recovery

The background of this novel study is how to apply an empirically adjusted Passive House concept in the tropics - beyond its otherwise prevailing global standards. Even though well-insulated houses have been on the planet since people settled down in some of their first dwellings, passive in the 21st century is different. It includes strict rules for airtightness and fitting of windows along with a sophisticated concept for artificial ventilation. Fresh air reachable from outside by filtered ventilation with heat recovery describes the heart of the system - if natural outside air is not preferable, it is convenient just in seasons with thermal comfort.Hence, the purpose and aim of the study presented here is to use a less common and at the same time more cost-saving approach: It might seem that the modern type of passive house entails the same standards that have been developed firmly on its own global market niche. However, this article tries to contribute toward a new development of modern passive homes for low-cost affordable tropical and subtropical houses in their entirety.As a concluding note, the author states that nobody has ever disproven this evolving concept as a combination of airtightness and a new way of forced ventilation without heat- or coolness recovery which is highly applicable for low-cost residential areas in tropical countries. By generating lower temperatures, it can help to surpass the overheating caused by climate change in certain tropical climate zones in higher altitudes and during cooler seasons. The condition is that the occupants are willing to accept a thermal comfort of up to 28 °C and humidity in its 70s and 80s.

In the realm of dental surgery, implants are essential for replacing missing teeth. To facilitate implant placement, techniques such as bone grafting and sinus lifts are utilized to augment the volume of atrophied alveolar bone in candidates for dental implants. Typically, patients undergo a period of recovery following bone grafts before proceeding with implant placement. This study investigates the efficacy of Cone Beam Computed Tomography (CBCT) in measuring the residual bone volume and assessing bone quality after the healing phase. A texture analysis was conducted on CBCT scans from 42 patients requiring maxillary sinus lift reconstruction. These patients were categorized into two groups based on the type of grafting material used: Xenograft or allograft. The study analyzed the distribution of various texture parameters and conducted a Mann-Whitney U test to identify significant statistical differences between the groups. Results indicated non-normal distributions for specific variables such as Area_S(1,0) and S(1,0)SumOfSqs, while others like S(1,0)Entropy displayed normal distributions. The findings revealed no significant statistical differences in the primary outcomes between the xenograft and allograft groups. However, the average values of the gray shades of pixels in the allograft group were statistically significantly higher compared to the xenograft group, suggesting differences in bone texture post-procedure.

Background: Adult patients with Acute Myeloid Leukemia (AML) have traditionally been hospitalized for the duration of intensive consolidation chemotherapy until blood count recovery to avoid complications. Recently, there has been a trend to shift the care of AML patients treated with intensive chemotherapy from inpatient to outpatient settings to reduce treatment costs and save beds. Methods and materials: A retrospective study of AML patients who received cytarabine consolidation chemotherapy between the 1st of August 2016 and the 31st of December 2023 at King Fahad Specialist Hospital in Dammam, Saudi Arabia was performed. Results: Over a period of 7 years and 4 months, 62 patients received a total of 127 cycles of intensive consolidation chemotherapy at outpatient setting. At diagnosis: 12 patients had extramedullary disease, and 17 patients had adverse cytogenetic abnormalities. Following the 127 cycles of chemotherapy, 38 episodes of febrile neutropenia were encountered, and 46 hospital admissions were required. No complications were encountered following 62.2% of the cycles of consolidation therapy and no early mortality due to intensive consolidation therapy was reported. Out of 62 patients studied, 36 patients underwent various forms of hematopoietic stem cell transplantation. Disease relapses were encountered in 24 patients and the 5-year incidence of relapse for the entire group of patients was 42%. The 5-year leukemia-free survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 43%, 38%, and 50% respectively. The 5-year overall survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 44%, 34%, and 65% respectively. At the end of follow-up: 37 patients (59.68%) were alive, 24 patients (38.71%) were dead, and the fate of 1 patient (1.61%) was unknown as the patient moved to another hospital. Conclusion: Administration of intensive consolidation chemotherapy for patients with AML at outpatient setting is safe, feasible, and cost-effective. The incidence of infectious complications was relatively low. No early treatment-related mortality due to intensive consolidation therapy was encountered. Outpatient administration of intensive consolidation therapy can save beds, reduce hospital costs, and is associated with short-term and long-term outcomes that are comparable to inpatient administration of consolidation therapy. 

