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Elevated Hemidiaphragm and Shortness of Breath: Challenges in Clinicoradiologic Integration 膈肌抬高和呼吸急促:临床和心理整合的挑战
Pub Date : 2018-12-06 DOI: 10.1159/000494618
V. Podder, R. Biswas, N. Sehgal
Unilateral diaphragmatic paralysis is often suspected when a hemidiaphragm is found abnormally elevated on chest radiography. Chest radiography has a high sensitivity for diaphragmatic palsy. A 67-year-old male presented to the hospital with a history of 4 months of exertional breathlessness that improved after taking a rest. The patient had normal cardiac and respiratory physical function. He also had a normal electrocardiogram and good systolic function on echocardiography. A treadmill test revealed ST-segment changes during peak exercise and recovery phases. On chest X-ray, his right hemidiaphragm was shown to be significantly elevated. Further investigation was conducted to rule out diaphragmatic paralysis, and the findings took a surprising turn to an entirely different diagnosis.
当胸部射线照相发现半横膈膜异常升高时,通常会怀疑单侧横膈膜麻痹。胸部x线摄影对膈肌麻痹有很高的敏感性。一名67岁的男性,有4个月的运动性呼吸困难史,在休息后有所改善。患者的心脏和呼吸物理功能正常。他心电图正常,超声心动图显示收缩功能良好。跑步机测试显示,在运动高峰和恢复阶段,ST段发生变化。胸部X光片显示,他的右半横膈膜明显抬高。为了排除膈肌麻痹,进行了进一步的调查,结果出人意料地转变为完全不同的诊断。
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引用次数: 1
Strengthening the Ability of General Hospital Neurology Departments to Treat Neuropsychiatric Diseases and Mental Disorders 加强综合医院神经内科治疗神经精神疾病和精神障碍的能力
Pub Date : 2018-08-23 DOI: 10.1159/000491998
Wei-wen Zhu, Weidong Pan
Due to the “stigma” of neuropsychological and psychogenic disorders in China, patients with psychological and affective disorders mostly prefer to go to general hospitals or integrative medicine hospitals, while the majority of patients with mental disorders in the department of internal medicine are treated in the department of neurology. At present, there are few physicians with the ability to diagnose and treat neuropsychiatric diseases properly in the neurological department of general hospitals in China, and the diagnosis and treatment experience of mental diseases is insufficient. At the same time, the diagnosis and treatment of comorbid patients with internal diseases and mental disorders are more complicated. The psychology departments in general hospitals or mental health centers also have a limited ability to diagnose and treat comorbid diseases relating to internal medicine and mental disorders together. Therefore, this article reviews the current status of diagnosis and treatment of neuropsychiatric and mental disorders in general hospitals or integrative medicine hospitals.
由于中国对神经心理和心因性障碍的“污名化”,心理和情感障碍患者大多倾向于去综合医院或中西医结合医院就诊,而内科精神障碍患者大多在神经内科就诊。目前,国内综合医院神经内科具备正确诊断和治疗神经精神疾病能力的医师很少,对精神疾病的诊治经验不足。同时,内科疾病和精神障碍合并症患者的诊断和治疗更为复杂。综合医院或精神卫生中心的心理科诊断和治疗与内科和精神障碍有关的合并症的能力也有限。因此,本文就综合医院和中西医结合医院神经精神障碍的诊治现状进行综述。
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引用次数: 0
Impact of Internet Addiction on Mental Health: An Integrative Therapy Is Needed 网络成瘾对心理健康的影响:需要一种综合治疗
Pub Date : 2018-08-01 DOI: 10.1159/000491997
A. Tripathi
In the past few years internet addiction (IA) and internet gaming disorder (IGD) have become very frequent, leading to many personality and psychiatric disorders including low self-esteem, impulsivity, poor sleep quality, mood disorder, and suicide. IA has been included in Appendix III of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) as IGD. In addition, IA leads to many neuroanatomical and neurochemical alterations including cortical thinning of various components of the brain and altered dopaminergic reward circuitry. Due to widespread neuropsychiatric and neurobiological implications of IA, multiple therapeutic approaches are needed. Integrative therapy in the form of yoga and mindfulness has proven to be effective in many addiction disorders including IA.
在过去的几年里,网络成瘾(IA)和网络游戏障碍(IGD)变得非常频繁,导致许多人格和精神障碍,包括自卑、冲动、睡眠质量差、情绪障碍和自杀。IA已作为IGD列入《精神障碍诊断与统计手册》(DSM-5)附录III。此外,IA导致许多神经解剖学和神经化学改变,包括大脑各组成部分的皮质变薄和多巴胺能奖励回路的改变。由于IA具有广泛的神经精神和神经生物学意义,因此需要多种治疗方法。以瑜伽和正念为形式的综合疗法已被证明对包括IA在内的许多成瘾疾病有效。
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引用次数: 30
Assessment of Acupuncture and Moxibustion Effects on the Electrophysiological Properties of the Ulnar Nerve: A Nerve Conduction Study 针灸对尺神经电生理特性影响的神经传导研究
Pub Date : 2018-07-11 DOI: 10.1159/000490176
Sónia Chan, Sérgio Ferreira, Bruno Ramos, Maria João Santos, L. C. Matos, J. Machado
Background/Aims: Acupuncture and moxibustion, when used together, have act mechanically and thermally on treated reflexological areas. The main goal of this work was to evaluate the effects of acupuncture and moxibustion on the electrophysiological properties of the ulnar nerve. Methods: Electrical stimulation was applied to the ulnar nerve above the epicondyle of 28 volunteers. A 20-V potential was applied, and after each 10 impulses it was increased by 10 V, up to a maximum of 80 V. At 20 and 80 V, the participants were asked to rate the discomfort from 0 to 10 on a Numeric Rating Scale for pain. After the first stimulation and data collection, the control group rested for 6 min, while the intervention group was submitted to acupuncture and moxibustion on Lingdao (HT 4). Following this period of time, a second electrical stimulation was performed on both groups. Results: The discomfort was greater in the intervention group during the second stimulation. The stimulus required to achieve the maximum amplitude decreased, but the changes were only statistically significant in the intervention group (p = 0.006). An increase in latency and a decrease in reaction velocity were noticed between the first and the second stimulation for both groups; however, only the control group presented statistically significant differences (p = 0.018 and p = 0.022, respectively). Conclusions: Acupuncture and moxibustion on HT 4 increased the electrical sensitivity, decreased the stimulus intensity to achieve the maximum amplitude, and avoided a significant increase in latency and decrease in reaction velocity in two consecutive electrical stimulations.
背景/目的:针灸和艾灸结合使用时,对治疗反射的区域具有机械和热作用。本研究的主要目的是评估针灸对尺神经电生理特性的影响。方法:对28例志愿者上髁上方尺神经进行电刺激。施加20伏的电势,每10次脉冲后,电势增加10伏,最高可达80伏。在20伏和80伏时,参与者被要求在疼痛的数字评定量表上从0到10对不适进行评分。在第一次刺激和数据收集后,对照组休息6min,而干预组接受针灸灵道(HT4)。在这段时间之后,对两组进行第二次电刺激。结果:在第二次刺激时,干预组的不适感更大。达到最大振幅所需的刺激减少,但这些变化仅在干预组中具有统计学意义(p=0.006)。两组在第一次和第二次刺激之间都注意到潜伏期增加和反应速度下降;然而,只有对照组表现出统计学上的显著差异(分别为p=0.018和p=0.022)。结论:在连续两次电刺激中,针灸HT 4可提高电敏感性,降低刺激强度以达到最大幅度,避免潜伏期显著增加和反应速度显著降低。
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引用次数: 5
Effect of Antenatal Pelvic Floor Muscle Exercise on Mode of Delivery: A Randomized Controlled Trial 产前盆底肌运动对分娩方式的影响:一项随机对照试验
Pub Date : 2018-04-25 DOI: 10.1159/000488351
Fayiz F. El-shamy, Eman Abd El Fatah
Background: Vaginal delivery is the best end of the pregnancy for the mother and the newborn. Aim: To evaluate the impacts of short-term antenatal pelvic floor muscle (PFM) exercises on a woman’s mode of delivery. Methods: This is a randomized controlled trial that recruited 20 healthy pregnant women aged between 20 and 25 years and able to contract the PFMs. The participants were included in the study at 20 weeks of gestation (WG) and were randomly allocated to one of two groups: the intervention group (n = 10) or the control group (n = 10). PFM strength was measured by vaginal squeeze pressure at 20 and 36 WG, and delivery outcomes were evaluated by a blinded searcher from the birth registry after labor. Results: There were no statistically significant changes between both groups at baseline regarding gestational age, type of labor, previous pregnancy complications, and PFM strength (p > 0.05). There was a significant change between both groups in mean PFM strength at 36 WG (p < 0.05). A significant correlation was observed between PFM strength at 36 WG and mode of delivery (vaginal delivery: r = 0.58, p < 0.05; caesarean delivery: r = –0.49, p < 0.05). Conclusions: PFM exercise is recommended for healthy pregnant women as a safe and inexpensive strategy for increasing the vaginal delivery rate.
