Journal of Internal Medicine Research & Reports
Journal of Internal Medicine Research & Reports is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Internal Medicine Research & Reports. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of Research, Review, Case Reports, Analysis, Magazines, Editorials, Opinion, Communications, Mini-Review, Short Communications, Picturized, Book Review, Video Type and Power Point Presentations (PPTS). Articles can be submitted through online from https://srcpublishers.com/internal-medicine-research-repor/user/register or can send through an e-mail with attachment for internalmedicine@onlinescientificresearch.info 0.5* Impact Factor 84.5% Citations 90% Acceptance
Hand Hygiene Auditing Utilizing the MEG Tool: A Pathway to Enhance Compliance and Perspective from IPAC Auditors
Hand hygiene is a fundamental practice in preventing healthcare-associated infections (HAIs). This study evaluates the effectiveness of the MEG Tool in improving hand hygiene compliance among nurses and explores the perceptions of Infection Prevention and Control (IPAC) auditors. A prospective observational study was conducted at Royale Hayat Hospital, Kuwait, analyzing 3,000 observations across multiple departments. The MEG Tool, a mobile-based auditing system, was used to assess compliance with the five moments of hand hygiene. Results demonstrated a significant improvement in compliance from 74% to 91.1%. IPAC auditors reported highly positive attitudes regarding usability, efficiency, and accuracy. The study highlights the importance of digital auditing tools in enhancing infection control practices and improving patient safety outcomes.
Copyright (c) 2026 Journal of Internal Medicine Research & Reports
Technical Design Study of a Mobile Portable (Movable), Home-Type (Domestical) Hemodialysis Machine Working as an Artificial Kidney
Dr. Emin Taner Elmas, Assistant Professor, has a significant project and academic work focusing on the design of portable and domestic hemodialysis machines working as an artificial kidney. This work stands out as an engineering vision aimed at improving the quality of life for dialysis patients. The details of the study and the advantages it offers to patients are as follows: • Freedom of Travel and Residence: The main purpose of the designed portable device is to free patients from dependence on hospitals or dialysis centers, granting them freedom of travel. • Home Treatment Option: The project aims to enable patients to receive treatment in their own homes (residences), saving them time traveling to and from the hospital and preventing fatigue that may occur during travel. • Reducing Infection Risk: By avoiding the crowded hospital environment, it aims to minimize the risk of infection for patients whose body resistance is weakened after treatment. • Engineering-Based Approach: Dr. Elmas, a mechanical engineer, plans to design this device using the principles of fluid mechanics, thermodynamics, and energy efficiency, aiming for it to be both lightweight and functional. Dr. Elmas’s project is currently in the project phase and is an academic proposal that aims to transform dialysis from a medical necessity into a technology that can be integrated into the patient’s daily life. Dr. Emin Taner Elmas’s academic expertise in thermodynamics, fluid mechanics, and heat/mass transfer provides critical engineering foundations for the development of dialysis technology. We can delve deeper into the details of his work that could benefit the field of dialysis under the following headings: Dialyzer (Artificial Kidney) Efficiency and Mass Transfer The dialysis process is based on the principle of removing waste products such as urea and creatinine from the blood through a semi-permeable membrane. • Diffusion and Convection Modeling: Elmas’s work on heat and mass transfer can be used to optimize the rate at which these substances pass from the blood to the dialysate fluid. This can shorten the patient’s time connected to the machine. • Membrane Technology: By improving the surface area and flow path design within the dialyzer using thermodynamic principles, maximum cleaning can be achieved with minimum fluid usage. Hemodynamics and Flow Safety Fluid mechanics is vital in the process of removing and returning blood to the body during dialysis. • Turbulence and Clotting Control: Dr. Elmas’s expertise in fluid mechanics forms the basis for designs that ensure blood flows smoothly (laminar flow) through the tubes and filter within the device without turbulence. This reduces the risk of damage to blood cells (hemolysis) and clotting. • Pump Optimization: Engineering algorithms play a critical role in adjusting the pressure balance of blood pumps in dialysis machines. Bio-Robotic Resonance and Smart Drug Algorithms Dr. Elmas’s “Bio-robotic Resonance and Thermodynamical Interaction” theory, presented in 2021, could bring a new perspective to dialysis processes: • Dosage Control: The focus could be on adjusting anticoagulants (blood thinners) or other medications administered to patients during dialysis using a robotic system based on the patient’s real-time body data (frequency and resonance values). • Personalized Treatment: Dynamic systems that determine filtration rates according to each patient’s needs can be developed using intelligent algorithms that monitor the body’s thermodynamic balance. Energy and Cost Efficiency • Energy Recovery: Dr. Elmas’s energy efficiency methods developed for industrial facilities can be adapted to reduce the operating costs of dialysis units that consume high energy and water. • Portable Systems: Thermodynamic and energy transfer optimization guides the design of lightweight and low-power components necessary for future “portable or wearable dialysis devices”.