Purpose: Peripartum cardiomyopathy is a rare life-threatening cardiomyopathy of unknown etiology with significant maternal morbidity and mortality. It causes heart failure due to left ventricular systolic dysfunction with or without left ventricular dilatation in the last month of pregnancy up to 5 months postpartum in previously healthy women. We aimed to determine short-term outcomes of peripartum cardiomyopathy clinically as well as in terms of left ventricular systolic function and to study the clinical profile and associated risk factors.Patients and methods: A prospective observational study was carried out in the Department of Cardiology of Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal, from July 2018 to January 2022. All the patients with peripartum cardiomyopathy who presented to the department of cardiology were enrolled in the study and re-evaluated with echocardiography at 6 months.Results: A total of 68 women met the inclusion criteria. The mean age was 28.38 ± 5.5 years (range 19 to 44 years). The most common clinical presentation was dyspnea followed by lower limb edema. Six (8.8%) patients presented during the last month of pregnancy whereas 62 (91.2%) patients presented in the postpartum period. The mean left ventricular ejection fraction on presentation was 30.01 ± 8.54. A full recovery was observed among 60.29% at 6 months. The mortality rate was 4.41%.Conclusion: Timely diagnosis and management of peripartum cardiomyopathy with standard therapy for heart failure leads to better recovery of left ventricular systolic function.

Introduction: The practice of plastic surgery began in the field of reconstructive surgery, in an attempt to recover the functionality of some area of ​​the body or give it a more natural appearance. In this sense, the role of the physical therapist is recommended in various aesthetic surgeries that, through physical therapy resources and techniques, promote tissue healing, reduce the appearance of adhesions, and reduce or eliminate pain, bruises, and edema. Objective: to identify the effects of physical therapy in the postoperative period of plastic surgery. Methodology: This is an integrative literature review, in which there will be a review of articles related to the study of the effects of physical therapy assistance applied to the postoperative period of plastic surgery. Articles related to the proposed theme were included, published between 2011 and 2024, available in full, without language restriction; in addition to theses, dissertations, and monographs. Exclusion criteria were literature review articles, articles or abstracts that had been published in conference proceedings; as well as letters from editors and preprints. Results and discussions: it can show that physiotherapy in the postoperative period of plastic surgery is essential in reducing recovery time, reducing edema, improving the healing process, and preventing the risk of complications in the postoperative period. The main physiotherapeutic resources and techniques were: lymphatic drainage, ultrasound, radiofrequency, laser, and high frequency. Regarding plastic surgeries, the most frequent in the literature were: abdominoplasty, blepharoplasty, rhytidectomy, and liposuction. Final considerations: Dermatofunctional physiotherapy is of paramount importance in the postoperative period of plastic surgery. It is essential in reducing recovery time and reducing the risks arising from surgery.

Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.

Purpose: Lipolysis is regulated by lipolytic hormones, like insulin, cortisol, growth Hormone (GH), and catecholamines. Unregulated lipolysis results in the accumulation of free fatty acids (FFAs), leading to dysfunction of cells and death. Thus, the main aim of this study was to determine the effects of interval and traditional resistance exercise on hormonal control of adipose-tissue lipolysis in healthy young men.Methods: Twelve healthy males (Mean ± SD; age, 25.5 ± 3.1 years; Body mass index, 24.2 ± 2.0 kg/m2) performed tradition resistance exercise (TRE) at 80% of 1RM (3 sets of 6 repetitions) with 2 min passive recovery, and an interval resistance exercise (IRE) trial at 60% of 1RM (3 sets of 6 repetitions) followed by active recovery (1 set of 6 repetitions at 20% of 1RM). Three blood samples were taken before and immediately after exercise, and after one-hour recovery and were analyzed to measure epinephrine, norepinephrine, cortisol, and GH. Results: Statistical analyses of the data revealed that concentrations of cortisol and GH increased in response to resistance exercise and significantly decreased (p < 0.05) during the recovery period. Although there were no significant differences between the two protocols for cortisol concentration, GH increases following IRE were profoundly higher than TRE protocol. Epinephrine and norepinephrine increased (p < 0.05) in response to both resistance exercise trials, though, no between-group differences were found for these variables. Conclusion: The results of our study showed increases in GH, cortisol, epinephrine, and norepinephrine in two resistance exercise protocols which may lead to increases in fat oxidation.

