Search results for: severe acute respiratory distress syndrome

Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

Abstract:

Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

Procedia PDF Downloads 219

Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

Abstract:

Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

Procedia PDF Downloads 123

Authors: Rania F. Ahmed, Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O. Saleh, Omar A. H. Ahmed-Farid

Abstract:

The metabolic syndrome is an important public health concern often related to obesity, improper diet, and sedentary lifestyles and can predispose individuals to the development of many dangerous health conditions, disability and early death. This research aimed to investigate the efficacy of resveratrol (RSV) to reverse the neuro-complications associated with metabolic syndrome experimentally-induced in rats using an eight weeks high fat, high fructose diet (HFHF) model. The corresponding drug treatments were administered orally during the last 10 days of the diet. Behavioural tests namely the open field test (OFT) and the forced swimming test (FST) were conducted. Brain levels of monoamines viz. serotonin, norepinephrine and dopamine as well as their metabolites were assessed. 8-hydroxyguanosine (8-OHDG) as an indicative of DNA-fragmentation, nitric oxide (NOx) and tumor necrosis factor-α (TNF- α) were estimated. Finally, brain antioxidant parameters namely malondialdehyde (MDA), reduced and oxidized glutathione (GSH, GSSG) were evaluated. HFHF-induced metabolic syndrome resulted in decreased activity in the OFT and increased immobility duration in the FST. Furthermore, HFHF-induced metabolic syndrome lead to a significant increase in brain monoamines turn over as well as elevation in 8-OHDG, NOx, TNF- α, MDA and GSSG; and reduction in GSH. Ten days daily treatment with RSV (20 and 40 mg/kg p.o) dose dependently increased activity in the OFT and decreased immobility duration in the FST. Moreover, RSV normalized brain monoamines contents, reduced 8-OHDG, NOx, TNF- α, MDA and GSSG; and elevated GSH. In conclusion, we can say that RSV showed neuro-protective properties against HFHF-induced metabolic syndrome represented by monoamines preservation, prevention of neurodegeneration, anti-inflammatory and antioxidant potentials and could be recommended as a beneficial daily dietary supplement to treat the neuronal side effects associated with HFHF-induced metabolic syndrome.

Keywords: antioxidants, DNA-fragmentation, forced swimming test, HFHF-induced metabolic syndrome, monoamines, nitric oxide (NOx), open field, resveratrol, tumor necrosis factor-α (TNF- α), 8-hydroxyguanosine (8-OHDG)

Procedia PDF Downloads 254

Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

Abstract:

Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression

Procedia PDF Downloads 405

Authors: Alexander Dao, Oscar Wambuguh

Abstract:

Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder

Procedia PDF Downloads 59

Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

Abstract:

Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

Procedia PDF Downloads 130

Authors: Ali Al Orf, Khawaja Bilal Waheed

Abstract:

Background and objective: Joubert syndrome (JS) is a rare, autosomal-recessive condition. Early recognition is important for management and counseling. Magnetic resonance imaging (MRI) can help in diagnosis. Therefore, we sought to evaluate clinical presentation and MRI findings in Joubert syndrome and related disorders. Method: A retrospective review of genetically proven cases of Joubert syndromes and related disorders was reviewed for their clinical presentation, demographic information, and magnetic resonance imaging findings in a period of the last 10 years. Two radiologists documented magnetic resonance imaging (MRI) findings. The presence of hypoplasia of the cerebellar vermis with hypoplasia of the superior cerebellar peduncle resembling the “Molar Tooth Sign” in the mid-brain was documented. Genetic testing results were collected to label genes linked to the diagnoses. Results: Out of 12 genetically proven JS cases, most were females (9/12), and nearly all presented with hypotonia, ataxia, developmental delay, intellectual impairment, and speech disorders. 5/12 children presented at age of 1 or below. The molar tooth sign was seen in 10/12 cases. Two cases were associated with other brain findings. Most of the cases were found associated with consanguineous marriage Conclusion and discussion: The molar tooth sign is a frequent and reliable sign of JS and related disorders. Genes related to defective cilia result in malfunctioning in the retina, renal tubule, and neural cell migration, thus producing heterogeneous syndrome complexes known as “ciliopathies.” Other ciliopathies like Senior-Loken syndrome, Bardet Biedl syndrome, and isolated nephronophthisis must be considered as the differential diagnosis of JS. The main imaging findings are the partial or complete absence of the cerebellar vermis, hypoplastic cerebellar peduncles (giving MTS), and (bat-wing appearance) fourth ventricular deformity. LimitationsSingle-center, small sample size, and retrospective nature of the study were a few of the study limitations.

