Small Bowel Internal Herniation through Acquired Defect of Vesicouterine Pouch- A Late Complication following Oophorectomy

Hollow viscus herniation through a defect between vesicouterine pouch following previous pelvis surgery is exceedingly rare. There was only 1 similar case reported in the English literature. In this current report, we describe a 84-year-old woman presented with lower abdominal pain. She had a history of previous gynecology surgery. Computed tomography of abdomen showed small bowel obstruction with transition zone at the pelvis. Laparotomy revealed small bowel loops trapped in the vesico-uterine space via a narrow defect about 1.5cm. The detailed clinical summary and operative management are described in the report.

Interaction between Nitrogen, Phosphorus, and Invasive Alien Plants

Plant invasion is significantly affected by environmental factors in the recipient habitats and affects the stability and sustainable development of society. The invasiveness of alien plants may be increased by anthropogenic-mediated disturbances, such as fluctuations in nutrients caused by excessive emissions of nitrogen (N) and phosphorus (P). To improve our understanding of the interactions between N and P fluctuations and invasive alien plants, the current report focuses on the biogeochemical behavior of N and P among invasive alien plants, native plants, and the soil within the plant–soil ecosystem. Our research, together with a synthesis of the literature, shows that fluctuations in N and P resources provide more opportunities and competitiveness for plant invasion. At the same time, the biogeochemical cycles of N and P are promoted because of their efficient and increased utilization and rate of release by invasive alien plants. However, there is no consensus on whether the N and P compositions of invasive species are different from those of the natives in their habitat. Quantitative studies that compare N and P contents in plant, litter, and soil between native plant communities and invaded communities on a global scale are an indispensable area of research focus for the future.

Case Report: Combination of Olaparib With Chemotherapy in a Patient With ATM-Deficient Colorectal Cancer

Poly-ADP ribose polymerase (PARP) inhibitors are constantly increasing in their indications for use as anti-cancer treatment in various neoplasms, the majority of which are linked with BRCA deficiency. Preclinical data support the investigation of PARP inhibitors in other neoplasms exhibiting “BRCAness” or homologous recombination deficiency (HRD) as monotherapy as well as in combination with chemotherapy. With the current report we present the case of a heavily pretreated 55-year-old male patient diagnosed with stage IV ATM-deficient CRC, who was effectively treated with an off-label olaparib-irinotecan combination after exhaustion of all available treatment choices; furthermore, we discuss the existing data providing evidence for the use of PARP inhibitors in ATM-deficient CRC and encourage the implementation of next-generation sequencing (NGS) in patients with no other available treatment options.

Osteosarcoma presenting as ludwig’s angina in a down’s syndrome patient: A case report

Individuals with Down's Syndrome are predisposed to leukaemia, possibly other malignancies, various infection as well as increased mortality from other causes. osteosarcoma has been linked to genetic illnesses such as hereditary retinoblastoma, Li-Fraumeni syndrome, and Rothman-Thomson syndrome, it has not been linked to Down syndrome. Treatment plan for osteosarcoma includes surgical resection with systemic chemotherapy. Osteosarcoma is highly resistant to radiotherapy. Here we present a 21 year old female patient which is a unique case of Osteosarcoma in Down’s Syndrome patient presenting as Ludwig’s Angina. This current report highlights a clinical presentation of Osteosarcoma in Down’s Syndrome.

The Biological Use of Platelet-Rich Plasma in Skeletal Muscle Injury and Repair

Platelet-rich plasma (PRP) is a blood product that contains several growth factors and active proteins. PRP is thought to be used autologously to assist in the repair of injured tissues as well as to treat pain at the site of injury. The mechanism behind PRP in regenerative medicine has been well investigated and includes the identification and concentration of released growth factors and exosomes. The benefits of PRP have been highly recommended and are used widely in orthopaedics and sports medicine, including repair of injured skeletal muscle. This current report summarizes some of the more recent studies in the use of PRP as it relates to muscle healing, in both the in vitro and clinical arenas.

Physiological magnesium concentrations increase fidelity of diverse reverse transcriptases from HIV-1, HIV-2, and foamy virus, but not MuLV or AMV

Reverse transcriptases (RTs) are typically assayed using optimized Mg2+ concentrations (~5–10 mM) several-fold higher than physiological cellular free Mg2+ (~0.5 mM). Recent analyses demonstrated that HIV-1, but not Moloney murine leukaemia (MuLV) or avain myeloblastosis (AMV) virus RTs has higher fidelity in low Mg2+. In the current report, lacZα-based α-complementation assays were used to measure the fidelity of several RTs including HIV-1 (subtype B and A/E), several drug-resistant HIV-1 derivatives, HIV-2, and prototype foamy virus (PFV), all which showed higher fidelity using physiological Mg2+, while MuLV and AMV RTs demonstrated equivalent fidelity in low and high Mg2+. In 0.5 mM Mg2+, all RTs demonstrated approximately equal fidelity, except for PFV which showed higher fidelity. A Next Generation Sequencing (NGS) approach that used barcoding to determine mutation profiles was used to examine the types of mutations made by HIV-1 RT (type B) in low (0.5 mM) and high (6 mM) Mg2+ on a lacZα template. Unlike α-complementation assays which are dependent on LacZα activity, the NGS assay scores mutations at all positions and of every type. Consistent with α-complementation assays, a ~four-fold increase in mutations was observed in high Mg2+. These findings help explain why HIV-1 RT displays lower fidelity in vitro (with high Mg2+ concentrations) than other RTs (e.g. MuLV and AMV), yet cellular fidelity for these viruses is comparable. Establishing in vitro conditions that accurately represent RT’s activity in cells is pivotal to determining the contribution of RT and other factors to the mutation profile observed with HIV-1.

