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Maize crop ranks the first place in Romania as cultivated area, representing 2.3-2.5 million ha annually, this being subjected to the attack of several pests. Various researches conducted in different locations of Romania indicated that pests (Tanymecus dilaticollis, Agriotes spp. Helicoverpa armigera, Diabrotica virgifera virgifera, Ostrinia nubilalis) can caused up to 100% losses in maize crops, especially because of those pests attacking in the first stages of vegetation. Recently, other very damaging pests have been reported to the maize crop as new threats or/and quarantine pests, which can cause major damages in the future, for example: Spodoptera frugiperda, Elasmopalpus lignosellus, Tylenchorhynchus claytoni, Chilo partellus. These new pests have established themselves in Europe, therefore the risk of spreading is very high. The data from literature were analysed on the pest short description, the damages produced to maize plants and the most effective control strategies through chemical, biological and cultural operations in the maize growing regions in Romania. It is important for growers to recognize all stages of these insects that attack maize crops, to making the correct decision by Integrated Pest Management (IPM) and/or other effective control methods. [ABSTRACT FROM AUTHOR]

Depression remains an underdiagnosed comorbidity which significantly decreases the quality of life in amyotrophic lateral sclerosis (ALS) patients. We aimed to investigate the prevalence of depression in a cohort of ALS patients with more than one year of disease evolution. A total of 50 ALS patients were evaluated with the Beck Depression Inventory II (BDI-II) and cognition, using the Mini-Cog Standardized Instrument (MCSI). The clinical disability was evaluated using the ALS Functional Rating Scale (ALSFRS). The prevalence of depression was 42.8%. A lower BDI-II score was significantly correlated with a higher education level, the spouse as a caregiver, spiritual devotion, and employment status (p < 0.05). A multiple linear regression analysis between the BDI-II score as the dependent variable and various independent variables such as spirituality, caregiver status, educational level, and occupational status revealed that only the type of caregiver (spouse or parent/child) significantly affected the BDI-II total score (p = 0.006). The functional disability significantly correlated with loss of appetite and loss of libido (p < 0.001). A high education, spiritual devotion, high ALSFRS, and the presence of the spouse as the caregiver were associated with the absence of depression.

Objective: The aim of this study was to compare non‐nutritive sweetened (NNS) beverages versus water for weight loss after a 12‐week behavioral weight‐management program. Methods: This is an ongoing, 2‐year, parallel‐group, open‐label, controlled equivalence trial; week‐12 data are reported. Adults with BMI of 27 to 35 kg/m2 who regularly drank cold beverages were randomized 1:1 to intention‐to‐treat water or NNS beverages while undergoing a weekly 12‐week group behavioral weight‐management program. Weight change to week 12 was the primary end point (equivalence: two‐sided p > 0.05); changes in waist and hip circumference, blood pressure, glycemic control markers, fasting lipid profiles, liver function tests, hunger (visual analog scale), sugar and sweetener consumption, and activity levels were secondary end points. Results: Overall, 493 participants were randomized (water: n = 246; NNS beverages: n = 247); 24.1% were NNS beverage naïve. Weight change was equivalent with water versus NNS beverages (−5.6 vs. −5.8 kg; difference [90% CI]: −0.2 kg [−0.7 to 0.4]). There were no significant differences between groups for secondary end points except reductions in waist circumference (greater with NNS beverages vs. water), glycated hemoglobin, and consumption of any type of sweetener (both greater with water vs. NNS beverages). Conclusions: Weight loss was equivalent with NNS beverages and water following a 12‐week behavioral weight‐management program. [ABSTRACT FROM AUTHOR]