Keywords: Joubart syndrome, magnetic resonance imaging, molar tooth sign, hypotonia

Procedia PDF Downloads 70

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

Abstract:

Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

Procedia PDF Downloads 216

Authors: Zoe Lynch, Kirsty Zieschank

Abstract:

There are several factors that compromise the utility and wide-spread use of existing emotional and behavioural distress screening instruments. Some of these factors include lengthy administration times, high costs, feasibility issues, and a lack of self-report options for children under 12 years of age. This animation-based resource was developed to overcome as many of these factors as possible. Developed for educators and medical and mental health professionals, this resource offers children a self-guided mechanism for reporting any current emotional and behavioural distress. An avatar assistant, selected by the child, accompanies them through each stage of the screening process, offering further instruction if prompted. Children enter their age and gender before viewing comparative animations conveying common childhood emotional and behavioural difficulties. The child then selects the most relatable animations, along with the frequency with which they experience the depicted emotions. From a perspective of intellectual development, an engaging, animated format means that outcomes will not be constrained by children’s reading, writing, cognitive, or verbal expression abilities. Having been user-tested with children aged 6 to 12, this resource shows promising results as a self-guided screening instrument.

Keywords: animation-based screening instrument, mental health, primary-aged children, self-guided

Procedia PDF Downloads 131

Authors: Nouha Bouayed Abdelmoula, Rim Louati, Nawel Abdellaoui, Balkiss Abdelmoula, Oldez Kaabi, Walid Smaoui, Samir Aloulou

Abstract:

Background and Aims: Cardiofaciocutaneous syndrome (CFC) is an autosomal dominant disorder with the vast majority of cases arising by a new mutation of BRAF, MEK1, MEK2, or rarely, KRAS genes. Here, we report a rare Tunisian case of CFC syndrome for whom we identify SOS1 mutation. Methods: Genomic DNA was obtained from peripheral blood collected in an EDTA tube and extracted from leukocytes using the phenol/chloroform method according to standard protocols. High resolution melting (HRM) analysis for screening of mutations in the entire coding sequence of PTPN11 was conducted first. Then, HRM assays to look for hot spot mutations coding regions of the other genes of the RAS-MAPK pathway (RAt Sarcoma viral oncogene homolog Mitogen-Activated Protein Kinases Pathway): SOS1, SHOC2, KRAS, RAF1, KRAS, NRAS, CBL, BRAF, MEK1, MEK2, HRAS, and RIT1, were applied. Results: Heterozygous SOS1 point mutation clustered in exon 10, which encodes for the PH domain of SOS1, was identified: c.1655 G > A. The patient was a 9-year-old female born from a consanguineous couple. She exhibited pulmonic valvular stenosis as congenital heart disease. She had facial features and other malformations of Noonan syndrome, including macrocephaly, hypertelorism, ptosis, downslanting palpebral fissures, sparse eyebrows, a short and broad nose with upturned tip, low-set ears, high forehead commonly associated with bitemporal narrowing and prominent supraorbital ridges, short and/or webbed neck and short stature. However, the phenotype is also suggestive of CFC syndrome with the presence of more severe ectodermal abnormalities, including curly hair, keloid scars, hyperkeratotic skin, deep plantar creases, and delayed permanent dentition with agenesis of the right maxillary first molar. Moreover, the familial history of the patient revealed recurrent brain malignancies in the paternal family and epileptic disease in the maternal family. Conclusions: This case report of an overlapping RASopathy associated with SOS1 mutation and familial history of brain tumorigenesis is exceptional. The evidence suggests that RASopathies are truly cancer-prone syndromes, but the magnitude of the cancer risk and the types of cancer partially overlap.

