Articles

Periacetabular Osteotomy (PAO) is the gold standard for the treatment of hip dysplasia or acetabular retroversion. Due to the proximity of intra-pelvic arteries, there is a risk of iatrogenic vascular injuries, which can present with a delay and should be part of the differential diagnosis of significant pain following a PAO. We present the case of a never-described vascular injury following a periacetabular osteotomy in a 25-year-old woman who presented with gluteal pain 3 weeks after surgery. A delayed diagnosis of a pseudoaneurysm of the superior gluteal artery was made and successfully treated by embolization. The lesion is most probably related to the tip of a screw or to the drilling process.

Cognitive impairment (CI) can be defined as a clinical syndrome characterized by a decline in at least two of several domains of cognitive function. Chronic kidney disease (CKD) is an independent risk factor for cognitive decline, and the prevalence in patients with end-stage renal disease is estimated at 50% - 80%. However, it appears that CI in patients on renal replacement therapy (RRT) may be underdiagnosed. In this cross-sectional study, 33 patients on Peritoneal Dialysis from the AOU Federico II were recruited, and matched by sex, age, and dialysis age to 33 patients on Hemodialysis and 33 controls belonging to healthy volunteers. The total 66 patients and their 33 controls were assessed for cognitive function using the Cognitive Reserve Index Questionnaire (CRIq) test. Between PD and HD patients, a statistically significant difference emerged in all subscores and in the total CRI. Between PD patients and controls, a statistically significant difference emerged in education, CRI- CRI-leisure time, and the total CRI. Therefore, CI may occur in patients undergoing PD earlier and with a greater frequency than in the general population, but with a lower incidence than in patients on HD. These considerations should be communicated to patients when they are educated about different replacement methods.

With the increase in incidence and prevalence of myeloid neoplasms in India, it has become a necessity to understand its molecular mechanisms, acquisition of genomic alterations, and understand its primary and secondary resistance pathways which ultimately impact the decision of therapeutics. The objective of this review is to investigate the molecular aspects of this disease type and identify the biomarkers that help with diagnosis, risk assessment, prognosis, and selecting the best line of treatment for a specific myeloid neoplasm. Advancements and innovations in molecular technologies from simplest Real-Time PCR to high throughput next-generation sequencing have played a vital role in screening the most common mutations and fusions to the novel and rare. Molecular technologies have helped to enumerate the genomic landscape of myeloid malignancies. The understanding of both- the mechanisms and the technology is a strong combination as it has helped revolutionize precision oncology and helped in giving better therapeutic choices with better clinical outcomes. The importance of cellular morphology, clinical symptoms, and molecular pathology in assessing the risk of myeloid malignancies is emphasized and summarized in the review. The review concludes that understanding molecular pathogenesis can be improved by using clinical-pathological-molecular strategies for diagnosis and therapy decision-making.

Pregnancy complications present significant challenges, impacting maternal health and fetal development. Oxidative stress, a key contributor to various pregnancy-related disorders such as preeclampsia, gestational diabetes mellitus (GDM), and preterm birth, has spurred interest in exploring antioxidant interventions. Antioxidants, known for their ability to counteract oxidative damage, have emerged as potential therapeutic agents to mitigate these complications. This paper synthesizes current knowledge on the role of antioxidants in pregnancy, elucidating their mechanisms of action, sources, and impact on oxidative stress-related complications. It examines diverse antioxidant compounds, including vitamins C and E, selenium, and natural phytochemicals, highlighting their potential to modulate oxidative stress pathways and promote maternal-fetal well-being. Furthermore, this paper critically analyzes clinical studies, meta-analyses, and preclinical research exploring the efficacy and safety of antioxidant supplementation during pregnancy. It discusses the complexities surrounding optimal dosages, timing, and formulations of antioxidants, aiming to delineate strategies for their integration into prenatal care. In conclusion, this review provides insights into the promising role of antioxidants as therapeutic strategies to alleviate pregnancy complications associated with oxidative stress. It highlights avenues for future research, advocating for a deeper understanding of antioxidant mechanisms and their optimal utilization in prenatal care to enhance maternal and fetal health outcomes.

The incidence of heart failure with preserved ejection fraction (HFpEF) continues to rise, and obesity continues to be a predominant comorbid condition affecting patients with HFpEF. Recent research sheds light on the important pathophysiologic role that obesity plays in the development of HFpEF, with many areas of opportunity existing for future developments in understanding the etiology and management of the disease. Crucial in these pathophysiologic developments are studies that clearly characterize the obesity phenotype in HFpEF and compare it to presentations of HFpEF in patients without obesity. This paper reviews the existing literature on the obesity phenotype within HFpEF and discusses some of the prevailing ideas behind the pathophysiologic interplay between the conditions, as well as the existing treatments demonstrating improved outcomes in HFpEF.

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership.Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic.Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05.Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each.Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each.2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children.3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided.4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person.