Simple Summary: The available chemotherapeutic regimens for metastatic pancreatic ductal adenocarcinoma (mPDAC) in Romania include FOLFIRINOX (FFX), gemcitabine-based regimens (GB), and gemcitabine monotherapy (Gem). The purpose of our study was to compare the efficacy of FFX, GB, and Gem in patients with mPDAC in real-world scenarios. Our research revealed that the overall survival (OS) of patients receiving FFX or GB was comparable, twice as long as that of patients receiving Gem, and the progression-free survival (PFS) was highest for patients receiving FFX as first-line chemotherapy (L1). Male gender, Eastern Cooperative Oncology Group Performance (ECOG-PS) 0/1, the FFX regimen, and neutrophil-to-lymphocyte ratio (NLR) > 4.15 were all independently linked to a longer OS. L1 with FFX improved both OS and PFS for second-line chemotherapy (L2). Purpose: To assess the efficacy of FOLFIRINOX(FFX), gemcitabine-based regimens (GB), and gemcitabine monotherapy (Gem) in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC). Methods: This is a retrospective study that included 83 patients with mPDAC treated with first-line chemotherapy (L1) with either FFX, GB or Gem between 2015 and 2017. Progression-free survival (PFS) for L1 and second-line chemotherapy (L2) (PFS-L1 and PFS-L2) and overall survival (OS) were estimated using the Kaplan–Meier method. Results: Median PFS-L1 for FFX, GB and Gem groups was 9 months (95% (Confidence Interval) CI 2.76–15.24), 5 months (95%CI 3.44–6.56), and 5 months (95%CI 3.76–6.24), respectively (p = 0.04). OS was 14 months (95%CI 11.16–16.85), 12 months (95%CI: 9.44–11.56), and 7 months (95%CI: 5.7–8.3) for patients treated with FFX, GB, and Gem, respectively (p = 0.0001). ECOG-PS (0/1) (Hazard Ratio (HR) 6.74, p = 0.002), age > 70 years (HR 0.25, p = 0.04), body tumors (HR 2.8, p = 0.048), CA19–9 > 39 U/mL (HR 0.26, p = 0.02), and neutrophil-to-lymphocyte ratio (NLR) > 4.15 (HR 6.76, p = 0.001) were independent prognostic factors for PFS-L1. Male gender (HR 3.02, p = 0.026), ECOG-PS (0/1) (HR 4.21, p = 0.003), L1 with FFX (HR 0.255, p = 0.007), and NLR > 4.15 (HR 2.65, p = 0.04) were independent prognostic factors of OS. PFS-L2 (HR 6.91, p = 0.013) and OS-L2 (HR 6.95, p = 0.037) were significantly higher in patients first treated with FFX. Conclusions: The OS of patients who receive FFX or GB is comparable. The best PFS-L1 belongs to the FFX group. Male gender, ECOG-PS 0/1, the FFX regimen, and NLR > 4.15 were independent predictors of OS. PFS-L2 and OS-L2 were favorably impacted by L1 with FFX. [ABSTRACT FROM AUTHOR]

Background: Ovarian cancer does not cause many symptoms in the early stages, which is why the majority of cases are of advanced disease. Increasing awareness of ovarian cancer symptoms may lead to earlier diagnosis and improved outcomes. Methods: Participants in Britain completed the Ovarian Cancer Awareness Measure by online survey (n = 459). Results: Our participants were 75% female, 25% male and a young (27.89 ± 11.44 years) ethnically diverse population (40.3% White, 29.3% Asian and 18.0% Black). Individuals recalled 1.24 ± 1.30 symptoms, and recognised 5.96 ± 2.4 symptoms. We found higher levels of recall and recognition compared to previous research possibly due to using an online survey. Recognition was lowest for difficulty eating (39.4%) and persistently feeling full (38.7%). Males had slightly lower symptom recall and recognition than females. Participants incorrectly recalled an irregular menstrual cycle (22.4%) as an ovarian cancer symptom and 67% answered the age of incidence question incorrectly. Suggesting that participants incorrectly associate ovarian cancer as a disease of pre‐menopausal women. Individuals recalled 1.47 ± 1.20 risk factors, and recognised 6.1 ± 2.4 risk factors. Family history of ovarian cancer was recalled by 59% of participants. Recognition was lowest for in vitro fertilisation treatment (23.0%) and talcum powder in the genital area (23.0%). The generic cancer risk factors of alcohol (9.3%) and poor diet (8.8%) were recalled as specific ovarian cancer risk factors. 57.9% of participants incorrectly answered that there is an ovarian cancer screening programme. Suggesting confusion between ovarian and cervical cancer as participants also recalled cervical cancer risk factors of sexually transmitted diseases (6.3%) and human papillomavirus (1.5%). 29.7% of female participants would seek help for an ovarian cancer symptom within 1–2 days. Help seeking was higher in the Black and Asian ethnicities (44.4% and 45.0%; p = 0.018). Conclusion: Awareness of ovarian cancer symptoms is low. Ovarian cancer awareness campaigns should include common misconceptions identified in this research. Awareness of ovarian cancer symptoms is low. Participants incorrectly associate ovarian cancer as a disease of pre‐menopausal women as well as confusing it with cervical cancer. Ovarian cancer awareness campaigns should include common misconceptions identified in this research. [ABSTRACT FROM AUTHOR]

