Παρασκευή, 2 Δεκεμβρίου 2016

What is COPD?

This video describe what COPD, or obstructive pulmonary disease, is and it's symptoms.

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Plasma and saliva miR-21 expression in colorectal cancer patients

Abstract

MicroRNA-21 (miR-21) expression was quantified by real-time qRT-PCR in peripheral blood and saliva samples obtained from patients diagnosed with colorectal cancer (CRC) of varying degrees of malignancy and healthy volunteers. All patients had adenocarcinoma located in the distal colon at different stages. Significant differences were detected between the control group and the total experimental group of CRC patients (plasma, P = 0.0001; saliva, P = 5e-12). MiR-21 expression was also significantly different in certain subgroups of patients with CRC disease stages II–IV as compared to the control group. No correlation of miR-21 expression was found with regard to gender and age of patents. Also, there were no significant individual correlations and linear regression of miR-21 expression in the plasma and saliva. The estimated diagnostic sensitivity and specificity of miR-21 expression were respectively 65 and 85% in the plasma, and 97 and 91% in the saliva. Our data suggest that miR-21 in both the saliva and plasma could be a proper biomarker for CRC screening, although the saliva miR-21 expression test looks preferable due to its higher sensitivity, specificity, and technical simplicity.



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What is COPD?

This video describe what COPD, or obstructive pulmonary disease, is and it's symptoms.

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What is COPD?

This video describe what COPD, or obstructive pulmonary disease, is and it's symptoms.

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What is COPD?

This video describe what COPD, or obstructive pulmonary disease, is and it's symptoms.

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Texas dispatcher talks woman through own baby delivery

By EMS1 Staff

HOUSTON — A dispatcher formed a special bond with a woman who gave birth to a baby this week. 

Dispatcher Renae Whitehouse received a 911 call Thursday morning from a woman who was going into labor. The 26-year-old woman told Whitehouse that she was home alone on her living room floor. 

"At first I was like, it probably won't happen before the medic unit gets there," Whitehouse told ABC. "And then she just had contraction after contraction after contraction. It was like, 'Oh, this is really happening.'"

The woman told Whitehouse she could feel the baby's head. Whitehouse instructed the woman to apply firm pressure to prevent the baby's head from delivering too quickly. Around eight minutes later, deputies arrived at the woman's home and the baby was delivered seconds later. 

"I cried a little bit after it was done," Whitehouse said. "I'm not gonna lie. I was just so happy."



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Mo. paramedic awarded Medal of Valor for daring rescue

By EMS1 Staff

VILLA RIDGE, Mo. — A paramedic was one of 10 first responders who were awarded the Medal of Valor this week.

"Each of these officers ignored extraordinary dangers to themselves, and instead thought only of the lives of others — people they had never met but who they have a solemn duty to protect," Gov. Jay Nixon said during the ceremony Monday. 

Meramec Ambulance paramedic Jordan V. Selsor was recognized for his efforts during a rescue, in which a victim was trapped in a vehicle that was quickly filling with floodwater, reported the EMissourian. Dispatchers lost contact with the victim once the water reached the victim's neck.

Since no other responders were at the scene, Selsor and another paramedic donned a lifevest and broke the rear window of the partially submerged vehicle. 

Although more water rushed into the vehicle, Selsor climbed onto the roof of the car to break the sunroof window. Due to the water's clouded nature, Selsor blindly pulled the victim out through the sunroof. Selsor then waited with the victim in knee-high water until rescue crews transported them to shore. 

The victim was treated for hypothermia; Selsor sustained numerous superficial cuts and abrasions.

"The Medal of Valor recipients carry out brace, decisive and selfless acts to protect the lives of other and make our communities safe. We should all be grateful for our outstanding public safety officers and they sacrifices they make to protect us." Gov. Nixon said.



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Meetings Calendar



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Editorial Board



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Change of command

I was taught at the Quantico Marine Officer training facility that a "change of command" was the formal transfer of legal authority and recognized command to orders from an existing commander of troops to a new commander, as directed by published orders. We practiced this and all sorts of close-order drill and ceremony on the sticky black tarmac of Quantico, where majors became light colonels, gunnery sergeants ascended to fearsome sergeants major, while we listened to the padres bless the profession of mass killing in tautologies that convinced me that he, dressed in the OD gabardine of the private Marine, was in another life a Jesuit at Fordham Prep, rousting the usual 16-year-old product of the Bronx underworld.

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Re: Chow, misleading negative conclusions on LLLT efficacy in an updated review of physical modalities in neck pain treatment

Thank you for allowing us the opportunity to respond to this letter. Please find our response below.

