Introduction Human albumin (HA) or serum albumin is encoded by the ALB gene and is the most abundant plasma protein in mammals. HA is essential for maintaining the osmotic pressure needed for proper distribution of body fluids between intravascular compartments and body tissues. HA also acts as a plasma carrier by non-specifically binding several hydrophobic steroid hormones and as a transport protein for hemin and fatty acids. The advantages of albumin over less costly alternative fluids continue to be debated. Meta-analyses focusing on survival have been inconclusive, and other clinically relevant end-points have not been systematically addressed. Database searches (MEDLINE, EMBASE, Cochrane Library) and other methods were used to identify randomized controlled trials comparing albumin with crystalloid, artificial colloid, no albumin, or lower-dose albumin. Major findings for all end-points were extracted and summarized [1,2]. Seventy-nine randomized trials with a total of 4755 patients were included. No significant treatment effects were detectable in 20/79 (25%) trials. In cardiac surgery, albumin administration resulted in lower fluid requirements, higher colloid oncotic pressure, reduced pulmonary edema with respiratory impairment, and greater hemodilution compared with crystalloid and hydroxyethyl starch increased postoperative bleeding. In non-cardiac surgery, fluid requirements and pulmonary and intestinal edema were decreased by albumin compared with crystalloid. In hypoalbuminemia, higher doses of albumin reduced morbidity. In ascites, albumin reduced hemodynamic derangements, morbidity, and length of stay and improved survival after spontaneous bacterial peritonitis. In sepsis, albumin decreased pulmonary edema and respiratory dysfunction compared with crystalloid, while hydroxyethyl starch induced abnormalities of hemostasis. Complications were lowered by albumin compared with crystalloid in burn patients. Albumin-containing therapeutic regimens improved outcomes after brain injury [3]. Neither benefit nor harm was shown when using HA to maintain hemodynamic stability in the perioperative period when compared with crystalloids or any other colloidal volume substitute [4-6].
{"title":"Fundamental knowledge about the physical and chemical properties of commercial albumin and its application in clinical practice","authors":"A. Belousov","doi":"10.5455/IM.48352","DOIUrl":"https://doi.org/10.5455/IM.48352","url":null,"abstract":"Introduction Human albumin (HA) or serum albumin is encoded by the ALB gene and is the most abundant plasma protein in mammals. HA is essential for maintaining the osmotic pressure needed for proper distribution of body fluids between intravascular compartments and body tissues. HA also acts as a plasma carrier by non-specifically binding several hydrophobic steroid hormones and as a transport protein for hemin and fatty acids. The advantages of albumin over less costly alternative fluids continue to be debated. Meta-analyses focusing on survival have been inconclusive, and other clinically relevant end-points have not been systematically addressed. Database searches (MEDLINE, EMBASE, Cochrane Library) and other methods were used to identify randomized controlled trials comparing albumin with crystalloid, artificial colloid, no albumin, or lower-dose albumin. Major findings for all end-points were extracted and summarized [1,2]. Seventy-nine randomized trials with a total of 4755 patients were included. No significant treatment effects were detectable in 20/79 (25%) trials. In cardiac surgery, albumin administration resulted in lower fluid requirements, higher colloid oncotic pressure, reduced pulmonary edema with respiratory impairment, and greater hemodilution compared with crystalloid and hydroxyethyl starch increased postoperative bleeding. In non-cardiac surgery, fluid requirements and pulmonary and intestinal edema were decreased by albumin compared with crystalloid. In hypoalbuminemia, higher doses of albumin reduced morbidity. In ascites, albumin reduced hemodynamic derangements, morbidity, and length of stay and improved survival after spontaneous bacterial peritonitis. In sepsis, albumin decreased pulmonary edema and respiratory dysfunction compared with crystalloid, while hydroxyethyl starch induced abnormalities of hemostasis. Complications were lowered by albumin compared with crystalloid in burn patients. Albumin-containing therapeutic regimens improved outcomes after brain injury [3]. Neither benefit nor harm was shown when using HA to maintain hemodynamic stability in the perioperative period when compared with crystalloids or any other colloidal volume substitute [4-6].","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794303","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}
