IFPMA Geneva Pharma Forum on 9 May 2014
Bringing Psoriasis into the Light
Presentation of Professor Mahira Hamdy El Sayed
Dermatology and Venereology, Ain Shams University
Giant cell arteritis (GCA), also known as temporal arteritis, is an inflammatory disease that affects medium and large arteries. It is most common in Caucasian women over age 50. Left untreated, it can cause permanent vision loss. Key symptoms include new headaches, jaw pain with chewing, and vision changes. Diagnosis involves blood tests showing elevated inflammatory markers and biopsy of the temporal artery showing inflammation. High-dose steroids are the primary treatment to prevent vision loss and other complications. The cause of GCA is unknown but may involve infection with certain bacteria.
A 40-year-old female presented with recurrent oral erosions for 7 years and raised red skin lesions over her body for 1 year. Examination found discoid skin plaques and oral ulcers. Laboratory tests showed positive ANA, low complement levels, and proteinuria. A skin biopsy demonstrated findings consistent with a connective tissue disease. She was diagnosed with systemic lupus erythematosus based on her skin and oral lesions, photosensitivity, positive serologies, and proteinuria. Her symptoms of renal tubular acidosis and hypokalemic paralysis also indicate an overlap with secondary Sjogren's syndrome.
Rheumatoid arthritis is a chronic inflammatory disease characterized by symmetrical polyarthritis and extra-articular features. Current management involves relieving symptoms with NSAIDs or COX-2 inhibitors while also using disease-modifying antirheumatic drugs to slow disease progression. For patients with moderate to severe active disease despite treatment, biologic response modifiers such as TNF-α inhibitors can be used and have been shown to reduce inflammation, joint damage, and improve hematological markers. Proper screening and monitoring is required when using biologics due to potential infection and malignancy risks.
Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints, causing swelling, warmth, pain, and stiffness. It results from an autoimmune reaction where the immune system mistakenly attacks healthy joint tissue. This leads to a proliferative synovitis that can cause cartilage and bone destruction over time. RA is characterized by symmetrical inflammation of multiple joints that typically involves the hands, feet, wrists, and knees. It has both articular and extra-articular effects and is associated with an increased risk of comorbidities such as lung or heart disease. The cause is unknown but involves genetic and environmental factors.
Approach towards a case of musculoskeletal disorder.#sirmohit
This document provides guidance for doctors on evaluating musculoskeletal complaints during initial patient encounters. It describes determining if the issue is articular or peri-articular, inflammatory or non-inflammatory, acute or chronic, and localized or widespread. Characteristics of articular vs. nonarticular disorders are outlined. Inflammatory conditions are distinguished from mechanical issues based on factors like stiffness, pain, and physical findings. Acute vs. chronic disorders are defined as less or greater than 6 weeks respectively. Extent of joint involvement from monoarticular to polyarticular is also addressed. Rheumatoid arthritis diagnosis criteria and distinguishing features from similar conditions are reviewed. Investigations like blood tests, synovial fluid analysis, and imaging are also summarized
Dermatomyositis is a rare inflammatory myopathy with characteristic skin manifestations and muscular weakness.
Polymyositis is a similar disease without skin lesions.
Amyopathic dermatomyositis: typical cutaneous manifestation of DM without clinical and/or laboratory findings of muscle involvement for at least 6 months after the onset of skin rash.
An acute illness caused by an autoimmune response to infection with group A Streptococcus, leading to a range of possible symptoms and signs affecting any or all of heart, joints, brain, skin and subcutaneous tissues
This document provides an overview of ankylosing spondylitis (AS). It defines AS as a chronic inflammatory disease primarily affecting the spine. Key points include that AS is strongly associated with the HLA-B27 gene and causes new bone formation and fusion of the spine. Symptoms include chronic back pain and stiffness. Treatment involves medications like NSAIDs, DMARDs, and TNF inhibitors like adalimumab, as well as exercise. Management can help improve symptoms but does not cure AS.