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Table of Contents



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Table of Contents



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Table of Contents



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Misleading negative conclusions on the efficacy of low-level laser therapy (LLLT) for neck pain

As a longtime researcher in the area of low-level laser therapy (LLLT), particularly in the treatment of neck pain [1,2], I would draw the Editors' attention to the misleading conclusion, by omission, in the abstract of the review by Wong et al. of various modalities in the treatment of neck pain [3]. This was an update of a previous review by the Bone and Joint Decade Task Force [4] and not a de novo review. The earlier review stated that there was "consistent evidence" for LLLT efficacy in the treatment of neck pain.

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Table of Contents



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Shear wave elastography reveals different degrees of passive and active stiffness of the neck extensor muscles

Abstract

Purpose

The neck extensor muscles contribute to spinal support and posture while performing head and neck motion. Muscle stiffness relates to passive elasticity (support) and active tensioning (posture and movement) of muscle. It was hypothesized that support and motion requirements are reflected in the distribution of stiffness between superficial and deep neck extensor muscles.

Methods

In ten healthy participants, shear modulus (stiffness) of five neck extensor muscles was determined in prone at rest and during isometric head lift at three intensities using shear wave elastography.

Results

Shear modulus differed between muscles (P < 0.001), and was larger for the deeper muscles: (median (interquartile range)) trapezius 7.7 kPa (4.4), splenius capitis 6.5 kPa (2.5), semispinalis capitis 8.9 kPa (2.8), semispinalis cervicis 9.5 kPa (2.5), multifidus 14.9 kPa (1.4). Shear modulus differed between the resting condition and head lift (P < 0.001) but not between levels of head lift intensity.

Conclusion

Shear wave elastography revealed highest passive and active stiffness of the deep neck extensor muscles most close to the spine. The highest active increase of stiffness during the head lift was found in the semispinalis cervicis muscle. The non-invasive, clinically applicable estimates of muscle stiffness have potential for the assessment of muscular changes associated with neck pain/injury.



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Changes in stiffness of the dorsal scapular muscles before and after computer work: a comparison between individuals with and without neck and shoulder complaints

Abstract

Purpose

The aim of this study was to compare the stiffness of the dorsal scapular muscles before and after computer work between individuals with and without neck and shoulder complaints.

Methods

Thirty subjects were divided into patient (n = 18) and control (n = 12) groups. The stiffness of the upper trapezius, levator scapulae, and rhomboid major was measured using ultrasound elastography before and after a 30-min typing task. The strain ratio of the muscle to an acoustic coupler was calculated (a lower strain ratio value indicates greater muscle stiffness).

Results

At baseline, the strain ratio of the upper trapezius in the patient group (3.762 ± 1.679) (mean ± SD) was significantly lower than that of the control group (7.763 ± 5.921) (p = 0.041). No significant change in the strain ratio of the upper trapezius after the typing task was observed in the patient group (4.158 ± 3.465) (p = 0.549). A significant decrease in the strain ratio of the levator scapulae after the typing task was observed in the patient group (before: 9.006 ± 7.079, after: 5.718 ± 2.847) (p = 0.022), whereas there was no significant change in the control group (p = 0.436).

Conclusions

The increase in stiffness of the upper trapezius is an objective finding and may be a persistently altered condition in individuals with neck and shoulder complaints. The patterns of change in stiffness of the levator scapulae are different between individuals with and without neck and shoulder complaints.



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The effect of fexofenadine, a newer second-generation antihistaminic, on phenobarbitone sleeping time and its comparison with terfenadine, astemizole and cetirizine in albino rats

2016-12-02T09-51-39Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Suresha K R, Suryanarayana R Babushaw.
Background: The second-generation antihistaminic fexofenadine has been claimed to be superior to terfenadine and cetirizine, in possessing the negligible sedating property and can be safely given to pilots and drivers. Here, it is a study that compares the sedative property of fexofenadine to terfenadine, astemizole, and cetirizine by phenobarbitone induced sleeping time in albino rats. Aims and Objectives: To evaluate the nonsedative antihistaminic action of fexofenadine and comparing it with cetirizine, terfenadine, and astemizole. Materials and Methods: A total of 90 albino rats of either sex weighing 100-200 g were selected and randomly divided into nine equal groups. At 0 h phenobarbitone 40 mg/kg is injected intraperitoneal to the rats. The animals are placed on their backs, and duration of loss of righting reflex is measured. Each rat was pretreated at −1 h with the drugs orally using orogastric tube. The different groups are as follows: Group 1 was given distilled water; Groups 2-9 were given with fexofenadine 20 mg and 40 mg/kg. Terfenadine 20 mg and 40 mg/kg, cetirizine 2 mg and 4 mg/kg, and astemizole 2 mg and 4 mg/kg body weight, respectively, and data are statistically analyzed by unpaired t-test and ANOVA. Results: The mean phenobarbitone sleep time duration of fexofenadine (20 mg and 40 mg) is comparable to placebo and is less sedative. This study shows cetirizine produces longer duration of sleep (P