Maize leaf weevil (Tanymecus dilaticollis Gyll) is one of Romania's most harmful pests of maize crops. The purpose of this study is to evaluate the effectiveness of the different control methods of the maize leaf weevil in conditions of the high pest pressure from a commercial farm, located in one of the most favorable areas for this weevils species, in the southeast of Romania (Mihail Kogălniceanu, Ialomița County). This study has tested foliar treatment with acetamiprid and lambda-cyhalothrin active ingredients, seeds treatment with imidacloprid and cyantraniliprole active ingredients, and granules application with the lambda-cyhalothrin active ingredient. In the spring of 2021, at the experimental site, it has registered a high pest density (15-20 weevils/m2). As a result of the weather's unfavorable conditions for weevils activity on the ground, the pest attack was moderate when maize was in early vegetation stages. At the control (untreated) variant, most of the maize plants had leaves chaffed in the proportion of 50-75%, but the majority of the plants survived after the attack. In this study, lower weevils attack has registered in the case of the variants with seeds treated with imidacloprid and cyantraniliprole active ingredients. From all experimental variants, higher maize yield was recorded in the case of the variant with seeds treated with imidacloprid active ingredient (12501 kg/ha). This study, effectuated in conditions of high pest pressure, in commercial farm conditions, demonstrates that seed treatment with systemic insecticides adequately protects the maize plants in early vegetation stages (BBCH 10-BBCH 14) against maize leaf weevil attack. [ABSTRACT FROM AUTHOR]

We document and make available to the scholarly community a uniquely detailed database of 20,680 observations of wages for men, women, and children and 30,000 observations of prices from eighteenth-century rural Denmark. These microlevel data were originally collected by the Danish Price History Project but have not previously been released. To illustrate the usefulness of such data, we discuss possible applications. [ABSTRACT FROM AUTHOR]

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Copyright of Romanian Case Law Review / Revista Română de Jurisprudenţă is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The maize leaf weevil (Tanymecus dilaticollis Gyllenhal, 1834) represent one of the most destructive pests of maize crops in Romania, especially in the south and south-east of the country. Every year was attacked more than 1 million hectares cultivated with maize. This pest is very dangerous when maize is in early vegetation stages, from plant emergence until four leaves (BBCH 10-BBCH 14). After the ban of the seeds treatment with neonicotinoids in the Europe Union, no alternatives for seed treatment to control this pest remain available in our country. In this article, it has assessed both, seeds treatment with neonicotinoids and possible alternatives for controlling of the maize leaf weevil in conditions of the commercial farm located in the south-east of Romania. Seeds treatment with imidacloprid (600 g/l), cyantraniliprole (625 g/l) active ingredients, maize foliar treatment with acetamiprid (20 %), lambda-cyhalothrin (50 g/l) active ingredients, granules application at maize sowing, with chlorpyrifos (5 %), lambda-cyhalothrin (4 g/kg) active ingredients or two granules application, at maize sowing and after plants emergence with cypermethrin (0.8 %) active ingredients were assessed. The efficacy of the applied insecticides was determined by evaluating weevils attack intensity at the maize plants, at BBCH 14 stage, using a scale from 1 (plant not attacked) to 9 (plant destroyed). In the spring of 2020, weather conditions from the experimental site, during assessments period were unfavorable for weevils activity at the soil surface. Even if the pest density from the experimental location was high (10-15 insects/m2) however weevils attack at maize plants was low. At variant with seeds treated with imidacloprid active ingredient, maize attack intensity at maize plant was 3.86, at untreated variant attack intensity was 4.47 while at rest of the experimental variants, attack intensity ranged between 4.29 and 4.46. It has registered significant statistical differences between weevils attack at maize plants from variant with seeds treated with imidacloprid active ingredient and the rest of the variants from this assessment (p<0.05). In the weather conditions of the year 2020, from the experimental location from the south-east of Romania, there weren't registered significant statistical differences between seeds treatment with cyantraniliprole active ingredient, maize foliar treatment with acetamiprid, lambda-cyhalothrin active ingredients, granules application with chlorpyrifos, cypermethrin, lambda-cyhalothrin active ingredients, and untreated variant (p<0.05). [ABSTRACT FROM AUTHOR]

