Case Report of a Hidden Intruder-Extremely Rare Presentation of Hydatidosis as a Nuchal Tumoural Mass.

Introduction: The parasitic tapeworm impersonated by the larvae of Echinococcus granulosus represents the aetiology of the hydatid pathology. The predilect site of invasion is the liver, but there are other cases of different localization all over the body, regardless of the type of invaded tissue. Soft tissue hydatidosis can be a real challenge for the clinician in terms of the diagnosis, and it might generate various complications such as anaphylactic shock. The aim of the present work is to illustrate a unique case of primary hydatidosis located in the nuchal region. Case Report: We report the case of a 68-year-old male patient, a zootechnic, who presented at the hospital with a tumoural mass (dimension: about 12/10 cm) located in the nuchal region. The complex approach needed consisted of surgical therapy along with histopathological confirmation of the diagnostic and antiparasitic medication, which led to a complete recovery with a low probability of recurrence. Discussion: Encounters with patients with primary soft tissue hydatidosis are exceptionally rare, but the surgeon must take into consideration this clinical diagnosis, especially for patients located in an endemic region with occupations that might have exposed the patient to this type of parasite.

A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy-A Case Report.

Colonic malakoplakia is an uncommon granulomatous development of cells resulting from the impaired capacity of the mononuclear cells to eliminate the phagocytosed bacteria, and in rare cases it can also affect the gastrointestinal tract. We report the case of a 78-year-old female patient that was admitted to hospital by The Emergency Department with the diagnosis of bowel obstruction, confirmed by the clinical and paraclinical investigations. We decided to surgically manage the case for suspicious symptomatic colonic neoplasm. The histological examination of the surgical specimens revealed colonic malakoplakia, characterized by the presence of the aggregated granular histiocytes and Michaelis-Gutmann bodies. Through this paper, we want to raise awareness for Malakoplakia, which remains an extremely rare disease that may affect multiple organs, and because it does not present specific symptoms or clinical manifestations, the final diagnosis remains the histopathological study. The clinical conduct should be decided after taking into consideration all the aspects of this pathology along with the benefits and risks for the patient.

Improving the Pharmacists' Response to Public Health Emergencies-Documentary Research on Online Resources Provided by National Pharmacists' Associations.

Objectives: Given the expanding role of pharmacists during COVID-19 pandemic, we aimed to investigate the approach of professional associations to supporting their practice and to find ways to improve their response to public health emergencies. Methods: We conducted documentary research on websites of seven national pharmacists' associations, submitted the findings to a comparative thematic analysis, and made proposals of specific good practices. Results: Many great resources were provided by pharmacists' associations in Australia, France, Spain, and the US. The similarities include scientific information on COVID-19 tests, treatments and vaccines, legal issues, and wellbeing management. The main differences were in developing medication management programs, supporting hospital pharmacists, helping families, or advocating for an equitable vaccination. In Finland, Hungary and Romania, the focus was on updating emerging information. Considering the need for better managing public health emergencies at organizational level, we suggested good practices regarding training and communication. Conclusion: Professional associations should develop preparedness and response plans for public health emergencies. Practical training and effective communication could improve the resilience of pharmacists and patients during pandemics, which could save lives.

The effect of 100-200 nm ZnO and TiO2 nanoparticles on the in vitro-grown soybean plants.

Engineered nanomaterials are increasingly used in everyday life applications and, in consequence, significant amounts are being released into the environment. From soil, water, and air they can reach the organelles of edible plants, potentially impacting the food chain and human health. The potential environmental and health impact of these nanoscale materials is of public concern. TiO2 and ZnO are among the most significant nanomaterials in terms of production amounts. Our study aimed at evaluating the effects of large-scale TiO2 (~100 nm) and ZnO (~200 nm) nanoparticles on soybean plants grown in vitro. The effect of different concentrations of nanoparticles (10, 100, 1000 mg/L) was evaluated regarding plant morphology and metabolic changes. ZnO nanoparticles showed higher toxicity compared to TiO2 in the experimental set-up. Overall, elevated levels of chlorophylls and proteins were observed, as well as increased concentrations of ascorbic and dehydroascorbic acids. Also, the decreasing stomatal conductance to water vapor and net CO2 assimilation rate show higher plant stress levels. In addition, ZnO nanoparticle treatments severely affected plant growth, while TEM analysis revealed ultrastructural changes in chloroplasts and rupture of leaf cell walls. By combining ICP-OES and TEM results, we were able to show that the nanoparticles were metabolized, and their internalization in the soybean plant tissues occurred in ionic forms. This behavior most likely is the main driving force of nanoparticle toxicity.