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Analysis of commonly used pediatric systemic antibacterial liquid formulations for rational drug therapy

2016-12-02T09-51-39Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Payal P Naik, Chaitali D Mehta, Sachendra K Srivastava.
Background: Antibiotics are frequently prescribed medication. When drugs are dispensed in form of syrups or suspensions, appropriate volume should be dispensed in a bottle otherwise, it may result into wastage of drug, inadequate treatment, and resistance and also increased cost of treatment. Aims and Objective: The aim of our study was to analyze systemic antibacterial liquid formulations to ascertain the availability of adequate strength, volume dispensed for adequate treatment. Materials and Methods: The commonly available (IDR triple, Issue 2, 2016) oral liquid antibacterial formulations were analyzed. According to the weight of child (for 12 and 18 kg), amount of drug and requirement of number of bottles for 5 days were calculated. Results: Majority of manufacturers have dispensed inadequate volume of antibacterial drugs which was not sufficient for one course of therapy. For example, most of the formulations of cephalexin, cefixime, cefpodoxime, and amoxicillin + clavulanic acid were available in dispensing volume of 30 ml. This results into inadequate dose, wastage of drug (residual volume), resistance, and unnecessary social and financial burden to the patient. Hence, more number of bottles shall be required to complete a course of antibiotic. Conclusion: The dispensing volume of oral liquid dosage forms of most of the formulations were inadequate and thus, minimum amount dispensed should be 60 ml or as applicable for an antibiotic.


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Clinicopathological correlation of serum prostate specific antigen levels in patients of prostatomegaly in a tertiary care hospital

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Vitesh Popli, Amit Rajan, Sonali Bose, Amit Kamewad.
Background: In clinical practice, biopsies are generally performed only when the results of a prostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract symptoms (LUTS) who have serum PSA levels higher than 4 ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific but not cancer specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH), and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA-based prostate cancer detection is fraught with high false-positive rate. Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e., prostatitis, BPH in prostatomegaly, and its correlation with serum PSA levels. Materials and Methods: This prospective descriptive study was conducted in Command Hospital (EC), Kolkata, West Bengal, India, in the period of June 2011 to June 2013. The patients were selected from the outdoor of Department of Urology and General Surgery. Institutional Ethical Committee Clearance and informed consent of all patients were obtained. 101 men at or >50 years of age presenting with LUTS specifically attributed to prostate problems were included in the study. Men with calcified or fibrotic prostate, with skeletal or distant metastasis or LUTS caused by any urological malignancy and who had previous prostatic surgery or pelvic radiotherapy or complications of urinary obstruction, were excluded from the study. Results: A total of 101 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority, i.e., 49 (48.5%) of the study group were in the age group of 61-70 years. 52 (51.5%) of patients had serum PSA


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Study of clinico-epidemiological profile, drug utilization pattern, and outcome of swine flu cases: A recent epidemic in Latur

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Aruna Gurung, Jugalkishor Bhavarlal Jaju, Shrikant Chandrakant Dharmadhikari, Ganesh Ramkrishna Pawar, Rajvardhan Rameshrao Solunke.
Background: Swine flu, an acute respiratory tract disease, is caused by swine flu virus. The World Health Organization (WHO) declared the H1N1 pandemic in June 2009 after more than 70 countries reported cases of H1N1 infection. Since 2009-2014, 59,677 cases and 4141 deaths have been reported in India. Objective: To study the clinico-epidemiological profile, drug utilization pattern, and outcome of H1N1 positive cases admitted to swine flu ward from January 2015 to September 2015 at a tertiary care hospital in Latur. Materials and Methods: The study was conducted from January 2015 to September 2015 at Government Medical College (GMC), Latur. Clinicoepidemiological profile, treatment details, and outcome of the patients were recorded. Prescription pattern was analyzed using the WHO International Network for Rational Use of Drug use indicators. Results: A total of 52 swine flu positive cases were admitted to GMC, Latur, out of which 38 (73.07%) were female patients and 14 (26.92%) were male patients. Total numbers of drugs prescribed were 267. The most common antimicrobial prescribed was oseltamivir. Total drugs prescribed from the National List of Essential Medicine 2015 were 98 (36.70%). Conclusion: This study is an attempt to know the clinico-epidemiological profile, drug utilization pattern, and outcome in swine flu positive patients. A good adherence to the WHO guideline for clinical management of swine flu cases, the Joint Indian Chest Society and the National College of Chest Physician guidelines, and the WHO Essential Drug List was seen in our study. However, prescription with the brand name, polypharmacy, and excessive use of fixed dose combinations are a matter of concern.


