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    Cover Art for TGLE Vol. 56 Nos 3 & 4

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    Cover Art for TGLE Vol. 56 Nos 3 &

    A new approach to balance dental fear and anxiety by using BachTM Flower Therapy

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    Treatments in dentistry currently consist of an interdisciplinary approach, including (but not necessarily limited to) the holistic perspective. The different fields of allopathic and complementary medicine are used together to ensure not only a high-quality restorative treatment, but also to provide patients with psychological and emotional support. This perspective also applies to dental anxiety, which consists of complex (emotional, vegetative and psychomotor) manifestations. One of the most well-known complementary therapies for reducing dental fear and anxiety is BachTM Flower Therapy. Even if the mechanism of action of this therapy is not yet scientifically documented, notable results have been and continue to be reported in the literature in several clinical studies on patients with dental diseases. It is indicated for both adults and children, in the latter when they go through major biological changes, such as primary and permanent dentition. As a conclusion, BachTM flower therapy is effective and complementary to dental treatments applied to patients, by reducing stress, anxiety, as well as creating a climate of peace, trust and confidence, both for the patient and the doctor. In addition, it is a relatively accessible and cheap form of care, with no significant adverse effects noted so far

    ERCP extraction of stones in situs inversus patients; state-of-the-art techniques

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    Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a pathology and the lack of medical information on this topic. Once the diagnosis is established, through endoscopic ultrasound and MRCP, the patient is sent to perform ERCP, which requires tailored approaches for each case. We present the case of a 33-year-old patient who was previously documented with SIT. On admission she presented with abdominal pain and fever that started a week before presentation, so antibiotic therapy was initiated. Imaging investigations revealed intrahepatic gallstones, so she underwent ERCP the next day with the identification of an intrahepatic bile lake containing stones within. Naso-biliary drainage was placed and further 2 ERCP procedures followed, with the insertion of 3 plastic biliary stents. The evolution was favorable, until the complete removal of gallstones and remission of clinical symptoms. The patient was carefully monitored in the following two days and the stents were removed, being later discharged and monitored for a period of 6 months in which no biliary/digestive symptoms were noted

    Major Northeastward Range Extension for a Western Grasshopper Species: New State Record for Trimerotropis pallidipennis (Burmeister) in Wisconsin

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    Trimerotropis pallidipennis (Burmeister) mostly occurs in the southwestern U.S., but is known to migrate significant distances periodically. It appears that some individuals of this species occasionally migrate very long distances. Here I present an extreme record for this species, over 480 km northeast of any previously known records, including any others recorded from 2022. A single male specimen was collected and photographed in Price County in north-central Wisconsin in June 2022

    Synchronous cervical sympathetic chain schwannoma, parathyroid adenoma and hypofunctional nodular goiter - a case report and literature review

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    Simultaneously diagnosing cervical sympathetic chain schwannoma, nodular goiter and parathyroid adenoma is a very rare event during clinical practice. We had the opportunity to find this unusual association on a female patient. While nodular goiter and parathyroid adenoma are more common diseases and easier to diagnose, identifying the etiology of a parapharyngeal space tumor remains a challenge and requires multiple imaging studies such as computed tomography scan, magnetic resonance imaging or angiography. A cervical sympathetic chain schwannoma, a carotid body tumor, a paraganglioma or a vagal schwannoma must be taken into account as possible diagnostic variants. Complaints such as Horner`s syndrome, hoarse voice or dysphagia may suggest a nerve originating tumor, but this is a rare situation. Only the surgical exploration is successful in detecting the tumor origin from the cervical sympathetic chain. Even so, the exact origin of the tumor cannot usually be detected without surgical exploration and removal of the piece or biopsies. Therefore, the pathological report of the specimen (adding or not immunohistochemistry tests) is mandatory to be able to confirm the diagnosis of schwannoma

    Letras 16

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    Effect of continuous renal replacement therapy on serum levels of inflammatory cytokines/interleukin-17 in severe acute pancreatitis

