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Cardiovascular diseases include coronary artery disease, stroke, hypertensive heart disease, valvular heart disease, cardiac arrhythmias, heart failure, aortic aneurysm and dissection, peripheral arterial disease, and deep venous thrombosis . Pulmonary diseases include asthma, bronchitis, chronic obstructive pulmonary disease (COPD), cystic fibrosis, idiopathic pulmonary fibrosis, lung cancer, pneumonia, pulmonary embolism, pulmonary hypertension, sarcoidosis, and tuberculosis . Both cardiovascular and pulmonary disorders share symptoms of chest pain, shortness of breath, palpitations, fatigue, and leg swelling. The literature is rich in interventions that aim to prevent or treat cardiovascular and pulmonary disorders. This chapter not only reviews the evidence for wellness interventions that can be implemented beyond traditional methods that are utilized to address cardiovascular and pulmonary symptom severity, but also explores the evidence for interventions that primarily improve wellness in patients with cardiovascular and pulmonary pathology.
How do people face challenging events that impact, and sometimes change, their lives? Adversity is ordinary, not extraordinary. Most of us at some point will experience a major trauma: the death of a loved one, debilitating illness, loss of a job, a natural disaster, or other traumatic events. It is estimated that up to 90 percent of us will experience at least one serious traumatic event during our lifetime . The ability to cope, respond to change, and return to a degree of normal functioning following a crisis is known as resilience ; this process may have not only a genetic basis and neurobiological substrate, but also factors and actions that can be learned and developed . As physicians and healthcare providers, we can make a difference by better understanding the coping mechanisms proven to be effective at enhancing resilience and its role in fostering wellness. With a better understanding of the process, we can develop interventions suggesting how patients can incorporate the best behaviors in their lives.
Chronic hypoxia during gestation induces greater occurrence of perinatal complications such as intrauterine growth restriction, fetal hypoxia, newborn asphyxia, and respiratory distress, among others. This condition may also cause a failure in the transition of the fetal to neonatal circulation, inducing pulmonary arterial hypertension of the neonate (PAHN), a syndrome that involves pulmonary vascular dysfunction, increased vasoconstrictor tone and pathological remodeling. As this syndrome has a relatively low prevalence in lowlands (~7 per 1000 live births) and very little is known about its prevalence and clinical evolution in highlands (above 2500 meters), our understanding is very limited. Therefore, studies on appropriate animal models have been crucial to comprehend the mechanisms underlying this pathology. Considering the strengths and weaknesses of any animal model of human disease is fundamental to achieve an effective and meaningful translation to clinical practice. The sheep model has been used to study the normal and abnormal cardiovascular development of the fetus and the neonate for almost a century. The aim of this review is to highlight the advances in our knowledge on the programming of cardiopulmonary function with the use of high-altitude newborn sheep as a translational model of PAHN.
Muchos animales se encuentran entretejidos en las visiones cósmicas de diferentes culturas del mundo. En este contexto varias especies han sido idealizadas como referentes que sintetizan atributos apreciados por el hombre como poder, valor, nobleza, así como fuerzas de la naturaleza o de lo desconocido. Con frecuencia son animales grandes los que han capturado la atención humana desde sus orígenes, como lo refleja el arte parietal antiguo. Probablemente esto obedece a que se les consideró importantes para la vida cotidiana y también a su supuesta influencia en mitos de mundos paralelos.
En varias culturas alrededor del mundo se ha asignado a los osos un sitio prominente. Se conocen rituales y cultos relacionados con la presencia del oso en distintos grupos humanos en Asia, en pueblos originarios de Norteamérica y culturas de los Andes. Estas manifestaciones ocurren, por lo general, en sociedades que se encuentran asentadas en territorios dentro las principales áreas de distintas especies de osos. Sin embargo, en partes marginales de territorios ocupados por osos, las referencias culturales a ellos son escasas. Por ejemplo, no se había reportado la representación de estos mamíferos en las culturas que se desarrollaron en Mesoamérica.
Trabajos arqueológicos recientes en el sitio de Tancama (Querétaro, México), ocupado por un grupo de afinidad Huasteca cuya mayor actividad se dio en el período clásico (entre 500 y 700 d.C.; fechas de C14), han revelado una escultura de barro asociada con restos de uno de los edificios principales, que representa un oso de cuerpo entero (se determinó como un oso negro, Ursus americanus, dado que es la única especie presente en el área). Además de la escultura, se encontraron vasijas y fragmentos cerámicos, excavados en otros edificios, que muestran rasgos diagnósticos de la cabeza de un oso.
El presente estudio analiza este primer y singular hallazgo para Mesoamérica, enfatizando su relevancia para la región. Se analizan las relaciones entre la efigie principal de oso como parte de un edificio y las numerosas vasijas con representaciones ursiformes, para explorar el posible significado cultural local de esta especie animal.
Fewer than 200 radiocarbon (14C) dates with secure contextual information are available for Cuba, making it challenging to reconstruct Caribbean indigenous population dynamics, their identities and interactions. In this paper, we discussed 21 accelerator mass spectrometry (AMS) 14C dates from two mounds (M1 and M2) at the Playa del Mango site (Granma province, Cuba), traditionally associated with the Banwaroid stone tool tradition. The ΔR calculated for the site was –132.0 ± 176 and –164.0 ± 68. The chronology of burials from the peripheral area of M2 suggested that the cemetery was continuously used from at least cal BC 116–AD 241 (2 σ). The domestic area of M2 was used at minimum between cal BC 55–AD 435 (2 σ), which encompasses the use of the funerary areas. An isolated human tooth from M1 [cal AD 125–435 (2 σ)] suggested that this funerary area is later than the one at the periphery of M2, and possibly contemporaneous with the later formation of the M2 shell midden. The archaeological assemblage of the “Banwaroid tradition” is widely distributed in Cuba, and mixed with other archaeological traditions, supporting that a complex web of human interactions took place in the Caribbean in precolonial times.