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Cutaneous metastasis: An unusual presenting feature of silent renal cell carcinoma

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Pradosh Kumar Sarangi, Pragnyamaya Debadatta Mangaraj, Pratisruti Hui, Sasmita Parida, Jayashree Mohanty.
Renal cell carcinoma (RCC) is a potentially lethal cancer with aggressive behavior and propensity for metastatic spread. However, it is very rare for RCC to present as metastasis to skin and it is virtually a sign of poor prognosis. Skin metastases have been reported to occur in around 3% of RCC. The most common site for cutaneous metastasis from RCC is the scalp and face, followed by the chest and the abdomen. Herein, we are reporting a case of RCC in a 60-year-old man who presented to us with multiple skin nodules in thorax and abdomen as the sole complaint. Fine needle aspiration cytology from these nodules revealed metastatic deposits of RCC though the patient had no urologic symptoms. Computed tomography and ultrasonography of abdomen revealed right RCC with multiple secondaries in liver, spleen, lungs, chest wall, abdominal wall with retroperitoneal lymphadenopathy, and inferior vena cava thrombus. This case highlights the ubiquity of RCC metastasis and emphasizes the importance of keeping RCC as differential in patients who present with cutaneous metastases.


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Socioeconomic impact on prevalence of chronic suppurative otitis media in school going children in a tribal district of India

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Sachin Garud, Aniket Buche, Prashant Keche, Gaurav Chamania.
Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in the South East Asia having a prevalence of approximately 5.2% in the general population. The socioeconomic cost of CSOM can hamper the auditory development of the child, thus putting a burden on the society. Objective: To find the prevalence of CSOM in school going children and its relation with socioeconomic status. Materials and Methods: Descriptive cross-sectional study involving 990 schools going children in Nanded District of Maharashtra. Result: The prevalence of CSOM was found to be 6.4%, with tubotympanic type constituting majority 87.50% trailed by atticoantral type 12.50%. With respect to socioeconomic groups, upper and lower groups had 37.5%, and lower group had 34.37% prevalence. The most patients presented with moderate hearing impairment 43.75% and mild hearing impairment 31.25%. Conclusion: The socioeconomic cost of CSOM puts an immense burden on the growth of a child. Improvement of health care facilities and awareness among health-care providers would definitely be helpful in reducing the prevalence of ear diseases in the developing countries like ours.


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A cross-sectional study to assess the knowledge and practices about breastfeeding among women in Sembakkam village, Kancheepuram District

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Sahaya Sona Thresa.
Background: Breastfeeding is one of the most effective ways to ensure child health and survival. A lack of exclusive breastfeeding (EBF) during the first 6 months of life contributes to over a million avoidable child deaths each year. Objectives: To estimate the prevalence of EBF and to assess the knowledge and practices about breastfeeding. Materials and Methods: This cross-sectional descriptive study was conducted for a period of 18-month in Sembakkam village. Universal sampling was employed based on the prevalence study, and the sample size was 334. All women with children between 6 and 24 months of age were included as study participants after obtaining written informed consent. Data entry was done in Microsoft Excel, and statistical analysis was performed using SPSS version 23. Chi-square test was used for testing the association at P = 0.05. Results: The prevalence of EBF among the mothers was observed to be 69.1% whereas 30.9% did not practice EBF for their children up to the recommended period. Further, parameters such as educational status, socioeconomic status, occupation, mode, and place of delivery had a significant impact on the prevalence of EBF, and they were statistically significant. Conclusion: The prevalence of EBF in this study was 69.1%. The study participants had good knowledge about breastfeeding though some gaps were observed with regard to their practices. The study clearly emphasized the importance of increasing awareness among pregnant women about breastfeeding and even gave impetus on the necessity of family supporting breastfeeding for the recommended duration.


