Introduction: Horseshoe appendix duplex is an extremely rare anomaly with 16 cases de-scribed worldwide. The objective of this work is to bring the 17th global case and to do a re-view of the literature. Case Report: A 15-year-old boy, received for acute appendicitis. The abdominal ultrasound revealed acute appendicitis with a small collection around. Surgery was performed and we found a horseshoe appendix in the right iliac fossa with the two bases, each communicating with the cecum. Histological examination confirmed the digestive origin of the duplex appen-dix with the four typical histological layers. Conclusion: The horseshoe shape is the rarest of appendicular duplications. It is most often discovered during appendectomies.

Acinetobacter baumannii is commonly known to cause infection in immunocompromised patients. During COVID-19 pandemic, outbreaks of multidrug-resistant organisms, including Acinetobacter, have been well documented in acute care hospitals, particularly among critically ill patients. In the case reported, a woman was admitted to our ICU because of a severe COVID-19 pneumonia. During her stay, she worsened due to Acinetobacterrelated lung cavitations and only after proper antibiotic treatment she eventually recovered. To our knowledge, very few cases have been reported pointing to Acinetobacter as a causal agent for the acute development of lung cavities, especially in COVID-19 patients.

The article highlights the views of Chinese and Russian researchers on traditional Chinese culture. A brief re-view of the literature is provided, key similarities and differences in the views of representatives of different national schools are highlighted. It is revealed that Chinese and Russian researchers are united by the recogni-tion of the importance of three main philosophical teachings, a high degree of continuity of values and tradi-tions. Differences in views are found in the definition of the core of traditional culture, the nature of its devel-opment and key areas of research. Chinese scholars often focus on Confucianism, while Russian researchers consider traditional Chinese culture in the context of the interaction of Confucianism, Taoism and Buddhism. Chinese researchers tend to perceive traditional culture as continuous, while Russian scientists study it through the prism of cyclicality and linearity. Chinese researchers focus on intangible heritage, while Russian scientists pay much attention to elements of material culture.

Introduction: Parkinson’s disease (PD) is a multisystemneurodegenerative disease that affects the centralnervous system. People with Parkinson’s disease(PPD) have both motor and non-motor symptoms.Physical exercise is one of the most promising nonpharmacologicalinterventions to complement medicaltreatment in PEP. Objective: A systematic review of theliterature was to analyze the effect of muscular strengthtraining (ST) on motor symptoms and describe how thevariables that shape EF were manipulated in studiesconducted with PEP. Methods: A systematic review ofthe literature was conducted according to the guidelinesof the Cochrane Handbook for Systematic Reviews.Studies were identified by searching four electronicdatabases: Web of Science, Scopus, PubMed, andEBSCOhost. The methodological quality of the selectedarticles was evaluated using the PEDro scale checklist.The included studies obtained a score ≥ 6. Results: The preliminary search yielded 2830 studies. Twenty articleswere considered after reviewing the abstract and full text.Seven studies were rejected for not recording some ofthe required strength training variables and three wererejected for using supplementary training to strengthtraining. A total of ten studies met the inclusion criteria.ST programs were implemented 2 - 3 times per week withintensities between 30 % - 90 % 1RM, a training volume of1 - 3 sets and 4 - 20 repetitions, sessions between 35 - 90minutes with significant improvements in resting tremor,gait measures, bradykinesia and balance. Conclusions:Regardless of how the ST stimulus was configured, thereare significant improvements in motor symptoms in PEP.These results promote the implementation of strengthtraining in PEP, but due to the low number of studies (10)and the high variability in the manipulation of the variablesthat configure the strength training stimulus, they preventus from knowing which the optimal prescription is toimprove the motor symptoms of PEP.