Keywords: cardiofaciocutaneous syndrome, CFC, SOS1, brain cancer, germline mutation

Procedia PDF Downloads 127

Authors: R. McGrath, A. Trace, S. Curtin, C. McCreary

Abstract:

Introduction: Although, in relation to Burning Mouth Syndrome (BMS), much energy has been expended on its definition and etiology, it still remains a contentious issue. There is agreement on the symptoms, but on little else; and approaches to treatment vary widely. However, it has been established that the condition has a detrimental effect on the sufferer’s quality of life. Much research focus has been put on the physical impact of the syndrome. Recently, some literature has turned the focus to social, functional, and psychological factors. However, there is very little qualitative research on how burning mouth syndrome affects the lives of sufferer’s and the present study seeks to remedy this. Method: The study recruited five male participants who took part in semi-structured interviews lasting between 30 and 50 minutes. Data was analysed using Interpretative Phenomenological Analysis. Results: The study identified four super-ordinate themes: Lack of Control due to Uncertainty about Condition; Disruption to Internal Sense of Self; Negative Future Expectation due to Chronic Symptoms; and Sense of BMS as an Intrusive Force. Aspects of these themes reflect areas of reduction in quality of life. Conclusion: BMS damages an individual’s quality of life in ways that have not been reflected in self-report surveys of health-related quality of life. The condition has serious implications for the individual's sense of self, identity, and future. The study recommends that further qualitative research be carried out in this area. Also, the use of therapeutic interventions with sufferers from BMS is recommended, which would help not only sufferers but best practice in relation to their treatment.

Keywords: burning mouth syndrome, interpretative phenomenological analysis, qualitative research, quality of life

Procedia PDF Downloads 414

Authors: Mariana P. Medeiros, Amanda P. Carvallo, Augusta Isaac, Milos Janecek, Peter Minarik, Mayerling Martinez Celis, Roberto. R. Figueiredo

Abstract:

The effect of high pressure torsion processing on mechanical properties and corrosion behavior of pure magnesium and Mg-Zn, Mg-Zn-Ca, Mg-Li-Y, and Mg-Y-RE alloys is investigated. Micro-tomography and SEM characterization are used to estimate corrosion rate and evaluate non-uniform corrosion features. The results show the severe plastic deformation processing improves the strength of all magnesium alloys, but deformation localization can take place in the Mg-Zn-Ca and Mg-Y-RE alloys. The occurrence of deformation localization is associated with low strain rate sensitivity in these alloys and with severe corrosion localization. Pure magnesium and Mg-Zn and Mg-Li-Y alloys display good corrosion resistance with low corrosion rate and maintained integrity after 28 days of immersion in Hank`s solution.

Keywords: magnesium alloys, severe plastic deformation, corrosion, biodegradable alloys

Procedia PDF Downloads 78

Authors: Mokhtar Kouki Inès Rekik

Abstract:

This paper focuses on the assessment of the air pollution and morbidity relationship in Tunisia. Air pollution is measured by ozone air concentration and the morbidity is measured by the number of respiratory-related restricted activity days during the 2-week period prior to the interview. Socioeconomic data are also collected in order to adjust for any confounding covariates. Our sample is composed by 407 Tunisian respondents; 44.7% are women, the average age is 35.2, near 69% are living in a house built after the 1980, and 27.8% have reported at least one day of respiratory-related restricted activity. The model consists on the regression of the number of respiratory-related restricted activity days on the air quality measure and the socioeconomic covariates. In order to correct for zero-inflation and heterogeneity, we estimate several models (Poisson, Negative binomial, Zero inflated Poisson, Poisson hurdle, Negative binomial hurdle and finite mixture Poisson models). Bootstrapping and post-stratification techniques are used in order to correct for any sample bias. According to the Akaike information criteria, the hurdle negative binomial model has the greatest goodness of fit. The main result indicates that, after adjusting for socioeconomic data, the ozone concentration increases the probability of positive number of restricted activity days.