Efficiency of platelet-rich plasma therapy for healing sports injuries in young athletes.

In recent years, platelet-rich plasma (PRP) therapy has been a subject of controversy in orthopedics field. Our objective was to assess the efficiency of PRP therapy for patients who have suffered grade 2 meniscal lesions and grade 2 anterior cruciate ligament (ACL) lesions, graded by magnetic resonance imaging (MRI). A retrospective observational study was conducted, which included 72 young recreational athletes who had been diagnosed with grade 2 meniscal injury, graded using MRI, that benefited from PRP therapy as an enhancement of the primary treatment, after cast immobilization. The Lysholm score, the pain intensity and the resuming of the physical activity before the PRP treatment and one month after were analyzed. Our study revealed that patients had an improved subjective perception of pain after PRP therapy and an improvement of the Lysholm score. Concurrently, 83.3% of patients could return to sports and daily physical activity. It can be concluded that PRP therapy is a safe, easy to manage treatment, efficient for pain relief and in resuming of sports activities for young recreational athletes who have sustained partial meniscal or ACL tears. In terms of pain relief, it appears that the PRP therapy could be more efficient for young patients with ACL injuries.

Evaluating the Functional Outcomes and the Quality of Life for Pediatric Patients with Osteogenesis Imperfecta after Fracture Treatment with Intramedullary Rodding.

BACKGROUND AND OBJECTIVES: Osteogenesis imperfecta is a rare pathology involving the bones and the connective tissues, generating alterations that lead to frequent fractures during childhood. When fractures occur at birth, they are associated with an impairment of walking and the quality of life. Although surgical techniques have significantly improved in recent years, functional outcomes and the quality of life for pediatric patients that benefited from surgical management with telescopic rods have been less evaluated. This study aimed to measure functional results and determine the factors that influence the quality of life for the pediatric population diagnosed with Osteogenesis imperfecta and surgically treated using the telescopic rod approach after suffering a fracture or severe deformity. MATERIALS AND METHODS: We conducted a cohort study that consisted of 15 patients diagnosed with Osteogenesis imperfecta (average age of 11.6 years). All individuals possessed at least one intramedullary telescopic rod as a result of the surgical treatment. RESULTS: We observed that the pain, both acute and chronic, impairs the quality of life and interferes with daily living activities, for instance, self-care tasks. CONCLUSIONS: Osteogenesis imperfecta is associated with a severely damaged level of walking. All of the aspects of the pediatric patient's daily life activity seem to be affected. Furthermore, these patients, especially those residing in rural areas, have a poor quality of life.

Research on developing environmental ethics in pharmacists' activities.

BACKGROUND: Authors of various backgrounds are preoccupied with the meaning of environmental ethics, which refers to specific values, norms, attitudes, and practices with respect to all beings and elements of nature. Many international organizations have adopted important documents proclaiming the ethical obligation to protect the environment in all professional activities. At the national level, professional associations should include and develop this obligation in their codes of conduct. This study aimed to analyze and compare elements of environmental protection included in codes of conduct for pharmacists, to find ways to integrate environmental ethics into their activities. METHODS: Seven codes of conduct for pharmacists were analyzed using the comparative method and methods of legal interpretation. Based on acknowledged values and principles of environmental ethics, a framework model for developing environmental protection in pharmacists' activities was created via an iterative process of reflection and discussion. RESULTS: Explicit provisions for environmental ethics were found in codes in force in three countries and in a Romanian project. These provisions refer, in general, to an ethical duty of environmental protection in pharmacists' activities. Regarding the other codes, the study could only interpret stipulations of public health ethics to deduce an ethical environmental obligation. Considering the need for developing such provisions, an ethical framework was proposed as a model for professional associations of pharmacists. CONCLUSIONS: The studied codes demonstrate a preoccupation of the professional associations with environmental protection in pharmacists' activities, with different degrees of interest in developing environmental ethics. To this end, the codes of conduct for pharmacists should include environmental values, principles, and ethics guidelines. Those guidelines should indicate the ethical attitude in relation to the environment for each activity. Further research is needed to stimulate, shape, and develop an environmental ethical behavior in pharmacists' practice.

The Relationship between the Dominant Hand and the Occurrence of the Supracondylar Humerus Fracture in Pediatric Orthopedics.