Treatment of cancer, one of the most fatal diseases in the present century, has become a topic of global concern. Unfavorable unintentional effects of chemotherapy and radiation treatments have been the main reasons for the research on the discovery of drugs with a broader spectrum of effectiveness and efficiency, with minimal side effects. Curcumin (diferuloylmethane) is a naturally occurring phenolic structure with anticancer properties through its inhibition of cell multiplication, metastasis, and prolongation of cell cycle suppression of apoptosis in various tumor cells. The primary restriction regarding the use of curcumin in cancer treatment is related to poor bioavailability and unfavorable pharmacokinetic profiles of curcumin due to its poor absorption rate, fast metabolism, and systemic elimination. A variety of ways have been proposed to overcome these limitations. With this background, the present study focuses on providing a comprehensive overview of the anticancer properties of curcumin derivatives and the synthesis of curcumin analogs with application to different types of cancers. The regulation of various target and signaling pathways is considered in various cancers, including breast, gastrointestinal, pancreatic, prostate, skin, and lung cancers. A review of the literature indicates that modifying the structure of curcumin through the substitution of the phenyl group and unsaturated carbon branch around the two main sites of oxygen can result in the improvement of physical and chemical properties, as well as the enhancement of physiological activities of the curcumin molecule and the anti-cancer activities of this polyphenol. Curcumin analogs demonstrate anticancer properties at multiple targets at different cell stages and by various signaling biochemical pathways. These include cytokines, transcription factors, growth factors, and modulation of genes involved in cellular proliferation and apoptosis in breast, gastrointestinal, skin, prostate, and lung cancers, thereby mitigating tumor progression.

Neuroblastoma is the most com mon extra-cranial solid tu mor in children. The survival rate of relapsed/refractory neuroblastoma is dismal. Late recurrence may occur rarely. We have, herein, presented a case with stage IV neuroblastoma who relapsed after 11 years and had a subsequent relapse after 15 years from the initial diagnosis, and reviewed cases with late relapsed (after >5 years) neuroblastoma in the literature. The case presented with recurrent disease at the T7 vertebra after 11 years from the initial diagnosis. The patient received surgery, che motherapy, MIBG treatment, and antiGD2 combined with che motherapy, and had a further local recurrence in the paravertebral area of the re moved T7 vertebra after three years. The patient was operated, received anti-GD2 combined with che motherapy, and is still alive with no symptoms for 19 months after the last relapse. There is not a well-established treatment regimen for the majority of these patients. MIBG treatment and antiGD2 combined with che motherapy may be promising options for relapsed/ refractory neuroblastoma.

Intra-articular calcaneus fractures are associated with a high rate of malunion resulting in hindfoot and ankle impingement, peroneal tendinitis, sural neuritis, arthritis, hindfoot varus or valgus deformity, loss of hindfoot height, and resulting gastrocnemius-soleus complex weakness and gait dysfunction. These issues can arise whether the patient’s injury is treated conservatively with non–weight-bearing precautions, neglected/missed, or treated surgically with open reduction and internal fixation. The sequelae of calcaneal malunions can arise early or late in this process. For patients undergoing subtalar arthrodesis following calcaneus fracture malunion, the use of a bone block wedge can assist with achieving a stable, well-aligned, pain-free hindfoot. Patient selection, preoperative planning, careful surgical technique, and compliance with postoperative care pathways are critical to optimize patient outcomes and healing of this complex reconstruction. Recent evidence supports the utility of weight-bearing CT to assist with preoperative planning for subtalar arthrodesis. Wedges used in subtalar distraction arthrodesis include bulk autograft (tricortical iliac crest), allograft (pre-fashioned or intraoperatively fashioned wedges from femoral head allograft or other source), and metallic wedges. These wedges are typically secured with screws spanning and compressing the arthrodesis site, which is filled with a mixture of concentrated bone marrow aspirate, bone growth factors, and allograft bone. Concomitant procedures may be indicated to ensure the overall success of the procedure, such as extra-articular, calcaneal osteotomy for additional realignment purposes and/or arthrolysis. A review of the literature shows high rates of union following subtalar bone block arthrodesis with improved functional outcomes. Our preferred technique for a bone block distraction subtalar arthrodesis, described herein, includes the use of an allograft wedge. Ongoing advances, such as the development of novel materials and structures for use in subtalar bone block arthrodesis, but most importantly, the incorporation of weight-bearing CT technology and potential for preoperative CT navigation to make this procedure more predictable, are all important areas for further exploration and future research. Level of Evidence: Level—IV.

Secukinumab was demonstrated to be efficient in the treatment of moderate to severe plaque psoriasis in the phase studies. Real-life treatment experiences obtained from patients that do not meet the inclusion criteria of phase studies can provide valuable information on efficacy and safety results. Results may also differ in different ethnic populations. To investigate short and long-term efficacy and drug continuation of secukinumab in Turkish population. The study conducted in three tertiary care psoriasis centers. Patients' demographic characteristics and week 0 / 4th week / 12th week / 1st year PASI values were analyzed. For systematic review of the literature a PubMed search using the keywords "secukinumab and real and psoriasis" from inception to April 2021 was performed. Mean PASI scores improved the compared to baseline at all assessment weeks (p = 0.000). In multivariate model, we found that bioexperience have negative influence on the PASI90 response at week 4. Univariate analysis showed significant relationship only between PASI90 response rate and gender at week 12 and year 1. Approximately 85% of patients remained on secukinumab treatment at the end of one year. Secukinumab seems to be an effective treatment option for plaque psoriasis. According to our knowledge, this is the first study concerning about long-term efficacy and drug continuation of secukinumab from Turkey.

Os trabalhadores, que atuam na linha de frente de combate à pandemia da COVID-19, em especial profissionais de saúde, estão expostos a mais riscos de agravos à saúde mental. O objetivo desse artigo foi identificar aspectos clínicos e epidemiológicos da saúde mental de trabalhadores da saúde, no enfrentamento à COVID-19. Foi realizada uma revisão sistemática de literatura de artigos publicados entre 1 de janeiro a 14 de maio de 2020, nas bases de dados Web of Science, Scopus, Scielo, Pubmed e Medline. Foram identificados 58 estudos, dos quais 10 artigos empíricos preencheram todos os critérios de inclusão definidos. Os modelos de pesquisa envolviam, de um lado, variáveis demográficas e ocupacionais e, de outro, agravos à saúde mental, como variáveis dependentes, destacando: depressão, ansiedade, medo, insônia e sintomas físicos. Na discussão destacam-se as principais consequências à saúde mental destes profissionais, bem como estratégias de enfrentamento e intervenções.

: The rise in age-adjusted mortality rates from hypertension and hypertensive diseases over the last several years suggests that hypertension is one of the main risk factors for heart disease. As a result, managing hypertension, both via preventive and therapeutic medicine, involves a heavy socioeconomic burden. This review paper's objective is to summarize information on chronotherapy techniques, which can make it possible for an active component to be distributed predictably and at a pace that may also minimize the patient’s illness symptoms. To incorporate published research and review papers, a comprehensive review of the literature from many sources during the past 25 years was conducted. This paper summarizes the principle and method of the chronotherapy technique. The review also throws light on different approaches that could be used to meet the need for medication for the hypertensive patient according to the circadian cycle. From the study, it was concluded that different formulation approaches are there that can work according to the principle of chronotherapy with improvement in drug bioavailability and patient compliance. To encourage future researchers to include chronotherapy in the creation of additional formulations, this review study intends to shed light on various benefits and methods of chronotherapy.

ObjectivesDevelopment of evidence-based good practice recommendations for clinicians considering the use of antibiotics in patients towards the end of life.DesignA multiprofessional group of experts in end-of-life care and antimicrobial stewardship...

Community organizing was originally intended to be the most democratic form of activism, a tool to be used to empower the marginalized and voiceless, bringing people together to work toward a common goal. While the goals of organizing activities are diverse, they can be classified within two general objectives, the first of which is resource provision and the second, transformation. Resource provision seeks to ensure that a community is provided with a resource it is lacking. Transformative organizing includes but goes beyond the goal of resource provision, endeavoring to fundamentally change the community as well as larger structures to ensure the rights and liberties of groups and individuals, and to realize a more equitable distribution of resources and power. This paper explores those aspects that differentiate transformative organizing from resource provision and makes the case that individuals involved in organizing must experience personal transformation before we are able to fundamentally change external structures and systems, as the structures organizers seek to change dwell within the emotional and psychological lives of us all.

Background: The concept of an "entourage" effect in the cannabis and cannabinoids' field was first introduced in the late 1990s, during a period when most research on medical cannabinoids focused on the effects of isolated cannabinoids, such as cannabidiol and Δ9-tetrahydrocannabinol. Over the past decade, however, with the increased understanding of the endocannabinoid system, the discovery of other phytocannabinoids and their potential therapeutic uses, the term has gained widespread use in scientific reviews and marketing campaigns. Objective: Critically review the application of the term "entourage effect (EE)" in the literature and its endorsement by certain sectors of the cannabis market. Also, explore the perspectives for further interpretation and elaboration of the term based on current evidence, aiming to contribute to a more nuanced understanding of the concept and its implications for cannabinoid-based medicine. Methods: A comprehensive review of the literature was conducted to evaluate the current state of knowledge regarding the entourage effect. Relevant studies and scientific reviews were analyzed to assess the evidence of clinical efficacy and safety, as well as the regulation of cannabinoid-containing product production. Results: The EE is now recognized as a synergistic phenomenon in which multiple components of cannabis interact to modulate the therapeutic actions of the plant. However, the literature provides limited evidence to support it as a stable and predictable phenomenon. Hence, there is also limited evidence to support clinical efficacy, safety, and appropriate regulation for cannabinoid-containing products based on a "entourage" hypothesis. Conclusion: The EE has significant implications for the medical use of cannabinoid-containing products and their prescription. Nevertheless, a critical evaluation of the term's application is necessary. Further research and evidence are needed to establish the clinical efficacy, safety, and regulatory framework for these products. It's crucial that regulators, the pharmaceutical industry, the media, and health care providers exercise caution and avoid prematurely promoting the entourage effect hypothesis as a scientific proven phenomenon for cannabinoids and other cannabis-derived compound combinations.

