scholarly journals Relationship between Respiratory Load Perception and Perception of Nonrespiratory Sensory Modalities in Subjects with Life-Threatening Asthma

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kathleen L. Davenport ◽  
Chien Hui Huang ◽  
Matthew P. Davenport ◽  
Paul W. Davenport
Keyword(s):  
Magnitude Estimation ◽  
Perceptual Sensitivity ◽  
Black Background ◽  
Pressure Threshold ◽  
White Disk ◽  
Significant Difference ◽  
Sensory Modalities ◽  
Life Threatening ◽  
Load Perception

Subjects with life-threatening asthma (LTA) have reported decreased sensitivity to inspiratory resistive (R) loads. It is unknown if decreased sensitivity is specific for inspiratoryRloads, other types of respiratory loads, or a general deficit affecting sensory modalities. This study hypothesized that impairment is specific to respiratory stimuli. This study tested perceptual sensitivity of LTA, asthmatic (A), and nonasthmatic (NA) subjects to 4 sensory modalities: respiratory, somatosensory, auditory, visual. Perceptual sensitivity was measured with magnitude estimation (ME): respiratory loads ME, determined using inspiratoryRand pressure threshold (PT) loads; somatosensory ME, determined using weight ranges of 2–20 kg; auditory ME, determined using graded magnitudes of 1 kHz tones delivered for 3 seconds bilaterally; visual ME, determined using gray-to-white disk intensity gradations on black background. ME for inspiratoryRloads lessened for LTA over A and NA subjects. There was no significant difference between the 3 groups in ME for PT inspiratory loads, weight, sound, and visual trials. These results demonstrate that LTA subjects are poor perceivers of inspiratoryRloads. This deficit in respiratory perception is specific to inspiratoryRloads and is not due to perceptual deficits in other types of inspiratory loads, somatosensory, auditory, or visual sensory modalities.

Renal Phosphate Handling in Antiretroviral-naïve HIV-infected Patients

2020 ◽  
Vol 20 ◽  
Author(s):  
Tewogbade Adeoye Adedeji ◽  
Simeon Adelani. Adebisi ◽  
Nife Olamide Adedeji ◽  
Olusola Akanni Jeje ◽  
Rotimi Samuel Owolabi
Keyword(s):  
Hiv Infection ◽  
Plasma Phosphate ◽  
Cross Sectional ◽  
Phosphate Retention ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Life Threatening ◽  
Moderate Chronic Kidney Disease ◽  
One Year ◽  
Sectional Analysis

Background: Human immunodeficiency virus (HIV) infection impairs renal function, thereby affecting renal phosphate metabolism. Objectives: We prospectively estimated the prevalence of phosphate abnormalities (mild, moderate to life-threatening hypophosphataemia, and hyperphosphataemia) before initiating antiretroviral therapy (ART). Methods: A cross-sectional analysis was performed on 170 consecutive newly diagnosed ART-naïve, HIV-infected patients attending our HIV/AIDS clinics over a period of one year. Fifty (50) screened HIV-negative blood donors were used for comparison (controls). Blood and urine were collected simultaneously for phosphate and creatinine assay to estimate fractional phosphate excretion (FEPi %) and glomerular filtration rate (eGFR). Results: eGFR showed significant difference between patients’ and controls’ medians (47.89ml/min/1.73m2 versus 60ml/min/1.73m2, p <0.001); which denotes a moderate chronic kidney disease in the patients. Of the 170 patients, 78 (45.9%) had normal plasma phosphate (0.6-1.4 mmol/L); 85 (50%) had hyperphosphataemia. Grades 1, 2 and 3 hypophosphataemia was observed in 3 (1.8%), 3 (1.8%), and 1(0.5%) patient(s) respectively. None had grade 4 hypophosphataemia. Overall, the patients had significantly higher median of plasma phosphate than the controls, 1.4 mmol/L (IQR: 1.0 – 2.2) versus 1.1 mmol/L (IQR: 0.3 – 1.6), p <0.001, implying hyperphosphataemia in the patients; significantly lower median urine phosphate than the controls, 1.5 mmol/L (IQR: 0.7 -2.1) versus 8.4 mmol/L (IQR: 3.4 – 16), p <0.001), justifying the hyperphosphataemia is from phosphate retention; but a non-significantly lower median FEPi% than the controls, 0.96 % (IQR: 0.3 -2.2) versus 1.4% (IQR: 1.2 -1.6), p > 0.05. Predictors of FEPi% were age (Odds ratio, OR 0.9, p = 0.009); weight (OR 2.0, p < 0.001); CD4+ cells count predicted urine phosphate among males (p = 0.029). Conclusion: HIV infection likely induces renal insufficiency with reduced renal phosphate clearance. Thus, hyperphosphataemia is highly prevalent, and there is mild to moderate hypophosphataemia but its life-threatening form (grade 4) is rare among ART-naïve HIV patients.

