Colon intussusception treated endoscopically (case report)

Secția endoscopie, Institutul Medicinei de Urgență, Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: În Clinică la 30 octombrie 2013 s-a adresat pacientul SA de 19 ani, cu acuze la dureri intense în flancul stîng, vomă repetată cu conținut gastric, astenie pronunțată, inapetență, lipsa scaunului (2 zile), lipsa emisiei de gaze (24 ore). Din anamneză, în copilărie – diagnosticat cu megacolon congenital, părinții au refuzat tratamentul chirurgical. La internare: abdomenul moderat balonat, simetric, dolor intens la palpare în flancul stîng și mezogastru, semne peritoneale – absente, per rectum – conținut intestinal, pereții – dilatați. Spitalizat cu diagnosticul de ocluzie intestinală joasă. Ecografia cavității abdominale a evidențiat un minim de lichid liber interileal. Radiografia abdomenului – aerocolie pronunțată. La 31 octombrie 2013 s-a efectuat colonoscopie pînă la flexura lienală, înaintarea fiind neinformativă (în lumen – materii fecale). În sigmoid, la distanța 25 cm de la orificiul anal pînă la 40 cm, peretele intestinului nu se reexpansiona complet, mucoasa – edemațiată, culoare violacee, cu peteșii hemoragice. Lumenul colonului nu se vizualiza. La insuflarea aerului porțiunea proximală de perete intestinal a glisat, eliberînd lumenul sigmoidului. Colonul descendent examenat – mărit în dimensiuni atît longitudinal cît și transversal. Mucoasa examinată subțiată, cu desen vascular pronunțat. Haustrele intestinale – absente. Peristaltismul intestinal – absent. Unghiul lienal – permeabil. Biopsia din mucoasa schimbată macroscopic al sigmoidului nu a fost prelevată din cauza pericolului hemoragiei și a perforației. La pacient s-a constatat o invaginație de colon la nivelul sigmoidului, megadolicocolon. După colonoscopie starea generală a pacientului s-a ameliorat, acesta fiind externat din staționar recomandîndu-se tratamentul chirurgical programat al dolicocolonului.Clinical case: This article reports a clinical case of intestinal obstruction intussusception, which was solved by colonoscopy. A 19-years-old patient was admitted on October 30, 2013 to the Hospital with the following complaints: severe pain in left abdominal flank, repeated vomiting, pronounced asthenia, decreased appetite, constipation and a lack of gas (2 days). In anamnesis, childhood-diagnosed with congenital megadolichocolon, parents refused surgical treatment. Physical exam: the swollen abdomen, abdominal pain on palpation, no peritoneal signs. Hospitalized with intestinal obstruction. Abdomenal cavity ultrasound showed minimal free liquid. X-rays of the abdomen showed a bowel distension. October 31, 2013 was conducted colonoscopy. In the sigmoid, at a distance of 25 cm from the anus, up to 40 cm, the intestinal wall was not deployed fully, the swelling, purple mucous with petechial hemorrhages. The lumen of the colon was not see. Under the inspiration of the air, the proximal portion of the intestinal wall, to drag it, giving the lumen of the sigmoid. Colon descending seen, increased in size, both lengthwise and transversely. Mucous were narrowed, with strikes pronounced. The folds of the intestine absented. Peristalsis was absent. No biopsy was taken of the macroscopic changed mucous of sigmoid, because of the risk of bleeding and perforation. The patient was found to intussusception of the colon sigmoid. After the colonoscopy the general condition of the patient improved, was discharged from the hospital and it was recommended surgical treatment of dolichocolon

Transition from ballistic to diffusive behavior of graphene ribbons in the presence of warping and charged impurities

We study the effects of the long-range disorder potential and warping on the conductivity and mobility of graphene ribbons using the Landauer formalism and the tight-binding p-orbital Hamiltonian. We demonstrate that as the length of the structure increases the system undergoes a transition from the ballistic to the diffusive regime. This is reflected in the calculated electron density dependencies of the conductivity and the mobility. In particular, we show that the mobility of graphene ribbons varies as mu(n) n^(-lambda), with 0<lambda<0.5. The exponent lambda depends on the length of the system with lambda=0.5 corresponding to short structures in the ballistic regime, whereas the diffusive regime lambda=0 (when the mobility is independent on the electron density) is reached for sufficiently long structures. Our results can be used for the interpretation of experimental data when the value of lambda can be used to distinguish the transport regime of the system (i.e. ballistic, quasi-ballistic or diffusive). Based on our findings we discuss available experimental results

