Аortic regurgitation – hemodynamic changes and evaluation

Valvular diseases are a leading cause of morbidity, mortality and impaired quality of life in all over the world with different epidemiology. It is extremely important to know the hemodynamic changes for the proper development of a strategy for future interventions. The recent years shows progress in various methodologies of the field of surgery and interventional treatments of valvular diseases. In this section, we focus mainly on aortic regurgitation and its clinical significance.

Omalizumab Reduces Unplanned Healthcare Interactions in Irish Patients With Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is a common, debilitating skin disorder associated with impaired quality of life and psychological comorbidity. Symptoms can be difficult to control and many individuals will not respond to first line treatment. Due to the chronic and unpredictable nature of the disorder, patients frequently have repeated healthcare attendances. Despite this, little is known about healthcare resource utilization internationally. Furthermore, there is no Irish data to inform fundholding decision makers. Omalizumab is an anti IgE monoclonal antibody used in refractory urticaria. It is a comparatively high cost medicine and access to this treatment can be challenging. Recent assessments of omalizumab compared with usual care suggest that omalizumab is a cost-effective treatment for refractory urticaria. We carried out a retrospective review of 47 patients commenced on omalizumab. We evaluated unplanned primary and secondary care attendances and urticaria symptomatology before and after treatment. As expected, patients with refractory disease that were commenced on omalizumab had objective improvements in urticaria symptoms. Importantly, we show that this is reflected in a dramatic reduction in unplanned healthcare interactions at primary care and emergency departments. These data suggest that omalizumab may benefit these patients by reducing disease activity and thereby reducing the need for unplanned healthcare interactions.

Parental, Gestational, and Early-life Exposure to Indoor Environmental Hazardous Facto Rs on Allergic Rhinitis Among Preschool Children in Urumqi City: A Case-control Study

BackgroundAllergic rhinitis is a disease associated with impaired quality of life and heredity. This study aimed to investigate the association of allergic rhinitis (AR) in preschool children with exposure to indoor environment-related factors early in life. MethodsIn August 2019, we implemented a study among 2020 preschool children in Urumqi City using a case-control design. The study included parental reports for the occurrence of AR in children, parental history of respiratory disease, and indoor environmental correlates of maternal exposure from 1 year prior to pregnancy until the child's age of 0-1 years.ResultsMode of birth (caesarean section) (OR=1.31, 95%CI=1.02~1.67), father with AR (OR=2.67, 95%CI=2.08~3.44), mother with AR (OR=3.70, 95%CI=2.88~4.74), mother with asthma (OR=3.11, 95%CI=1.18~8.20), and mother with newly purchased furniture in the parents' residence during pregnancy (OR=1.49, 95%CI=1.03~2.14) were risk factors for AR in children. ConclusionsThe focus of allergic rhinitis should should be on children with a family history of AR and asthma and caesarean delivery. Primary prevention efforts for AR in preschool children are avoiding exposure of children to indoor environmental hazardous factors early in life.

Problems of Diagnosis, Conservative Treatment and Long-Term Results of “Mallet Finger” Fracture

Summary. Distal phalanx dorsal edge fracture is treated in a relatively simple closed manner during the first weeks after injury. The role of the distal interphalangeal joint in the upper extremity integral function reaches conventionally only a few percent. This may lead to insufficient attention and a large number of mistakes in diagnosis and treatment of such injuries, which in turn provokes complications that are much more difficult to treat than the primary injury. This article considers the most common problems of diagnosis and treatment of “mallet finger” fractures. Advantages and disadvantages of various techniques used in the treatment of such fractures in acute and neglected cases are considered and analyzed. Objective: to study the effect of distal phalanx dorsal edge avulsive fractures on function of the upper limb, quality of life, and depression rate in long term period after injury. Materials and Methods. Data from 11 patients (8 (88%) males and 3 (12%) females) with neglected cases of distal phalanx dorsal edge avulsive fractures were studied. QuickDASH questionnaire and visual analog scales were used to study impaired quality of life and depression rate in such patients. Indicators that lead to the need for surgery in long term period after injury have been identified. Results. It was determined that in long term period, in patients with a “mallet finger” fracture, function of the upper extremity suffered significantly and was 29.2±20.2 points (range 2.3-75) according to QuickDASH scale. This condition also significantly affected the general well-being of the patient. Average value of impaired quality of life was 43.6±24.6 (range 0-90 points), and depression rate due to upper extremity dysfunction was 44.6±22.7 (range 0-90 points). Conclusions. Despite the relatively minor injury, high rates of dysfunction, impact on quality of life and depression rate indicate the need to restore finger function even in long term period after injury.

