Hepatitis B virus associated cirrhosis: overview of prognostic and management

Hepatitis B virus (HBV) infection is a global public health problem ; two billion people worldwide have evidence of past or present infection with HBV, and 296 million individuals are chronic carriers (i.e., positive for hepatitis B surface antigen [HBsAg]), of whom approximately 887,000 dies annually from HBV-related liver disease: chronic hepatitis B-associated cirrhosis and hepatocellular carcinoma. There are described some risk factors to the development of cirrhosis to HBV-infected persons: alcohol consumption, HBeAg status, metabolic syndrome, HBV genotypes and variants, and the level of HBV replication. The observation of a strong association between the development and decompensation of cirrhosis as well as between the development of HCC and the level of HBV replication suggests that suppression of HBV replication by long-term antiviral treatment may decrease the risk of complications in patients with HBV-related cirrhosis. The indication for antiviral treatment is given if any HBV DNA levels are detectable in the serum of HBV-infected patients with cirrhosis. Into the new era of antiviral treatment with nucleos(t)ide analogs we can prevent the development of cirrhosis in patients with chronic HBV infection and hepatic decompensation in many patients with HBV-related cirrhosis

Banat-Crişana as Micro-destination – Elements of Tourism Image and Tourism Identity

Geographical regions, according to some authors, are defined and delimited by criteria that vary from one geographical school to another. These criteria may be: scenic, functional, political-administrative, mental etc. (processed after Cocean cited in Neguţ, 2011, p. 157). They also can be combined according to the objectives/strategies that are elaborated for each branch of the economy: industry, agriculture, tourism, etc. In this regard, from tourism point of view, the region of Banat-Crişana was taken into consideration, that includes the following counties: Caraş-Severin, Timiş, Arad and Bihor. Due to the many land and air border points, it represents the first contact with the tourists coming from the West, with other words “its visiting card… crucial in formulating the first impressions regarding Romania” (Cocean, 2010, p. 201). The presented research aims to highlight the role of the image of the region of Banat-Crişana in building its own brand, by identifying its main tourist attractions and forms of tourism

ESTIMATING THE YIN-YANG NATURE OF WESTERN HERBS: A POTENTIAL TOOL BASED ON ANTIOXIDATION- OXIDATION THEORY

Background : One of the biggest obstacles to progress in traditional Chinese medicine (TCM) development in Western countries is the difficulty of applying the traditional concepts to the Western medicinal plants, which are not traditionally described in ancient literature. During recent years, new advances in the field of understanding Yin/Yang aspects from a modern bioscientific point of view have led to the conclusion that antioxidation-oxidation concepts might mirror a Yin-Yang relationship. Methods: This study was intended to integrate the Yin-Yang theory of the traditional Chinese medicine with modern antioxidation-oxidation theory, and to propose a biochemical tool based on redox parameters (e.g. antioxidant capacity, chemiluminescence-CL signal inducing capacity), usable for the classification of Western medicinal plants from Yin/Yang perspective. Trolox equivalent antioxidant capacity (TEAC) of six vegetal aqueous extracts (Symphitum officinalae (radix)- SYM, Inula helenium (radix)- INU, Calendula officinalis (flores)- CAL, Angelica arhanghelica (folium)- ANG(F), Angelica arhanghelica (radix)- ANG(R), Ecbalium Elaterium (fruits)- ECB) and luminol-enhanced chemiluminescence of PMNL on addition of these vegetal extracts were measured. Percentages from the maximal or minimal values obtained were calculated for each extract (TEAC%, PMNL stimulation%, PMNL inhibition%, relative speed of action% (RSA%%)), specific Yin-Yang significance was assigned to each relative parameter. In the end, an integration of all the relative values was done, in order to find a global ”Yin” or a ”Yang” trait of each vegetal extract. Results: TEAC decreased in the following order: SYM > INU > CAL >ANG(F) > ANG(R > ECB. Three vegetal extracts (SYM > INU > ECB) decreased the luminol-enhanced chemiluminescence of PMNL, two (ANG(R) > ANG(F)) increased it, while one (CAL) had a dual effect. After the integration of the percentages, CAL was found to have a global ”Yang” trait, while the rest of the plants had a global ”Yin” trait. Conclusions: TEAC% and PMNL inhibition% appears to correlate with the Yin properties of herbs, while PMNL stimulation% and RSA% might correlate with Yang aspects within the formal TCM classification system, and may be useful criteria in describing the Western herbs from a TCM point of view