Giant cell arteritis (GCA), also known as temporal arteritis, is an inflammatory disease that affects medium and large arteries. It is most common in Caucasian women over age 50. Left untreated, it can cause permanent vision loss. Key symptoms include new headaches, jaw pain with chewing, and vision changes. Diagnosis involves blood tests showing elevated inflammatory markers and biopsy of the temporal artery showing inflammation. High-dose steroids are the primary treatment to prevent vision loss and other complications. The cause of GCA is unknown but may involve infection with certain bacteria.
A 40-year-old female presented with recurrent oral erosions for 7 years and raised red skin lesions over her body for 1 year. Examination found discoid skin plaques and oral ulcers. Laboratory tests showed positive ANA, low complement levels, and proteinuria. A skin biopsy demonstrated findings consistent with a connective tissue disease. She was diagnosed with systemic lupus erythematosus based on her skin and oral lesions, photosensitivity, positive serologies, and proteinuria. Her symptoms of renal tubular acidosis and hypokalemic paralysis also indicate an overlap with secondary Sjogren's syndrome.
Rheumatoid arthritis is a chronic inflammatory disease characterized by symmetrical polyarthritis and extra-articular features. Current management involves relieving symptoms with NSAIDs or COX-2 inhibitors while also using disease-modifying antirheumatic drugs to slow disease progression. For patients with moderate to severe active disease despite treatment, biologic response modifiers such as TNF-α inhibitors can be used and have been shown to reduce inflammation, joint damage, and improve hematological markers. Proper screening and monitoring is required when using biologics due to potential infection and malignancy risks.
Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints, causing swelling, warmth, pain, and stiffness. It results from an autoimmune reaction where the immune system mistakenly attacks healthy joint tissue. This leads to a proliferative synovitis that can cause cartilage and bone destruction over time. RA is characterized by symmetrical inflammation of multiple joints that typically involves the hands, feet, wrists, and knees. It has both articular and extra-articular effects and is associated with an increased risk of comorbidities such as lung or heart disease. The cause is unknown but involves genetic and environmental factors.
Approach towards a case of musculoskeletal disorder.#sirmohit
This document provides guidance for doctors on evaluating musculoskeletal complaints during initial patient encounters. It describes determining if the issue is articular or peri-articular, inflammatory or non-inflammatory, acute or chronic, and localized or widespread. Characteristics of articular vs. nonarticular disorders are outlined. Inflammatory conditions are distinguished from mechanical issues based on factors like stiffness, pain, and physical findings. Acute vs. chronic disorders are defined as less or greater than 6 weeks respectively. Extent of joint involvement from monoarticular to polyarticular is also addressed. Rheumatoid arthritis diagnosis criteria and distinguishing features from similar conditions are reviewed. Investigations like blood tests, synovial fluid analysis, and imaging are also summarized
Dermatomyositis is a rare inflammatory myopathy with characteristic skin manifestations and muscular weakness.
Polymyositis is a similar disease without skin lesions.
Amyopathic dermatomyositis: typical cutaneous manifestation of DM without clinical and/or laboratory findings of muscle involvement for at least 6 months after the onset of skin rash.
An acute illness caused by an autoimmune response to infection with group A Streptococcus, leading to a range of possible symptoms and signs affecting any or all of heart, joints, brain, skin and subcutaneous tissues
This document provides an overview of ankylosing spondylitis (AS). It defines AS as a chronic inflammatory disease primarily affecting the spine. Key points include that AS is strongly associated with the HLA-B27 gene and causes new bone formation and fusion of the spine. Symptoms include chronic back pain and stiffness. Treatment involves medications like NSAIDs, DMARDs, and TNF inhibitors like adalimumab, as well as exercise. Management can help improve symptoms but does not cure AS.
This document provides an overview of the management of rheumatoid arthritis (RA). It discusses the etiology and pathology of RA and describes the diagnostic criteria. It then outlines various treatment approaches for RA including physical therapies, medications like NSAIDs, glucocorticoids, DMARDs, and biologics. Newer targeted biologic therapies that inhibit cytokines like TNF-α, IL-1, IL-6 are discussed. The goals of RA treatment and factors influencing treatment choice are also summarized.
