The Importance of the BRICS Group in the International Economic System

This study is conducted on the BRICS group and it presents some possible future evolutions ofthe alliance through scenarios in terms of its growth and development - both horizontally andvertically. It is based on the analyzes carried out by several international organizations such as Goldman Sachs or the UN, but also on the data and information made public by the BRICS through reports, statements and other official documents

The imagistic diagnosis of the pathology of the breast implant

Catedra Radiologie şi imagistică USMF „Nicolae Testemiţanu”, IMSP Institutul OncologicThe abstract study evaluates the algorithm of diagnosis of breast implant complication by means of medical imaging methods. The idea of implantation exists for more centuries having been practis since in 1962. Knowledge concerning technical and medical modern possibilities, advantages, and risks, complications of breast implant and appearance of cancer in the future are initial conditions of objective judgment in monitoring patients with breast prosthesis. In this section, we have analyzed two aspects, which show the correlation between breasts implant: - assessing the integrity of implant (early detection and late complications), - the diagnosis of breast cancer or some other diseases of mammary gland in holders of mammary implants; finally estimating, sensitivity, specificity and effectiveness of each separate imaging method and complexity. In studiul dat se integreaza evaluarea algoritmului de dignostic a complicatiilor implantului mamar prin intermediul metodelor imagisticii medicale. Ideea implantarii exista de mai multe secole, insa pentru prima data aceasta practica a fost utilizata in 1962. Cunoştinţele referitoare la posibilităţile tehnologice şi medicale moderne, avantajele, riscurile, complicaţiile implantului mamar şi apariţia unui eventual cancer sunt primordiale pentru a lua o decizie obiectivă in monitorizarea pacientelor cu proteze mamare. Am analizat două aspecte, care evidenţiază corelaţia dintre imageria sînilor şi implantele mamare: - evaluarea integrităţii implantelor (detecţia complicaţiilor precoce şi tardive), - diagnosticul cancerului de sîn sau a altor patologii a glandelor mamare la purtătoarele de implante mamare; estimand, in final, sensibilitatea, specificitatea şi eficacitatea fiecarei metode imagistice separat şi în complexitate

The effect of biogel content on the some viscoelastic properties of a snail pate

Four sorts of snail pâté with different contents (0, 1, 2, 3%) of a vegetal protein (biogel) were prepared. The influence of the content of biogel on the viscoelastic characteristics of snail pâté were studied in this paper. These characteristics of snail pâté were derived from stress relaxation tests. The relaxation times and the elastic moduli, as viscoelastic characteristics, were calculated from the relaxation curves by non-linear regression. The best correspondence between experimental data and calculated curves was obtained for a mechanical model with three Maxwell elements in parallel with a lone ideal spring element. Every measurement was made in triplicate. From above viscoelastic parameters, the viscosities were calculated. Correlation between experimental relaxation curves and calculated curves were emphasized by absolute average deviation (AAD), the minimum AAD value being 0.15% and the maximum one 0.82%. The stiffest snail pâté contains 2% biogel, and the snail pâté with 3% biogel is more viscous

The effect of biogel content on the some viscoelastic properties of a snail pate

Four sorts of snail pâté with different contents (0, 1, 2, 3%) of a vegetal protein (biogel) were prepared. The influence of the content of biogel on the viscoelastic characteristics of snail pâté were studied in this paper. These characteristics of snail pâté were derived from stress relaxation tests. The relaxation times and the elastic moduli, as viscoelastic characteristics, were calculated from the relaxation curves by non-linear regression. The best correspondence between experimental data and calculated curves was obtained for a mechanical model with three Maxwell elements in parallel with a lone ideal spring element. Every measurement was made in triplicate. From above viscoelastic parameters, the viscosities were calculated. Correlation between experimental relaxation curves and calculated curves were emphasized by absolute average deviation (AAD), the minimum AAD value being 0.15% and the maximum one 0.82%. The stiffest snail pâté contains 2% biogel, and the snail pâté with 3% biogel is more viscous

Diagnostique diferentielle des tumeurs osseuses primitives

Tumorile osoase primare reprezintă un număr mic din numărul total al tumorilor(1-5%), dar care merită o atenţie deosebită datorită complicaţiilor şi consecinţelor care pot apărea în urma lor. O importanţă mare are diagnosticul diferenţiat: benign sau malign, primar sau metastaze, de care depinde şi tactica de tratament. Radiografia simplă reprezintă un diagnostic prezumtiv care permite diferenţierea tumorilor maligne de cele benigne, după mai multe criterii

Dificultăţi în diagnosticul herniilor lombare

Herniile lombare congenitale sunt rare şi fiecare caz este particular şi unic. Examinarea acestor pacienţi este migăloasă şi trebuie să se facă cu precauţie, deoarece în majoritatea cazurilor diagnosticul correct este stabilit tardiv

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS >5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p<0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication