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Management of Right Sided Carcinoid Heart Failure 右侧类癌性心力衰竭的治疗
Pub Date : 2022-05-31 DOI: 10.53785/2769-2779.1065
Ganesh Arun, I. Cheema, Lorrie Pennfield, Mohammed Raza, Erik Raborn, Ami Patel, Farhan Ali
Abstract Carcinoid heart disease is a rare complication of an already rare disease. This issue is theorized to be secondary to released proinflammatory molecules that deposit on the surfaces of heart valves. These molecules are released from the carcinoid tumor itself and manifest symptoms based on liver, lung and brain function. The detection of 5-HIAA, a breakdown source of serotonin, is useful for diagnosis. These deposits occur most commonly on the endocardium of valvular cusps and cardiac chambers. This case presents a 48 year old woman with echo findings of right heart failure in the setting of a carcinoid tumor. It is important for early recognition and treatment of cardiac lesions to prevent worsening heart failure.
类癌性心脏病是一种罕见疾病的罕见并发症。从理论上讲,这个问题是继发于释放的促炎分子沉积在心脏瓣膜表面。这些分子从类癌肿瘤本身释放出来,并表现出基于肝、肺和脑功能的症状。5-HIAA(血清素的分解源)的检测对诊断是有用的。这些沉积物最常见于瓣尖和心腔的心内膜。本病例是一位48岁的女性,在类癌肿瘤的背景下出现了右心衰的回声表现。早期识别和治疗心脏病变对防止心衰恶化具有重要意义。
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引用次数: 0
Risk of Venous Thromboembolism: The Prothrombin-G20210A Mutation and Combined Oral Contraceptives 静脉血栓栓塞的风险:凝血酶原g20210a突变和联合口服避孕药
Pub Date : 2022-05-31 DOI: 10.53785/2769-2779.1097
Nedal Darwish, Halima Bakillah, Ganesh Arun, Sowmya Srinivas, Mohamed Manaa, Kyle Berliner, Dayakar Reddy
Abstract The risk of venous thromboembolism in oral contraceptive pill users becomes dramatically increased in patients with inherited thrombophilias. The often undiscovered prothrombotic genetic conditions pose a potentially deadly threat to its generally young demographic. When thrombosis is discovered in oral contraceptive pill users with a strong family history of related events, it becomes essential to screen for prothrombotic genetic conditions and further mitigate any associated modifiable risk factors. Here we present a case of pulmonary embolism requiring cardiopulmonary resuscitation in 30-year-old female found to have a Prothrombin G20210A on oral contraceptive pills. The emergent management of the critical case, as well as the subsequent evaluation for prothrombotic conditions and the role of potential screening is discussed.
口服避孕药使用者发生静脉血栓栓塞的风险在遗传性血栓患者中显著增加。通常未被发现的血栓前遗传条件对其一般年轻人口构成潜在的致命威胁。当发现血栓形成时,口服避孕药使用者有强烈的相关家族史,就必须筛查血栓形成前的遗传条件,并进一步减轻任何相关的可改变的危险因素。在这里,我们提出一个病例肺动脉栓塞需要心肺复苏在30岁的女性发现有凝血酶原G20210A口服避孕药。危急情况下的紧急管理,以及后续评估血栓形成的条件和潜在筛选的作用进行了讨论。
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引用次数: 0
A Nurse is to a Patient What a Mother is to a Child 护士之于病人犹如母亲之于孩子
Pub Date : 2022-05-31 DOI: 10.53785/2769-2779.1103
Farhan S Imran
A physician's tribute the profession of nursing.
医生对护理职业的敬意。
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引用次数: 0
Multiparametric Ultrasound Examinations in the Diagnosis of Intraventricular Cerebral Hemorrhages in Children 多参数超声检查对儿童脑室内出血的诊断价值
Pub Date : 2022-03-31 DOI: 10.48112/acmr.v3i1.28
Gulnora Akmalovna Yusupalieva​, Adiba Rustamovna Manashova, Laylo Rustamjonovna Sultanova​, Umida Umarova, Shakhnoza Ortikboy Ortikboeva​
Intraventricular cerebral hemorrhages in children in the structure of pediatric morbidity in Uzbekistan account for about 8-15% of newborns (Statistical materials on the activities of healthcare institutions of the Republic of Uzbekistan in 2017). For the further development of perinatal neurology, it is necessary to search for new objective methods for assessing the functional and structural state of the brain. Topical diagnostics is possible with the help of radiation research methods. The present work was based on the results of a neurosonographic examination of 90 sick children with VVC. All patients underwent brain ultrasound using standard and polypositional neurosonography (stNSG and pNSG) techniques. All children in the hospital population had an increased risk of developing VVC. The ratio of newborns and children aged 1-12 months of life was approximately the same (52.5 and 47.5%), boys significantly prevailed (71.2%). More than half of the children (61.8%) were born from natural childbirth in the head presentation. In 15 children with grade II VVC, the CNS depression syndrome is more pronounced. There may be a disorder of consciousness, sopor, and in more severe cases – coma, 4 children have anomalies of pupillary reactions, 7 children oculomotor disorders were often combined with bulbar disorders (violation of sucking, swallowing, pathology of breathing and cardiac activity.) Differences with the comparison group were significant only in relation to the frequency of convulsive syndrome in 5 children.
