Essays on Ischemia

‘Author’s name’

‘Institution’ This document is a review of the article Cannulation Strategies and Pitfalls in Minimally Invasive Cardiac Surgery by Ramchandani, Jabbari, Abu Saleh, and Ramlawi (2016). The article provided informative discussions on minimally invasive cardiac surgery (MICS) and presented the different cannulation techniques. MICS is a very important development in the field of cardiothoracic medicine. It eliminates the inconveniences experienced during the median sternotomy and bypass circuit placement. The key in the success of MICS is the cannulation technique employed. Options for arterial cannulation in MICS include ascending aorta, femoral artery, and axillary artery. Each has its own advantages ...

Introduction

Atherosclerotic cardiovascular disease (CVD) involves peripheral circulation, the brain, and the heart. The disease is a primary health issue in many countries around the world (Sawhney, et al., 2012). CVD develops through complex processes involving novel risk markers and common risk factors. Decades of research have demonstrated that a sibling’s or parent’s family history is linked to the development of atherosclerotic CVD (Gupta et al., 2013; Nelson, 2013; Imes and Lewis, 2014), which manifests as peripheral arterial disorder, stroke, and coronary heart disorder (CHD). Various Mendelian disorders have also been shown to contribute to atherosclerotic CVD. Although ...

Abdominal Pain

Acute abdominal pain is a common presenting complaint. It can be due to a range of conditions some of which are benign and self-limiting and others life-threatening medical/surgical emergencies (Cartwright and Knudson, 2008). This paper will address the issue of abdominal pain from a paramedicine perspective in reference to a 29 year old male patient who presents with this complaint. It will interrogate the provided information and identify other essential information that is needed, three differential diagnoses for the patient, and the pathophysiology of the most probable diagnosis. Lastly, the implications of the case on paramedicine practice will be ...

Coursename Pressure ulcers are damaged areas of the skin, which develop due to the long-term effect of pressure or friction in the areas where the bone is close to the skin, such as heels, sacrum, ischial tuberosity, lateral malleoli and greater trochanters. The epidemiology of pressure ulcers proves that today, despite the profound understanding of them, pressure ulcers are still a serious global health care problem, which affects millions of people worldwide. For example, in the US every year more than 2.5 million people suffer from the pressure ulcers (Cuddigan, Berlowitz, and Ayello 208-215). In 2013 pressure ulcers caused ...

Why does she have bacteria and white blood cell casts in her urine?

In this case, Ms, Cornwall has focal bacterial infection of her calyces, medulla and renal pelvis. The presence of these bacterial and their invasion within the mentioned parts causes a body response to defend against the invasion. This occurs though a trigger of the inflammatory mediators and other body defense mechanism in this case the white blood cells. With the white blood cells now dominating the region of infection, there occurs a systematic abscess formation and necrosis within the medulla (Alexander et al., 2012). At this point, the next step that could occur is the scar tissue formation which ...

Monomorphic Ventricular Tachycardia

Cardiac arrhythmias often require immediate medical care that may include resuscitation (Ray, 2004). The diagnosis of cardiac arrhythmias can be challenging particularly in situations whereby the patient is asymptomatic and ECG findings are normal between symptomatic episodes (Cruickshank, 2008). Distinguishing between supraventricular and ventricular tachycardia is also a challenge (Australian Resuscitation Council, 2008). Cardiac arrhythmia should be suspected in patients with a history of syncope, near syncope, palpitations, and/or chest pain (Cruickshank, 2008). This paper will justify why monomophic ventricular tachycardia is the most likely diagnosis of a male patient who collapsed abruptly and has hypotension (BP 63/38), tachycardia ( ...

Mechanical ventilation (MV) causes oxidative stress that is responsible for adverse consequences on organs. In a situation of MV, the excessive pressure impairs the function of the mitochondrial respiratory chain leading to oxidative and nitrosative stress (Kavazis, 2009; Hafner et al., 2014). MV is commonly associated with hyperoxia where an excess of oxygen is provided. In such a case an oxidative stress can be induced when the oxygen pressure in the alveolar exceeds that of the normal breathing conditions because the biological system is not able to readily detoxify the environment from components such as reactive oxygen species (ROS) ( ...

