-
The Evaluation After the Zones of Laboratorial Diagnosis
Janos Vincze,
Gabriella Vincze-Tiszay
Issue:
Volume 8, Issue 1, January 2020
Pages:
1-7
Received:
5 July 2019
Accepted:
13 December 2019
Published:
7 January 2020
Abstract: During our ontogenetic development, the reference system of temporalisation is given by the synchronisation of the biophysical, biochemical and physiological needs and of the body movements. This is ruined by the requirement of minute and second accuracy of social adaptation, to which the inner biological clock of the human being is unable to synchronise. The functional scheme of the block-scheme is made of functional blocks which represent system elements or devices, which fulfil certain functions. In the schemes, the functional blocks are denoted with rectangles, bearing their names according to the functions fulfilled. In case of living systems the negative feedback regulation known from cybernetics is available only in the optimal range, as the other ranges are asymmetrical and due to this fact a modified negative feedback is created in which the regulation of major and minor ranges is not uniform. For the all laboratorial parameters exists five zones: optimum (1), admissible (2a., 2b), dangerous (3a., 3b), inactivity (4a., 4b) and inviability (5a., 5b). As a conclusion, the present medical science reserves the word perinormal for naming biophysical, biochemical and physiological responses in a wide range that warn us referring to the existence of mainly quantitative or reversible qualitative changes and the possibility of irreversibly pathological qualitative alterations. The role of the biophysics consists of the study of the vital pro¬cesses which take place in the living organisms, their correlations in the discovery of the causal relationships betOuren the phenomena, establishing the underlying connections and the quality differences of the processes which take place in the living organism.
Abstract: During our ontogenetic development, the reference system of temporalisation is given by the synchronisation of the biophysical, biochemical and physiological needs and of the body movements. This is ruined by the requirement of minute and second accuracy of social adaptation, to which the inner biological clock of the human being is unable to synch...
Show More
-
Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population
Eric Walter Pefura-Yone,
Olen Jean Pierre Kamga,
Adamou Dodo Balkissou,
Jérôme François Kaze-Folefack,
Amadou Djenabou,
Virginie Poka-Mayap,
Alain Kuaban,
Haman Djabbo Abdoul Whahab,
Sounou Asmaou,
Corine Kenne-Kenyo,
Christopher Kuaban
Issue:
Volume 8, Issue 1, January 2020
Pages:
8-13
Received:
18 December 2019
Accepted:
30 December 2019
Published:
8 January 2020
Abstract: Data on association between excessive daytime sleepiness (EDS) and hypertension are very limited in sub-Saharan Africa. The aim of this study was to look for an independent association between EDS and hypertension and identify the factors associated to EDS in adult subjects with hypertension in Cameroon. Data from cross-sectional community surveys conducted from 2015 to 2018 in three regions of Cameroon (West, Littoral, and North) were analyzed. The participants aged ≥ 19 years were included using multilevel stratified random sampling method. EDS was defined as an Epworth score ≥ 10. Subjects were considered to have hypertension if they were on treatment for hypertension or had a blood pressure ≥ 140/90 mmHg measured by standard protocols. Logistic regression was used to investigate the factors associated to EDS. The p-value < 0.05 was set as significant statistical threshold. A total of 8288 subjects (55.2% females) of median age (25th -75th percentiles) of 39 (27-54) years were included. The prevalence of EDS was higher in subjects who had hypertension as than in those without hypertension (13.4% vs 11.5%, p = 0.015), with an unadjusted odds ratio (IC 95%) of 1.19 (1.04-1.38). After multivariate analysis including place of residence, age, sex, education level and body mass index (BMI), we did not find an independent association between EDS and hypertension [odds ratio 95% CI): 1.01 (0.8-1.18), p = 0.937]. The determinants of EDS in subjects with hypertension were residence in Bandjoun [2.23 (1.12-4.11), p = 0.10], Douala [2.78 (1.48-5.25), p = 0.002] and Garoua [1.95 (1.01-3.74), p = 0.045] compared to Figuil; and BMI [1.04 (1.02-1.06) per 1kg/m2 increase, p = 0.001]. In conclusion, we did not find an independent association between EDS and hypertension in Cameroon. Obesity is associated with EDS in subjects with hypertension.
Abstract: Data on association between excessive daytime sleepiness (EDS) and hypertension are very limited in sub-Saharan Africa. The aim of this study was to look for an independent association between EDS and hypertension and identify the factors associated to EDS in adult subjects with hypertension in Cameroon. Data from cross-sectional community surveys ...
