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The pathophysiology of primary hypertension. A hypothetical scheme for the pathogenesis of essential hypertension, implicating genetic defects in renal excretion of sodium, functional regulation of vascular tone and structural regulation of vascular calibre. Environmental factors, especially increased sodium intake, may potentiate the effects of genetic factors. The resultant increases in cardiac output and peripheral resistance contribute to hypertension. ECF = extracellular fluid. Source: Modified from Kumar V. Robbins & Cotran pathologic basis of disease. 7th edn. Philadelphia: Saunders; 2004. 

The pathophysiology of primary hypertension. A hypothetical scheme for the pathogenesis of essential hypertension, implicating genetic defects in renal excretion of sodium, functional regulation of vascular tone and structural regulation of vascular calibre. Environmental factors, especially increased sodium intake, may potentiate the effects of genetic factors. The resultant increases in cardiac output and peripheral resistance contribute to hypertension. ECF = extracellular fluid. Source: Modified from Kumar V. Robbins & Cotran pathologic basis of disease. 7th edn. Philadelphia: Saunders; 2004. 

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... CVI has a pathophysiologic basis consistent with chronic, ambulatory venous hypertension 17 . CVI is insidious and despite revascularization, may lead to venous ulceration, as presented in this case. ...
Preprint
Chronic venous insufficiency (CVI) is a lifelong, moribund, and debilitating disease process with tremendous personal and financial costs. At its core, CVI involves blood pooling in the lower extremities secondary to inadequate venous blood return, resulting in venous hypertension and incompetence of the one-way valves in the lower extremity veins. As venous circulation slows, metabolic demands of the cells in the lower extremities increase, leading to stasis dermatitis, infection, cellular death, and venous ulceration. This case study aims to report the efficacy of dehydrated amniotic membrane allograft (DAMA) applications to a chronic right lateral ankle ulcer resulting from chronic venous insufficiency. The patient in this study received DAMA applications weekly for six weeks. Upon examination at the initial application, the wound was wet and macerated due to drainage with significant hemosiderosis and lipodermatosclerosis consistent with a Venous Clinical Severity Score (VCSS) of 2. Upon inspection at the final visit, the wound was closed, with a VCSS of 0. This case study demonstrates that the application of DAMA has the potential to act as an effective barrier to cover and accelerate wound closure time. Future non randomized and randomized controlled trials may further establish standardized protocols for DAMA application in venous ulceration, help create treatment algorithms to predict wound closure endpoints, and encourage innovation that may further accelerate healing time.
... CVI has a pathophysiologic basis consistent with chronic, ambulatory venous hypertension 17 . CVI is insidious and despite revascularization, may lead to venous ulceration, as presented in this case. ...
Preprint
Chronic venous insufficiency (CVI) is a lifelong, moribund, and debilitating disease process with tremendous personal and financial costs. At its core, CVI involves blood pooling in the lower extremities secondary to inadequate venous blood return, resulting in venous hypertension and incompetence of the one-way valves in the lower extremity veins. As venous circulation slows, metabolic demands of the cells in the lower extremities increase, leading to stasis dermatitis, infection, cellular death, and venous ulceration. This case study aims to report the efficacy of dehydrated amniotic membrane allograft (DAMA) applications to a chronic right lateral ankle ulcer resulting from chronic venous insufficiency. The patient in this study received DAMA applications weekly for six weeks. Upon examination at the initial application, the wound was wet and macerated due to drainage with significant hemosiderosis and lipodermatosclerosis consistent with a Venous Clinical Severity Score (VCSS) of 2. Upon inspection at the final visit, the wound was closed, with a VCSS of 0. This case study demonstrates that the application of DAMA has the potential to act as an effective barrier to cover and accelerate wound closure time. Future non randomized and randomized controlled trials may further establish standardized protocols for DAMA application in venous ulceration, help create treatment algorithms to predict wound closure endpoints, and encourage innovation that may further accelerate healing time.