Background: Acromegaly is a rare progressive chronic disease characterized by hypersecretion of growth hormone (GH) and elevated levels of insulin-like growth factor 1 (IGF-1), primarily caused by a GH-secreting pituitary adenoma. Patients suffering from this disease frequently have an impaired Quality of Life (QoL) which may persist despite biochemical control on the IGF-1. The Acromegaly Quality of Life Questionnaire (AcroQoL) is a useful tool to asses QoL in these patients. Objective: We aimed to present the QoL evolution in a complex case of aggressive acromegaly which required multiple interventions (2 surgeries, radiotherapy and multimodal pharmacological treatment) to achieve biochemical control. Material and methods: We present a 33-year-old male patient with a history of active acromegaly with an aggressive GH-secreting pituitary macroadenoma operated twice, with significant tumor remnant that required gamma-knife radiotherapy. The patient is currently on combined treatment with Pegvisomant and Cabergoline maximum dose due to resistance to first generation somatostatin analogs. Biochemical control was achieved after a long history of poor control. We applied the AcroQoL questionnaire at two different times during the patients evolution. Results: In the prior investigation, the patient exhibited a QoL score of 97,72p, with minimal physical compromise (93,75p), while other facets remained unaltered. He was partially biochemically controlled at that time. However, in the current examination, despite the achievement of biochemical control, his QoL score declined to 87,5p. Notably, physical well-being decreased to 87,5p, alongside a decrease in psychological and appearance- dimensions. Conclusions: Through effective treatment and meticulous control of the disease after a long history of multiple therapies, this patient's quality of life remained altered and decreased in comparison to the previous evaluation, revealing the difficulties in successfully managing an aggressive case of GH producing pituitary macroadenoma. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current study was to investigate possible associations between catalase C262T (CAT C262T), glutathione peroxidase 1 Pro198Leu (GPX1 Pro198Leu), manganese superoxide dismutase Ala16Val (MnSOD Ala16Val) gene polymorphisms and non-Hodgkin Lymphoma risk (NHL) in a Romanian population and the five-year overall survival rate of the NHL patients. Methods: We included in this case-control study 406 individuals, divided into two groups: the control group (n=315) and the patients group (n=91). The DNA was extracted from peripheral blood and amplified using specific techniques. Results: The variant homozygous genotype of GPX1 Pro198Leu represents a risk factor for NHL development and no associations regarding the risk for NHL were found for MnSOD Ala16Val and CAT C262T gene polymorphisms. Two of the studied polymorphisms were associated with the overall survival rate thus: negative association regarding MnSOD Ala16Val, associated with higher overall survival rate and a positive one regarding CAT C262T, associated with lower overall survival rate. Conclusions: According to our results, the mentioned polymorphisms may be considered as susceptible markers of the five-year overall survival rate for NHL patients. Future studies with a larger number of patients are needed to confirm our results. [ABSTRACT FROM AUTHOR]