Show More
-
Capnometry in the Assessment of Pulmonary Ventilation in Patients with Bronchial Asthma
Yurii Feshchenko,
Liudmyla Iashyna,
Svitlana Opimakh,
Maryna Polianska,
Viktoria Ignatieva,
Svitlana Moskalenko,
Galyna Gumenuk,
Inna Zvol,
Nataliia Vlasova,
Liudmyla Halai
Issue:
Volume 8, Issue 1, January 2020
Pages:
14-18
Received:
16 December 2019
Accepted:
3 January 2020
Published:
13 January 2020
Abstract: Background: Bronchial obstruction as characteristic feature of bronchial asthma (BA) can lead to gas exchange disorders. The distinction of asthma is that even in patients without clinical symptoms and almost normal spirometry parameters may have been significant gas exchange disorders including that due alveolar ventilation reducing. This study aimed to investigate lung ventilation pecularities in patients with BA. Results: Among patients with uncontrolled course of 40% have a smoking history with index (25,8 ± 8,8) pack-years. In patients with uncontrolled asthma "dead" space ventilation volume is (211 ± 8) ml, and part of the "dead" space of the tidal volume - (30,5 ± 1,5)%, which is statistically significantly greater than that rate for patients with controlled asthma - (176 ± 11) ml and (24,6 ± 0,5)%, respectively, p < 0.05. Alveolar ventilation in patients with uncontrolled disease course is lower, namely (7,3 ± 0,4) l/min. than when controlled asthma - (8,3 ± 0,2), p < 0.05. Conclusions: Lung ventilation parameters in patients with asthma without exacerbation in general slightly different from those in healthy subjects, but the effectiveness of alveolar ventilation is reduced by 14% in uncontrolled asthma due to high waste "dead" space ventilation.
Abstract: Background: Bronchial obstruction as characteristic feature of bronchial asthma (BA) can lead to gas exchange disorders. The distinction of asthma is that even in patients without clinical symptoms and almost normal spirometry parameters may have been significant gas exchange disorders including that due alveolar ventilation reducing. This study ai...
Show More
-
Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol
Díaz Arizmendi Diana Elizabeth,
Mendieta Zerón Hugo
Issue:
Volume 8, Issue 1, January 2020
Pages:
19-23
Received:
27 December 2019
Accepted:
6 January 2020
Published:
13 January 2020
Abstract: Hyperthyroidism is one of the main endocrinopathies during pregnancy. The aim of this project was to identify the degree of control of hyperthyroid pregnant women based on the recommendations of the American Thyroid Association (ATA) in a real situation without the availability of propylthiouracil. This was a descriptive, retrospective and longitudinal study, including medical files of pregnant women with hyperthyroidism between 18 and 35 years. They were classified as having "Adequate" control if their thyroid profiles were within the recommendations of the ATA and had no adrenergic symptoms; and were categorized as having "Inadequate" control if they were not stabilized with monotherapy, or if they required high doses of antithyroid drugs or beta-blockers or showed serious complications including the need of an Intensive Care Unit (ICU) for mothers or neonates. The Chi square test was performed between treatment groups during the third trimester and the complications of pregnant women or neonates. A total of 173 hyperthyroid pregnant women were studied with an average age of 21 ± 4.7 years. Of the 33 patients with hyperthyroidism who received monotherapy with methimazole until the end of pregnancy, 23 (69.69%) were classified as having "Adequate" control. In a real life situation there is delay in the diagnosis of hyperthyroidism during pregnancy but even without propylthiuracil, an “Adequate” control can be reached in up to 20.53% of cases based on a methimazole monotherapy.
Abstract: Hyperthyroidism is one of the main endocrinopathies during pregnancy. The aim of this project was to identify the degree of control of hyperthyroid pregnant women based on the recommendations of the American Thyroid Association (ATA) in a real situation without the availability of propylthiouracil. This was a descriptive, retrospective and longitud...
Show More
-
Bezold Jarisch Reflex- New Interest, Old Phenomenon
Sanjeev Arya,
Shantanu Belwal,
Bhupesh Uniyal,
Bhuwan Tiwari,
Preeti Sharma
Issue:
Volume 8, Issue 1, January 2020
Pages:
24-29
Received:
13 December 2019
Accepted:
6 January 2020
Published:
16 January 2020
Abstract: Bezold Jarisch reflex (BJR) is an eponym for a triad of responses namely: bradycardia, hypotension and vasodilation that develops upon stimulation of intracardiac mechanoreceptors and is mediated by vagal afferent nerve fibers. Though it was first reported in 1867 it remains a topic of discussion due to its implications in various clinical scenarios. The reflex can be stimulated either by mechanical or chemical stimulators. Often considered a physiologic response, if identified by the clinician at earlier phase, can avoid cardiac complication, it also acts as a prognostic indicator in various diseases. This review focuses on the physiology of the BJR and its possible physiologic role in several clinical situations. We used evidence obtained from a computerized literature of medical databases search using PubMed/Medline/NIH (all articles till October 2019). The search was carried out with MeSH phrase “Bezold Jarisch reflex” and articles were limited to English language only. The relevant published reports, abstracts and human studies with clinical cases to determine the clinical implications of BJR were considered for the review. It has been concluded that BJR is a physiologic response that can occur in number of clinical scenarios. Therefore, simultaneous occurrence of bradycardia and hypotension should alert clinicians to the possibility of BJR.
