Medicine and Pharmacy in the works of Dante Alighieri (1265-1321).

The 700th commemorative year of Dante's death began on 25 March 2021, the day of the Annunciation of the Lord, of the creation of the world, the New Year's Day in old Florence according to ab Incarnatione. On 25 March 2021, Holy Father Francis published the apostolic letter Candor Lucis Aeternae solemnly uniting the voice of the catholic church with the chorus of all the ones honoring the memory of the illustrious poet Dante Alighieri. In professional fraternity the voices of the guild colleagues join in, physicians and pharmacists, descendants of those in Arte dei Medici e degli Speziali, which proudly included among their members Dante Alighieri, at the crossing between the 13th and 14th centuries.

Supragastric belching: Pathogenesis, diagnostic issues and treatment.

Belching is defined as an audible escape of air from the esophagus or the stomach into the pharynx. It becomes pathologic if it is excessive and becomes bothersome. According to Rome IV diagnostic criteria, there is a belching disorder when one experiences bothersome belching (severe enough to impact on usual activities) more than 3 days a week. Esophageal impedance can differentiate between gastric and supragastric belching. The aim of this review was to provide data on pathogenesis and diagnosis of supragastric belching and study its relationship with gastroesophageal reflux disease and psychological factors. Treatment options for supragastric belching are also presented.

Florence Nightingale bicentennial: 1820-2020. Her contributions to health care improvement.

In 2020 we celebrate the bicentennial of the birth of Florence Nightingale and 110 years from her death (1820-1910). This gives us the opportunity to remember her life and her achievements. She is mainly known for her contribution to the foundation of modern nursing in the British Empire and subsequently to the world. Besides her personal engagement in the Crimean War, she organized a professional training for nurses, wrote the first textbook on nursing ("Notes on Nursing") and took public positions in favor of health care and philanthropic funding. She was a militant for the rights of the women and for social justice. She was a pioneer of medical statistics and hospital management. Her activity is acknowledged worldwide.

LARGE CELL METASTATIC PANCREATIC NEUROENDOCRINE CARCINOMA TREATED WITH SOMATOSTATIN ANALOGUES - CASE REPORT AND LITERATURE REVIEW.

We report the case of a 55-year-old-male with a large cell metastatic pancreatic neuroendocrine carcinoma treated for 14 months with lanreotide autogel having a stable disease (SD) and not responding to chemotherapy. The somatostatin analogues (SSA) were introduced after an episode of diarrhea and controlled the disease. Progression-free survival (PFS) as determined by Computerized Tomography (CT) scans was obtained for 14 months. After more than a year, the patient's health state deteriorated along with progressive disease. The capecitabine-temozolomide regimen was challenged, but after three cycles, a rapid clinical decline was noted. CONCLUSION: This unexpected event (diarrhea) in the course of the disease could represent the beginning of carcinoid syndrome. While the lanreotide autogel helped the episode of diarrhea pass, it also helped gain control over the disease itself.

Biomaterials for orbital fractures repair.

The unique and complex anatomy of the orbit requires significant contouring of the implants to restore the proper anatomy. Fractures of the orbital region have an incidence of 10-25% from the total facial fractures and the most common age group was the third decade of life. The majority of cases required reconstruction of the orbital floor to support the globe position and restore the shape of the orbit. The reason for this was that the bony walls were comminuted and/ or bone fragments were missing. Therefore, the reconstruction of the missing bone was important rather than reducing the bone fragments. This could be accomplished by using various materials. There is hardly any anatomic region in the human body that is so controversial in terms of appropriate material used for fracture repair: non resorbable versus resorbable, autogenous/ allogeneic/ xenogenous versus alloplastic material, non-prebent versus preformed (anatomical) plates, standard versus custom-made plates, nonporous versus porous material, non-coated versus coated plates. Thus, the importance of the material used for reconstruction becomes more challenging for the ophthalmologist and the oral and maxillofacial surgeon.

Pedicled perforator flaps for covering the elbow region. A case report.

