Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference

ACUTE ACALCULOUS CHOLECYSTITIS WITH GALLBLADDER PERFORATION IN CHILDREN – CASE REPOR

Although relatively common in adult pathology, acute acalculous cholecystitis with gallbladder perforation is a rather infrequent entity in pediatric practice. In many cases, its unspecifi c clinical symptoms and the often inconclusive medical imagining results lead to the diagnosis of acute acalculous cholecystitis being set intraoperatively. Nevertheless, this condition should be considered when setting the differential diagnosis of a peritonitis syndrome in children

DRUG INDUCED ACUTE TUBULAR NECROSIS – RARE CASE OF NEPHROTIC SYNDROME

We presented two cases of nephrotic syndrome (NS) drug-induced with tubular nephrotoxicity, with different evolution in the context of etiologic diseases. First is 5-month-old girl admitted with NS (clinically and biological proven) and acute renal failure after another hospitalization for pneumonia. The girl was treated with ceftriaxone and gentamicin 12 days. Congenital NS suspicion was eliminated by renal biopsy who revealed renal tubular necrosis highlighting recovery phase. The development was favorable in 7 days of peritoneal dialysis. The second case was 16 years old adolescents treated 3 years with carbimazol for Basedow disease. Was presented with nephrotic syndrome not influenced by corticosteroids. Histopathology revealed toxic tubular necrosis, interstitial fibrosis, absence of glomerular injury. Nephrotoxic treatment was stopped, and, after thyroidectomy, edema were reduced, but kidney function continued to depreciate, while nephrotoxic therapy given for 3 years. Conclusions. Renal tubular necrosis clinical and laboratory expressed by nephrotic syndrome, accompanied by renal insufficiency is a rare occurrence in children; gentamicin and carbimazol can be criminalized. The suffering or impairment may be improved by removing the causative drug. Treatment failure was associated with duration of drug aggression and evolution of comorbidities

Sustainability Reporting as a Mixture of CSR and Sustainable Development. A Model for Micro-Enterprises within the Romanian Forestry Sector

In the last decades, the issue of the behavior geared towards society and the environment of small and medium-sized enterprises (SMEs) has created a new niche for economic researches. Most studies point out that entities operating in the forestry sector, despite having difficulties in applying valid corporate social responsibility (CSR) instruments, are concerned about the role they play in society. Therefore, they tend to develop their business by giving importance to the principles of sustainable development. The aim of the paper was to propose an econometric model to report the sustainability of non-financial performance for the companies operating in the forestry field. The main objectives of the study focused on defining and analyzing the studied problem through the specialized literature, defining and conceptualizing the statistical model in order to identify the risk factors and vulnerability, influencing the forestry sector in Romania. In this context, based on a sample of 248 Romanian active companies in the forestry sector in four distinct sectors, we calculated a number of indicators specific to the forestry sector in order to identify the risks and vulnerabilities and analyze the entities associated with this sector. Our research led us to the conclusion that, as far as the forestry sector is concerned, the companies that operate in Statistical classification of economic activities in the European Community (NACE) 240 and NACE 210 have registered superior results compared to the average in regards to the vulnerability of the sector, while those that operate in NACE 220 and NACE 230 focus mostly on those vulnerabilities regarding the risk zone of their sustainable development. The study could be useful both to stakeholders by giving them the possibility to identify those entities, classified according to the NACE code, taking into account the sector vulnerabilities and the risks associated with the profile market, as well as to the state that could influence through economic policies the sectors in which vulnerabilities are manifested

A NEW INCOME IN PEDIATRIC PATHOLOGY: GASTROENTERO‐ PANCREATIC NEUROENDOCRINE TUMORS. II: CARCINOID TUMORS

Carcinoid tumors are classified according to their embryologic origin, that might be the foregut (stomach, duodenum, biliary tree and also lung, thymus, thyroid), the midgut (ileum, right colon) and the hindgut (left colon and rectum). The clinical picture of these lesions is varia‐ ble, evidencing completely asymptomatic cases, symptoms due to complications (acute appendicitis, peritonitis, obstructions or hemorrhages) or sudden apparition of car‐ cinoid syndromes. The diagnosis includes urinary 5 – HIAA, chromogranine A dosage and Ki‐67 expression, as well as localising studies, such as echoendoscopy, video‐ capsule and enteroscopy, CT, MRI, selective abdominal angiography, somatostatin‐receptor‐scintigraphy (Octre‐ oscan, SRI). Coronal contrast‐enhanced CT or MRI angio‐ gram can evaluate the mesenteric vessels spread before surgery. Upper endoscopy or/and colonoscopy can be performed to detect foregut or hindgut lesions. The treat‐ ment is based on surgery and other removal techniques, such as cryoablation and radiofrequency ablation, tradi‐ tional drugs: streptozocin, 5‐fluorouracyl, doxorubicin, cyclophos phamide, mitomicycin, metrotrexate together with somatostatin analogs; the future belongs to radionu‐ clide‐radiopeptide therapy

Support and feedback services version 2

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Deliverable 5.3 LTfLL – Learning support and feedback

This report presents Version 1.5 of the Learning support and feedback services (delivering recommendations based on interaction analysis and on students’ textual production) that can be integrated within an e-learning environment