Hüponatreemia

Hüponatreemia on oluline ja sage organismi elektrolüütide tasakaalu häire, mille korral on seerumi naatriumisisaldus alla 135 mmol/l. Hüponatreemiat võib klassifitseerida seerumi naatriumisisalduse, häire kujunemise kiiruse, sümptomite raskusastme, seerumi osmolaalsuse ja ringleva verehulga seisundi järgi. Sümptomid võivad olla vähe väljendunud, kuid võivad olla ka rasked nagu oksendamine, südame-hingamisprobleemid, somnolentsus, epileptilised hood ja teadvusekadu. Rasked neuroloogilised sümptomid tekivad enamasti seerumi väga väikse naatriumisisalduse korral, kui tekib vedeliku ümberpaiknemine kudedes ja ajuturse.Hüponatreemia ravis tuleb leida tasakaal, et vältida kahe võimaliku tüsistuse – ajuturse ja osmootse demüelinisatsiooni sündroomi – teket. Siin on oluline osa seerumi naatriumisisalduse korrigeerimise kiirusel. Ohutuks peetakse seerumi naatriumisisalduse suurendamist kuni 10 mmol/l võrra esimesel ööpäeval ja edasi kuni 8 mmol/l võrra iga järgneva 24 tunni jooksul, kuni seerumi naatriumisisaldus on 130 mmol/l. Artiklis on kirjeldatud ka osmootse demüelinisatsiooni sündroomiga haigusjuhtu. Eesti Arst 2017; 96(9):513–52

On the Infrared Behaviour of Landau Gauge Yang-Mills Theory with Differently Charged Scalar Fields

Recently it has been argued that infrared singularities of the quark-gluon vertex of Landau gauge QCD can confine static quarks via a linear potential. It is demonstrated that the same mechanism also may confine fundamental scalar fields. This opens the possibility that within functional approaches static confinement is an universal property of the gauge sector even though it is formally represented in the functional equations of the matter sector. The colour structure of Dyson-Schwinger equations for fundamental and adjoint scalar fields is determined for the gauge groups SU(N) and G(2) exhibiting interesting cancelations purely due to colour algebra.Comment: 3 pages, 1 figure; talk given at the Quark Confinement and the Hadron Spectrum IX, Aug. 30 - Sept. 3, Madrid, Spai

Kas patsientide pöördumine erakorralise meditsiini osakonda on põhjendatud?

Eesti Arst 2018; 97(5):278–279 &nbsp

Ajukahjustusega patsiendi intensiivravi põhimõtted

Spetsialiseeritud neurointensiivravi osakondade loomine, kus on tagatud ööpäevaringne intensivisti ja õenduspersonali valve, on oluliselt parandanud raske ajukahjustusega haigete ravi tulemusi. Nüüdisajal ravitakse spetsialiseeritud osakondades raske ajutraumaga, ajuveresoonte patoloogiaga, närvisüsteemi põletikuliste haigustega,epileptilise staatusega ja närvi-lihashaigustega kaasneva hingamispuudulikkusega haigeid

Sõja- ja katastroofi meditsiini õpe meditsiinitudengitele

Eesti Arst 2014; 93(1):10–1

HELLP-sündroom

HELLP-sündroom on üks raske preeklampsia ilmingutest, mida iseloomustab hemolüüs, maksaensüümide suurenenud aktiivsus ja väike vereliistakute arv patsiendi veres. Enamikul haigetest esineb ülakõhuvalu, iiveldus, oksendamine, hüpertensioon, proteinuuria. Varajane diagnoos on eriti oluline, kuna HELLP-sündroomi puhul on ema- ja lootepoolsete raskete tüsistuste risk suurenenud. Ravitaktika sõltub raseduse kestu- sest ja patsiendi üldseisundist. Artiklis on kirjeldatud 27aastase naise haigusjuhtu, kellel 27. rasedusnädalal tekkis HELLP-sündroom, mille tüsistuseks oli platsenta enneaegne irdumine ja ajusisene hemorraagia. Eesti Arst 2006; 85 (9): 595–60