I. General pathology information

A. Other Names

1. Urinary tract infection 2. Inflammatory disease of the kidney

B. Causes

1. Vesicoureteral reflux 2. Altered bladder function 3. Congenital urinary tract anomalies 4. Renal calculi C. Incidence rates 1. In females, annual rates for outpatient treatment are 12-13 cases per 10,000. 2. In females, annual rates for inpatient treatments are 3-4 cases per 10,000. 3. Among males, outpatient annual rates are 2-3 cases per 10,000. 4. Among males, inpatient annual rates are 1-2 cases per 10,000. 5. Incidences are highest among young women, followed by infants and the elderly. D. Signs ...

Acute coronary syndrome is an umbrella term for a group of clinical symptoms indicative of acute myocardial ischemia. These conditions include non-ST-segment elevation myocardial ischemia (NSTEMI), unstable angina, and ST-segment elevation myocardial infarction (STEMI). These conditions are high-risk manifestations of atherosclerosis in the coronary artery and significant causes of utilization of emergency services and hospitalization (Kumar and Cannon, 2009). STEMI causes 30% of all acute coronary syndromes in Australia (Harper and Lefkovits, 2010). This paper will describe the expected presentation, pathophysiology, ECG findings, pre-hospital management, and initial 24-hour management of STEMI in hospitals settings. These aspects will be described ...

Thesis proposal

ABSTRACT NIRS is the continuous real- time monitoring of the efficiency of human brain perfusion. It can provide important information that belongs to the variety of clinical situations. Typical technologies can include pharmaceutical, food and agrochemical quality control, medical diagnostics that include blood sugar and pulse oximetry and combo-tion reach. The current availability of near- infrared spectroscopy can detect the cerebral ischemia. Moreover, NIRS can be also used in monitoring of other tissue beds. These are splanchnic, renal and spinal cord. Near- infrared spectroscopy is based on molecular overtone and combination vibrations. As a result, in the near- IR ...

Acute Kidney injury is also recognized as an acute renal failure that is defined as an abrupt reduction in kidney function that develops for several hours in a day (Waugh, 1959). The cause of the acute renal failure is divided into three categories: Prerenal, Intrarenal and post-renal. Prerenal Acute Renal Failure it occurs after there is an unexpected decrease in blood flow to the kidney that causes a loss of kidney function (Seibert et al., 2016). In other words, it is a condition that causes reduction of normal flow of blood through the kidney. The following are the examples ...

(Author, Department, University,

Corresponding Address and email)

Single-photon emission computed tomography (SPECT scintigraphy) utilizes nuclear medicine along with gamma rays to get three-dimensional images (NLM, n.d.) of an internal part of the body such as heart with an objective of diagnosing a problem.

SPECT

In SPECT, a gamma-emitting radioisotope is administered into the bloodstream of a patient with the help of injection (Boyd, 2014; Hademenos, 1998). The radioisotope is, usually, a simple soluble ion as, for example, isotope of gallium(III) (Sharma, Prior, Belinsky, Kruh, & Piwnica-Worms, 2005; Wadas, Wong, Weisman, & Anderson, 2010). Most often, a marker radioisotope is also bound to a particular ligand ...

(Author, Department, University,

Corresponding Address and email)

Acute ischemic stroke refers to the death of brain tissue caused by interruption of the blood flow to brain. This interruption is caused by occlusion of a cervical or cerebral artery, or cerebral vein (Uchino, Pary, & Grotta, 2011). It is among the leading causes of death in the world. According to the estimates of American Heart Association, nearly one stroke occurs in every 40 seconds in the U.S., approximating 795,000 cases of stroke per year (American Heart Association Stroke, 2015). Assessment and management of acute ischemic stroke patients need to be done as soon as ...

Heart failure is a pathophysiologic condition characterized by the heart’s inability to generate sufficient cardiac output, resulting in either inefficient tissue perfusion or increase in the diastolic filling pressure of the left ventricle, or both, which lead to increased pulmonary capillary pressure (McCance, Huether, Brashers, & Rote, 2014). Heart failure is a leading cause of death in the US (McCance et al., 2014; Mozaffarian et al., 2015). American Heart Association has estimated that in 2013, cardiovascular diseases were responsible for 30.8% of all deaths in the US, or 222.9 per 100,000 deaths (Mozaffarian et al., 2015). The 2013 ...

Abstract

The field of medicine has gone through an immense transformation over the past years to the betterment of the field. In the past couple decades, there have been significant improvements in the patients imaging. There have been some imaging modalities that have been practiced in the medical sectors to help provide the body structures where standard prescriptive methods have proved ineffective. In the recent years, magnetic resonance imaging has been one of the fundamental modalities used in the imaging in the clinical medicine. There are several benefits and structural advantage that it exhibits over other imaging modalities. Among the ...

