms such as sinonasal myxomas.

In sports medicine, the recovery process for injuries to the musculoskeletal system has been well established, including the recovery time until the athlete can compete again to prevent relapses. These decisions support the sports physician in acting with greater confidence. However, there are no clear criteria and protocols for other systemic diseases. In the following study, we report our experience and suggest an action protocol for a professional basketball team.

Mesenchymal stem cell (MSC) transplantation may be an alternative to liver transplantation for patients with end-stage liver disease. A 24-year-old patient with Hepatic Encephalopathy due to alcoholic liver cirrhosis underwent UCMSC transplantation because there were no donors available for liver transplants involving adult deceased and living individuals. The patient was given allogeneic Umbilical cord-derived MSCs, which were then cultured following accepted practices. Subsequently, the UCMSCs were infused through the intravenous route 3 times at the interval of 30 days. Serum bilirubin, globulin, and ammonia levels were improved after the infusion and the morphology of the liver and spleen had also improved.

This research centered on the transition from sustainability to the post-COVID-19 era, significantly altered and transformed cities, city plans, and housing models holistically approach. Although the academic world concentrating on sustainable urban and housing design since the 1990s, the pandemic has emerged as a critical paradigm shift in context since 2019. During the COVID-19 period the Paris city 15 minutes concept, first introduced by Paris Mayor A. Hidalgo initially sparked controversy as temporary now considered permanent in Paris recently, Oxford. In the post-pandemic era, sustainability has become significant on the global agenda, shaping cities, city models, and residences through profound and radical changes. Some efforts are supported by Climate-change conferences in the world and subsequently some determinations like the Paris Agreement and UN declarations that guide more livable environments and houses. Due to COVID-19 the newly emerged conditions and compulsory changes that have taken place in the cities the social isolation, distance living, and remote working led to radical changes in the living style, environment, city plans, housing models, and typologies holistically. Although many publications have been published in the last few years about the pandemic and the Paris City 15 minutes concept, they only address the city and urban scale solutions. There is no research with a holistic approach that relates the subject from the urban scale to the architectural scale, housing, and blocks. Within the 15-minute concept, searched, developed, innovative, and sustainable urban and housing-oriented suggestions for cities in the future are presented at the end of the research. In conclusion, it is revealed that the issue of sustainability has gained importance with an increasing momentum in the world agenda, witnessed the radical changes in cities and residences, in the post-COVID-19 period in the last 2-3 years.

After kidney transplantation, BK polyomavirus reactivation can manifest as nephropathy in 1% to 10% of patients. PCR testing of urine and blood is commonly used to screen for BK polyomavirus nephropathy. The study aims to detect BK virus infection in kidney transplant patients to prevent tubulointerstitial nephropathy and graft loss. This retrospective study includes 26 patients who underwent kidney transplants between January 2019 and December 2023. We diagnosed BK virus infection by performing real-time PCR on blood and urine samples. BKV DNA was detected in 3 patients. Reducing immunosuppressive therapy led to negative PCR results and favorable clinical and biological outcomes in these 3 patients.

Gut microbial flora is the largest micro-ecosystem in the human body, it is symbiotically associated with the host; and maintains normal physiological processes in a dynamic equilibrium state. A plethora of evidence supports that gut microbial flora influences the neurotransmitters of the central nervous system. This gut flora influences cognitive function, anxiety, depression; and mood disorders as they are capable of synthesizing neurotransmitters in the nervous system. Therefore intake of probiotics influences gut microbiome; and depression. The versatility and number of gut microbial flora varies individually, so the content of common gut microbes may affect the neurotransmitters, manipulating the gut microbiota with probiotics offers a novel approach to treat brain disorders such as depression via GUT-BRAIN AXIS. The present review outlines the aspect of such alterations and how modulation of gut microbiota influences depression.

Herbarium records provide a valuable historical database for assessing plant phenology shifts in the context of global climate change. The herbarium specimens, collected from diverse locations and periods, offer comprehensive data illustrating how many plants are altering their blooming times in response to global climate change. The appropriate use and analysis of long-term herbarium records offer an additional dimension for the study of plant phenology through the application of advanced experimental methodologies such as bioinformatics and satellite imagery, statistics, and Artificial Intelligence (AI) which, coupled with field observations, will improve ecosystems evaluation. These efforts can significantly contribute to conservation strategies and climate change mitigation and further support the synchronization of scientific inputs for evaluating the impacts of climate change and its ecological implications.

The nuclear fusion reaction can be catalyzed in a suitable fusion fuel by muons (heavy electrons). “For the fractal relations, ranging from DNA knots to solar neutrino flux signals”, ever derived of scale-invariant properties distinguished between classical invariant theory & quantum invariant theory subfactors. Accompanying isomorphic & Connes FusionTensor Product retrieved to μ-catalyzed fusion where surroundings of room temperature fusion driven by the balance in mtDNA fusion & fission. On behalf of the nanometer dimension of the radius of heavy electrons & wavelength of UV-light, it assumed that muons can be produced by oxidation-like decay when UV-light impinging water.