Asploro Journal of Biomedical and Clinical Case Reports
EISSN : 25820370
Current Publisher: Asploro Open Access Publications (10.36502)
Total articles ≅ 57
Latest articles in this journal
Published: 22 May 2020
Asploro Journal of Biomedical and Clinical Case Reports; doi:10.36502/asjbccr
Published: 12 May 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 116-117; doi:10.36502/2020/asjbccr.6197
An 88-year-old male presented for a routine transthoracic echocardiogram. Dilated coronary sinus was noted, raising the suspicion for persistent left superior venous cava (PLSVC). An agitated saline study from the left upper extremity demonstrated a flow through the coronary sinus into the right ventricle in a parasternal long-axis view. A venogram from the right internal jugular vein showed the PLSVC drained into a much dilated coronary sinus (CS) that connected to the right atrium. The right superior vena cava was absent. PLSVC along with absent right superior vena cava is rare and the inadvertent CS cannulation may result in vessel perforation.
Published: 8 April 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 90-98; doi:10.36502/2020/asjbccr.6192
Introduction and Objective: Evidence demonstrates that there are many errors and misconceptions on fluid therapy. Starling’s law underlies it all. This report gives the complete evidence that Starling’s law is wrong on both forces and the correct replacement is hydrodynamic of the G tube. New physiological evidence is provided with clinical relevance and significance. Material and Methods: The physics proof is based on G tube hydrodynamic. The physiological proof is based on a study of the hind limb of sheep: running plasma and later saline through the artery compared to that through the vein as regards the formation of oedema. The clinical significance is based on 2 studies one prospective and a 23 case series on volumetric overload shocks (VOS). The recent clinical studies on albumin and hydroxyethyl starch versus saline and also that on plasma proteins partly affirm that Starling’s law is wrong. My physics and physiological research completes this evidence. Results: Hydrodynamics of G tube showed that proximal, akin to arterial, pressure induces suction “absorption”, not “filtration”. In Poiseuille’s tube side pressure is all positive causing filtration based on which Starling proposed his hypothesis. The physiological evidence proves that the capillary works as G tube not Poiseuille’s tube: Oedema occurred when fluids are run through the vein but not through the artery. There was no difference using saline or plasma proteins, neither in physiological nor in clinical studies. The wrong Starling’s law dictates the faulty rules on fluid therapy misleading physicians into giving too much fluid during shock resuscitation and surgery inducing VOS and ARDS. Conclusion: Hydrodynamic of the G tube challenges the role attributed to arterial pressure as filtration force in Starling’s law. A literature review shows that oncotic pressure does not work either. The new hydrodynamic of G tube is proposed to replace Starling’s law which is wrong on both forces. The physiological proof and relevance to clinical importance on the pathogenesis of clinical syndromes are discussed.
Published: 6 April 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 87-89; doi:10.36502/2020/asjbccr.6191
Some years ago – let’s say, for sure, some decades ago – a “good physician” was considered the one who would request a few laboratory tests to some patient and they would come out all altered. – Yes – one would say – he got it right to the point, disease concerning. However, in the 21st century, when we have moved the focus of preventive care from prevention of diseases to health maintenance, we believe that the “good physician” may be considered the one that aims at keeping all the test results basically normal. Actually, more than that: optimal. In fact, keeping the eyes on optimal test results is a major goal for Age Management practitioners. For that, even if we still have the established reference ranges, we’ve got to have our own interpretation of the tests we are used to from a different, more detailed standpoint than in the general practice. Some normal results must be seen as subnormal, which are, indeed, still different from abnormal. Some results may also be considered critical – that is, those ones which demand some urgent and immediate action.
Published: 14 March 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 75-86; doi:10.36502/2020/asjbccr.6190
Objective: Evaluating the association between gestational diabetes and fetal/maternal complications such as poor obstetric outcomes. Methods: Historical cohort comprising patients from the High-Risk Service of Federal University of Juiz de Fora (UFJF,) who were diagnosed with diabetes (exposed), as well as patients from the Low-Risk Service of UFJF (non-exposed). Data generated through anamnesis, physical examination and medical conduct, as well as data of newborns such as fetal weight, ICU admission and fetal/neonatal death), were collected and stored in the Epi Info software (version 6.0); p < 0.05. Results: 176 patients treated in the aforementioned services, 108 diabetic, and 68 non-diabetics, were investigated in the current study. In total, 92 (52.2%) of them were diagnosed with Gestational Diabetes Mellitus (GDM); 6 had DM type 1 (3.4%) and 10 had DM type 2 (5.6%). Therefore, 68 patients (38.6%) presented normal glucose metabolism. The mean age of the patients was 30.27 ± 6.77 years, the mean number of births was 1.06 ± 1.20. Macrosomia was diagnosed in 6.81% (n = 6) of the cases; it was associated with maternal glycemia (p < 0.05). D- and F-class pregnant women, who had been previously diagnosed with diabetes, presented lower fetal weight than other pregnant women (p = 0.03). Treatment was based on diet, insulin or metformin, whenever necessary. Fasting glycemia levels decreased throughout the gestational trimesters. Eighteen (10.2%) preterm fetuses were identified; 12 were born from diabetic mothers and 6 were born from non-diabetic ones (p = 0.01; X2 = 10.51). All infants hospitalized in the neonatal ICU (n = 10) were born from diabetic mothers; their mean gestational age was 36.28 + 2.9 weeks, whereas the mean gestational age of infants who were not hospitalized in the ICU was 38.31 ± 1.5 (p = 0.005; T = 12.58). Cesarean section was the most common way of delivery adopted for diabetic pregnant women (p = 0.04). Conclusion: Based on the results, gestational diabetes (GDM) is a predisposing factor to fetal macrosomia, prematurity, and hospitalization in neonatal ICUs. Pregnant women subjected to proper glycemic control in the current study presented lower complication rates in comparison to other studies in the literature.