1. How can the disease described above create a mismatch between ventilation and perfusion? Use your understanding of alveolar dead space and physiologic shunt to explain your answer. In coal-miner’s pneumoconiosis, respirable coal dust that are inhaled for long periods of time trigger hyperactive immune responses that lead to destruction of the lung. At the beginning, coal dust particles are expelled out of the lung through the function of pulmonary macrophages beneath the epithelial layer of airways and near capillaries (Kopf, Schneider & Nobs, 2015). These macrophages phagocytize the dust particles and transport them to the lymphatic tree or ...

Elderly depression stems from a variety of causes. Elderly men encompass the highest suicide rate in the United States. The condition affects 6.5 million out of 35 millions Americans aged 65 years old and above.

Some of the identified causes of depression among the elderly are; - Memory problems - Social withdrawal - Confusion - Demanding behavior - Lack of active movements

Depressive disorders are described in the Diagnostics and Statistical Manual for Mental Disorders (DSM-IV) that caused by general medical condition. Variants of geriatric-spectrum of depression were introduced to reflect differentiate depletion syndrome ...

Answers

- The differences between the cardiovascular diseases and the coronary heart diseases

The major differences between these two types of diseases relates to the vascular components of the cardiovascular system. This simply means that the cardiovascular diseases do not only involve the heart alone but also involves all the heart linked vessels. i.e all arteries, veins and lymphatics found to be associated with the heart and blood passes to and from the heart. However, the coronary heart diseases only relate to the vessels that are within the heart itself and supply the heart itself and also the muscles of ...

Clinical Case Study

The evidence based clinical literature reveals the difficulties in diagnosing Myocardial Infarction (MI) concomitantly with pre-existing left bundle branch block (LBBB) with the application of 12 lead ECG in the pre-hospital environment (Surawicz and Knilans, 2008). Indeed, the T waves and baseline ST segments incongruently displaced in negative direction in cases of LBBB as evident through the ECG findings. These abnormal variations in ECG findings tend to override the actual ECG results in relation to MI manifestations, thereby challenging the confirmation of MI with the ECG intervention. However, the moving ST segments revealed through the serial ECGs during ischemic ...

Business case for quality

Introduction Clinical preparation guidelines are declarations that include commendations intended to enhance patient care. These are informed by a methodical review of indication and a valuation of the aids and harms of alternate care options. Due to the hefty number of clinical preparation guidelines available, doctors and other guide users find it stimulating to determine which guidelines are of decent quality. If the guideline users could invent a mechanism to instantly identify decent quality, trustworthy and clinical practice procedures their health-related issues would certainly get improved. Thus, both the health care quality and health outcomes would potentially improve.

The past few ...

Myocardial ischemia or cardiac ischemia is the decrease of blood flow, and thus oxygen supply, in the heart due to partial or complete blockage of the heart’s arteries. Its effects range from damage of the heart muscle (heart failure), to heart attack (myocardial infarction), and to abnormal heart rhythms (arrhythmia). Symptoms of myocardial ischemia may not appear (silent ischemia), or may be characterized by chest pressure or pain (angina pectoris), neck or jaw pains, shoulder or arm pains, fast heartbeat, shortness of breath, and nausea and vomiting. Myocardial ischemia may occur slowly as arteries become blocked over ...

[Author’s Name] [Insititutional Affiliation] A stroke is a cerebrovascular event resulting in rapid functional cell death in local tissue. Strokes, also known as cerebrovascular accidents (CVA) are a major cause of disability globally (Doyle, Simon, & Stenzel-Poore, 2008) and occur due to a disturbance in the blood supply to the brain. This disturbance in cerebral blood flow commonly results in a period of ischemia, an interruption to the delivery of oxygen to the brain tissue. Focal ischemia due to occlusion of brain artery is the cause of more than 80 % of all strokes (Flynn, MacWalter, & Doney, 2008). The other major cause ...

Part 1.

The pathophysiological template of an ischemic stroke involving the dominant left hemisphere of the brain is usually caused by the arterial occlusion resulting from a thrombus that embolized from a more proximal anatomical structure in the body that is closer to the brain, such as the heart and lungs and arterial plaques. The thrombus may cause a significant occlusion to the major intracranial arteries like the middle cerebral artery which carries the blood flow to the frontal, parietal and temporal lobes. A left middle cerebral artery stroke will manifest a right hemiplegia and hemiparesis with the upper extremities more significantly affected than the ...