背景:阴道分娩对母亲和新生儿来说是最好的妊娠结束方式。目的:评估短期产前盆底肌(PFM)运动对妇女分娩方式的影响。方法:这是一项随机对照试验,招募了20名年龄在20至25岁之间、能够感染PFMs的健康孕妇。参与者在妊娠20周(WG)时被纳入研究,并被随机分配到两组之一:干预组(n = 10)或对照组(n = 10)。通过20和36 WG时阴道挤压压力测量PFM强度,分娩后通过出生登记处的盲法搜索评估分娩结果。结果:两组在胎龄、产程类型、既往妊娠并发症、PFM强度基线时无统计学差异(p < 0.05)。36 WG时,两组间平均PFM强度差异有统计学意义(p < 0.05)。孕36 WG时PFM强度与分娩方式显著相关(阴道分娩:r = 0.58, p < 0.05;剖宫产:r = -0.49, p < 0.05)。结论:PFM运动作为一种安全、廉价的提高阴道分娩率的策略推荐给健康孕妇。
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引用次数: 11
Effect of a Residential Integrated Yoga Program on Blood Glucose Levels, Physiological Variables, and Anti-Diabetic Medication Score of Patients with Type 2 Diabetes Mellitus: A Retrospective Study 住院综合瑜伽项目对2型糖尿病患者血糖水平、生理变量和抗糖尿病药物评分的影响:一项回顾性研究
Pub Date : 2018-04-04 DOI: 10.1159/000487947
A. Singh, Padmini Tekur, K. Metri, Hemant Bhargav, N. Raghuram, Nagendra Hongasandra Ramarao
Background: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease characterized by chronic hyperglycemia. Yoga is a form of mind-body intervention shown to have a positive impact on several health conditions in both healthy and diseased patients. The present study is intended to assess the effects of the Residential Integrated Yoga Program (RIYP) on blood glucose levels in patients with T2DM. Material and Methods: Data of 598 (186 females) T2DM patients from a holistic health center in Bengaluru, India, who attended a 15-day RIYP between January 2013 and December 2015 was obtained retrospectively. Average age of the participants was 56.45 ± 11.02 years. All subjects underwent a 15-day RIYP which involved yoga-based lifestyle changes with components of regulated sleep, balanced diet, asanas, pranayama, relaxation techniques, meditations, yogic cleaning procedures, and tuning to the nature. Fasting and post-prandial blood sugar, medication score, symptom score, systolic and diastolic blood pressure, pulse rate, and respiratory rate were assessed before and after intervention. Result: There was a significant decrease in fasting (p < 0.001) and post-prandial blood sugar levels (p < 0.001) along with a significant reduction in medication and symptom scores after 15 days of RIYP compared to baseline. Conclusion: The present study indicates that 2 weeks of a yoga-based residential program improves blood glucose levels, blood pressure, and medication score in patients with T2DM. However, further randomized controlled studies need to be performed in order to confirm the present findings.