The early childhood inhibitory touchscreen task: A new measure of response inhibition in toddlerhood and across the lifespan

Research into the earliest development of inhibitory control is limited by a lack of suitable tasks. In particular, commonly used inhibitory control tasks frequently have too high language and working memory demands for children under 3 years of age. Furthermore, researchers currently tend to shift to a new set of inhibitory control tasks between infancy, toddlerhood, and early childhood, raising doubts about whether the same function is being measured. Tasks that are structurally equivalent across age could potentially help resolve this issue. In the current report, a new response inhibition task, the Early Childhood Inhibitory Touchscreen Task (ECITT), was developed. This task can be minimally modified to suit different ages, whilst remaining structurally equivalent. In the new task, participants have to overcome a tendency to respond to a frequently rewarded location on a touchscreen and instead make an alternative response. The ECITT was validated in three independent studies (with additional data, N = 166, reported in Supporting Information). In Study 1 (N = 81), cross-sectional data indicated that inhibitory performance on the task improved significantly between 24 and 30 months of age. In Study 2 (N = 38), longitudinal data indicated steady improvement in inhibitory control between 18, 21 and 24 months, with significant stability in individual performance differences between each consecutive age in terms of accuracy (but not in terms of reaction time). Finally, in Study 3 (N = 64), inhibitory performance on a faster-paced version of the same task showed a similar developmental course across the lifespan (4–84 years) to other response inhibition tasks and was significantly correlated with Stop-signal performance. The ECITT extends the assessment of response inhibition earlier than previous tasks–into early toddlerhood. Because the task is simple and structurally equivalent across age, future longitudinal studies should benefit from using the ECITT to investigate the development of inhibitory control in a consistent manner across the toddler years and beyond.

Metanephric Adenoma Associated with Unusual Urinary Candidiasis: A Challenging Morbidity from Postoperative Anastomotic Leak

Metanephric adenoma (MA) of the kidney is a rare benign neoplasm, which is mostly incidental-discovered during imaging studies for other clinical problems. However, this tumor may overlap in morphology with the papillary renal cell carcinoma and there are descriptions of metastatic disease. To date, fewer than 200 cases of MA have been reported worldwide and usually have a good prognosis. In the current report, a case of MA in a middle-aged lady is presented, which developed postoperative morbidity resulting from prolonged perinephric leakage secondary to urinary and perinephric fungus infection as a part of systemic candidiasis. The clinical, morphological and immunohistochemical features are presented together with a review of the current literature.

DETERMINATION OF THE NUMBER OF NURSES FOR HOSPITAL AID IN THE REPUBLIC OF BULGARIA

The nurses in the Republic of Bulgaria addressed a number of official demands to the Ministry of Health, one of them was to work out a long-term strategy for the development of standards, including detailed minimal requirements for the number of staff for both hospital, and outpatient care. Objectives: The goal of the current report is a summary of the regulatory documents, concerning the number of nurses in the Republic of Bulgaria, in context of the global practices. Methods: Current medical standards in the Republic of Bulgaria are being taken into account, and methods for determining the number of nurses in other countries. Results: In the period between November and December 2020, within the public consultations for projects of different Regulations for approval of medical standards, the proposed and developed methods by the Bulgarian association of health professionals in nursing to be included in the standards, which concern calculating the necessary staff of nurses, was not admitted for inclusion in any of those standards. Conclusions: Until now, the number of active nurses in the Republic of Bulgaria in all active medical standards is calculated either on the basis of doctors (not patients), or it’s pointed out that the methods of calculating the sufficient number of nurses may be applied. It should be noted that the International Council of Nurses, actually does not recommend universal methods for all countries worldwide.

Analysis of Fractal Correlation Properties of Heart Rate Variability during an Initial Session of Eccentric Cycling

Eccentric cycling (ECC) has attracted attention as a method to improve muscle strength and aerobic fitness in populations unable to tolerate conventional methods. However, agreement on exercise prescription targets have been problematic. The current report is an initial exploration of a potentially useful tool, a nonlinear heart rate (HR) variability (HRV) index based on the short-term scaling exponent alpha1 of detrended fluctuation analysis (DFA a1), which has been previously shown to correspond to exercise intensity. Eleven male volunteers performed 45 min of concentric (CON) cycling and ECC separated by 1 month. Work rates were matched for HR (~50% of the maximal HR) during the first 5 min and remained stable thereafter. HRV, HR, oxygen consumption (VO2), and cycling power were monitored and evaluated at elapsed times of 10 (T10) and 45 (T45) minutes duration. HR significantly increased between ECC T10 and ECC T45 (p = 0.003, d = 1.485), while DFA a1 significantly decreased (p = 0.004, d = 1.087). During CON, HR significantly increased (p < 0.001 d = 1.570) without significant DFA a1 change (p = 0.48, d = 0.22). Significantly higher HR was observed at T45 in ECC than in CON (p = 0.047, d = 1.059). A session of unaccustomed ECC lead to decreased values of DFA a1 at T45 in comparison to that seen with CON at similar VO2. ECC lead to altered autonomic nervous system balance as reflected by the loss of correlation properties compared to CON.