Vertebral Artery Asymmetry: Frequency, Degree, and Clinical Significance
Background: Vertebral Artery (VA) asymmetry is a common anatomical variant associated with altered hemodynamics and increased risk of posterior circulation ischemia. Despite its clinical relevance, population-specific data on VA asymmetry remain limited, particularly in Eastern European cohorts. Objective: To assess the frequency and degree of VA asymmetry using Magnetic Resonance Imaging (MRI) and to evaluate its potential clinical significance in a hospital-based patient population. Materials and Methods: Fifty patients (22 men, 28 women; mean age 52.3±14.1 years) who underwent cranial and cervical MRI at the Grodno Regional Emergency Hospital were retrospectively enrolled. VA diameters were measured bilaterally at the C5-C6 level. Asymmetry was defined as an Asymmetry Index (AI) exceeding 25%. Hypoplasia was defined as a diameter below 2.0 mm. Statistical analysis was performed using the Mann-Whitney U test and chi-square test. Results: The mean right VA diameter was 3.42±0.61 mm and the mean left VA diameter was 3.18±0.58 mm (p=0.043). Significant asymmetry (AI>25%) was detected in 14 patients (28.0%). Right-sided dominance was observed in 31 patients (62.0%), left-sided dominance in 12 (24.0%), and codominance in 7 (14.0%). VA hypoplasia was identified in 10 patients (20.0%). Patients with VA hypoplasia reported a significantly higher prevalence of vestibular symptoms and headache (p<0.05). Conclusion: VA asymmetry and hypoplasia are common findings on routine MRI. These variants should be considered in clinical practice when evaluating patients with posterior circulation symptoms. Population-based morphometric data can contribute to improved radiological interpretation and neurosurgical planning.
Can Chitin Became Yaluronic Acid Acting as Vehicle and Active Ingredient?
The probable synthesis of Hyaluronic acid made by Chitin saccharide units is explained and reported together with the use of the Chitin polymer to make a novel tissue-vehicle (tissue-carrier) used to realize innovative cosme- utraceuticalsThese novel products have been characterized for their effectiveness and safety,as reported from some examples.
The Relationship Between Celiac Disease and Kidney Disease: Immunological, Endothelial and Pathophysiological Mechanisms With Clinical Implications
Celiac disease is a systemic autoimmune disorder with growing recognition of extraintestinal involvement, including endothelial dysfunction and renal disease. Recent studies highlight a gut-vascular-renal axis driven by immune activation, oxidative stress, and cytokine signaling. This review integrates epidemiological, immunological, endothelial, and renal mechanisms, with emphasis on immunoglobulin A nephropathy and chronic kidney disease.
Sexual Dimorphism of Morphometric Parameters of the Vertebral Artery: A Retrospective CT Angiographic Study
Background and Objectives: Despite the well-documented clinical significance of the Vertebral Artery (VA) in posterior cerebral circulation, standardised normative data stratified by biological sex remain scarce. The aim of this study was to compare morphometric parameters of the extracranial VA between males and females using Multidetector Computed Tomography Angiography (MDCTA). Materials and Methods: A retrospective analysis of 120 consecutive MDCTA examinations performed between January 2025 and March 2026 was conducted. Sixty males and 60 females, aged 25-75 years, were included. VA diameters were measured at three standardised levels: V1 (origin), V2 (C4 vertebra), and V3 (suboccipital segment). Dominance pattern, asymmetry index, and the prevalence of VA hypoplasia (diameter <2.0 mm) were assessed. Statistical comparisons used the independentsamples t-test and chi-square test. Results: Males consistently exhibited larger VA diameters than females at all measured levels (p<0.001). The mean right V1 diameter was 4.12±0.68 mm in males versus 3.58±0.61 mm in females. Left VA dominance was predominant in both sexes (56.7% overall). VA hypoplasia was identified in 14 subjects (11.7%), with a higher frequency in females (16.7%) than in males (6.7%), although the difference did not reach statistical significance (p=0.087). Right-sided hypoplasia accounted for 71.4% of all cases. Conclusions: Significant sexual dimorphism exists in VA diameter across all extracranial segments. These findings underscore the necessity of sex-stratified reference values in clinical imaging interpretation and preoperative planning for cervical and posterior cranial interventions.
Cognitive Decline in an Elderly Patient with a History of Pernicious Anemia: an Unexpected Finding
An 82-year-old woman presented with a two-week history of progressive cognitive decline. Her past medical history included wellcontrolled hypertension and pernicious anemia diagnosed six months earlier, confirmed by positive anti-parietal cell antibodies and treated with cyanocobalamin, currently on monthly maintenance. She reported generalized weakness, slowed thinking, memory loss, and language difficulties characterized by word-finding pauses and slow speech. She denied headache, urinary incontinence, and paresthesias.
Could Pre-and Post-Op Stem Cell Revitalization Cuisine Bring New Excellence to Spinal Surgery?
