Cardiovascular risk scores in relation to age and gender.

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Cardiovascular is something relating to the heart hence the term cardiovascular disease when referring to an illness that hinders proper heart function. Cardiovascular disease is a collective term for different problems of the heart or blood vessel to prevent proper pumping and flow of blood to all body parts. Below are some examples of cardiovascular diseases:

  • Heart failure
  • High blood pressure (hypertension)
  • Cerebral vascular disease (stroke)
  • Coronary heart disease (heart attack)
  • Congenital heart disease
  • Rheumatic heart disease
  • Cardiomyopathies

Cardiovascular diseases (CVDs) are the leading cause of death as they cause the death of more globally than other reasons. Around 30% of all deaths are as a result of VCDs with coronary heart disease and stroke leading other cardiovascular diseases. Most of these deaths occur in low and middle-income countries that record up to 80% of deaths that occur to VCDs globally. The estimate is that by 2030 the deaths of almost 23.6 million people will occur due to heart disease and stroke.

Various risk factors increase the chances of getting cardiovascular condition including:

  • High blood pressure
  • Tobacco use
  • Diabetes
  • Overweight/obesity
  • Lack of physical exercise
  • Poor diet /nutrition

Most of the above factors are manageable to reduce the risk, but cardiovascular risk also has a relation to age and gender that nobody can change. What are the risk scores?

Cardiovascular Risk Scores in Relation To Age

Heart disease might affect people of all ages but is more common among those in the older ages. The number of people who have heart diseases increases with age for both men and women. Approximately four out five of those who die due to heart disease are at the age of 65 or older. The risk for men b to develop CVDs is higher than women’s and begins earlier by nearly ten years. Almost one in a hundred men develops signs of heart disease by the age of 45. At the age 55, the risk increases and continues increase up to age 55 when about 7 out of a 100 get heart disease.

The reason why people many people get the cardiovascular disease at an old age is that the aging also occurs on the blood vessels making them to harden and less flexible. Less flexibility of the blood vessels makes it harder for blood to move through them and reduces the rate of flow. The heart needs to work harder to pump blood at a pressure that will pump blood through the hard vessels to reach all the body parts.

Fatty deposits (plaques) also collect on artery walls with age to slow down the flow of blood from the heart. These things together with lack of enough exercises and poor nutritional habits can increase the risk of heart disease. The increase is even higher id other risk factors that come with age such as diabetes are also present.

The gender of a person can increase the risk of age. Men are at a higher risk of cardiovascular disease and suffer heard conditions earlier. The risk of having a heart disease for women becomes as much likely as that of men when they reach menopause. At this age, they are more likely to die from cardiac complications than the men.

Women face many risk factors that also affect men such as high cholesterol, smoking and blood pressure but their high levels of estrogen help to reduce the chances of developing the disease until they reach menopause. It is at this age when the level of estrogen drops significantly. Diabetes is particularly a significant risk factor for developing cardiovascular disease in women. The symptoms of the heart disease in women with diabetes are very subtle. Women might have breathlessness or heartburn during a physical exertion rather than chest pains which is typical in men or among the people with diabetes.

Cardiovascular Risk Scores in Relation to Gender

Most men are at a higher risk of contracting a heart disease than women in their age group. Scientists blame the increased risk on unhealthy habits saying that they are partly to blame for the vulnerability of the men. The risk of heart disease among the omen only increases after menopause. The natural hormone which is in higher levels among young women could be playing a protective role in protecting the women from heart attacks. Unfortunate for men, their gender is a risk score, and it could be the reason why they get attacks at a younger age than women. Cardiovascular diseases are more likely to cause death to women until after menopause, but the number of those who contract the disease to the severity of causing fatality is still lesser than that of the men.

Why Cardiovascular Risk Scores Are Higher In Men than In Women

These are some of the reason why most of those who get CVDs are men.

1.Stress

A prominent theory on the reason many more men suffer from heart disease while younger than women is that they endure more stress from draining actions and heavy physical activities than women. Historically it is the men who were occupying the job roles with more stress while women engaged in the less engaging role or stayed at home. However, the gender gap in job responsibilities has been closing to the point where women are now occupying highly stressful job roles.

Some people believe that a likely cause of extreme stress in men is their limited ways of expressing emotional stress at workplaces and elsewhere than the women. The society accepts that women can express emotional feelings and even cry. On a behavioral level, women are likely to share their situation or create time for self-care such as taking a long warm bath or reading. These reactions to difficult circumstances help to relieve stress. The society frown upon men who cry or discuss their problems thus most of them bottles up everything allowing stress to take a more significant toll on their bodies.