This document discusses hereditary spherocytosis (HS), an inherited disorder caused by defects in the red blood cell membrane skeleton. HS is characterized by spherical red blood cells that are less deformable and vulnerable to splenic sequestration and destruction. The defects are primarily in proteins like ankyrin, band 3, spectrin or band 4.2 that make up the membrane skeleton. This leads to a reduced red blood cell life span of 10-20 days instead of the normal 120 days. Clinical features include anemia, splenomegaly, jaundice, and hemolytic crises from infections. Diagnosis involves tests like peripheral smear, bone marrow examination, and osmotic fragility testing. Treatment
This document discusses autoantibodies and methods for detecting anti-nuclear antibodies (ANA). ANAs are antibodies directed against nuclear and cytoplasmic antigens and are associated with various autoimmune diseases. The three main methods for detecting ANAs are indirect immunofluorescence assay using HEp-2 cells, ELISA, and multiplex bead immunoassays. The immunofluorescence assay is commonly used for initial screening due to its ability to detect multiple antigen patterns but has limitations. ELISA and bead assays allow detection of specific autoantibodies and have improved sensitivity and specificity compared to immunofluorescence.
The document discusses atopic dermatitis (AD), also known as eczema. It defines AD as a pruritic, chronic inflammatory skin condition characterized by dry skin and itchy rashes. AD is common in childhood and often runs in families with other allergic diseases. The pathogenesis involves genetic predisposition, skin barrier defects, and abnormal immune responses. Clinical manifestations vary depending on the stage of life, from facial rashes in infants to thickened plaques on flexural areas in older patients. Treatment focuses on moisturizing the skin, identifying trigger factors, and using topical corticosteroids or calcineurin inhibitors to control symptoms.
This document discusses Kawasaki disease, an acute febrile vasculitic syndrome that mainly affects children under 5 years old. While it usually has a good prognosis with treatment, it can lead to coronary artery aneurysms in a small percentage of patients. The document covers the pathogenesis, differential diagnosis, diagnosis, management including intravenous immunoglobulin treatment, refractory disease treatment, and long term monitoring of Kawasaki disease.
1) The document outlines an overview of chronic spontaneous urticaria (CSU), including its epidemiology, clinical presentation, natural history, and pathogenesis.
2) CSU affects approximately 0.5-1% of the general population and is more common in adults than children, with a peak age of onset between 20-40 years.
3) The pathogenesis of CSU is not fully understood but is believed to involve inappropriate activation of mast cells and basophils by autoantibodies, leading to the release of inflammatory mediators that cause wheals and angioedema.
Stroke ( concise long case approach ) summaryDr. Rubz
The document provides guidance on evaluating and managing patients presenting with suspected stroke. It outlines an approach to answering 6 key questions from the history, physical exam, and investigations to determine if the patient is having a stroke, identify the location and type of stroke, understand the mechanism, assess functional impairment, and identify risk factors. Principles of acute management include aspirin, thrombolysis if eligible, controlling blood pressure and blood glucose, and preventing hyperthermia. Secondary prevention involves antiplatelet therapy, anticoagulation if indicated, carotid endarterectomy for severe stenosis, controlling hypertension and lipids, smoking cessation, and managing diabetes risk factors.
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by blood clots in arteries or veins and/or pregnancy complications. It results from antibodies that cause blood to clot more easily than normal. Symptoms include blood clots in both arteries and veins as well as pregnancy-related issues. APS can occur on its own or in conjunction with other autoimmune diseases like lupus. Treatment involves blood thinners to prevent clots and aspirin/heparin during pregnancy to prevent complications. Prognosis depends on symptoms, with blood clots requiring long-term anticoagulation and pregnancy morbidity treated to allow successful pregnancies.
This document discusses spondyloarthritis, a group of conditions affecting the spine and peripheral joints. Key points include:
- It is linked to certain HLA antigens and often runs in families. Joint involvement is usually more limited than rheumatoid arthritis.
- The main types are ankylosing spondylitis, psoriatic arthritis, reactive arthritis, and enteropathic arthritis.