Surgeons and clinicians are humbly asked to begin reviewing the known obstacles created by processed food, which block restorative treatment outcomes and successes. Processed food, Maillard reaction product-induced illnesses are itemized by medical specialty within the free public health service reference lists in The Unseen Treasure of Healthcare Discoveries posted on LinkedIn. It is time for healers to put aside their geopolitical differences and restore quality of care and more brisk revenue flow within their medical specialties, ending the hopeless waiting for responsible governments to be established and replace self-serving officials who are careless regarding global public health. The following is a basic sketch of how each specialist, a large group of specialists, or a newly formed all-specialty association can legally proceed to accelerate regional and global public health, along with significant boosts in their practice’s daily collections, including weekends and holidays.
Textiles in internal medicine refer to a specialized branch of technical textiles (meditech) designed for hygiene, wound care, infection control, and, increasingly, for advanced, implantable, or smart, therapeutic applications. These materials are designed to be biocompatible, non-toxic, and often antimicrobial to improve patient comfort and facilitate recovery.
IgG4-Related Disease: Fibrofire to B-Cell Breakthroughs
IgG4-related disease (IgG4-RD) is a systemic immune-mediated disorder that may involve multiple organs and typically presents with inflammatory tissue enlargement and variable fibrotic changes. Since its recognition in the early 2000s, IgG4-RD has been increasingly recognized as a systemic condition encompassing a wide range of clinical manifestations. The latter often mimicking malignancy, infection or other autoimmune diseases contribute to persistent underdiagnosis and delayed treatment. Yet, early recognition is crucial, as timely immunosuppressive therapy can induce remission and prevent irreversible fibrotic sequelae. This narrative review synthesizes current knowledge on the epidemiology, immunopathogenesis, clinical spectrum, diagnostic criteria, differential diagnoses and therapeutic strategies of IgG4-RD, with particular emphasis on evolving targeted therapies that are reshaping disease management and prognosis.
The kidney plays a central role in lipoprotein(a) catabolism, acting as a “cemetery for lipoprotein(a)” through uptake, fragmentation, and excretion. Direct human evidence comes from Kronenberg et al., who found significant arteriovenous differences in lipoprotein(a) levels between the aorta and renal vein, demonstrating active renal uptake. Clinical evidence from renal replacement therapy further supports this role: lipoprotein(a) levels decrease rapidly after kidney transplantation but remain unchanged with hemodialysis, indicating that functioning renal tissue, not filtration, drives lipoprotein(a) metabolism. Animal studies by Reblin et al. provided mechanistic insights, showing rapid clearance of injected human lipoprotein(a) in rats, with apolipoprotein(a) localized in proximal tubular cells and fragments detected in urine. This supports the idea that the kidney fragments lipoprotein(a) before excretion. Kostner & Kostner proposed a model where circulating lipoprotein(a) undergoes proteolytic cleavage in the kidney, producing apolipoprotein(a) fragments that may themselves be biologically active and contribute to lipoprotein(a)’s atherogenicity. Clinical observations confirm that chronic kidney disease alters lipoprotein(a) metabolism. Patients with proteinuria or amyloidosis show elevated lipoprotein(a), often correlating with urinary albumin excretion, highlighting the kidney’s regulatory role. The mechanism of elevation varies by disease: in proteinuria and peritoneal dialysis, hepatic synthesis is upregulated, while in hemodialysis, impaired catabolism predominates. These abnormalities likely amplify the already high cardiovascular risk in chronic kidney disease, particularly in individuals with genetically determined small apolipoprotein(a) isoforms. Despite advances, the precise site and mechanisms of lipoprotein(a) clearance remain unclear. However, the consensus is that reduced clearance, not increased production, drives lipoprotein(a) accumulation in kidney disease. Understanding renal processing of lipoprotein(a) may provide therapeutic opportunities, with future strategies aiming to inhibit lipoprotein(a) assembly or enhance apolipoprotein(a) fragmentation to mitigate cardiovascular risk.
Copyright (c) 2025 Journal of Internal Medicine Research & Reports
The Circle of Willis as a Functional Unit: Myth or Reality
Background: The Circle of Willis (COW) has historically been regarded as a crucial collateral pathway ensuring cerebral perfusion during arterial obstruction. However, its true role as a functional unit remains debated, given the frequent anatomical variations and inconsistent clinical protection against ischemic events. Methods: This review integrates historical accounts, anatomical and morphological studies, hemodynamic analyses, computational modeling, and clinical observations. Evidence was synthesized to evaluate the structural variability of the COW, its hemodynamic behavior, and its clinical relevance in cerebrovascular disease. Results: Anatomical investigations show that a complete and symmetric COW is relatively rare, with hypoplasia and absence of key segments being common. Hemodynamic studies and computational simulations demonstrate that collateral efficiency depends on vessel diameter, branching geometry, pressure gradients, and vascular compliance, rather than anatomical presence alone. Clinical findings reveal paradoxes: patients with a morphologically intact COW may still experience severe ischemia, whereas incomplete variants may maintain adequate perfusion through alternative collateral routes. Conclusion: The COW should be viewed as a conditional, context-dependent reserve system rather than a continuously active circulatory safeguard. Its collateral role emerges predominantly under pathological stress and is constrained by individual vascular geometry and hemodynamic conditions. Advances in imaging and patient-specific computational modeling hold promise for bridging the gap between morphology and functional competence, with potential to improve risk stratification and therapeutic decision-making in cerebrovascular care.
