Search

Imaging is an important tool in the diagnosis and management of infective endocarditis (IE). Echocardiography is an essential examination, especially in native valve endocarditis (NVE), but its diagnostic accuracy is reduced in prosthetic valve endocarditis (PVE). The diagnostic ability is superior for transoesophageal echocardiography (TEE), but a negative test cannot exclude PVE. Both transthoracic echocardiography (TTE) and TEE can provide normal or inconclusive findings in up to 30% of cases, especially in patients with prosthetic devices. New advanced non-invasive imaging tests are increasingly used in the diagnosis of IE. Nuclear medicine imaging techniques have demonstrated their superiority over TEE for the diagnosis of PVE and cardiac implantable electronic device infective endocarditis (CIED-IE). Cardiac computed tomography angiography imaging is useful in PVE cases with inconclusive TTE and TEE investigations and for the evaluation of paravalvular complications. In the present review, imaging tools are described with their values and limitations for improving diagnosis in NVE, PVE and CIED-IE. Current knowledge about multimodality imaging approaches in IE and imaging methods to assess the local and distant complications of IE is also reviewed. Furthermore, a potential diagnostic work-up for different clinical scenarios is described. However, further studies are essential for refining diagnostic and management approaches in infective endocarditis, addressing limitations and optimizing advanced imaging techniques across different clinical scenarios.

Hepatic disorders are considered major health problems, due to their high incidence, increased risk of chronicling or death and the costs involved in therapies. A large number of patients with chronic liver diseases use herbal medicines and dietary supplements in parallel with allopathic treatment. The current review provides a thorough analysis of the studies conducted on the most important species of medicinal plants used in this disease, bioactive compounds and on the activity of herbal medicines in the evolution of chronic liver diseases. However, a negative aspect is that there is frequently a lack of comprehensive data on the progression of the illness and the living standards of patients who are affected when evaluating the effects of these phytocomponents on the evolution of chronic liver disease, the patients' health, and their quality of life. It is essential to take this impairment into account when evaluating the long-term effects of herbal treatments on the health of individuals who suffer from liver illness. Bioactive phytocomponents may be a suitable source for the development of novel medications due to the correlation between traditional uses and medical advances. Additional high-quality preclinical examinations utilizing cutting-edge approaches are needed to assess safety and effectiveness and to detect, categorize, and standardize the active substances and their formulations for the most suitable therapeutic management of liver illnesses.

Interest in functional foods is continuously increasing, having the potential to be an ally in reducing cardiometabolic risk factors. This study focuses on developing and evaluating oat- and millet-based snack bars enriched with freeze-dried elderberry powder (FDEBP), aiming to combine great taste with enhanced nutritional value, antioxidant properties, and prebiotic potential. The research encompassed a sensory evaluation, nutritional assessment, and rheological analysis of the snack bars. A hedonic test was conducted to gauge consumer preferences and overall liking, providing insights into taste, texture, and acceptance. Sensory evaluation revealed positive feedback from participants, and acceptance rating scores ranged from 7 to 8.04, the best score recorded by one of the enhanced bars with 1% FDEBP. The rheological analysis determined the bars’ dynamic storage modulus (G′) and loss modulus (G″), assessing the material’s elasticity and mechanical properties. Results showed that the incorporation of 0.5% and 1% FDEBP in the oat and millet snack bars significantly impacted their rheological properties, enhancing structural strength. Nutritional analysis demonstrated that the snack bars provided a complete mix of macronutrients required in a daily diet. The study sheds light on the potential of functional snack bars enriched with FDEBP, offering a delectable way to access essential nutrients and bioactive compounds in a minimally processed form, without the addition of sweeteners or additives, friendly to the gut microbiota.

Dyspnea is defined by an increased laboured breathing, due to interactions of motor, sen-sory and metabolic nerve impulses, with increased airway resistance, caused by hypox-emia or hypercapnia. Chronic dyspnea presents various causes, respiratory disease, car-diovascular disease, skeletal disease, anaemia, obesity or even physical deconditioning, a condition that persists for more than 4–8 weeks. As for the rehabilitation program, it in-volves the patient’s re-education, the actual physical recovery, change in risk factors and psychological counselling, all leading to the definite improvement of the physical and mental condition, with positive consequences on the quality of life. The rehabilitation pro-gramme applied to increase exercise tolerance in patients with chronic dyspnea can be performed safely; it will also result in an increase in the quality of life of patients. There is a need to develop a strategy for a long-term approach to patients with chronic dyspnea, involving a multidisciplinary team for the constant follow-up of these patients using easi-ly reproducible, feasible and low-cost methods. Rehabilitation therapy in patients with chronic dyspnea uses a set of therapeutic measures, with the aim of restoring greater physical and mental capacity than before the programme.