ObjectiveTo systematically review the literature describing children and young people (CYP) admissions to paediatric general wards because of primary mental health (MH) reasons, particularly in MH crisis.DesignPubMed, Embase, PsycINFO, Web...

The use of herbal remedies, medicinal plants, and their derivatives for the treatment and control of hypertension is well-known and widespread throughout Morocco. The aim of the study was to review the antihypertensive and vasorelaxant medicinal plants of the Moroccan pharmacopeia. To date, no review on Moroccan medicinal plants exhibiting antihypertensive effects has been performed, and their mechanism of action has not been specified. The objective of this review was to collect, analyze, and critically assess published publications on experimental and clinical research that explored the blood pressure-reducing abilities of Moroccan medicinal plant extracts. This study collected, processed, and critically analyzed published studies related to experimental and clinical research that investigated Moroccan herbal derivatives' blood pressure-lowering abilities using a number of scientific databases, including ScienceDirect, Scopus, PubMed, Google Scholar, and others. Plantlist.org was used to validate the right plant names. The results revealed 22 species of Moroccan medicinal plants belonging to 13 different groups with recognized antihypertensive properties. The species were abundant in a variety of chemical elements. Asteraceae (08 species), Lamiaceae (3 species), Apiaceae (2 species), and 1 species each from the following families: Parmeliaceae, Fabaceae, Cistaceae, Malvaceae, Polygonaceae, Brassicaceae, Myrtaceae, Rutaceae, Amaranthaceae, Rosaceae, and Lauraceae were the most frequently mentioned families for their antihypertensive properties. The most used parts were the leaves and the aerial parts. The two main methods of preparation among Moroccans were decoction and infusion. This study demonstrated the known antihypertensive and vasorelaxant properties of Moroccan medicinal plants in vivo and in vitro, as well as their mechanisms of action. Interestingly, phytochemicals can operate on blood vessels directly via a vasorelaxant impact involving a range of signaling cascades or indirectly by blocking or activating multiple systems, such as an angiotensin-converting enzyme (ACE), renin-angiotensin system (RAS), or diuretic activity. The review of the available data reveals that more work needs to be done to examine all the Moroccan medicinal plants that have been suggested as antihypertensive in published ethnopharmacological surveys. A review of the literature in this area reveals that methodologies of the experimental study need to be standardized, and purified molecules need to be studied. In addition, mechanistic investigations, when they exist, are generally incomplete. In contrast, only a few advanced clinical investigations have been conducted. However, all studies fail to determine the efficacy/safety ratio.

Background: Despite the huge global socioeconomic burden of depressive disorders, depression is often underreported and undertreated due to a lower level of awareness from both healthcare providers and payers in many countries. The lack of an evidence-based approach to care delivery has resulted in the inequitable allocation of health resources, causing resource scarcity issues in Argentina. Objective: The aim of this paper is to identify the gaps in evidence related to patients’ journeys and barriers in the existing care ecosystem contributing to poor access to quality care for depression in an Argentine context. Methods: A semi-systematic review of the literature was performed from 2012 to 2021 using Medline, Embase and Biosis and other unstructured sources (Google Scholar, the World Health Organization (WHO) website, Argentina Ministry of Health website, and Incidence and Prevalence Database (IPD) on awareness, screening, diagnosis, treatment, adherence and/or control of depression amongst adults (≥18 years). Any identified data gaps were supplemented with anecdotal data from local experts. Results: Low percentages of adult patients with depression awareness (<25%), screening (<10%), diagnosis (37.5%), received treatment (41.9%), adherence to treatment (37.5%), and control (37.5%) were observed. Conclusion: Ensuring a care continuum while considering full clinical remission with functional recovery as a therapeutic goal and advocacy for patient-centric adjustments in existing mental health policies would be key drivers for improving the depression care scenario.