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    Despite continuous investigations in the diagnosis and treatment of severe acute pancreatitis (SAP), this disease still remains a critical condition with a mortality rate of up to 35%. The pathophysiology of SAP involves an important inflammatory reaction of the pancreas (mediated by inflammatory cytokines and immune system activation), causing severe local tissue damage as well as important systemic imbalances. IL-17 is an inflammatory mediator that have a pivotal role in SAP evolution, generating multiple interactions between inflammatory cytokines and significantly influencing the immune system response. Consequently, continuous renal replacement therapy/CRRT was added to the conventional therapy, leading to improved treatment results. This review aims to evaluate the involvement of Interleukin 17 in the diagnosis, pathogenesis and evolution of SAP, as well as the role of CRRT in reducing elevated serum levels of IL-17. As a conclusion, CRRT is a promising method to eliminate cytokine mediators from the blood, thus leading to a reduction of both pancreatic/peripancreatic tissue damage and systemic imbalances in severe acute pancreatitis, being strongly correlated with better therapeutic outcomes

    Medical and psychological management of patients with a history of surgical treatment for pancreatic diseases

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    Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are expected to raise the incidence of pancreatic cancer, further challenging healthcare systems. Methods. The general objective of this study was to analyze doctors\u27 experiences regarding the health status of patients with benign pancreatic pathology who underwent surgery and were admitted to CF2 Clinical Hospital in Bucharest. The research involved a specialized questionnaire addressing various aspects of patient health, including mobility, pain intensity, psycho-emotional state, and prognosis. The study also included a protocol evaluating patients based on criteria like symptomatology, treatment, and postoperative complications. Results. The findings show significant discrepancies between patients\u27 perceptions and doctors\u27 evaluations in quality-of-life domains, with some positive correlations. The statistical analysis, including reliability, alpha, mean, and standard deviation, underscores these differences. Respondents reported a relatively good perception of their overall health state, and a moderate perception of their level of social functioning. The correlation between patients\u27 perceptions and medical evaluations of mental health was 0.423, indicating a moderate but not necessarily significant relationship. Conclusions. The study reveals that physicians recognize the multifaceted challenges faced by patients with surgically treated pancreatic diseases. It emphasizes the need for a comprehensive approach to patient care, addressing physical, emotional, and social aspects. The study also highlights the importance of early detection and the complexity of doctor-patient interactions in pancreatic cancer treatment

    Genetic and serological markers in colorectal cancer surgery

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    Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic markers in the management of patients with colon cancer, focusing on carcinoembryonic antigen, mismatch repair deficiency (dMMR), as well as KRAS and BRAF mutations. As a preliminary conclusion, tumor biomarkers seem to have a significant contribution to the diagnosis, decisions related to operative management, prognosis and postoperative follow-up of colon cancer, both in the categories of patients from high-risk groups and those without a clear predisposition to this condition

    The Ring Cycle: Journeying Through the Language of Tolkien’s Third Age with Corpus Linguistics

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    This article explores the journey taken by the One Ring across J.R.R. Tolkien’s Third Age writings. It employs a digital humanities approach to analyse linguistic patterns in Tolkien’s use of the word ring, across The Hobbit and The Lord of the Rings. Specifically, the article employs corpus linguistic methods to track shifts in the quantities and qualities of the Ring’s appearance across these texts. It uses techniques of keyness and collocation analysis to trace transformations in these quantities/qualities, including: a) the Ring’s transition from a central to a peripheral place in the Third Age’s narrative arc; and b) the Ring’s progress from a magical to a burdensome device, via the evolving lexical fields within which Tolkien operationalised it. Cumulatively, these transformations point to the gradual disenchantment of Tolkien’s world, across his writings: with this world falling from a child-like state of mystery, adventure, and faerie, to one of darkness, hierarchy, and amnesia. These findings contribute to Tolkien studies, specifically, as well as to literary studies’ digital turn more broadly. Firstly, they uncover the hidden wiring of Middle-earth’s linguistic development – using computational readings to map Tolkien’s unfolding language use, in ways that build upon intuitive human interpretations. Secondly, they reveal possibilities of digital text analysis – demonstrating how statistical techniques might be used, alongside in-depth qualitative readings, to “pop the bonnet” on authors’ language choices/styles

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