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Prescription pattern of antihypertensive drugs in a tertiary care teaching hospital

2016-12-02T09-16-04Z
Source: International Journal of Medical Science and Public Health
Rajeev Mishra, Priyanka Kesarwani, Shyam Sunder Keshari.
Background: Hypertension is a major health problem all over the world. It is not a disease in itself, but it is an important risk factor for cardiovascular mortality and morbidity. Objective: To evaluate the prescribing pattern of antihypertensive drugs in a tertiary care teaching hospital in Lucknow region. Materials and Methods: A cross-sectional study was carried out at the Outpatient Department in a tertiary care teaching hospital in Lucknow to access the prescription pattern of antihypertensive drugs during October 2015 to July 2016. Results: In the present study, 65.2% patients received monotherapy while 34.8% received combination therapy. In monotherapy, calcium channel blockers (CCBs) were most commonly prescribed, while angiotensin receptor blockers (ARBs) + diuretics were the most commonly prescribed combination therapy. Conclusion: In the present study, it was found that CCBs were the most commonly prescribed antihypertensive drug, followed by ARBs in monotherapy. Combination therapy was given according to associated risk factors and comorbid conditions.


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The Icee Company selects Getac T800 Rugged Tablet to streamline sales & service activities and conduct remote online training

Handheld tablet becomes all-in-one solution for ICEE using fully rugged design, fast processor, integrated features, and large viewing screen in small form factor

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Total intravenous anesthesia without muscle relaxant in a parturient with amyotrophic lateral sclerosis undergoing cesarean section: a case report

Cases of amyotrophic lateral sclerosis with pregnancy are quite rare. The aim of this case report is to present the successful use of total intravenous anesthesia without muscle relaxant for cesarean section in a parturient with amyotrophic lateral sclerosis at 35 weeks' gestation. The parturient presented with impaired neuromuscular function. Titrated general anesthesia with short-acting anesthetics was applied. During the procedure, no muscle relaxant was used. This strategy helped avoid prolonged ventilation and prevent maternal respiratory complications.

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Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy

To evaluate the effects of postoperative dexmedetomidine infusion on sleep quality in patients undergoing abdominal hysterectomy.

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Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial

To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy.

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Hypocapnia measured by end-tidal carbon dioxide tension during anesthesia is associated with increased 30-day mortality rate

To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS).

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Airway management for glossopexy in infants with micrognathia and obstructive breathing

To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia.

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Cerebral air embolism after ERCP

Digestive endoscopic procedures have become increasingly common diagnostic and therapeutic procedures in hospitals. Generally they are safe procedures and complications, though infrequent, can occur and are potentially lethal. As the number of procedures performed increases, the complications arising are likely to become more frequent, so it is advisable to bear this in mind when establishing early diagnosis and treatment.Cerebral air embolism is a rare complication after a digestive endoscopic procedure, although in the case of endoscopic retrograde cholangiopancreatography (ERCP), may be as high as 10%.

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A Pregnant Teen Living in an Area With Active Zika Virus Transmission

"For the past week or so during the night I feel hot and then I feel chilled. This morning I saw a rash on my face and stomach," stated a 16-year-old female patient at a visit to her local health clinic. The patient, at 20 weeks' gestation, is halfway through her first pregnancy. She had been in her usual good state of health until 1 week ago, when she noticed mild, flu-like symptoms.

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A survey study in diabetic subjects on the general information about diabetes mellitus, it’s social aspects, complications and treatment

2016-12-02T04-57-08Z
Source: Medicine Science | International Medical Journal
Gokhan Colpan, Merve Colpan, Canan Ersoy.
Diabetes mellitus (DM) is a metabolic disorder affecting many people worldwide, and its complications have become a global public health burden. Most diabetic patients are not aware of their conditions and the importance of the disease until complications develop, despite education programmes. This study was conducted to evaluate the general information level of diabetic patients about DM, its social aspects, treatment and complications. Patients with type 1 and 2 diabetes were enrolled in the study. A face to face questionnaire was applied to obtain patients' general information and diabetes awareness. To evaluate the overall knowledge, 40 questions were asked. In the assessment of the total scale scores (TSS), each correct answer was scored as 1 and incorrect as 0 point. The mean age of 120 participants was 42.5±15.4 years, 60.8% were females, 75% were married. The information level about the complications were statistically significantly higher in female diabetics than males. Information level about treatment of diabetes was higher in single diabetics compared to married ones. Married group had significantly higher scores concerning complications compared to single group. The results for the general information level, social aspect of diabetes, treatment and TSS were found to be statistically significantly higher in high education level group compared to low. In conclusion, education level of a patient seems to be the most prominent contributor of level of knowledge of diabetes, its complications, treatment and social aspects.