After febrile conditions and diarrheal syndrome, skin diseases are the third most common medical problem among people returning from regions with the tropical climate. Hookworm-related cutaneous larva migrans is caused when animal filariform larva penetrates the human dermis. The larva is unable to move into deeper tissues and moves “migrates” in the dermis. The condition is also known as "creeping eruption" and most often affects the skin on the feet, buttocks and abdomen. Diagnosis is clinical, based on the typical cutaneous manifestations and recent travel history. Serologic tests or other diagnostic methods for cutaneous larva migrans are not available. The purpose of this work was to present two cases of a 30-year-old man and a 4-year-old child who were examined at the National Centre of Infectious and Parasitic Diseases in Sofia, Bulgaria, after tourist trip in Brazil and the Goa State of India, respectively. Reason for examination was itchy linear rash in both patients, located on the dorsal surface of the left foot in the man and the left gluteal region in the child. Based on the typical exanthema of the skin and the epidemiological history of visiting an endemic region, diagnosis of "cutaneous larva migrans" was made in both cases. Treatment with albendazole was applied, as directed, after which the clinical manifestations in both patients, resolved completely. The increasing travel of people across borders may result in an increased incidence of non-endemic or rarely seen in the temperate geographic regions diseases of which the physicians should be informed.
{"title":"Two clinical cases of cutaneous larva migrans among travelers returning from tropical countries","authors":"R. Harizanov, I. Kaftandjiev","doi":"10.5455/im.63429","DOIUrl":"https://doi.org/10.5455/im.63429","url":null,"abstract":"After febrile conditions and diarrheal syndrome, skin diseases are the third most common medical problem among people returning from regions with the tropical climate. Hookworm-related cutaneous larva migrans is caused when animal filariform larva penetrates the human dermis. The larva is unable to move into deeper tissues and moves “migrates” in the dermis. The condition is also known as \"creeping eruption\" and most often affects the skin on the feet, buttocks and abdomen. Diagnosis is clinical, based on the typical cutaneous manifestations and recent travel history. Serologic tests or other diagnostic methods for cutaneous larva migrans are not available. The purpose of this work was to present two cases of a 30-year-old man and a 4-year-old child who were examined at the National Centre of Infectious and Parasitic Diseases in Sofia, Bulgaria, after tourist trip in Brazil and the Goa State of India, respectively. Reason for examination was itchy linear rash in both patients, located on the dorsal surface of the left foot in the man and the left gluteal region in the child. Based on the typical exanthema of the skin and the epidemiological history of visiting an endemic region, diagnosis of \"cutaneous larva migrans\" was made in both cases. Treatment with albendazole was applied, as directed, after which the clinical manifestations in both patients, resolved completely. The increasing travel of people across borders may result in an increased incidence of non-endemic or rarely seen in the temperate geographic regions diseases of which the physicians should be informed.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70795091","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}
An 87-year-old man with hypertension presented with left arm weakness immediately after getting out of bed in the morning. Medical Research Council (MRC) scale demonstrated muscle weakness solely in the left triceps (grade 3/5) and forearm pronator (grade 3/5). No sensory impairment was recognized. The left biceps and brachioradialis reflexes were brisker. The left triceps reflex was inverted, which had not been recognized before. The other reflexes were normal. These clinical manifestations were reminiscent of C7 motor radiculopathy. The left Hoffmann sign was positive, while the Babinski sign was negative. Ultrasonography revealed moderate stenosis of both internal carotid arteries (right side, 56.1%; left side, 55.9%) according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria [1]. Motor nerve conduction study (inching test) at the left elbow was normal. The cervical MRI revealed moderate spondylotic changes at the levels of C5/C6 and C6/C7. Diffusion-weighted MRI showed a small infarction (Figure 1) next to the medial part of the precentral knob [2] of the contralateral primary motor cortex. An apparent diffusion coefficient map demonstrated a hypointense lesion in the infarcted region. MR angiography vaguely exhibited the right distal anterior cerebral artery. In this case, the ischemic infarct affecting the primary motor cortex may be due to atherosclerotic changes of the carotid artery, suggesting an arterio-arterial thromboembolic stroke mechanism. There have been several reports that lesions restricted to the premotor cortex [3] and the pons [4] could cause a contralateral arm weakness. Thus, when patients with risk factors for stroke develop clinical features mimicking acute-onset cervical motor radiculopathy, primary motor cortex infarction should be considered as a differential diagnosis in the clinical setting.
