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The sternum together with the rib bones protects the inner organs such as heart and lungs from trauma and physical injury.
Though sternum protects the inner vital organs like heart and lungs, the pain in the sternum has nothing to do with cardiac problem.
Sternum pain is not serious condition but if the pain persists for long time, you should consult your family physician. The MELIO magnetic therapy set consists of the broad back PIANO applicator and the small flat MANIC applicator.
The Lung Meridian originates in the middle portion of the body, and runs downwards connecting with the large intestine. According to TCM, the lung rules and regulates qi throughout the body and administers respiration (breathing).
The Spleen Meridian begins at the big toe and runs along the inside of the foot crossing the inner ankle. The spleen is responsible for the transformation and transportation of different substances, and is the foundation of our after-birth existence.
Disharmony of the Heart Meridian leads to pain at the heart position (precordial pain or pain at the sternum). Disharmony of the Liver Meridian leads to groin pain, chest fullness, urinary incontinence, difficulty urinating, swelling of the lower abdomen and hernias.
The Small Intestine Meridian starts from the tip of the little finger and crosses the palm and wrist.
Disharmony of the Small Intestine Meridian presents mainly as symptoms along its pathway such as a swollen chin, stiff neck, sore throat, hearing problems, yellow eyes, and pain along the shoulder, upper arm, elbow and forearm. The Bladder Meridian starts at the inner side of the eye and goes across the forehead to reach the top of the head where it branches into the brain. The Triple Heater Meridian begins at the outer tip of the ring finger and goes along the back of the hand, wrist, forearm and upper arm, until it reaches the shoulder region where it branches off. Disharmony of the Triple Heater Meridian leads to symptoms like abdominal distention, edema (swelling), urinary incontinence, difficulty urinating, loss of hearing, and ringing in the ears (tinnitus).
The Gall Bladder Meridian starts from the outer corner of the eye and divides into two branches. The Large Intestine Meridian starts from the tip of the index finger and runs between the thumb and the index finger. Disharmony of the Large Intestine Meridian can lead to symptoms of abdominal pain, intestinal cramping, diarrhea, constipation and dysentery. The Stomach Meridian starts from the end of the Large Intestine Meridian at the side of the nose, and passes through the inner corner of the eye to emerge from the lower part of the eye. Stomach Meridian disorders have symptoms of stomachache, rapid digestion, hunger, nausea and vomiting, or thirst. Tourists from malaria-free regions who visit areas with a high prevalence of malaria are highly vulnerable to infection for Plasmodium spp. Severe malaria is caused by Plasmodium falciparum, a protozoan belonging to the Sporozoa class of the Plasmodiidae family whose genus is Plasmodium and whose species is Plasmodiumfalciparum. This disease remains an important cause of morbidity and mortality in many areas, and the severe forms of the disease require treatment in intensive care units.(12) This article is focused on the clinical and pathophysiological aspects of severe malaria with the aim of providing information concerning diagnosis and therapy. Seventy-nine references were selected based on their focus on the intensive care of malaria patients. The severity of malaria depends on the interaction between the host (vulnerability and immune status) and Plasmodium spp. Due to its shorter tissue cycle, higher merozoites production during tissue and erythrocyte schizogony and the ability to infect any age of red blood cells, P. The capacity of infected cells to bind to endothelial cells depends on host cells receptors, such as ELAM-1, ICAM-1, VCAM-1 and CD36.
Other factors may protect individuals from severe malaria, such as glucose-6-dehydrogenase deficiency, sickle cell syndrome and thalassemia. The clinical features and laboratory results vary widely among cases of severe malaria and affect multiple organs and organ system disorders (see Table 1).
The main clinical-pathological features of severe malaria will be discussed below and include central nervous system (CNS) involvement, severe anemia, renal failure, pulmonary dysfunction, shock, disseminated intravascular coagulation, hypoglycemia, metabolic acidosis and liver dysfunction.
