Piezopulsometric analysis of autonomic regulation of the cardiovascular system in an elderly person under stress

Описаны результаты применения нового метода артериальной пьезопульсометрии для неинвазивной оценки функционального состояния и физиологических механизмов автономной регуляции сердечно-сосудистой системы (ССС) у пожилого человека при острой боли, связанной с неожиданной физической травмой. Такое воздействие в первый же день вызвало негативную стресс-реакцию в мышечных эффекторах (МЭ) ССС, провоцируя аномальное усиление и ускорение сократимости миокарда ЛЖ сердца. Анализ графиков волн пульсового АД крови (ПАДК) показал, что максимальная скорость прироста ПАДК - VmaxPP, отражающая сократительную способность миокарда, выросла с 625±74 перед травмой до 2 117±173 мм рт. ст./с после травмы, исказив контур нормального графика. Причиной этого роста могло быть быстрое суммарное воздействие трансмиттеров нейроэндокринной симпатико-адреналовой системы на адренорецепторы кардиомиоцитов. Результаты спектрального анализа вариабельности параметров волн ПАДК подтвердили такую возможность. Было показано, что при стрессе норадреналин из активированных симпатических эфферентов добавляется к характерному для пожилых людей уже повышенному содержанию гуморальных катехоламинов в межклеточной среде миокарда вблизи адренорецепторов кардиомиоцитов. При этом существенно возрастает активность парасимпатических эфферентов, выделяющих ацетилхолин, ингибирующий контрактильную реакцию миокарда и тем самым выполняющий сдерживающую кардиопротекторную функцию. При исследовании механизмов автономной регуляции МЭ ССС в условиях стрессорного воздействия использовали персонализированный подход. The article describes the results of using the method of arterial piezopulsometry for non-invasive assessment of the functional state and physiological mechanisms of autonomous regulation of the cardiovascular system (CVS) in an elderly person with acute pain associated with unexpected physical trauma. On the first day, such an effect caused a negative stress reaction in the muscle effectors (ME) of the CVS, provoking an abnormal increase and acceleration of the contractility of the left ventricular myocardium. Analysis of the arterial blood pressure (PP) pulse wave graphs showed that the maximum rate of PP growth - VmaxPP, which reflects myocardial contractility, increased from 625±74 before injury to 2 117±173 mm Hg/s after injury, distorting the contour of the normal PP waveform. The reason for this growth could be the rapid cumulative effect of transmitters of the neuroendocrine sympathoadrenal system on adrenergic receptors (AR) of cardiomyocytes (CM). The results of the spectral analysis of the variability of the parameters of the PP waves confirmed this possibility. It was shown that under stress, norepinephrine from activated sympathetic efferents is added to the already increased content of humoral catecholamines in the extracellular environment of the myocardium near the AR of the CM, which is characteristic of the elderly. At the same time, the activity of parasympathetic efferents, releasing acetylcholine, which inhibits the contractile reaction of the myocardium and, thereby, performs a restraining cardioprotective function, significantly increases. A personalized approach was used for piezopulsometric study of the mechanisms of autonomous regulation of ME CVS under specific conditions of stress.

Teenage pregnancy: The cost of seeking our pound of flesh

The disturbing effects of unplanned teenage pregnancy coupled with the damage done by societal stigmatization often lead to deep and, sometimes, lifelong psychological, mental, emotional and physical trauma. All-round support rather than stereotyping would give these teen girls wings to fly again.

