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  • 1
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 24, No. 4 ( 2023-02-15), p. 3886-
    Abstract: As the backbone of oncological treatments, systemic chemotherapy is still one of the main pawns in cancer care, alone or in combination with newer targeted agents. All chemotherapy agents can be associated with a type of adverse event called an infusion reaction, which can be characterized as unpredictable, non-dose related, and unexplained by the cytotoxic profile of the drug. For some of these events, a certain immunological mechanism can be identified by blood or skin testing. In this case, we can speak of true hypersensitivity reactions that occur as a response to an antigen/allergen. The current work summarizes the main antineoplastic therapy agents and their susceptibility to induce hypersensitivity reactions and also includes a review of clinical presentation, diagnostic methods in hypersensitivity reactions, and perspectives to overcome these negative events in the treatment of patients suffering from various types of cancer.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 2
    In: Life, MDPI AG, Vol. 13, No. 3 ( 2023-02-21), p. 597-
    Abstract: Duodenal gangliocytic paragangliomas are rare neuroendocrine tumors primarily localized in the periampullary area. Though mostly asymptomatic, they can present with various symptoms, most often jaundice, anemia and abdominal pain. The present paper is a case series report, describing our personal experience with patients presenting to the Emergency Unit with different symptoms due to duodenal gangliocytic paraganglioma. Endoscopic resection is safe and indicated in most of the cases, being also associated with lower medical costs. EUS plays a central role in the pre-resection management and in surveillance, and immunostaining is decisive to ascertain the tumor histologic origin. In addition to reporting our experience, we researched the literature regarding these rare tumors and performed a comprehensive review.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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  • 3
    In: Energies, MDPI AG, Vol. 11, No. 12 ( 2018-12-11), p. 3469-
    Abstract: Leather processing for commercial purposes involves going through a set of complex and laborious operations, resulting in over 70% waste relative to the initial feedstock; a quarter of this waste is produced in Europe. Worldwide there are about 36,000 companies active in this sector, generating a turnover of almost 48 billion euros. As in any industrial sector, waste recovery is a highly researched topic, with alternatives for its use being constantly considered. One of the most interesting solutions to this problem consists of using part of the waste for power applications. For instance, the 10% fats from total animal waste could well be employed to power diesel engines, both in raw state or as biodiesel. The remainder, which contains mostly proteins, can be exploited to obtain biogas through anaerobic digestion. This paper presents the results of experimental determinations on the combustion of animal fats and compares it to other biofuels, such as vegetable oils and solid biomass. The advantages of co-firing hydrogen-rich gas (HRG) and vegetable biomass are also analyzed. According to the presented results, combustion of the investigated fuels has a lower impact on the environment, with the concentration of pollutants in the flue gases being low. Thus, the paper proves that all the proposed solutions are ecological alternatives for biomass exploitation for energy recovery purposes, based on comparing the results in terms of pollutant emissions. This paper provides qualitative and quantitative perspectives on multiple alternatives of energy recovery from biomass resources, while also briefly describing the methods and equipment used to this end.
    Type of Medium: Online Resource
    ISSN: 1996-1073
    Language: English
    Publisher: MDPI AG
    Publication Date: 2018
    detail.hit.zdb_id: 2437446-5
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  • 4
    In: Biomedicines, MDPI AG, Vol. 11, No. 7 ( 2023-06-29), p. 1860-
    Abstract: Background: Histologic activity has emerged as an aspirational therapeutic goal in ulcerative colitis management. It is not yet a formal treatment target in ulcerative colitis. However, it could be used as an adjunct to mucosal healing to represent a deeper level of healing. We investigated mucosal and histologic remission rates and potential predictors of these outcomes in a cohort of UC patients. Methods: We conducted a retrospective analysis of data collected from UC patients enrolled in an ongoing prospective cohort study. Mucosal healing was defined as Mayo endoscopic score = 0. Results: A total of 131 patients with ulcerative colitis were enrolled in our study and were prospectively followed for a median length of 2 years (range 0–5 years), totaling 266 study visits. Mucosal healing was recorded for 27 patients at 70 (26%) different study visits. For patients with mucosal healing, histologic remission was achieved in 18/27 (66%) patients. On univariate analysis, sustained clinical remission, SIBDQ scores ≥ 5.5, CRP ≤ 5 mg/dL and absence of corticotherapy were associated with mucosal healing and SIBDQ scores ≥ 5.5 and CRP ≤ 5 mg/dL with histologic