scholarly journals Secondary hypokalemic myoplegias

2019 ◽  
Vol 11 (3) ◽  
pp. 52-56
Author(s):  
T. G. Sakovets ◽  
E. I. Bogdanov
Keyword(s):  
Pregnant Women ◽  
Neuromuscular Disorders ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
The Other ◽  
Adrenal Tumors ◽  
Electrolyte Disorders ◽  
Endocrine Disease ◽  
Blood Potassium

Objective: to investigate the features of clinical manifestations and course of secondary hypokalemic myoplegia (SHM) of various etiologies.Patients and methods. The investigation enrolled 10 patients with SHM. The patients' mean age was 39.5±16.2 years. The cause of SHM was hyperaldosteronism in 3 cases, thyrotoxicosis in 1, nontraumatic rhabdomyolysis in 2, and severe toxicosis and massive obstetric hemorrhage in 4.Results and discussion. The blood potassium level difference between days 7 and 1 of hospitalization in patients with hyperaldosteronism and thyrotoxicosis was 2.2±0.4 mmol/l; this indicator in the other patients was less (1.6±0.8 mmol/l). The dynamics of an increase in the blood potassium concentrations during the 7 days differed significantly in 4 pregnant women who had undergone a cesarean section for placental abruption, antenatal fetal death, or their severe toxicosis with suddenly developed neuromuscular disorders (2.1±0.8 mmol/l), and in other patients with SHM (1.4±0.2 mmol/l). SHM in Conn's syndrome and thyrotoxicosis was characterized by long-term (11.8±3.6-day) neuromuscular disorders, while in SHM of another etiology, there were shorter (5.8±4-day) muscle weakness episodes (p<0.05). The SHM duration was recorded to be shorter in 4 pregnant women (4.3±4 days) than that in the other patients (10.3±2.9 days) (p<0.05). In nontraumatic rhabdomyolysis, the duration of hypokalemic paralysis (HP) was significantly longer (9±1.4 days) than in pregnancy (4.3±3.9 days). The episodes of HP in thyrotoxicosis and aldosteroma turned out to be longer (495.8±331.5 days) (p<0.05) than those in the presence of electrolyte changes in pregnant women and in rhabdomyolysis (14±5.7 days). In patients without adrenal tumors, thyrotoxicosis, the SHM periods requiring urgent hospitalization were more prolonged in nontraumatic rhabdomyolysis (30±8.5 days) (p<0.05) than those in the presence with electrolyte disorders in pregnant women (11.2±3.7 days).Conclusion. The differential diagnostic algorithm for examining patients with acute flaccid paralysis of various etiologies due to hypokalemia has not been well elaborated, especially in endocrine disease and rhabdomyolysis. The differences in the rate of hypokalemia reversal in hyperaldosteronism, thyrotoxicosis, and rhabdomyolysis are likely to be associated with the multifactorial etiology of SHM. An incorrect assessment of the etiology of SHM is a common reason for its late diagnosis and inadequate treatment.

scholarly journals Rolling technique for treatment of left displacement of the large colon in horses: 11 cases (2004-2009)

2013 ◽  
Vol 65 (2) ◽  
pp. 329-334 ◽  
Author(s):  
P.A. Canola ◽  
J.C. Lacerda Neto ◽  
J.C. Canola
Keyword(s):  
General Anesthesia ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
The Other ◽  
Safe Procedure ◽  
Emergency Procedures ◽  
Case Selection ◽  
Percutaneous Ultrasonography ◽  
Rectal Palpation

The left displacement of the large colon, a condition that commonly occurs in horses, has two clinical manifestations. Different treatments including medical treatment, rolling the horse under general anesthesia or surgical correction have been recommended. The diagnosis can often be made by rectal examination and confirmed by percutaneous ultrasonography. During the period between 2004 and 2009, 11 horses were treated for left displacement of the large colon by rolling the horses under general anesthesia, using a slightly different technique than the ones previously described. The clinical case selection was based on rectal palpation confirmed with ultrasonogram. Nine animals were successfully treated and two had to be submitted to surgery after three attempts of rolling. No short or long term complications were observed after the procedure. Only one animal had a recurrence of the clinical manifestation 10 months after the first treatment and was successfully rolled once again. Despite a bit different from the other rolling procedures, this also proved to be an effective procedure. Rolling a horse even when attempted more than once showed to be a safe procedure, however, we reinforce the need for special attention following the procedure in order to establish proper emergency procedures in case complications occur.