{"title":"Primary motor cortex infarction mimicking C7 motor radiculopathy","authors":"S. Sasaki","doi":"10.5455/im.54754","DOIUrl":"https://doi.org/10.5455/im.54754","url":null,"abstract":"An 87-year-old man with hypertension presented with left arm weakness immediately after getting out of bed in the morning. Medical Research Council (MRC) scale demonstrated muscle weakness solely in the left triceps (grade 3/5) and forearm pronator (grade 3/5). No sensory impairment was recognized. The left biceps and brachioradialis reflexes were brisker. The left triceps reflex was inverted, which had not been recognized before. The other reflexes were normal. These clinical manifestations were reminiscent of C7 motor radiculopathy. The left Hoffmann sign was positive, while the Babinski sign was negative. Ultrasonography revealed moderate stenosis of both internal carotid arteries (right side, 56.1%; left side, 55.9%) according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria [1]. Motor nerve conduction study (inching test) at the left elbow was normal. The cervical MRI revealed moderate spondylotic changes at the levels of C5/C6 and C6/C7. Diffusion-weighted MRI showed a small infarction (Figure 1) next to the medial part of the precentral knob [2] of the contralateral primary motor cortex. An apparent diffusion coefficient map demonstrated a hypointense lesion in the infarcted region. MR angiography vaguely exhibited the right distal anterior cerebral artery. In this case, the ischemic infarct affecting the primary motor cortex may be due to atherosclerotic changes of the carotid artery, suggesting an arterio-arterial thromboembolic stroke mechanism. There have been several reports that lesions restricted to the premotor cortex [3] and the pons [4] could cause a contralateral arm weakness. Thus, when patients with risk factors for stroke develop clinical features mimicking acute-onset cervical motor radiculopathy, primary motor cortex infarction should be considered as a differential diagnosis in the clinical setting.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70795258","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}
Pub Date : 2019-01-01DOI: 10.35248/2375-4273.19.07.245
R. Sareen
Euthanasia is a dilemma due to the presence of more than one course of conduct justified on various grounds. Medical science has devised solutions for battling excruciating pain and agony. The Supreme Court in March 2018 delivered landmark judgment allowing ‘living will’ where, an adult in his conscious mind, is permitted to refuse medical treatment or voluntarily decide not to take medical treatment to embrace death in a natural way. The judgment gave legal recognition to Passive euthanasia in India and robust interpretation of ‘Right to life’ including ‘Right to die’ thereby bringing it within manifold of article-21 of constitution of India. The present paper describes evolution of Euthanasia in India contemporary to Dutch law as well as pros and cones of the landmark judgment in Aruna Shanbaug case.
{"title":"India decides on Euthanasia: Is the debate over?","authors":"R. Sareen","doi":"10.35248/2375-4273.19.07.245","DOIUrl":"https://doi.org/10.35248/2375-4273.19.07.245","url":null,"abstract":"Euthanasia is a dilemma due to the presence of more than one course of conduct justified on various grounds. Medical science has devised solutions for battling excruciating pain and agony. The Supreme Court in March 2018 delivered landmark judgment allowing ‘living will’ where, an adult in his conscious mind, is permitted to refuse medical treatment or voluntarily decide not to take medical treatment to embrace death in a natural way. The judgment gave legal recognition to Passive euthanasia in India and robust interpretation of ‘Right to life’ including ‘Right to die’ thereby bringing it within manifold of article-21 of constitution of India. The present paper describes evolution of Euthanasia in India contemporary to Dutch law as well as pros and cones of the landmark judgment in Aruna Shanbaug case.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70014910","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}
Hiccups are the products of simultaneous involuntary spasmodic contractions of the diaphragm and glottic closure, resulting in the failure of air to enter the trachea. Multiple causes have been attributed to the etiology of hiccups, including drugs. Selective serotonin reuptake inhibitor (SSRI)-related hiccups are rarely reported in the available literature. Hereby, we present a 10-year-old girl with obsessive-compulsive disorder who developed persistent hiccups with sertraline treatment.