healing, respectively. After logistic regression analysis, none of the investigated factors were associated with mucosal and histologic healing. The number of CD8+ intraepithelial lymphocytes (IELs) was significantly greater than the number of CD4+ IELs in periods of disease activity, as well as during mucosal healing (p 〈 0.01 in both cases). Conclusions: Mucosal healing and histologic remission rates are low in real-life settings. The results of univariate analysis indicate that a good quality of life (SIBDQ score) and normal inflammatory markers (CRP) are associated with mucosal and histologic healing. However, frequently used patient- and disease-related factors, including mucosal healing, are not reliable predictors for histologic remission. Greater CD8+ lymphocyte involvement and higher CD8+/CD4+ distribution can have a meaningful impact on understanding the pathogenesis and natural history of ulcerative colitis, as well as future treatment options for lymphocyte-targeting medications.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2720867-9
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  • 5
    In: Healthcare, MDPI AG, Vol. 11, No. 18 ( 2023-09-07), p. 2482-
    Abstract: (1) Introduction: Acute pancreatitis (AP) remains a global burden of cost for healthcare services. We found a high degree of heterogeneity in cost-related reports and a scarcity of data regarding the cost of AP episodes in European and Asian populations. We aimed to estimate the median daily cost of hospitalisation (DCH) of AP in our population. Our secondary aims included estimating the total cost of hospitalisation (TCH) and the total cost of AP in Romania, as well as assessing the correlation between median DCH and ward, age, sex, length of stay (LoS), intensive care unit (ICU), outcome, severity, morphology, and aetiology of AP. (2) Material and methods: This retrospective cohort study included 1473 cases recruited from the electronic health records of the University Emergency Hospital of Bucharest. Statistical tests used included Kolmogorov–Smirnov, Kruskal–Wallis with post-hoc Dunn–Bonferroni, and Pearson correlation two-tailed. (3) Results: We found a median DCH of AP of USD 203.8 and a median TCH of USD 1360.5. The total yearly cost of AP in Romania was estimated at around USD 19 million. The majority of males with AP (61.8%) were mostly discharged as healed/ameliorated (83.8%); a majority had local complications (55.4%), which were mostly alcohol-related (35.1%). Regarding the aetiology, biliary-related AP was a cost driver, with significant statistical differences observed in all studied groups (p 〈 0.01). Morphology assessment revealed that acute necrotic collections were associated with high cost and meaningful disparities among the groups (p 〈 0.01). Cost was also associated with severity, with significant deviations among all groups (p 〈 0.01). Outcome-at-discharge as deceased correlated with higher costs, with substantial differences within groups (p 〈 0.01). The need for an intensive care unit was also a large driver of cost (p 〈 0.01). Females were prone to more expensive costs (p 〈 0.01). Surgical cases necessitated more financial resources (p 〈 0.01). (4) Conclusions: To the best of our knowledge, this is the first study on the cost of AP in Romania. Our findings showed that the drivers of increased AP costs might be older age, ICU, intra-hospital mortality, severe AP, local complications such as acute necrotic collections, biliary aetiology, and female sex. We found large heterogeneity and scarcity regarding cost-related data in the literature.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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  • 6
    Online Resource
    Online Resource
    MDPI AG ; 2023
    In:  Biomedicines Vol. 11, No. 2 ( 2023-02-13), p. 544-
    In: Biomedicines, MDPI AG, Vol. 11, No. 2 ( 2023-02-13), p. 544-
    Abstract: Background: The expansion of advanced therapies for inflammatory bowel disease created a lag between the development of these new therapies and their incorporation and use in daily practice. At present, no clear definitions for treatment optimization, treatment failure or criteria to abandon therapy are available. We aimed to centralize criteria for a nonresponse to all available molecules and to summarize guideline principles for treatment optimization. Methods: We conducted a systematic review of studies that reported criteria for the treatment response to all advanced therapies (infliximab, adalimumab, golimumab, ustekinumab, vedolizumab and tofacitinib) in patients with inflammatory bowel disease. Results: Across trials, criteria for a response of both patients with ulcerative colitis and Crohn’s disease are heterogenous. Investigators use different definitions for clinical and endoscopic remission, and endoscopic response and outcomes are assessed at variable time points. Current society guidelines provide heterogenous recommendations on treatment optimization. Most available data on loss of response concern anti-TNF molecules, and newer therapies are not included in the guidelines. Conclusion: The lack of clear definitions and formal recommendations provide the premise for empirical treatment strategies and premature abandonment of therapies.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2720867-9
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