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Conduit quality control protocol in CABG
No full textCardiac revascularization surgery has a long history. Its results and safety are well known. Nonetheless, the long-term patency rate of certain grafts used in cardiac revascularization is non-optimal, and CABG is associated with a risk of cerebrovascular stroke due to aortic manipulation. We have developed a simple control quality protocol of the anastomosis performed in CABG, aiming to improve the long-term patency of certain grafts used in cardiac revascularization surgery and reduce the risk of cerebrovascular stroke in those patients. 
Ectopic Pregnancy Risk Factors Presentation and Management Outcomes
No full textBackground: Ectopic pregnancy (EP) is a common and serious early pregnancy problem with a significant morbidity rate and the potential for maternal death. Women commonly present with minimal vaginal bleeding and abdominal pain.Objective: The main objective of the study was to evaluate the risk factors, clinical presentation, sites, and management outcomes of ectopic pregnancies. Methodology: It was a prospective descriptive, cross-sectional hospital-based study conducted at Bashair Teaching Hospital during the period January 2021–June 2021.An interview questionnaire was used, and eighty-two (82) women were included after informed consent. Demographic and clinical data concerning personal history, symptoms of presentation, risk, site, and type of management were recorded.Results: Ectopic pregnancy incidence was 2% and most risk factors were infection 29.3%, surgery 15.9%, miscarriage 13.4%, infertility 12.2%, tubal surgery 4.9%, previous ectopic pregnancy 4.9%, intrauterine contraceptive device (IUCD) 3.6%, and tubal ligation 2.4%. Women presented with bleeding and abdominal pain at 47.5%, bleeding at 18.3%, abdominal pain at 9.7%, and shock at 8.5%.The sites are ampullary (57.3%), fimbria (9.7%), interstitial (8.5%), isthmus (8.5%), ovarian (7.3%), cervical (4.8%), and abdominal (3.6%).Surgical management was 93.9%, medical and surgical management was 3.6% and medical management was 2.4%. A blood transfusion was received at 37.8%.Conclusion: The study concluded that women of reproductive age are at risk of ectopic pregnancy, so healthcare providers and doctors should have a high index of suspicion, prompt diagnosis, and intervention for ectopic pregnancy. Assessment of women at risk factors and modifications will reduce incidence. 
Digital Health Opportunities and Risks: The Psychological Field
No full textThe digital transformation in the health sector represents an extraordinary challenge not only concerning patient care and assistance processes but also for the purpose of promoting new models capable of responding to the growing complexity of the environment and its impact on health. Psychological services are among the non-medical healthcare services heavily invested by this radical transformation. The constant increase in online psychology demand by users follows the need to carefully regulate its practice since this digital space, virtually a non-place, is the focus of large commercial interests. Being a part of the application of digital technologies to psychological performance, the aim of the paper was to emphasize clinical work, especially focused on childhood and adolescence with the need of identifying the limits and problems of digital health psychology in this group of subjects. Considering also that the massive use of digitization in healthcare also raises considerations of a bioethical nature regarding the priority of the principle of patient autonomy in the complex and articulated process of healthcare and protection. In conclusion, although TM is spread in our area in an uneven way, the representations of TM are mostly positive. However, it seems to emerge a picture in which part of some professionals still look to be too cautious and resist this new way
Magnets, Gradients, and RF Coils of MR Scanners