Arteries tend to narrow when stress builds up and increase the blood pressure. It is a significant problem that can increase the risk of cardiovascular disease for a man who already has narrowing arteries.

2.Diet and lifestyle

A weakness in the life of many men is that they have a habit of living unhealthy lifestyles than women and the trend causes a significant impaction their heart health. A significant risk factor for cardiovascular diseases among the men is their excess intake of alcohol. More men take a larger volume of alcoholic drinks exceeding the recommendations regularly compared to women.

A higher percentage of the men are overweight or obese compared to that of the women. A break down into the age range shows that the most significant gap is that of adults between the ages of 45-54. A higher number of men are overweight or obese than the women. Part of the difference in the number of men and women who contract heart diseases is because of a difference in their eating habits although cultural expectations also contribute. Men, in general, eat more meat than the women and most of the time they consume red meat in high quantity. Meats especially the red has elements that cause inflammation to the body and also have excess saturated fats that increase the risk of cardiovascular problems. Taking a few extra portions of red meat and fewer vegetables is a risk factor for cardiovascular diseases. Part of the reason could be that eating meat especially red meat such as steak has for long been seen as a masculine behavior. On the other hand, women have a habit of eating more cruciferous, broccoli and leafy green than the men which is healthy as they do not have fat that clogs up the arteries.

3.High cholesterol

The diet habits of the men make them be at a higher risk of accumulating cholesterol the fatty substance in the blood. There is good, bad cholesterol that increases the risk of heart diseases if it is too much. It can cause a build-up of atheroma inside artery walls to prevent enough blood from reaching the heart or other body parts. A piece of atheroma can break off to settle in an artery, and it can cause an even more dangerous blood clot by blocking the flow of blood. The measure of cholesterol is accurate after evaluating the good (HDL) cholesterol and the bad (non-HDL). The non-HDL cholesterol should not exceed 4 millimoles per liter( mmol/L) of blood while the total cholesterol including the HDL should not exceed 5mmol/L.

4.Overweight or obesity

Being overweight or obese increases the risk of having CVD and other conditions including the type 2 diabetes. The term overweight means that the body mass index (BMI) is 25 or more. A BMI of 30 or more is in the classification of obese. The shape of the body and the place where the excess fat settles can increase risk of CVDs. BMI is not the only measurement of risk. Too much weight around the middle raises the risk of CVD and other conditions that are harmful to the body including high blood pressure, diabetes and high blood pressure. When fat in the middle makes the waist of a man to be more 94 centimeters (37 inches) increases the risk of heart disease. It is also the same for women who have a waist of more 80 centimeters (31.5 inches).

Cardiovascular Risk Scores for Women

Certain conditions that only occur to women increase their risk of having a cardiovascular disease.

i.Diabetes

Diabetes increases the risk of heart disease. Women with diabetes are at more risk of getting cardiovascular diseases that the men with the same condition. The risk is still high even after managing the glucose levels but even greater when there is no proper control of blood sugars. At least 68 percent of the people suffering from diabetes and are over 65 years die due to a form of cardiovascular disease, A percentage of patients with diabetes also die because of stroke. Women with diabetes should work with their doctors to control other risk factors. Diabetes patients should also make lifestyle changes such as engaging in regular exercises and eating a healthier diet to maintain a healthy weight.

ii.Reducing of estrogen levels

Estrogen helps to protect women from cardiovascular diseases because of a positive effect on the in a layer of the artery wall and helps to maintain flexibility of the blood vessels. It means they can relax as well as expand to allow blood flow. The advantage of a natural hormone that prevents cardiovascular diseases begins to diminish at menopause when the body starts producing less estrogen. A drop in estrogen levels is the reason why women become more vulnerable to heat attack as they get older. The average age of for women to great a heart attack is 70 but 66 in men.

iii.Lifestyle risk factors

Some aspects that cause the lifestyle of a woman to be unhealthy increases the risk of CVDs. Taking as high fat-diet, drinking, smoking, and inactivity cause a greater risk factor for cardiovascular diseases than in men.

iv.Broken heart syndrome

A broken heart syndrome occurs after going through stressful situations that might cause temporary failure of the heart muscle. It mostly affects women after menopause. Stress cardiomyopathy, takotsubo cardiomyopathy, and apical ballooning syndrome are the other names for this condition.