Risk Factors Associated with Sudden Unexpected Death in Epilepsy (Sudep): A Systematic Literature Review
Introduction: Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality in patients with epilepsy, particularly those with refractory forms. Mechanisms involve cardiovascular autonomic dysfunction linked to generalized tonic–clonic seizures (GTCS). Despite the identification of multiple risk factors, methodological inconsistencies hinder generalization and development of effective preventive strategies. Objectives: This review aims to identify and synthesize current evidence on risk factors associated with SUDEP, clarify discrepancies, detect knowledge gaps, and propose foundations for preventive clinical measures. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. We included observational studies and clinical trials published in English or Spanish, retrieved from PubMed, Embase, and The Cochrane Library. Methodological quality was assessed using validated tools. Out of 348 records, 26 studies met the inclusion criteria. Results: Recent GTCS episodes were strongly associated with higher SUDEP risk (OR = 26.81; 95% CI: 14.86–48.38). High seizure frequency and lack of night supervision increased the risk even further (OR = 67.10; 95% CI: 29.66–151.88). Poor adherence to antiepileptic treatment also emerged as a significant risk factor (OR = 2.75; 95% CI: 1.58–4.78). Discussion: GTCS frequency and treatment adherence are critical in SUDEP risk. Implementing night monitoring and adherenceenhancing strategies may help reduce incidence. However, limitations such as heterogeneous SUDEP definitions and small sample sizes underline the need for robust, prospective research to refine prevention efforts.
Prevalence of Alcohol use Disorder among Healthcare Professionals in FMC Yenagoa
Introduction: Alcohol is a distinctive and profoundly habit-forming substance with numerous motives or reasons associated with its usage. Concerns about the growing prevalence of alcohol use disorder among medical professionals worldwide have heightened in recent years. Considering the enormous negative impact of AUD on the health of healthcare professionals and the critical role they play providing healthcare services to the public generally, it is therefore imperative to access the prevalence of alcohol use disorder among healthcare professionals in FMC Yenagoa. Methodology: This study involved 394 healthcare professionals and it was carried out using a descriptive cross-sectional survey among healthcare professionals in FMC Yenagoa to gather information about the prevalence of alcohol use disorder and the factors influencing alcohol use. The data obtained was analyzed using The Statistical Package for Social Sciences (IBM SPSS) version 25. Results: The findings showed that 152(40.0%) of the participants were males and 229(60.0%) were females. 240(63%) participants were between the ages of thirty and above and 229(60%) were married. 172(50%) of the respondents reported having an alcoholic beverage 2-4 times each month and 69(20%) reported having one or more times per week. The findings also showed 60% of the respondents did not face the risk of alcohol dependency, but 40% of them did. 30% of the respondents were at danger of alcohol misuse/abuse, whereas the majority of respondents (70%) were not. The study also revealed a 20% prevalence of Alcohol Use Disorder. Conclusion: This study assessed the prevalence of Alcohol Use Disorder (AUD) among healthcare professionals in Federal Medical Centre (FMC), Yenagoa. The study further reported that AUD was significantly associated with age of <30, male sex, being married, spending 4 or less hours at work, 0-10 years of experience in healthcare. This shows that there is need for an intervention.
Adverse Effects ARIA (ARIA-E and ARIA-H) in Aducanumab and Lecanemab According to APOE Genotype: Systematic Review of the Literature
Introduction: Alzheimer’s Disease (AD) is characterized by cerebral accumulation of β-amyloid (Aβ) plaques and tau tangles, leading to progressive cognitive decline. Monoclonal antibodies targeting Aβ, such as aducanumab and lecanemab, have demonstrated plaque reduction and slowed clinical deterioration by 25–40%, but their use is complicated by Amyloid‐Related Imaging Abnormalities (ARIA), Manifesting as Vasogenic Edema (ARIA-E) and microhemorrhages or siderosis (ARIA-H). Objective: To systematically review the incidence and characteristics of ARIA-E and ARIA-H in patients treated with aducanumab or lecanemab, stratified by APOE ε4 genotype. Methods: A systematic review of Randomized Clinical Trials (RCTs) was conducted. PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched through June 2025 for RCTs reporting ARIA adverse events by APOE genotype. Trials involving adult AD or mild cognitive impairment patients with documented APOE status and imaging‐assessed ARIA were included. Data extraction and Cochrane RoB 2.0 bias assessment were performed by two independent reviewers, with narrative synthesis of ARIA incidence and management strategies. Results: Four RCTs met inclusion criteria. In phase 3 CLARITY-AD (lecanemab), overall ARIA-E incidence was 13.6%; among APOE ε4/ε4 homozygotes it rose to 34.5% versus 6.9% in non-carriers (principal result), with most cases mild/moderate and resolving within 3–6 months. Symptomatic ARIA-E occurred in 3.3% and serious events in 1.1% of all treated patients. Discussion: APOE ε4 carriage, especially homozygosity, markedly elevates ARIA risk with anti-Aβ antibodies. Pre-treatment genotyping is recommended to tailor safety monitoring: ε4/ε4 individuals may benefit from slower dose titration, more frequent MRI surveillance during the first 6–12 months, and stricter criteria for treatment interruption. These strategies aim to optimize therapeutic benefit while minimizing ARIA-related harm.
