Political de-radicalization: why it is no longer possible in the wilāyāt system of the Islamic State

The emergence of the Islamic State as a regional and ideological player deeply affected the mechanisms of radicalization witnessed worldwide. The article will compare a former instance of jihadism, the Egyptian al-Gamā’a al-Islāmiya (Islamic Group, IG), with the phenomenon of the Islamic State and its wilāyāt system. The Islamic Group, which has been active during the last three decades of the Twentieth century, constitutes an ideal case study because it performed a process of political de-radicalization and disengagement that led its members to abandon violence. The hypothesis underlying the paper is that a similar process could no longer take place in the case of the Islamic State. Indeed, the transnational project of the Caliphate is likely to exclude every chance of undertaking a de-radicalization and/or disengagement process in which a group effectively negotiates with a nation-state, and this difference is likely to represent one of the major counter-terrorism challenges arising from the Syrian-Iraqi scenario.  In order to complete its de-radicalization process, the IG issued four books of murāğa’āt, “recantations”, in January 2002, under the general title of The Correcting Conceptions Series. The major one was titled The Initiative for Ceasing Violence: a Realistic View and a Legitimate Perspective. It was authored by two Shura Council members and it generally addressed the practical and the ideological reasons behind the initiative. Unquestionably, this gradual process has been possible not only thanks to the new attitudes towards violence endorsed by al-Gamā’a al-Islāmiya, but also to the perceptive reaction of the State. By contrast, the a-national nature of the Islamic State obstructs this process. Indeed, after the local-oriented attitude of the first gam’iyāt and the emergence of al-Qa’ida as the premium brand of global terror, aims, push factors and geographical horizons of jihadism deeply changed. It is therefore not a question whether jihad is a binding religious prescription: it unquestionably is. The fundamental issue is whether and how one is to conduct it by lawful and prudent means and it is precisely this question that profoundly and irremediably divides the national jihadi movements from the Islamic State. As an internal Islamist critique - one that relies on a common Salafi substratum - the gam’iyāt refutation of global jihad may shed a light over the role of Da’ish in the contemporary jihadi panorama.

What are the effects of taking 300 pills of sodium valproate? - case report

INTRODUCTION: Sodium valproate is one of the most important antiepileptic drugs. It can be effective as a preventive treatment for migraine, it has also found use in the maintenance treatment of bipolar disorder and acute mania,it is sometimes used in the treatment of chronic neuropathic pain and fibromyalgia, in the treatment of schizophrenia borderline personality disorder and acquired brain injury, this drug is used off-label. Its overdose can be fatal. MATERIALS    AND  METHOD:  Patient  information  was  collected  from  hospital  records available in the clinical toxicology department. In addition, we conducted a literature review on sodium valproate treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE  REPORT:  A 57-year-old patient with a history of depressive disorders was admitted to the Clinical Department of Toxicology and Cardiology in Lublin for intentional intoxication with the drug Absenor (sodium valproate). The patient had taken 3 packages of Absenor 500 mg (300 tablets in total) for suicidal purposes. The determined concentration of valproic acid was 841 µg/ml, and the patient's condition was very severe. Despite the treatment administered-multiple attempts at gastric lavage, administration of activated charcoal, performance of hemodialysis procedures, administration of infusion of catecholamines, the patient died on the fifth day of hospitalization. CONCLUSION:  An overdose of sodium valproate can be fatal. Keep this in mind when ordering this drug for patients with a positive history of suicide attempts.&nbsp

Triple-negative breast cancer with ACTH-dependent Cushing's syndrome : case report

Introduction: Endocrine and metabolic paraneoplastic syndromes in the course of malignant tumors result from ectopic production of hormones or hormone precursors in tumor cells. Production of hormones by endocrine tumors is relatively frequent, while such production by adenocarcinoma cells is definitely rare. The study presents a case of triple-negative invasive breast cancer, with the ectopic secretion of ACTH (adrenocorticotropic hormone), which provokes serious metabolic disorders. Materials and methods: The patient was admitted to hospital with symptoms of Cushing`s syndrome. Diagnostic tests revealed that the cause of metabolic disorders was breast cancer. After proper preparation, the patient was qualified for surgery. Results: After the mastectomy, the patient’s metabolism stabilized. The patient underwent adjuvant chemotherapy and radiotherapy. Four months after the last cycle of systemic treatment, cancer dissemination was found. The patient was treated with second-line chemotherapy, however, control CT revealed progression. The patient died 20 months after surgery and two months after the last cycle of chemotherapy. Conclusions: The case reported in this study – triple-negative invasive breast cancer, responsible for ectopic production of ACTH and causing Cushing’s syndrome – is a rare phenomenon. Treatment of patients with breast cancer showing hormonal activity should not differ from general rules applied for breast cancer. However, due to accompanying metabolic disturbances, the patients need individualized oncological approach, precise diagnostic tests, and adequate preoperative preparation