- Ankylosing spondylitis commonly causes inflammation of the sacroiliac joints in late teens/early 20s. It is strongly associated with HLA-B27. Left untreated, it can cause a "bamboo spine" with fusion of vertebrae.
- TNF blockers like adal
Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems. It typically affects young women and is characterized by periods of disease flares and remissions. While the exact cause is unknown, genetic and environmental factors likely contribute to abnormal immune system functioning and production of autoantibodies. Common clinical manifestations include malar rash, arthritis, kidney problems, and hematological abnormalities. Diagnosis involves identifying clinical features and detecting autoantibodies such as antinuclear antibodies and anti-dsDNA antibodies. With proper management, 10-year survival rates are over 90%.
Bio-Markers of Heart Failure (Dr.LIKHIT T)Likhit T
A brief on bio-markers of Heart failure...First of all, I thank the Authors of all the books from which I picked the points to make this presentation.. This presentation includes classification of bio-markers and explanation according their importance.. Thank you
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints, causing pain, stiffness, and swelling. It can also impact other body systems. While the exact cause is unknown, genetics and environmental factors are believed to play a role. Common symptoms include joint deformities, fatigue, and anemia. Diagnosis involves evaluating symptoms, physical exam findings, blood tests, and x-rays. Treatment focuses on reducing inflammation and joint damage through medications like DMARDs, NSAIDs, and corticosteroids. The goals are to relieve symptoms, improve function, and prevent disability. Care requires a multidisciplinary approach including medication management, exercise, and lifestyle changes.
Cutaneous lupus erythematosus (CLE) is a manifestation of the autoimmune disease systemic lupus erythematosus (SLE) that presents with diverse skin lesions. There are three main subtypes of CLE - acute (ACLE), subacute (SCLE), and chronic (CCLE, including discoid lupus erythematosus (DLE)). CLE results from a complex interplay between genetic susceptibility, environmental triggers like ultraviolet light, and dysregulated immune responses. Histopathology is useful but not definitive for diagnosis, which relies on clinical presentation and serological markers. CLE can range from limited skin involvement to systemic disease affecting major organs.
This document provides an overview of vasculitis, including classification, pathophysiology, clinical manifestations, investigations, and management approaches. It discusses several specific large vessel vasculitides - giant cell arteritis, Takayasu arteritis, and polyarteritis nodosa. Giant cell arteritis commonly involves temporal arteries and causes headaches. Takayasu arteritis primarily affects the aorta and its branches. Polyarteritis nodosa preferentially involves the skin, nerves, gastrointestinal tract and kidneys. Diagnosis relies on tissue biopsy and imaging. Treatment focuses on glucocorticoids, with additional immunosuppressants for severe or refractory disease.
This document provides guidance on evaluating patients presenting with arthritis. It discusses taking a rheumatologic history and performing a physical exam to determine if the arthritis is articular or non-articular, inflammatory or non-inflammatory, acute or chronic, and monoarticular or polyarticular. Key signs of inflammatory versus non-inflammatory arthritis are outlined. Common causes of mono/oligoarthritis like septic arthritis and gout are described. Approaches to polyarthritis and distinguishing rheumatoid arthritis from other conditions are also covered. Imaging and laboratory tests that can aid evaluation are mentioned.
This document summarizes key information about morphea from Fitzpatrick's Dermatology in General Medicine, 8th edition. Morphea is a self-limited or chronically relapsing autoimmune skin disorder that causes thickened, sclerotic skin. It occurs more commonly in females than males and can affect both children and adults. Common subtypes include linear, circumscribed, generalized, and pansclerotic morphea. Histopathology of morphea skin lesions shows thickened collagen fibers parallel to the epidermis. Morphea has been associated with arthritis and other systemic involvement. Autoantibodies frequently seen in morphea patients include ANA.
Mitral regurgitation (MR) occurs when there is abnormal backflow of blood from the left ventricle into the left atrium during systole. It can be caused by problems with the mitral valve apparatus including the annulus, leaflets, chordae tendineae and papillary muscles. MR is classified as acute, chronic compensated, or chronic decompensated. Chronic MR puts a volume overload on the left atrium and ventricle, leading to dilation and hypertrophy as compensatory mechanisms. However, this can eventually cause reduced cardiac output, pulmonary congestion, and heart failure.
