SIDE EFFECTS AND PROGNOSIS WITH THE TREATMENT OF PEMPHIGUS VULGARIS

Pemphigus vulgaris is an autoimmune bullous dermatosis that affects between 0,1 and 0,5%000 of the population. The prognosis of the disease is determined by the severity of the side effects of corticosteroid therapy and their compensation. The present study covered 52 patients with pemphigus vulgaris treated in the Clinic of Dermatology and Venereology, Prof. P. Stoyanov Medical University of Varna, during a 10-year period (1990-2000). There were 20 males aged between 28 and 86 years and 32 females aged between 17 and 77 years. The adverse effects of the corticosteroids in the patients with pemphigus vulgaris and their influence on the course of the disease were  described. The combination with a cytostatic drug (cyclophosphamide or imuran) proved to be  effective in reducing the total course and maintenance dosage of the corticostteroids in these  patients

EPIDEMIOLOGICAL, DIAGNOSTIC AND THERAPEUTIC PROBLEMS OF GONORRHOE

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Sacral nerve stimulation in patients with ileal pouch-anal anastomosis

Purpose: Functional results after proctocolectomy and ileal pouch-anal anastomosis (IPAA) are generally good. However, some patients suffer from high stool frequency or fecal incontinence. Sacral nerve stimulation (SNS) may represent a therapeutic alternative in these patients, but little is known about indication and results. The aim of this study was to evaluate incontinence after IPAA and demonstrate SNS feasibility in these patients. Methods: This retrospective study includes patients who received a SNS between 1993 and 2020 for increased stool frequency or fecal incontinence after proctocolectomy with IPAA for ulcerative colitis. Proctocolectomy was performed in a two- or three-step approach with ileostomy closure as the last step. Demographic, follow-up data and functional results were obtained from the hospital database. Results: SNS was performed in 23 patients. Median follow-up time after SNS was 6.5 years (min. 4.2-max. 8.8). Two patients were lost to follow-up. The median time from ileostomy closure to SNS implantation was 6 years (min. 0.5-max. 14.5). Continence after SNS improved in 16 patients (69%) with a median St. Marks score for anal incontinence of 19 (min. 4-max. 22) before SNS compared to 4 (0-10) after SNS placement (p = 0.012). In seven patients, SNS therapy was not successful. Conclusion: SNS implantation improves symptoms in over two-thirds of patients suffering from high stool frequency or fecal incontinence after proctocolectomy with IPAA. Awareness of the beneficial effects of SNS should be increased in physicians involved in the management of these patients

Electrochemical testing of an innovative dual membrane fuel cell design in reversible mode

Solid oxide fuel Cells (SOFC) are intrinsically reversible which makes them attractive for the development of reversible devices (rSOC). The main hurdles that have to be overcome are the higher degradation in electrolyzer (EL) mode and the slow and difficult switching form mode to mode. This work aims at the development and experimental validation of a concept for rSOC based on a new dual membrane fuel cell (dmFC) design which can overcome the existing problems of the classical SOFC. The kernel of the system is additional chamber - central membrane (CM) for water formation/evacuation in FC mode and injection in El mode. Its optimization in respect of microstructure and geometry in laboratory conditions is carried out on button cells. The electrochemical performance is evaluated based on volt-ampere characteristics (VACs) combined with impedance measurements in different working points. The influence of a catalyst in the water chamber is also examined. The VACs which give integral picture of the cell performance are in excellent agreement with the impedance studies which ensure deeper and quantitative information about the processes, including information about the rate limiting step. The results from the optimization of the water chamber show that the combination of design and material brings to important principle advantages in respect to the classical rSOC \u2013 better performance in electrolyzer mode combined with instantaneous switching

Estimation of errors in text and data processing

The company Adiss Lab Lts. obtained 1 000 000 medical reports that are either in free form text, or in XML format. One of the main goals of their development is to integrate an algorithm for information extraction (IE) in their platform. The verification of the algorithm’s output for a report is done by a medical doctor (MD) for a certain fee. Validating the correctness of all data would be overwhelming and very expensive. Hence, the problem, as presented by the company, is to provide a method (algorithm) which determines the minimum amount of reports that will validate the correctness of the IE algorithm and a procedure for selecting these reports. In order to solve the problem we have considered an algorithm-centric approach uses active learning and semi-supervised learning

Enhancing Timeliness of Drug Overdose Mortality Surveillance: A Machine Learning Approach

BACKGROUND: Timely data is key to effective public health responses to epidemics. Drug overdose deaths are identified in surveillance systems through ICD-10 codes present on death certificates. ICD-10 coding takes time, but free-text information is available on death certificates prior to ICD-10 coding. The objective of this study was to develop a machine learning method to classify free-text death certificates as drug overdoses to provide faster drug overdose mortality surveillance. METHODS: Using 2017–2018 Kentucky death certificate data, free-text fields were tokenized and features were created from these tokens using natural language processing (NLP). Word, bigram, and trigram features were created as well as features indicating the part-of-speech of each word. These features were then used to train machine learning classifiers on 2017 data. The resulting models were tested on 2018 Kentucky data and compared to a simple rule-based classification approach. Documented code for this method is available for reuse and extensions: https://github.com/pjward5656/dcnlp. RESULTS: The top scoring machine learning model achieved 0.96 positive predictive value (PPV) and 0.98 sensitivity for an F-score of 0.97 in identification of fatal drug overdoses on test data. This machine learning model achieved significantly higher performance for sensitivity (p \u3c 0.001) than the rule-based approach. Additional feature engineering may improve the model’s prediction. This model can be deployed on death certificates as soon as the free-text is available, eliminating the time needed to code the death certificates. CONCLUSION: Machine learning using natural language processing is a relatively new approach in the context of surveillance of health conditions. This method presents an accessible application of machine learning that improves the timeliness of drug overdose mortality surveillance. As such, it can be employed to inform public health responses to the drug overdose epidemic in near-real time as opposed to several weeks following events

Impact of non‐CNS childhood cancer on resting‐state connectivity and its association with cognition

Introduction Non‐central nervous system cancer in childhood (non‐CNS CC) and its treatments pose a major threat to brain development, with implications for functional networks. Structural and functional alterations might underlie the cognitive late‐effects identified in survivors of non‐CNS CC. The present study evaluated resting‐state functional networks and their associations with cognition in a mixed sample of non‐CNS CC survivors (i.e., leukemia, lymphoma, and other non‐CNS solid tumors). Methods Forty‐three patients (off‐therapy for at least 1 year and aged 7–16 years) were compared with 43 healthy controls matched for age and sex. High‐resolution T1‐weighted structural magnetic resonance and resting‐state functional magnetic resonance imaging were acquired. Executive functions, attention, processing speed, and memory were assessed outside the scanner. Results Cognitive performance was within the normal range for both groups; however, patients after CNS‐directed therapy showed lower executive functions than controls. Seed‐based connectivity analyses revealed that patients exhibited stronger functional connectivity between fronto‐ and temporo‐parietal pathways and weaker connectivity between parietal‐cerebellar and temporal‐occipital pathways in the right hemisphere than controls. Functional hyperconnectivity was related to weaker memory performance in the patients' group. Conclusion These data suggest that even in the absence of brain tumors, non‐CNS CC and its treatment can lead to persistent cerebral alterations in resting‐state network connectivity

Natural chain-breaking antioxidants and their synthetic analogs as modulators of oxidative stress

Oxidative stress is associated with the increased production of reactive oxygen species or with a significant decrease in the effectiveness of antioxidant enzymes and nonenzymatic defense. The penetration of oxygen and free radicals in the hydrophobic interior of biological membranes initiates radical disintegration of the hydrocarbon “tails” of the lipids. This process is known as “lipid peroxidation”, and the accumulation of the oxidation products as peroxides and the alde-hydes and acids derived from them are often used as a measure of oxidative stress levels. In total, 40 phenolic antioxidants were selected for a comparative study and analysis of their chain-breaking antioxidant activity, and thus as modulators of oxidative stress. This included natural and natural-like ortho-methoxy and ortho-hydroxy phenols, nine of them newly synthesized. Applied experimental and theoretical methods (bulk lipid autoxidation, chemiluminescence, in silico methods such as density functional theory (DFT) and quantitative structure–activity relationship ((Q)SAR) modeling) were used to clarify their structure–activity relationship. Kinetics of non-inhibited and inhibited lipid oxidation in close connection with inhibitor transformation under oxidative stress is considered. Special attention has been paid to chemical reactions resulting in the initiation of free radicals, a key stage of oxidative stress. Effects of substituents in the side chains and in the phenolic ring of hydroxylated phenols and biphenols, and the concentration were discussed