Ophthalmic disorders consist of a broad spectrum of ailments that impact the structures and functions of the eye. Due to the crucial function of the retina in the vision process, the management of eye ailments is of the utmost importance, but several unmet needs have been identified in terms of the outcome measures in clinical trials, more proven minimally invasive glaucoma surgery, and a lack of comprehensive bibliometric assessments, among others. The current evaluation seeks to fulfill several of these unmet needs via a dual approach consisting of a molecular docking analysis based on the potential of ripasudil and fasudil to inhibit Rho-associated protein kinases (ROCKs), virtual screening of ligands, and pharmacokinetic predictions, emphasizing the identification of new compounds potentially active in the management of glaucoma, and a comprehensive bibliometric analysis of the most recent publications indexed in the Web of Science evaluating the management of several of the most common eye conditions. This method resulted in the finding of ligands (i.e., ZINC000000022706 with the most elevated binding potential for ROCK1 and ZINC000034800307 in the case of ROCK2) that are not presently utilized in any therapeutic regimen but may represent a future option to be successfully applied in the therapeutic scheme of glaucoma following further comprehensive testing validations. In addition, this research also analyzed multiple papers listed in the Web of Science collection of databases via the VOSviewer application to deliver, through descriptive analysis of the results, an in-depth overview of publications contributing to the present level of comprehension in therapeutic approaches to ocular diseases in terms of scientific impact, citation analyses, most productive authors, journals, and countries, as well as collaborative networks. Based on the molecular docking study’s preliminary findings, the most promising candidates must be thoroughly studied to determine their efficacy and risk profiles. Bibliometric analysis may also help researchers set targets to improve ocular disease outcomes.

Ocular diseases can significantly impact vision and quality of life through pathophysiological alterations to the structure of the eye. The management of these conditions often involves a combination of pharmaceutical interventions, surgical procedures, and laser therapy. Laser technology has revolutionized many medical fields, including ophthalmology, offering precise and targeted treatment options that solve some of the unmet needs of other therapeutic strategies. Conventional laser techniques, while effective, can generate excessive thermal energy, leading to collateral tissue damage and potential side effects. Compared to conventional laser techniques, micropulse laser therapy delivers laser energy in a pulsed manner, minimizing collateral damage while effectively treating target tissues. The present paper highlights the advantages of micropulse laser therapy over conventional laser treatments, presents the implications of applying these strategies to some of the most prevalent ocular diseases, and highlights several types and mechanisms of micropulse lasers. Although micropulse laser therapy shows great potential in the management of ocular diseases, further research is needed to optimize treatment protocols, evaluate long-term efficacy, and explore its role in combination therapies.

Rheumatoid arthritis (RA) is a heterogeneous inflammatory disease with an autoimmune origin and an incompletely elucidated pathophysiological mechanism. RA pharmacotherapy is based on chemically or biologically active substances that provide clinical alleviation and remission, but the disease is still incurable. As a result, there remains a need for significant therapeutic development, and adjuvant therapies may play an essential role in the search for novel RA treatment strategies. The aim of the present study was to investigate potential phytocompounds and phytocompound derivates as RA treatment agents, using in silico methodologies. In this regard, five phytoconstituents identified in different structures of Embelia ribes were evaluated by in silico methods for their potential action on target proteins of therapeutic interest in RA. The methodology involved identifying the phytocompound with the highest binding toward the target protein via molecular docking using AutoDock Vina 1.5.7, followed by a ligand-based virtual screening based on the structure of the most promising phytocompound using SwissSimilarity. This process led to the identification of ligands that are not currently utilized in medical practice, but that might have the potential to be used in the management of RA after further extensive experimental endorsements. ZINC000004024651 showed the highest binding affinity for the Bruton’s tyrosine kinase protein, followed by ZINC000000434197 for p38 mitogen-activated protein kinases, ZINC000087606977 for interleukin-1 receptor-associated kinase 4, and ZINC000014728393 for matrix metallopeptidase 9, the latter two showing higher affinity than the co-crystallized compound. The relatively high affinities to target proteins and the pharmacokinetic data obtained by in silico studies using SwisADME suggest a first step for the inclusion of promising new compounds in various more advanced studies, leading to the evaluation of efficacy and safety profiles.