Keywords: bootstrapping, hurdle negbin model, overdispersion, ozone concentration, respiratory-related restricted activity days

Procedia PDF Downloads 234

Authors: Urmita Chakraborty

Abstract:

To start with, Organic Illnesses are no longer considered as only health difficulties. Functional Illnesses that are emotional in origin have become the search areas in many investigations. In the present study, an attempt has made to study the psychological nature of Functional Gastro-Intestinal Disorders (FGID) in West Bengal. In the specialty of Gastroenterology, the medically unexplained symptom-based conditions are known as Functional Gastrointestinal Disorder (FGID). In the present study, Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS) have been taken for investigations. 72 cases have been discussed in this context. Results of the investigation have been analyzed in terms of a qualitative framework. Theoretical concepts on persistent thoughts and behaviors will be delineated in the analysis. Processes of self-categorization will be implemented too. Aspects of Attachments and controlling of affect as well as meta-cognitive appraisals are further considered for the depiction.

Keywords: functional dyspepsia, irritable bowel syndrome, self-categorization

Procedia PDF Downloads 546

Authors: Mekdelawit Teferi Alamirew

Abstract:

As a practical tool, the Geographical information system (GIS) was used for data integration, collection, management, analysis, and output presentation in pavement mangement systems . There are many GIS techniques to improve the maintenance activities like Dynamic segmentation and weighted overlay analysis which considers Multi Criteria Decision Making process. The results indicated that the developed MPI model works sufficiently and yields adequate output for providing accurate decisions. Hence considering multi criteria to prioritize the pavement sections for maintenance, as a result of the fact that GIS maps can express position, extent, and severity of pavement distress features more effectively than manual approaches, lastly the paper also offers digitized distress maps that can help agencies in their decision-making processes.

Keywords: pavement, flexible, maintenance, index

Procedia PDF Downloads 34

Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

Abstract:

Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

Procedia PDF Downloads 409

Authors: Felipe H. Sanders, Bryan A. Edwards, Matthew Fusco, Rod J. Oskouian, R. Shane Tubbs

Abstract:

Introduction: Sinus pericranii is a rare vascular malformation that connects the intracranial dural sinuses to the extracranial venous drainage system and is caused by either trauma or congenital defects. Although the majority of these vascular structures are due to trauma, some are congenital. Case report: Herein, we report a 5-month-old patient with a very large and fluctuating subcutaneous mass over the occiput and the diagnosis of Crouzon’s syndrome. The child presented with a large midline mass that on imaging, connected to the underlying torcular and was diagnosed as a sinus pericranii. At long-term follow up and without operative intervention, the sinus pericranii resolved. This uncommon relationship is reviewed. Conclusion: Premature closure of posterior fossa sutures as part of Crouzon syndrome can present with large sinus pericranii. Such subcutaneous swellings might resolve spontaneously.

Keywords: congenital, craniosynostosis, pediatric, vascular malformation

Procedia PDF Downloads 179

Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

Abstract:

Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

Procedia PDF Downloads 299

Authors: Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi

Abstract:

Background: Higher consumption of white rice has been suggested as a risk factor for development of metabolic abnormalities. In this study we investigated the association between consumption of white rice and the 3-year occurrence of metabolic syndrome (MetS) in adults with and without abdominal obesity. Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years. Dietary intakes were measured, using a 168-food items validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were evaluated at both baseline (2006-2008) and after 3-year follow-up (2009-2011). MetS and its components were defined according to the diagnostic criteria proposed by NCEP ATP III, and the new cutoff points of waist circumference for Iranian adults. Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of white rice consumption. Results: The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m2 at baseline. The prevalence of MetS in subjects with abdominal obesity was significantly higher (40.9 vs. 16.2%, P<0.01). There was no significant difference in white rice consumption between the two groups. Mean daily intake of white rice was 93±59, 209±58, 262±60 and 432±224 g/d, in the first to fourth quartiles of white rice, respectively. Stratified analysis by categories of waist circumference showed that higher consumption of white rice was more strongly related to the risk of metabolic syndrome in participants who had abdominal obesity (OR: 2.34, 95% CI:1.14-4.41 vs. OR:0.99, 95% CI:0.60-1.65) Conclusion: We demonstrated that higher consumption of white rice may be a risk for development of metabolic syndrome in adults with abdominal obesity.