No full textThe topic of this paper is the parts of modern MR devices, which contain magnet coils. MR scanner magnets are made of four types of electromagnetic coils: 1) Main magnet, made of superconducting material. The main magnet of an MR (Magnetic Resonance Imaging) scanner creates a strong and uniform magnetic field around the patient being scanned. This magnetic field is typically in the range of 0.5 to 3 Tesla and is used to align the magnetic moments of the hydrogen atoms in the patient's body. The superconductors, which create the main magnetic field, should be cooled with liquid helium and liquid nitrogen. The main magnets made of superconductors should use a cryostat, with cooling vessels with liquid helium and liquid nitrogen, thermal insulation, and other protective elements of the magnet system. 2) The gradient magnetic field is made of three types of coils: x-coils, y-coils, and z-coils. The X coil, made of resistive material, creates a variable magnetic field, horizontally, from left to right, across the scanning tube; 3) The Y coil creates a variable magnetic field, vertically, from bottom to top; 4) The Z coil creates a variable magnetic field, longitudinally, from head to toe, inside the scanning tube. RF coils are used to generate RF pulses to excite the hydrogen protons (spins) in the patient's body and detect the signals emitted by the protons when they return to their equilibrium state after the RF excitation is turned off. The resulting interaction between the magnetic field and the aligned hydrogen atoms produces a signal that is used to generate the images seen in an MRI scan. The main magnetic field is what allows MR imaging to produce detailed anatomical and functional information non-invasively. The structure of the MR scanner magnet is complex. The resonant frequency changes at each point of the field in a controlled manner. Inside the copper core are embedded the windings of the main magnet made of superconducting material in the form of microfibers. A non-linear gradient field is created by coils of conductive material. It adds to the main magnetic field. Thus the resulting magnetic field is obtained. The types of magnets that exist in the basic configurations of MR scanners are analyzed. Scanners in the form of a closed cylindrical cavity generate their magnetic fields by passing current through a solenoid, which is maintained at the temperature of a superconductor. Exclusively used superconductors are niobium-titanium (NbTi), niobium-tin (Nb3Sn), vanadium-gallium (V3Ga), and magnesium-diboride (MgB2). Only magnesium diboride is a high-temperature superconductor, with a critical temperature Tc = 390K. The three remaining superconductors are low temperatures. New high-temperature superconductors have been discovered, as well as superconductors at room temperature. Newly discovered superconducting materials are not used in MR scanners
Evaluation of the Antihyperglycaemic Activities, Safety and Phytochemical Profile of Celtis zenkeri Engl
No full textObjective: The study evaluated the hyperglycaemia-lowering effects, safety, and phytochemical profile of Celtis zenkeri leaf extract in order to justify its antidiabetic folkloric usage. Methods: Modified OECD test guidelines were used to assess its acute and sub-acute toxicity while its effect on blood parameters such as blood glucose, and haematological and biochemical levels were evaluated using appropriate assays. Both in vitro and in vivo antihyperglycaemic assays were used for the antidiabetic studies while histology of the pancreas, liver, and kidney of the rats was examined after treatment with the extract at 250, 500, and 1000 mg/kg for 21 days. GC-MS analysis was used to determine the chemical constituents of the extract. Results: The results obtained showed that the leaf extract of C. zenkeri was not toxic in rats at 5000 mg/kg. It elicited a significant decrease in the blood glucose levels of the animals but did not affect the haematological and biochemical components of normal rats. It significantly inhibited α-amylase and α-glucosidase actions and gave comparable activity to glibenclamide (5 mg/kg) at all time points at 200 and 400 mg/kg. The extract comparably reduced blood glucose levels with glibenclamide at 100 and 200 mg/kg on days 10 and 14 in drug-induced diabetic rats and maintained the histoarchitecture of the liver, kidney, and pancreas at 250 and 500 mg/kg.Conclusion: The study justified the ethnomedicinal use of C. zenkeri in diabetes management
Case Report of Gardner-Diamond Syndrome
No full textGardner-Diamond syndrome or psychogenic purpura is a rare vasculopathy disorder characterized by spontaneous painful purpuric rash without a history of trauma or antiplatelet or anticoagulant therapy. It occurs in women with mental health disorders. Gardner and Diamond in 1955 described a syndrome of auto erythrocyte sensitization which presented in abnormal crops of painful inflammatory ecchymosis in 4 patients at the site of trauma followed by progressive erythema and edema.