scholarly journals Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Phase ◽  
Mainland China ◽  
Hospital Setting ◽  
Academic Hospital ◽  
Significant Difference ◽  
Before And After ◽  
Life Threatening ◽  
The Mean ◽  
Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

scholarly journals Apoptosis as a Mechanism for Keratinocyte Death in Canine Toxic Epidermal Necrolysis

2016 ◽  
Vol 54 (2) ◽  
pp. 249-253 ◽  
Author(s):  
F. Banovic ◽  
S. Dunston ◽  
K. E. Linder ◽  
P. Rakich ◽  
T. Olivry
Keyword(s):  
Cell Death ◽  
Toxic Epidermal Necrolysis ◽  
Caspase 3 ◽  
Skin Lesions ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Epidermal Keratinocytes ◽  
Biopsy Specimens ◽  
Significant Difference ◽  
Keratinocyte Cell ◽  
Life Threatening

In humans and dogs, toxic epidermal necrolysis (TEN) is a life-threatening dermatosis characterized by sudden epidermal death resulting in extensive skin detachment. There is little information on the pathogenesis of keratinocyte cell death in canine TEN. We studied the occurrence of apoptosis in skin lesions of dogs with TEN to determine if apoptosis contributes to the pathogenesis of this disease. Immunostaining with antibodies to activated caspase-3 and the terminal deoxynucleotidyl-transferase (TdT)–mediated deoxyuridine triphosphate (dUTP) nick-end labeling technique revealed positive apoptotic keratinocytes in basal and suprabasal epidermal compartments in 17 biopsy specimens collected from 3 dogs with TEN and 16 from 3 dogs with erythema multiforme (EM). There was no significant difference in the number of positively stained epidermal cells between TEN and EM. These results suggest that apoptosis of epidermal keratinocytes and lymphocytic satellitosis represent one of the early steps in the pathogenesis of canine TEN, as in the human disease counterpart.

Effects of Gender on Listeners' Judgments of Speech Intelligibility

1996 ◽  
Vol 83 (3) ◽  
pp. 771-775 ◽  
Author(s):  
Lee Ellis ◽  
Donald Fucci ◽  
Loriann Reynolds ◽  
Barbaranne Benjamin
Keyword(s):  
Magnitude Estimation ◽  
Speech Intelligibility ◽  
Male And Female ◽  
Female Speaker ◽  
Gender Biases ◽  
Significant Difference ◽  
Male Speaker ◽  
Female Subjects

Effects of gender on listeners' judgments of intelligibility were investigated. Subjects (15 women; 15 men) provided magnitude-estimation scaling responses and over-all impressions of the intelligibility of a male and female speaker's comparable versions of audiotaped speech samples varying systematically in terms of the number of phonemes produced correctly. There was no significant difference between male and female subjects' magnitude-estimation scaling responses; however, their over-all impressions of the intelligibility of the speakers tended to differ. Women indicated that the male speaker was more understandable, and men indicated that the female speaker was more understandable. Magnitude-estimation scaling may provide an objective means for evaluating a speaker's intelligibility. It appears to transcend gender-biases associated with judgments of speech intelligibility.

scholarly journals Effect of designed nursing instructions on knowledge and self-care behavior among patients with chemotherapy induced neutropenia

2018 ◽  
Vol 7 (2) ◽  
pp. 94
Author(s):  
Asmaa Sayed Abd-Almageed ◽  
. .
Keyword(s):  
Neutropenic Patient ◽  
Self Care ◽  
Education Of Patients ◽  
Significant Difference ◽  
Assessment Sheet ◽  
Life Threatening ◽  
Level Of Knowledge ◽  
Chemotherapy Induced Neutropenia ◽  
Dose Limiting Toxicity ◽  
Care Behavior