Physiotherapy treatments employ complex approaches tailored to the patient’s diagnosis. Exercise is the primary strategy to enhance rehabilitation processes for most individuals. However, electrophysical agents, such as Photobiomodulation (PBM), that utilize specific wavelengths of light to penetrate tissues and stimulate cellular activity, can modulate various biological processes and may improve physiotherapy outcomes. This non-invasive treatment can reduce pain and inflammation, promote tissue repair, and accelerate tissue healing. Currently, PBM has numerous applications, including pain and inflammation treatment, wound healing (such as diabetic foot ulcers, pressure ulcers, post-surgery wounds, and skin grafts in burn injuries), and the management of musculoskeletal disorders (such as arthritis, tendinopathies, muscle injuries, and spinal disorders). It is also utilized to improve muscle performance and recovery in rehabilitation and sports. Additionally, transcranial PBM has shown promise in enhancing neurorehabilitative processes by facilitating the recovery of cognitive and motor functions in various types of lesions. The safety and efficacy of this treatment allow it to be incorporated alongside regular exercises and manual therapies as an adjunctive treatment, potentially enhancing outcomes in different areas of rehabilitation.

In sports medicine, the recovery process for injuries to the musculoskeletal system has been well established, including the recovery time until the athlete can compete again to prevent relapses. These decisions support the sports physician in acting with greater confidence. However, there are no clear criteria and protocols for other systemic diseases. In the following study, we report our experience and suggest an action protocol for a professional basketball team.

The incidence of obstetric acute renal failure remains significant in developing countries. The aim of our study is to define the risk factors involved in the occurrence of ARF during pregnancy or during the immediate postpartum period and to evaluate its evolutionary profile in terms of epidemiology, etiopathogenesis, and therapeutic management over the years in Morocco. This is a retrospective study conducted in the maternal-infant resuscitation service of the Ibn Rochd University Hospital of Casablanca, over the period from January 2020 to August 2023, including 95 patients. The current incidence in our series over this period was 22.2%. The mean age of our population was 33 ± 7.74 years [18-43 years], 67.3% of patients were in the gestational period, compared to 33.7% in the immediate postpartum period. Fourteen patients were primiparous (8.6%), 27.4% had a history of miscarriage, and 10.7% had a history of pre-eclampsia. Oligo-anuria was initially identified in 24 patients. The most frequent etiology was pre-eclampsia (56.7%), followed by hemorrhage (27%) and sepsis (19.3%). The evolution was marked by recourse to hemodialysis in 62% of cases, with a maternal mortality of 26%. The existence of heart disease, the context of pre-eclampsia, and the use of diuretics and vasoactive drugs were significantly correlated with maternal survival. No factor was correlated with secondary recovery from ARF. The development of health structures and the optimization of screening strategies are the keywords for prevention.

This editorial explores the crucial yet often overlooked role of sleep in enhancing student-athlete performance and well-being. It highlights sleep’s impact on physical recovery, cognitive function, and emotional stability, emphasizing the unique benefits for athletes. The editorial examines the detrimental effects of early school start times on adolescent sleep patterns and their subsequent impact on academic and athletic performance. By advocating for policy changes that prioritize sleep, such as delaying school start times, this editorial presents a novel approach to optimizing student-athlete success. Through a synthesis of current research and practical insights, it urges stakeholders in education and sports to recognize and act upon the foundational importance of sleep, positioning it as a key component of athletic and academic excellence.