Covering the elbow soft tissue defects is a difficult task for the plastic surgeon. Because of, the important anatomical structures situated superficially and the high tendency for stiffness of the elbow, the reconstructive method must be chosen carefully. Traditionally the free flaps were the choice method for elbow reconstruction. In our department, we use the perforator pedicled flaps for covering elbow defects, as a viable alternative to the free microsurgical transfer. This paper presents a successful case of covering an elbow soft tissue defect in a male patient. By using a local pedicled flap we replaced "like with like" to obtain a very good cosmetic result. The lack of microsurgical anastomosis allowed an early physical therapy.

Biomaterials for orbital fractures repair.

The unique and complex anatomy of the orbit requires significant contouring of the implants to restore the proper anatomy. Fractures of the orbital region have an incidence of 10-25% from total facial fractures and the most common age group was the third decade of life. The majority of cases require reconstruction of the orbital floor to support the globe position and restore the shape of the orbit. The reason for this is that the bony walls are comminuted and/or bone fragments are missing. Therefore, the reconstruction of missing bone is important rather than reducing bone fragments. This can be accomplished using various materials. There is hardly any anatomic region in the human body that is so controversial in terms of appropriate material used for fracture repair: nonresorbable versus resorbable, autogenous/allogenous/xenogenous versus alloplastic material, non-prebent versus preformed (anatomical) plates, standard versus custom-made plates, nonporous versus porous material, non-coated versus coated plates. Thus, the importance of material used for reconstruction becomes more challenging for the ophthalmologist and the oral and maxillofacial surgeon.

Comparison between the efficacy and side effects of intravitreal versus anterior chamber Bevacizumab injection in neovascular glaucoma patients.

Rationale. Neovascular glaucoma is the type of glaucoma most refractory to treatment. The most frequent causes are those associated with retinal hypoxia, which promotes the upregulation of the VEGF synthesis and produces fibrovascular membranes over the anterior chamber angle. Because the administration of anti VEGF products is still off label for neovascular glaucoma, there is not a single accepted way of treatment. There are differences between the site of administration (vitreal or anterior chamber or both at the same time), the dose or the setting of the procedure. Objective. The objective of our study was to asses the difference of efficacy and complications of bevacizumab injection for vitreal administration versus anterior chamber administration. Methods and results. Prospective study with 18 eyes from 18 patients with neovascular glaucoma associated with proliferative diabetic retinopathy or retinal vein occlusion. Group A (10 patients) received intravitreal injection with 0.05 ml Bevacizumab. Group B (8 patients) received anterior chamber injection with 0.03 ml Bevacizumab. There was a significant decrease of intraocular pressure (p<0.01 for group A, p<0.05 for group B) for both groups. Group A also had a statistically significant decrease of the macular edema (p<0.05). The side effects were reduced for both groups. Discussion. Our conclusion was that for the neovascular glaucoma, which associates significant macular edema, the intravitreal procedure should be performed, while for neovascular glaucoma patients without retinal edema, the anterior chamber procedure should be preferred because of reduced potential side effects.

A doctoral thesis about Carol Davila written in Paris in 1936.

Carol Davila, the father of the Romanian modern medicine, made decisive contributions to the development of health sciences in the Romanian Principalities in the last decades of the nineteenth century. The merit of his scientific work was recognized beyond the borders of his country. His life (not devoid of anecdotic instances and unknown episodes) and especially his work have aroused considerable interest among numerous medical historians. This paper presents a historical study elaborated in France, but until recently ignored, dedicated to the biography of Carol Davila. It concerns the medical doctoral thesis (State Diploma) elaborated by Joseph Adler (born 1910 in Botosani, Romania) under the supervision of professor Maxime Laignel-Lavastine, whose interest in Romania is well-known. Professor Laignel-Lavastine held the office of Secretary General of the International Society of History of Medicine (ISHM), founded in 1921, (replaced in this position by another French professor with links to Romania: Jules Guiart). The thesis comprises 48 pages and an exhaustive bibliography. It represents a token of the appreciation given to Davila's achievements by Europe's medical community.

The management of biofilm formation after hyaluronic acid gel filler injections: a review.