v.Pregnancy complications

Unhealthy conditions that occur during pregnancy such as diabetes of high blood pressure can increase the risk of their recurrence or staying in place after birth to increase the risk of development of the heart disease in mothers. Some research shows that children born to women who suffer from pregnancy complications might be at an increased risk of cardiovascular conditions in the future.

vi.Some Chemotherapy drugs and radiation therapy

Some of the medications that doctors prescribe when treating certain cancers like that affecting the breast and radiation therapies might increase the risk of cardiovascular diseases. Mental stress and depression Stress and depression affect the heart of a woman more than a man's. A woman's heart and some of the interiors chambers are smaller than that of a man. The walls separating the chambers are also thinner. The smaller size makes the heart to pump blood faster, but it ejects lesser blood than that of a man by ten percent. The pulse rate for stressed women rises to make the heart to pump more blood, unlike men whose heart arteries constrict and raise blood pressure during stress. The problem for women occurs when stress turns to depression because it prevents them from maintaining a healthy lifestyle and adhering to recommendations by a doctor.

Women with inflammatory diseases such as lupus or rheumatoid arthritis as well as those from a familiarity with the history of cardiovascular diseases are at a higher risk.

Cardiovascular risk scores about age and gender show that men are more likely to get heart disease or stroke when younger. The risk of cardiovascular disease in women occurs when they are older but it is harder for them, and the treatment takes longer. A reason is that the age at which many get the disease is when they are likely to have other untreated risk factors such as blood pressure or diabetes.

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Harms versus benefits of antipsychotics in the prevention of delirium.

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Delirium is a transient and acute but reversible fluctuation disturbance in the level of cognition, attention and consciousness. Other names for delirium are toxic or metabolic encephalopathy or confusional state.

The cause can be any disorder or drug intolerance.

The diagnosis for delirium is clinical with the use of imaging and laboratory tests to identify the cause. Correcting the cause and other supportive measures are the approach to treating delirium.

Delirium can occur at any stage of life but mostly affects the elderly. Approximately 10% of the elderly patients in the hospital have hallucination and 15-50% experiences the condition at a particular time in their hospitalization. Delirium is also frequent after surgery, among ICU patients and nursing home residents.

It might also affect the younger people usually because of life-threatening systematic disorder or drug use.

Symptoms and Signs of Delirium

These are the primary signs that characterize the presence of fever:

Difficulties in maintaining, focusing or shifting attention

The level of consciousness fluctuates making the patients become disoriented to time, place and sometimes person. The patient might have hallucinations, paranoia and delusions. It is common for the patient to have confusion regarding their daily events and daily routines as well as changes in personality. Delirium might disorganize thinking and speech with exceptional rapidity, slurring, aphasic errors, neologisms or chaotic patterns. Symptoms of delirium keep fluctuating over minutes or hours. They might lessen as the day progresses but become worse at night.

Other symptoms

  • Irritability, hyperactivity, hyperalertness and agitation
  • Withdrawal, excess quietness and weariness
  • Extremely elderly people with delirium become withdrawn and quiet. People can mistake these changes for depression though some patients might alternate between both.
  • Distortion in sleeping and eating habits
  • Poor insight and impaired judgment because of the many cognitive disturbances.
  • A patient with delirium might have other signs and symptoms depending on the cause.

    Relationship between Delirium and Dementia

    It is essential to differentiate between dementia and delirium before prescribing antipsychotics as they are separate disorders, but sometimes they seem similar. Cognition is present in both, but the following helps in distinguishing them.

    Delirium mainly affects attention and occurs due to acute illness or toxicity after using a particular drug that sometimes becomes life-threatening but often is reversible.

    Dementia occurs because of the anatomic changes affecting the brain and mainly affects memory after a slower onset. It is irreversible.

    What Are Antipsychotics

    These are a group of medicine that physicians prescribe for treating mental health illnesses including those that occur due to a bipolar disorder such as mania that causes persons suffering from it to feel that they are in a state of elation or high. They also help to treat severe anxiety and depression. Antipsychotics are at times known as major tranquillizers. Antipsychotics are sold in form of capsules, tablets, depot injections (long-acting) and liquids. Pharmacists stock antipsychotics in various brand names. Antipsychotics are in two main types:

    Older antipsychotics: these are the well-established types also known as the first generation. They have been in use since the 1950s and until now, they are still in the market. The brands fitting to the older antipsychotics include:

    • Chlorpromazine
    • Haloperidol, , flupentixol,
    • Levomepromazine
    • Pericyazine
    • Perphenazine
    • uclopenthixol
    • Sulpiride