Alcoholic liver cirrhosis, more than a simple hepatic disease – A brief review of the risk factors associated with alcohol abuse

Liver cirrhosis is a significant public health problem, being an important cause of mortality and morbidity, responsible for approximately 1.8% of the total number of deaths in Europe. Chronic alcohol consumption is the most common cause of liver cirrhosis in developed countries. Europe has the highest level of alcohol consumption among all the global World Health Organisation (WHO) regions. In this paper, we briefly review major factors leading to excessive alcohol consumption in order to draw attention to the fact that alcoholic liver cirrhosis is more than a simple liver disease, and if those risk/causal factors can be prevented, the incidence of this disease could be reduced greatly. Although excessive alcohol consumption is regarded as the cause of alcoholic liver cirrhosis, the etiology is complex, involving multiple factors that act in synchrony, and which, if prevented, could greatly reduce the incidence of this disease. Children of addicts are likely to develop an alcohol-related mental disorder; however, there is no “gene for alcoholism”

OSTEOPROTECTIVE MEDICINAL PLANTS - PART 1 (A HUMAN CLINICAL EVIDENCE-BASED REVIEW)

Background. Osteoporosis is a bone metabolic disease affecting a large percentage of aging population, which leads to an increased risk of fractures and has a negative impact on life quality. The available treatments for osteoporosis are effective, but are associated with several severe adverse reactions, hence the interest for alternative treatments devoid of such redoubtable side effects. Medicinal plants represent a viable resource for new therapeutic agents. The purpose of this review is to provide an overview about the medicinal plants that have been reported to have anti-osteoporotic effects in human clinical studies. Materials and Methods. Relevant studies found in PubMed database, pertaining to efficacy in humans, mechanism of action, osteoactive phytochemicals and safety, were selected. For the inquiry, keywords such as “medicinal plant”, “osteoporosis”, “bone”, “fracture”, “osteoclast” and “osteoblast” were used in various combinations. The information extracted was integrated with the traditional knowledge on the correspondent medicinal plants. Results. Eight medicinal plants (Cimicifuga racemosa, Cissus quadrangularis, Eleutherococcus senticosus, Epimedium spp., Glycine max, Pueraria spp., Panax notoginseng, Salvia milthiorriza) were selected. Mechanisms involved include the activation of osteoblasts, inhibition of osteoclastogenesis, estrogen-like activity, anti-inflammatory activity, inhibition of collagen degradation by cathepsin K. Conclusion. Several medicinal plants have been included in clinical studies successfully targeting osteoporosis, thus showing the potential to modulate bone resorption and bone formation

Is a Fecal Microbiota Transplant Useful for Treating Inflammatory Bowel Disease?

Ulcerative colitis and Crohn’s disease represent the major groups of idiopathic disorders in inflammatory bowel disease (IBD). The etiology includes environmental factors, genetic factors, and immune responses. The pathogenesis is diversified; however, no guaranteed curative therapeutic regimen has been developed so far. This review contains information related to pathophysiology and current treatment options for IBD. It is known that IBD is caused by tissue-disruptive inflammatory reactions of the gut wall; that is why downregulation of the immune responses allows the healing of the damaged mucosa and allows the resetting of the physiological functions of the gut back to normal. The main treatment options are still corticosteroids, immunomodulators, antibiotics, probiotics, and a series of new agents. Their effects include modulation of cytokines, neutrophil-derived factors, adhesion molecules, and reactive oxygen/nitrogen metabolites. The monoclonal antitumor necrosis factor as infliximab recombinant anti-inflammatory cytokines or related gene therapy is also used nowadays. Still, the fecal microbiota transplantation (FMT) is considered to revolutionize the therapy in IBD, considering the abnormal inflammatory response due to the complicated relationship between microbiota and the immune system. It is imperative to mention the critical role dysbiosis may have in the pathogenesis of IBDs. This review summarizes the available literature concerning the efficacy of FMT in IBDs