BACKGROUND AND AIM: One of the most popular procedures of facial fillers in recent years has become the use of hyaluronic acid (HA). However, this method may be associated with local side effects of different severity. Many of them are not due to allergies, as previously believed, but to the formation of biofilm. We review the current knowledge on biofilm after HA. METHODS: All pertinent full text papers retrieved from PubMed under search words: "biofilm", "hyaluronic acid", "dermal fillers", "hyaluronic acid complications" and "hyaluronic acid side effects" were analyzed; 29 of 60 articles were selected fro analysis. RESULTS: Local infections were reported: 13 cases are attributable to the activation of the biofilm. Clinical evolution is generally mild. Therapy should avoid NSAID and is based on the administration of antibiotics, oral corticosteroids, or 5-Flourouracil. Removal of HA with hyaluronidase has also been proposed. CONCLUSIONS: The use of HA in cosmetic procedures might be accompanied by local adverse effects attributable to biofilm formation. This usually has a mild evolution, but in special cases requires specific therapy.

The association of the rs1049353 polymorphism of the CNR1 gene with hypoadiponectinemia.

The endocannabinoid system (ECS) is an important physiological system that modulates appetite, food intake, energy homeostasis, substance addiction. It is comprised of the cannabinoid receptors (CB1 and CB2), the endogenous lipid ligands of these receptors and the enzymes that mediate the endogenous ligands' biosynthesis and degradation. CB1 receptor is expressed in the brain, adipose tissue, liver, skeletal muscle, gastrointestinal tract and pancreas. The CB1 receptor is encoded by CNR1 gene located at 6q14-q15 level. The aim of our study was to investigate the possible correlation between rs1049353 polymorphism of the CNR1 gene with levels of adiponectin in a group of subjects from Romania. The study included 305 subjects divided in two groups according to their fasting adiponectin levels. Fasting adiponectin levels were determined using ELISA technique. The genotyping of the rs1049353 polymorphism of the CNR1 gene was made using the Real-Time PCR technique. The statistical analysis was performed using De Finetti's program. The differences between the allelic frequencies indicated that the presence of G-wild allele seems to confer risk for expressing low levels of adiponectin (OR=1.917; 95%C.I.=1.353-2.715; p=0.00023) and A-mutant allele seems to be protective (OR=0.522; 95%C.I.=0.368-0.739; p=0.00023). At the test of allelic positivity, the presence of the G-allele conferred risk of hypoadiponectinemia (OR=2.113; 95%C.I.=1.324-3.373). In conclusion, this study indicates that the rs1049353 polymorphism of the CNR1 gene is associated with decreased levels of adiponectin. Further research is needed in order to elucidate the link between the polymorphisms of the CNR1 gene and adiponectin levels.

The implication of CNR1 gene's polymorphisms in the modulation of endocannabinoid system effects.

The endocannabinoid system (ECS) represents one of the most important physiologic systems involved in organism homeostasis, having various implications upon individual behavior and metabolic phenotype. It is composed of cannabinoid receptors CB1 and CB2, and their genes (CNR1 and CNR2), their endogenous ligands and the enzymes which mediate endogenous ligands' biosynthesis and degradation. Anandamide and 2-arachidonoylglycerol are two endogenous agonists of the cannabinoid receptors. It is considered that ECS connects physical and emotional response to stress with appetite and energy balance, functioning like an after stress recovery system which remains inactive in repose physiologic conditions. It is involved in several physiologic processes like nociception, motor control, memory, learning, appetite, food intake and energy balance. This review analyzes the implication of 11 polymorphisms of CNR1 gene in the modulation of the ECS metabolic and central effects. A lot of studies show that rs12720071, rs1049353, rs806381, rs10485170, rs6454674, rs2023239 polymorphisms are associated with metabolic effects. From them rs12720071, rs104935, rs6454674, rs2023239 polymorphisms are also associated with central effects of ECS (substance addiction, impulsivity, resistance to antidepressive treatment). Other studies indicate that rs806368, rs1535255, (AAT)9,(AAT)12 and (AAT)n are correlated only with central effects (schizophrenia, substance addiction, impulsivity, Parkinson syndrome). The discovery of ECS and its signaling pathways opens a door towards the understanding of several important physiologic processes regarding appetite, food intake, metabolism, weight gain, motor control, memory, learning, drug addiction and nociception. The detailed analysis and validation of the ECS functioning can bring us very close to the discovery of new diagnosis and treatment methods for obesity, drugs abuse and numerous psychic diseases.