Artritis Psoriatika

To know the risk factors, pharmacological treatment and prevention of psoriatic arthritis. Psoriatic arthritis is a chronic musculoskeletal disease associated with psoriasis. at least 5% of psoriasis patients develop psoriatic arthritis. Globally, the incidence of PsA reaches 133 per 100,000 patient subjects. The annual incidence of PsA is about 2.7 cases per 100 people diagnosed with psoriasis. In Asia, PsA cases increased from 2000 to 2013 with a prevalence (per 100,000 population) of 11.12 to 37.75. Based on a study at Sanglah Hospital Bali found PsA patients as much as 6.3% of psoriasis patients. PsA patients may have clinical features such as peripheral arthritis, enthesitis, dactylitis, skin, nail, and axial involvement. Risk factors for psoriatic arthritis include obesity, physical trauma, smoking, location of psoriasis in the body, education level and genetic factors. Pharmacological treatment of PsA based on the latest guidelines from EULAR 2019 and ACR recommendations. These two guidelines discuss pharmacological treatment based on the patient's clinical picture. The goal of pharmacological therapy is to improve the patient's quality of life by improving symptomatic complaints and preventing structural damage. As a prevention, PsA maintains an ideal body weight, reduces cigarette consumption, and performs detection as an early detection.

Frequency of Anticardiolipin Antibodies in Women with Recurrent Fetal Loss

Aim: To find out the frequency of Anticardiolipin Antibodies in women with recurrent fetal loss Study design & duration: One year descriptive study Methods: Seventy five females were included in the study with ages ranging from 20-40 years with minimum two miscarriages. Diabetic females and females with history of bacterial or viral diseases were excluded from the study. Results: In this group the mean age was 27.60±3.29 years. Mean number of fetal losses was 2.95±1.45 whereas mean duration of marriage was 5.79±4.11 years. Conclusion: It is suggested that the patient with history of recurrent miscarriages must be screened for Anticardiolipin Antibodies to bring them out of psychological and physical trauma. Keywords: Anticardiolipin Antibodies (aCL), Recurrent fetal loss (RFL), aPTT

Minimally invasive biological treatment in endodontics

Functional forces might also lead to fracture after endodontic treatment. This might occur secondary to exposure to erosion, abrasion, physical trauma, and caries. Interventing against these events can be achieved by conducting long follow-up periods and enhancing the endodontic treatment approaches. The current endodontic treatment modalities aim at tissue preservation to enhance resistance to fractures and prevent potential post-treatment complications. In this context, evidence shows the validity of minimally invasive modalities in endodontic treatment with favorable outcomes and reduced frequency of complications. In the present literature review, we have discussed the efficacy of minimally invasive biological treatment in endodontics. It is vital to maintain the integrity of the structures of the tooth-related paracervical area, particularly when treating molars. This is attributed to enhancing the long-term survival rates of the pericervical dentin of these teeth. The current trends represent a revolution in the field of endodontic treatment. This is attributed to the novel development of the various disinfection modalities, which do not need to shape the canal into a round form and induce flaring reactions. Overall, the main advantages of vital pulp therapy include being simple, reduced cost, and reduced risk of treatment-related complications secondary to overcoming the difficulties with the anatomy of the root canals.

Multiscale Brain Aging in the Context of Neurodegeneration and Alzheimer's Disease

The brain, with a diverse array of specialized cells, regional substructures, and a relatively isolated microenvironment, represents a uniquely challenging organ system for aging research. The brain can experience physical trauma, interact with the periphery, and is responsible for cognitive and behavioral modifications that can feed back into the molecular processes of aging both within and external to the brain. Advances to our understanding and ability to intervene in the complexity that personifies brain aging and associated neurodegeneration will require integrated, multiscale approaches operating in tandem. Therefore, we have organized this symposium to highlight promising new approaches to study brain aging through the lens of multiple biological levels of organization. We will provide insight not only into normal brain aging, but will also suggest key spurious processes that may drive neurodegeneration and functional decline.

Mobilizing Endogenous Repair Through Understanding Immune Reaction With Biomaterials

With few exceptions, humans are incapable of fully recovering from severe physical trauma. Due to these limitations, the field of regenerative medicine seeks to find clinically viable ways to repair permanently damaged tissue. There are two main approaches to regenerative medicine: promoting endogenous repair of the wound, or transplanting a material to replace the injured tissue. In recent years, these two methods have fused with the development of biomaterials that act as a scaffold and mobilize the body’s natural healing capabilities. This process involves not only promoting stem cell behavior, but by also inducing activity of the immune system. Through understanding the immune interactions with biomaterials, we can understand how the immune system participates in regeneration and wound healing. In this review, we will focus on biomaterials that promote endogenous tissue repair, with discussion on their interactions with the immune system.