The article describes the gamma activation analysis method used to determine the gold content in rock samples using the Aura measuring complex. The physicochemical basis of gold extraction in the process of cyanide leaching is considered. The technology for extracting gold from solutions of tailing waste “ponds” of tailings dumps of hydrometallurgical plants of the Joint Stock Company “Navoi Mining and Metallurgical Combine” (JSC NMMC) is presented. It has been shown that in the dynamic mode of sorption of tailing waste solutions acidified to pH = 3.3÷3.5 through AM-2B and VP-1P ion exchange resins, gold is sorbed on the AM-2B anion exchanger up to 3.9 mg/g and on the VP-1P anion exchanger up to 1.5 mg/g. It has been shown that when solutions of tailing waste are exposed to ammonia, ammonia complex compounds of base metal impurities are formed, which decompose, while the gold cyanide complex does not decompose and is sorbed on the AM-2B ion exchange resin up to 3.0 mg/g. The mechanisms of the chemical reactions of the process of extracting gold from tailing waste and the technological scheme of the installation for extracting gold from solutions of the tailing waste “pond” are presented.

In this study, we evaluated the assessed the hypoglycemiant, toxicogenetic and genotoxic effects of nanoencapsulate extracts of Bauhinia forficata Link. Phytochemical evaluations of extracts were carried out, as well as the evaluation using HPLC-MS and of antioxidant capacity in vitro. DM2 was induced in mice with streptozotocin and extracts were given orally for 28 days. That dried extract from infusion (ESIN) had a higher rate of bioactive compounds compared to the dried extract from decoction (ESDC), and higher antioxidant capacity. Glucose levels decreased from 77.26% to 57.79% and 45.15% after supplementation with ESIN (200 and 600 mg/kg/day) and ESDC (600 mg/kg/day), respectively, when compared to the diabetic group treated with metformin (600 mg/kg/day) (21.53%), with an improvement in the glycemic response e recovery of pancreatic β cells. Thus, our study has shown that these extracts exhibit hypoglycemiant activity, with a beneficial effect superior to metformin, as a result they could be considered as potential therapeutic agents for application in pharmaceutical formulations in the treatment of DM2.

Micronutrients are critical components of an athlete’s diet, affecting both performance and cardiovascular health. This review summarizes current studies on the importance of micronutrients in sports cardiology, focusing on their effects on energy metabolism, antioxidant defense, and cardiac function. Key findings emphasize the relevance of micronutrient sufficiency in improving athletic performance and avoiding long-term health issues linked to strenuous training programs. Micronutrients like B vitamins help energy generation pathways, while antioxidants like C and E reduce exercise-induced oxidative damage. Minerals like magnesium and iron are important for muscle function and oxygen delivery, which are required for endurance and recovery. Effective nutritional practices include balancing food intake and, if required, supplementing under medical supervision to address individual needs and enhance performance results. Future research paths will focus on individualized nutrition techniques based on genetic and metabolic profiles, allowing for more precise food recommendations for athletes. Collaboration between sports medicine and nutrition disciplines is critical for establishing evidence-based practices and improving cardiovascular health in athletes.

Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.

Objective: Current guidelines favour radial access (TRA) over femoral access (TFA) for percutaneous coronary interventions due to lower bleeding risks and quicker patient recovery. This study compares patient satisfaction and complications between the two methods to identify the most suitable access route in coronary angiography (CAG).Materials and methods: A total of 152 patients who underwent CAG between February and June 2024 at our clinic were included. The operator and patient made access site decisions. Patients were surveyed 24 hours post-procedure, and complications were tracked for one month. The primary endpoint was patient satisfaction, while complications were classified as minor and major bleeding, pseudoaneurysm, hematoma, and spasm.Results: Of the 152 patients, 33% (n = 50) underwent TRA and 67% (n = 102) underwent TFA. Minor bleeding occurred in 16% (n = 24) and major bleeding in 0.02% (n = 3) patients. Pre-procedure anxiety, satisfaction with the access method, and awareness of TRA showed no significant differences between groups. However, post-procedure pain was higher in the TRA group (46% vs. 15%, p < 0.001), and systolic blood pressure was slightly elevated in the TRA group. Anxiety was more common in females, while elderly and obese patients showed no significant differences in bleeding or complications.Conclusion: Despite TRA’s benefits, no significant difference in satisfaction between TRA and TFA was observed. Patient preferences, radial artery spasms in females, and improved TFA techniques may influence outcomes. A shared decision-making process between operator and patient seems optimal for access site choice, with further investigation into patient satisfaction factors warranted.

