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2021 ◽  
Vol 27 (4) ◽  
pp. 464-471
O. M. Drapkina ◽  
I. I. Almazova ◽  
A. A. Telkhigova ◽  
O. N. Dzhioeva ◽  
S. A. Berns ◽  

Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery of all vital functions without signs of neurological deficits. Syncope is a multidisciplinary medical problem common in clinical practice. As a rule, syncope occurs due to cardiovascular dysfunction of organic or functional origin, which either develops spontaneously or is induced by a trigger. Due to a various etiology differential diagnosis and prognostic evaluation is difficult. This clinical case demonstrates the features of differential diagnosis of vasovagal syncope in a patient with polymorbid pathology and the features of the choice of an adequate management, including recommendations for lifestyle modifications, specialized education regarding prodromal symptoms recognition methods and timely application of countermeasures.

2021 ◽  
Vol 11 (5) ◽  
pp. 7-11
Petronela Nechita ◽  
Liliana Luca ◽  
Codrina Moraru ◽  
Raluca-Ioana Cojocariu ◽  
Anamaria Ciubara

Coercion raises serious ethical and legal issues in psychiatric care. Coercive medical measures are applied in psychiatric institutions for protective purposes. Alcoholism is a social and medical problem because it especially affects the behavior of the individual. Alcohol consumption can catalyze exacerbations of mental illness and predispose to behaviors with an increased risk of violence. Aim: The purpose of this study is to illustrate medical and legal issues related to coercive measures in emergency psychiatric care during the pandemic. Methods: The study is retrospective, and the data were taken from the observation sheets of patients in the period between March 1, 2020–March 31, 2021, in acute section II in the Institute of Psychiatry "Socola" Iasi. Results: Of those who required coercive measures during hospitalization, most were restraint for symptoms such as: self-aggression and aggression towards others. Mechanical restraint measures were also necessary in cases with hallucinatory-delusional symptoms, associated with self-aggression and aggression towards others. The share of hospitalized patients for alcohol abuse, who required coercive measures, was significantly higher during the pandemic. Conclusion: Manifestations of violence among patients with major mental disorders are rare. Mechanical restraint was necessary especially in those who had self-aggression and aggression towards others, symptoms secondary to alcohol consumption. Alcohol consumption amplifies the psychological imbalance in the context of the COVID-19 pandemic.

2021 ◽  
Vol LXXXII (4) ◽  
pp. 297-313
Diana Aksamit

The aim of this article is to characterize the cognitive development of a preschool child on the basis of selected theoretical concepts in relation to moderate and severe intellectual disability. These considerations will serve as a guideline for further theoretical analyses and practical activities supporting the development of children with intellectual disabilities. From a biological perspective, intellectual disability is a typical medical problem. In the developmental context, it means “a failure in the process of development” (Kościelska 1995; Speck, 2015). I assume that the determinant for planning and implementing the content, forms and methods of teaching in special kindergarten should be the level of cognitive development of each child. In the study I refer to selected concepts of development in the terms of Jean Piaget and Lev Vygotsky, which, as I assume, can be a field for analysis of the development of children who require multi-profile support.

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Jan Krhut ◽  
Lukas Peter ◽  
Michal Rejchrt ◽  
Martin Slovak ◽  
Barbora Skugarevska ◽  

Overactive bladder syndrome (OAB) is a prevalent medical problem with a significant impact on the quality of life of the affected individuals. Pharmacotherapy is considered the main treatment method, although it is discontinued in a significant proportion of patients due to inefficacy or associated side effects. If pharmacotherapy fails, patients can undergo peripheral neuromodulation of the somatic nerves of the lower limb or sacral neuromodulation; however, neither of these represents an ideal therapeutic tool. The Peroneal electric Transcutaneous NeuroModulation (Peroneal eTNM®), based on the selective stimulation of the peroneal nerve, is the new fully noninvasive neuromodulation method intended to treat OAB. The URIS® neuromodulation system, engineered to provide Peroneal eTNM®, consists of the URIS® device, URIS® active electrodes, and the biofeedback foot sensor (BFS). The unique design of the URIS® device and URIS® active electrodes allows for the use of a low voltage and current during neuromodulation, which significantly reduces the unpleasant sensations. The BFS allows for precise localization of the active electrodes and for continuous adjustment of the voltage and frequency to achieve the optimal therapeutic effect. The URIS® system adopts several principles of telemedicine, which makes it compatible with the US Food and Drug Administration (FDA) and European Union (EU) regulations for home-based use. This article describes both the Peroneal eTNM® method and the URIS® neuromodulation system, including its technical specifications and data from laboratory testing. Preclinical and early clinical data demonstrate the feasibility of this new method for noninvasive OAB treatment and possible implications for clinical practice.