    Atypical or newer antipsychotics- these are the types of antipsychotic that manufacturers developed in the recent years compared to older forms. Although they are more modern, their shelf life is long since developers began manufacturing them in the 1970s. The purpose of developing them was to create products with fewer effects than the older type. However, they still have a few side effects. Some call them second-generation antipsychotics and they include these brands:

    • Amisulpride
    • Clozapine
    • Aripiprazole
    • Olanzapine
    • Risperidone
    • Quetiapine

    The choice of antipsychotic that a physician prescribes depend on the severity of the symptoms that require treatment and if the person has other health issues. Antipsychotic medicine has some differences. For instance, some have more sedating capabilities and might be better for individuals in dire need of relaxation. A specialist usually offers advice on the best type to take use for every case. It is difficult to tell the antipsychotics that will work in a manner that favors a person without the advice of a doctor. It helps to try another type if the first that a patient uses does not work well.

    There is a general observation that both older and newer antipsychotics work similarly. Some brands like clozapine are exceptional in producing better results than others. Unfortunate their strength can trigger various possible side effects, especially on the blood cells. It means that people who are taking this prescription require regular blood tests.

    In some cases, doctors can decide to use an injection of long-acting medicine (depot injection) after easing of the symptoms. The drug in depot injection releases slowly into the body. A patient should get it every 2-4 weeks. The injections help to prevent recurrence of symptoms and they are an advantage to the patients because they do have to memorize taking of tablets every day.

    Benefits of Antipsychotics in Prevention of Delirium

    Some people have reservations about the use of antipsychotics, but they benefit patients with delirium by doing the following;

    1. Altering the effect of certain body chemicals

    Antipsychotics change the functioning of certain substances that cause reactions that cause disorientation. They alter the effect of particular chemicals in the brain called serotonin, dopamine, acetylcholine and noradrenaline. These are the chemicals that cause an effect that changes the mood, emotions and behavior. Dopamine is the primary chemical that antipsychotics direct their force. An alteration of the effects by these chemicals in the brain helps to prevent or suppress the following from occurring:

    • Delusions which make a patient have ideas without any basis on reality

    • Hallucinations such as hearing non-existent noises
    • Extreme mood swings that have an association with bipolar disorder
    • Thought disorder

    Antipsychotic medications are a short-term treatment for bipolar disorders to help also help in controlling mania symptoms alongside delusions and hallucinations. These are the symptoms that occur during a severe depression or acute mania. Some even help in the treatment of bipolar depression and some of them have demonstrated their long-term ability to prevent future episodes or depression or mania that occurs due to bipolar disorder. General practitioners usually refrain from prescribing antipsychotics before consulting a psychiatry specialist.

    2.Creates a Calming effect

    Antipsychotics are off-label sedatives for the patients with bipolar disorders to manage insomnia, agitation or anxiety. Doctors prescribe them to stabilize the mood and decrease symptoms of mania until the full effect of mood stabilizers. Some antipsychotics can help to stabilize the moods, and as a result, patients can solely rely on them for long-term treatment if they so do not respond to or tolerate to anticonvulsants and lithium.

  • New Diagnostic Tests

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    A diagnostic test or procedure is an examination that identifies specific areas of strength and weakness to determine the condition, illness or disease in a person. For instance, physicians may use MRI (Magnetic Resonance Imaging), Electromyography (EMG) or Computer Assisted Tomography (CAT scan to determine if there is impingement of a nerve root by a herniated disc.

    The ability and range of diagnostic test continuously evolve as researchers find a way to detect diseases earlier, get more detail and get an accurate diagnosis in many people across all regions of the globe. There are many attempts to find new ways of performing diagnostic tests, but these are the latest developments in the diagnostic technologies.

    1. CancerSEEK

    Cancer has become such a killer, but researchers have invented another way of testing and detecting eight most frequent types at once. These include the elusive pancreatic and liver cancers that are difficult to detect. As the new technology develops, doctors will one time use it to spot cancers in the early stages even before the onset of symptoms to improve chances of treatment and survival. Cancer SEEK looks for various compounds that could be early signs of cancer from the blood. The compounds it checks include 16 different cancer driver genes with association to tumors and eight proteins.

    The intention is to make cancer screening a routine activity so that patients who visit a health facility for an annual physical checkup can get also get a blood screening for cancer at the same time. An additional benefit is that cancer SCREEN appears to have ability for screening for these five cancers for which other screening tests fail to detect.