Alcoholic liver cirrhosis, more than a simple hepatic disease – A brief review of the risk factors associated with alcohol abuse

Liver cirrhosis is a significant public health problem, being an important cause of mortality and morbidity, responsible for approximately 1.8% of the total number of deaths in Europe. Chronic alcohol consumption is the most common cause of liver cirrhosis in developed countries. Europe has the highest level of alcohol consumption among all the global World Health Organisation (WHO) regions. In this paper, we briefly review major factors leading to excessive alcohol consumption in order to draw attention to the fact that alcoholic liver cirrhosis is more than a simple liver disease, and if those risk/causal factors can be prevented, the incidence of this disease could be reduced greatly. Although excessive alcohol consumption is regarded as the cause of alcoholic liver cirrhosis, the etiology is complex, involving multiple factors that act in synchrony, and which, if prevented, could greatly reduce the incidence of this disease. Children of addicts are likely to develop an alcohol-related mental disorder; however, there is no “gene for alcoholism”

SOLIDWORKS 3D PARAMETRIC MODELLING TECHNIQUE FOR ROOT CUTTING EQUIPMENT DECLINING GROWTH OF SHOOTS IN ORCHARDS

This work was focused, by using computer aided engineering application (SolidWorks) and structural simulation (SolidWorks SIMULATION), on obtaining a technical and economic strength indicator used in the analysis of metallic material choice from which is made active body large diameter disc knife type, that equips the technical equipment for soil tillage on trees row, while cuttings root for moderating growth of shoots and precision foliar fertilization. For this purpose, on the 3D parametric modeling were selected from the software library various metallic materials, followed by finite element analysis (FEA) which was carried out to simulate the distributions of stress and strain on the body active. Based on the resulting data, were determined the reports price- coefficient of resistance for the materials analyzed. Comparing these indicators led to the selection of a material that has high resistance under a price as low as possible. Analysis based on technical and economic choice of a metallic material reduces the time validation of the design, by eliminating the realization and physical testing, and allows management to determine the existing resources in the company in order to use their total for achieve economic and financial results as high

A clinical approach of renal involvement in granulomatosis with polyangiitis

Granulomatosis with polyangiitis (GPA, Wegeners granulomatosis) is one of the antineutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis involving various organs such as nasal septum, sinuses, upper respiratory tract, lungs, and kidneys. GPA is pathologically characterized by necrotizing granulomatous inflammation ANCA-associated small vessel vasculitis represent a major challenge in hospital admissions; therefore, early and accurate diagnosis with aggressive treatment is essential to improve the disease outcome. Renal involvement of Granulomatosis with Polyangiitis is characterized morphologically by extensive crescent formation (extracapillary proliferation in Bowman's space), and clinically by crescentic or rapidly progressive glomerulonephritis that causes hematuria, erythrocyte casts, and proteinuria with progressive loss of renal function. The diagnosis of Granulomatosis with Polyangiitis is established most securely by biopsy specimens showing the triad of vasculitis, granulomata, and large areas of necrosis (known as geographic necrosis) admitted with acute and chronic inflammatory cells. Usually, renal involvement is severe and is the leading cause of mortality. The combination of high-dose corticosteroids and cyclophosphamide is the mainstay of treatment for vasculitis and disease resistance to this combination is rare

Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis

This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors