Reversibility and Improved Hydrogen Release of Magnesium Borohydride

Desorption and subsequent rehydrogenation of Mg(BH_4)_2 with and without 5 mol % TiF_3 and ScCl_3 have been investigated. Temperature programmed desorption (TPD) experiments revealed a significant increase in the rate of desorption as well as the weight percentage of hydrogen released with additives upon heating to 300 °C. Stable Mg(B_xH_y)_n intermediates were formed at 300 °C, whereas MgB_2 was the major product when heated to 600 °C. These samples were then rehydrogenated and subsequently characterized with powder X-ray diffraction (pXRD), Raman, and NMR spectroscopy. We confirmed significant conversion of MgB_2 to fully hydrogenated Mg(BH_4)_2 for the sample with and without additives. TPD and NMR studies revealed that the additives have a significant effect on the reaction pathway during both dehydrogenation and rehydrogenation reactions. This work suggests that the use of additives may provide a valid pathway for improving intrinsic hydrogen storage properties of magnesium borohydride

Collaborative management of the family doctor's team with public services

Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. In 2016, a family doctor received about 3935 visits a year. (Visits 3001611 to / 762.75 med). Approximately (68%) of the normative acts within the Ministry of Health, NHIC, regulate the work of the family doctor team

Erectile dysfunction in patients with neurological disorders

State Medical and Pharmaceutical University “Nicolae Testemitanu”, Chisinau, Republic of MoldovaIntroduction: Erectile dysfunction (ED) is a common symptom in many neurologic diseases. This fact has led to the increasing involvement of the neurologists in the evaluation of ED. Materials and Methods: 1.Bibliographic review on the topic: ED in patients with neurological disorders,- Ovid - 1995-2013, 40 selected sources, MedLine - 15 sources, HINARI - 20 sources; 2. Studying pathophysiological mechanisms of neurogenic ED; 3. Studying of medical cases of patients with neurological disorders and ED, in Neurology and Urology Clinics; 4.Evaluation of selected cases. Results: The clinical case reported below, is to reveal the importance of the collaboration between andrologist and neurologist in managing a patient with neurologic ED. G. is a 38-year-old man first time to andrologist. He reports significant ED, progressed over the past few months, no spontaneous erections. Other complaints-back pain radiating to left leg, bilateral paresthesia.Symptoms started about 4 years ago. He consulted several urologists, and was diagnosed with chronic prostatitis and followed several treatments with transient temporary relief. Medical history- diagnosed with a herniated lumbar disc 5-6 mm - 2009, conservative treatment. Sexual history- single, stable sexual partner, psychological climate appropriate torque. SHIM questionnaire = 11 points (moderate ED). Physical examination - normal genitalia and prostate.Laboratory results- no abnormalities.Treatment recommendations - inhibitor PDE 5, with positive effect. But due to complaints of back pain radiating to left leg and bilateral paresthesia was recommended lumbar MRI - found discal herniation 18-20 mm. The patient was referred to neurosurgery for surgical treatment. After 6 months, he presented to andrologist for evaluation. SHIM questionnaire = 20 points - satisfactory sexual function with no PDE5 medication. Conclusions: l. The evaluation of ED causes needs a multidisciplinary cooperation between several specialists in urology, endocrinology, neurology, psychiatry, and others. 2. The reported clinical case shows the importance of right neurologic evaluation. And the professional treatment has resolved not only the neurological problem but the andrological problem