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Factor analyses for the Örebro Musculoskeletal Pain Questionnaire for working and non-working patients with chronic low back pain

The ÖMPQ has good psychometric properties to predict return to work in patients with acute low back pain. Although it is used in patients with chronic back pain and non-workers, there is no evidence on the factor structure of the ÖMPQ in these populations. This is deemed an important prerequisite for future prediction studies.

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The impact of obesity on compensatory mechanisms in response to progressive sagittal malalignment

Obesity's impact on standing sagittal alignment remains poorly understood, especially with respect to the role of the lower-limbs. Given energetic expenditure in standing, a complete understanding of compensation in obese patients with sagittal malalignment remains relevant.

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Finding the right fit: studying the biomechanics of under-tapping with varied thread depth and pitch

Compromise of pedicle screw purchase is a concern in maintaining rigid spinal fixation, especially with osteoporosis. Little consistency exists among various tapping techniques. Pedicle screws are often prepared with taps of a smaller diameter, which can further exacerbate inconsistency.

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Effect of flunarizine on memory function by using step down passive avoidance test in albino rats

2016-12-02T04-03-15Z
Source: International Journal of Basic & Clinical Pharmacology
Vinod Shinde, Radha Yegnanarayan, Khyati Doshi, Akhil Agarwal.
Background: Aim of the study was to evaluate effect of flunarizine on memory function by using step down passive avoidance test in albino rats. Methods: The study approved by IAEC was conducted using 24 albino rats (n= 6 in each group). Effect of normal saline (0.1 ml/100g), fluoxetine (10 mg/kg, intraperitoneally (ip)), and flunarizine (2 and 10 mg/kg, ip) on memory retrieval in rats was evaluated by using Step-down passive avoidance test. One day prior to conducting the test, each rat was trained to stay on central shock free zone platform (SFZ) for at least 90s. For the training, animals were applied shock of 15s every time when the rat stepped down placing all the paws on the grid floor. On the consecutive day retention of the memory was tested thirty minutes after administration of all test drugs. Step down latency (SDL) and number of mistakes was observed for a period of 5 min in all rats. Results: The data was analyzed by one-way analysis of variance (ANOVA) and Students t-test and P


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Pharmacological evaluation of substituted 4, 5-diphenyl furan-3-carboxamide compound for antidepressant activity in mice

2016-12-02T04-03-15Z
Source: International Journal of Basic & Clinical Pharmacology
Jayakumar J. K., Nityakarnam, Kishore Kumar P., Supriya.
Background: Depressive disorder is a prevalent psychiatric disorder, which affects 21% of the world population. Many drugs are available as effective antidepressants. But still there is necessity of developing novel compounds with minimized side effects. Hence this study was aimed to investigate the antidepressant activity of novel furan compound in albino mice. Methods: Antidepressant activity of novel furan compound was investigated by using forced swimming test (FST) and tail suspension test (TST) models. Fluoxetine was used as standard drug in this study. Results: It has been observed from our study that medium dose of test compound (10 mg/kg) reduced duration of immobility time to 35 seconds when compared to control group (147 seconds) in FST model. In TST model, the test compound of medium dose (10 mg/kg) had produced 83% protection against passive behaviour which is almost similar to standard drug fluoxetine (100%). Conclusions: The results of the specifies that compared to other two doses of test compound (5 mg/kg and 20 mg/kg), medium dose of test compound found as an effective dose for treating depression produced due to stress. However, further expansion of the study is needed for this compound to prove as a novel effective antidepressant compared to other drugs available for treating depression.


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A prospective study on adverse drug reactions reported in a tertiary referral hospital

