ABSTRACT
Uncontrolled breathing is the most critical and challenging situation for a healthcare person to patients. It may be due to simple cough/cold/critical disease to severe respiratory infection of the patients and resulting directly impacts the lungs and damages the alveoli which leads to shortness of breath and also impairs the oxygen exchange. The prolonged respiratory failure in such patients may cause death. In this condition, supportive care of the patients by medicine and a controlled oxygen supply is only the emergency treatment. In this paper, as a part of emergency support, the intelligent set-point modulated fuzzy PI-based model reference adaptive controller (SFPIMRAC) is delineated to control the oxygen supply to uncomforted breathing or respiratory infected patients. The effectiveness of the model reference adaptive controller (MRAC) is enhanced by assimilating the worthiness of fuzzy-based tuning and set-point modulation strategies. Since then, different conventional and intelligent controllers have attempted to regulate the supply of oxygen to respiratory distress patients. To overcome the limitations of previous techniques, researchers created the set-point modulated fuzzy PI-based model reference adaptive controller, which can react instantly to changes in oxygen demand in patients. Nonlinear mathematical formulations of the respiratory system and the exchange of oxygen with time delay are modeled and simulated for study. The efficacy of the proposed SFPIMRAC is tested, with transport delay and set-point variations in the devised respiratory model.
Subject(s)
Biopsy/statistics & numerical data , Endoscopy, Gastrointestinal/statistics & numerical data , Physicians/statistics & numerical data , Platelet Aggregation Inhibitors/adverse effects , Practice Guidelines as Topic , Professional Practice/statistics & numerical data , Aspirin/adverse effects , Biopsy/adverse effects , Clopidogrel , Endoscopy, Gastrointestinal/adverse effects , Gastrointestinal Hemorrhage/etiology , Humans , Risk , Surveys and Questionnaires , Ticlopidine/adverse effects , Ticlopidine/analogs & derivativesABSTRACT
We present the case of a 28 year old lady with refractory Crohn's Disease treated with infliximab throughout her pregnancy. Her baby was born healthy and received a Bacillus Calmette-Guérin (BCG) vaccine aged 3 months. Soon after this the infant became unwell and died aged 4.5 months. At post-mortem the cause of death was attributed to an unusual complication of the BCG vaccine, known as disseminated BCG. BCG vaccination is contraindicated in individuals who are receiving immunosuppressive drugs. We recommend physicians should exercise caution before such vaccines are used in infants born to mothers taking anti-TNF therapies or other potentially immunosuppressive IgG1 antibodies.
Subject(s)
Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal/adverse effects , BCG Vaccine/adverse effects , Crohn Disease/drug therapy , Pregnancy Complications/drug therapy , Tuberculosis, Pulmonary/prevention & control , Adult , Contraindications , Fatal Outcome , Female , Humans , Immunosuppression Therapy/adverse effects , Infant , Infliximab , Male , Mycobacterium Infections/etiology , Mycobacterium bovis , Pregnancy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Vaccination/adverse effectsABSTRACT
Recent research evidence suggests a central role for hepcidin in iron homeostasis. Hepcidin is a hormone synthesized in the liver. Hepcidin is also thought to play a vital role in the pathogenic mechanism of anaemia in patients with inflammation or chronic disease. A 38-year-old female who presented with recurrent abdominal pain was found to have raised urinary porphyrins and a blood lead level of 779 µg/l. Her haemoglobin level was 8.3 g/dl. Her MCV was normal. Serum ferritin, B12 and folate were normal. Her serum prohepcidin level was 2,489 ng/ml (normal <450 ng/ml). To our knowledge, this is the first report of raised prohepcidin levels in a patient with anaemia of chronic disease resulting from lead poisoning.