RELATIONSHIP BETWEEN DIABETES MELLITUS AND CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY. CLINICAL CASE REPORT

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Neuropatiile inflamatorii pot apărea la pacienți cu diabet zaharat (20 %) sau prediabet (10 -15%) sub diferite manifestări clinice. Polineuropatia demielinizantă inflamatorie cronică (PDIC) este cea mai frecventă neuropatie cronică tratabilă la nivel mondial. Scopul lucrării. Prezentarea unui caz clinic de diabet zaharat complicat cu PDIC. Material și metode. Diagnosticul a fost confirmat clinic și electrofioziologic prin efectuarea electroneuromiografiei (ENMG). A fost analizată revista literaturii, utilizându-se articole publicate în sursele electronice recunoscute de societatea medicală internațională ca: PubMed, Medline, MedScape și NCBI, având în vedere particularitățile cazului. Rezultate. Pacienta de 64 ani, cu diabet zaharat, a fost internată cu amorțeală, senzație de electricitate de la nivelul taloanelor până în genunchi, anestezie distală, slăbiciune musculară la nivelul membrelor inferioare bilateral, crampe musculare dureroase, hipotrofie a mușchilor gambieni. Examenul neurologic a relevat alterarea sensibilității profunde, ROT absente și ușor hipotonus la nivelul membrelor inferioare. ENMG a confirmat semne de PDIC (reducerea vitezelor de conducere, latențe terminale majorate, dispersie temporală marcată, prezența blocurilor de conducere). Investigațiile de laborator au indicat niveluri ridicate de glucoză (7,2 mmol/l). Pacienta a efectuat 6 ședințe de plasmafereză și tratament medicamentos cu deflazacort 30 mg (1 tab. pe zi), a inițiat tratament cu citostatice (azatioprina 3 mg/kg). Evoluția bolii cu ameliorarea manifestărilor. Concluzii. Corelația dintre PDIC și diabet zaharat este esențială din cauza progresiei bolii, având o importanță majoră prezența criteriilor clinice, electrodiagnostice și răspunsul pozitiv la tratament, astfel creșterea gradului de conștientizare a apariției PDIC la acești pacienți este crucială.Background. Inflammatory neuropathies may occur in patients with diabetes mellitus (20%) or prediabetes (1015%) under different clinical manifestations. Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common treatable chronic neuropathy worldwide. Objective of the study. We present a case of diabetes mellitus complicated with CIDP. Material and methods. The diagnosis was confirmed clinically and electrophysiologically by electroneuromyography (ENMG). The literature review was conducted based on the particularities of the case, using articles published in electronic sources recognized by the international medical society as PubMed, Medline, MedScape and NCBI. Results. A 64-year-old patient with diabetes mellitus was hospitalized with numbness, electrical sensation from the heels to the knees, distal anesthesia, muscle weakness in the lower limbs bilaterally, painful muscle cramps, hypotrophy of the gambian muscles. Neurological examination revealed altered deep sensitivity, absent ROT and mild hypotonus in the lower limbs. ENMG confirmed signs of CIDP (reduced conduction velocities, increased terminal latencies, marked temporal dispersion, presence of conduction blocks). Laboratory investigations showed high glucose levels (7.2 mmol/l). The patient did 6 sessions of plasmapheresis and drug treatment with deflazacort 30 mg (1 tab per day), initiated cytostatic treatment (azathioprine 3mg/kg). Evolution of the disease with improvement of manifestations. Conclusion. The correlation between CIDP and diabetes mellitus is essential because of disease progression, the presence of clinical, electrodiagnostic criteria and positive response to treatment have a major importance, and it is crucial to raise awareness of the presence of CIDP in these patients

Assessment of quality of life in COPD patients with comorbidities

Introduction. Chronic obstructive pulmonary disease (COPD) continues to be one of the leading causes of death and health-care cost worldwide. The majority of patients have at least one comorbid condition of clinical significance. Aim of study. Study of comorbidities in chronic obstructive pulmonary diseases. Methods and materials. The study was conducted in 75 patients with COPD. Comorbidities were assessed by Charlson comorbidity index (CCI). Health-related quality of life was assessed by the Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT) and St. George Respiratory Questionnaire (SGRQ). Spirometric data were analyzed (FEV1, FVC, FEV1/FVC). Results. 75 COPD patients were studied, mean age was 59.2±6.5 years, mean FEV1, % was 36.6±13.3%. Patients across all stages of the GOLD classification had similar age and pack/years (p>0.01). Charlson comorbidity index (CCI) had a moderate negative correlation with 6MWD (r=-0.39, p<0.01) and absence correlation with the rate of exacerbations (r=0.15, p=0.01). CCI had a moderate correlation with SGRQ activity (r=0.39, p<0.01), impact (r=0.38, p<0.001) and total (r=0.38, p<0.001) scores. Questionnaires for assessing the quality of life when applied to assess the risk of comorbidities showed unsatisfactory discriminatory power (SGRQ AUC - 0.4, CCQ AUC - 0.44 and CAT AUC - 0.39). Conclusion. COPD is frequently associated with other diseases. Comorbidities have a greater negative impact on COPD patients in terms of quality of life. HRQL questionnaires, when applied to assess the risk of comorbidities showed unsatisfactory discriminatory power

Хроническая обструктивная болезнь легких: фенотипы и эндотипы, сопутствующие заболевания и индивидуальный терапевтический подход (обзор литературы)