Keywords: white rice, abdominal obesity, metabolic syndrome, food science, triglycerides

Procedia PDF Downloads 418

Authors: Courtney Manthey-Pierce, Anna Warrener

Abstract:

Polycystic ovarian syndrome (PCOS) is the most common endocrine disruptive disorder in females. PCOS is primarily characterized by polycystic ovaries, anovulation, hirsutism, insulin resistance, and hyperandrogenism. Despite negative reproductive consequences for females from anovulation and endocrine dysfunction, genes associated with the pathogenesis of PCOS are highly hereditable (h2 = 0.72). An evolutionary mismatch occurs when a trait that evolved in one environment has become maladaptive in another environment. The idea that PCOS is an evolutionary mismatch disease has been promoted by several researchers. Each trait of the resulting PCOS phenotype should be investigated individually in order to demonstrate an evolutionary mismatch. Hyperandrogenism is often regarded as the main characteristic of PCOS Hyperandrogenism may have aided with conception in older females, increased bone mineral density, and supported prolonged breastfeeding in nutritionally distressed populations. Because of the high prevalence of PCOS in the modern world, approximately 6%, it is often argued that PCOS emerged in an ancestral population prior to the migration out of Africa approximately 200,000 years ago. This environment would be characterized by sporadic periods of nutrition deficit and resource hardships as the climate began changing. Presently, modern society is characterized by obesity and sedentary lifestyles. The prevalence of obesity renders hyperandrogenism PCOS useless as there are no periods of nutritional distress requiring androgens for increased reproductive rates. In an ancestral environment, hyperandrogenism would likely lead to sporadic anovulation and mild secondary symptoms, however high levels of androgens in a modern environment led to prolonged if not permanent infertility and excessive secondary problems. Thus, hyperandrogenism related to PCOS appears to meet evolutionary mismatch criteria. Seen in this light, PCOS may be effectively treated as a probably evolutionary mismatch.

Keywords: evolutionary mismatch, heritability, hyperandrogenism, mismatch disorder

Procedia PDF Downloads 219

Authors: Wu Liching

Abstract:

Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

Procedia PDF Downloads 47

Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

Abstract:

Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

Procedia PDF Downloads 93

Authors: Linda Saili, Amel Hanini, Chiraz Smirani, Iness Azzouz, Amina Azzouz, Hafedh Abdemelek, Zihad Bouslama

Abstract:

Electrocardiogram and arterial pressure measurements were studied under acute exposures to WIFI (2.45 GHz) during one hour in adult male rabbits. Antennas of WIFI were placed at 25 cm at the right side near the heart. Acute exposure of rabbits to WIFI increased heart frequency (+ 22%) and arterial blood pressure (+14%). Moreover, analysis of ECG revealed that WIFI induced a combined increase of PR and QT intervals. By contrast, the same exposure failed to alter the maximum amplitude and P waves. After intravenously injection of dopamine (0.50 ml/kg) and epinephrine (0.50ml/kg) under acute exposure to RF we found that WIFI alter catecholamines(dopamine, epinephrine) action on heart variability and blood pressure compared to control. These results suggest for the first time, as far as we know, that exposure to WIFI affect heart rhythm, blood pressure, and catecholamines efficacy on cardiovascular system; indicating that radio frequency can act directly and/or indirectly on the cardiovascular system.

Keywords: heart rate (HR), arterial pressure (PA), electrocardiogram (ECG), the efficacy of catecholamines, dopamine, epinephrine

Procedia PDF Downloads 427

Authors: Mayantoinette F. Watson

Abstract:

During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with a significant need for nursing staff. Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses in nursing programs. The risk of psychological distress is at a maximum, and its effects can negatively impact not only nursing students but also nursing education and academia. The high exposures to interpersonal, economic, and academic demands contribute to the major health concerns, which include a potential risk for psychological distress. Achievement of educational success among nursing students is directly affected by the high exposure to anxiety and depression from experiences within the program. Working relationships and achieving academic success is imperative to positive student outcomes within the nursing program. The purpose of this study is to identify and establish influences and associations within multilevel factors, including the effects of the COVID-19 pandemic on psychological distress in nursing students. Neuman’s Systems Model Theory was used to determine nursing students’ responses to internal and external stressors. The research in this study utilized a mixed-methods, convergent study design. The study population included undergraduate nursing students from Southeastern U.S. The research surveyed a convenience sample of undergraduate nursing students. The quantitative survey was completed by 202 participants, and 11 participants participated in the qualitative follow-up interview surveys. Participants completed the Kessler Psychological Distress Scale (K6), the Perceived Stress Scale (PSS4), and the Dundee Readiness Educational Environment Scale (DREEM12) to measure psychological distress, perceived stress, and perceived educational environment. Participants also answered open-ended questions regarding their experience during the COVID-19 pandemic. Statistical tests, including bivariate analyses, multiple linear regression analyses, and binary logistics regression analyses were performed in effort to identify and highlight the effects of independent variables on the dependent variable, psychological distress. Coding and qualitative content analysis were performed to identify overarching themes within participants’ interviews. Quantitative data were sufficient in identifying correlations between psychological distress and multilevel factors of coping, marital status, COVID-19 stress, perceived stress, educational environment, and social support in nursing students. Qualitative data were sufficient in identifying common themes of students’ perceptions during COVID-19 and included online learning, workload, finances, experience, breaks, time, unknown, support, encouragement, unchanged, communication, and transmission. The findings are significant, specifically regarding contributing factors to nursing students’ psychological distress, which will help to improve learning in the academic environment.

Keywords: nursing education, nursing students, pandemic, psychological distress

Procedia PDF Downloads 63

Authors: Fatemeh Kourkinejad Gharaei, Tahereh Safari, Zahra Saebinasab

Abstract:

Metabolic syndrome (MetS) is a set of risk factors associated with cardiovascular diseases, atherosclerosis, and type 2 diabetes. Nonalcoholic fatty liver disease (NAFLD) is the most important liver disorder in metabolic syndrome. High fructose consumption increases the risk of NAFLD. Eugenol shows anti-thrombotic, insulin-sensitive, fat-reducing effects. This study was designed to investigate the protective role of eugenol in NAFLD caused by metabolic syndrome. Methods: Thirty male Wistar rats were randomly divided into five groups; group 1, drinking water intake animals; group 2, fructose, group 3, fructose+eugenol solvent; group 4, fructose+ eugenol 50mg/kg and group 5, fructose+ eugenol 100mg/kg. At the end of the experiment, after 12 hours of fasting and under anesthesia, blood samples were taken for measurement of fast blood glucose (FBS), SGOT, AGPT, LDL, HDL, cholesterol, triglyceride. Results: FBG significantly increased in group 2 compared to group 1 (p < 0.001); however, it significantly decreased in groups 4 and 5 compared to group 2 (p < 0.05). SGOT and SGPT levels significantly increased in group 2 compared to drinking water alone (p < 0.001). However, SGOT and SGPT levels significantly decreased in groups 4 and 5. MDA and LTDS significantly increased in group 2 compared with drinking water alone (p < 0.01), while MDA and LTDS decreased in 4 and 5 groups compared to group 2 (p < 0.05), which confirms the pathology results related to the liver damage. Conclusion: Eugenol has protective effects on the liver and fat accumulation in liver cells.

Keywords: eugenol, fructose, metabolic syndrome, nonalcoholic fatty liver disease

Procedia PDF Downloads 100

Authors: Aicha Laouani, Pascale Calabrese, Sonia Rouatbi, Saad Saguem

Abstract:

Distances between signals (S d) and between asters (A d) calculated from respiratory inductive plethysmography signals has been used in order to evaluation airways resistances (Raw) during reversibility test among 28 subject with airways obstructions. Correlations studies between these distances and Raw measured by body plethysmography (BP) showed that these RIP variables could be potentially used in airway resistance assessment in patients with airway obstruction. Significant correlation was found between ΔAd and airway resistance changes (ΔRaw) (r= 0.407, p=0.03) and not between ΔSd and ΔRaw. This assumption was supported by the high correlations found when relating the average of ΔS and of ΔA calculated on successive intervals of ΔRaw, with the ΔRaw averages calculated for each interval (r= 0.892, p= 0.006 and r= 0.857, p=0.006 respectively).