During its history, the evolution of the orchestra has always been strongly connected to the development of instruments as well as to the evolution of vocal and instrumental genres in different epochs. In Opera, the role and the size of the orchestra has grown over time, from Romanticism and continuing through the 20th century, becoming the heart of drama itself. Its sonorities have been permanently enriched by exploring the resources of each instrument, the texture and combinations of different timbres, all destined to intensify dramatic situations, to deepen the inner life of the characters and valorise space. Here are some aspects of the opera's orchestra evolution through the 20th century, its impact on vocalism and the influence of the conductors in the destiny of lyrical theatre. [ABSTRACT FROM AUTHOR]

From a theoretical standpoint, there is no apparent controversy regarding participation in corruption offences. Legal doctrine states that participation is possible in all of its forms: co-authorship, abetment, complicity. However, seemingly simple questions have given rise to discussions and various solutions in judicial practice. Some of which are being examined in this study. One issue would be the legal qualification of the offence or offences committed by the intermediary to giving and to receiving bribe. Although the opinion in favour of concurrent offences for the intermediary is perfectly justifiable from a theoretical point of view, the author concludes that this solution is excessive. For this reason, she believes that the intermediary should be charged with a single offence, either complicity to giving bribe or complicity to receiving bribe, depending on the way the offence was committed, whether the help was provided to the briber or to the public servant. If there is no way of establishing for a fact that the intermediary initially aided the briber or the public servant, the proposed solution is charging the more serious offence, that of complicity to receiving the bribe. A second issue would be to assess whether the briber can be also charged with complicity or abetment to the offence committed by the public servant who asked for or accepted the proposal of receiving material gain. Finally, the solution of concurrent offences is rejected, as the legislator opted for creating particular offences. Another issue analysed in this study is the legal qualification of the deed of the person who facilitates the receiving of a sum of money by a public servant as bribery, he/she having previously accepted the proposal for receiving set money. Although there is the temptation of charging the complicity to receiving the bribe in this particular situation, the author finally reaches the conclusion that the actual handing of the money is a subsequent act, with no legal relevance lex lata. Lex ferenda, the author has some proposals for a possible sanctioning of these persons on another ground. The author then focuses on other difficult aspects regarding these offences: she argues, with actual examples, the way in which, under the current legislation, it is possible to charge a person with giving bribe although there are not enough elements for charging the act of receiving the bribe. Finally, the study analyses the possibility of charging the complicity or instigation to bribery in all situations in which the intermediary asks for a sum of money in the name of the public servant. After imagining various situations, the author reaches the conclusion that one cannot always be charged with these offences, and argues for other solutions. In conclusion, to reach some solutions of principle, the author argues that the 'independence' of the offence of giving bribe in relation to the offence of receiving bribe must be established and takes on the responsibility of fulfilling the difficult task of proposing some criteria in order to do so. [ABSTRACT FROM AUTHOR]

We are presenting the case of a 36 years old male diagnosed at the age of 20 with reactive arthritis and at 27 years with ankylosing spondylitis. During the course of the disease, the patient followed treatment with nonsteroidal anti-inflammatory drugs, Sulfasalazine and biological therapy. The first two anti-TNF had a very good response. During Adalimumab therapy the patient conceived a child without any teratogenic effect on it. The effect of the two anti-TNF has been long-lasting, but the effectiveness has decreased on the other two. The future of this patient lies in blocking a new molecule in ankylosing spondylitis named IL-17, so we are expecting the disease response to the new biological introduced into ankylosing spondylitis, named Secukinumab. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the serum levels of Lipoprotein(a) [Lp(a)] in subjects with thyroid disorders, as well as to investigate their relationship with lipid profile and the markers of thyroid function and autoimmunity, admitting that elevated Lp(a) levels and dyslipidemia caused by thyroid disorders synergistically increased the atherogenic process. Methods: This study enrolled 38 subjects with hypothyroidism, 30 with hyperthyroidism and 55 with euthyroidism. The following parameters were measured: Lp(a), apolipoprotein AI (apo AI), apolipoprotein B (apo B), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL), thyroid stimulating hormone (TSH), free thyroxine (FT4), triiodothyronine (T3), thyroid-peroxidase antibody (TPO-Ab). Results: Lp(a) was found with increased mean serum levels in hypothyroid subjects (483.28 ± 281.55 mg/L). Hyperthyroid subjects showed normal levels (253.13 ± 94.29 mg/L) of Lp(a), but significantly lower than those with hypothyroidism and slightly increased levels in the euthyroid subjects (305 ± 100.44 mg/L). In hypothyroidism a significant positive correlation between Lp(a) and TSH, apo B, TC, TG, TC/HDL, VLDL levels and a negative correlation with FT4, T3 and apo AI/B (p < 0.05) was observed. No correlations were found between serum Lp(a) levels, lipids profile and thyroid function parameters in hyperthyroid subjects, neither with TPO-Ab. Conclusions: The association of hypothyroidism with increased levels of Lp(a) seems to increase the already high cardiovascular risk in the hypothyroid subjects, while increased levels of Lp(a) represents independently a relevant cardiovascular risk factor. [ABSTRACT FROM AUTHOR]