... Musculoskeletal injuries are typically associated with tissue damage, pain, and inflammation [1]. Resolution of soft tissue damage relies on endothelium-dependent blood flow to deliver essential cellular components and healing factors [2]. ...
... NO regulates vascular tone and permeability, inhibits platelet aggregation, and stimulates angiogenesis [4][5][6][7]. NO synthesis during tissue healing has a positive clinical implication as it promotes aforementioned essential components required for maintaining hematological stasis around the injured tissue [1]. ...
... Modulated microcirculation has been shown to accelerate healing by controlling ischemia, hypoxia, edema, and local secondary tissue damage [1,2]. There have been a few studies investigating the effects of physical agents in larger microcirculation beds; however, these studies were laser therapy-induced, not TUS-induced [25,32]. ...
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A randomized, double-blind, placebo-controlled, cross-over study where continuous therapeutic ultrasound (CUS; at 0.4 W/cm2), pulsed therapeutic ultrasound (PUS; at 20% duty cycle, 0.08 W/cm2), both at 1 MHz, and placebo (equipment on, no energy provided) were randomized and applied over the forearm of the non-dominant arm for 5 min in 10 young, healthy individuals. Absolute and peak forearm blood flow (FBF) were measured via Venous Occlusion Plethysmography. FBF was measured before, halfway, and after (immediately and 5 min after) the therapeutic ultrasound (TUS) intervention. Post-ischemic peak FBF was measured 10 min before and 10 min after the TUS intervention. A two-way repeated measures ANOVA (group × time) was selected to assess differences in FBF before, during, and after TUS treatment, and for peak FBF before and after TUS treatment. FBF increased 5 min after TUS in CUS compared to placebo (2.96 ± 1.04 vs. 2.09 ± 0.63 mL/min/100 mL of tissue, p < 0.05). PUS resulted in the greatest increase in Peak FBF at 10 min after US (Δ = 3.96 ± 2.02 mL/min/100 mL of tissue, p = 0.06). CUS at 1 MHz was an effective treatment modality for increasing FBF up to 5 min after intervention, but PUS resulted in the greatest increase in peak FBF at 10 min after intervention.
... These enzymes possess the ability to separate tumor cells from one another, making it easier for tumor cells to move freely and then penetrate into the normal tissues of the host [5]. That changing the genetic makeup of cells that may occur due to internal or external factors leads to an abnormal division, which leads to the formation of tumors, and tumors are of two types, benign tumors, these tumors are slow-growing, defined by a membrane, they remain in one place and do not extend To nearby tissues or healthy organs [6]. As for malignant tumors, these tumors are rapidly growing. ...
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Colon cancer is an abnormal growth of cells that occurs in the large intestine. Sometimes growth remains restricted for a relatively long time before it becomes a malignant tumor and then spreads through the intestinal wall to the lymph nodes and other parts of the body. The study aims to estimate the effectiveness and partial purification of lipoxygenase (LOX) enzyme and measure gamma-glutamyle transferase (GGT) activity in serum patients of colon cancer in Baghdad. The study included (80) case male patients with colon cancer with (50) samples of apparently healthy males (control) as comparison group. The result displayed a noteworthy increase in lipoxygenase effectiveness (805.0±517.23 IU/L) in serum of patients with colon cancer (T3 stage) compared with control (114.6±49.77 IU/L). The enzyme was purified by the precipitation of the serum protein using (40% (NH4)2SO4) then removing the remaining salts by dialysis. The column of gel (sephadex G.100) was used to separate the enzyme from another protein, in this step a single peak was obtained. The effective part of lipoxygenase at yield (71.42%) and folds (11.033). The ion exchange chromatography (DEAE–CeA50) was used to isolate LOX isoenzyme, two bands (LOX1 and LOX2) were acquired with different degree of purity (16.372) and (12.16) folds respectively. The result displayed a noteworthy increase in the (GGT) activity in patients (58.69±16.94IU/L) (probability P≤ 0.000) compared with control (12.79±5.68 IU/L). The increase in activity of LOX can be used as a tumor marker to detect the colon cancer disease.