乌兹别克斯坦儿童发病结构中的儿童脑室内脑出血约占新生儿的8-15%(2017年乌兹别克斯坦共和国医疗机构活动统计资料)。为了围产期神经学的进一步发展,有必要寻找新的客观方法来评估大脑的功能和结构状态。在辐射研究方法的帮助下,局部诊断成为可能。目前的工作是基于对90名VVC患儿的神经超声检查结果。所有患者均采用标准和多位置神经超声(stNSG和pNSG)技术进行脑超声检查。医院人群中所有儿童发生VVC的风险均增加。新生儿与1 ~ 12月龄儿童的比例基本相同(分别为52.5%和47.5%),男孩占明显优势(71.2%)。超过一半的儿童(61.8%)是在头部分娩时自然分娩出生的。在15名II级VVC患儿中,中枢神经系统抑郁综合征更为明显。可出现意识障碍、昏睡,严重者昏迷,4例患儿瞳孔反应异常,7例患儿眼动障碍常合并球功能障碍(吸吮、吞咽、呼吸和心脏活动障碍)。与对照组的差异仅与5例患儿惊厥综合征的发生频率有关。
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引用次数: 0
Effect of Antibiotic Therapy in Children with Pyelouretheral Segment Obstruction 抗生素治疗儿童肾盂输尿管梗阻的效果
Pub Date : 2022-03-31 DOI: 10.48112/acmr.v3i1.30
Abdusattor Akhatovich Nasirov, F. F. Bayakhmedov, Sayyora Markhamatovna Sobitova, Shakhnozakhon Ikboljon qizi Fozilova, Gulnoza Umidullo qizi Gaybullaeva
The present retrospective study, which was conducted from 2013 to 2018 years, includes data of 131 children with antenatally diagnosed grade III and IV hydronephrosis (SFU). All patients underwent surgical treatment at the age from 3 months to 3 years and did not receive antibiotic prophylaxis. Urinary tract infection was diagnosed in the presence of WBC in urine sample (> 10 WBC/field of view), positive bacterial growth (≥105 CFU/ml) and fever (≥38.5 ° C). Children with duplex system, obstructive megaureter, vesicoureteral reflux, posterior urethral valve, and neurogenic bladder were excluded from this study. Grade III hydronephrosis was detected in 113 children and grade IV in 18 patients. The total incidence of urinary tract infection was 9.2% (12 patients), while in the group of children with grade IV hydronephrosis it was higher (in 3 of 18 - 16.7%) than in children with grade III (in 9 out of 113 - 7.9%) (P <0.05). The incidence of urinary tract infections did not differ significantly depending on the sex or age of the patients. In 7 (58.3%) patients, urinary tract infection was noted before the age of 6 months, with an average age of 2.7 months. A bacteriological study revealed that in eight (66.7%) patients, E. Coli was the causative agent of urinary tract infection. Children with antenatal diagnosed and postnatal confirmed ureteropelvic junction obstruction do not need antibiotic prophylaxis because of the low incidence of urinary tract infection. However, patients with grade IV hydronephrosis under the age of 6 months should be closely follow-up by physicians for the early diagnosis and treatment of urinary tract infection.
