Cardio-ankle vascular index in Turner Syndrome Patients

Turner Syndrome (TS) also known as Monosomy X, is a sex chromosomal abnormality in the X chromosome of individuals in particular the 45 karyotype . The disorder arises due to the partial loss or complete loss of a sex chromosome from an abnormal formation in reproduction during non-disjunction in meiosis . The disorder far more apparent in females with a ratio of "1 in 3000" women being affected is quite onerous . From its many symptoms is stunt in developmental growth, premature ovarian failure as well as a heart defect. The biggest health concern for individuals with Turner Syndrome is the early onset of cardiovascular malfunction.
Heart defects in a prepuberty adolescent with Turner syndrome is among the most leading causes of morbidity and mortality . Recent studies show early detections may help researchers understand new techniques to efficiently treat heart defects. A cardiovascular complication is a broad term that often covers many defects from an aortic aneurysm, valve disorders to aortic dissolution. Many of these defects can easily lead to far more serious complications such as ruptured or dissection of the aorta . A method of recognizing cardiovascular defect is through a cardio-ankle index . Cardio-ankle vascular index (CAVI) is calculated by measuring patient's Arterial stiffness. Arterial stiffness is the thickening of the artery walls due to hypertension that collapses the artery walls causing an individual to be hypertensive . The CAVI reflects the stiffness of arteries independent of the changes in blood pressure and measures the blood flow from the ascending aorta to the ankle arteries . TS patients show a greater increase in arterial stiffness consistent with CAVI then healthy individuals . This data collected from CAVI better help physicians on treating and serving TS patients with their inherent vasculopathy. The many disorders associated with Vasculopathy can often be reduced if caught early on with treatment, therapies and cardiac surgeries. Unfortunately, Turner Syndrome is unpreventable due to its random chromosomal assignment during non-disjunction. However, new possible inventions with the help of biomedical technology can be the solution that can help tackle some of the detrimental effects and symptoms. Something that may aid the search for a permanent cure for Turner Syndrome may be biomedical engineered devices. Neuroscientist's have been using devices such as cuffing's on sciatic nerves to help record stimulations of electrode . A similar device like a vascular cuff could be tailored towards TS patients by assisting the stiffness of the arteries. The details of such ideas and inventions have not been discussed in detail among researchers but appear to be possible soon.
The emergence of biomedical engineered devices has unlatched an innumerable opportunity for researchers to find solutions for individuals with Cardiovascular defects. Cardio-ankle vascular index (CAVI) alongside prototypes for medical devices may be the possible long-term solution for Tuner Syndrome patients and an avenue within the field of Vasculopathy research. As of now, in 2019 Turner syndrome has yet to have a cure but with rapid technological advancement and the integration of medicine and technology, there are endless possibilities and hope for TS patients.
Defects in the United States Articles of Confederation are what were ultimately going to destroy the American National Government. These defects were divided into three main parts, each affecting the country in different ways. For one, there was no power to enforce federal laws. The states could pass laws, but not ensure people followed them. Therefore, they "have no powers to exact obedience, or punish disobedience." If this problem were ongoing, the United States would be proof of a government without any constitutional power to enforce the execution of their own laws. Not being worse than the inability of the constitution to sanction its laws, but still a defect is the lack of mutual guarantee of the state government. By not having this guarantee in place, the union cannot help fighting off any threats made towards the state constitutions. If there were a foreign invasion, and they were to take the money or power of the states, affecting their liberties, the National Government legally cannot intervene. They can only stand back and watch it ruin them. Lastly, the government's inability to raise income from the states was another mistake in the Confederation. The financial needs during this time period were not being met, but they could not forcibly make the states pay what they demanded of them. There was no way to determine a nation's wealth, because of all the factors that come to play. It is argued that to increase the government's revenue, a tax must be applied towards everyday life. But there must be a limit to this consumption tax, because if they are too high, consumption will go down, thus, not making any enough money. So, there is a fair balance while getting the government money.
Fast forward in American history, these issues have been solved for the good of the American National Government. Unlike the 18th century, now, no law-breaking action goes unpunished. People who break laws face: time in prison, fines, injunctions and other forms of punishment. Therefore, the government has the upper hand. To correct the second defect addressed by Hamilton in Federalist Paper No.21, we have Article IV, Section 4 of the constitution. In this article, it is stated the United States must "guarantee to the states a republican form of government and provide protection from foreign invasion and domestic violence." This is called The Guarantee Clause. It is the opposite of what the Articles of Confederation originally offered. When it comes to taxation in the United States now, it is set up on the federal and state level. We pay income taxes and sales taxes on our everyday purchases. The sales tax is not excessive; therefore, it balances out. To ensure everyone pays their taxes at the end of every year, there are penalties in place.
When these problems were first addressed in Federalist Paper No.21, Hamilton was fearful that the cause for the constitution might be lost in his home state. Therefore, it was not surprising when he decided to defend the new constitution, because he favored in strengthening the government. There were people who felt the government would be too strong and would limit individual freedoms designated to the people. Writing the Federalist Papers helped persuade people to accept ratifying the Constitution, but it also helped people better understand what the writers of the Constitution meant when they first drafted it. Now in day, the interpreters of the Federalist Paper are judges, lawyers, students, etc. They have held it up to determine the true intentions of the framers of the U.S constitution.
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