Stroke is a clinically defined syndrome of acute focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide. Stroke is not a single disease but can be caused by a wide range of risk factors, disease processes and mechanisms. Approximately 15% of strokes worldwide are the result of intracerebral hemorrhage, which can be deep (basal ganglia, brainstem), cerebellar or lobar. A minority (about 20%) of intracerebral hemorrhages are caused by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes.

Stroke and acute myocardial infarction are primary global causes of mortality. Statistical studies have shown that acute myocardial infarction is responsible for around 9 million deaths each year. Ischemic stroke and myocardial infarction have a significant role in global adult physical disabilities. While reperfusion is vital for tissue recovery, it may paradoxically, inadvertently increase damage through oxidative stress, inflammation, and cell death. Early reperfusion procedures are currently the sole therapy to reduce infarct size. There are many mysteries about heart biology. It is not known the source of energy for myocardial tissues. The heart-beating force (120 mm Hg) cannot explain how erythrocytes are impelled through almost 95,000 km of capillaries in less than 5 minutes. A better knowledge of how the heart is oxygenated should allow the development of new therapies.

Blood cell production through hematopoiesis within the bone marrow serves both to maintain blood equilibrium and to respond to tissue injury and infectious demands. Hematopoietic stem cell (HSC) therapy developments have revolutionized medical treatment approaches for anemia leukemia and bone marrow failure caused by chemotherapy or radiation exposure. The therapeutic compounds present in medicinal plants have traditionally supported blood health and researchers now understand these plants could help regenerate bone marrow tissue. The analysis investigates how phytochemicals affect HSC proliferation and differentiation while supporting HSC survival. The medicinal plants Panax ginseng, Astragalus membranaceus, and Curcuma longa receive special attention for their documented ability to enhance hematopoiesis in preclinical and clinical settings. This review examines the challenges that include standardization issues, toxicity concerns, and regulatory barriers alongside future perspectives about combining plant-based therapies with traditional treatments to improve bone marrow recovery and health results. 

Background: Studies explored the therapeutic role of agents inhibiting RAS in epilepsy. Fewer studies addressed the electrophysiological changes associated with angiotensin converting enzyme inhibitors (ACEIs) in terms of sustained seizures (status epilepticus). Sodium valproate (SVPA), a broad-spectrum anticonvulsant, has been associated with adverse cardiac events upon long-term use, in contrast to the beneficial role of ACEIs in cardiovascular disorders.  This work explored the potential effects of ramipril, an ACEI, compared to SVPA, on the behavior, and electrophysiology of the brain and heart in a rat model of status epilepticus. The dose dependent pattern of the presumed ramipril activities was investigated. Methods: Adult male rats were assigned into seven groups, controls, IP pyridostigmine (36 mg/kg)-induced status epilepticus (PISE), oral SVPA (5 mg/kg), and three groups receiving oral ramipril at respective doses of 5 (R5), 10 (R10), and 20 mg/kg (R20). Rat behavior was assessed using Racine’s motor convulsion scoring for 10 minutes.  Blood pressure was recorded, and electroencephalography (EEG) and electrocardiography (ECG) were performed on the sedated rats 24 hours after recovery. Results: Despite the partial behavioral improvement of motor convulsions with R5 and R10 exhibited epileptogenic activity, as indicated by the increased relative power of fast and slow gamma waves and total EEG power. R10 triggered arrhythmia and cardiac ischemia as indicated by absence of P wave, along with ST elevation and tall T wave, slowed heart rate and prolonged QRS, QTc, and RR intervals. Conclusion: PISE was resistant to sodium valproate and ramipril. Ramipril at low and moderate doses induced epileptogenic activity and, especially at moderate dose, precipitated cardiac ischemia and arrhythmia. SummaryThe debatable role of ramipril in epilepsy was studied in a rat model of pyridostigmine-induced status epilepticus, compared to sodium valproate. Increasing ramipril doses did not resolve status epilepticus in rats. Instead, low and moderate doses exhibited epileptogenic activity, opposite to high dose ramipril and sodium valproate. Blood pressure was dose-dependently reduced with ramipril. Electrocardiography showed evidence of cardiac arrythmia and ischemia, especially with the moderate ramipril dose. The behavioral and EEG indices correlated with systolic blood pressure and ECG changes.