{"title":"Sertraline-Related Hiccups in a Girl With Obsessive-Compulsive Disorder","authors":"Nuran Ekinci, Merve Kalınlı","doi":"10.5455/im.28797","DOIUrl":"https://doi.org/10.5455/im.28797","url":null,"abstract":"Hiccups are the products of simultaneous involuntary spasmodic contractions of the diaphragm and glottic closure, resulting in the failure of air to enter the trachea. Multiple causes have been attributed to the etiology of hiccups, including drugs. Selective serotonin reuptake inhibitor (SSRI)-related hiccups are rarely reported in the available literature. Hereby, we present a 10-year-old girl with obsessive-compulsive disorder who developed persistent hiccups with sertraline treatment.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70792508","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}
Epidemiology is a science that studies the spread and disease factors of the human population and the application of this science to addressing health problems. Epidemiology is considered a fundamental set of methods in all public health research and has great application in clinical medicine in determining the risk factors of the disease and determining the best health effect in clinical practice. Epidemiology as a science deals with factors affecting the health and illness of individuals and societies, and in that sense serves as the basis and logical basis for interventions in the interest of public health and preventive medicine.
{"title":"Epidemiology and forensics","authors":"Siniša Franjić","doi":"10.5455/IM.302644234","DOIUrl":"https://doi.org/10.5455/IM.302644234","url":null,"abstract":"Epidemiology is a science that studies the spread and disease factors of the human population and the application of this science to addressing health problems. Epidemiology is considered a fundamental set of methods in all public health research and has great application in clinical medicine in determining the risk factors of the disease and determining the best health effect in clinical practice. Epidemiology as a science deals with factors affecting the health and illness of individuals and societies, and in that sense serves as the basis and logical basis for interventions in the interest of public health and preventive medicine.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70792647","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}
{"title":"Attribute Control Charts for Outbreaks Trend of Selected States in the USA: A Case Report of the Insight into Pattern","authors":"M. Eissa","doi":"10.5455/IM.31744","DOIUrl":"https://doi.org/10.5455/IM.31744","url":null,"abstract":"","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793035","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}
Nodular Fasciitis (NF) is a benign, self-limiting condition that is characterized by myofibroblast / fibroblast proliferation. It is commonly found in the trunk, upper limbs (volar aspect of the forearm), and the back. Patient who are diagnosed with this condition typically presents with a history of rapidly enlarging subcutaneous mass over several weeks or months [1]. NF often mimicks a malignant process due to its rapid growth clinically, its high mitotic activity and cellularity and nonspecific cytomorphologic findings which makes it diagnosis pretty challenging. We describe a case of NF of the left posterior chest wall that presented to us and underwent wide local excision followed by chest wall reconstruction using a prolene mesh.
{"title":"Left Posterior Chest Wall Reconstruction Using Prolene Mesh Following Excision Of Nodular Fasciitis\u0000A Case Report","authors":"Mior Faiq Mior Abu Tahrin","doi":"10.5455/IM.36767","DOIUrl":"https://doi.org/10.5455/IM.36767","url":null,"abstract":"Nodular Fasciitis (NF) is a benign, self-limiting condition that is characterized by myofibroblast / fibroblast proliferation. It is commonly found in the trunk, upper limbs (volar aspect of the forearm), and the back. Patient who are diagnosed with this condition typically presents with a history of rapidly enlarging subcutaneous mass over several weeks or months [1]. NF often mimicks a malignant process due to its rapid growth clinically, its high mitotic activity and cellularity and nonspecific cytomorphologic findings which makes it diagnosis pretty challenging. We describe a case of NF of the left posterior chest wall that presented to us and underwent wide local excision followed by chest wall reconstruction using a prolene mesh.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793422","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}
{"title":"Muscle weakness in CPEO patients may not only be determined by myopathy, smoking, or gender","authors":"J. Finsterer","doi":"10.5455/im.36813","DOIUrl":"https://doi.org/10.5455/im.36813","url":null,"abstract":"","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793452","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}
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