Measuring the right outcomes in mental healthJohn Brazier
This talk presents the findings of an MRC study on whether the generic health measures of EQ-5D and SF-36 are valid in mental health. It uses mixed methods research (including interviews with service users) to show that these measures miss important ways in which mental health impacts on people's lives. It proposes 7 themes that seem to capture the important domains of recovery for people with mental health problems that provide the basis for a new generic outcome measure for mental health.
N.B. These slides were presented at the 20th Anniversary of the Centre for Mental and Physical Health Economics, 7th November 2013.
This document provides an overview of the management of rheumatoid arthritis (RA). It discusses the etiology and pathology of RA and describes the diagnostic criteria. It then outlines various treatment approaches for RA including physical therapies, medications like NSAIDs, glucocorticoids, DMARDs, and biologics. Newer targeted biologic therapies that inhibit cytokines like TNF-α, IL-1, IL-6 are discussed. The goals of RA treatment and factors influencing treatment choice are also summarized.
This document discusses hereditary spherocytosis (HS), an inherited disorder caused by defects in the red blood cell membrane skeleton. HS is characterized by spherical red blood cells that are less deformable and vulnerable to splenic sequestration and destruction. The defects are primarily in proteins like ankyrin, band 3, spectrin or band 4.2 that make up the membrane skeleton. This leads to a reduced red blood cell life span of 10-20 days instead of the normal 120 days. Clinical features include anemia, splenomegaly, jaundice, and hemolytic crises from infections. Diagnosis involves tests like peripheral smear, bone marrow examination, and osmotic fragility testing. Treatment
This document discusses autoantibodies and methods for detecting anti-nuclear antibodies (ANA). ANAs are antibodies directed against nuclear and cytoplasmic antigens and are associated with various autoimmune diseases. The three main methods for detecting ANAs are indirect immunofluorescence assay using HEp-2 cells, ELISA, and multiplex bead immunoassays. The immunofluorescence assay is commonly used for initial screening due to its ability to detect multiple antigen patterns but has limitations. ELISA and bead assays allow detection of specific autoantibodies and have improved sensitivity and specificity compared to immunofluorescence.
The document discusses atopic dermatitis (AD), also known as eczema. It defines AD as a pruritic, chronic inflammatory skin condition characterized by dry skin and itchy rashes. AD is common in childhood and often runs in families with other allergic diseases. The pathogenesis involves genetic predisposition, skin barrier defects, and abnormal immune responses. Clinical manifestations vary depending on the stage of life, from facial rashes in infants to thickened plaques on flexural areas in older patients. Treatment focuses on moisturizing the skin, identifying trigger factors, and using topical corticosteroids or calcineurin inhibitors to control symptoms.
This document discusses Kawasaki disease, an acute febrile vasculitic syndrome that mainly affects children under 5 years old. While it usually has a good prognosis with treatment, it can lead to coronary artery aneurysms in a small percentage of patients. The document covers the pathogenesis, differential diagnosis, diagnosis, management including intravenous immunoglobulin treatment, refractory disease treatment, and long term monitoring of Kawasaki disease.
1) The document outlines an overview of chronic spontaneous urticaria (CSU), including its epidemiology, clinical presentation, natural history, and pathogenesis.
2) CSU affects approximately 0.5-1% of the general population and is more common in adults than children, with a peak age of onset between 20-40 years.
3) The pathogenesis of CSU is not fully understood but is believed to involve inappropriate activation of mast cells and basophils by autoantibodies, leading to the release of inflammatory mediators that cause wheals and angioedema.
Stroke ( concise long case approach ) summaryDr. Rubz
The document provides guidance on evaluating and managing patients presenting with suspected stroke. It outlines an approach to answering 6 key questions from the history, physical exam, and investigations to determine if the patient is having a stroke, identify the location and type of stroke, understand the mechanism, assess functional impairment, and identify risk factors. Principles of acute management include aspirin, thrombolysis if eligible, controlling blood pressure and blood glucose, and preventing hyperthermia. Secondary prevention involves antiplatelet therapy, anticoagulation if indicated, carotid endarterectomy for severe stenosis, controlling hypertension and lipids, smoking cessation, and managing diabetes risk factors.