Prenatal glucocorticoid overexposure has been shown to programme adult cardiovascular function in a range of species, but much less is known about the long-term effects of neonatal glucocorticoid overexposure. In horses, prenatal maturation of the hypothalamus–pituitary–adrenal axis and the normal prepartum surge in fetal cortisol occur late in gestation compared to other precocious species. Cortisol levels continue to rise in the hours after birth of full-term foals and increase further in the subsequent days in premature, dysmature and maladapted foals. Thus, this study examined the adult cardiovascular consequences of neonatal cortisol overexposure induced by adrenocorticotropic hormone administration to full-term male and female pony foals. After catheterisation at 2–3 years of age, basal arterial blood pressures (BP) and heart rate were measured together with the responses to phenylephrine (PE) and sodium nitroprusside (SNP). These data were used to assess cardiac baroreflex sensitivity. Neonatal cortisol overexposure reduced both the pressor and bradycardic responses to PE in the young adult males, but not females. It also enhanced the initial hypotensive response to SNP, slowed recovery of BP after infusion and reduced the gain of the cardiac baroreflex in the females, but not males. Basal diastolic pressure and cardiac baroreflex sensitivity also differed with sex, irrespective of neonatal treatment. The results show that there is a window of susceptibility for glucocorticoid programming during the immediate neonatal period that alters cardiovascular function in young adult horses in a sex-linked manner.
For patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization, a traditional fist-bump greeting did not significantly reduce MRSA transfer in comparison to a handshake. However, transfer was reduced with a modified fist bump that minimized the surface area of contact and when hand hygiene was performed before the handshake.
In order to assess the response of cocoa trees to drought, changes in water status, gas exchange, leaf carbon isotopic ratio (δ13C), photochemical activity, and leaf N and chlorophyll content during the rainy and dry season were measured in 31 Venezuelan cocoa clones (17 Trinitarios, 6 Criollos, and 8 Modern Criollos) grown in a common garden. Drought caused a 40% decrease in water potential (ψ) in all but the Modern Criollos, and a reduction in net photosynthetic rate (A) and stomatal conductance (gs) without an increase in instantaneous water use efficiency (WUE) in 93% of clones, and an increase in δ13C (long-term WUE) in 74% of clones; these responses suggest differences in tolerance to drought among clones. A positive correlation between A and both gs and leaf N content was found for all genotypes. Leaf N content, chlorophyll content, and photochemical activity were reduced during drought, suggesting that metabolism was also inhibited. The best performance during drought was shown by Modern Criollos with the highest WUE, while five Trinitario clones seemed to be less sensitive to drought, since neither chlorophyll, N, total soluble protein concentration, nor gs changed with drought, indicating that those Trinitario clones, with lower A, have a conservative water use. Modern Criollos showed no reductions in either ψ or gs; A remained unchanged, as did WUE, which was the highest, suggesting that these clones would be more successful in environments with low water availability. Our results indicate large variation in physiological response to drought over a range of parameters, suggesting possible differences in tolerance among clones.
To identify factors associated with visits by patients with schizophrenia and related disorders to community mental health services, under the Mental Health Department of Carlos Haya Hospital in Malaga, Spain.
We undertook a cross-sectional study. Data on demographic and clinical factors and service use were obtained from the public mental health services database and centralized in the “Malaga Schizophrenia Case Register (RESMA)”. The outcome measure, defined as the total number of outpatient consultations during one year, was analyzed by multilevel multivariate linear regression.
The analysis included 1097 patients with diagnoses of schizophrenia and related disorders (F20-F29, ICD-10).The adjusted model explained 46.35% of the variance. Patients who contacted both types of professional (nurses and psychiatrists) had a higher number of visits compared to patients who only contacted a psychiatrist (p< 0.001), and the individual psychiatrist attending the patients was also associated with the number of visits (p< 0.001).Clinical variables, such as a higher global level of severity (p< 0.001), a diagnosis of a persistent delusion disorder and having an inpatient episode (p< 0.001), were also associated with a higher number of visits. Patients who were receiving welfare benefits or who had no formal education or were illiterate had a higher number of visits. Patients living alone, living outside the study area and living in more rural municipalities was associated with fewer ambulatory contacts.
Among all variables, the role of psychiatrists and nurses in organized outpatient settings present the strongest association with the number of visits by similar patients.
Patients with schizophrenia show a deficit in emotion recognition through facial expression and the low sense of familiarity may be a factor involved. However, the emotion facial expression in families of patients could be disturbed and be another factor related to the deficit in emotion recognition and in sense of familiarity in schizophrenia.
To assess the emotion facial expression in a sample of 21 families of patients with schizophrenia and families of healthy controls.
22 healthy volunteers, all of them professionals of mental health, were assessed with the Ekman Test of emotion recognition in unfamiliar people which was photographed by expressing the 6 Ekman’s basic emotions. The task was composed of 42 pictures, half of them from families of patients and the other half from families of healthy control.
Volunteers recognize worse emotions in relatives of patients than in relatives of control group and this difference was statistically significant (Wilcoxon W = -4.13; p = .001). The average of pictures correctly recognized from families of patients was lower than pictures from families of control group (54.28% vs. 82%).
The emotion facial expression in families of patients with schizophrenia seems worse than in families of healthy controls. It could be a factor involved in face emotion recognition deficit in schizophrenia.