本回顾性研究于2013年至2018年进行,包括131名产前诊断为III级和IV级肾积水(SFU)的儿童的数据。所有患者在3个月至3岁时接受手术治疗,未接受抗生素预防治疗。尿样中WBC (> 10 WBC/视野)、细菌阳性生长(≥105 CFU/ml)、发热(≥38.5℃)诊断为尿路感染。伴有双系统、梗阻性血压计、膀胱输尿管反流、后尿道瓣膜和神经源性膀胱的儿童排除在本研究之外。III级肾积水113例,IV级肾积水18例。尿路感染的总发生率为9.2%(12例),而IV级肾积水组(18例中3例- 16.7%)高于III级肾积水组(113例中9例- 7.9%)(P <0.05)。尿路感染的发生率并没有因患者的性别和年龄而有显著差异。7例(58.3%)患者在6个月前出现尿路感染,平均年龄为2.7个月。细菌学研究显示,8例(66.7%)患者以大肠杆菌为尿路感染的病原体。由于尿路感染的发生率低,产前诊断和产后确认输尿管肾盂连接处梗阻的儿童不需要抗生素预防。然而,6个月以下的IV级肾积水患者应由医生密切随访,早期诊断和治疗尿路感染。
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引用次数: 0
The Possibilities of Complex Echography in the Diagnosis of Acute Appendicitis in Children 复合超声在儿童急性阑尾炎诊断中的可能性
Pub Date : 2022-03-31 DOI: 10.48112/acmr.v3i1.26
G. Yusupalieva, Munisa Yakupdjanovna Abzalova, Elyor Allayarovich Akhmedov, Qudrat Nazarovich Bekimbetov, Feruz Ergashovich Turdiev​
Acute appendicitis (OA) is currently the most common urgent disease of the abdominal cavity and occurs in 2-5 people per 1,000 populations. In the Republic of Uzbekistan, this indicator is 3.05 people per 1,000 populations according to the statistical materials on the activities of healthcare institutions of the Republic of Uzbekistan. Children with acute appendicitis were admitted to the hospital with complaints lasting up to 12 hours - 110 (46.6%), from 12 to 24 hours - 49 (20.8%), from 24 to 48 hours - 43 (18.2%) and from 48 hours or more - 34 (14.4%) children. In children with a disease duration of more than a day, only destructive forms of inflammation of the vermiform process were recorded. After 24 hours from the onset of clinical manifestations, children with phlegmonous and gangrenous appendicitis were admitted. Various variants of the location of the cecum and the vermiform process made it necessary to thoroughly examine the entire abdominal cavity. In 15 children, the diagnosis of OA was excluded due to the presence of other acute abdominal diseases. Thus, ovarian apoplexy was observed in 3 girls, pelvic pain syndrome caused by various gynecological diseases in 5 girls, acute pancreatitis with diffuse pains in 2, an attack of renal colic on the right in 5 children. Thus, the study of the features of the course of various clinical forms of acute appendicitis in children allowed to increase the effectiveness of diagnosis and improve the results of treatment. Ultrasound examination is a promising and safe method of diagnosing acute appendicitis, which allows to bring the effectiveness of complex diagnostics to 100% and is of important importance when choosing treatment tactics.
急性阑尾炎(OA)是目前最常见的腹腔急症,发病率为每1000人中2-5人。在乌兹别克斯坦共和国,根据乌兹别克斯坦共和国保健机构活动的统计资料,这一指标为每1 000人中有3.05人。急性阑尾炎患儿入院时,抱怨时间长达12小时的有110例(46.6%),12至24小时的有49例(20.8%),24至48小时的有43例(18.2%),48小时或更长时间的有34例(14.4%)。在病程超过一天的儿童中,仅记录了蚓状过程的破坏性炎症形式。从临床表现开始24小时后,痰性坏疽性阑尾炎患儿入院。盲肠位置的各种变异和蚓状突使得有必要彻底检查整个腹腔。在15名儿童中,由于存在其他急性腹部疾病而排除了OA的诊断。其中卵巢卒中3例,各种妇科疾病所致盆腔疼痛综合征5例,急性胰腺炎伴弥漫性疼痛2例,右侧肾绞痛5例。因此,研究小儿急性阑尾炎各种临床表现的病程特点,可以提高诊断的有效性,改善治疗的效果。超声检查是一种有前途的、安全的诊断急性阑尾炎的方法,可使复杂诊断的有效性达到100%,在选择治疗策略时具有重要意义。
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引用次数: 0
Indicators of Biochemical Studies in Children with Bronchial Asthma and Obesity 支气管哮喘合并肥胖儿童的生化指标研究
Pub Date : 2022-03-31 DOI: 10.48112/acmr.v3i1.29
Guldonakhon Kabilzhanovna Makhpieva​, Furkat Mukhitdinovich Shamsiev, Nigora Davletovna Azizova​
The aim of the study was to identify the biochemical features of obesity in children with bronchial asthma. The results of the study showed that obesity occurs in 16.2% of the total number of children with bronchial asthma and develops against the background of unfavorable perinatal factors, concomitant and transferred diseases affecting the development, course and outcome of the disease. Diagnostic criteria were determined, including a combination of indicators of low-density lipoproteins, fasting glucose, serum insulin level, HOMA-R index. The main diagnostic criteria are: decreased concentration of high-density lipoproteins and triglycerides and impaired carbohydrate metabolism.