... At the cellular level, hypothermia freezes cytoplasm and results in crystals formation which results in cellular rupture. There is a decrease in microcirculation due to increase in blood viscosity along with increased coagulation [7]. Lethal triad is a serious consequential complication which includes hypothermia, acidosis and coagulopathy. ...
Article
Introduction Mild hypothermia is common after general anesthesia. It is associated with discomfort and shivering. Greater fall of temperature is associated with more devastating complications. Data regarding the effect of gender on perioperative hypothermia is scanty. Objectives of the study To determine and compare mean core temperature loss in males and females undergoing laparoscopic cholecystectomy under general anesthesia. Setting and design Descriptive cross-sectional study in a tertiary care teaching hospital. Subjects and methods Ninety-seven elective laparoscopy patients were included through non-probability consecutive sampling. Intraoperatively, there was standardization of monitoring equipment, drapes, operation room temperature (21-22 °C), humidity (50%), irrigation fluid temperature (37 °C), peritoneal CO2 temperature (21-22 °C), anesthetic fresh gas flow rates at induction and maintenance. Temperature recording equipment (nasopharyngeal probe) and temperature recording interval (10 minutes) were also standardized from induction till the end of surgery. Final temperature was recorded at the end of surgery before emergence. Results Mean temperature loss was 0.73 ⁰C ± 0.47⁰C. Mean loss was significant in males compared to females with a mean difference of 0.28°C ± 0.93⁰C; P-value= 0.003. Conclusion Mean temperature decreases significantly in laparoscopic cholecystectomy patients under general anesthesia. We recommend that more care is needed to prevent hypothermia in male patients because of their higher susceptibility to hypothermia.
... Studies have indicated that the presence of interstitial inflammation interferes with the transport of oxygen which subsequently results in an increased ratio of oxygen need and oxygen supply that stimulates an increased production rate of the vasodilator, adenosine 41,42 . This leads to dilatation of the vessels and increased blood flow to restore the oxygen ratio to the normal level 41 . ...
... Studies have indicated that the presence of interstitial inflammation interferes with the transport of oxygen which subsequently results in an increased ratio of oxygen need and oxygen supply that stimulates an increased production rate of the vasodilator, adenosine 41,42 . This leads to dilatation of the vessels and increased blood flow to restore the oxygen ratio to the normal level 41 . Besides, diffuse hemorrhage and increased interstitial fluid, which suggests a vascular mediated lesion, was observed at all treatment groups. ...
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Introduction:Aloe megalacanthaBaker is an endemic plant growing in Ethiopia. It is commonly used by traditional healers in the eastern and northern parts of the country to treat various ailments. Aim: The present study was aimed at investigating the effects of Aloe megalacanthaBaker leaf latex on testicular histopathology and hormonal profiles of adult male Sprague Dawley rats. Methodology:Adult male Sprague Dawleyrats were randomly divided into four groups of six rats each. GroupI received 0.5ml distilled water. Groups II, III, and IV were treated with doses of 200mg, 400mg,and 600mg per kilogram body weight per dayofAloemegalacanthaleaf latex orally using gavage for 28 days(sub-acute treatment). Assessments of testicular histopathology, sperm analysis, and hormonal assays were performed to evaluate the contraceptive effect of the leaf latex. Results: Thisstudy revealed thatAloe megalacanthaBaker leaf latex induces vascular, cellular, and structural changes in the testesat all doses. The mean values of testosterone and luteinizing hormones weresignificantly decreased in rats treated at 400mg/kg and 600mg/kgof leaf latex compared with the control group. The concentration of follicle-stimulating hormone levels also decreased significantly at 600mg/kg/daydosing of the leaf latex when compared with the control group. Increased morphological abnormality of sperm cells accompanied by a dose-dependent significant reduction of sperm count and motility were also observed in the study. Conclusions:Aloe megalacanthaBaker could affect male rats by altering histoarchitecture of the testes, lowering hormone levels, increasing abnormal sperm morphology, reducing sperm concentration, and decreasing sperm motility. It could, therefore, act asa contraceptive or antifertility agent.