背景:2型糖尿病(T2DM)是一种以慢性高血糖为特征的高发疾病。瑜伽是一种身心干预的形式,对健康和患病患者的几种健康状况都有积极的影响。本研究旨在评估住宅综合瑜伽项目(RIYP)对2型糖尿病患者血糖水平的影响。材料和方法:回顾性分析2013年1月至2015年12月印度班加罗尔一家综合健康中心参加为期15天的RIYP的598例(186例女性)T2DM患者的数据。参与者平均年龄56.45±11.02岁。所有受试者都进行了为期15天的RIYP,其中包括以瑜伽为基础的生活方式改变,包括调节睡眠、均衡饮食、体式、调息、放松技巧、冥想、瑜伽清洁程序和调整自然。评估干预前后空腹和餐后血糖、用药评分、症状评分、收缩压和舒张压、脉搏率和呼吸率。结果:与基线相比,RIYP治疗15天后,空腹(p < 0.001)和餐后血糖水平显著降低(p < 0.001),药物和症状评分显著降低。结论:目前的研究表明,2周以瑜伽为基础的住宿项目可以改善T2DM患者的血糖水平、血压和药物评分。然而,需要进行进一步的随机对照研究来证实目前的发现。
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引用次数: 2
The State of Intracellular Molecular Regulators during the Reconvalescence of Community-Acquired Pneumonia under the Influence of Microwaves at 1 GHz 1GHz微波作用下社区获得性肺炎康复过程中细胞内分子调节因子的状态
Pub Date : 2018-02-06 DOI: 10.1159/000486240
A. Voevodin, A. Khadartsev, S. Bondar, I. Terekhov, V. S. Nikiforov
We evaluated the levels of protein p53, retinoblastoma protein (RB), β-catenin, SMAD2, protein kinases AKT and focal adhesion kinase (FAK), and transcription factor CREB using ELISA in mononuclear leukocytes of patients with community-acquired pneumonia on days 15–17 of the disease. The research results showed that the subclinical immune-inflammatory process was characterized by a higher content of β-catenin by 19.8%, CREB by 23.3%, RB protein by 14.7%, increased phosphorylation level of protein kinase FAK by 19.8%, АKТ1 at serine-473 by 65.6%, and RB by 13.7%. In the cells, there was a decrease in p53 of 15.7%, SMAD2 of 16.9%, and protein kinase АKТ1 of 31.2%. Three hours after 1-GHz microwave irradiation, MNCs displayed a statistically significant increase in their content of the p53 protein of 20.0‰, RB of 9.35‰, β-catenin of 10.9‰, protein kinase FAK of 10.0‰, and CREB of 8.55‰. A day after a single irradiation of the cultures of whole blood cells, in irradiated cells compared to nonirradiated control, we observed a statistically significant increase in the content of p53 of 24.2‰, β-catenin of 15.1‰, SMAD2 of 20.4‰, RB of 9.8‰, as well as a reduction of the initially elevated levels of protein kinase AKT1 of 25.1‰, its phosphorylated form at serine-473 of 16.5‰, and a decrease in the phosphorylated form of the transcription factor CREB at serine-133 of 4.1‰. The research results indicate that a low-intensity microwave frequency of 1 GHz can be considered as a factor in molecular immune rehabilitation in conditions of community-acquired pneumonia.
