BiomedGrid

  Pathophysiological Aspects of the Use of Hypobaric Hypoxic Training in the Treatment of Anemia in Chronic Glomerulonephritis Summary The course of chronic glomerulonephritis (CGN) is often accompanied by the development of anemia, which contributes to the progression of chronic kidney disease (CKD) and, in severe cases, leads to death. Therefore, correction of renal anemia at the earliest stages of CKD is important, allowing to reduce the rate of progression of renal dysfunction and delaying the onset of renal replacement therapy. Currently, erythropoietin is widely used in the treatment of renal anemia, which, however, is not always available to most patients due to its high cost. In this regard, the possibility of using it for this purpose, along with erythropoietin, and hypobaric hypoxic training, anti-anemic efficacy of which is proved by numerous studies, is of interest. The purpose of the study is to evaluate the effectiveness of correction of anemia with erythropoietin (EP...

  Road Rage in the Doctor’s Office Editorial A man appears in my office. Distinguished looking, a CEO, in his early 70’s. He is here because he has minor, intermittent knee pain. His exam and XR’s are consistent with early osteoarthritis. I suggest that he take an anti-inflammatory medication such as Motrin when needed. He tells me that Motrin works well and he has no problem tolerating it, but that he doesn’t intend to take pills for the rest of his life. He says he wants to have his knee fixed. When I realize that he is talking about a total joint replacement, I suggest that this is perhaps premature, considering how well he is functioning, and that even if the surgery goes smoothly, a joint replacement is never as good as one’s own knee. I repeat that surgery is perhaps not the appropriate treatment for the minor symptoms that he is having. He repeats that he wants his knee fixed. He insists on a second opinion. What is wrong with this picture? Or this one An engineer in his for...

  A Death of Malignant Hyperthermia Performed Autopsy: A Case Report Abstract Malignant hyperthermia (MH) is a potentially lethal disorder triggered by certain anesthetics. MH is characterized by hypermetabolism, muscle rigidity, hypercapnia, tachycardia, hypoxaemia, respiratory and metabolic acidosis, and hyperthermia. Mutations in the RYR1(account for about half of MH cases), CACNA1S, or STAC3 genes are associated with MH. We report on the case of a 19-year-old girl who is suffering from MH, without history of MH-susceptible and she died suddenly after cardiac arrest for more than 2 hours. The lack of clinical experience and vigilance resulted to the difficulty of early diagnosis. If MH is highly suspected during general anesthesia of potent volatile anaesthetics with or without succinylcholine, a collaborative treatment approach is mandatory, especially treatmented with dantrolene should begin as soon as possible. Autopsy of patients with MH, similar cases are infrequent in the ...

  Atrial Autonomic Denervation for The Treatment of Longstanding Symptomatic Sinus Bradycardia: A Case Report Abstract A 56-year-old man with symptomatic sinus bradycardia (SB) of 5 years accepted the suggestion of atrial autonomic denervation. Radiofrequency pulses were delivered on atrial ganglionated plexi (GP) with positive vagal reflex according to the standard of heart rate (HR) drop ≥20% after high frequency stimulation (HFS). The endpoint of inexistence of HR decrease at repeating HFS was achieved in 16 sites. After 12 months of follow-up, the patient continued to have normal 24-hour total heart beats and mean heart rate and SB-related symptoms substantially improved. Autonomic denervation in LA and RA by endocardial ablation of GP may increase sinus rate and improve symptoms in non-elderly patients with symptomatic longstanding SB. Introduction Sinus bradycardia (SB) is not unusual in non-elderly individuals, most of whom are asymptomatic. Pacemaker implantation has been p...

  False Negative PCR Tests for SARS-COV-2 – the Elephant in the Room Abstract Introduction:  Without criterion standards, clinicians have often been at a loss to interpret the meaningfulness of negative SARS-COV2 PCR testing in admitted patients. We provide a compelling epidemiologic analysis to ascertain an estimated false negative rate in an institution in New York City which experienced a surge early pandemic in the Bronx N.Y. Methods:  Using admitted historical controls from March 2019 as well as current patients analyzed from the initial surge of cases in NYC we used a logistic regression to determine the expected mortality rate in the Covid Negative, compare to the controls, and use an algebraic mixture equation to determine the false negative rate that could be responsible for the observed high mortality rate among the Admitted Covid test negatives. Results:  Unadjusted Mortality observed in March 2019 admissions 189/7462 (2.5%). Mortality in March 2020 CN 68/...