Objective: This policy report aimed at two goals, that is, to report the findings of the literature review and explore the perceptions of the key stakeholders in seeking better insight into the antimicrobial stewardship program (AMSP), and to develop antimicrobial resistance (AMR) policy recommendations for the Ministry of Health and Family Welfare (MoHFW), India, based on the findings from the rapid systematic review of the literature (both published and grey) and the views of key stakeholders. Methods: A mixed method approach using literature review and qualitative interviews has been applied. A rapid systematic literature review focusing on the antimicrobial stewardship pro-gram’s key achievements and its implementation and impact, implementation challenges, gaps and barriers, and opportunities, has been carried out, which has been followed by conducting interviews of key stakeholders and reporting the findings along with the recommendations. Results: The findings have shown significant progress towards AMSP, such as expanding to 90 secondary-level hospitals and district-level hospitals/nursing homes, and the Indian Council of Medical Research antimicrobial resistance surveillance and research network (ICMR AMRSN) program. Education, training, and microbiological testing have been found to be the current focus areas. However, there exist challenges, including a lack of leadership support, diagnostic stew-ardship, and staffing of clinical pharmacists and infectious control nurses. Key gaps and barriers identified include setting up microbiology laboratories and hiring ICN nurses and clinical phar-macists. Opportunities have also been identified. Based on these findings, we have made succinct recommendations to address the themes and issues identified. Conclusion: Without new medicines, India will struggle to manage antimicrobial resistance. This situation calls for national oversight. This study has demonstrated AMSP as crucial for fighting this silent pandemic. The Indian government and policymakers must swiftly address critical chal-lenges, gaps, and opportunities. These findings and recommendations might potentially strengthen the future antimicrobial resistance national action plan (AMR NAP).

The purpose of the study is to review Russian and English-language publications that directly or indirectly address communicative imposition. The scientific novelty of the research consists in the fact that for the first time information on communicative imposition is summarized in the work, the concept of communicative imposition is clarified, and the main motives for using impositive statements and related relevant phenomena are revealed. The article describes the etymology of the lexeme " imposition ", as well as its introduction into scientific use. Using the elements of the method of systematic review of the litera-ture, the main provisions of the works of domestic and foreign researchers are presented. The intercultural aspect of the phenomenon is noted, the consideration of which can greatly affect the environmental friendliness of communication. As a result, it was determined that imposition correlates with linguistic (persistence) and socially regulated (power distance) phenomena. Aggravation of imposition often occurs as a result of leaving the "communicative corridor" of communication participants. imposition is a communicative effect associated with a threat to the speaker's face, which is culturally specific. The results of the study can be used to improve the theory of politeness and the practice of intercultural communication

To develop a nursing diagnosis proposal derived from the concept of "disuse syndrome" based on an integrative review. The conceptual derivation technique, proposed by Walker and Avant, was used in the following phases: an integrative review of the literature was carried out, applying the parameters of Whitermore and Knalf, where 43 articles were selected that covered the existence of the concept in the nursing discipline and other health sciences, the concepts were subsequently analyzed, and the new concept was redefined following the middle-range theory of causality and validation of nursing diagnoses proposed by Oliveira-Lopes etal. The proposal of the new nursing diagnosis was developed, including the following elements: diagnostic label adult disuse syndrome, the corresponding definition, 25 defining characteristics, eight related factors, eight risk populations, and 14 associated problems. The concept of the proposed new diagnosis describes adult disuse syndrome as a phenomenon that transcends the physiological component and should be viewed from a multidimensional view, expressing a clinical judgment related to a series of nursing diagnoses that appear together. The results of this study will help nursing professionals to identify the phenomenon of adult disuse syndrome in any setting and in turn guide optimal care interventions that decrease the consequences of adult disuse syndrome.

The castor plant (Ricinus communis) is primarily known for its seeds, which contain a unique fatty acid called ricinoleic acid with several industrial and commercial applications. Castor seeds also contain ricin, a toxin considered a chemical and biological warfare agent. Despite years of investigation, there is still no effective antidote or vaccine available. However, some progress has been made, and the development of an effective treatment may be on the horizon. To provide an updated overview of this issue, we have conducted a comprehensive review of the literature on the current state of research in the fight against ricin. This review is based on the reported research and aims to address the challenges faced by researchers, as well as highlight the most successful cases achieved thus far. Our goal is to encourage the scientific community to continue their efforts in this critical search.