Diet and physical activity in the treatment of obesity - current knowledge

Introduction: Obesity is now becoming a growing problem and challenge for medicine. The number of people with excessive body weight has now reached more than 2 billion, or about 30% of the world's population. The purpose of this article is to identify and describe some of the already known treatments for obesity, along with the latest research on the subject, in order to show the importance of developing and introducing new methods of weight loss.Aim of the study: The purpose of this article is to review the impact of obesity on health and the diets offered to people struggling with the disease.Materials and methods: We reviewed the literature available in the PubMed database up to November 2022, using the keywords.Results: Consistently limiting caloric intake is a must when losing weight. There are also diets such as low-carbohydrate, low-fat and high-protein diets, but following them can also have some side effects. For example, a high-protein diet can lead to kidney stones. The Mediterranean diet is also a good option for people with obesity. It lowers the risk of cardiovascular disease and cancer. All obesity treatment suggestions consistently recommend a balanced and low-calorie diet with reduced fat (along with saturated fatty acids) and optimal amounts of fiber. In addition to diet, physical activity is an important topic. The primary recommendation for people with obesity is at least moderate to vigorous physical activity of at least 150 minutes per week.Summary: In conclusion, the overarching goal of obesity treatment is to improve quality of life. Calorie restriction, regular exercise or a combination of both is accepted as an effective strategy for preventing or treating obesity

Twiddler syndrome in a patient with tremor dominant Parkinson's disease. A case report and literature review

Twiddler syndrome is described as a spontaneous rotation or intentional external manipulation of implanted cardiac or occasionally deep brain stimulation (DBS) devices. We report this hardware related complication in a patient with tremor dominant Parkinson's disease (PD), who underwent unilateral subthalamic nucleus (STN) DBS and subsequently developed twiddler syndrome. The clinical course of twiddler syndrome in this patient is described. Some surgical nuances which may prevent its occurrence are suggested. Our case report indicates that twiddler syndrome occurs in DBS patients. Impedance check of DBS hardware, plain chest X-ray, or palpation for a knobbly extension lead through the skin above the IPG allows the correct diagnosis and subsequently a prompt surgical revision. Our subsequent literature review revealed only 10 patients with twiddler syndrome in DBS patient population worldwide. This number may suggest that this syndrome may be unrecognized or underreported, given the number of patients with movement disorders implanted with DBS hardware worldwide

Escherichia coli: Great Diversity around a Common Core

The 2011 Escherichia coli outbreak in Germany, which resulted in more than 4,000 cases, including 908 cases of hemolytic-uremic syndrome (HUS) and at least 50 deaths, highlighted the genome plasticity of E. coli and the potential for new virulent strains to emerge. The analysis of 170 E. coli genome sequences for the presence of nine previously identified protective extraintestinal pathogenic E. coli antigens suggested the feasibility of a combination vaccine as a universal intervention against all pathogenic E. coli strains

What affects chronic lithium poisoning in psychiatric patients? - a case report

INTRODUCTION: Despite medical developments, drug poisoning still occurs. Lithium is a drug that has been used for more than 60 years as a mood stabilizer in the treatment and prevention of bipolar disorder, mania and recurrent depression. Lithium is the most commonly prescribed mood stabilizer. It has a narrow therapeutic index.  Its target concentration in acute mania should be 0.6-1.5 mEq/L and 0.6-0.8 mEq/L for maintenance therapy. Because of this, there is a risk of lithium intoxication. We would like to present to you the case of a patient with chronic lithium poisoning. MATERIALS  AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on lithium treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE REPORT: The patient, 58, was referred for lithium poisoning and admitted to the Clinical Toxicology and Cardiology Department in Lublin for treatment. The patient had a previous diagnosis of bipolar affective disorder, hypertension and obesity. According to the history, the patient was admitted to the psychiatric ward due to deterioration of her mental state for a month. She was found to have a high lithium level -2.98 mmol/L and elevated renal function parameters-creatinine 2.13 mg/dl.  During treatment with hemodialysis, these parameters returned to normal. CONCLUSION: It is important to remember that lithium has a narrow therapeutic range. Attention should be paid during lithium treatment to situations that increase the risk of adverse effects and the development of toxicity, and serum lithium concentrations should be monitored during treatment

