Rheumatic heart disease (RHD) is the leading cause of valvular heart disease in underdeveloped nations. It remains a significant public health issue in Sub-Saharan African countries. This study aimed to determine the pattern, severity, and complications of RHD in Somalia. This was a retrospective cross-sectional study of all patients diagnosed with rheumatic heart disease. A total of 8526 echocardiographic examinations were done in our center over a two-year study period from January 2020 to December 2021. Patients with congenital cardiac disease, post-operative cases, myxomatous and old age degenerative disease were all excluded. Of 433 patients, 286 (66.1%) were female, and the mean age was 46.5 ± 20.3. The isolated mitral valve (MV) affected 222 (51.3%). Dual involvement of mitral and aortic valve (AV) was present in 190 (44%). Overall isolated or combined valve involvement, mitral regurgitation (MR) was the most common valve lesion 345 (79.7%), followed by mitral stenosis (MS) 160 (37%). According to the severity of lesions, severe MR was 230 (53.1%) patients, followed by severe MS (n=129, 29.8%). The most common complication of RHD depicted in our study were secondary pulmonary hypertension and enlarged left atrium, 23.8% (n=103) and 19.6% (n=85), respectively. In conclusion, in our study majority of RHD patients were females. Both isolated and in combination, MV was the most commonly affected, and mitral regurgitation was the most common valvular lesion. In our study high percentage of patients already had complications at the time of diagnosis.

Background: The association between diabetes mellitus type 2 (T2DM) and pulmonary embolism (PE) is still unclear. Objective: The aim of this study was to determine the prognostic value of prothrombotic, proinflammatory markers, and troponin for pulmonary embolism and its complications in patients with type 2 diabetes mellitus. Methods: The retrospective cohort study included 294 patients with type 2 diabetes mellitus divided into two groups: (a) the first group with pulmonary embolism (n=165); (b) the control group without pulmonary embolism (n=129). The data were collected from May 2018 to May 2023. In all patients we analyzed: anthropometric parameters, laboratory parameters (troponin, D-dimer, CRP, fibrinogen, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides), arterial blood pressure, antiphospholipid antibodies, HOMA-IR index, CT angiography of the pulmonary artery, rate of adverse clinical events in pulmonary embolism (need for inotropic catecholamine support, fibrinolysis, cardiopulmonary resuscitation) and rate of intrahospital mortality from pulmonary embolism. Results: Troponin levels were significantly higher in the PE group compared to the non-PE group (p = 0.002). D-dimer, CRP, uric acid, fibrinogen and HOMA- IR were significantly elevated in the PE group compared to the non-PE group (p < 0.001). Patients with pulmonary embolism in T2DM proved to have significantly more in-hospital death within 10 days of hospital admission (p<0.001), compared to patients with T2DM, without pulmonary embolism. Conclusion : Prothrombotic, proinflammatory markers, and troponin have good prognostic value for short-term outcomes in PE among patients with T2DM.

Background: Lyme disease (Lyme disease-LD) is a disease of humans and animals that is transmitted by hematophagous insects, especially ticks. The causative agent is the spirochete Borrelia burgdorferi, a bacterium with a complex structure and a slow biorhythm, which has the ability to coat the host's organism with mucus - create a biofilm - or turn into a cyst, and the host does not recognize it and does not create antibodies. This is the reason why, in 10-60% of cases, Borrelia tests are negative, even though it is present. The diagnosis of LD is made clinically, and it is confirmed serologically and microbiologically by isolation and/or detection of the causative agent by the PCR method from tissue samples and body fluids. Lyme disease stage II and III is called „the great imitator“ because its symptoms resemble those of other diseases, so diagnostic errors are often made. Objective: In this article we presented a case of stubborn urticaria in a 28-year-old saleswoman. Case presentation: Mother of two children, who was ruled out by clinical examination for autoimmune diseases and allergies to available allergens. We subsequently confirmed the diagnosis of chronic borreliosis, caused by five types of borrelia, serologically, after advanced intermittent antibiotic therapy, and after acquired food intolerance was discovered. In the available literature, we did not find information that chronic generalized urticaria was caused by Borrelia in combination with food intolerance. Conclusion: The presented case of a patient with chronic urticaria indicates that similar cases with urticaria, as well as all skin changes with intermittent walking symptomatology, should: Undergo clinical treatment, rule out immunological diseases and drug allergies, then test for Borrelia (ELISA+ immunoblot with Borrelia protein sequences!). Take into account the duration of the disease, the possibility of the disappearance of antibodies created in early childhood or a false-negative finding of antibodies, and in case of a negative finding, do not give up ex-yuvantibus therapy.

Radiation-based local-regional therapies for hepatocellular carcinoma (HCC) have gained wide acceptance due to promising rates of tumor response, survival, and safety profiles. After treatment, it is important to assess tumor response to determine further management, patient prognosis, and endpoint outcomes for clinical trials. To standardize imaging interpretation and reporting of HCC response to local-regional treatment, a few imaging-based response assessment systems were developed. Two of them have emerged as the most used: the Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Algorithm (LR-TRA) and the modified Response Evaluation Criteria in Solid Tumors (mRECIST). While these systems have been validated for the assessment of response to ablative locoregional therapies, assessment of response to radiation-based therapies can be challenged by persistent or evolving imaging features and is still an area of active research. Following the advances in technology and a better understanding of tumor biology that allowed for the increased application of radiation-based local-regional therapies for the treatment of HCC, research is still needed to address the limitations of current imaging criteria for assessing tumor response to these novel techniques. In this review, we describe radiation-based liver-directed treatment options, examine imaging criteria for assessing treatment response, discuss practical limitations and gaps in knowledge when applying these response criteria, and address future directions that may help to improve accuracy and outcomes when assessing response to radiation-based HCC treatment.

Soil erosion is a problem that affects the landscape at different scales and represents a serious challenge for land management and soil conservation in both natural forests and meadows. The aim of this study was to determine how the parent material and land use affect the physical and chemical properties of the soil in the area of the Fruska gora Mountain. The soils were developed on five bedrock types: serpentinite, marl, trachyte, shale, loess and two land use types: forest and meadow. Twenty-three forest soil and 24 meadow soil from a depth of 0-20 cm were sampled from the Fruska gora Mt. Following properties were determined: pH, electrical conductivity, oxidation-reduction potential, content of organic carbon, sodium adsorption ratio, aggregate size and stability. There is no statistically significant difference in pH, Eh, EC, and SAR values between the analyzed forest and meadow soils, but there is a statistically significant difference in the content of Corg. It can be conculded that both the parent matrial, and to a slightly less extent, land use have a great influence on physico-chemical properties of the soil.

The healthcare environment is made up of highly complicated interactions between many technologies, activities, and people. Ensuring a solid communication between them is vital to ease the healthcare management. Semantic ontologies are knowledge representation tools that implement abstractions to fully describe a given topic in terms of subjects and relations. This scoping review aims to identify and analyse available ontologies which can depict all the available use-cases that describe the hospital environment in relation to the European project ODIN and its future expansion. The review has been conducted on the Scopus database on January 13th, 2023 using the PRISMA extensions for scoping reviews. Two reviewers screened 3,225 documents emerged from the database search. Further filtering led to a final set of 32 articles to be analysed for the results. A set of 34 ontologies extracted by the identified articles has been analysed and discussed as well. The results of this study will lead to the implementation of a common integrated ontology which could hold information about healthcare entities as well as their semantic relationships, strengthen data exchange and interconnections among people, devices and applications in an expanded scenario which include Internet of Things, robots and Artificial Intelligence.