    • Stomach
    • Ovarian
    • Pancreatic
    • Esophageal
    • Liver

    These cancers types can develop without detection because they do not cause symptoms until the time they reach an advanced stage. Sadly at this time, the treating the disease is difficult. The difference between CancerSEEK from recently developed liquid biopsy test is that it uses two types of indicators which are genes and proteins to get results that are more accurate across a broader range of cancers. Liquid biopsy tests only look for cancer markers in the blood.

    CancerSEEK tests use an artificial intelligence algorithm for analyzing combinations of genes together with protein biomarkers in a blood sample to identify the type of cancer that someone is likely to have. This method of testing is of much help to the general practitioners who can administer the test and send their patients for additional testing that verifies the result. For instance, if the results of a blood test suggest that a patient could be having stomach cancer, his doctor can recommend that the patient goes for an endoscopy to confirm the results. Similarly tests results showing a likelihood of colon cancer could be a reason to request for colonoscopy.

    Paper point –of-care Zika test

    Diagnosis and management of Zika virus have more gains if there is proper population screening to detect the symptoms before they develop to cause severe illness. The level of population testing depends on access to user-friendly and low-cost tests that fit in resource-limited settings. It is the reason for researchers from Washington University St. Louis to start developing such a test. The test made of paper costs approximately 10-15 cents. It tests the Zika virus by producing a color change when there is a reaction between the immune globins in the blood of an infected patient reacts with some tiny nanorods on the testing papers. A nanocrystal layer protects the test during storage and shipping.

    2. Self-powered paper electrochemical diagnostics

    This point of care diagnostics test is for testing some diseases without a need for specialist skills. It is portable, low cost and does not require much infrastructure but will help to improve healthcare in the regions that have limited access to sophisticated lab equipment. Point-of-care diagnostics which are portable, low-cost, and require little infrastructure can help to improve healthcare in regions with limited access to more sophisticated laboratory equipment. The developers are from Purdue University and were targeting users in remote areas or military bases. The devices are easy to carry because they are lightweight and flexible.

    3. Mass Spec Pen for Rapid cancer identification

    Here is another test for detecting cancer that tries to address one of the biggest challenges in cancer surgery. It is difficult for a surgeon to determine if the surgery removes all the traces of cancer while still preserving much of the healthy tissue as possible. Mass Spen Pen by researchers at The University of Texas attempts to improve the gains of a surgery. It provides accurate identification of the cancerous tissue during surgery in just 10 seconds. Despite the speed, Mass Spec Pen achieves an accuracy of over 96%. The pen works by analyzing the metabolites of the tissue that differ between cancerous and normal cells. This technology is still new, but surgeons are ready to begin testing it as they operate on cancer patients in 2018.

    4.Transparent tissues for pathological diagnosis

    The conventional methods for pathological diagnosis rely on staining of some thin sections of the patient specimen. Imaging in 3D is to try to overcome some limitations of pathological diagnosis technique. It helps pathologists to detect some of the abnormalities that someone using the initial technology is likely to miss. The results of a recent study demonstrated that clear, unobstructed body/brain imaging cocktail and computation analysis (CUBIC) is efficient in delineating the normal as well as abnormal regions in lymph node and lung tissues. The promising results highlight a potential for 3D histopathology in improving diagnosis procedures.

    5. Wearable sweat sensor

    Many people may not know that sweat can help in diagnosis, but this new diagnostic test shows that it a bio-fluid for non-invasive diagnostics. It contains various solutes that act as biomarkers for the presence or absence of a disease. A new wearable sweat sensor detects ions and molecules present after stimulation of the skin to produce little amounts of sweat and send a data to an allocated server for analysis. This sensor has been in use in the studies for detecting chloride ions to improve the efficiency in diagnosing cystic fibrosis.

    6. Microfluidic chip for predicting preterm birth

    Identifying the risk of preterm delivery in pregnant women can help to determine and plan early interventions that assist in delaying childbirth and strengthening the lungs of the fetus to reduce chances of mortality and morbidity. The purpose of the newly developed microfluidic integrated chip is to concentrate, separate and also detect tiny amounts of the P1 peptide in a blood sample. P1 helps to indicate a higher risk of preterm birth. Then eventual use if the chip is a healthcare setting for identifying pregnant women who need and can benefit from medical interventions to prevent the premature birth of their babies.

    7. Smartphone TRI Analyzer

    Smartphones are one of the many devices that researchers are turning to diagnostic tools. A smartphone is convenient because of the widespread presence, abilities, and simplicity to use.