Article Review: The Causes of Cerebral Desaturation in

Article Review: The Causes of Cerebral Desaturation in The study by Brinkman, Amadeo, Funk, and Grocott (2013) investigated cerebral desaturation, which frequently occurs in one-lung ventilation procedures for thoracic surgery and is possibly caused by lower cardiac output. The aim of the study was to explore the correlation between decreases in cerebral oxygen saturation that occurs in patients undergoing one-lung ventilation and decreased cardiac output. Although cerebral oxygen saturation was lowered in all of the participants, the researchers did not have statistically significant data that could be used to establish a correlation between cerebral desaturation and cardiac output, so ...

Abstract:

Strokes are a leading cause of morbidity and mortality in the developed world. Key to prevention and control of strokes is a thorough understanding of their etiology and the pathophysiologic processes that occur. A review of the literature regarding cerebrovascular disease was undertaken to more fully understand the changes that lead to strokes. The causes are manifold and there are many risk factors that may lead to pathology causing a stroke. The third leading cause of death in the United States is stroke, it is also the cause of significant neurologic disorders and morbidity. A pathological process involving the blood vessels ...

The blood vessels of the human body are predominantly made up of endothelial cells (EC) and smooth muscle cells (SMC). The remainder of it is composed of extracellular matric (ECM), which includes collagen, elastin, and glycosaminoglycans (Robbins, 2007, pg. 340). The walls of the vessels can be separated into three layers. The innermost layer, or tunica intima is made up of a single layer of endothelial cells overlying extracellular matrix (Robbins, 2007, pg.340) The next layer, or tunica media is separated from the tunica intima by the internal elastic lamina; the tunica media is mainly composed of SMC’s and ...

Introduction

In this paper, the pathopyiology of syncope is discussed with emphasis on Mr. Peter’s medical history and factors that could have contributed to his syncope. Further, the paper discusses the colonoscopy and its findings, his right hemi colectomy and the complications arising from his fall.

Pathopysiology of Syncope

Syncope is the transient loss of memory that occurs when cerebral blood flow falls to below half the normal value resulting in a brief period of inadequate oxygen, glucose and other nutrients supply to the brain tissues (Hainsworth, 2004). Syncope occurs rapidly, lasts for a short duration and the patient almost always recovers spontaneously. Syncope ...

Myocardial infarction is a term that is used in the clinical setting in reference to the necrosis of a section of the myocardium which occurs as a result of the interruption of the supply of blood to the heart. This often takes place as a result of the occlusion of the coronary artery. From a pathological point of view, myocardial infarction is myocardial infarction refers to the death of the myocardial cells as a result of prolonged ischemia. It may the result of chronic heart disease or as the onset of coronary heart disease. The prolonged ischemia which triggers the death of myocardial cells ...

Diagnostic tests and complementary/alternative medicines for coronary artery disease

The diagnosis of CAD is based on the presenting manifestations, medical history, and a battery of tests. These tests are usually conducted in a systematic manner beginning with the least expensive and non-invasive ones to the more expensive and invasive ones. If the findings of one level of tests are inconclusive or abnormal, the tests in the next level of diagnostic tests are conducted. The tests utilized in the diagnosis of coronary artery disease include blood tests, stress testing, non-invasive and invasive imaging techniques. Non-invasive imaging techniques include electrocardiography, echocardiography, nuclear imaging, positron emission tomography, electronic beam computed tomography, and magnetic ...

Literature Review

Physicians always encounter innumerable number of patients with chest pains every day. The cause of these chest pains cannot always be pinpointed to a single health factor. However, veritably a good percentage of these chest pain cases are traced to a wide range of heart diseases. Acute Coronary Syndrome is one such heart disease that has been found to be a possible causation of the chest pains that are incessantly encountered by physicians. Commonly abbreviated as ACS, Acute Coronary Syndrome results in the blockage of some parts or the heart’s entire coronary arteries.

Definition

Acute Coronary Syndrome (ACS) is a cardiac condition with an ...

Congestive heart failure

Congestive heart failure is by caused by amongst other reasons heart failure occurring due to either or both systolic and diastolic ventricular dysfunction. The use of the term “congestive heart failure” is used to imply that the patient in question is having some form of fluid overload. Congestive heart failure is a major cause of morbidity and mortality accounting for a significant proportion of hospitalizations. Of further note is that its incidence increases with advancing age (Tansley, 2010, p.1396). Although the presenting signs and symptoms of CHF have remained the same over time, great advances have been made in terms of ...