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1839
Tomasz Bogiel ◽  
Mateusz Rzepka ◽  
Dagmara Depka

SARS-CoV-2 is a new virus from the Coronaviridae family and its rapid spread is now the most important medical problem worldwide. Currently used tests vary in the number and selection of SARS-CoV-2 target genes. Meanwhile, the choice of the appropriate target gene may be important in terms of a reliable detection of a viral RNA. As some researchers questioned the sensitivity of the monogenic VIASURE SARS-CoV-2 S gene Real Time PCR Detection Kit (CerTest Biotec, Zaragoza, Spain) in mid-2020, the aim of the study was to evaluate the usefulness of this kit, used along with the BD MAX™ System (Becton Dickinson, East Rutherford, NJ, USA), and compare the results with two-gene Bosphore Novel Coronavirus (2019-nCoV) Detection Kit v1 (Anatolia Diagnostics and Biotechnology Products Inc., Istanbul, Turkey). Both tests were carried out on 306 nasopharyngeal/oropharyngeal swabs. The consistent results (72 positive and 225 negative results found simultaneously in both kits) were obtained for 297 (97.1%) samples altogether, while discrepancies between the results of the evaluated tests were observed for nine (2.9%) specimens. There were no statistically significant differences between the method used and the frequency of positive results. Both tests, targeted at detecting one and two genes, are effective in SARS-CoV-2 RNA detection.

L. S. Evert ◽  
S. Yu. Tereshchenko ◽  
Yu. R. Kostyuchenko ◽  
N. B. Semenova

Summary. The increased maladaptive Internet use and associated psychosomatic disorders in modern adolescents is an urgent medical problem. The aim of the study was to research the gender prevalence and pattern structure of various types of online behavior in adolescents from Abakan (Khakassia). Material and methods. A one-time screening examination of random samples of students from 4 schools in the city of Abakan was carried out from April to May 2019. It was examined 1360 adolescents (49.5% of boys and 50.5% of girls) aged 12-18 years (mean age 14.7 ± 1.3). Online behavior was assessed using the Chen Internet Addiction Scale (CIAS) based on the total CIAS score. There were 2 groups (boys and girls) for the indicators to be analyzed, with the data processed using the “Statistica 12” program. Results. Adaptive Internet use (AIU) is typical for 56.5% of Abakan adolescents, Non-adaptive maladaptive (NIU) — for 37.6% and Internet-dependent, pathological Internet use (PIU) — for 5.9%. The incidence and pattern structure of various types of online behavior are associated with gender. The prevalence of maladaptive types of online behavior is higher among girls: non-adaptive (42.4% versus 32.8% in boys) and pathological (8.0% versus 3.7%). There are significant gender differences in the Com, Wit, Tol scales, key symptoms of Internet addiction (KSIA), Problems Associated with Internet Addiction (PAIA) and the total CIAS score of the Chen scale. Girls have higher average scores for all subscales of the Chen questionnaire, i.e. both key symptoms of Internet addiction, and the total CIAS score. Conclusion. The prevalence of maladaptive types of online behavior among adolescents in Abakan and also a high association with gender confirm the relevance of the problem and indicate the further research in the given area is needed.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Ola S Ahmed ◽  
Dalia G Sos ◽  
Dina N. K Boulos ◽  
Samia I El-Damaty ◽  
Maysa A Samy

Abstract Background Obesity is a complex disease involving an excessive amount of body fat. It is a medical problem that increases the risk of heart disease, diabetes, high blood pressure and certain cancers. New evidence supports the view that there is a relationship between consuming energy restricted diet during weight loss program on anthropometric measurements, example; weight, waist circumference, hip circumference and fat percentage. Objectives: to study the effect of weight loss program on anthropometric and laboratory measurements of adult obese females. Method: an intervention study was carried out in the obesity management clinics of National Nutritional institute. Results our findings demonstrate that energy restriction regimen results in modest effect on anthropometric and laboratory measurements which is statistically highly significant. Conclusion and Recommendation: Prevention of obesity should be a high priority in public health, with particular emphasis on encouraging healthy lifestyles in all age groups, starting from early childhood.