It is known that during a fall, a child would rather protect their dominant hand by using the non-dominant one, although the role of handedness in upper limb fractures has not been studied in-depth. We carried out a retrospective, cross-sectional cohort study, including pediatric patients who presented to the emergency room with a supracondylar humerus fracture following an injury by falling from the same height. In total, 245 patients were selected and grouped according to age. In the 1-3 years group, no statistical significance was found between hand dominance and the side of fracture (p = 0.7315). During preschool years (4-6 years old), the non-dominant hand is more often involved (p = 0.03, odds ratio: 3.5). In the 7-14 years group this trend was maintained and actually increased (p = 0.052, odds ratio: 3.8). We might conclude that children tend to protect their dominant hand by falling on their non-dominant one. The main objective of this study is to highlight a link between handedness and the side of the body where the hand fracture will be identified in the pediatric population, regarding supracondylar humerus fracture.

Heterocycles 51: Liphophilicity investigation of some thiazole chalcones and aurones by experimental and theoretical methods.

Reversed-phase thin-layer chromatography and reversed-phase high-performance liquid chromatography were used for lipophilicity determination of a library of 30 thiazole chalcones and aurones previously synthetized in our laboratory. The experimental lipophilicity data have been compared with theoretical lipophilicity parameters estimated by various computational methods. Good correlations between the experimental and calculated lipophilicity parameters have been found for both investigated classes of compounds. Correlations between the lipophilicity of the thiazole chalcones and aurones and their antiproliferative activity were discussed. The methodologies and data gathered in this study will contribute to the lipophilicity studies of chalcones and aurones derivatives, two important classes of compounds in medicinal chemistry.

Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review.

Background and Objectives: Distal symmetrical polyneuropathy (DSPN) is one of the most common chronic complications of diabetes mellitus. Although it is usually characterized by progressive sensory loss, some patients may develop chronic pain. Assessment of DSPN is not difficult, but the biggest challenge is making the correct diagnosis and choosing the right treatment. The treatment of DSPN has three primary objectives: glycemic control, pathogenic mechanisms, and pain management. The aim of this brief narrative review is to summarize the current pharmacological treatment of painful DSPN. It also summarizes knowledge on pathogenesis-oriented therapy, which is generally overlooked in many publications and guidelines. Materials and Methods: The present review reports the relevant information available on DSPN treatment. The search was performed on PubMed, Cochrane, Semantic Scholar, Medline, Scopus, and Cochrane Library databases, including among others the terms "distal symmetrical polyneuropathy", "neuropathic pain treatment", "diabetic neuropathy", "diabetes complications", "glycaemic control", "antidepressants", "opioids", and "anticonvulsants". Results: First-line drugs include antidepressants (selective serotonin reuptake inhibitors and tricyclic antidepressants) and pregabalin. Second- and third-line drugs include opioids and topical analgesics. While potentially effective in the treatment of neuropathic pain, opioids are not considered to be the first choice because of adverse reactions and addiction concerns. Conclusions: DSPN is a common complication in patients with diabetes, and severely affects the quality of life of these patients. Although multiple therapies are available, the guidelines and recommendations regarding the treatment of diabetic neuropathy have failed to offer a unitary consensus, which often hinders the therapeutic options in clinical practice.

Green pharmacy - a narrative review.

INTRODUCTION: Active pharmaceutical ingredients are present in various sections of the environment, because of both the human and veterinary use of medicinal products. Ways of minimizing the risk of environmental contamination should be observed during all pharmaceutical activities (research, manufacturing, prescribing, dispensing and disposal of medicinal products). METHODS: For the present study we searched specific literature on this subject, using the main international databases (Thomson Reuters - Web of Science, SCOPUS and Science Direct). RESULTS: This narrative review focuses on the main aspects concerning environmental contamination with medicinal products. Consequently, the present study is structured on four different topics: environmental research on medicinal products, minimizing environmental contamination, waste disposal management and towards a greener community pharmacy. CONCLUSION: Waste management activities are important for reducing the presence of active pharmaceutical ingredients in the environment. Pharmacists should inform patients on proper pharmaceutical waste disposal and organize collection programs for unused and expired medicines, in order to develop a greener pharmacy for the future.

Heterocycles 33: lipophilicity of a new class of thioethers estimated by reversed-phase thin-layer chromatography and different computational methods.

The retention behavior for a series of new polyheterocyclic compounds containing azolic rings (1,3-thiazole, 1,2,4-triazole, 1,3,4-oxadiazole, 1,3,4-thiadiazole) has been investigated using reversed-phase thin-layer chromatography. Different approaches and computational methods were employed to evaluate their lipophilicity indices derived from chromatographic parameters. The obtained experimental results were correlated with various lipophilicity indices estimated via different computer software and internet websites. A strong correlation between experimental and computed results was observed. Furthermore, the lipophilicity parameters obtained by applying principal component analysis divided the investigated compounds into four groups according to their structural similarities.