Drug Repurposing: Far Beyond New Targets for Old Drugs

Repurposing drugs requires finding novel therapeutic indications compared to the ones for which they were already approved. This is an increasingly utilized strategy for finding novel medicines, one that capitalizes on previous investments while derisking clinical activities. This approach is of interest primarily because we continue to face significant gaps in the drug–target interactions matrix and to accumulate safety and efficacy data during clinical studies. Collecting and making publicly available as much data as possible on the target profile of drugs offer opportunities for drug repurposing, but may limit the commercial applications by patent applications. Certain clinical applications may be more feasible for repurposing than others because of marked differences in side effect tolerance. Other factors that ought to be considered when assessing drug repurposing opportunities include relevance to the disease in question and the intellectual property landscape. These activities go far beyond the identification of new targets for old drugs

Physiochemical property space distribution among human metabolites, drugs and toxins

<p>Abstract</p> <p>Background</p> <p>The current approach to screen for drug-like molecules is to sieve for molecules with biochemical properties suitable for desirable pharmacokinetics and reduced toxicity, using predominantly biophysical properties of chemical compounds, based on empirical rules such as Lipinski's "rule of five" (Ro5). For over a decade, Ro5 has been applied to combinatorial compounds, drugs and ligands, in the search for suitable lead compounds. Unfortunately, till date, a clear distinction between drugs and non-drugs has not been achieved. The current trend is to seek out drugs which show metabolite-likeness. In identifying similar physicochemical characteristics, compounds have usually been clustered based on some characteristic, to reduce the search space presented by large molecular datasets. This paper examines the similarity of current drug molecules with human metabolites and toxins, using a range of computed molecular descriptors as well as the effect of comparison to clustered data compared to searches against complete datasets.</p> <p>Results</p> <p>We have carried out statistical and substructure functional group analyses of three datasets, namely human metabolites, drugs and toxin molecules. The distributions of various molecular descriptors were investigated. Our analyses show that, although the three groups are distinct, present-day drugs are closer to toxin molecules than to metabolites. Furthermore, these distributions are quite similar for both clustered data as well as complete or unclustered datasets.</p> <p>Conclusion</p> <p>The property space occupied by metabolites is dissimilar to that of drugs or toxin molecules, with current drugs showing greater similarity to toxins than to metabolites. Additionally, empirical rules like Ro5 can be refined to identify drugs or drug-like molecules that are clearly distinct from toxic compounds and more metabolite-like. The inclusion of human metabolites in this study provides a deeper insight into metabolite/drug/toxin-like properties and will also prove to be valuable in the prediction or optimization of small molecules as ligands for therapeutic applications.</p

Primary endoscopic diagnosis of microgastria (case report)