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by blood clots in arteries or veins and/or pregnancy complications. It results from antibodies that cause blood to clot more easily than normal. Symptoms include blood clots in both arteries and veins as well as pregnancy-related issues. APS can occur on its own or in conjunction with other autoimmune diseases like lupus. Treatment involves blood thinners to prevent clots and aspirin/heparin during pregnancy to prevent complications. Prognosis depends on symptoms, with blood clots requiring long-term anticoagulation and pregnancy morbidity treated to allow successful pregnancies.
This document discusses spondyloarthritis, a group of conditions affecting the spine and peripheral joints. Key points include:
- It is linked to certain HLA antigens and often runs in families. Joint involvement is usually more limited than rheumatoid arthritis.
- The main types are ankylosing spondylitis, psoriatic arthritis, reactive arthritis, and enteropathic arthritis.
- Ankylosing spondylitis commonly causes inflammation of the sacroiliac joints in late teens/early 20s. It is strongly associated with HLA-B27. Left untreated, it can cause a "bamboo spine" with fusion of vertebrae.
- TNF blockers like adal
Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems. It typically affects young women and is characterized by periods of disease flares and remissions. While the exact cause is unknown, genetic and environmental factors likely contribute to abnormal immune system functioning and production of autoantibodies. Common clinical manifestations include malar rash, arthritis, kidney problems, and hematological abnormalities. Diagnosis involves identifying clinical features and detecting autoantibodies such as antinuclear antibodies and anti-dsDNA antibodies. With proper management, 10-year survival rates are over 90%.
Bio-Markers of Heart Failure (Dr.LIKHIT T)Likhit T
A brief on bio-markers of Heart failure...First of all, I thank the Authors of all the books from which I picked the points to make this presentation.. This presentation includes classification of bio-markers and explanation according their importance.. Thank you
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints, causing pain, stiffness, and swelling. It can also impact other body systems. While the exact cause is unknown, genetics and environmental factors are believed to play a role. Common symptoms include joint deformities, fatigue, and anemia. Diagnosis involves evaluating symptoms, physical exam findings, blood tests, and x-rays. Treatment focuses on reducing inflammation and joint damage through medications like DMARDs, NSAIDs, and corticosteroids. The goals are to relieve symptoms, improve function, and prevent disability. Care requires a multidisciplinary approach including medication management, exercise, and lifestyle changes.
Cutaneous lupus erythematosus (CLE) is a manifestation of the autoimmune disease systemic lupus erythematosus (SLE) that presents with diverse skin lesions. There are three main subtypes of CLE - acute (ACLE), subacute (SCLE), and chronic (CCLE, including discoid lupus erythematosus (DLE)). CLE results from a complex interplay between genetic susceptibility, environmental triggers like ultraviolet light, and dysregulated immune responses. Histopathology is useful but not definitive for diagnosis, which relies on clinical presentation and serological markers. CLE can range from limited skin involvement to systemic disease affecting major organs.
This document provides an overview of vasculitis, including classification, pathophysiology, clinical manifestations, investigations, and management approaches. It discusses several specific large vessel vasculitides - giant cell arteritis, Takayasu arteritis, and polyarteritis nodosa. Giant cell arteritis commonly involves temporal arteries and causes headaches. Takayasu arteritis primarily affects the aorta and its branches. Polyarteritis nodosa preferentially involves the skin, nerves, gastrointestinal tract and kidneys. Diagnosis relies on tissue biopsy and imaging. Treatment focuses on glucocorticoids, with additional immunosuppressants for severe or refractory disease.
This document provides guidance on evaluating patients presenting with arthritis. It discusses taking a rheumatologic history and performing a physical exam to determine if the arthritis is articular or non-articular, inflammatory or non-inflammatory, acute or chronic, and monoarticular or polyarticular. Key signs of inflammatory versus non-inflammatory arthritis are outlined. Common causes of mono/oligoarthritis like septic arthritis and gout are described. Approaches to polyarthritis and distinguishing rheumatoid arthritis from other conditions are also covered. Imaging and laboratory tests that can aid evaluation are mentioned.