Stroke-Like Episodes in PMM2-CDG: When the Lack of Other Evidence Is the Only Evidence

Phosphomannomutase 2 deficiency (PMM2-CDG) is the most frequent congenital disorder of glycosylation. PMM2-CDG patients develop chronic cerebellar atrophy as a neurological hallmark. However, other acute neurological phenomena such as stroke-like episodes (SLE), epilepsy, migraine, and cerebrovascular events, may also occur, and they are frequently the cause of disability and impaired quality of life. Among these, SLE are among the most stressful situations for families and doctors, as their risk factors are not known, their underlying pathomechanisms remain undiscovered, and clinical guidelines for diagnosis, prevention, and treatment are lacking. In this paper, the recent SLE experiences of two PMM2-CDG patients are examined to provide clinical clues to help improve diagnosis through a clinical constellation of symptoms and a clinical definition, but also to support a neuroelectrical hypothesis as an underlying mechanism. An up-to-date literature review will help to identify evidence-based and non-evidence-based management recommendations. Presently neuropediatricians and neurologists are not capable of diagnosing stroke-like episodes in an unequivocal way, so there is still a need to perform invasive studies (to rule out other acute diseases) that may, in the end, prove unnecessary or even harmful. However, reaching a correct and early diagnosis would lead not only to avoidance of invasive tests but also to better recognition, management, and understanding of the disease itself. There is a great need for understanding of SLE that may ultimately be very informative for the detection of patients at risk, and the future development of preventive and management measures.

EPISODES OF HEARTBURN AND BLOATING IN MEDICAL PRACTICE

The aim of this study was to determine the incidence of heartburn and nausea in patients with various forms of chronic gastritis in the Georgian population, how often, in terms of character, intensity and interrelationship, taking into account the histomorphological and morphometric changes in the topographic area of ​​the gastric mucosa, as well as taking into account the parameters of gastric juice secretion parameters. For this purpose, we examined 172 patients with chronic gastritis who were admitted to our therapeutic unit due to disease exacerbation. The analysis of the material revealed two main forms of chronic gastritis: the first chronic pangastritis of varying severity (diffuse antral and fundal gastritis) 141–81.9% and the second chronic gastritis with fundic glands hyperplasia (31–18.02%). The analysis showed that episodes of heartburn were detected in cases of different forms of chronic gastritis, with the highest frequency in patients with form II [chronic gastritis (chronic gastritis with fundic glands hyperplasia)] from 31 cases of chronic form I 18-(58.06%), than in chronic gastritis I form (chronic pangastritis 47-(33.33%) of 141 cases). As regards the frequency of bloating in 47-(33.33%) of 141 patients with form of gastritis I, and 14-(45.16%) in 31 cases of the second form of chronic gastritis. Examination of patients' anamnesis revealed that most patients were not adequately treated, because they were not properly diagnosed in time, which is an important contributing factor to disease progression, complications and heartburn episodes, impaired quality of life, and reduced quality of life.

The Importance of Echocardiography Assessment in Coronary Patients Subject to Cardiovascular Recovery Programs

Cardiovascular diseases cause approximately one-third of deaths worldwide and an increasing number of individuals with non-fatal ischemic heart disease live with chronic disabilities and impaired quality of life. Cardiac rehabilitation is designed to limit the physiological and psychological effects of cardiac illness, reduce the risk for sudden death or re-infarction, control cardiac symptoms and enhance the psychosocial and vocational status of selected patients. The study group included a group of 78 patients who had a coronary event no more than 3 months ago and who are included in cardio-vascular recovery programs. The patients were echocardiographic evaluated at the first admission and later at 6 months. The evolution of the patients was a favorable one, being objectified an increase of both the ejection fraction of the left ventricle, as well as an improvement of MAPSE and TAPSE.

Diagnosis and Treatment of Adult Growth Hormone Deficiency

Adult growth hormone (GH) deficiency is associated with insulin resistance, elevated cardiovascular risk profile, increased fat mass, reduced muscle mass, skeletal fragility, and impaired quality of life. GH replacement therapy improves body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life, while reducing mortality. Prior to initiation of GH replacement therapy, it is essential to diagnose GH deficiency via a GH stimulation test in adults suspicious of such deficiency. Therapy should be started using (individualized) low dose of GH, followed by titration to the normal range of insulin-like growth factor-1. Clinical improvements should be monitored and side effects should be minimized.

IoT Solution for Enhancing the Quality of Life of Visually Impaired People

One of the treading technologies in the field of data processing and communication is internet of things. To make life a lot easier for the disabled and visually impaired people, IoT can offer assistance and support in various ways. Visually impaired (VI) is a term used to describe any kind of sight loss; some people are completely blind, but many others have legal blindness. The proposed system visually impaired-quality of life (VI-QOL) consists of Arduino UNO, ultrasonic sensors, proximity sensors, and some of the IoT components along with smartphone. Using these components, the author's research goal is to improve the mobility of VI people in a wider range of travel activities. The proposed VI-QOL framework tested all the consequences of IoT components and the Android applications. Total transaction time for navigation system of the proposed solution is measured with and without any load in the application, which proves the efficiency of the proposed work. The throughput of the proposed solution is proved to be high.

Is Psoriatic Arthritis Associated With Higher Risk of Mortality?

Psoriatic arthritis (PsA) is a systemic inflammatory disease affecting domains beyond the musculoskeletal system, and may lead to disability and impaired quality of life. It is associated with comorbidities such as hypertension, diabetes mellitus, obesity, metabolic syndrome, and increased risk of cardiovascular events.