Chronic Exertional Compartment Syndrome: A Review of Literature

Chronic exertional compartment syndrome (CECS) is a serious, yet underdiagnosed condition that can cause severe lower extremity pain in running athletes. CECS is a transient increase in compartment pressure leading to severe pain, paresthesia, and vascular compromise. Understanding the detailed anatomy is paramount to proper diagnosis and treatment. Diagnosis is made with measuring compartments pressures before and after exercise at certain time intervals. When properly diagnosed and treated, CECS can be appropriately managed and patients can return to their previous level of activity.

Dental fractures: types, causes, and treatment

Studies indicate that the management of dental fractures might be challenging because many cases present with minor, hard-to-discover traumas, requiring extensive evaluation and diagnostic procedures. Accordingly, adequate management can only be achieved by establishing a proper diagnosis, drawing an adequate treatment plan, and conducting regular follow-up appointments. We have discussed the different causes, types, and treatments of dental fractures. The commonest causes include impaction by trauma, whether direct or indirect. Many traumatic events were reported in the literature, and age and carious lesions are important factors to consider. Many types of dental fractures were also reported in the literature, including root fractures, crown root fractures, enamel-dentin fractures with and without pulp exposure or crown fractures, enamel infractions, and fractures. Other types include avulsion, intrusion, extrusion, lateral luxation, concussion or subluxation, splinting, and alveolar segment fractures. The treatment should be integrated based on the fracture type, and adequate follow-up should be established to achieve the best predictive outcomes.

From membranoproliferative glomerulonephritis to a final diagnosis: Hypocomplementemic urticarial vasculitis syndrome

Membranoproliferative glomerulonephritis describes a glomerular-injury pattern common to a heterogeneous group of diseases. Evaluation based on clinical and laboratory presentation and immunofluorescence staining on kidney biopsy allows identification of underlying pathophysiological processes and may facilitate proper diagnosis and treatment. Hypocomplementemic urticarial vasculitis syndrome is a rare autoimmune disease of multi-organ involvement. The diagnosis is based on well-defined clinical and laboratory criteria. The pathophysiology is not completely understood but the presence of anti-C1q antibody seems to be involved. Renal involvement occurs in up to 50% of cases. It can be heterogeneous and can be indistinguishable from lupus nephritis. Serological findings and skin involvement distinguish these two entities. We report the case of a 40-year-old female who presented with urticarial skin lesions, hypocomplementemia and nephrotic syndrome. Kidney biopsy showed membranoproliferative glomerulonephritis with full house immune complex deposits. The diagnosis of hypocomplementemic urticarial vasculitis syndrome was made and the patient was successfully treated with prednisolone and mycophenolate mofetil.

Harnessing novel data sources to understand patients’ perspectives (Preprint)

UNSTRUCTURED Patient perspectives are central to the U.S. Food and Drug Administration’s benefit-risk decision-making process in the evaluation of medical products. Traditional channels of communication may not be comfortable for all patients and consumers. Social media websites have increasingly been recognized by researchers as a means to gain insights on patients’ views about treatment and diagnostic options, the healthcare system, and their experiences living with their conditions. Utilizing multiple patient perspective data sources offers the FDA the opportunity to capture diverse patient voices and experiences with chronic pain. The FDA Office of Minority Health and Health Equity (OMHHE) and the Center for Devices and Radiological Health (CDRH) worked with INSPIRE (Clinica Health, Inc.) to conduct a pilot study exploring posts from INSPIRE’s own patient platform and several social media platforms to gain insights into the key challenges and barriers faced by chronic pain patients (CPPs). The most common topics discussed among CPPs were disease burden, support and advocacy needs, and proper diagnosis. The two most frequently discussed treatments were opioids or narcotics, and devices such as transcutaneous electrical nerve stimulation (TENS) machines and spinal cord stimulators. Success in pain reduction was tempered by concerns of stigmatization regarding opioid addiction and dependency. The study illustrates how social listening data may provide valuable insights into diverse patient perspectives, preferences, and unmet needs, especially for conditions that may be perceived as stigmatizing.

COVID-19 Detection and Analysis Using Chest X-Ray and CT- Scan Images

COVID-19 seems to be the most devastating and lethal illness characterized by an unique coronavirus for the human body. Coronavirus, which is considered to have originated in Wuhan, China, and is responsible for a huge number of deaths, spread swiftly around the world in December 2019. Early discovery of COVID-19 by proper diagnosis, especially in situations with no evident symptoms, could reduce the death rate of patients. The primary diagnostic tools for this condition are chest Xrays and CT scans. COVID-19 may be detected using a machine vision technique from chest X-ray pictures and CT scans, according to this study.The model's performance was evaluated using generalised data throughout the testing step. According to recent studies gained using radiological imaging techniques, such images convey crucial data about the COVID-19 virus. This proposed approach, which makes use of modern artificial intelligence (AI) techniques, has shown to be effective in recognising COVID-19, and when combined with radiological imaging, can aid in the correct detection of this disease. The proposed approach was created in order to provide accurate assessments for COVID and non-COVID patients.The results demonstrate that VGG-16 is the best architecture for the reference dataset, with 98.87 percent accuracy in network evaluations and 95.91 percent success in patient status identification. Convolutional layers were developed, with distinct filtering applied to each layer. As a result, the VGG-16 design performed well in the classification of COVID-19 cases. Nevertheless, by modifying it or adding a preprocessing step on top of it, this architecture allows for significant gains. Our methodology can be used to help radiologists validate their first screenings and can also be used to screen patients quickly via the cloud.