The development of cerebral malaria progresses from symptoms, such as headaches, behavioral changes and confusion, to seizures and coma. Studies have shown that viral infections (such as HIV) and bacterial and parasitic infections (such as helminths) increase the likelihood of severe anemia in patients with P. The effects of infected red blood cells on the microcirculation of the patient are the main cause of ARF. The inflammatory mediators released by the immune response induce vasoconstriction and the release of catecholamines, which then additionally increase vasoconstriction. Endothelial injury is likely to play a central role in lung injury due to the adherence of the infected red blood cells, cytokine release and leukocyte adhesion.(53) In the post-mortem studies of patients with P. Attempts to compensate for metabolic acidosis may include hyperventilation, as has been seen with Kussmaul breathing. The strategy recommended by the Brazilian Health Ministry consists of early diagnosis and timely and appropriate therapy.(60) Recent studies indicate that delayed diagnosis is responsible for the worsening of malaria in patients, especially those with malaria caused by P.
Malaria should be suspected in any subject who has a fever of unknown origin, who has a history of visiting regions where malaria is endemic or who has visited the Atlantic Forest.(61) In addition to natural transmission (Anopheles spp. When intensive care physicians are asked to evaluate a case of fever of unknown origin, malaria should be suspected as a differential diagnosis along with other infections, such as meningitis, typhoid fever, sepsis, influenza, dengue, hepatitis, leptospirosis and viral encephalitis. The diagnosis of malaria is confirmed through the microscopic identification of Plasmodium spp. 2) Thin blood smear assess the form of the parasite and can differentiate between infecting species, which is important for choosing the appropriate therapy. Blood for the thick blood smear can be obtained from any peripheral vein or by digital pulp puncture.
For the thin blood smear assessment, the different species characteristics should be considered in reference to the differential diagnosis of P.
In addition to hematoscopy, other methods are in development for the diagnosis of malaria, such as the capillary method for parasite identification (using acridine orange staining) and ParaSight®. In recent years, several studies have used polymerase chain reaction (PCR) for Plasmodium spp.
Because the level of parasitemia determines the severity of the infection, it must be controlled. Although age is an important factor, the patient's weight should be considered the most important factor for maximal effectiveness and minimal toxicity when adjusting the dosage of these drugs.(67) The Brazilian Health Ministry provides antimalarial therapy free of charge across the country.
In addition to antimalarial drugs, general supportive measures, as shown on Table 3, should be considered. Appropriate follow-up, advanced support and early diagnosis can impact the disease-related mortality. It is the area of chest bone located in the central part of the chest and is in the shape of “T”.
The sternum pain can be as a result of damage of cartilages or injury to the rib cartilage bone.
The doctor may prescribe corticosteroid drugs or anti-inflammatory medicines for healing pain.
The PIANO applicator may be used for example for treatment of back and spine pain in all its sections a€“ the small of the back, lumbar, thoracic, neck. Spleen function is essential in maintaining the digestive power of the body and transforming food into qi and blood.
Crossing the middle of the sole and the arch of the foot, it circles behind the inner ankle and travels along the innermost side of the lower leg and thigh, until it enters the body near the base of the backbone. After crossing the inner ankle, it continues to go upwards along the inner side of the lower leg and the thigh, until it reaches the pubic region. It runs upwards along the posterior side of the forearm until it reaches the back of shoulder where it ends at the uppermost part of the back (the bottom of the neck).


It is often related to symptoms caused by external pernicious influences (outside influences that cause disease such as cold, wind, fire, dampness, dryness and summer heat). One branch travels internally into the chest and passes through the pericardium and diaphragm uniting the upper, middle and lower heater (triple heater).
Pain in the pharynx (throat), eyes, cheek, back of the ear, shoulder and the upper arm can occur as these structures are located along this meridian's pathway.
Hence, the disharmony of the Gall Bladder Meridian causes symptoms such as a bitter taste in the mouth, dizziness, headache, and pain at the outer angle of the eyelids. It then proceeds along the lateral side of the forearm and the anterior side of the upper arm, until it reaches the highest point of the shoulder. Since it passes through the oral cavity and the nose, symptoms like toothache, a runny nose, nosebleeds, and pain or heat along the meridian pathway can also indicate a disorder in this meridian. Other symptoms that relate to disorders along the meridian pathway include abdominal distension, ascites (a fluid build up in the abdomen), sore throat, nosebleeds, or pain in the chest or knee.