Background: Temporomandibular joint (TMJ) is responsible for vital functions like mas-tication, swallowing, and suction reflex and other relational functions, like talking and phonation. The etiology of temporomandibular joint disorders is multifactorial and in-volves subjective and objective clinical symptomatology. (2) Methods: The therapy is complex and encompasses a series of methods that interconnects various medical spe-cialties. Bad habits and parafunction are risk factors that may initiate and exacerbate a temporomandibular joint pathology. This prospective study aimed to show the positive impact of correct multidisciplinary therapy on the complex of TMJ disorders - pain and bad oral behaviors. The therapy methods used in this study were: medical, prosthetic, or-thodontic, surgical, and physiotherapy (PKT). (3) Results: The data obtained showed good results if the oral habits and TMJ disorders are treated correctly and simultaneous-ly. (4) Conclusions: All therapeutical approaches addressed in this study had beneficial effects on the recovery of the temporomandibular joint.

It is considered that COVID-19’s pandemic expansion is responsible for the particular increase in deaths, especially among the population with comorbidities. The health system is often overwhelmed by the large number of cases of patients addressing it, by the regional limitation of funds, and by the gravity of cases at subjects suffering from this pathology. Several associated conditions including diabetes, cardiovascular illnesses, obesity, persistent lung condition, neurodegenerative diseases, etc., increase the mortality risk and hospitalization of subjects suffering from COVID-19. The rapid identification of patients with increased risk of death from the SARS-CoV-2 virus, the stratification in accordance with the risk and the allocation of human, financial, and logistical resources in proportion must be a priority for health systems worldwide.

Increased environmental pollution, urbanization, and a wide variety of anthropogenic activities have led to the release of toxic pollutants into the environment, including heavy metals (HMs). It has been found that increasing concentrations of HMs lead to toxicity, mineral imbalances, and serious diseases, which are occurring more and more frequently. Therefore, testing has become imperative to detect these deficiencies in a timely manner. The detection of traces of HMs, especially toxic ones, in human tissues, various biological fluids, or hair is a complex, high-precision analysis that enables early diagnosis, addressing people under constant stress or exposed to a toxic environment; the test also targets people who have died in suspicious circumstances. Tissue mineral analysis (TMA) determines the concentration of toxic minerals/metals at the intracellular level and can therefore determine correlations between measured concentrations and imbalances in the body. Framing the already-published information on the topic, this review aimed to explore the toxicity of HMs to human health, the harmful effects of their accumulation, the advantages vs. the disadvantages of choosing different biological fluids/tissues/organs necessary for the quantitative measurement of HM in the human body, as well as the choice of the optimal method, correlated with the purpose of the analysis.

Adequate therapeutic intervention performed in the case of extradural spinal AVM and an inten-sive recovery program allow the amelioration of neurological manifestations in a very high percentage. With the ultimate goal of practicing a trade, a good biological recovery is needed for social recovery. The effectiveness of strategies for professional integration and reintegration de-pends largely on the patient’s experiences before the onset of the disease. The paper aims to re-view the treatment, the evolution of patients with extradural spinal AV and the possibilities of socio-professional reintegration. Methods and analysis. A case presentation of a patient diag-nosed with extradural spinal AV fistula is proposed, along with a review of the current literature on the treatment of this pathology, the evolution and the possibilities of vocational recovery. The studies will be analysed and selected in two stages, in the first stage the titles and abstracts, in the second stage, the articles with full text will be analysed, selected and a narrative synthesis of the included studies will be made. Summary case. The 51-year-old urban patient, a profes-sional driving instructor who underwent endovascular and surgical treatment for extradural spinal AV fistula, is hospitalized for a moderate motor deficit, such as paraparesis, back pain, mechanical pain in the knees and gait disorders. The objectives of recovery are represented by neuromotor recovery and socio-professional reintegration. Conclusions. Spinal EAVFs are rare lesions with a low risk of bleeding; the clinical manifestations are determined by the compres-sion of the bone marrow; these being significantly improved after the endovascular and surgical treatment. Studies show a good long-term prognosis, which is determined by the absence of re-currences. An essential role in the integration of patients with disabilities in the socio-professional life is the identification of their deficiencies and their reorientation according to the outstanding abilities, the stimulation of the preserved skills.