Published: 2 March 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 71-74; doi:10.36502/2020/asjbccr.6189
Upper urinary tract abnormalities are relatively common and may be diagnosed before or at birth. Some cases will be seen during complications that most often are obstructive. We herein report one case of complete right ureter duplication revealed by sepsis. The case involved one little girl aged 3 years, referred from a peripheral health center for prolonged fever. Physical examination found out a right flank mass connecting with the lumbar spine, renal ballottement, and pain due to a blow to the right flank. Further explorations helped establish the diagnosis of complete duplication of the right ureter with the destruction of the upper renal pelvis. Little girl benefitted from a dual antibiotic therapy combined with partial nephrectomy of the right kidney upper pole. Infectious are serious complications in upper urinary tract obstructions resulting in kidney destruction; therefore, early diagnosis is required.
Published: 27 February 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 62-66; doi:10.36502/2020/asjbccr.6187
Pentalogy of Fallot is a congenital cardiac defect comprising infundibular stenosis of the pulmonary artery, overriding aorta, ventricular septal defect, right ventricular hypertrophy and atrial septal defect. It is one of the most common cyanotic congenital heart defects with detrimental consequences if left untreated. We present the case of a 25-year-old female artisan and stroke survivor who was admitted with episodes of recurrent dizziness. She was diagnosed with the pentalogy of Fallot after echocardiography and awaiting cardiac repair surgery.
Published: 27 February 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 67-70; doi:10.36502/2020/asjbccr.6188
The QT interval represents the duration of ventricular depolarization and repolarization. It is measured from the beginning of the QRS complex to the end of the T wave. Prolongation of the QT interval may be congenital or acquired. This increases the risk of polymorphic ventricular tachycardia (i.e torsades de pointes) and cardiac arrest. To increase the awareness of this life-threatening phenomenon I outline an illustrative case in which acquired prolongation of the QT interval due to electrolyte derangement and administration of ciprofloxacin resulted in cardiac arrest due to torsade de pointes. Management of a patient with a long QT syndrome includes Immediate cessation of drugs that prolong the QT interval; cardiac monitoring, serial 12 lead ECGs and transthoracic echocardiography; measurement of serum electrolytes; intravenous potassium replacement; intravenous magnesium replacement; beta-blockade. Causes of acquired prolongation of the QT interval are common in critically ill patients. It is important to recognize this and consider screening with 12 lead ECG to reduce the risk of life-threatening ventricular arrhythmias.
Published: 21 February 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 51-61; doi:10.36502/2020/asjbccr.6186
Objective: The present study aimed to evaluate the vitamin D blood dosage during the three gestational trimesters, while identifying the frequency of pregnant women in the normal range, the variance in the three periods and evaluate the association between vitamin D and the obstetric complications such as preeclampsia, diabetes, and weight of the newborn. Methods: This is a longitudinal study with pregnant and non-pregnant women, from which there was collected data of anamneses, physical exam, obstetric info, as well as milk consumption habits, sunscreen and sun exposure, and also the vitamin D blood dosage. Results: There were 91 Pregnant Women studied, from whom the comparison between the vitamin D dosages identified the absence of gestation as a protective factor for VDD; the tendency for lower levels of supplementations when the workplace is in an external environment; the association between vitamin D and pre-eclampsia in the first trimester. Conclusion: The most relevant consequences from VDD were pre-eclampsia in the first trimester, the absence of gestation as a protective factor for VDD, and the need to consider the workplace before supplementation.
Published: 6 February 2020
Asploro Journal of Biomedical and Clinical Case Reports, Volume 3, pp 42-43; doi:10.36502/2020/asjbccr.6184
All organisms have a minimal level of functional reserve required to sustain life that eventually declines to a point incompatible with survival at death. AHE seeks to maintain or restore the optimal functional reserve of critical tissues and organs. Tissue reserve correlates with well being. Diet, physical exercise, and currently available small molecule based therapeutics may attenuate the rate of decline of specific organs or organ systems, but are unlikely to restore lost reserve. Inherent evolutionary-derived limitations in tissue homeostasis and cell maintenance necessitate the development of therapies to enhance regenerative processes and possibly replace whole organs or tissues. AHE supports the study of the cell, tissue, and organ homeostatic mechanisms to derive new regenerative and tissue replacement therapies to extend the period of human health.