Cardiovascular risk factors of poor prognosis in COVID-19 – a review

Since the first report in 2019, COVID-19 has claimed many lives, even those previously in good health. Therefore, a proper diagnosis and identification of patients at the highest risk of serious complications is vital. In fact, COVID-19 can lead to systemic inflammation and multiorgan dysfunction. Apart from the respiratory system, the circulatory system is also affected, including numerous complications due to the cytokine storm, direct cytotoxic effects, downregulation of angiotensin-converting enzyme 2, and low oxygen blood levels. In this review, we discussed cardiovascular risk factors associated with a poor prognosis in COVID-19 patients, including pre-existing risk factors or those acquired in the course of the infection. We also analyzed the role of biomarkers, ECG, and imaging in the identification of patients at the highest risk of unfavorable outcomes, as even subtle abnormalities in additional tests may have a significant impact on disease management.

Sleep Apnoea and Heart Failure

Heart Failure (HF) and Sleep-Disordered-Breathing (SDB) are two common conditions that frequently overlap and have been studied extensively in the past three decades. Obstructive Sleep Apnea (OSA) may result in myocardial damage, due to intermittent hypoxia increased sympathetic activity and transmural pressures, low-grade vascular inflammation and oxidative stress. On the other hand, central sleep apnoea and Cheyne-Stokes respiration (CSA-CSR) occurs in HF, irrespective of ejection fraction either reduced (HFrEF), preserved (HFpEF) or mildly reduced (HFmrEF). The pathophysiology of CSA-CSR relies on several mechanisms leading to hyperventilation, breathing cessation and periodic breathing. Pharyngeal collapse may result at least in part from fluid accumulation in the neck, owing to daytime fluid retention and overnight rostral fluid shift from the legs. Although both OSA and CSA-CSR occur in HF, the symptoms are less suggestive than in typical (non-HF related) OSA. Overnight monitoring is mandatory for a proper diagnosis, with accurate measurement and scoring of central and obstructive events, since the management will be different depending on whether the sleep apnea in HF is predominantly OSA or CSA-CSR. SDB in HF are associated with worse prognosis, including higher mortality than in patients with HF but without SDB. However, there is currently no evidence that treating SDB improves clinically important outcomes in patients with HF, such as cardiovascular morbidity and mortality.

Sleep Problems in Chronic Inflammatory Diseases: Prevalence, Treatment, and New Perspectives: A Narrative Review

Epidemiological studies have shown that individuals with sleep problems are at a greater risk of developing immune and chronic inflammatory diseases. As sleep disorders and low sleep quality in the general population are frequent ailments, it seems important to recognize them as serious public health problems. The exact relation between immunity and sleep remains elusive; however, it might be suspected that it is shaped by others stress and alterations of the circadian rhythm (commonly caused by for example shift work). As studies show, drugs used in the therapy of chronic inflammatory diseases, such as steroids or monoclonal antibodies, also influence sleep in more complex ways than those resulting from attenuation of the disease symptoms. Interestingly, the relation between sleep and immunity appears to be bidirectional; that is, sleep may influence the course of immune diseases, such as inflammatory bowel disease. Thus, proper diagnosis and treatment of sleep disorders are vital to the patient’s immune status and, in effect, health. This review examines the epidemiology of sleep disorders and immune diseases, the associations between them, and their current treatment and novel perspectives in therapy.

Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review

BACKGROUND: Low back pain is a significant spinal disorder that affects much of the population at some point during their lives. OBJECTIVE: While proper diagnosis is key, diagnosing the underlying cause of low back pain may often be unclear. METHOD: In this review article, we discuss lumbar instability as an etiology of low back pain and its treatment by prolotherapy. RESULTS: Spinal ligaments may be an underlying culprit in the development of lumbar instability with resultant low back pain and associated disorders. CONCLUSION: In these cases, adequate treatment consisting of non-biologic prolotherapy or cellular prolotherapy, including platelet rich plasma (PRP), can be beneficial in restoring spinal stability and resolving chronic low back pain.

Clinical features, diagnosis, and types of optic neuritis

Establishing a proper diagnosis and identifying the underlying etiology of optic neuritis can be challenging in clinical settings. This is due to the various subtypes and etiologies that were reported for the condition. However, conducting a thorough examination and the laboratory and imaging modalities can significantly enhance the diagnosis. Therefore, it is essential to be adequately aware of the different subtypes of optic neuritis and distinguish between the different clinical features and diagnostic findings of each subtype to conduct a proper diagnosis and enhance management of the affected cases. Optic neuritis is a severe condition that can lead to permanent vision loss. In the present literature review, we have discussed the potential clinical features and diagnostic findings of the different types of optic neuritis. More severe cases of optic neuritis are usually associated with NMOSD and IgG-MOG cases with a worsened prognosis. Painless and chronic vision loss might occur secondary to infections and granulomatous diseases. On the other hand, optic neuritis secondary to multiple sclerosis is usually self-limited. Many of the cases of optic neuritis are characterized by being responsive to steroid therapy. However, acute vision loss was also reported in some cases. Therefore, clinicians must be knowledgeable enough to conduct the most appropriate diagnostic and management modalities to enhance the prognosis of the affected patients. Further research is needed for optimizing the treatment plan and drawing better interventions.