    Researcher from the University of Illinois created the Smartphone accessory that tests liquid samples to determine if there is a disease. It puts a medical testing lab in the palm of a patient’s hand. The spectral analysis devices use a 3D printer and engineering that helps to process samples saliva, blood or urine utilizing the phone flashlight and optics from the camera. A TRI analyzer device transforms camera of the phone into a high performing spectrometer. It illuminates a sample fluid using an internal white LED flash although it can still use an external green laser diode. The light from the sample collects in an optical fiber for guiding into the rear-facing internal camera. The arrangement of the optical components is within a 3D-printed plastic cradle.

    The researchers make an effort to maximize on the potential of a Smartphone in a diagnostic test by recently using a TRI Analyzer for performing two tests that people get commercially. The first test was to detect a biomarker with close association to pre-term birth in expectant women .the another test is on newborns for indirect detection of an enzyme that contributes to normal development and growth. The tests had similarity to those that professionals got from clinic grade spectrometer instrumentation.

    8.Loop-Mediated Isothermal Amplification (LAMP) to detect meningitis

    A LAMP is an isothermal nucleic acid amplification technique that targets and amplifies a sequence at a constant temperature of 60-65% using two or even three primer sets. It also uses a polymerase with a high strand displacement activity in addition to replication activity. The primers identify six distinct regions on a target gene which adds to the specificity. An extra pair of loop primers further accelerates the reaction. Because of the specific nature of its action, the action of the primers makes the amount of DNA that LAMP produces to be higher than PCR (polymerase chain reaction) based technology amplification in which reaction takes place with a series of temperature steps or cycles.

    A quick reaction and accuracy of a LAMP are helpful in detection of meningitis and meningococcal disease that is difficult to diagnose early because the first symptoms mimic those of a common cold. Time is essential for the treatment of meningitis because patients can recover well if it is treated early, but many die due to lack of early treatment. The diagnosis of meningococcal is difficult to detect, and many take place when it is too late considering that diagnostic tests in traditional labs take up to 48 hours before returning results. Some get an assurance that they do not have meningitis only to turn out that they have an infection that early testing did not detect.

    9. Blood test to diagnose TB onset by two years

    Tuberculosis an infection that occurs due to Mycobacterium tuberculosis (M.tb) is the leading cause of death that occurs due to an infection by one pathogen. Doctors diagnose as many as 10 million new cases of TB. The team of researchers to develop a simple, affordable and rapid point of care test was led by Gerhard Walz, MMed Ph.D. and head of immunology research at Stellnbosch University South Africa.

    Researchers now have developed a blood test that can predict the possibility of contracting TB by up to two years before its onset using a combination of four gene signatures in blood. The name of this signature that combines four genes with an association with inflammatory responses is RISK4. An individual component of this signature might not be sufficient in delivering an accurate diagnosis of prediction but using a combination of the markers improves the accuracy.

    RISK4 test concentrate on the people who live with someone with active TB infection with researchers enrolling up to 4,466 HIV-negative participants to give their blood samples. The purpose was to provide primary health clinics with a test and reagents that will be available in a format that they now use for TB diagnosis. The first tests on RISK4 signature took place in South Africa, the Gambia, and Ethiopia but the next step is to take it to another setting with non-African populations to determine its feasibility in providing global near patient test.

    Are disposable pressure cuffs a safer option?

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    Blood pressure cuff is a medical device that comprises of a rubber piece or a similar material that a clinician wraps around the arm of a patient and inflates it to measure the blood pressure.

    The purpose of blood pressure cuff is to take blood pressure. The cuff has an inflatable bladder made of rubber for fastening around an arm. A pressure meter indicates the pressure off the cuff. A clinician uses a small handheld air pump to inflate the blood pressure cuff.

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    Rehabilitation of brain injuries. Discuss mirror therapy

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    A brain injury is the sort of damage that a blow to the brain caused by an external force but is not of congenital or degenerative nature. It might lead to temporary or permanent impairment of the physical, cognitive and psychological functions. An injury to the brain might generate an altered or diminished state of consciousness to cause these effects that prevent normal functioning as before the injury:

    • Impairment of physical functioning and cognitive abilities
    • Profound disturbances of emotional, cognitive and behavior functioning
    • Permanent impairments that cause partial or full functional disability as well as psychosocial maladjustment

    The Brain Injury Association Board adopted the definition of acquired brain injury to add the definition of a brain injury to include other causes that occur because of other nontrauma causes. An acquired brain injury (ABI): An injury to the brain that occurs after birth. It commonly causes a change in neuronal activities that affect physical, metabolic or functional ability of a cell. The causes of ABI include an application of external forces to the head or neck without causing a fracture.