该研究的目的是确定支气管哮喘儿童肥胖的生化特征。本研究结果显示,支气管哮喘患儿中肥胖发生率为16.2%,其发病背景是不利的围产期因素、影响疾病发展、病程和转归的伴发和转移性疾病。确定诊断标准,包括低密度脂蛋白、空腹血糖、血清胰岛素水平、HOMA-R指数等综合指标。主要诊断标准为:高密度脂蛋白、甘油三酯浓度降低,碳水化合物代谢受损。
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引用次数: 0
Complex Radiation Diagnostics of Non-Healed Fractures and Post-Traumatic False Joints of Long Tubular Bones 长管骨未愈合骨折和创伤后假关节的复杂放射诊断
Pub Date : 2022-03-31 DOI: 10.48112/acmr.v3i1.27
Gulnora Akmalovna Yusupalieva​, Temur Abdurashidovich Yuldashev, Sherzod Farkhadovich Akhralov, Adiba Rustamovna Manashova, Umida Asqarovna Umarova​
The dependence of severity, and accordingly, the number of complications and consequences, including false joints, on the mechanism of injury is known. Recently, there has been an increase in the number of injuries resulting from exposure to high kinetic energy (road traffic, firearms), leading to an increase in disability. In this regard, in order to reduce the severity of the social consequences of injuries, specialized assistance to victims, the introduction of new diagnostic and treatment technologies, both at the stage of primary care and at the stage of treatment of consequences, is becoming important. The purpose of the study. To improve the diagnosis of ungrown fractures and post-traumatic false joints of long tubular bones by using complex ultrasound diagnostics. The study of patients was carried out in a supine position or sitting at rest and was carried out both under conditions of plaster immobilization and without it. During plaster immobilization, the sensor was positioned through a "window" in the plaster splint, while control from the healthy limb was carried out in the same position of the sensor as on the affected side.
严重程度的依赖性,以及相应的并发症和后果的数量,包括假关节,对损伤的机制是已知的。最近,由于接触高动能(道路交通、火器)而受伤的人数有所增加,导致残疾人数增加。在这方面,为了减少伤害造成的社会后果的严重程度,向受害者提供专门援助,在初级保健阶段和后果处理阶段采用新的诊断和治疗技术变得越来越重要。研究的目的。目的提高综合超声诊断对长管骨未生长骨折及创伤后假关节的诊断水平。患者采用仰卧位或休息时坐着进行研究,并在石膏固定和不固定的情况下进行研究。在石膏固定期间,传感器通过石膏夹板中的“窗口”定位,而来自健康肢体的控制在传感器与患侧相同的位置进行。
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引用次数: 0
Managing Concurrent Discitis and Epidural Abscess Following TFESI Arising from Unlikely Bacterial Species: The Importance of Post-Procedure Education 处理由不可能的细菌种类引起的TFESI并发椎间盘炎和硬膜外脓肿:术后教育的重要性
Pub Date : 2022-02-14 DOI: 10.53785/2769-2779.1071
Adlai Pappy, Robert Louis, Vinita Singh
Introduction: Transforaminal epidural steroid injection (TFESI) can provide pain relief when patients’ radicular pain is refractory to medication and physical therapy. However, it is important that clinicians understand potential signs and symptoms of TFESI complications to prevent long-term sequelae. Literature has not documented both discitis and an epidural abscess concurrently following a lumbar TFESI.
简介:经椎间孔硬膜外类固醇注射(TFESI)可以缓解患者的神经根性疼痛,当药物和物理治疗难治性。然而,临床医生了解TFESI并发症的潜在体征和症状以预防长期后遗症是很重要的。文献没有记录椎间盘炎和硬膜外脓肿并发腰椎TFESI。
{"title":"Managing Concurrent Discitis and Epidural Abscess Following TFESI Arising from Unlikely Bacterial Species: The Importance of Post-Procedure Education","authors":"Adlai Pappy, Robert Louis, Vinita Singh","doi":"10.53785/2769-2779.1071","DOIUrl":"https://doi.org/10.53785/2769-2779.1071","url":null,"abstract":"Introduction: Transforaminal epidural steroid injection (TFESI) can provide pain relief when patients’ radicular pain is refractory to medication and physical therapy. However, it is important that clinicians understand potential signs and symptoms of TFESI complications to prevent long-term sequelae. Literature has not documented both discitis and an epidural abscess concurrently following a lumbar TFESI.","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77722739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case Of Diphenhydramine With Alcohol Induced Rhabdomyolysis 苯海拉明合并酒精致横纹肌溶解1例
Pub Date : 2022-02-14 DOI: 10.53785/2769-2779.1091
Adham Abdulamir, Kayla Szolek, Wahab A Gbadamosi, M. Awais
{"title":"A Case Of Diphenhydramine With Alcohol Induced Rhabdomyolysis","authors":"Adham Abdulamir, Kayla Szolek, Wahab A Gbadamosi, M. Awais","doi":"10.53785/2769-2779.1091","DOIUrl":"https://doi.org/10.53785/2769-2779.1091","url":null,"abstract":"","PeriodicalId":7266,"journal":{"name":"Advances in Clinical Medical Research and Healthcare Delivery","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80458092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Advances in Clinical Medical Research and Healthcare Delivery
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