Secția endoscopie, Institutul Medicinei de Urgență, Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: La 30.07.2014 s-a adresat un pacient de 31 ani cu acuzele: astenie pronunțată, vomă cu sînge, melenă, dureri în epigastru. La internare starea generală a pacientului era gravă, stabilă. Pacientul – adecvat. Tegumentele palide, reci, transpirate. Mucoasele vizibile – pale. Starea de nutriție – scăzută. Sistemul muscular – hipotrofic. Cutia toracică – cifoscoliotică. Per rectum – pe mănușă urme de melenă. A fost internat în staționar cu diagnosticul preventiv de hemoragie digestivă superioară. S-a efectuat o endoscopie urgentă, care a evidențiat o dilatare moderată a esofagului în 1/3 distală. În regiunea cardiei – defect ulceros 0,6 cm în diametru acoperit cu fibrină, cu bont vascular vizibil pe suprafață. Efectuată hemostaza endoscopică. Stomacul examinat – permeabil, localizat la distanța 35 cm de la orificiul bucal, micșorat semnificativ în dimensiuni (hipogenezie gastrică). Pilor – permeabil. Duodenul – permeabil, localizat la distanța 40 cm de la orificiul bucal, mărit considerabil în dimensiuni. Papila duodenală mare – vizualizată. Concluzia endoscopică: “Ulcer acut al cardiei complicat cu hemoragie Forrest IIA. Anomalie de dezvoltare gastrică (microgastrie). Anomalie de dezvoltare a duodenului”. Investigarea pacientului cu scopul identificării altor anomalii de dezvoltare a confirmat paraclinic atît microgastria cât și alte malformații congenitale: anomalie de poziție și formă a duodenului, dilatarea esofagului, hipogenezie lienală, dilatarea căilor biliare intra- și extrahepatice, anomalii ale scheletului osos – scolioză dextroconcavă în formă de S de gradul IV. Concluzie: Acest caz clinic este impresionant prin faptul că diagnosticul de microgastrie a fost stabilit la vîrsta de 31 ani, și faptul supraviețuirii persoanei fără supraveghere și asistență medicală necesară.Clinical case: A 31-years-old patient was admitted at 06.18 on July 30, 2014 with the following complaints: pronounced asthenia, multiple episodes of hematemesis, melena and epigastric pain. Upon admission the patient's general condition was serious but stable. The skin was pale, cold, sweaty. Visible mucous membranes were pale. The muscular-looking man, hypotrophic, with poor nutrition status. His chest looked deformed and kyphoscoliotic. Rectal examination displayed visual traces of melena. He was admitted to the hospital with a preliminary diagnosis of upper gastrointestinal bleeding. At the time of admission upper gastrointestinal endoscopy was performed, which showed a moderate distal esophageal dilatation. In the cardiac region of the stomach ulcer defect of 0.6 cm in diameter covered with fibrin was detected, with vascularity visible on the surface. Endoscopic hemostasis was performed. Further evaluation revealed permeable stomach located at the distance of 35 cm from the mouth, decreased significantly in size. The duodenum was permeable, located at 40 cm distance from the mouth, increased considerably in size. Endoscopic result: “Acute hemorrhagic ulcer of the stomach’s cardiac region (Forrest IIA). Gastric abnormality (microgastria). Duodenal malformation”. Conclusions: The presented clinical case re-confirms association of reported paraclinical confirmation so as to microgastria and other congenital malformations: abnormal position and shape of the duodenum, dilated esophagus, involutive spleen, dilated intra- and extra-hepatic biliary tract, skeletal abnormalities, scoliosis in S-shaped IV degree. Surprisingly, as microgastria was first diagnosed at the age of 31, and not in the childhood, this makes patient’s survival without specialized medical care more impressive

Projects as Knowledge Swirls in the Technological Innovation: Romania's Situation

The present paper uses as research basis a new way of thinking regarding the relation between innovation and knowledge - the Knowledge Flow Percolation Model (KFPM). In this model’s center, human beings are seen as thinking electrons, both consuming and generating knowledge flows. Through the interdependent actions of individuals, knowledge circulates inside organizations, allowing them to innovate in order to obtain competitive advantages. But there is a wide range of barriers which impede the creation and movement of flows in the model grid and consequently, hinder their change into innovation. The solution proposed by this paper as one of the most adequate instruments to make KFPM more spreadable is the project. On this basis, in an empirical study, we try to demonstrate the hypothesis of the positive influence of projects, as knowledge swirls, on the development of innovative skills which will help solving problems in the organization, creating and widening of knowledge and reducing the barriers in knowledge transfer.This work was supported by the project “Post-Doctoral Studies in Economics: training program for elite researchers – SPODE” co-funded from the European Social Fund through the Development of Human Resources Operational Programme 2007-2013, contract no. POSDRU/89/1.5/S/61755

Defining the microbial effluxome in the content of the host-microbiome interaction

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ChemProt: a disease chemical biology database

Systems pharmacology is an emergent area that studies drug action across multiple scales of complexity, from molecular and cellular to tissue and organism levels. There is a critical need to develop network-based approaches to integrate the growing body of chemical biology knowledge with network biology. Here, we report ChemProt, a disease chemical biology database, which is based on a compilation of multiple chemical–protein annotation resources, as well as disease-associated protein–protein interactions (PPIs). We assembled more than 700 000 unique chemicals with biological annotation for 30 578 proteins. We gathered over 2-million chemical–protein interactions, which were integrated in a quality scored human PPI network of 428 429 interactions. The PPI network layer allows for studying disease and tissue specificity through each protein complex. ChemProt can assist in the in silico evaluation of environmental chemicals, natural products and approved drugs, as well as the selection of new compounds based on their activity profile against most known biological targets, including those related to adverse drug events. Results from the disease chemical biology database associate citalopram, an antidepressant, with osteogenesis imperfect and leukemia and bisphenol A, an endocrine disruptor, with certain types of cancer, respectively. The server can be accessed at http://www.cbs.dtu.dk/services/ChemProt/