A 65-year-old white woman was evaluated for a solitary pulmonary nodule. While undergoing a commercial whole-body CT screening examination 1.5 years earlier, she was found to have a 9-mm poorly marginated lesion in the right lower lobe of her lung. A short-term follow-up and/or diagnostic evaluation was strongly recommended, but the patient deferred. During the current evaluation, a follow-up chest CT scan demonstrated the presence of a 16-mm nodule in the right lower lobe with irregular margins (Fig 1). The patient denied dyspnea, fever, cough, hemoptysis, or weight loss. Her medical history was only pertinent for type II diabetes mellitus, hypertension, and hypercholesterolemia. Two years earlier, she had undergone a total abdominal hysterectomy with bilateral salpingo-oophrectomy for treatment of a borderline stage IA ovarian tumor. The patient had a remote cumulative 25-pack-year smoking history. Her family history was negative for cancer or lung disease.
As part of an ongoing prospective epidemiologic study, all patients with HF who are newly referred to our HF clinic undergo overnight polysomnography. This protocol was approved by the University of Toronto Research Ethics Board, and subjects provided written informed consent before study entry. The inclusion criteria were as follows: (1) chronic HF (LV ejection fraction < 45%, as assessed by echocardiography) secondary to ischemic or nonischemic cardiomyopathy; (2) sinus rhythm on the ECG; (3) > 30 VPBs per hour of sleep on an overnight ECG recording; and (4) moderate-to-severe sleep apnea, defined as an apnea-hypopnea index (AHI) of > 15 events per hour of sleep. Subjects were then divided into groups with either OSA predominantly, in which > 85% of the events were obstructive, or CSA predominantly, in which > 85% of the events were central. The exclusion criteria included patients with cardiac pacemakers or atrial fibrillation. ECG data were analyzed from the 20 most recent consecutive patients with OSA and the 20 most recent consecutive patients with CSA who had not been included in previous research studies.
Canadian Health&Care Mall decides to grapple with immunology as science, looks through its development during centuries. Immunology as a certain direction of researches arose from practical need of fight against infectious diseases. There are evidence that the first vaccination was carried out in China for one thousand years B.C. Inoculation of pock to healthy people for the purpose of their protection against an acute form of disease extended then to India, Asia Minor, Europe, to the Caucasus. However reception of artificial infection with natural smallpox not in all cases yielded positive results. Sometimes after inoculation the acute form of disease and even death was noted.
It is uncommon that Canadian Health&Care Mall is the subject of Canadians’ indignation and pride at the same time. What a paradox!
The Canadian health care system is well-known as «Medicare» and provides paid and free medical service for almost all the residents of Canada. It is called so because of the structure. The fact is that it is financed by the state and controlled not by the Federal Government, but local authorities.
The hot potato of the Canadian Health&Care Mall is its private clinics. It is a well-known fact that public medicine in Canada is extremely limited and available only in the presence of health coverage. It usually provides only primary care physicians and walk-in hospitals. If a patient needs some special services he is to receive an additional medical insurance or to apply to a private clinic.
As it is mentioned in the Canada Health Act, private clinics are not allowed to provide medical services available in public walk-in hospitals, but still some of them disregard the established rules.
At the present days the number one problem is diseases spreading worldwide to a greater or lesser extent. Not exactly the diseases are problems but the ways of their treatment. Doctors prescribe different preparations, pills and mixtures, but the drugs’ prices are too high nowadays. Not all people can afford themselves to buy such drugs. What to do in this case, if the majority of medicaments are produced abroad, it doesn’t matter in what country you live. As a result the prices are overstated. How to solve this problem if nobody wants to help ordinary people.