In the present paper we introduce a new q-generalization of Szász-Mirakjan operators and we investigate their approximation properties. By using a weighted modulus of smoothness, we give local and global estimations for the error of approximation. [ABSTRACT FROM AUTHOR]

In the present paper we introduce a q-analogue of the Baskakov-Kantorovich operators and investigate their weighted statistical approximation properties. By using a weighted modulus of smoothness, we give some direct estimations for error in case 0 < q < 1. [ABSTRACT FROM AUTHOR]

• Sweetener scale factor structure was good upon removal of negatively worded items. • Internal reliability of the modified version of the scale was good. • Avoidance of sweeteners was associated with perceived risk and lack of benefit. • Older participants were more likely to avoid sweeteners. • In those who consume sweeteners, elevated use was associated with perceived benefit. Bearth, Cousin, and Siegrist (2014) Perception of Artificial Sweetener Scale (PASS) has been widely used but has yet to be subject to thorough psychometric evaluation. The current study aimed to assess the factor structure and internal reliability of the scale, as well as assess its predictive utility. In a pre-registered study, 489 participants (age range 18–86 y) completed the attitudes towards sweeteners scale and a survey assessing their sweetener consumption over the past month. Initial confirmatory factor analysis showed an acceptable to poor fit of the scale largely due to three reverse coded items. Upon their removal model fit was excellent and McDonald's Omega values showed good internal reliability for all subscales. Zero inflated (hurdle) negative binomial regression revealed that higher scores on the risk subscale, lower scores on the benefit subscale, and older age were associated with avoidance of sweeteners. Of those who did consume sweeteners, greater perceived benefit was associated with increased consumption. The current study recommends that a shorter version of the PASS (PASS-23) should be used in future research with this scale showing good psychometric properties. Furthermore, it suggests that if sweetener over sugar consumption is to be encouraged, perceived risk and benefits should be targeted in public health messaging. [ABSTRACT FROM AUTHOR]