Considering the epidemiological reach of Plasmodium falciparum, which is almost always responsible for the most severe cases of malaria, a discussion of the clinical features and therapeutic interventions is important.
Brazil has the largest number of cases on the American continent with an estimated 300,000 yearly cases.(2) Reporting this disease is mandatory in Brazil. The DeCS (health sciences key words) search strategy included the keywords malaria and intensive care.
In this process, infected cells adhere to non-infected cells and form conglomerates that block microcirculatory flow.
The expression of these receptors may vary according to the concentration of cytokines, such as tumor necrosis factor (TNF-alpha), which is produced and released from activated macrophages in the presence of material from the disrupted infected cells. The consequent renal injury is directly related to direct catecholamine toxicity of the renal parenchyma, as well as with the hemodynamic implications that result in ischemia. The pathophysiology of adult hypoglycemia is usually associated with hyperinsulinemia, which may result from pancreatic cell stimulation and Plasmodium spp-derived factors.
The main symptoms include jaundice (increased direct bilirubin), hepatomegaly and a mild increase in serum aminotransferase. DNA detection.(64-66) However, due to the cost, this technique has not been routinely used for diagnosis and is restricted to research sites. Fast-acting erythrocytary schizonticides, such as artemisinin derivatives, should be prescribed. Parasitemia assessment after 24 hours of treatment is important to detect treatment failures, especially in patients with an unchanged or worsening status. Hill DR, Ericsson CD, Pearson RD, Keystone JS, Freedman DO, Kozarsky PE, DuPont HL, Bia FJ, Fischer PR, Ryan ET; Infectious Diseases Society of America. Siqueira-Batista R, Gomes AP, Calixto-lima L, Vitorino RR, Alvarez-Perez MC, Mendonça EG, Oliveira MGA, Geller M.
Mockenhaupt FP, Hamann L, von Gaertner C, Bedu-Addo G, von Kleinsorgen C, Schumann RR, Bienzle U.
There may be acute or chronic pain in the sternum and on certain occasions, there may be crackling sensation on the sternum bone.
You will get sternum pain if there is some injury to sterno clavicular joint, fracture in the sternum, trauma to the collarbone and injury to the cartilages of sternum and damage caused to the lymph nodes. Thanks to its size its effect also reaches the related musculature whose overall stiffness and local contractions often significantly add to pain development. This meridian branches out from the axilla (armpit) and runs down the medial aspect of the upper arm where it crosses the elbow crease. Symptoms like chest discomfort with a fullness sensation, dyspnea (shortness of breath), cough, and wheezing indicate Lung Meridian disharmony. Once it enters the abdominal cavity, it internally connects with the spleen and continues upward to reach the Heart Meridian. If the Spleen Meridian does not function properly, qi cannot be efficiently transported to the spleen. The second runs upwards along the throat towards the eyes, and the third branch emerges under the arm and runs along the inner side of the forearm, elbow and upper arm. If there is insufficient nourishment and warming of the kidney, symptoms like edema (swelling), constipation, and diarrhea can indicate an imbalance in this meridian.
It is also the first line of defence against the Heart from External Pathogenic Influences. At this position, it first branches off and moves internally through the heart and stomach to reach the small intestine. One branch crosses the center of the base of the neck and extends downwards parallel to the spine. Because the Tai Yang Meridian is considered the most exterior, it is the first meridian to be invaded if there is any external attack. The other branch runs externally up the side of the neck, circles the ear and face, and finally ends at the outer end of the eyebrow where it connects with the Gall Bladder Meridian. After curving behind the ear, it reaches the top of the shoulder and crosses the lateral side of rib cage and abdomen, until it ends up at the side of the hip. Pain along the meridian pathway such as in the axilla (armpit), chest, lower chest, buttocks and the lateral side of the lower limbs can also indicate a disorder of the Gall Bladder Meridian.
It then turns upwards, passing in front of the ear, until it reaches the corner of the forehead where it splits into an internal and external branch. In the cases of patients with severe malaria, admission to an intensive care unit is mandatory to reduce complications.
If they are not appropriately treated, they may have their diagnosis delayed upon return home. The codification in 2002 of the Plasmodium falciparum genome provided the basis for comparative proteomics trials.