Stroke Subtypes and Outcomes in Hypertensive Patients at the Rivers State University Teaching Hospital, Port Harcourt, Nigeria
Introduction: The global burden of stroke is increasing alarmingly, with hypertension reported as the most prevalent risk factor. The aim of this study was to assess stroke among patients with hypertension as well as the factors associated with 30 days mortality at the Rivers State University Teaching Hospital. Materials and Methods: This was a hospital-based descriptive cross-sectional study of adult hypertensive patients who received a clinical diagnosis of a stroke between January 2022 to December 2023. Sociodemographic, clinical and brain imaging data and were recorded, along with mortality at 30 days. Data was analysed by using SPSS version 25. Results: A total of 311 patients were admitted with a diagnosis of stroke of which, 249 (80.1%) were hypertensive. The mean age of the hypertensive stroke patients was 60.7±12.1years, 140(56.2%) were women and 226(90.8%) of these patients were aware of their hypertensive status. Brain imaging revealed that 194(77.9%) patients had an ischaemic stroke while 55(22.1) had a haemorrhagic event. At the end of 30 days, 62(24.9%) persons died and there was a significant relationship between increasing age and mortality (p=0.021), while the mean systolic blood pressure was significantly higher in the hypertensive patients that died (p=0.045). Conclusion: Hypertension is a major risk factor for stroke morbidity and mortality. Urgent measures are needed to improve on blood pressure control as these may potentially reduce stroke occurrence rates in hypertensive subjects.
Does Nutrition Cause Cancer? Is Newtrition Prevention and Treatment?
It is both outrageous and startling that the World’s collective consciousness regarding public health and epidemiology research in general and cancer has explicitly been held captive and, more frequently, willfully captivated by greedy geopolitical alignment.
Our Experience with the Eras Program in Children with Hirschsprung Disease
Background: The ERAS program has only recently been applied to children, with the main obstacle being the complexity of pediatric surgeries. Children have their own unique physiological response to surgery, including being more vulnerable to dehydration and hypothermia, having a lower tolerance for intraoperative blood loss, and an increased risk of anesthesia complications. However, the use of ERAS has been limited in the pediatric population due to a clear lack of evidence. We have used components of ERAS in our pediatric patients undergoing surgery for Hirschsprung disease. Purpose of the Study: To evaluate the safety and efficacy of accelerated surgery (ERAS) combined with laparoscopy in the treatment of Hirschsprung disease in children. Material and Methods of Research: The study was conducted on 76 children with Hirschsprung’s disease who underwent elective surgery with bowel pull-down in the period from 2011 to 2024 in the surgical clinic and in the bases of the AMU. The patients were divided into two groups: the ERAS program combined with laparoscopy (study group, n=38) and the laparoscopic surgery with conventional perioperative management (control group, n=38). Postoperative bowel function recovery, hospital stay, hospital costs, complications were compared, and postoperative recovery was monitored for four weeks. Research Results: There were no significant differences in intraoperative blood loss and operative time between the ERAS group and the control group (both P>0.05). Recovery of bowel movements occurred earlier in the ERAS group, but the difference was not statistically significant (P=0.062). Hospital stay was shorter [(5,77±0,8) days versus (14,2±2,8) days], and hospitalization costs were significantly lower in the study group than in the control group. Conclusions: • The ERAS protocol is applicable to pediatric Hirschsprung disease surgeries with shorter hospital stay and fewer complications, especially in the form of SSI. We recommend using the maximum number of components based on our experience to obtain optimal results. • Accelerated surgery combined with laparoscopy in the treatment of Hirschsprung’s disease in children is safe and effective.
Beer Potomania: A Literature Review of an Underrecognized Cause of Severe Hyponatremia
Beer potomania is a rare but significant cause of severe hyponatremia, often misdiagnosed as syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is characterized by excessive beer consumption and insufficient dietary solute intake, leading to impaired renal water excretion and dilutional hyponatremia. The pathophysiology involves reduced osmotic load, altered antidiuretic hormone (ADH) regulation, and compromised renal handling of free water. The clinical overlap with SIADH presents diagnostic challenges, necessitating a thorough dietary and biochemical evaluation. This review discusses the mechanisms, differential diagnosis, and management strategies for beer potomania, emphasizing the need for gradual sodium correction to prevent osmotic demyelination syndrome (ODS) and addressing underlying alcohol use disorder to reduce recurrence.
