Exercise testing and risk assessment of pulmonary hypertension

Managing pulmonary hypertension (PH) involves approaches to relieve symptoms, slow disease progression, and improve patient outcomes. Advances in treatment strategies, risk assessment methods, and lifestyle adjustments have significantly improved PH care. While PH has no cure, treatment options are available to alleviate symptoms, extend life expectancy, and slow disease advancement. Tailoring treatment strategies based on the type and severity of PH as individual patient response and tolerance is crucial. The main goals include alleviating symptoms, enhancing quality of life, improving capacity, and increasing survival rates. Diagnosis and management require evaluation and regular follow-up due to the complexity of PH treatments. Different medical approaches play a role in symptom relief. Improving overall system function. Oxygen therapy and procedures such as septostomy or lung transplantation may be warranted, contingent on disease severity. Lifestyle modifications, encompassing exercise training, smoking cessation, and weight management, complement pharmacological interventions. Risk assessment tools, typified by the REVEAL risk score, have revolutionized PH care by facilitating personalized therapeutic approaches. Genetic factors are increasingly considered, heralding a new era in tailored treatment. While challenges persist, ongoing research endeavors promise.

The contribution of nursing expertise to the management of complex comorbidities in internal medicine setting: a systematic review

The burden of comorbidities is on the rise, and nursing has long been recognized as having a crucial role in assisting individuals to manage long-term conditions. Over the past ten years, a growing number of chronic disease delivery models have given nurses great opportunities to develop roles and abilities focused on effective chronic disease management. We have conducted both electronic and manual searches within the potential databases to find relevant studies. Studies from the years 2010-2023 were included. Case reports with limited sample sizes, no descriptive statistics, review papers, and meta-analyses were excluded from this review. A quality assessment for all included studies was performed. Final inclusion resulted in a total of eight studies. Cardiovascular diseases, hypertension, and diabetes were the comorbidities reported by the majority of the studies, while chronic obstructive pulmonary disease, end-stage renal disease, and metastatic cancer were reported by each study. Overall, the findings suggest that nurses play a significant role in the management of comorbidities among patients, further improving patient outcomes, reducing readmissions and hospital costs, and preventing complications. The care of patients with complicated medical and social needs is coordinated through the employment of a wide range of interventions in an internal medicine setting. Nurse-led interventions /programs can play a vital part in reducing the burden of rising comorbidities among patients. However, the role of nurses in the internal medicine setting needs to be highlighted further by evidence-based research.

Detection and screening of obstructive sleep apnea in primary care

The most prevalent sleep-related breathing condition, obstructive sleep apnea (OSA), is linked to greater morbidity and poor cardiovascular outcomes. Even though sleep disorders are frequently present, primary care physicians hardly see or treat them. Better OSA symptom and intensity identification and classification to support OSA evaluation and diagnosis were the first outcomes of a task group of the American Academy of Sleep Medicine that produced quality metrics for the treatment of adult patients with the condition in 2015. The OSA screening tools (Berlin questionnaire, Epworth sleepiness scale, STOP Bang) have proven to be effective instruments for screening of sleep disorders. The present primary care practice approach for OSA screening and evaluation is disorganized and inadequate. Patients with OSA symptomatology are seen by primary care physicians, but they are not regularly screened, assessed, or referred to a sleep specialist. For the OSA screening assessments in general practice, more psychometric investigations are required. The findings from these investigations can be applied in real-world settings to improve OSA identification.

Wound-healing and cytokine-modulating potential of medicinal oil formulation comprising leaf extract of Murraya koenigii and olive oil / Potencial de cicatrização de feridas e modulação de citocinas de formulação de óleo medicinal compreendendo extrato de folhas de Murraya koenigii e azeite de oliva

The study investigated the wound healing effect of medicinal oil (MO) formulation prepared from Murraya koenigii leaves extract (methanolic) incorporated in olive oil. The MO was visually transparent, homogenous, smooth in texture, the viscosity grade was observed as 140 cP and easily spreadable. Pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α were significantly reduced to 82.3 ± 3.5, 156 ± 6.2, 137.3. ± 5.5 pg/ml, respectively after treatment with MO when compared to disease control animals that showed IL-1ß, IL-6, and TNF-α levels of 170 ± 6, 265 ± 7, and 288.6 ± 11, pg/ml respectively. The level of pro-inflammatory cytokine in povidone iodine solution (PIS) group was 95.3 ± 3, 162 ± 6, 177.6 ± 8.9 pg/ml of IL-1ß, IL-6, and TNF-α respectively. Interestingly, the wound-healing efficacy of MO was found better as compared to povidone iodine treated standard group and concluded that MO has excellent wound healing effect.

O estudo investigou o efeito cicatrizante da formulação de óleo medicinal (MO) preparado a partir do extrato de folhas de Murraya koenigii (metanol) incorporado ao azeite de oliva. O MO era visualmente transparente, homogêneo, de textura lisa, o grau de viscosidade observado foi de 140 cP e facilmente espalhável. As citocinas pró-inflamatórias IL-1ß, IL-6 e TNF-α foram significativamente reduzidas para 82,3 ± 3,5, 156 ± 6,2, 137,3. ± 5,5 pg/ml, respectivamente, após o tratamento com MO quando comparados aos animais controle da doença que apresentaram níveis de IL-1ß, IL-6 e TNF-α de 170 ± 6, 265 ± 7 e 288,6 ± 11, pg/ml, respectivamente . O nível de citocina pró-inflamatória no grupo solução de iodopovidona (PIS) foi de 95,3 ± 3, 162 ± 6, 177,6 ± 8,9 pg/ml de IL-1ß, IL-6 e TNF-α, respectivamente. Curiosamente, a eficácia de cicatrização de feridas de MO foi encontrada melhor em comparação com o grupo padrão tratado com iodopovidona e concluiu que a preparação de MO tem efeito de cicatrização de feridas.