The search for articles was conducted through the SciELO (Scientific Electronic Library Online) and PubMed (U. Both infected and noninfected red blood cells also become rigid in cases of severe malaria, which additionally affects blood flow.(24) Cytoadherence explains why only young trophozoites are visible in peripheral blood samples. In addition to TNF-alpha, other substances are released into the circulation, such as interleukins IL1, IL6 and IL8. At the cellular level, activated phagocytic cells release nitric oxide and toxic oxygen derivatives that induce the destruction of infected red blood cells in the spleen. In some cases, edema is associated with the infusion of an excessive amount of fluids.(13) Fluid replacement therapy should be judiciously administered.
Liver dysfunction has a distinctive histopathology that may result in a reduction in the synthesis of coagulation factors, in the impaired metabolism of certain antimalarial drugs and in changes to glycogenesis, all of which contribute to hypoglycemia and lactic acidosis.
Thin blood smear can identify the species, but shows less sensitivity than thick blood smear.
Admission into intensive care units should be considered for the management of these patients. Fractionation and identification of proteins by 2-DE and MS: towards a proteomic analysis of Plasmodium falciparum. Proteome analysis of separated male and female gametocytes reveals novel sex-specific Plasmodium biology. Multidrug-resistant Plasmodium vivax associated with severe and fatal malaria: a prospective study in Papua, Indonesia. The basolateral domain of the hepatocyte plasma membrane bears receptors for the circumsporozoite protein of Plasmodium falciparum sporozoites. Divergent roles of IRAK4-mediated innate immune responses in two experimental models of severe malaria. Complications and mortality patterns due to Plasmodium falciparum malaria in hospitalized adults and children, Rourkela, Orissa, India.
Common polymorphisms of toll-like receptors 4 and 9 are associated with the clinical manifestation of malaria during pregnancy. Single nucleotide polymorphisms of Toll-like receptors and susceptibility to infectious disease.


Lung injury in uncomplicated and severe falciparum malaria: a longitudinal study in Papua, Indonesia. Parasite burden and CD36-mediated sequestration are determinants of acute lung injury in an experimental malaria model.
Diagnosis of malaria aided by polymerase chain reaction in two cases with low-level parasitaemia. Standardization of a very specific and sensitive single PCR for detection of Plasmodium vivax in low parasitized individuals and its usefulness for screening blood donors. Towards a precise test for malaria diagnosis in the Brazilian Amazon: comparison among field microscopy, a rapid diagnostic test, nested PCR, and a computational expert system based on artificial neural networks. Epidemiology, pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection. To avoid complications such as lymphoma in sternum, it is better you consult the doctor and take imaging test to diagnose the illness. The PIANO applicator causes improvement of blood circulation in the exposed tissue, thus achieving relaxation of the muscles and acceleration of clearance of acid products of metabolism. It continues until it passes above the major artery of the wrist, and emerges at the tip of the thumb. Externally, the Spleen Meridian continues moving toward the chest and branches out to reach the throat and the root of the tongue. As a result, symptoms like abdominal distention, loose stools, diarrhea, epigastric pain, flatulence and a heavy sensation in the body occur. It then crosses the inner side of the wrist and palm and ends at the inside tip of the little finger, where it connects with the Small Intestine Meridian.
Pain in the inner side of the forearm and heat in the palm may also indicate problems in this meridian.
Over the abdomen, it runs externally upwards until it reaches the upper part of the chest (the inner side of clavicle). Pain in the groin and pharynx (throat), which are located along the meridian's pathway, also can indicate a problem with the Kidney Meridian.
Afterwards, it goes up the abdomen and reaches the lower chest to connect with the liver and gall bladder.
The second branch travels externally across the neck and cheek until it reaches the outer corner of the eye and then enters the ear. Therefore, its disharmony can cause symptoms such as difficult urination, incontinence, painful eyes, runny nose, nose bleeding and nasal congestion. The other branch enters the cheek and runs internally downward, through the neck and chest to connect with the gall bladder.