A Review on the Role of Endogenous Neurotrophins and Schwann Cells in Axonal Regeneration

Injury to the peripheral nerve is traditionally referred to acquired nerve injury as they are the result of physical trauma due to laceration, stretch, crush and compression of nerves. However, peripheral nerve injury may not be completely limited to acquired physical trauma. Peripheral nerve injury equally implies clinical conditions like Guillain-Barré syndrome (GBS), Carpal tunnel syndrome, rheumatoid arthritis and diabetes. Physical trauma is commonly mono-neuropathic as it engages a single nerve and produces focal damage, while in the context of pathological conditions the damage is divergent involving a group of the nerve causing polyneuropathy. Damage to the peripheral nerve can cause a diverse range of manifestations from sensory impairment to loss of function with unpredictable recovery patterns. Presently no treatment option provides complete or functional recovery in nerve injury, as nerve cells are highly differentiated and inert to regeneration. However, the regenerative phenotypes in Schwann cells get expressed when a signalling cascade is triggered by neurotrophins. Neurotrophins are one of the promising biomolecules that are released naturally post-injury with the potential to exhibit better functional recovery. Pharmacological intervention modulating the expression of these neurotrophins such as brain-derived neurotrophic factor (BDNF) and pituitary adenylyl cyclase-activating peptide (PACAP) can prove to be a significant treatment option as endogenous compounds which may have remarkable innate advantage showing maximum ‘biological relevance’. Graphical abstract

Self-efficacy in relation to the use of complementary and alternative medicine, lifestyle choices and cancer aetiology

Purpose This survey assesses cancer patients’ etiological concepts, lifestyle choices, use of complementary and alternative medicine (CAM), and self-efficacy, as well as associations between those. It aims to find patterns which may facilitate communication and understanding between patients and physicians. Methods 353 oncological patients attending lectures on CAM answered a questionnaire. Correlations were examined and an exploratory factor analysis conducted to identify comprehensive lay-etiological concepts among a list of potential carcinogenic factors. Results Patients considered scientifically proven agents as well as other non-carcinogenic influences to be responsible for their disease. An exploratory factor analysis yielded vague indications of possible underlying concepts but factors tend to include items that do not fit the pattern in terms of content. Higher self-efficacy correlated with healthy diet and sports, but not with use of CAM. No conclusive correlations emerged between lay-aetiological concepts and most other variables, but we found a tendency for higher self-efficacy among patients who assigned higher carcinogenic effects to tobacco and lower carcinogenic effects to fasting and physical trauma. Conclusion Interest in CAM can arise for many reasons that are not necessarily related to self-efficacy. Lay-aetiological concepts of cancer differ significantly from scientific ones. They are complex and presumably highly individualistic. Their connection to use of CAM methods, lifestyle choices and self-efficacy should be explored in more detail. Patient information and communication with clinicians need to address cancer patients’ individual aetiological concepts to further patient’s understanding not only of their diagnosis but also of the treatment as well.

Critical Care, Psychology, and Rehabilitation

This chapter discusses the integration of psychological and rehabilitative interventions into critical care practice and indicates how it can have a positive impact on desired outcomes, both short and long term. While there is a specific focus on postintensive care syndrome, the author also outlines overlapping issues relevant to caring for those with critical injuries and physical trauma. The chapter reviews barriers to developing truly interdisciplinary teams and how to address factors that interfere with the coordination of care. The importance of psychology and rehabilitation involvement across the critical care continuum is emphasized while also providing a summary of the literature supporting the efficacy of rehabilitation on and after the intensive care admission.