... Cortisol (i.e., glucocorticoids) is a key regulating stress hormone in the human HPA axis cascade. Cortisol potentiates the effects of catecholamines on beta receptors (necessary for impacting peripheral receptors), suppresses immune function, and terminates the fight-or-flight response (via negative feedback loop) [15]. Cortisol is excreted in a dose-response manner to the level of perceived threat by the individual, meaning the greater the perceived threat, the more cortisol that is excreted [16]. ...
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Occupational stress is a pervasive problem that is relevant across the world. Stress, in combination with occupational hazards, may pose additive risks for health and wellbeing. This chapter discusses the influence of physical and psychosocial stressors on basal cortisol regulation as associated with higher-risk occupational duties among two subspecialties of police officers (frontline and special tactical unit officers). Results reveal significant differences in dysregulated cortisol awakening response associated with the higher risk duties among special tactical unit officers. In contrast, frontline officers with a lower objective occupational risk profiles report higher subjective stress levels. Dysregulated or maladaptive cortisol levels are associated with increased health risk. Thus, individuals working in high stress occupations with elevated cortisol profiles may be at increased risk of chronic health conditions. Results suggest that considering both objective physiological markers and subjective reports of stress are dually important aspects in designing interventions for police officers of differing subspecialties.
... The use of salivary cortisol implies several methodological constraints, such as that a stress/threat threshold needs to be exceeded in order for cortisol to be released [36,22]; there is a delay in peak response (ranging approximately between 20-40 mins depending on stressor-stimulus) for cortisol, resulting in long experimental procedures [22,35]; there exists bio-chemical interplay with other bodily functions related to circadian rhythm [35,22], food intake [32,55], and caffeine and nicotine consumption [44,36], requiring instructions/control prior to experimentation; and considerable efforts and costs for sampling and bio-chemical analysis of salivary probes. Compared to other physiological measures such as EDA or ECG, however, salivary cortisol is robust against physiological artifacts (e.g., resulting from body movements and/or external factors like lighting conditions or mild temperature fluctuation). ...
... Before Study. Prior to the experiment, we instruct the participants not to eat or drink warm beverages (especially caffeine/energizing drinks and food), take warm baths/showers, sleep, brush their teeth (toothpaste includes citric acid, which stimulates saliva production and potentially alters the salivary cortisol concentration), perform heavy exercise, smoke or snus less than one hour before the experiment, as these activities might influence their physiological reactivity during the experiment [36,22,32]. Furthermore, we ask the participants to complete a prescreening questionnaire inquiring about their demographics and on-sea experience, as well as possible physiological and/or psychological disorders, regular medications (e.g., antihistamine medications, beta-blockers, or contraceptives) or chronic high stress levels, as these are possible confounding parameters for salivary cortisol. ...
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The understanding of stress and its impact on human performance is crucial to mitigate human error in the face of a threat. This is especially the case for critical incidents on a ship bridge, where human error can easily lead to severe danger for crew, cargo, and other vessels. To overcome the current limitations of robust objective stress measures that reliably detect (di-)stress under highly noisy conditions, we set out to explore whether salivary cortisol – the stress biomarker in medicine and psychology – is a valuable complementary assessment tool in a high stress/emergency context. In a controlled within-subjects experiment (N=12) using a ship bridge simulator, we measured stress levels under three conditions (80 minutes each): baseline, low stress (open water navigation task in autopilot), and high stress (open water emergency scenario). We sampled salivary cortisol at 10 minute intervals in conjunction with heart rate (variability) monitoring, and subjective stress assessments from both participants and expert evaluators. Results validate salivary cortisol as a successful tool for detecting distress. Unlike the other stress measures, salivary cortisol strongly correlated with expert stress assessments (r = .856) and overt stress behavior like instances of freezing and missing response cues. Surprisingly, data further revealed decreased salivary cortisol across periods of self assessed improved performance (i.e., eustress). In fact, data suggests an inverted u-relationship between performance and salivary cortisol. The findings have direct implications for the vast field of emergency training, and serve as a first important validation and benchmark to proceed with real life applications.