The internal branch emerges from the lower jaw, running downwards until it reaches its pertaining organ, the stomach. To have an impact on survival rates, treatment with antimalarial drugs and supportive measures should be initiated as quickly as possible. The surface of infected red blood cells have electrodense protrusions that easily adhere to the post-capillary venulae and capillary vessels of several organs,(22) such as the brain, lungs and kidneys.
In the humoral mechanism, antibodies activate the macrophage and monocyte receptors on the surface of the infected red blood cells, which causes an increase in parasitemia. Some studies have shown that this method has a sensitivity and specificity of greater than 95%.(60) However, this test is not useful for cure control. The prognosis for this infectious process is closely related to the initiation of early therapy, the appropriate supportive measures and the management of complications. The applicator is also excellent for breast applications for treatment of angina pectoris and regeneration of the heart muscle after myocardium infarct or for abdominal applications for treatment of stomach and duodena disorders (ulcers), inflammations of pancreas and intestines, constipation and painful menstruation. Another branch emerges from the back of the wrist and ends at the radial side of the tip of the index finger to connect with the Large Intestine Meridian.
For example, a person may feel pain in the shoulder and back or along the anterior border of the medial aspect of the arm. In addition, symptoms such as pain at the root of the tongue, swelling of the inner side of the lower limb may also indicate disharmony of the Spleen Meridian.
A second branch emerges from the kidney and moves internally upwards and passes through the liver, diaphragm, lungs and throat, finally terminating at the root of the tongue. A short branch in the cheek moves upward to the inner corner of the eye where it connects with the Bladder Meridian. The other branch crosses the back of the shoulder and runs downward on the outside, which is adjacent and parallel to the inner branch.
Pain in the head, neck, back, groin and buttock areas indicate disharmony in the Bladder Meridian pathway.
It continues moving downwards and comes out in the lower abdomen, where it connects with the other branch at the hip. The other travels externally upwards where it passes the neck and cheek, and enters the lower teeth and gums. The external branch crosses the neck, chest, abdomen and groin where it goes further downward along the front of the thigh and the lower leg, until it reaches the top of the foot.
During acute infections, there is a poor antigen-specific response that then slows the systemic immune response.
Blood samples should be drawn for the following laboratory tests: blood glucose, complete blood count, parasite counting, arterial blood gas and both renal and hepatic function parameters. MANIC applicator is very suitable for application to places where intensive therapeutic effect is desired, such as attenuation of joint pain, toothache, tinnitus, tennis elbow and carpal tunnel.
In treatment, it is often best to approach heart problems via the Pericardium, rather than directly. It continues down until it reaches the buttocks where two branches run across the back of thigh along different pathways that join at the back of the knee. This parasite is introduced through the mosquito's saliva in the form of sporozoites (the infecting form). In regions where malaria is endemic, individuals who are continuously exposed to malaria gradually develop specific antibodies that increase in number and stabilize by the third decade of life.(13) The immune response provides protection against the most severe presentations of malaria. One of its internal branches originates internally from the eye and moves downwards to the cheek where it curves around the inner surface of the lips. The joint meridian then continues along the back of the lower leg, circles behind the outer ankle, runs along the outside of the foot and terminates on the lateral side of the tip of the small toe, where it connects with the Kidney Meridian. Another branch emerges from the top of the foot and ends at the big toe to connect with the Spleen Meridian.
A detailed neurological examination is recommended, especially with the use of the Glasgow scale for the assessment of consciousness.
These drugs are well tolerated with only a few adverse effects, such as diarrhea, abdominal pain and nausea. Another branch starts from the liver and passes through the diaphragm to reach the lung where it connects with the Lung Meridian and completes the cycle of the twelve meridians. Another small branch leaves the meridian and terminates at the big toe to connect with the Liver Meridian.
The divisions of the blood schizonts (schizogony) develop into 8 to 32 merozoites, depending on the species.(19,20) The infected cells are then disrupted, liberating the merozoites, which then restart the cycle and cause fever paroxysms. The blood schizogony periodicity, which varies between the species, is 36 to 48 hours for P.
The intravenous infusion of this medication can lead to thrombosis, arterial hypertension and changes in heart rhythm. Currently, it is recommended that clindamycin should be prescribed along with quinine, as is shown in table 2.



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