    The severity of Traumatic Brain Injury

    Moderate traumatic brain injury–Trauma to the head causing a loss of consciousness that lasts 30 minutes to 24 hours. Posttraumatic amnesia can last 24 hours to a week.

    Severe traumatic brain injury-this injury is a trauma to the head that causes a loss of consciousness lasting more than 24 hours and an initial Glasgow Coma scale of 3-8. It also creates a posttraumatic amnesia period that goes beyond seven days.

    Traumatic Brain Injury (TBI)- TBI IS an insult to the brain occurring after an external physical force to produce an altered and diminished state of consciousness interfering with physical or cognitive abilities. TBI can cause altering or diminishing state of consciousness.TBI might cause permanent impairments resulting in partial or full functional disability as well as psychosocial maladjustment.

    Head injuries that cause brain injury might be open or closed. A closed head injury is that which does not break the skull. An open or penetrating head injury is that which cracks the scalp o skull to enter the brain. Assessing the severity of the head injury by observation is hard. Some of the injuries on the head can cause much bleeding while other does not cause any bleeding. Head injuries are dangerous, and nobody should take them lightly. It is essential to go for assessment by a doctor quickly.

    What is Rehabilitation of Brain Injuries

    Brain injuries can affect the way of doing everything from walking, talking or even entire thinking. Brain healing is a process occurring after brain damage. The brain has the resilience to adapt but when cells within can cause significant damage or die for instance after a stroke, there might be formation on those cells or repair might be impossible.

    Some TBIs increase the risk of a stroke. The necessity to start healing is the reason for rehabilitation of brain injuries which is a term referring to different types of specialized support and services that attempt at making an emergency or early phase intervention. Some brain injury rehab is a program within a hospital or other clinical settings. Some of them can take place on an outpatient basis. Every patient benefits from rehabilitation after a brain injury with the specific type depending on the unique needs by a person and challenges they face.

    Mirror therapy

    Mirror therapy is a type of motor imagery therapy that involves using a mirror to convey visual stimuli to the brain through observation of the body part that is still intact after the injury as it performs setoff movements. The underlying principle behind mirror therapy is that visual cues from the functional side of the body will stimulate the action of an affected limb. The thinking behind the therapy is that might be useful among the patients who lose movement or a limb after a brain injury or after suffering a stroke.

    Mirror therapy involves using a tabletop mirror for creating a reflection of the unaffected part of the body such as an arm in place of the one that is affected during the therapy. A mirror should stand in line with the middle of the patient’s body. The position allows reflection of the unaffected half. It creates an optical illusion that the week part suck as a leg or hand has regained the ability to move. The initial use of this technique was to help in the rehabilitation of the patients suffering from chronic pain, but now those who are recovering from brain injury and stroke can also benefit. An advantage is that someone can set it up without challenges even when having some form of disability. A patient can even perform the therapy alone at home.

    The mirror becomes a tool for performing various rehab exercises by just using the healthy side or part of the body.

    Why Use Mirror Therapy for Rehabilitation of Brain Injuries

    A reason for therapists, physicians as well as patients or their families to use a mirror to consider using mirror therapy is its ability to fire the neurons. The movement takes place after firing of the motor neurons in the brain that communicate to the muscles to move. Every time a person talks, walk or stands, it is a result of motor neurons in the brain. These motor neurons are in the same area of the brain as the mirror neurons. The difference between motor and mirror neurons is that the former fire up after a person sees the occurrence of a movement. In simple terms, the mirror neuron fire off after watching someone to move. The use of the word mirror is not a coincidence. Mirror therapy triggers firing of mirror neurons after a patient notices an illusion of affected arm as it moves in the mirror. Even though it is a mere reflection of a natural body part such as an arm, studies show that the brain perceives it as an affected part. The mobility improves after moving the affected area to inspire to move the affected.

    Neuroplasticity effect

    The mirror image tricks the brain into thinking that the affected body side but the truth is that the image is of the healthy part. The conscious mind knows it is a reflection, but the illusion helps the brain to rewire through a phenomenon called neuroplasticity. Plasticity is the ability of a cell to change. Each time a person makes a movement or the brain assumes that there is mobility, it is building connections.

