8 research outputs found
Erythromelalgia in a patient with feet erythema and cyanosis
No full textErythromelalgia is a rare disease characterised by a triad of a clinical syndrome of redness, warmth and painful extremities. We present the case of a male adolescent with no prior medical history who presents to our family medicine clinic with a 3-month history of bilateral feet erythema followed by episodes of cyanosis in bilateral toes. Given his history, the findings on clinical examination, and the lack of any pathology on the diagnostic testing, the patient is diagnosed with erythromelalgia. He is then counselled on both pharmacological and non-pharmacological treatments for his condition and is discharged on non-pharmacological treatment options such as leg elevation, cooling with a fan and limiting exposure to heat. The patient is also advised to perform an annual complete blood count given the association of erythromelalgia with myeloproliferative disorders. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ
Should I seek help for sexual difficulties? Middle-aged Lebanese women's views
No full textThis qualitative study explored the way middle-aged Lebanese women address their sexual difficulties. Data analysis revealed three overarching themes and subthemes. From these we developed a help-seeking behavior framework for sexual difficulties. The framework focuses on: the perception of the problem, the beliefs about help-seeking and the sources of help. This framework can be used to facilitate access to personalized sexuality-related care based on a better understanding of the complex interplay of personal, socio-cultural and service-related factors that influence help-seeking behavior for sexual problems.</p
Effect of magnesium salt contamination on the behavior of drilling fluids
No full textAbstractThe drilling engineer must have a good estimate of how the stability of drilling fluid changes due to salt contamination encountered during drilling operation. Two mud samples with different concentrations of magnesium chloride salt (MgCl2) were formulated in order to study its effect on the rheological properties of drilling fluid at ambient and elevated temperature conditions. This study shows that the drilling mud efficiency is affected with temperature as the result of thermal degradation until the mud fails; it is observed that the Gypsum mud tolerates higher temperature than Lignite mud. It was concluded that the rheological properties such as viscosity, yield point, and gel strength of drilling mud decrease as the concentration of magnesium salt increases. This indicates that with the magnesium salt contamination, there is an advanced decline in the performance of drilling mud and the salt affects the dispersion, hydration and flocculation behavior of the particles which make it incompetent for cutting suspender. Also, it was observed that when the concentration of salt increases in the drilling mud samples the fluid loss into the formation increases
The STAR format journal club: An equation for evidence-based education and empowerment of allied health professionals
No full textA journal club is an effective way to promote the evaluation of scientific literature and the adoption of evidence-based practices. We developed a STAR format journal club (JC) for allied health professionals. This format is based on inviting a “star” author to present his group's article. Participants will evaluate the paper using the STAR (Study design validity, Tackling the methodology, Analysis of the results, Reflecting the results into practice) concise critical appraisal checklist. The STAR format JC will help participants develop an efficient and consistent means to appraise evidence, stay abreast of the latest clinical research, network directly with researchers, and be empowered to stimulate change. Alternatively, the participation of authors in an educational activity may broaden the impact of their research, increase the level of engagement for participants, and influence practice decisions
Efficient Plasma Cell Differentiation and Trafficking Require Cxcr4 Desensitization
No full textSummaryCXCR4 plays a central role in B cell immune response, notably by promoting plasma cell (PC) migration and maintenance in the bone marrow (BM). Gain-of-function mutations in CXCR4 affecting receptor desensitization have been reported in the rare immunodeficiency called WHIM syndrome (WS). Despite lymphopenia, patients mount an immune response but fail to maintain it over time. Using a knockin mouse model phenocopying WS, we showed that, counter-intuitively, a gain of Cxcr4 function inhibited the maintenance of antibody titers after immunization. Although the Cxcr4 mutation intrinsically and locally promoted germinal center response and PC differentiation, antigen-specific PCs were barely detected in the BM, a defect mirrored by early accumulation of immature plasmablasts potentially occupying the survival niches for long-lived PCs. Therefore, fine-tuning of Cxcr4 desensitization is critically required for efficient PC differentiation and maintenance, and absence of such a regulatory process may account for the defective humoral immunity observed in WS patients
Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication
No full textBackground: Bisphosphonate therapy is used to manage osteoporosis and decrease the risk of vertebral and hip fractures. These drugs act by suppressing osteoclast activity by inducing the inhibition of bone resorption and increasing bone mineral density. It has been shown that long-term use of bisphosphonate is correlated to a higher incidence of atypical femoral fractures.
Case report: This is a case report of an 81-year-old female, on bisphosphonate therapy for 12 years and with chronic left thigh pain for two and a half years who developed an incomplete atypical left femur fracture. What’s special about this case is that the fracture was ignored and then progressed after three months into a complete displaced spiral fracture that required surgical fixation.
Conclusion: The benefits of bisphosphonate treatment in preventing osteoporotic fractures outweigh the risk of the occurrence of these atypical fractures. Orthopedic surgeons as well as primary care physicians must keep atypical fractures in their differential diagnosis in patients presenting with prodromal symptoms and who are on long-term bisphosphonate therap
Determination of segmental and overall ventilation of clothed walking human by means of electric circuit analogy
No full textA new simplified model has been developed to determine the ventilation induced by swinging motion and external wind for a fabric clothed cylinder representing a limb or a trunk. The simplified model is based on an analogy between air flow and an electric circuit. When a clothed body segment is subject to external wind, the microclimate air flow electric circuit is represented by resistances. When the clothed segment is subject to a swinging motion, the air flow electric circuit is composed of inductance and resistance elements. The model is validated by comparing the predicted ventilation rates to published experimental data in different conditions: varying permeability, wind speeds, swinging frequencies (for the clothed arm), walking conditions, and aperture configurations. The predictions of the simplified model lie within the standard deviation range of the published experiments. Moreover, although it is simplified, the relative error between the simplified model and the published experiment of an oscillating limb is considered acceptable (18%). © 2016, © The Author(s) 2016
Comprehensive model of upper human body clothing ventilation in standing and walking conditions
No full textThe ventilation of the microclimate air of the clothed human body segment is a result of (1) the air flow from the environment through the clothing open apertures, (2) the penetration of the porous clothing, or (3) air flow originating in the microclimate of the other clothed body parts. The microclimate air flow at the connections of clothed segments is named the inter-segmental ventilation and constitutes a real physical boundary condition that leads to ventilation of connected segments. In this study, a simplified electric circuit model is developed to estimate clothing ventilation based on the analogy between the air flow in the microclimate air layer and an electric circuit composed of resistance and inductance elements. The model takes into account the inter-connection between the segments for the clothed human upper part driven by difference of pressure in the microclimate air of the trunk and the upper arms. The developed model is validated using the tracer gas method applied on a walking manikin placed in a climatic chamber under windy conditions. Good agreement was found between predicted segmental ventilation and the experimental values with a maximum error of 16%. It was found that the inter-segmental ventilation is significant at high relative velocity for permeable clothing and increased with the increase in the relative velocity constituting about 30% of the arm ventilation and 14% of the trunk ventilation. © The Author(s) 2018