... Prolonged exposure to depression and anxiety have been identified as important to the development and prognosis of CVD (Huether & Mccance, 2012), although the link between psychological treatment and cardiac outcomes remains unclear. A large review of outcomes in coronary heart disease studies did not find a reduction in mortality associated with psychological treatments (Richards et al., 2017). ...
Article
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Depression and anxiety are common among people who have experienced an acute coronary event (e.g., heart attack). Multidisciplinary cardiac rehabilitation programs often focus on reducing risk factors associated with future cardiac events, however, mental health interventions are not routinely available. Given known difficulties with access to mental health treatment, the present study sought to explore the efficacy and acceptability of an Internet-delivered cognitive behavioural therapy program (Cardiac Wellbeing Course) among participants who experienced an acute coronary event. The five-lesson course was delivered over eight weeks and was provided with brief weekly contact, via telephone and secure email with a guide. Participants were randomized to the Cardiac Wellbeing Course (n = 25) or waiting-list control group (n = 28). Symptoms were assessed at pre-treatment, post-treatment, and four-week follow-up. Completion rates (84%) and satisfaction ratings (95%) were high. Statistically significant between-group improvements were observed for the treatment group on primary measures of general anxiety (Cohen's d = 1.62; 67% reduction), depression (Cohen's d = 1.09; 61% reduction), and physical activity levels (Cohen's d = 0.27; 70% increase). Statistically significant improvements were also observed on secondary measures of distress (Cohen's d = 0.98; 51% reduction), cardiac anxiety (Cohen's d = 0.92; 34% reduction), and mental-health quality of life (Cohen's d = 0.23; 24% improvement). The changes were maintained at four-week follow-up. The current findings add to the existing literature and highlight the potential of Internet-delivered cognitive behavioural therapy programs among participants who have experienced an acute coronary event.
... Lyme disease, mumps, measles, cat-scratch fever, syphilis, and herpes may cause optic neuritis [7]. CSF analysis ruled-out viral, bacterial, or fungal infection. ...
... Sarcoidosis causes symptoms such as lacrimation, red eyes, blurred vision, reddish bumps on the skin, kidney stone formation, swollen and painful joints, hepatomegaly, and nervous system effects. Nervous system involvement includes meningitis, hearing loss, seizures, depression, and dementia [7]. Our patient experienced numbness on the bottom of the right foot and calf but no joint pain. ...
... The absence of pain on presentation and negative imaging precludes this diagnosis. [7]. The absence of oligoclonal bands ( Table 1) and negative neuroimaging ruled out multiple sclerosis [9]. ...
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Leber hereditary optic neuropathy (LHON) is a genetic condition that typically presents with unilateral, painless, sub-acute central vision loss followed by contralateral vision loss after a few weeks to months. It is a rare disease that typically affects young adults - men more than women - and is a relatively common cause of blindness. It is due to a mutation in mitochondrial DNA (mtDNA). The majority (more than 95%) of patients have one of three mtDNA point mutations: m.14484T→C, m.3460G→A, or m.11778G→A. These mutations lead to disruption of the mitochondrial respiratory chain activating pro-apoptotic pathways. For reasons unknown, this insult tends to affect the retinal ganglion cells more than any other cell in the body, leading to the disease state. Due to its low prevalence in the United States (1:50,000), this diagnosis is often overlooked, misdiagnosed, and mismanaged, which may exacerbate symptoms. It is essential then for physicians to recognize the presentation of and understand the diagnostic work-up for LHON. In this case report, we present the diagnostic challenges of a patient who presented with progressive vision loss, discuss the various differential diagnoses, review the literature on LHON, and propose an explanatory model for vision loss in patients with LHON.