Introduction: An important cause of recurrent hypoglycemia related to endogenous hyperinsulinism is represented by insulinoma, a rare tumor with a low incidence, impacting 1-4 individuals per million of the general population. The hallmark of this condition is an autonomous hypersecretion of insulin, which occurs independently of the normal glycemic control mechanisms. Typically, it results in non-specific neuroglycopenic symptoms and increased sympathoadrenal activity during the hypoglycemic episodes, posing a challenge in diagnosis. Case Report: This report describes the case of a 66-year-old female patient with recurrent episodes of hypoglycemia, accompanied by various comorbidities including chronic autoimmune thyroiditis, hypertension, dyslipidemia and grade 1 obesity. The patient had been experiencing recurrent episodes of malaise associated with low blood glucose levels (<40 mg/dL) since 2021, with occasional loss of consciousness due to severe hypoglycemia. Initially misdiagnosed as diabetes mellitus type 2, based on a flat oral glucose tolerance test curve, she was treated with Metformin, but discontinued treatment due to persistent symptomatic hypoglycemic episodes. Through meticulous dietary adaptations, the patient achieved control of her early-onset symptoms by unrestricted intake of glucose-rich liquids and foods. Subsequently, the patient was diagnosed with endogenous hyperinsulinism (glucose level of 21 mg/dl during the fasting test, unsuppressed insulin and C-peptide). Abdominal MRI revealed the presence of a cephalic pancreatic nodule, later confirmed to be an insulinoma upon biopsy. The patient underwent surgical intervention for the removal of the tumor and symptomatic episodes improved thereafter. Discussions : The patient's condition illustrates a typical case of severe hyperinsulinism, that was diagnosed after several years of symptomatic evolution. The patient tolerated the hypoglycemic episodes unexpectedly well, explained by the chronic adaptation of the autonomic nervous system to low glucose levels. Ultimately, the patient was diagnosed with endogenous hyperinsulinism associated with a pancreatic tumor, which was successfully surgically removed. The case also highlights how the possibility of a deceptive appearance, such as a flat OGTT curve in this condition, is misleadingly implying the presence of diabetes mellitus. Conclusions: Increased awareness to symptoms of hypoglycemia should lead to a prompt evaluation for endogenous hyperinsulinism, which is attributed to a pancreatic tumor in the majority of cases. This condition, if unifocal and surgically accessible, as revealed in our case, can be effectively managed through surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired, immune-mediated disorder of the peripheral nervous system in which the primary pathogenic mechanism is presumed to be mediated by both cellular and humoral immune reactions against myelin and the peripheral nerve axon causing motor deficits, sensory dysfunction, peripheral loss of reflexes. CIDP has a progressive evolution during at least 8 weeks or has episodes of relapses. Case report: We present the case of a young male of 21 years old with CIDP. He had six episodes of acute relapses which were treated either with corticotherapy or with intravenous immunoglobulins (IG Iv) administration with good response initially at corticotherapy, lately only at IG Iv. At the last two admissions in hospital he did not show improvement after IV Ig administration and required plasmapheresis as a therapeutic procedure with subsequent improvement. At the last hospitalization, the therapeutic solution chosen was plasmapheresis by peripheral approach performed by the neurologist. Conclusions: In the treatment of CIDP neurologists have a number of therapeutic options, including administration of corticosteroids, IV Ig and therapeutic procedures such as plasmapheresis. The advantage of plasma exchange is the procedural removal of pathogenic auto-antibodies and circulating immune complexes followed by the rapid installation of the therapeutic effect. Plasmapheresis is generally reserved for severe cases in which other therapies have failed, being a treatment given on the short term until obtaining the remission and followed by immunosuppression. There are also situations in which the long-term use with the individualized and careful analysis of the risk-benefit ratio is necessary. Peripheral veins access is preferred and is easy to be achieved by the neurologist because it is associated with fewer infections, thrombotic complications and pneumothorax compared to central veins and additionally relieves the intensive care clinic from a neurological therapeutic procedure that can be performed in these conditions safely in the neurology clinic. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) has increased exponentially in recent years in Western European countries, where the number of hepatitis of viral etiology has been declining, and it is thought to be the most common cause of chronic liver disease in the near future (1). Currently, NAFLD is both the second most common cause of hepatocellular carcinoma (HCC) and the second most common indication for liver transplantation (2-4). This problem is very serious, as cases of NAFLDs are increasingly in children, a population with a long life ahead, and in whom the disease has all the time to progress to cirrhosis and HCC (5, 6). Objectives: The goal of this prospective study is to determine the effect of an original formula consisting in silymarin, organic selenium and alpha lipoic acid, in reducing liver damage in patients with chronic liver disease. Material and methods: The study started in March 2018, initially with a group of patients from Bucharest, integrated in the study at St. Mary's Hospital. In October 2018 it was expanded at the national level to 1 718 patients, monitored by 145 investigating physicians from 134 centers, with an average of 11.8 patients per investigating physician. Outcomes: Taking each stage of fatty liver disease (FLD) at T0 moment (the beginning of the study), we observed that 25% of patients with grade I FLD had no sign of disease at the end of the study, 74% of those with grade II FLD recovered or improved their health, and 83% of patients with grade III FLD recovered or improved their health. There were 149 patients with no FLD detected at the end of the study (recovered). Conclusions: Based on triple antioxidant therapy, the original formula improved the evolution and prognosis of patients with chronic liver disease. [ABSTRACT FROM AUTHOR]