The properties that make the wood of fast-grown Ash pliable, strong, and resilient have been exploited by man for thousands of years, and are illustrated by reference to the probable use of Ash timber for tools, arms, and transport by the Roman Army of Occupation in Britain two thousand years ago. Militarily organized and disciplined, the Roman Army was responsible for changing the face of Britain with huge infrastructure projects that required significant numbers of tools, equipment, and fuel, in addition to the arms it used to maintain control over the fractious tribes of the north. The extent to which it maintained supplies of this valuable resource by managing its woods, possibly by coppicing, is discussed and raises the question as to the degree of genetic selection involved in coppicing.Ash: Fraxinus excelsior: extinction: prehistoric and historic uses: Roman army military use of Ash.

To reach such a consistent theory which contains the quantum field theory of particle physics and Einstein’s theory of gravitation as limiting cases, one may proceed in the following way: Standard quantum field theory just ignores the effects of gravity. This is justified in many cases due to the weakness of gravitational interactions at the presently accessible scales. In a first step beyond this approximation, one may consider an external gravitational field that is not influenced by the quantum fields. Here one may think of sources of gravitational fields that are not influenced by the quantum fields under consideration, as high-energy experiments in the gravitational field of the earth or quantum fields in the gravitational field of dark matter and dark energy. This approach amounts to the treatment of quantum field theory on curved spacetimes. The problem of quantization in curved spacetimes is now clearly visible. In Minkowski spacetime, there is a large group of symmetries that enforces a particular choice of vacuum by demanding the vacuum to be invariant. Such a criterion is absent for a general spacetime (M,g). We therefore do not know which state to choose as the vacuum. One might hope that the different prescriptions might be unitarily equivalent such that it doesn’t matter which state one takes to define the theory. Sadly this is not the case: The Stone-Von Neumann theorem is no longer valid for systems with an infinite amount of degrees of freedom. This means that unitarily inequivalent representations of the canonical commutation relations will arise, and it is not clear which equivalence concept representation is the physical one. In the second section of this chapter, we review the notions of Cauchy surfaces and global hyperbolicity.

Background: Dysgerminomas, account for only 1% - 2% of all malignant ovarian neoplasms.Objective: This case report aims to present a rare occurrence of dysgerminoma in a pediatric patient, highlighting the clinical characteristics, diagnosis, and management.Case presentation: We present a case of dysgerminoma in a 12-year-old girl who presented with a three-week history of pelvic pain and progressive abdominal swelling. Physical examination revealed a distended abdomen with evident suprapubic fullness, and a palpable abdominopelvic mass measuring approximately 20 weeks in size. Imaging studies confirmed the presence of a solid heterogeneous mass originating from the pelvis. The patient underwent a right salpingo-oophorectomy without complications. Histological examination coupled with an immunohistochemical study confirmed the diagnosis of dysgerminoma. The patient had an uneventful postoperative course and was discharged without adjuvant treatment. Regular follow-up visits, physical examinations, ultrasound scans, and lactate dehydrogenase assays were initiated for monitoring. Conclusion: Prompt recognition and appropriate surgical intervention, followed by regular monitoring, are crucial for optimal outcomes in pediatric dysgerminoma cases.

Biochemical systems are analytically investigated after encoding the properties of the dynamics, which rule the time evolution of the transition properties, using some Markov models, such as the Hierarchical Markov-State Models. The present paper is aimed at analytically writing the (finite) Markov chain originating from the considered Markov models. Within this framework, the interaction with the environment is considered, and the ergodicity of the systems obtained from numerical simulation is controlled and compared with the qualities of the Markov chain. The (von Neumann) conditions to be imposed on the Bloch equations for the biomaterial structures to be described analytically in a consistent way are governed. The formalisms of the ’heat bath’ and that of the control of the numerical errors ensure the good measure-theoretical framework and the ergodicity of the finite chain, respectively.The finite Markov chains are investigated and the analytical expressions are presented, after which the Hierarchical Markov-State-Model provides the time evolution of the transition probabilities in biochemical systems.The notion of heat bath is used to describe the interactions of the biomaterial with the environment and thus to control the uses of the projection operators in the Markovian processes where the appropriate measure is defined; the stochastic equations allow one to obtain the wanted measure from the probability spaces.The cases in which a violation of the Markov property of the process occurs, i.e. in open systems, or dissipative processes are also considered. Furthermore, in complex molecules in biological systems, these features are investigated to be possibly even more dramatic. As far as molecular processes are concerned, this occurrence is associated with the appearance of chaotic effects with certain characteristics of potential surfaces: rather than the technique of isocommittors, the method of projectors in measure spaces is used for the Nakajima-Zwanzig paradigm for the density operator; this latter method complementary compares the time-convolution-less technique.The finite Markov chains are finally proven to be ergodic after the control of the numerical errors which provide the Sinai-Markov partitions to be applied for the analysis of the measure space of the Markov chain, that is, one endowed with a Hilbert measure. The von Neumann conditions are therefore newly demonstrated to be apt to be applied to the Bloch equations for biomaterial structures after the use of the notion of heat bath, from which the measure space arises.The qualities of the Hierarchical Markov-Sate Models which bring the analytical expression of the time evolution of probabilities of biomaterials are therefore newly analytically studied.