2021 ◽  
Vol 14 (10) ◽  
pp. e239587
Siobhan Helen Gee ◽  
Camille Wratten ◽  
Ruth Cairns ◽  
Alastair Santhouse ◽  
David Taylor

Major depressive disorder (MDD) is common in general medical settings, and can usually be treated with conventional oral antidepressants. For some patients, however, oral treatment is refused or not possible, and the untreated symptoms can have a significant impact on the treatment of the acute medical problem. Use of intravenous ketamine has been widely reported in mental health settings for the treatment of MDD. We describe use of intravenous ketamine in a general medical hospital for the treatment of MDD in an 83-year-old male patient who refused food, fluid and medical investigations following a stroke.

2021 ◽  
Vol 14 (4) ◽  
pp. 56-61
Kavi Ratanabanangkoon

Snakebite envenoming has killed about 138000 people and maimed 400,000 victims annually. WHO has designated this medical problem as one of the most neglected tropical diseases for which effective, affordable antivenoms (AVs) are urgently needed. Production of potent AV against neurotoxic venoms was difficult and was thought to be due to the low immunogenicity of the postsynaptic neurotoxins (PSNT) which cause death in the victims. However, it was showed that the use of ineffective adjuvant in the immunization of horse was the root cause. The highly effective Freund adjuvant (FA) causes severe local reactions and could not be used. A novel immunization protocol termed ‘low dose low volume multi-site’ was tested and shown to obliterate the local side effect and allow for the safe use of FA in horse. The immunization protocol led to the production of 7 highly potent monovalent AVs, and 2 potent polyvalent AVs, one against 4 neurotoxic venoms and another against 3 hematotoxic venoms. These AVs allow the treatment of snakebite victims without the need to identify the culprit snakes. Furthermore, we have tested a novel immunization strategy using ‘Diverse toxin repertoire’ of 12 Asian elapid toxin fractions. The resulting antiserum effectively neutralized at least 36 elapid venoms of 28 species encompassing 10 genera and from 20 countries on 4 continents, and most likely all the elapid neurotoxic snake venoms. These results indicate that effective universal antivenom against all elapid neurotoxic venoms of the world can be produced and save numerous lives.

2021 ◽  
Vol 47 (3) ◽  
pp. 84-94
Radosław Bernard Maksym

One of the leading health conditions associated with female infertility is endometriosis, which is the presence of endometrial-like tissue outside the uterine cavity. It is estimated that endometriosis can be demonstrated in up to half of infertile patients, but this does not mean that in all cases, it is the only cause that reduces fertility. Apart from the relatively rare case of endometriosis-induced anatomical changes that mechanically impede fertilization, the main effect is to modify the immune system by the secretion of soluble signaling factors by ectopic endometriotic lesions. The primary treatment of endometriosis in patients trying to become pregnant is radical excision of foci outside the uterus, which is associated with the normalization of immune system disorders and often leads to pregnancy. However, the significant technical complexity and the possibility of complications make the surgery a good solution, mainly for patients who, apart from infertility, pain is also an important factor. An important medical problem remains the development of methods that could eliminate disorders caused by endometriosis and, at the same time, could be used in patients with minor or moderate ailments and in patients with contraindications to surgery. At present, despite many approaches, there are no specific immunotherapy methods. It is interesting that for several decades, it has been reported that the examination of the patency of the Fallopian tubes has a beneficial effect on the possibility of pregnancy. Detailed analyzes have shown that this is not a common effect, but it mainly concerns patients with endometriosis and the use of etiodized oil contrast. In this group, there is a significant, five-fold increase in infertility. Therefore, every second previously infertile patient becomes pregnant within six months. A smaller but also distinct effect is observed in the case of idiopathic infertility. The impact is so significant that it can be used both for the practical treatment of patients as well as to understand the mechanisms underlying fertility disorders occurring in endometriosis. The data so far show that the immunotherapeutic effect of etiodized oil contrast is overwhelming. However, it is not entirely clear why the improvement is not achieved using other currently more popular water contrasts. The dissemination of perfusion of the uterine cavity and Fallopian tubes with the use of oil contrast seems to be a simple, safe and effective strategy that allows patients to offer patients alternative treatment methods and improve the final effectiveness and increase the pharmacoeconomics of treatment of endometriosis-related infertility.

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