scholarly journals Long-term consequences of polycystic ovary syndrome

2017 ◽  
Vol 89 (10) ◽  
pp. 75-79 ◽  
Author(s):  
O R Grigoryan ◽  
N S Zhemaite ◽  
N N Volevodz ◽  
E N Andreeva ◽  
G A Melnichenko ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Metabolic Disorder ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Young Age ◽  
Ovary Syndrome ◽  
Endocrine Disease ◽  
Menstrual Irregularities ◽  
Long Term Consequences

Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disease in women. The prevailing complaints at a young age are menstrual irregularities, infertility, and hyperandrogenism-related problems. However, metabolic disorder-induced complications have been in the foreground over years. The review gives the current ideas on a change of clinical manifestations in the natural course of PCOS, as well as the pathogenetically grounded prevention of complications in patients.

scholarly journals Endogenous hypercortisolism in the patient with obesity: the cause or a competing disorder

2016 ◽  
Vol 13 (1) ◽  
pp. 57-61
Author(s):  
Zhanna E. Belaya ◽  
Aleksandr V. Vorontsov ◽  
Aleksandr V. Il'in ◽  
Andrey Y. Grigor'ev ◽  
Lyudmila Y. Rozhinskaya
Keyword(s):  
Metabolic Syndrome ◽  
Weight Gain ◽  
Clinical Manifestations ◽  
Uncontrolled Hypertension ◽  
Adrenal Tumors ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
High Prevalence ◽  
Neurosurgical Treatment

Endogenous hypercortisolism (EH) is a rare endocrine disorder, one of the most frequent manifestations of which is obesity. Due to the high prevalence of the metabolic syndrome and the similarity of the clinical manifestations, EH may remain undiagnosed. However, prompt diagnosis and treatment can effectively promote complete cure of the patient. We describe the clinical case of a patient К., 58 years old, who suffered from morbid obesity, diabetes, uncontrolled hypertension and dyslipidemia. The CT examination revealed bilateral adrenal incidentalomas. The further follow-up let us to establish Cushing's disease. The adrenal tumors in this case may be the results of a long-term stimulation of the adrenal glands by ACTH. There is a possibility that the first manifestation of the disease began at the age of 30 years after the second pregnancy, when she observed weight gain and poorly controlled hypertension. When remission was achieved after neurosurgical treatment, we could observe significant improvements (reduction in body weight of 10 kg, improved glucose levels), but without the full normalization of all complications and symptoms.Conclusion: EH may cause the development of obesity and metabolic syndrome or significantly exacerbate its course. In cases of doubt, weight gain and poorly controlled manifestations of metabolic syndrome screening is justified to exclude EH.

scholarly journals Congenital hepatic fibrosis (a case report)

2021 ◽  
Vol 23 (6) ◽  
pp. 882-888
Author(s):  
O. O. Popovych ◽  
L. V. Moroz ◽  
Yu. V. Avdosiev ◽  
F. A. Chabanov ◽  
O. O. Voinalovych
Keyword(s):  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Diagnosis And Treatment ◽  
Type I ◽  
Liver Pathology ◽  
Congenital Hepatic Fibrosis ◽  
Splenic Artery Embolization

Congenital hepatic fibrosis (CHF) is an autosomal recessive disorder of intrauterine morphogenesis of the portobiliary system, characterized by periportal fibrosis and defective remodeling of the bile ducts. The article describes the features of the clinical course, diagnosis and treatment of type I CHF in the different terms of a patient’s life: from birth to her pregnancy, during pregnancy and after childbirth. The aim of this work is to familiarize specialists with the problem of diagnosis and treatment of type I CHF in a patient with a provisional misdiagnosis of cryptogenic liver cirrhosis. Results. The features of type I CHF that determine a wider diagnostic testing in long-term unspecified liver pathology cases were identified. First-time decompensation of portal hypertension (PH) occurred at 35 weeks of gestation with the development of ascitic-edematous syndrome, hypersplenism, preeclampsia without signs of hepatic encephalopathy (HE). Cesarean section was performed at 37 weeks’ gestation and healthy baby was born. One year and 9 months after delivery, hypersplenism compensation was achieved by performing splenic artery embolization (SAE). There were no clinical manifestations of HE throughout the follow-up period. Conclusions. The diagnostic algorithm for a long-term compensated unspecified liver pathology with PH should confirm or rule out CHF. Type I CHF patients can give birth to a healthy child. SAE successfully compensates for hypersplenism and PH in type I CHF. Transient elastography is an effective method for the assessment of liver fibrosis progression in patients with type I CHF.  