Background:Chemotherapy-induced neutropenia (CIN) is the main dose limiting toxicity of systemic chemotherapy and it is associated with significant morbidity, mortality and treatment cost.Aim:Of the study was to evaluate effect of designed nursing instructions on knowledge and self-care behavior among patients with chemotherapy-induced neutropenia.Research design: Pre-post research design was utilized.Setting: The study was conducted at internal Medical Oncology Department at South Egypt Cancer Institute.Sample: Sixty adult patients with chemotherapy induced neutropenia. Tools of data collection: Tool (I): Patient assessment sheet, Tool (II): Self-care behavior assessment.Results: There was a highly statistically significant difference between pre and post applying of designed nursing instructions as regard patients' level of knowledge and self- care behavior of the studied patients (p<0.01).Conclusion: The designed nursing instructions improved knowledge and self-care behavior among patients with chemotherapy-induced neutropenia.Recommendation: Each neutropenic patient should be given a booklet including knowledge about neutropenia, importance, and how to practice standards self-care behavior. Education of patients and families are keys to prompt recognition about potentially life-threatening symptoms associated with neutropenia.  

scholarly journals The Use of Milrinone Versus Conventional Treatment for the Management of Life-Threatening Bronchial Asthma

2019 ◽  
Vol 13 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Amr Sobhy ◽  
Doaa M. K. Eldin ◽  
Hany V. Zaki
Keyword(s):  
Bronchial Asthma ◽  
Conventional Treatment ◽  
Controlled Trial ◽  
Blood Gases ◽  
Categorical Variables ◽  
Chi Square ◽  
Arterial Blood ◽  
Number Of Patients ◽  
Significant Difference ◽  
Life Threatening

Background and Aims: In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment. Methods: Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables. Results: Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05). Conclusion: Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.

scholarly journals Prevalence of Hepatitis B among Food Vendors in Wurukum Market, Makurdi Benue State

2018 ◽  
pp. 1-5
Author(s):  
V. U. Obisike ◽  
C. M. Uke ◽  
E. U. Amuta
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Age Groups ◽  
Hbv Infection ◽  
Test Strips ◽  
Significant Difference ◽  
B Virus ◽  
Life Threatening

Hepatitis B is a life threatening infectious liver disease caused by hepatitis B virus (HBV). The aim of this study was to determine the prevalence of HBV among food vendors in Wurukum, a highly commercial section of metropolitan Makurdi in Benue State. The test was carried out with the use of an immunochromatographic  micropoint HBsAg test strips and a HBsAg  buffer screen for the virus. Out of the 250 non-vaccinated food vendors sampled, 27(10.8%) had HBV infection, with more in males (21.7%) than in females (6.6%). No significant difference (p>0.05) was found among age groups in spite of the observed highest prevalence of 14.3% among the 20-29 year olds. Therefore, the need for routine screening cannot be overemphasized in spite of known risk factors among food vendors.

scholarly journals Rationale for the Use of Radiation-Activated Mesenchymal Stromal/Stem Cells in Acute Respiratory Distress Syndrome

Cells ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 2015 ◽  
Author(s):  
Isabel Tovar ◽  
Rosa Guerrero ◽  
Jesús J. López-Peñalver ◽  
José Expósito ◽  
José Mariano Ruiz de Almodóvar
Keyword(s):  
Stem Cells ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Human Umbilical Cord ◽  
Annexin A1 ◽  
Significant Difference ◽  
Life Threatening ◽  
Stromal Stem Cells

We have previously shown that the combination of radiotherapy with human umbilical-cord-derived mesenchymal stromal/stem cells (MSCs) cell therapy significantly reduces the size of the xenotumors in mice, both in the directly irradiated tumor and in the distant nonirradiated tumor or its metastasis. We have also shown that exosomes secreted from MSCs preirradiated with 2 Gy are quantitatively, functionally and qualitatively different from the exosomes secreted from nonirradiated mesenchymal cells, and also that proteins, exosomes and microvesicles secreted by MSCs suffer a significant change when the cells are activated or nonactivated, with the amount of protein present in the exosomes of the preirradiated cells being 1.5 times greater compared to those from nonirradiated cells. This finding correlates with a dramatic increase in the antitumor activity of the radiotherapy when is combined with MSCs or with preirradiated mesenchymal stromal/stem cells (MSCs*). After the proteomic analysis of the load of the exosomes released from both irradiated and nonirradiated cells, we conclude that annexin A1 is the most important and significant difference between the exosomes released by the cells in either status. Knowing the role of annexin A1 in the control of hypoxia and inflammation that is characteristic of acute respiratory-distress syndrome (ARDS), we designed a hypothetical therapeutic strategy, based on the transplantation of mesenchymal stromal/stem cells stimulated with radiation, to alleviate the symptoms of patients who, due to pneumonia caused by SARS-CoV-2, require to be admitted to an intensive care unit for patients with life-threatening conditions. With this hypothesis, we seek to improve the patients’ respiratory capacity and increase the expectations of their cure.