我们使用ELISA评估了社区获得性肺炎患者在发病第15-17天的单核白细胞中p53蛋白、视网膜母细胞瘤蛋白(RB)、β-连环蛋白、SMAD2、蛋白激酶AKT和粘着斑激酶(FAK)以及转录因子CREB的水平。研究结果表明,亚临床免疫炎症过程的特征是β-连环蛋白含量增加19.8%,CREB含量增加23.3%,RB蛋白含量增加14.7%,蛋白激酶FAK磷酸化水平增加19.8%、АKТ1在473序列增加65.6%,RB增加13.7%,和蛋白激酶АKТ1为31.2%。1-GHz微波照射后3小时,MNCs的p53蛋白含量增加了20.0‰,RB增加了9.35‰,β-连环蛋白增加了10.9‰,蛋白激酶FAK增加了10.0‰,CREB增加了8.55‰,具有统计学意义,我们观察到p53含量显著增加24.2‰,β-连环蛋白含量显著增加15.1‰,SMAD2含量显著增加20.4‰,RB含量显著增加9.8‰,蛋白激酶AKT1的初始升高水平显著降低25.1‰,其在473序列的磷酸化形式为16.5‰,研究结果表明,1GHz的低强度微波频率可以被认为是社区获得性肺炎条件下分子免疫康复的一个因素。
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引用次数: 2
Cell Death and Induced p53 Expression in Oral Cancer, HeLa, and Bone Marrow Mesenchyme Cells under the Exposure to Noncontact Electric Fields 暴露于非接触电场下口腔癌、HeLa和骨髓间充质细胞的细胞死亡和诱导p53表达
Pub Date : 2017-12-21 DOI: 10.1159/000485186
Sahudi Abdul Mujib, F. Alamsyah, W. Taruno
Background: p53 acts as a transcription factor to regulate the expression of genes that modulate various cellular activities. The proliferation of cancer cells has been inhibited under the exposure to low-intensity (18 peak-to-peak voltage) and intermediate-frequency (100 KHz) electric fields generated between 2 capacitive electrodes. Therefore, the aims of this study were to observe the molecular mechanism of cell death caused by noncontact electric field exposure and to determine whether p53 protein can serve as a biomarker for this exposure or not. Methods: Oral squamous cell carcinoma, HeLa, and bone marrow mesenchyme cells were exposed to noncontact electric fields of Electro-Capacitive Cancer Therapy (ECCT) for 24 h. To observe the mechanism of cell death caused by ECCT, immunocytochemistry of p53 was performed, and the p53 expression was evaluated using immunoreactive score (IRS) calculation. Results: Electric field exposure by ECCT increased the percentage of dead cells in oral cancer cells (18.39%), HeLa cells (6.60%), and bone marrow mesenchyme cells (34.05%) with statistical significance using the independent t test compared to each control group. The IRS of p53 in oral cancer, HeLa, and bone marrow mesenchyme cultures were 10.50, 11.25, and 4.94, respectively. Conclusion: The high IRS shown in the treated oral cancer and HeLa culture cells may suggest that p53 expression in these culture cells is associated with the cell death mechanism induced by the exposure to noncontact electric fields, and the increased cell death in these culture cells may correlate with the IRS.
背景:p53作为一种转录因子,调节各种细胞活动的基因表达。在两个电容电极之间产生的低强度(18峰对峰电压)和中频(100 KHz)电场暴露下,癌细胞的增殖受到抑制。因此,本研究的目的是观察非接触电场暴露导致细胞死亡的分子机制,并确定p53蛋白是否可以作为这种暴露的生物标志物。方法:将口腔鳞状细胞癌、HeLa细胞和骨髓间充质细胞暴露于非接触电致癌治疗(ECCT)电场下24 h,对ECCT引起的细胞死亡机制进行免疫细胞化学检测,并计算免疫反应评分(immunoreactive score, IRS)评价p53的表达。结果:ECCT电场暴露使口腔癌细胞、HeLa细胞和骨髓间充质细胞的死亡细胞比例分别增加18.39%、6.60%和34.05%,经独立t检验,差异均有统计学意义。p53在口腔癌、HeLa和骨髓间质培养中的IRS分别为10.50、11.25和4.94。结论:口腔癌和HeLa培养细胞的高IRS可能与非接触电场诱导的细胞死亡机制有关,细胞死亡增加可能与IRS有关。
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引用次数: 15
Whitening Efficacy of Tranexamic Acid Cataplasm on Melasma in Chinese Women 氨甲环酸膏剂对中国女性黄褐斑的美白效果
Pub Date : 2017-12-21 DOI: 10.1159/000485101
Jun Lu, Lili Yang, P. Xu, Feng-hua Bian, Huimin Zhang
Background/Aims: Oral tranexamic acid (TXA) has been reported to be effective for treating melasma. However, the effect of topical TXA on melasma remains controversial. The aim of this study was to assess the effects of topical TXA cataplasm on melasma. Methods: Eighty-four patients with melasma were randomly assigned to a treatment group or a separate control group. They were instructed to apply 2 pieces of cataplasm with or without TXA. The melasma area severity index (MASI), skin color tone scale (SCTS), and area score were evaluated by dermatologists blinded to the treatment. Results: A significant decrease in the MASI and SCTS was observed on either or both sides of the face by the end of 8 weeks compared to the control group (p < 0.05). The area score was also significantly reduced on both tested sides compared to the control group (p < 0.05). Conclusion: Based on these results, we believe that localized cataplasm of TXA may be used as a potentially new, effective, and safe therapeutic modality for treating melasma.