scholarly journals EFFECTS OF CALCIUM CHANNELBLOCKER VERAPAMIL ON BONE AND DENTAL GERM IN RATS

1999 ◽  
Vol 4 (1) ◽  
Author(s):  
MARIA DAS GRAÇAS VILELA-GOULART ◽  
WILMA P. BASTOS-RAMOS ◽  
ROSILENE FERNANDES DA ROCHA ◽  
MIGUEL ANGEL C. SALGADO ◽  
JOSÉ RANALI
Keyword(s):  
Pregnant Women ◽  
Bone Mineralization ◽  
Plasma Calcium ◽  
The Other ◽  
Calcium Deposition ◽  
Femoral Bone ◽  
Calcium Blocker ◽  
Dental Eruption

O verapamil e outros bloqueadores dos canais de cálcio são usados como antihipertensivos e antiarrítmicos tratamentos prolongados ou por toda a vida, podendo ser indicados em gestantes. Foi estudado o efeito do bloqueador dos canais de cálcio sobre o germe dental, tempo de erupção dentária de filhotes nascidos de mães tratadas e mineralização óssea nas mães. As fêmeas tratadas foram divididas em dois grupos: o primeiro recebeu verapamil na dose de 2,4 mg/rato/dia e o segundo, 24 mg/rato/dia. Os animais foram divididas em dois subgrupos: o primeiro recebeu a droga durante 10 semanas: 7 semanas antes do acasalamento e 3 semanas durante a gestação realizando-se a operação cesariana ao 21o dia; o outro foi tratado como o primeiro, porem os filhotes nasceram de parto natural e o tratamento das mães foi continuado por 15 dias. Foram determinados os níveis plasmáticos de cálcio e fosfato de mães e filhotes. As cabeças dos filhotes foram seccionadas para histologia dos germes dentários e determinados os pesos úmido e seco do osso femoral das mães. Os resultados mostraram que a droga, na dose mais elevada, diminuiu os níveis séricos de cálcio e fosfato nas mães, enquanto que nos filhotes, os valores foram significativamente mais baixos em comparação com as mães. O verapamil causou aumento da mineralização óssea nas mães durante a gestação, mas não após o parto. Um aumento da calcificação dos germes dentários dos filhotes não pôde ser demonstrada, porem na dose mais elevada, o verapamil causou retardo significativo na erupção dentária. Abstract Verapamil and other calcium blocker drugs are used as antihypertensive and antiarrhythmic in long term treatments and appropriate to be prescribed for pregnant women. It was studied in rats the effects of verapamil on dental germ calcification, the time of dental eruption in offspring born from treated mothers and on mother’s bone mineralization. The rats were divided in two groups: one received verapamil in doses of 2.4 mg/rat/day and the other, 24 mg/rat/day. The animals were divided in two subgroups: one was treated during 10 weeks: 7 before mating and 3 during pregnancy, cesarean surgery performed on the 21st day; the other was treated in the same way but the offspring were born by natural delivery and the mothers’ treatment continued for 15 days. Plasma calcium and phosphate were assayed in mothers and offspring. The offspring’s heads were isolated to histology of dental germs and determined mothers’ femoral bone fresh and dry weights. Results show that the higher dose verapamil lowered mother’s plasmatic calcium and phosphate while a significant lower values were observed in offspring as compared to their mothers. Verapamil increased mothers’ femoral bone mineralization during mineralization but not after delivery. An increased calcium deposition of dental germ could not be demonstrated but verapamil significantly delayed newborn’s dental eruption.