Hydrotherapy Interventions for Muscle Recovery in Athletes: A Narrative Review
Background: Hydrotherapy, leveraging water-based interventions, has garnered interest in sports medicine for its potential to enhance muscle recovery in athletes. This narrative review aims to synthesize current evidence regarding the effectiveness of various hydrotherapy interventions and their physiological underpinnings in promoting muscle recovery. Research Problem and Aim: Despite the growing body of literature, there remains a need for a consolidated understanding of how specific hydrotherapy modalities contribute to muscle recovery, including the mechanisms involved and practical applications for athletes. This review seeks to clarify these aspects. Methodology: A comprehensive literature search was conducted across electronic databases such as PubMed, Embase, and Cochrane Library, using keywords related to hydrotherapy and muscle recovery in athletes. Only articles published in English that focused on hydrotherapy interventions and their effects on muscle function, performance, and recovery perceptions were included. Results: The findings indicate that hydrotherapy interventions, including cold water immersion, contrast water therapy, ice massage, aquatic exercise, and cryotherapy, effectively reduce muscle edema, inflammation, and pain, leading to improved muscle function and performance. Specifically, cold water immersion and contrast water therapy show significant benefits in enhancing recovery measures, while localized interventions like ice massage target specific muscle groups. Implications: These results underscore the utility of hydrotherapy in athletic recovery protocols. Practitioners should tailor hydrotherapy interventions based on individual athlete needs, optimizing temperature, duration, and modality to maximize recovery outcomes while minimizing risks.
Pathophysiology, Risk Factors, and Advances in the Management of PepticUlcers: A Comprehensive Review
Peptic ulcers, characterized by mucosal erosion in the stomach or duodenum, continue to pose significant health challenges worldwide. This comprehensive review explores the pathophysiology of peptic ulcers, including the roles of Helicobacter pylori, acid secretion, and mucosal defense mechanisms. We examine key risk factors such as NSAID use, smoking, alcohol consumption, and genetic predisposition. Advances in diagnostic techniques, including endoscopy, biopsy, and non-invasive tests like urea breath tests and stool antigen tests, are discussed, alongside recent improvements in molecular diagnostics and imaging. The review also covers current management strategies, focusing on pharmacological treatments like proton pump inhibitors (PPIs) and H2 receptor antagonists, as well as surgical interventions for complicated cases. Emerging treatment modalities, such as novel drugs, probiotics, and minimally invasive surgical techniques, are highlighted. Additionally, the paper identifies future research directions, including the exploration of new therapeutic targets, enhanced diagnostic tools, and the impact of gut microbiota on ulcer formation. By integrating recent advancements and identifying gaps in current knowledge, this review aims to provide a comprehensive understanding of peptic ulcers and inform future research and clinical practice.
Copyright (c) 2024 Journal of Internal Medicine Research & Reports
A circadian rhythm of serum thyrotropin (TSH) has been demonstrated by measurements performed on the majority of blood from 6 healthy young adults, 3 males and 3 females. The serum TSH level decreased from 8 am to 2 pm. The difference between the morning and midday levels was very visible. There was no correlation between meals and TSH level variations. The circadian rhythm of serum TSH is not only of physiological interest but also has practical implications where collecting blood for TSH determination is best done at 11:00 a.m. when the TSH level has fallen to the daytime amount. The mechanism of decreasing TSH levels in the blood within 24 hours is still not fully studied.
Nephrotoxicity of Iodinated Contrast Drugs: A Comparative Analysis of Old Versus New, Ionic Versus Non Ionic Agents, Dose Effects, and the Impact of Relative Dehydration in Stroke Patients
Stroke is a type of cerebrovascular disease that impairs the functionality of the brain due to disturbance in the blood supply to the brain. There is approximately 1 stroke every 40 seconds, amounting to it being a leading cause of serious long-term disability [1]. It accounts for about 140,000 deaths annually with an incidence rate of 795,000 each year, necessitating need for prompt and accurate diagnosis and intervention. Stroke can either be hemorrhagic or ischemic in nature. Hemorrhagic stroke is when there is rupturing of blood vessels in the blood vessels in the brain and its majorly treated by reducing blood pressure in the brain or use of ‘pro-hemostasis’ medications. Ischemic stroke is when there is occlusion of the blood vessels supplying blood to the brain leading to shortage (hypoxemia) or no supply of blood supply (hypoxia) in the brain. It is majorly treated with thrombolytic medications that break down clots and must be administered early to prevent risk of dangerous bleeding or use of mechanical thrombectomy.