Abstract: Bezold Jarisch reflex (BJR) is an eponym for a triad of responses namely: bradycardia, hypotension and vasodilation that develops upon stimulation of intracardiac mechanoreceptors and is mediated by vagal afferent nerve fibers. Though it was first reported in 1867 it remains a topic of discussion due to its implications in various clinical scenario...
Show More
-
Synthetic Cannabinoid Receptor Agonist-related Intoxication: Impact and Legislative Success
Getaw Worku Hassen,
Andrew Eng,
Ioana Scherbakova,
Aida Eliza Abdul Majid,
Alessandra Renee Piscina,
Thara Amilineni,
Cynthia Francois,
Asha Roy,
Kevin Yiu,
Canny Li,
Michael Lyashenko,
Monica Diep,
Roger Chirurgi,
Golnar Pashmforoosh,
Hossein Kalantari
Issue:
Volume 8, Issue 1, January 2020
Pages:
30-33
Received:
19 December 2019
Accepted:
16 January 2020
Published:
31 January 2020
Abstract: Synthetic cannabinoids Receptor Agonist (SCRA) intoxication presents with various medical and psychiatric symptoms. The products are sold as K2 or Spice. The symptoms range from agitation, altered mental status (AMS), lethargy, paranoid behavior, psychosis and seizures. In some cases, brief psychiatric or inpatient medicine admission was required for stabilization. Some patients seem to stay longer for observation in the ED. These patients worsen the already problematic ED crowding. To assess K2-related ED presentation, length of stay in the ED and types of disposition over a 5 year period. A retrospective chart review of patients who presented with K2 intoxication. Charts were reviewed from January 1, 2012 until December 31st, 2016 excluding 2016. Demographics, age, gender, past psychiatric illness and other substance abuse history were reviewed. A total of 1405 patients were seen for K2-related ED visits from January 1, 2012 until December 31st, 2016 of which 1279 patients (91%) were male and 126 patients (9%) were female. One hundred thirty nine patients (9.9%) were hospitalized and 1266 patients (90.1%) were either discharged or left from the ED. Twenty-eight (2.0%) stayed more than 16 hours in the ED. Of the 53 patients, whose urine the showed benzodiazepine or opiates 36 patients stayed more than 6 hours in the ED. Most patients with K2 use were male (91%) between the ages of 19 and 50 years (76.4%). There was a surge in K2-related presentation in 2015, particularly in the months of April until November. In addition, K2-related intoxication led to prolonged ED stay, which could affect the ED crowding phenomenon. A concerted effort from public pressure and legislative measures led to a reduction of K2-related visits to the ED.
Abstract: Synthetic cannabinoids Receptor Agonist (SCRA) intoxication presents with various medical and psychiatric symptoms. The products are sold as K2 or Spice. The symptoms range from agitation, altered mental status (AMS), lethargy, paranoid behavior, psychosis and seizures. In some cases, brief psychiatric or inpatient medicine admission was required f...
Show More
-
The Biophysical Modeling of Fracture Types
Janos Vincze,
Gabriella Vincze-Tiszay
Issue:
Volume 8, Issue 1, January 2020
Pages:
34-39
Received:
21 January 2020
Accepted:
10 February 2020
Published:
18 February 2020
Abstract: The fracture leads immediately to the impossibility to perform certain movements, followed by tumefaction, sharp pain, haematoma, sometimes a visible deformation and even a wound of the skin, in the case of an open fracture. For any person who has the signs of fracture, that region must be immobilized immediately during first aid and for the final healing they must be taken to the hospital. A fracture can appear in various circumstances: through a direct- and indirect-mechanism or is called “pathological bone fracture”. The degree of fracture we distinguish: incomplete fractures, complete fractures and avulsions. The knowledge of fracture types has therapeutic implications. The very frequently fracture types are next: compression, rupture, bending, extension, torsion. In this paper we use the biophysical modeling of different fracture types. To get hold of the biophysical view is not an easy task, because it applies mathematical apparatus to biological systems, on the other hand as a reward it guides to fascinating results, recognizing theoretically which conformity of rules are valid on principle in the inanimate-living-spiritual triple system from the lowest to the highest organizational level.