Underestimation of breast cancer in intraductal papillomas treated with vacuum-assisted core needle biopsy

Objectives: The aims of the study were as follows: 1) to determine the applicability of vacuum-assisted core needle biopsy in the diagnosis and management of intraductal papillomas of the breast; 2) to define factors which increase the risk for underestimation of breast cancer.  Material and methods: Between 2002–2017, a total of 222 cases of intraductal papillomas were diagnosed in one center (201 using vacuum-assisted core-needle ultrasound-guided biopsy and 21 using stereotactic biopsy). All patients under- went scheduled follow-up imaging.  Results: Pure papillomas were diagnosed in 158 women, whereas papillomas with atypia, in this case atypical ductal hyperplasia (ADH), were found in 29 subjects. In the latter group, 3 cases of invasive carcinoma and 5 cases of ductal carci- noma in situ (DCIS) were detected using open surgical biopsy. Breast cancer underestimation in that group of patients was 20%. Overall, ADH, whose presence increases the risk for BC by thirteen-fold as compared to other accompanying lesions, proved to be the most important predictive factor. Also, age, non-radical biopsy excision, and high BI-RADS ultrasound and mammogram scores increased the probability of malignancy. During the control follow-up, no cases of IP recurrence in the primary localization were observed in the group without open surgical biopsy.  Conclusions: Vacuum-assisted core needle biopsy is an efficient tool in the diagnosis and management of intraductal papillomas of the breast. Surgical excision is not indicated in cases when a pure intraductal papilloma, and data correlation between the diagnosis and the clinical presentation were confirmed. Regardless, caution is advised if residual lesions were left and in older populations. Open surgical biopsy should remain the standard of care in cases with atypia and discordance between clinical and pathology data. 

Genome sequence of <i>Escherichia coli</i> 536: insights into uropathogenicity through comparison with genomes of <i>Escherichia coli</i> MG1655, CFT073, and EDL933

Der uropathogene Escherichia coli (UPEC) Stamm 536 (O6:K15:H31) ist einer der Modellorganismen der pathogenen extraintestinalen E. colis. Zur Analyse der genetische Grundlage der Urovirulenz wurde das gesamte Genom des Stammes sequenziert, und mit der Genomsequenz des Stammes CFT073 (O6:K2:H1), einem anderen gut untersuchten UPEC-Stamm, sowie den verfügbaren Genomen des nichtpathogenen Stammes MG1655(K12), sowie anderen pathogenen Stämmen verglichen. Die Sequenzierung ergab daß das Genom des Stammes 536 etwa 292 Kbp kleiner ist als das des Stammen CFT073 und daß es damit das derzeit kleinste bekannte sequenzierte Genom eines pathogenen E. coli Stammes ist. Die genomischen Unterschiede zwischen den beiden UPEC Stämmen sind im wesentlichen auf große pathogene Inseln beschränkt, die zum Teil spezifisch für den Stamm 536 bzw. für den Stamm CFT073 sind. Darüber hinaus wurden 450 Gene identifiziert, die nur in uropathogenen Stämmen vorkommen. Die Mehrzahl dieser Gene werden auf kleinen, per horizontalen Gentransfer erworbenen, inselartigen Regionen, welche über das gesamte Genom verteilt sind, codiert und sind mit tRNS Genen oder mobilen Elementen assoziiert. Die Funktionen der entsprechende Gene legen nahe, das sie eine Funktion für die Überlebensfähigkeit der pathogenen Stämme haben sowie bei der Anpaßung an die Bedingungen während der Infektion des Harntraktes benötigt werden. Genomvergleiche der UPEC O6 Stämme unterstreichen die enorme Variabilität der uropathogenen Stämme, sowie die Beobachtung, daß die Fähigkeit zur Expression verschiedener Virulenzfaktoren die Basis der unterschiedlichen Virulenzpotentiale bildet. Demnach existiert nicht ein gemeinsamer Virulenzmechanismus, sondern alternative Wege welche extraintestnale E. coli Stämme befähigen Krankheiten zu verursachen