We present a 52-year-old age woman who was admitted to the internal medicine department and referred for dermatological consultation for recurrent spontaneous purpuric eruptions. The patient was under treatment for depression for many months. Her investigations and coagulation profile were nearly within normal
Myxedema Coma and Acute Respiratory Failure in a Young Child: A Case Report
No full textBackground: Myxedema is an extreme manifestation seen in patients with untreated hypothyroidism. It is a lethal endocrine emergency, which arises when a precipitating cause overwhelms the compensatory mechanisms of the hypothyroid state.Objectives: This case report aims to present a case of myxedema coma secondary to cretinism. It also aims to discuss how hypothyroidism leads to hypoventilation and eventually respiratory failure, as well as to discuss the epidemiology, pathophysiology, clinical manifestation, diagnosis, and management of a child with myxedema coma.Case presentation: This is a case of a 7-year-old female, diagnosed with congenital hypothyroidism at 5 months of age, but eventually was lost to follow-up. She came back after 7 years presenting with difficulty of breathing. She was seen hypothermic, obtunded, and in severe respiratory distress. She was severely stunted and underweight with coarse facial features. Initial laboratory work-up showed elevated Thyroid Stimulating Hormone (TSH) as well as decreased tri-iodothyronine (FT3) and thyroxine (FT4). She was immediately started on levothyroxine, with noted resolution of the edema and improvement in sensorium. There was also noted improvement in the patient’s ventilation and was sent home on Continuous Positive Airway Pressure (CPAP) while asleep.Conclusion: This case highlights the importance of having a high index of suspicion of its clinical manifestations, which could lead to earlier intervention thereby preventing further complications. A multidimensional approach is essential in managing this case, as various organ systems are involved in this condition
Early Outcomes of a Next-Generation Balloon-Expandable Transcatheter Heart Valve - The Myval System: A Single-Center Experience From Serbia
No full textTranscatheter aortic valve implantation (TAVI) is one of the most effective treatments for severe aortic valve stenosis (AVS). Different genres and generations of transcatheter heart valves (THVs) are accessible, offering operators an opportunity to choose a patient-tailored device. In this single-center study, we present the outcomes of Serbian patients treated with next-generation Myval THV for severe symptomatic AVS. Myval THV was implanted in all consecutive patients who underwent TAVI at the Dedinje Cardiovascular Institute of Belgrade, Serbia between October 2020 and September 2021. The primary endpoint was device success on day 30. Secondary endpoints included 30-day all-cause mortality, cardiovascular death, stroke, moderate/severe paravalvular leak (PVL), and new permanent pacemaker implantation (PPI). TAVI was performed as per the European Society of Cardiology guidelines. The study comprised thirteen patients, aged 72±13 years with mean EuroSCORE (7.17%) and Society of Thoracic Surgeons (2.72%,) scores who underwent TAVI successfully with 92.3% using the percutaneous approach. Myval THV intermediate and extra-large sizes were implanted in 46% and 15% of patients, respectively. This acute procedure success rate was 100%. The primary composite endpoint of early device success was achieved in all patients. None of the patients had clinically significant aortic regurgitation or moderate/severe PVL. No patient experienced stroke, contrast-induced acute kidney injury, device-related vascular complications, or a new PPI. The all-cause mortality rate at 30 days was 0%. Myval THV system demonstrated a favorable safety/efficacy profile within 30 days post-procedure at a single center in Serbia. This is the first report of my experience with Myval THV from Serbia
Individual Treatment Trial of PIGV-Associated Mabry Syndrome with D-Mannose in a Young Child
No full textWe describe the first individual treatment trial with D-mannose in a young girl with PIGV-CDG. PIGV-CDG belongs to the GPI anchor deficiencies leading to intellectual disability, dysmorphic features, epilepsy, and, less frequently, organ malformations. A hallmark of the GPI anchor deficiencies is the elevated serum alkaline phosphatase (AP). Our patient carried the germline homozygous PIGV variant c.1022C>A, p. (Ala341Glu), the most commonly reported pathogenic variant leading to PIGV-CDG so far. We aimed to improve the impaired enzymatic function of PIGV through elevated substrate levels by giving D-mannose orally. We monitored the clinical status, developmental progress as well as serum AP levels. Our patient experienced no side effects. Standardized developmental testing showed better developmental progress during the 21-month treatment period with D-mannose than in the 12 months following the discontinuation of treatment. The D-Mannose treatment might have had a positive effect on the development of our patient with PIGV-CDG
An Executive Information System: Inherent Information and Functional Information
No full textThis review article deals with quantum biology, the new tool that helps traditional biology unravel some mysteries concerning life and living organisms on Earth. We use Einstein’s famous equation to explain how an unknown energy realm creates the material universe. We demonstrate how material existence precedes living existence and elucidate how non-living atoms transition to living molecules, Francis Crick’s faded dream that comes to reality. Finally, we expose the two types of Information available inside a cell to sustain life in living organisms and elaborate on a new formulation of the biogenesis theory