Rezumat. Bronhopneumopatia cronică obstructivă (BPOC) reprezintă o afecțiune multisistemică și eterogenă, care și actual ramâne subdiagnosticată și subapreciată la nivel global, fiind printre maladiile cu evoluție ascendentă a morbidității și mortalității. Actual, BPOC este acceptată ca o condiție eterogenă cu endotipuri și fenotipuri multiple. Pe lângă fenotipurile BPOC bine cunoscute deja acceptate pe scara largă, există noi fenotipuri ale bronhopneumopatiei cronice obstructive în curs de dezvoltare și aprobare. Prezența unor comorbidități semnificative este probabil unul dintre cei mai importanți factori de risc pentru severitatea BPOC, majoritatea pacienților cu BPOC au cel puțin o condiție comorbidă, care complică și mai mult evoluția și managementul bolii. Scopul principal al identificării fenotipurilor, este de a oferi pacienților cea mai bună îngrijire medicală posibilă, adaptând abordarea terapeutică individualizată, atât non-farmacologică cât și farmacologică, în funcție de simptomatologie, exacerbări, funcția pulmonară, și inevitabil comorbidități.Summary. Chronic Obstructive Pulmonary Disease (COPD) is a multisystem and heterogeneous disease that remains under-diagnosed and undervalued overall, as one of the diseases with increased morbidity and mortality. At this time, COPD is accepted as a heterogeneous condition consisting of multiple endotypes and phenotypes. In addition to known and already widely accepted COPD phenotypes, new phenotypes of chronic obstructive pulmonary disease are also emerging. The presence of significant comorbidities is likely to be one of the most significant risk factors for the severity of COPD, most COPD patients have at least one comorbid condition, making the course and management of the disease more difficult. The main goal of identifying phenotypes is to provide patients with the best possible medical care, adapting the individualized therapeutic approach, both, non-pharmacological and pharmacological, according to symptoms, exacerbations, lung function, and inevitably comorbidities.Резюме. Хроническое обструктивное болезнь легких (ХОБЛ) представляет собой многосистемное и разнородное заболевание, которое в целом по-прежнему не диагностировано в достаточной степени и недооценивается как одно из заболеваний с повышенной заболеваемостью и смертностью. В это время ХОБЛ считается гетерогенным состоянием, состоящим из нескольких эндотипов и фенотипов. Помимо известных и уже широко распространенных фенотипов ХОБЛ появляются также новые фенотипы хронических обструктивных легочных заболеваний. Наличие значительных сопутствующих заболеваний, вероятно, является одним из наиболее существенных факторов риска для серьезности ХОБЛ, большинство пациентов с ХОБЛ имеют по крайней мере одно сопутствующие заболевание, что затрудняет лечение. Основной целью выявления фенотипов является предоставление пациентам наилучшей медицинской помощи, адаптация индивидуализированного терапевтического подхода, как нефармакологического, так и фармакологического, в зависимости от симптомов, обострений, легочной функции и неизбежно сопутствующих заболеваний

Explainable Machine Learning for Hydrogen Diffusion in Metals and Random Binary Alloys

Hydrogen diffusion in metals and alloys plays an important role in the discovery of new materials for fuel cell and energy storage technology. While analytic models use hand-selected features that have clear physical ties to hydrogen diffusion, they often lack accuracy when making quantitative predictions. Machine learning models are capable of making accurate predictions, but their inner workings are obscured, rendering it unclear which physical features are truly important. To develop interpretable machine learning models to predict the activation energies of hydrogen diffusion in metals and random binary alloys, we create a database for physical and chemical properties of the species and use it to fit six machine learning models. Our models achieve root-mean-squared-errors between 98-119 meV on the testing data and accurately predict that elemental Ru has a large activation energy, while elemental Cr and Fe have small activation energies.By analyzing the feature importances of these fitted models, we identify relevant physical properties for predicting hydrogen diffusivity. While metrics for measuring the individual feature importances for machine learning models exist, correlations between the features lead to disagreement between models and limit the conclusions that can be drawn. Instead grouped feature importances, formed by combining the features via their correlations, agree across the six models and reveal that the two groups containing the packing factor and electronic specific heat are particularly significant for predicting hydrogen diffusion in metals and random binary alloys. This framework allows us to interpret machine learning models and enables rapid screening of new materials with the desired rates of hydrogen diffusion.Comment: 36 pages, 8 figures, supplemental materia