Lifestyle Interventions Improving Cannabinoid Tone During COVID-19 Lockdowns May Enhance Compliance With Preventive Regulations and Decrease Psychophysical Health Complications

Studies investigating the psychosomatic effects of social isolation in animals have shown that one of the physiologic system that gets disrupted by this environment-affective change is the Endocannabinoid System. As the levels of endocannabinoids change in limbic areas and prefrontal cortex during stressful times, so is the subject more prone to fearful and negative thoughts and aggressive behavior. The interplay of social isolation on the hypothalamic-pituitary-adrenal axis and cannabinoid tone triggers a vicious cycle which further impairs the natural body's homeostatic neuroendocrine levels and provokes a series of risk factors for developing health complications. In this paper, we explore the psychosomatic impact of prolonged quarantine in healthy individuals, and propose management and coping strategies that may improve endocannabinoid tone, such as integration of probiotics, cannabidiol, meditation, and physical exercise interventions with the aim of supporting interpersonal, individual, and professional adherence with COVID-19 emergency public measures whilst minimizing their psycho-physical impact.

Weighing in on heart failure: the potential impact of bariatric surgery

Obesity is a growing worldwide epidemic with significant economic burden that carries with it impacts on every physiologic system including the cardiovascular system. Specifically, the risk of heart failure has been shown to increase dramatically in obese individuals. The purpose of this review is to provide background on the individual burdens of heart failure and obesity, followed by exploring proposed physiologic mechanisms that interconnect these conditions, and furthermore introduce treatment strategies for weight loss focusing on bariatric surgery. Review of the existing literature on patients with obesity and heart failure who have undergone bariatric surgery is presented, compared, and contrasted.

Back to the Future: Impact of a Paper-Based Admission H&P on Clinical Documentation Improvement at a Level 1 Trauma Center

The Medicare Severity Diagnosis Related Group (MS-DRG) weight, as derived from the MS-DRG assigned at discharge, is in part determined by the physician-documented diagnoses. However, the terminology associated with MS-DRG determination is often not aligned with typical physician language, leading to inaccurate coding and decreased hospital reimbursements. The goal of this study was to evaluate the impact of a diagnosis picklist within a paper-based history and physical examination (H&P) on the average MS-DRG weight and the Case-mix index (CMI). Our trauma center implemented a paper H&P form for trauma patients featuring picklist diagnoses aligned with the MS-DRG terminology and arranged by the physiologic system. To evaluate its impact, we conducted a cohort study using data from our trauma registry between July 2015 and November 2017. Our cohort included 442 (26.0%) paper and 1,261 (74.0%) dictated H&Ps. Average CMI (2.56 vs 2.15) and expected patients ($25,057 vs $19,825) were higher for the paper group ( P < 0.001, P = 0.002). Adjusted regression models demonstrated paper coding to be associated with 0.265 CMI points, translating to an average increase in expected payment of 6.5 per cent per patient. Utilization of a standardized, paper-based H&P template with picklist diagnoses was associated with a higher trauma service CMI and higher expected payments. Preprinted diagnoses that align with the MS-DRG terminology lead to clinical documentation improvement.

Human Adult Reproductive System

The human reproductive system is a unique combination of organs and endocrine components that is extremely complex and adaptive. The reproductive organs are distinct between males and females, and sexual differentiation is a result of genotype, gonadal type, and phenotype. The anatomic and physiologic system of each sex is composed with a set purpose: to propagate the human species. Linked closely to the reproductive system is the endocrine system, which provides the messengers and feedback mechanisms that allow the development, maintenance, and function of the reproductive organs. The gonads have both endocrine and exocrine functions, namely steroidogenesis and gametogenesis. This review focuses on the components of the endocrine system as well as male and female anatomy and physiology to fully grasp the human reproductive system. Key words: fertility, hypothalamic-pituitary-adrenal axis, reproductive anatomy, sexual aging, sexual physiology

Human Adult Reproductive System

The human reproductive system is a unique combination of organs and endocrine components that is extremely complex and adaptive. The reproductive organs are distinct between males and females, and sexual differentiation is a result of genotype, gonadal type, and phenotype. The anatomic and physiologic system of each sex is composed with a set purpose: to propagate the human species. Linked closely to the reproductive system is the endocrine system, which provides the messengers and feedback mechanisms that allow the development, maintenance, and function of the reproductive organs. The gonads have both endocrine and exocrine functions, namely steroidogenesis and gametogenesis. This review focuses on the components of the endocrine system as well as male and female anatomy and physiology to fully grasp the human reproductive system. Key words: fertility, hypothalamic-pituitary-adrenal axis, reproductive anatomy, sexual aging, sexual physiology

Severe iron deficiency anaemia following bariatric surgery

The human body stores energy in the fat cells as triglycerides, which when needed gets released as free fatty acids. This physiologic system enables humans to withstand starvation for several months. But this system may get interrupted by genetic factors and sedentary lifestyle, leading to increase adipose energy stores and morbidity or mortality. Obesity is a chronic condition, which may be difficult to treat with therapeutic lifestyle modifications alone, that is diet and exercise. In such cases, bariatric surgery (BS) is an option to lose weight, in order to prevent serious health issues. However, nutritional deficiencies following this surgery have been of great concern. This case report is regarding a young lady who developed severe iron deficiency anaemia (IDA) within 6 months of BS despite taking nutritional supplements.Asian Journal of Medical Sciences Vol.7(4) 2016 110-112

Particle Filter for Plasma Insulin Estimation

Bergman’s Minimal Model (MM) captures simply but accurately the homeostasis of glucose and insulin in plasma. The MM has been proposed as an estimator of insulin for Diabetes Mellitus. Along this line of research, the present work takes into account the error between Bergman’s simple compartmental model and the complex physiologic system it depicts. The author employs a Particle Filter (PF) in order to construct the posterior probability density of insulin from data. As a sequential Bayesian estimator, the PF can handle nonlinear state equations, such as the MM, as well as non-Gaussian modeling error. These advantages of the PF over the Kalman Filter warrant further consideration for insulin estimation and, in turn, avoidance of hyperinsulinemia.