2016-12-02T04-03-15Z
Source: International Journal of Basic & Clinical Pharmacology
Brahadeesh Mayathevar, Dhivya Thiyagarajan, Thamilarasi Soundararajan, Vallish B. N., Rizwan S. A..
Background: To determine the incidence of Adverse drug reactions in our hospital, to study the age wise distribution, the role of concurrent medication and the common drugs that are prone to cause adverse drug reactions and its seriousness. Methods: After getting prior approval from Institutional ethical committee a prospective study was done where in cases attending OPD, ward, ICU were studied over a year. A complete history was taken regarding drug exposure (dosage, date started, duration and interruptions in use), initiation of drug use and onset of reaction ,previous adverse drug reactions, improvement after decrease in dosage, disease states predisposing to eruptions, previous family and personal history of skin disease, environmental and occupational exposure to chemicals. Relevant laboratory test such as blood investigations, liver and renal function tests are carried out and results were analysed statistically by SPSS version 21 and interpretations done based on the results. Results: Incidence of ADR among OPD =0.18, IPD=1.98, OPD+IPD=0.39 /1000cases.The highest incidence of Adverse drug reactions were found among the age group of 30-39 years (27.45%), 40-49 years (23.53%), with the highest among antibiotic group of drugs (35.29%) involving a maximum duration of 2-7 days. Drug reactions mostly occurred with the oral route 66.67) and most of it requiring hospitalization (47.06%), 60.78% of reactions were manifested in skin, 58.82% of patients with ADR had concomitant medications and 19.61% had Diabetes mellitus, 90% of reactions abated after drug withdrawal with regard to its outcome 94.12% of reactions recovered. Conclusions: The study suggest the adverse drug reactions commonly occur in middle age, mostly manifesting in skin with oral route of administration ,associated with concomitant medications and it requires hospitalisation with a good recovery rate with diabetes being the common comorbid disorder.


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ACTN3 X-allele carriers had greater levels of muscle damage during a half-ironman

Abstract

Purpose

Alpha-actinin-3, encoded by the ACTN3 gene, is an actin-binding protein with an important role in myofibril contraction and muscle force output. In humans, there is a relatively common deficiency of the α-actinin-3 due to homozygosity in a polymorphism of the ACTN3 gene (R577X, rs1815739), that has been related to decreased resistance to strain during voluntary muscle contractions. The purpose of this study was to investigate the influence of the ACTN3 genotype on the level of exercise-induced muscle damage attained by 23 experienced triathletes during an official half-ironman competition.

Methods

Before and after the race, a sample of venous blood was obtained and jump height was measured during a countermovement jump. The changes in serum creatine kinase (CK-MM isoform) were measured in the blood samples and muscle pain was measured with a visual analogue scale (0–10 cm). Data from RX heterozygotes and XX mutant homozygotes were grouped as X-allele carriers (n = 13) and compared to RR homozygotes (n = 10).

Results

Race time was very similar between groups (313 ± 31 vs. 313 ± 25 min; P = 0.45); however, pre-to-post-competition reduction in jump height was greater in X-allele carriers than RR homozygotes (−18.4 ± 11.4 vs. −8.2 ± 6.9%; P = 0.04). At the end of the race, X-allele carriers presented higher serum CK-MM concentrations (682 ± 144 vs. 472 ± 269 U/L; P = 0.03), and there was also a tendency for higher self-reported values of lower limb muscle pain (7.7 ± 1.1 vs. 6.3 ± 2.3 cm; P = 0.06).

Conclusions

X-allele triathletes in the ACTN3 R577X polymorphism presented greater signs of exercise-induced muscle damage during a half-ironman race than RR homozygotes.



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Escobar syndrome: non-lethal multiple pterygium syndrome case report

2016-12-02T01-57-08Z
Source: Medicine Science | International Medical Journal
Bayram Ali Dorum, Hilal Ozkan, Nilgun Koksal.
Escobar syndrome is a rare disorder that is a nonlethal variant of multiple pterygium syndromes. It is usually diagnosed in utero on fetal ultrasound and then confirmed in the neonatal period. Escobar syndrome is characterized by arthrogryposis multiplex congenita, excessive pterygia, congenital contractures, and abnormal facial appearance. It manifests as an autosomal recessive condition, and is caused by homozygous or compound heterozygous mutation of the CHRNG gene. Other variable features include growth retardation, congenital respiratory distress, ptosis, low set ears, cleft palate, and cryptorchidism. In this article, a newborn patient with Escobar syndrome was presented to share difficulties in the neonatal period, and the clinical features were discussed in the light of the literatüre.


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The Influence of Test Positions on Clinical Assessment for Scapular Dyskinesis

Appropriate evaluation of scapular dyskinesis is essential for therapy strategies. Although the current visual-based assessment is rapid and practical, the reliability of this method is unsatisfactory. It is necessary to adequately understand the conditions of assessment to maximize the benefit of therapeutic interventions.

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Monitoring the short-term effect of intravenous immunoglobulins in multifocal motor neuropathy using motor unit number index

To determine whether motor unit number index (MUNIX) is pertinent to monitor the effect of intravenous immunoglobulins (IVIg) in multifocal motor neuropathy (MMN).

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Anesthesia for nonintubated video-assisted thoracic surgery.