Skin Delivery and Innovative Carrier’s Effectiveness
The skin serves as the body first protecting barrier against the external attacks of chemicals and microorganisms. On the other hand, it is an obstacle to penetration and transdermal delivery of any substance applied on its surface. Thus, a need to report some news on the skin composition for a better understanding of the transdermal delivery mechanisms of topical products applied on its surface. Therefore, due to the actual increased use of topical drugs, cosmetics, and diet supplement treatments, further feasibility research studies have been carried out to extend the knowledge of the percutaneous absorption ‘rules and means. These studies are retained necessary to control the release through the skin layers of various selected active ingredients, loaded and carried out by different vehicles. The paper will focus on the effectiveness of innovative tissue carriers that, are able to deliver active ingredients throughout the skin layers, are made by a very low consumption of water, and are free of chemicals also. In conclusion, these novel eco-sustainable carriers, resulting skin- and environmentally friendly, might be used as innovative vehicles in substitution of the normal emulsions that, made by the use of preservatives, emulsifiers, fragrances, and other chemicals may often cause allergic and/or sensitization phenomena, consuming a great quantity of water also.
The Clinical Challenge of Distinguishing between Happy Heart and Broken Heart Syndromes
Takotsubo Cardiomyopathy (TC), or stress-induced cardiomyopathy, is an acquired cardiomyopathy which is famously attributed to tragic or stressful life events. Triggers for TC are notable to be physical or emotional, with surgery and death of a loved one as examples. More recently and considerably less common, TC has been recognized following joyous events, which has been referred to as the Happy Heart Syndrome (HHS). Here we describe a case of HHS in a 62-year-old female who presented to an emergency department with chest pain and shortness of breath precipitated by receiving good news about the recovery of her critically ill husband. Furthermore, we discuss the diagnostic challenges in identifying the trigger and categorization of this condition.
Possibilities of Skin Autofluorescence Reflecting the Characteristics of Diabetes Mellitus in Childhood
Objective: To measure skin autofluorescence in children and adolescents suffering from type 1 diabetes mellitus and evaluate its relationship with gender, age, experience and chronic complications of the disease. Materials and Methods: The study group included 47 children and adolescents with type 1 diabetes. Autofluorescence of the skin from the inner surface of the shoulder and nail of patients was measured using an original compact spectrofluorimeter based on the STS-VIS OCEAN OPTICS © USA microspectrometer with UVA excitation. Statistical analysis was carried out using StatsoftStatistica 12.0 software. The data is presented as a two-dimensional array. The UV LED signal was averaged and smoothed using the moving average method with a 10 nm window. Then the spectra were renormalized taking into account the found coefficients. The result of applying additional normalization is a decrease in the standard deviation. Results and Discussion: Significant differences were revealed in the skin fluorescence spectra of children of different ages. between age groups (5-7) and (8-12) is most significant in the region of the alpha band of oxyhemoglobin (540 nm) (p <0.005). When using I-normalization, the NADH peak region (p < 0.02) is significant with increasing disease duration. When studying the influence of gender factors on the level of skin autofluorescence, the most significant differences are found in the area of only the isosbestic points of deoxy and oxyhemoglobin 442 nm (p<10-7) and 491 nm (p<10-8). Significant differences in skin autofluorescence at the reference length were also obtained waves in the autofluorescence spectrum of 500 nm correspond to p<10-14, depending on the presence of complications. Conclusion: In Russia, as well as throughout the world, there is an increase in the incidence of type 1 diabetes mellitus. For early diagnosis of changes in carbohydrate metabolism and complications of the disease, a simple, accessible, non-invasive research method is needed. Taking into account the results of our study, when creating non-invasive methods for monitoring the state of carbohydrate metabolism, it is necessary to take into account gender and age characteristics, experience and the presence of complications of type 1 diabetes mellitus.
AI Applications in Pediatrics: Past, Present, and Future
In pediatric medicine, Artificial Intelligence (AI) currently remains as a novel area for research and development. Most AI applications created for adults are often complicated to fully transfer over to pediatrics due to several limiting factors. These factors include physiological differences, lack of data, and unknown implications. Nevertheless, applications in adult medicine have influenced extensive reviews for algorithms that show significant potential in pediatrics. As pediatric data gradually increases, several AI algorithms for adults can be fine-tuned to provide similar accuracies and sensitivities for diagnosing specific pediatric diseases. This chapter will discuss the pioneering applications of AI in medicine as well as current and arising applications or subspecialties. Areas of discussion encompass precision medicine, oncology, cardiology, radiology, chatbots, neurology, and ophthalmology. AI algorithms within these domains range from assistance with diagnoses, shorter waiting times, to continuous monitoring. Common benefits exhibited by many applications include increased accuracy, time and cost efficiency, patient compliance, and flexibility. For example, medical wearable technology and chatbots are two AI applications that can provide certain patient care in both outpatient and inpatient settings. These algorithms are convenient to use and offer continuous monitoring when a provider may not be readily available. Furthermore, other topics explored in this chapter relate to common concerns for using AI in pediatric medicine and education for health professionals, parents, and children. Most apprehension pertains to the misuse of data and quality of care. Reviewing these concerns is crucial for AI to exponentially flourish in medicine. Without established comprehension, hesitance and distrust may prevail over the promising potential AI can offer. Education and training can help alleviate these common misunderstandings by explaining how AI can affect both medicine and health care. Moreover, learning environments can allow health professionals, parents, and children to openly communicate their concerns that could guide ethical frameworks for developing AI applications. Analyzing these past, present, future applications, and related concerns can help demonstrate how AI will transform pediatric medicine.
