Tags: dyspareunia, diagnosis and treatment
21 October 2011
Dyspareunia is persistent or recurrent pain with attempted or complete vaginal entry and/or penile vaginal intercourse.

Fact#1: Dyspareunia is persistent or recurrent pain with attempted or complete vaginal entry and/or penile vaginal intercourse.

Fact#2: The female postmenopausal population is particularly susceptible to dyspareunia because of vaginal hypoestrogenism.

Fact#3: In the National Health and Social Life Survey of 1,749 women, 43% of women surveyed experienced sexual dysfunction, which included the diagnosis of dyspareunia.

Fact#4: A study evaluating the chief complaint of women presenting to a specialty vulvovaginal clinic revealed that 70% (228/330) reported dyspareunia.

Tags: achalasia, chalasia cardiae
16 October 2011
Cardiospasm affects young adults in their 20s and 30s. Main symptoms are: dysphagia for solid foods and liquids, regurgitation, chest discomfort/pain, weight loss

Cardiospasm (=achalasia, achalasia cardiae, esophageal achalasia and esophageal aperistalsis) - is esophageal motility disorder involving the smooth muscle of the esophagus and the lower esophageal sphincter (LES) and characterized by aperistalsis and failure to relax the smooth muscle fibers LES, thus causing functional obstruction of the esophagus.

Epidemiology: 1 to 2 per 200,000

Prevalence: Cardiospasm affects young adults in their 20s and 30s

Etiology: is unknown. However viral cause appears to have limited contribution. Antibodies to myenteric neurons are present in 50% of patients, which suggest an autoimmune process. Genetic predisposition also has been described, with certain HLA loci.

Antiphospholipid Syndrome (APS/Hughes syndrome) is an autoimmune, hypercoagulable state caused by antibodies against cell-membrane phospholipids. Up to 46% of stroke patients <50 years old have antiphospholipid antibodies Antiphospholipid Syndrome (APS/Hughes syndrome) is an autoimmune, hypercoagulable state caused by antibodies against cell-membrane phospholipids. The most common of these antibodies, lupus anticoagulant (LA) and anticardiolipin antibodies (aCL), are the basis of laboratory diagnosis. Primary Antiphospholipid Syndrome - thrombosis or multiple pregnancy loss with the laboratory findings of persistent paradoxical prolongation of activated partial thromboplastin time (aPTT) or high titers of aCL antibodies. Secondary Antiphospholipid Syndrome: associated with other autoimmune diseases, infection, drugs, and malignancy. Primary and secondary APS can result in venous or arterial thrombosis in virtually any location; lower extremity deep vein thrombosis (DVT) is the most common presentation. Thrombotic stroke/transient ischemic attack (TIA) is the leading arterial manifestation of APS. Up to 46% of stroke patients <50 years old have antiphospholipid antibodies.
Tags: acrocyanosis, microcirculation
09 October 2011
✓ Acrocyanosis is characterized by painless, symmetric, bluish discoloration and coolness most commonly affecting hands and feet

Acrocyanosis is characterized by painless, symmetric, bluish discoloration and coolness most commonly affecting hands and feet. The condition is exacerbated by cold exposure; however, some degree of cyanosis is often present continuously. Other areas affected are:

✓ nose

✓ ears

✓ lips

✓ nipples.

Schimmelbusch mask, covered with several beds of gauze is applied at the face of the patient, then high-volatility anaesthetic is dripped on it (as a rule - aether or halothanum) Here is only short description of mask anaesthesia by dripping volatile anesthetics as nowadays it is still applied only in developing countries. Special schimmelbusch mask, covered with several beds of gauze is applied at the patient's face. Then high-volatility anaesthetic is dripped on it (as a rule - aether or halothanum). During an inspiration air transits through a gauze and, having sated with anaesthetic pairs, arrives in respiratory airways. Transpiration of an anaesthetic decreases mask temperature that leads to condensation of moisture. This also decreases the pressure of a saturated anaesthetic gas (saturation pressure is directly proportional to temperature).
First reason is breathing by a atmospheric gas mixture with the low percent of oxygen. Concentration of oxygen in an inhaled mixture less than 17% (for an unexercised organism) leads to clinical demonstration of Acute Respiratory FailureFirst reason is breathing by a atmospheric gas mixture with the low percent of oxygen. Concentration of oxygen in an inhaled mixture <17% (for an unexercised organism) leads to clinical demonstration of Acute Respiratory Failure. A typical example is lifting on the big heights (> 3 km) without pre-award acclimatisation and additional oxygen supply
Perfusive form of Acute Respiratory Failure is connected with some blood flow restriction in the branches of pulmonary artery and increasing of physiological dead space

Perfusive form of Acute Respiratory Failure is connected with some blood flow restriction in the branches of pulmonary artery and increasing of physiological dead space. Main causes of Perfusive Acute Respiratory Failure are:

  • thromboembolism of a pulmonary artery
  • significant hypovolemia (blood loss, dehydration).
Tags: restrictive, respiratory failure
02 September 2011
Etiological causes of Restrictive Acute Respiratory Failure are: polysegmental pneumonia, fibrous processes, non-obturative atelectasis, cardiogenic hypostasis, 
some life-threatening complication of pregnancy

Restrictive form of Acute Respiratory Failure is connected with heavy and acute violation of a pulmonary tissue compliance, atelectasis, blockage of alveocapillary membranes. Etiological causes of Restrictive Acute Respiratory Failure are following:

  • polysegmental pneumonia, fibrous processes at lungs, non-obturative atelectasis
  • respiratory distress-syndrome of adults, Mendelson's syndrome
  • cardiogenic and non-cardiogenic lungs hypostasis
  • some life-threatening complication of pregnancy (pre-eclampsia, eclampsia, etc.)
Tags: obstructive, respiratory failure
01 September 2011
Obstructive form of Acute Respiratory Failure is connected with sharp violation of passableness of respiratory airways. Various causes can lead to obstruction of the upper or lower airways

Obstructive form of Acute Respiratory Failure is connected with sharp violation of passableness of respiratory airways. It is one of most often frequent and at the same time one of the most dangerous kind of Acute Respiratory Failure. Various causes can lead to obstruction of the upper or lower airways. No matter what's the cause of obstructive pathology, the resistance of respiratory airways increases dramatically (according to Poiseuille's law).

Tags: respiratory, failure
31 August 2011
Neuromuscular Acute Respiratory Failure is caused by violation of nervous impulse transfer from a respiratory center to respiratory muscles or by the proper pathology of respiratory muscles

The Pathology of impulse conduction by neurotransmitter system arises at traumas and spinal cord diseases (especially cervical vertebrae) and abducent nerves:

  • traumatic intersection
  • tumours
  • ischemic problems
  • inflammation of the bacterial or virus origin
  • amyotrophic lateral sclerosis
  • traumas
  • demyelination
  • poliomyelitis
  • polyneuropathy (Guillain-Barré Syndrome).