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Purpose of review: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. Recent findings: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive. As a consequence, the need for general anesthesia and endotracheal intubation has been re-examined, such that regional or epidural analgesia may be sufficient for cases where lung collapse can be accomplished with spontaneous ventilation and an open hemithorax. This concept of NIVATS has gained popularity, and in some centers has now expanded to include procedures involving placement of multiple ports. Although still relatively uncommon at present, a small number of randomized trials and meta-analyses have indicated some advantages, suggesting that NIVATS may be a desirable alternative to general anesthesia with endotracheal intubation for specific indications. Summary: Although anesthesia for NIVATS is associated with some of the same risks as general anesthesia with endotracheal intubation, NIVATS can be successfully performed in carefully selected patients. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers.

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Purpose of review: Acute kidney injury (AKI) occurs in up to 30% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice. Recent findings: We present an updated review on the use of blood and urinary NGAL in CSA-AKI. NGAL is a good predictor, and performs better in children than adults. There is a large variation in predictive ability, possibly caused by diversity of AKI definitions used, different time of measurement of NGAL, and lack of specificity of NGAL assays. Similarly, there are conflicting data on the predictive ability of urinary [TIMP-2] [IGFBP7] for CSA-AKI. Recently, both for NGAL and for urinary [TIMP-2] [IGFBP7], a set of actions, based on pretest assessment of risk for CSA-AKI and biomarker test results, was developed. These scores should be evaluated in prospective trials. Summary: NGAL and urinary [TIMP-2] [IGFBP7], in combination with pretest assessment, are promising tools for early detection and treatment in CSA-AKI. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Decisions regarding forgoing life-sustaining treatments.

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Purpose of review: Decisions to forego life-sustaining treatments are complex, and disagreements between physicians and patients occur. This review discusses recent findings regarding what factors influence physicians and patients or their surrogates in these decisions and considers whether futility arguments regarding life-sustaining treatments should be abandoned. Recent findings: Cardiopulmonary resuscitation is one paradigm in the literature for studying end-of-life decision-making. Outcomes for cardiopulmonary resuscitation are poor, and physicians tend to over-rely on tacit versus evidence-based knowledge for resuscitation decisions. Physician decisions are often inherently biased regarding elderly and intellectually impaired patients. Patient decisions regarding life-sustaining treatments are poorly understood by physicians, and also include inherent bias against the elderly and intellectually impaired. Although patients and their decision-makers frequently incorporate religious or spiritual beliefs in their decisions, physicians rarely discuss these factors with them. Defining 'futility' is problematic, and futility arguments have limited utility in clinical end-of-life treatment discussions. Summary: Further research is needed about factors that affect both physicians and patients with regard to forgoing life-sustaining interventions. Physicians need more information regarding religious/spiritual preferences of patients and decision-makers. 'Futility' arguments in end-of-life decision-making are flawed and should probably be abandoned. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Preoperative evaluation and preparation of the morbidly obese patient.

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Purpose of review: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. Recent findings: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management. Medical history-taking and physical examination ought to be performed following a standardized scheme especially focussing on the presence of obstructive sleep apnea. Routine testing for fasting glucose and lipoprotein levels should be performed in order to diagnose a metabolic syndrome. ECG recording should be limited to those patients having one or more additional cardiac risk factors or presenting clinical signs of cardiovascular disease or were planned for intermediate or high-risk surgery. Spirometry should be limited to those patients with obstructive sleep apnea or other respiratory findings. Summary: Synthesis of proper medical history-taking and physical examination as well as detailed search for obstructive sleep apnea and metabolic syndrome are key components of preoperative evaluation. Further testing should be based on the findings of these steps and comprise the cardiac risk of the surgical procedure. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Spectrum of postoperative complications in pulmonary hypertension and obesity hypoventilation syndrome.

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Purpose of review: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. Recent findings: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. Summary: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse. Pulmonary hypertension was only recently classified as an independent risk factor for postoperative complications in the American Heart Association/American College of Cardiology Foundation Practice Guideline for noncardiac surgery. Spinal anesthesia should be avoided in most surgeries on patients with pulmonary hypertension because of it's rapid sympatholytic effects. The presence of significant right ventricle dysfunction and marked hypoxemia should prompt re-evaluation of the need for elective surgery. Obesity hypoventilation syndrome is even harder to recognize preoperatively as arterial blood gases are generally not obtained prior to elective noncardiac surgery. Amongst patients with obstructive sleep apnea this group of patients carries much higher risk of postoperative respiratory and congestive heart failure. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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