Pathway analysis of microarray data via regression.

Pathway analysis of microarray data evaluates gene expression profiles of a priori defined biological pathways in association with a phenotype of interest. We propose a unified pathway-analysis method that can be used for diverse phenotypes including binary, multiclass, continuous, count, rate, and censored survival phenotypes. The proposed method also allows covariate adjustments and correlation in the phenotype variable that is encountered in longitudinal, cluster-sampled, and paired designs. These are accomplished by combining the regression-based test statistic for each individual gene in a pathway of interest into a pathway-level test statistic. Applications of the proposed method are illustrated with two real pathway-analysis examples: one evaluating relapse-associated gene expression involving a matched-pair binary phenotype in children with acute lymphoblastic leukemia; and the other investigating gene expression in breast cancer tissues in relation to patients' survival (a censored survival phenotype). Implementations for various phenotypes are available in R. Additionally, an Excel Add-in for a user-friendly interface is currently being developed.

Novel inter-series hybrids in Solanum, section Petota.

Sexual hybrids between distantly related Solanum species can undergo endosperm failure, a post-zygotic barrier in inter-species hybridizations. This barrier is explained by the endosperm balance number (EBN) hypothesis, which states that parents must have corresponding EBNs for viable seed formation. Tests for inter-crossability were made involving the Mexican species Solanum pinnatisectum Dunal. (series Pinnatisecta, ApiApi, 1EBN), autotetraploids of this species, Solanum verrucosum Schlechtd. (series Tuberosa, AA, 2EBN), haploids (2x, 2EBN) of the South American S. tuberosum L. (series Tuberosa, A1A1A2A2, 4EBN), and F2 haploid-species hybrids with South American species (AA, 2EBN) S. berthaultii Hawkes, S. sparsipilum (Bitter.) Juz. and Bukasov and S. chacoense Bitter. The development of hybrid endosperms was investigated for these combinations by confocal microscopy with regard to cell-division timing and tissue collapse. Novel sexual diploid (AApi) and triploid (AApiApi) inter-series hybrids were generated from S. verrucosum x S. pinnatisectum crosses by using post-pollination applications of auxin. F1 embryos were rescued in vitro. The hybrid status of recovered plants was verified by microsatellite marker analysis, and the ploidy was determined by chromosome counting. The application of phytohormones in inter-ploidy S. pinnatisectum x S. tuberosum crosses, however, did not delay endosperm collapse, and embryos were not formed. Other diploid, 1EBN species tested in remote hybridizations with Group Tuberosum were S. cardiophyllum Lindl., S. trifidum Correll, and S. tarnii Hawkes and Hjert., series Pinnatisecta, and S. bulbocastanum Dunal., series Bulbocastana. Based on the analysis of post-zygotic reproductive barriers among isolated species of section Petota, we propose strategies to overcome such incompatibilities.

Augmentation of CD8 and CD4 lymphocytes subsets in AIDS infected children after treatment with a non-toxic chelating agents compound--Rodilemid.

Twelve children were included into the protocol, 5 in March 1989 and 7 in April 1993. All of them were HIV 1 positive and had diarrhoea, important adenopathy and opportunistic infections. Seven out of 12 patients had an immunological monitoring. One out of 12 children with B hepatitis died with liver cirrhosis. Eleven children had a clear improvement in their clinical course, during the treatment. Five out of 7 patients had a significant increase of the CD4 lymphocytes at 4 and 7 months follow-up. Four patients had an important and significant increase of the CD8 count at 4 months and 6 out of 7 patients at 7 months. Interestingly, in 4 out of 7 patients after 7 months treatment we observed higher than normal value of the CD8 count. Variations observed for CD8 population compared to CD4 were more important.