Keywords: airways obstruction, distances, respiratory inductive plethysmography, reversibility test

Procedia PDF Downloads 432

Authors: M. R. Dahmardeh Ghaleno, M. Nohtani, S. Khaledi

Abstract:

Flood simulation and prediction is one of the most active research areas in surface water management. WetSpa is a distributed, continuous, and physical model with daily or hourly time step that explains precipitation, runoff, and evapotranspiration processes for both simple and complex contexts. This model uses a modified rational method for runoff calculation. In this model, runoff is routed along the flow path using Diffusion-Wave equation which depends on the slope, velocity, and flow route characteristics. Golestan Dam Basin is located in Golestan province in Iran and it is passing over coordinates 55° 16´ 50" to 56° 4´ 25" E and 37° 19´ 39" to 37° 49´ 28"N. The area of the catchment is about 224 km², and elevations in the catchment range from 414 to 2856 m at the outlet, with average slope of 29.78%. Results of the simulations show a good agreement between calculated and measured hydrographs at the outlet of the basin. Drawing upon Nash-Sutcliffe model efficiency coefficient for calibration periodic model estimated daily hydrographs and maximum flow rate with an accuracy up to 59% and 80.18%, respectively.

Keywords: watershed simulation, WetSpa, stream flow, flood prediction

Procedia PDF Downloads 224

Authors: Aicha Laouani, Sonia Rouatbi, Saad Saguem, Gila Benchetrit, Pascale calabrese

Abstract:

A new approach based on respiratory inductive plethysmography (RIP) signal analysis has been used for bronchoconstriction changes evaluation in 50 healthy controls and in 44 adults with moderate bronchial obstruction treated with a bronchodilatation protocol. Thoracic and abdominal motions were recorded ( 5 min) by RIP. For each recording the thoracoabdominal signals were analysed and a mean distance (D) was calculated. Airway resistance (Raw) and spirometric data were measured with a body plethysmograph. The results showed that both D and Raw were higher in subjects compared to the healthy group. Significant decreases of D and Raw were also observed after bronchodilatation in the obstructive group. There was also a positive and a significant correlation between D and Raw in subjects before and after bronchodilatation. This D calculated from RIP Signals could be used as a non invasive tool for continuous monitoring of bronchoconstriction changes.

Keywords: airway resistance, bronchoconstriction, thorax, respiratory inductive plethysmography

Procedia PDF Downloads 316

Authors: Emna Ketata, Wafa Farhat

Abstract:

Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

Procedia PDF Downloads 69

Authors: Xiuguo Zhao, Xudong Ren, Chen Su, Xinxi Xu, Fu Niu, Lingshuai Meng

Abstract:

The respiratory diseases such as asthma, emphysema and bronchitis are connected with the air pollution and the number of these diseases tends to increase, which may attribute to the toxic aerosol deposition in human upper respiratory tract or in the bifurcation of human lung. The therapy of these diseases mostly uses pharmaceuticals in the form of aerosol delivered into the human upper respiratory tract or the lung. Understanding of airflow structures in human upper respiratory tract plays a very important role in the analysis of the “filtering” effect in the pharynx/larynx and for obtaining correct air-particle inlet conditions to the lung. However, numerical simulation based CFD (Computational Fluid Dynamics) technology has its own advantage on studying airflow structure in human upper respiratory tract. In this paper, a representative human upper respiratory tract is built and the CFD technology was used to investigate the air movement characteristic in the human upper respiratory tract. The airflow movement characteristic, the effect of the airflow movement on the shear stress distribution and the probability of the wall injury caused by the shear stress are discussed. Experimentally validated computational fluid-aerosol dynamics results showed the following: the phenomenon of airflow separation appears near the outer wall of the pharynx and the trachea. The high velocity zone is created near the inner wall of the trachea. The airflow splits at the divider and a new boundary layer is generated at the inner wall of the downstream from the bifurcation with the high velocity near the inner wall of the trachea. The maximum velocity appears at the exterior of the boundary layer. The secondary swirls and axial velocity distribution result in the high shear stress acting on the inner wall of the trachea and bifurcation, finally lead to the inner wall injury. The enhancement of breathing intensity enhances the intensity of the shear stress acting on the inner wall of the trachea and the bifurcation. If human keep the high breathing intensity for long time, not only the ability for the transportation and regulation of the gas through the trachea and the bifurcation fall, but also result in the increase of the probability of the wall strain and tissue injury.

Keywords: airflow structure, computational fluid dynamics, human upper respiratory tract, wall shear stress, numerical simulation

Procedia PDF Downloads 217