This document summarizes key information about morphea from Fitzpatrick's Dermatology in General Medicine, 8th edition. Morphea is a self-limited or chronically relapsing autoimmune skin disorder that causes thickened, sclerotic skin. It occurs more commonly in females than males and can affect both children and adults. Common subtypes include linear, circumscribed, generalized, and pansclerotic morphea. Histopathology of morphea skin lesions shows thickened collagen fibers parallel to the epidermis. Morphea has been associated with arthritis and other systemic involvement. Autoantibodies frequently seen in morphea patients include ANA.
Mitral regurgitation (MR) occurs when there is abnormal backflow of blood from the left ventricle into the left atrium during systole. It can be caused by problems with the mitral valve apparatus including the annulus, leaflets, chordae tendineae and papillary muscles. MR is classified as acute, chronic compensated, or chronic decompensated. Chronic MR puts a volume overload on the left atrium and ventricle, leading to dilation and hypertrophy as compensatory mechanisms. However, this can eventually cause reduced cardiac output, pulmonary congestion, and heart failure.
Measuring the right outcomes in mental healthJohn Brazier
This talk presents the findings of an MRC study on whether the generic health measures of EQ-5D and SF-36 are valid in mental health. It uses mixed methods research (including interviews with service users) to show that these measures miss important ways in which mental health impacts on people's lives. It proposes 7 themes that seem to capture the important domains of recovery for people with mental health problems that provide the basis for a new generic outcome measure for mental health.
N.B. These slides were presented at the 20th Anniversary of the Centre for Mental and Physical Health Economics, 7th November 2013.
The document outlines the K to 12 Health curriculum for the Philippines from Kindergarten to Grade 10. It aims to develop lifelong wellness by focusing on physical, mental, emotional, social, moral and spiritual health dimensions. Key concepts include nutrition, disease prevention, injury prevention, substance abuse prevention, and promoting personal and community health. The curriculum utilizes learner-centered teaching approaches and provides grade-level standards and content to be covered each year.
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 1: Current Regulatorz Landscape & Initiatives Against Fake Medicines
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 4: Collaboration within and between countries
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 3: Practices and Technologies for Prevention, Detection, Control and Monitoring of Fake Medicines.
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
This document is comprised of copyright notices from the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) spanning the years 2014 through 2018, suggesting it contains content owned by IFPMA over those years. No other substantive information is provided in the document.
The document provides an overview of the International Psoriasis Council (IPC) and their partnership with ILDS and IFPA to execute the Global Psoriasis Atlas project. The IPC is a nonprofit organization comprised of the world's leading experts in psoriasis. They aim to advance knowledge of psoriasis and enhance patient care through research, education, and clinical practice guidelines. The document notes that worldwide prevalence and incidence of psoriasis is poorly understood currently. The Global Psoriasis Atlas project aims to address this through collecting epidemiological data on psoriasis prevalence, burden, and natural history across countries to inform policy and improve care.
David K. Robinson, Ph. D.Vice President, BiologicsHead and Executive Director, Biologics and Vaccines CMC RegulatoryMerck & Co, Inc.
Presenting on behalf of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)WCBP CASS, Washington DC, USAJanuary 2014
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session4: Collaboration within and between countries
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 1: Current Regulatory Landscape & Initiatives Against Fake Medicines
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 4: Collaboration within and between countries
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 2: Supply Chain Integrity
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
The document discusses psoriasis, a chronic skin condition affecting over 125 million people worldwide. Psoriasis causes thickened, red, scaly skin patches that often itch and bleed. It can also cause joint pain and increase risks for other health issues. The document outlines pharmaceutical company efforts to develop new drug treatments for psoriasis, including topical treatments, biologics, and oral medications currently in clinical trials. It emphasizes the need for comprehensive care that coordinates treatment from specialists and considers patients' needs to best manage psoriasis as a chronic condition.
