Adaptation to Intermittent Hypoxia and its use for Protecting the Heart from Stress and Ischemic Damage
Felix Z. Meerson in Adaptive Protection of The Heart: Protecting Against Stress and Ischemic Damage, 2019
This chapter demonstrates first experimentally and then clinically, that adaptation to moderate, rationally dosed hypoxia can be used to protect the heart against stress-induced and ischemic damage. Such a broad structural basis of adaptation to hypoxia should not be surprising, since in the whole organism hypoxia may arise not only from reduced oxygen content in the inhaled air and is not an exclusive domain of pathology. On the contrary, in the healthy organism hypoxemia or relative tissue hypoxia inevitably and most commonly occurs in significant loads on the whole organism or on particular organs and systems. Since adaptation to intermittent hypoxia activates the central stress-limiting systems and concurrently restricts or abolishes the disturbances to cardiac electric stability, it was reasonable to assess its effect on the course of neurasthenia and mentioned arrhythmias. After adaptation to intermittent hypoxia, the patients’ condition improved and the high erythrocyte sedimentation rate was attenuated.
Metabolic and endocrine bone disorders
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Metabolic bone disorders are associated with critical alterations in the regulation of bone formation, bone resorption and distribution of minerals in bone. Glucocorticoid excess in Cushing's disease is associated with adverse effects on bone metabolism characterized by suppressed bone formation, leading to a decrease in bone mineral density (BMD) and increased risk of osteoporosis. The main indications for using bone densitometry is to assess the degree and progress of bone loss in patients with clinically diagnosed metabolic bone disease or conditions such as hyperparathyroidism, corticosteroid-induced osteoporosis, gonadal deficiency or other endocrine disorders. Postmenopausal osteoporosis is an exaggerated form of the physiological bone depletion that normally accompanies ageing and loss of gonadal activity. Glucocorticoid overload occurs in endogenous Cushing's disease or after prolonged treatment with corticosteroids. Generalized osteoporosis, anaemia and a high erythrocyte sedimentation rate (ESR) are characteristic features of myelomatosis and metastatic bone disease.
Recurrent abdominal pain
Quentin Spender, Niki Salt, Judith Dawkins, Tony Kendrick, Peter Hill, David Hall, Jackie Carnell in Child Mental Health in Primary Care, 2018
Recurrent abdominal pain is a common problem affecting around 10% of school-age children. Boys and girls are affected to a similar extent, and there is no clear social class link. Abdominal pain associated with pallor, anorexia, nausea or vomiting may be caused by abdominal migraine, even in the absence of headaches. The abdomen is examined to exclude localised tenderness, guarding or constipation. It is also worth examining the eardrums, chest and genitalia. Investigations should be kept to a minimum, as an endless search for possible causes reinforces in the mind of the child and their parents that there must be a serious cause that no one can pinpoint. Tests that are appropriate in primary care include a full blood count, erythrocyte sedimentation rate, urinary microscopy and urinary culture. Other problems may coexist with recurrent abdominal pain. School refusal is potentially one of the most serious, and should be addressed as soon as possible.
The Use of a Nomogram to Visually Interpret a Logistic Regression Prediction Model for Giant Cell Arteritis
Published in Neuro-Ophthalmology, 2018
Objective: To illustrate the utility of a nomogram for the prediction of giant cell arteritis (GCA). Method: A nomogram was constructed from a multivariable logistic regression prediction model with 10 covariates: age, sex, clinical temporal artery abnormality, new-onset headache, jaw claudication, vision loss, diplopia, erythrocyte sedimentation rate, C-reactive protein, and platelet level. Results: The magnitude and location of the nomogram scale for each predictor variable graphically illustrates the net effect of each covariate and is especially useful for continuous variables such as age and bloodwork values. Conclusions: Nomograms allow integration and synthesis of the relative importance of clinical variables and provide a graphic representation of the odds ratios, p values, and confidence intervals of logistic regression prediction models. Although nomograms and prediction rules cannot substitute for clinical judgment, they help objectify and optimize the individualized risk assessments for patients with suspected GCA.
Inflammatory biomarkers to guide diagnostic and therapeutic decisions in children presenting with fever without apparent source
Published in Journal of Chemotherapy, 2018
Giulia Trippella, Luisa Galli, Maurizio de Martino, Elena Chiappini
A systematic review of literature from 2011 to 2016 was performed, in order to evaluate the diagnostic performance of inflammatory biomarkers in children with fever without apparent source and their usefulness in clinical decision-making. Data source was the Pubmed database. Thirteen studies were included, analysing the following biomarkers: erythrocyte sedimentation rate, white blood count, absolute neutrophil count, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6) and the Lab-score (a combination of CRP, PCT and urine dipstick). Among the available biomarkers, CRP and PCT seem to be the most useful, showing the best performance at a threshold of 20 mg/L for CRP and 0.5 ng/mL for PCT. Lab-score increases diagnostic accuracy and also health-care costs. PCT demonstrated higher specificity levels, particularly in younger children. However, CRP remains the most accessible biomarker and is also available as a validated point-of-care test.
Impact of preanalytical storage on the measurement of erythrocyte sedimentation rate using an infrared microphotometer system (TEST1)
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2020
Claudio Ilardo, Christiane Richerd, Vanessa Rostain
This study examined the influence of temperature and time on the pre-analytical stability of the erythrocyte sedimentation rate (ESR) measured on a TEST1 system. The first experiment included 102 samples stored at room temperature and the second experiment included 112 subjects and investigated refrigerated (2–8 °C) storage. Our study showed a stable ESR results at room temperature (15–25 °C) up to 8 h (p = 0.512). Samples stored at 2–8 °C for 24 h were stable (p = 0.280) for 24 h.
Related Knowledge Centers
- Erythrocytes
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