背景/目的:口服氨甲环酸(TXA)已被报道为治疗黄褐斑有效。然而,局部TXA对黄褐斑的影响仍然存在争议。本研究的目的是评估局部TXA治疗黄褐斑的效果。方法:84例黄褐斑患者随机分为治疗组和单独对照组。他们被指示使用2片含或不含TXA的布布。黄褐斑区域严重程度指数(MASI)、皮肤色调量表(SCTS)和区域评分由对治疗不知情的皮肤科医生评估。结果:8周结束时,与对照组相比,面部一侧或两侧的MASI和SCTS均显著降低(p < 0.05)。与对照组相比,被试两侧的面积评分也显著降低(p < 0.05)。结论:基于以上结果,我们认为局部化血凝素可作为治疗黄褐斑的一种新的、有效的、安全的治疗方式。
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引用次数: 3
Postural Orthostatic Tachycardia Syndrome (POTS): Assess, Diagnose, and Evaluate for POTS Treatment (ADEPT) 体位性站立性心动过速综合征(POTS):评估、诊断和评估POTS治疗(ADEPT)
Pub Date : 2017-11-30 DOI: 10.1159/000484205
Lisa Schmidt, B. Karabin, A. Malone
Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being clinically underdiagnosed and undertreated, resulting in unnecessary costs and poorer patient outcomes. Method: Through a literature search, the information has been synthesized, supporting the creation of a POTS diagnostic screening tool that can be implemented within the psychiatric outpatient clinic. Results: POTS patients are often referred to psychiatry for the treatment of chronic fatigue and anxiety disorders. Psychiatric professionals are in a position to prescreen for POTS in patients with orthostatic intolerance. Conclusion: A diagnostic prescreening tool helps to identify patients with POTS so they can be referred for proper treatment, improving their functionality and quality of life, and decreasing the healthcare burden.
背景/目的:体位性站立性心动过速综合征(POTS)通常被认为是临床诊断和治疗不足,导致不必要的费用和较差的患者预后。方法:通过文献检索,综合资料,支持创建一个可在精神科门诊实施的POTS诊断筛选工具。结果:慢性疲劳焦虑症患者常转诊精神科。精神科专业人员可以对直立不耐受患者的POTS进行预筛查。结论:诊断预筛查工具有助于识别POTS患者,使其能够进行适当的治疗,改善其功能和生活质量,减轻医疗负担。
{"title":"Postural Orthostatic Tachycardia Syndrome (POTS): Assess, Diagnose, and Evaluate for POTS Treatment (ADEPT)","authors":"Lisa Schmidt, B. Karabin, A. Malone","doi":"10.1159/000484205","DOIUrl":"https://doi.org/10.1159/000484205","url":null,"abstract":"Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being clinically underdiagnosed and undertreated, resulting in unnecessary costs and poorer patient outcomes. Method: Through a literature search, the information has been synthesized, supporting the creation of a POTS diagnostic screening tool that can be implemented within the psychiatric outpatient clinic. Results: POTS patients are often referred to psychiatry for the treatment of chronic fatigue and anxiety disorders. Psychiatric professionals are in a position to prescreen for POTS in patients with orthostatic intolerance. Conclusion: A diagnostic prescreening tool helps to identify patients with POTS so they can be referred for proper treatment, improving their functionality and quality of life, and decreasing the healthcare burden.","PeriodicalId":91502,"journal":{"name":"Integrative medicine international","volume":"4 1","pages":"142 - 153"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000484205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46298642","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: 8
期刊
Integrative medicine international
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