scholarly journals HAEMOSTATIC EFFECT OF ETHANOLIC EXTRACT OF Ageratum conyzoides L TO STRAINS OF MICE MALE SWISS WEBSTER INDUCED WITH COMBINATION OF ASPIRIN, CLOPIDOGREL AND ENOXAPARIN

2017 ◽  
Vol 10 (7) ◽  
pp. 276
Author(s):  
Yedy Purwandi Sukmawan ◽  
Hendy Suhendy
Keyword(s):  
Bleeding Time ◽  
Ethanolic Extract ◽  
Bleeding Complications ◽  
Negative Group ◽  
Clotting Time ◽  
Ageratum Conyzoides ◽  
Coronary Syndrome ◽  
Hemostatic Effect ◽  
Significant Difference ◽  
Life Threatening

Objective: Bleeding complications are a common concern with the use of combination of antiagregations and anticoagulant agents especially on acute coronary syndrome treatment. In selected situations such as life-threatening, reversing may be desired, but no specific antidotum for the newer agents such as enoxaparin, fondaparinux, levirudin, bivalirudin, and argatroban. Ageratum conyzoides L is a medicinal plants that have a hemostatic effect. The objective of the study is to know the hemostatic effect of A. conyzoides L to induction of acetosal, clopidogrel, and enoxaparin.Methods: A total of 20 mice are divided into five groups that are normal, negative, positive, Test I and II. There were no treatment for normal, induction of drugs combination for negative, induction of drugs combination and tranexamic acid for positive, induction of drugs combination and ethanolic extract of A. conyzoides L (100 mg/Kg BW) for Test I, induction of drugs combination and ethanolic extract of A. conyzoides L (250 mg/Kg BW) for Test II.Results: The Test Groups I and II showed reversing of clotting time to normal baseline and shown a significant difference (p<0.05) compared with the negative group. In addition, the Test Groups I and II showed significant difference (p<0.05) of bleeding time compared with the negative group and the Test II (250 mg/Kg BW) shown reversing of bleeding time to normal baseline.Conclusion: The hemostatic effect showed by ethanolic extract of A. conyzoides L to induction of combination acetosal, clopidogrel and enoxaparin are very valuable for reversing agent novel.

Diverting Loop Ileostomy for Clostridium Difficile Colitis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 86 (10) ◽  
pp. 1269-1276
Author(s):  
Adam D. Shellito ◽  
Marcia M. Russell
Keyword(s):  
Clostridium Difficile ◽  
Meta Analysis ◽  
Loop Ileostomy ◽  
Patient Characteristics ◽  
Specific Patient ◽  
Entire Cohort ◽  
Significant Difference ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diverting Loop Ileostomy

Diverting loop ileostomy (DLI) with colonic lavage has been proposed as an alternative to total abdominal colectomy (TAC) for fulminant Clostridium difficile infection (CDI). Controversy exists regarding the mortality benefit and outcomes of this surgical approach. We conducted a MEDLINE database search for articles between 1999 and 2019 pertaining to DLI for the surgical treatment of CDI. Five articles met the inclusion criteria. Four studies were retrospective and one was a prospective matched cohort study. 3683 patients were included in the 5 studies; 733 patients (20%) underwent DLI, while 2950 patients (80%) underwent TAC. The only shared outcome measure across all 5 studies was mortality. The overall mortality rate for the entire cohort undergoing both procedures was 30.3%. There was no statistically significant difference in pooled mortality between DLI and TAC (OR: .73; 95% CI, .45-1.2; P = .22). Reporting of other postoperative outcomes was variable. Fulminant CDI remains a life-threatening condition with high mortality. Loop ileostomy may be a viable surgical alternative to total colectomy with similar mortality; however, further work is needed to determine specific patient characteristics that warrant routine use of DLI.

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