    If the brain injury was extremely severe to cause stroke, parts of it might have more damage, and it will begin to form new connections. Damage to the brain that hinders an ability to move a part of the body, the area requires repopulation with healthy connecting neurons to regain a full movement. The brain has a role in repurposing cells that control the other parts and trains them to learn new tasks.

    Therapists can harness neuroplasticity to the advantage of a patient in rehabilitation. Approaches like mirrors or visualization utilize neuroscientific principles for rehabilitating areas of the brain for survivors to regain new control of their thinking as well as an independent ability to complete the daily tasks.

    A developer of mirror box for use in mirror therapy therapeutic approach to regenerate neural networks that control the limbs as well as other body parts Vilayanur S. Ramachandran had the intention to address phantom limb pain. A mirror box uses mirrors to create an impression in the brain of a user that the movement of an affected body part is taking place whereas it is the one that is not suffering the effects of brain injury. The reflective surfaces in a box trigger patients to perform exercises using the unaffected limbs as the appearance seems as if the exercise is on the affected limb.

    A study on the efficiency of the mirror therapy supports confirms that it a supports motor recovery even in post-stroke hemiparesis. The theory behind mirror therapy is that positive visual feedback encourages a neuroplastic change leading to quicker recovery for the survivors. Mirror boxes are on sale, but those with a specific preference might ask for customization.

    Mirror therapy works in an almost similar way to another rehab technique whose basis of performance is on the science of visualization. Information on rehabilitation after brain injury and stroke show that visualizing or mental rehearsal of a task can cause the same effects as performing a task. A study on visualization showed that it increases the efficiency of brain recovery when someone performs it together with physical activity rather than rely on conventional rehabilitation or practice on its own. Visualization can boost mirror therapy for rehabilitation of brain injuries because it has powerful effects with richness in sensory details. They show the effect of sights, feelings, and smells. Visualization, for instance, helps a patient who is unable to walk after a brain injury or stroke can have a vivid imagination of strolling in a part while doing rehabilitative exercises.

    Does Mirror Therapy Work

    Mirror therapy is an efficient way of rehabilitation the brain and helping a patient to achieve the normal functionality of the body after a brain injury. It is more efficient when the injury affects one side of the brain than the other in a similar way to a stroke. It can leave the patient feeling weaker and off-balance on one side. Sometimes the patients are unable to stand upright or use an arm or leg on the affected side. Exercises and physical therapy helps much in the recovery. Mirror therapy still plays some role because they will fire the neurons.

    An example is a study by a team of researchers in Germany who undertook 62 studies on mirror therapy as way brain rehabilitation. The study was on 1892 patients, and the outcomes showed that the mirror therapy led to the moderate improvement of the motor action. It also helped in the daily activities. Mirror therapy also helped in the management of complex regional pain syndrome a form of chronic pain that occurs after damage to the nerves usually after complications of brain injury such as stroke. However, the scope of research did not include studying whether mirror therapy helps with neglect that occurs when the people have hard times noticing the things in a visual field of the bad side.

    It does not hurt to try mirror therapy for those who want to test means that will help in rehabilitation from brain injury. However, it is not a reason to replace all the efforts of physical therapy and activity.

    Mirror therapy is not a replacement to other standard therapies but should be a supplement to what they achieve. It is as a good as other treatments but one of the varieties to try along the recovery training that a patient gets from a therapist. Mirror therapy is a non-pharmacological and alternate treatment strategy that some therapists propose as a way of managing PLP. It is a neuron-rehabilitation technique with a design to re-modulate the cortical mechanisms. MT is a technique that enables patients to perform movements with the unaffected limb while watching a mirror reflection superimposed over the affected limb that is out of the picture in the instance. It provides positive feedback and creates a visual illusion to motor cortex by creating an impression of a movement of the affected limb. This approach offers potential relief through the ocular dominance of the motor and the sensory processes.

    Since PLP is very important as well its management, mirror therapy offers clinicians a low cost and a simple to implement rehabilitation technique. The higher weight of evidence about the efficiency of this process show that it has more benefit when in use as a sequential or combined therapy like graded motor imagery but not as a stand-alone modality.

    Nonetheless, Mirror Therapy is not something to disregard. A crossover study on the effects of MT -Garry, Loftus & Summers (2004)-on healthy individuals shows that viewing a mirror image of an active hand makes the neurons in the ipsilateral primary motor cortex to be excited more than a direct view without using the mirror. The trend to view a mirror image shows that the patients undergoing rehabilitation of brain injuries will also favor watching their limb or body part move on the mirror. The movement prompts the brain to attempt to start moving the side with mobility difficulties.

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