Radioimmunotherapy for treatment of acute myeloid leukaemia and myelodysplastic syndrome

2005 ◽  
Vol 44 (03) ◽  
pp. 107-117
Author(s):  
R. G. Meyer ◽  
W. Herr ◽  
A. Helisch ◽  
P. Bartenstein ◽  
I. Buchmann
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Primary Tumour ◽  
The Other ◽  
Haematopoietic Stem Cell ◽  
Other Hand ◽  
Primary Reduction ◽  
The One ◽  
Acute Myeloid

SummaryThe prognosis of patients with acute myeloid leukaemia (AML) has improved considerably by introduction of aggressive consolidation chemotherapy and haematopoietic stem cell transplantation (SCT). Nevertheless, only 20-30% of patients with AML achieve long-term diseasefree survival after SCT. The most common cause of treatment failure is relapse. Additionally, mortality rates are significantly increased by therapy-related causes such as toxicity of chemotherapy and complications of SCT. Including radioimmunotherapies in the treatment of AML and myelodyplastic syndrome (MDS) allows for the achievement of a pronounced antileukaemic effect for the reduction of relapse rates on the one hand. On the other hand, no increase of acute toxicity and later complications should be induced. These effects are important for the primary reduction of tumour cells as well as for the myeloablative conditioning before SCT.This paper provides a systematic and critical review of the currently used radionuclides and immunoconjugates for the treatment of AML and MDS and summarizes the literature on primary tumour cell reductive radioimmunotherapies on the one hand and conditioning radioimmunotherapies before SCT on the other hand.

Hidden “holes” in the capital of banks and the supply of credit to the real sector of economy

2018 ◽  
pp. 49-68 ◽  
Author(s):  
M. E. Mamonov
Keyword(s):  
Credit Risk ◽  
The Other ◽  
Real Sector ◽  
Capital Management ◽  
Loan Loss ◽  
Short Term ◽  
The Real ◽  
Ex Post ◽  
The One

Our analysis documents that the existence of hidden “holes” in the capital of not yet failed banks - while creating intertemporal pressure on the actual level of capital - leads to changing of maturity of loans supplied rather than to contracting of their volume. Long-term loans decrease, whereas short-term loans rise - and, what is most remarkably, by approximately the same amounts. Standardly, the higher the maturity of loans the higher the credit risk and, thus, the more loan loss reserves (LLP) banks are forced to create, increasing the pressure on capital. Banks that already hide “holes” in the capital, but have not yet faced with license withdrawal, must possess strong incentives to shorten the maturity of supplied loans. On the one hand, it raises the turnovers of LLP and facilitates the flexibility of capital management; on the other hand, it allows increasing the speed of shifting of attracted deposits to loans to related parties in domestic or foreign jurisdictions. This enlarges the potential size of ex post revealed “hole” in the capital and, therefore, allows us to assume that not every loan might be viewed as a good for the economy: excessive short-term and insufficient long-term loans can produce the source for future losses.

Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

Interrelationships between municipal spatial policy strategy and airport operation and development. Lodz Airport case study

2018 ◽  
Vol 59 (1) ◽  
pp. 65-79
Author(s):  
Katarzyna Nikorowicz-Zatorska
Keyword(s):  
Land Use ◽  
Urban Planning ◽  
Cultural Development ◽  
The Other ◽  
Local Authorities ◽  
Spatial Management ◽  
The One ◽  
Surrounding Areas

Abstract The present paper focuses on spatial management regulations in order to carry out investment in the field of airport facilities. The construction, upgrades, and maintenance of airports falls within the area of responsibility of local authorities. This task poses a great challenge in terms of organisation and finances. On the one hand, an active airport is a municipal landmark and drives local economic, social and cultural development, and on the other, the scale of investment often exceeds the capabilities of local authorities. The immediate environment of the airport determines its final use and prosperity. The objective of the paper is to review legislation that affects airports and the surrounding communities. The process of urban planning in Lodz and surrounding areas will be presented as a background to the problem of land use management in the vicinity of the airport. This paper seeks to address the following questions: if and how airports have affected urban planning in Lodz, does the land use around the airport prevent the development of Lodz Airport, and how has the situation changed over the time? It can be assumed that as a result of lack of experience, land resources and size of investments on one hand and legislative dissonance and peculiar practices on the other, aviation infrastructure in Lodz is designed to meet temporary needs and is characterised by achieving short-term goals. Cyclical problems are solved in an intermittent manner and involve all the municipal resources, so there’s little left to secure long-term investments.

Features of the course and treatment of glaucoma during pregnancy

2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Pregnant Women ◽  
Laser Treatment ◽  
Progressive Disease ◽  
Clinical Course ◽  
The Other ◽  
Third Trimester ◽  
The Third ◽  
Chronic Progressive Disease ◽  
Hypotensive Therapy ◽  
Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

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