Maliigne neuroleptiline sündroom – kahe haigusjuhu esitlus

Maliigne neuroleptiline sündroom (MNS) on tsentraalset dopaminergilist süsteemi mõjutavate ravimite harva esinev, kuid potentsiaalselt eluohtlik kõrvaltoime. Diferentsiaaldiagnostiliselt tuleb MNSi peale mõelda iga neuroleptikume tarvitava verpatsiendi puhul, kellel on tekkinud kõrge palavik, lihasrigiidsus ja teadvushäire ning suurenenud kreatiinkinaasi sisaldus veres. MNSi ravis on oluline kohene põhjustava ravimi tarvitamise lõpetamine ning toetav ravi, eelkõige palaviku alandamine, vajaduse korral intensiivravi. Spetsiifi liste ravivõtete kasutamise tõhususe kohta on vastuolulisi arvamusi. Enim on kasutamist leidnud dopamiini agonist bromokriptiin ning lihasrelaksant dantroleen. Viimastel aastakümnetel on suremus MNSi oluliselt vähenenud. Enamik patsiente, kes jäävad ellu, paraneb MNSist täielikult. Eesti Arst 2008; 87(1):45−5

A study of the influence of the gauge group on the Dyson-Schwinger equations for scalar-Yang-Mills systems

The particular choice of the gauge group for Yang-Mills theory plays an important role when it comes to the influence of matter fields. In particular, both the chosen gauge group and the representation of the matter fields yield structural differences in the quenched case. Especially, the qualitative behavior of the Wilson potential is strongly dependent on this selection. Though the algebraic reasons for this observation is clear, it is far from obvious how this behavior can be described besides using numerical simulations. Herein, it is investigated how the group structure appears in the Dyson-Schwinger equations, which as a hierarchy of equations for the correlation functions have to be satisfied. It is found that there are differences depending on both the gauge group and the representation of the matter fields. This provides insight into possible truncation schemes for practical calculations using these equations.Comment: 47 page

KRAS mutation analysis in ovarian samples using a high sensitivity biochip assay

<p>Abstract</p> <p>Background</p> <p>Mutations in the <it>KRAS </it>gene are one of the most frequent genetic abnormalities in ovarian carcinoma. They are of renewed interest as new epidermal growth factor receptor (EGFR)-targeted therapies are being investigated for use in ovarian carcinoma. As <it>KRAS </it>mutations are associated with poor response and resistance to EGFR-targeting drugs, this study was conducted to obtain more information on the spectrum of <it>KRAS </it>mutations in ovarian carcinoma.</p> <p>Methods</p> <p>The presence of <it>KRAS </it>mutations in codon 12 and 13 was analyzed in frozen and formalin-fixed paraffin-embedded (FFPE) tissue with a low density biochip platform. 381 malignant (29 borderline malignancy, 270 primary carcinomas, and 82 recurrent carcinomas) and 22 benign tissue samples from a total of 394 patients were examined. <it>KRAS </it>mutational status of each sample was correlated with dignity, FIGO stage, grade, histology, and survival.</p> <p>Results</p> <p><it>KRAS </it>mutations were found in 60 (15%) samples with 58 samples deriving from malignant tissue and 2 samples deriving from benign tissue. In 55 (92%) samples codon 12 was found to be mutated. Frozen and FFPE samples concurred with respect to <it>KRAS </it>mutation status.</p> <p>Conclusion</p> <p><it>KRAS </it>mutation is a common event in ovarian cancer primarily in carcinomas of lower grade, lower FIGO stage, and mucinous histotype. The <it>KRAS </it>mutational status is no prognostic factor for patients treated with standard therapy. However, in line with experience from colorectal cancer and non-small-cell-lung cancer (NSCLC), it may be important for prediction of response to EGFR-targeted therapies.</p

Studies in Health Technology and Informatics

Background: Standards have become available to share semantically encoded vital parameters from medical devices, as required for example by personal healthcare records. Standardised sharing of biosignal data largely remains open. Objectives: The goal of this work is to explore available biosignal file format and data exchange standards and profiles, and to conceptualise end-To-end solutions. Methods: The authors reviewed and discussed available biosignal file format standards with other members of international standards development organisations (SDOs). Results: A raw concept for standards based acquisition, storage, archiving and sharing of biosignals was developed. The GDF format may serve for storing biosignals. Signals can then be shared using FHIR resources and may be stored on FHIR servers or in DICOM archives, with DICOM waveforms as one possible format. Conclusion: Currently a group of international SDOs (e.g. HL7, IHE, DICOM, IEEE) is engaged in intensive discussions. This discussion extends existing work that already was adopted by large implementer communities. The concept presented here only reports the current status of the discussion in Austria. The discussion will continue internationally, with results to be expected over the coming years