The Association between Urinary Alcohol Metabolites on Hepatitis C Treatment and Response
Background: Direct-acting antiviral (DAA) medications for the treatment of chronic hepatitis C virus (HCV) infection has achieved higher rates of sustained virologic response (SVR) with shorter treatment durations and no alcohol abstinence prerequisite. Previous therapies required alcohol abstinence for at least 6 months. Methods: Our retrospective cohort study in Veterans with chronic HCV infection presenting for care at the Joseph Maxwell Cleland Atlanta VA medical center (AVAMC) between 1/1/2015 – 11/29/2017 examined the relationship between alcohol use, DAA initiation, and SVR. Results: The cohort included 1763 people that were mostly males (97%) with a mean age of 63 years and 70% Black. In multivariate analysis, the odds of receiving DAA were 0.7 (95% CI: 0.674, 0.9; p=0.0013) in those with “detectable” alcohol metabolites compared with those who had “undetectable” alcohol metabolites. The odds of achieving SVR were 0.7 (95% CI: 0.5, 1.0; p=0.0525) in those with “detectable” alcohol metabolites. Overall, 86% of patients who received DAA therapy achieved SVR. Conclusions: Alcohol use categorized using urine alcohol metabolite testing, during the study period was associated with a significantly lower odds of receiving DAA therapy but had no statistical significance on the odds of achieving SVR. While patients with chronic hepatitis C should be counseled on the risks of alcohol use, it is not associated with lower likelihood of achieving SVR and should not preclude the initiation of DAA therapy
Navigating Diagnostic Challenges: Chronic Anemia Leading to the Diagnosis of Gastric Antral Vascular Ectasia (GAVE) in the Absence of Typical Symptoms
Gastric antral vascular ectasia (GAVE) is a rare acquired vascular dysplasia usually associated with portal hypertension or CREST syndrome. Here we present a case of a 62-year-old female with no significant related comorbidities who presented to our clinic due to severe acute on chronic anemia. On initial review of systems, the only complaint the patient had was fatigue, shortness of breath and being lightheaded. Patient denied hematochezia or melena, no hematemesis or other gastrointestinal complaints, no history of NSAIDs or aspirin use. Initial labs were significant for iron-deficiency anemia with hemoglobin of 8.5 g/ dL. Recent colonoscopy was non diagnostic for the cause of anemia as well. Due to unrevealing previous workup patient was referred to gastroenterologist and undergone esophagogastroduodenoscopy (EGD) with findings of ecstatic vessels in stomach antrum suggestive of GAVE, successfully treated with argon plasma coagulation. Total in a span of 4 years due to recurrence of anemia patient required 3 EGDs, while GAVE was successfully treated each time with argon plasma coagulation. Due to absence of gastrointestinal (GI) complaints patient was recommended to have regular laboratory workup to monitor for silent blood loss. This atypical presentation of upper GI bleeding warrants physicians to refer patients to gastroenterologists to perform EGD for further evaluation and treatment in cases of unknown etiology of iron deficiency anemia even in the absence of gastrointestinal (GI) complaints and non-revealing previous GI workup with colonoscopy
Review on Virulence and Diagnostic Methods of Mareks Disease Virus in Chickens
Marek’s Disease is a highly contagious oncogenic and neuropathic disease of chickens caused by Marek’s Disease Virus which is a highly cell-associated Alpha herpes virus that replicates in chicken lymphocytes and establishes a latent infection within T cells. Evolution of Marek’s Disease Virus towards higher virulence have been a concern over the years from mild to virulent, very virulent and very virulent plus. Mareks Disease is diagnosed by clinical examination of infected chickens accompanied with demonstration of postmortem lesions. The technique for diagnosis of infection with Marek’s Disease Virus involves isolation and identification of Marek’s Disease Virus from infected tissues. Virus isolation is usually by virus propagation in cell culture and identification/ quantification by cytopathic changes. Further confirmatory diagnosis of Marek’s Disease Virus can be done by serological test such as Agar Gel Immuno Diffusion Test and Enzyme Linked Immuno Sorbent Assay and molecular based technique such as Polymerase Chain Reaction. High-throughput sequencing technology which is a second-generation sequencing, provide the possibility to rapidly obtain the full sequence of pathogen genome at once for studying virus evolution and development of novel vaccines. Mareks Disease can be controlled by live-attenuated vaccines. In Ethiopia, reports coming from various regions of the country indicated that Marek’s Disease possesses a great threat to the flourishing young poultry industry.
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