Abstract: The fracture leads immediately to the impossibility to perform certain movements, followed by tumefaction, sharp pain, haematoma, sometimes a visible deformation and even a wound of the skin, in the case of an open fracture. For any person who has the signs of fracture, that region must be immobilized immediately during first aid and for the final ...
Show More
-
Predictive Value of Caprini Venous Thromboembolism Risk Assessment Model for Deep Vein Thrombosis in Intensive Care Unit Non-surgical Patients
Xin Zhang,
Wanxian Lu,
Miaohang Shan
Issue:
Volume 8, Issue 1, January 2020
Pages:
40-44
Received:
9 February 2020
Accepted:
19 February 2020
Published:
28 February 2020
Abstract: Objective: By evaluating the relationship between deep vein thrombosis (DVT) in intensive care unit (ICU) non-surgical patients and Caprini venous thromboembolism risk assessment model (Caprini model for short), the predictive value of Caprini model in ICU non-surgical patients was analyzed. Methods: 200 ICU non-surgical inpatients in the first affiliated hospital of Jinan university from April to September 2019 were retrospectively analyzed. General data of patients and the number of new DVT events were collected, and Caprini model was used for scoring the risk of venous thromboembolism (VTE). Results: There were 31 patients with DVT, accounting for 15.50%, and 169 patients without new DVT (non-DVT). Caprini model score was 9.03±2.70 in patients with DVT, higher than that in patients without DVT (6.80±2.48, P<0.001). 24 (12.00%) non-surgical ICU patients were at high risk of VTE and 171 cases (85.50%) were at very high risk. Only one patient with DVT was at high risk of VTE (3.23%), while the other 30 patients were at very high risk of VTE (96.77%). There were 1 case in low risk of VTE (0.59%), 4 cases in medium risk (2.37%), 23 cases in high risk (13.61%) and 141 cases in very high risk (83.43%) in non-DVT group. There was no significant difference in VTE risk stratification between DVT patients and non-DVT patients (P=0.063). The receiver operating characteristic (ROC) curve was plotted by using Caprini model score to predict DVT. The area under the ROC curve was 0.731, and the 95% confidence interval was 0.663-0.791 (P<0.001). The optimal cut-off point was 7, the sensitivity was 74.19%, the specificity was 65.68% and Youden’s index was 0.3897. Conclusion: The incidence of high risk and very high risk of VTE in ICU non-surgical patients was high, and Caprini model could better predict the occurrence of DVT, so it was necessary to strengthen the nursing of ICU non-surgical patients and effectively prevent DVT.
Abstract: Objective: By evaluating the relationship between deep vein thrombosis (DVT) in intensive care unit (ICU) non-surgical patients and Caprini venous thromboembolism risk assessment model (Caprini model for short), the predictive value of Caprini model in ICU non-surgical patients was analyzed. Methods: 200 ICU non-surgical inpatients in the first aff...
Show More
-
Management of the Bronchial Asthma Patients at Practice of Family Doctors
Yuriy Mostovoy,
Anna Demchuk,
Tetyana Konstantynovych
Issue:
Volume 8, Issue 1, January 2020
Pages:
45-50
Received:
9 February 2020
Accepted:
18 February 2020
Published:
28 February 2020
Abstract: With purpose to assess the primary care for bronchial asthma (BA) patients the anonymous survey of 175 family doctors was performed. We established low percent (2,9%) of self-depended diagnosis of BA by family doctors. It showed their extremely poor role in the primary BA diagnosis. The most frequently diagnosis of BA made by pulmonologist or allergist (75,4%). The management of a patient with BA was performed by a family doctor in collaboration with allergist or pulmonologist in 53,2% of cases, 70% family doctors meet with BA patients for control of disease every 1-3 month. They prescribed correct basis therapy with inhaled corticosteroid (ICS) or combination of ICS with long-action beta agonist most of patients. Misinterpretation of asthma control are showed by most of family doctors. The vast majority of patients (98.8%) had at least one exacerbation of asthma per year. Only 25% of family doctors treated patients with BA exacerbation self-dependently. They used nebulization of high doses of bronchodilators and ICS for treatment of BA exacerbation in outpatient setting for 91,4% of cases. We found low level of prescriptions of systemic corticosteroids for treatment of BA exacerbations in outpatient setting and misunderstanding of systemic corticosteroid therapy. Family doctors need additional educational activities and monitoring adherence to national and international guidelines.
Abstract: With purpose to assess the primary care for bronchial asthma (BA) patients the anonymous survey of 175 family doctors was performed. We established low percent (2,9%) of self-depended diagnosis of BA by family doctors. It showed their extremely poor role in the primary BA diagnosis. The most frequently diagnosis of BA made by pulmonologist or aller...
Show More