Background & Aims: Evaluation of severity and extension of gastric atrophy and intestinal metaplasia is recommended to identify subjects with a high risk for gastric cancer. The inter-observer agreement for the assessment of gastric atrophy is reported to be low. The aim of the study was to evaluate the inter-observer agreement for the assessment of severity and extension of gastric atrophy using oriented and unoriented gastric biopsy samples. Furthermore, the quality of biopsy specimens in oriented and unoriented samples was analyzed. Methods: A total of 35 subjects with dyspeptic symptoms addressed for gastrointestinal endoscopy that agreed to enter the study were prospectively enrolled. The OLGA/OLGIM gastric biopsies protocol was used. From each subject two sets of biopsies were obtained (four from the antrum, two oriented and two unoriented, two from the gastric incisure, one oriented and one unoriented, four from the gastric body, two oriented and two unoriented). The orientation of the biopsy samples was completed using nitrocellulose filters (Endokit®, BioOptica, Milan, Italy). The samples were blindly examined by two experienced pathologists. Inter-observer agreement was evaluated using kappa statistic for inter-rater agreement. The quality of histopathology specimens taking into account the identification of lamina propria was analyzed in oriented vs. unoriented samples. The samples with detectable lamina propria mucosae were defined as good quality specimens. Categorical data was analyzed using chi-square test and a two-sided p value <0.05 was considered statistically significant. Results: A total of 350 biopsy samples were analyzed (175 oriented / 175 unoriented). The kappa index values for oriented/unoriented OLGA 0/I/II/III and IV stages have been 0.62/0.13, 0.70/0.20, 0.61/0.06, 0.62/0.46, and 0.77/0.50, respectively. For OLGIM 0/I/II/III stages the kappa index values for oriented/unoriented samples were 0.83/0.83, 0.88/0.89, 0.70/0.88 and 0.83/1, respectively. No case of OLGIM IV stage was found in the present case series. Good quality histopathology specimens were described in 95.43% of the oriented biopsy samples, and in 89.14% of the unoriented biopsy samples, respectively (p=0.0275). Conclusion: The orientation of gastric biopsies specimens improves the inter-observer agreement for the assessment of gastric atrophy. [ABSTRACT FROM AUTHOR]

XRCC1 polymorphisms may alter the individual’s capacity to repair DNA damages and may increase the risk for developing different types of cancer, including Non-Hodgkin Lymphoma (NHL). The purpose of our study was to investigate the association between XRCC1 Arg194Trp and Arg399Gln polymorphisms and risk of NHL, in a case-control study consisted of 81 patients with NHL and 113 healthy controls. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods were performed to determine the XRCC1 genotypes. A statistically significant association was observed between the XRCC1 Arg194Trp polymorphism and risk of NHL (p < 0.0001, OR = 7.01, 95% CI = 2.488-19.753) in both male and female. We found no association between NHL and control groups with respect to XRCC1 Arg399Gln polymorphism (p = 0.4867, OR = 1.346, 95% CI = 0.5822-3.111). Also, we did not find differences between the XRCC1 polymorphisms and NHL risk taking into account the IPI score, ECOG performance status, Ann Arbor stage and the treatment outcome (p > 0.05, for all comparisons). Our results suggested an increased risk for NHL regarding the XRCC1 Arg194Trp polymorphism in a Romania population, while XRCC1 Arg399Gln polymorphism is not associated with NHL. Further work is needed to validate these results on a larger sample study.

Introduction: The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre., Material and Methods: This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease., Results: Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57)., Conclusions: In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up.