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 2: Supply Chain Integrity
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
This document summarizes a study on cervical lymph node enlargement. It analyzed 70 patients with enlarged cervical lymph nodes. Tuberculosis was found to be the most common cause, affecting females more than males. Lymph node enlargement was most common in patients under 40 years old. Histopathological examination was required for accurate diagnosis. The upper cervical lymph nodes were most frequently involved. The study concluded that tuberculosis was a major factor for cervical lymphadenopathy in younger patients, while secondary cancers were more common in older patients above 50 years old.
This document summarizes a study on cervical lymph node enlargement. It analyzed 70 patients with enlarged cervical lymph nodes. Tuberculosis was found to be the most common cause, affecting females more than males. Lymph node enlargement was most common in patients under 40 years old. Histopathological examination was required for accurate diagnosis. The upper cervical lymph nodes were most frequently involved. The study concluded that tuberculosis was a major factor for cervical lymphadenopathy in younger patients, while secondary cancers were more common in older patients above 50 years old.
This document summarizes a study on cervical lymph node enlargement. It analyzed 70 patients with enlarged cervical lymph nodes. Tuberculosis was found to be the most common cause, affecting females more than males. Lymph node enlargement was most common in patients under 40 years old. Histopathological examination was required for accurate diagnosis. The upper cervical lymph nodes were most frequently involved. The study concluded that tuberculosis was a major factor for cervical lymphadenopathy in younger patients, while secondary cancers were more common in older patients above 50 years old.
This study summarizes research on male infertility conducted at the University Teaching Hospital Maiduguri in Nigeria between 2008-2012. 73 male infertility patients were reviewed. Common causes of infertility found were sexually transmitted diseases in 34.25% of patients, varicoceles in 34.93% of testes, and abnormal sperm parameters or hormonal imbalances. Treatment outcomes varied, with conception occurring in 26.03% of patients, partial response in 31.51%, and treatment failure in 42.47%. The study concludes that thorough evaluation of treatable causes and referral for assisted reproduction can help optimize fertility treatment results.
Vitiligo clinical findings in 1436 patientstloanphan
This study analyzed clinical findings from 1436 patients with vitiligo seen between 1989-1993. The key findings were:
1) Vitiligo vulgaris was the most common type (69.8% of patients), followed by focal (14.9%) and segmental (5.0%) vitiligo.
2) The most common sites of onset were the face (22.9%), trunk (22.3%), and legs (18.6%). Less than 20% body area was involved in 94.4% of patients.
3) Associated conditions included atopic/nummular eczema (1.4%), bronchial asthma (0.7%), diabetes (0.
This study examined the pattern of cutaneous pathology among 490 HIV/AIDS patients in Nigeria over 12 months. The most common skin conditions were viral infections (37.1%), fungal infections (24.3%), and drug reactions (11.4%). The viral conditions were predominantly herpes zoster (27%) and viral warts (15.4%). Common fungal infections included tinea corporis (52.9%) and seborrheic dermatitis (23.5%). Neoplasms such as Kaposi's sarcoma accounted for 5.7% of cases. Cotrimoxazole and nevirapine were the most frequent causes of drug reactions. The study concludes that skin manifestations of HIV are
This document describes a study on the efficacy of homeopathic treatment for vitiligo. The study was conducted from 2012-2015 and included 332 patients with vitiligo. It assessed precipitating factors, clinical features, response to homeopathic treatment, and maintenance of remission. The results showed that homeopathic medicines were effective in achieving and maintaining remission of vitiligo with minimum side effects and cost of treatment.
This document discusses the relationship between epidemiology and public health. It argues that epidemiology has become too focused on identifying disease risk factors and transmission, and has lost sight of its original goal of improving overall population health. It proposes that epidemiology should adopt a more holistic approach that integrates biological, social, and analytical perspectives to better inform public health interventions and policies. Recent decades have seen the growth of international training programs to develop epidemiologists able to address global health challenges.
The Relation of Obesity and Chronic Diseases among Home Health Care Patientsijtsrd
Background The prevalence of overweight and obesity among older adults is clearly increasing. The serious public health consequences e.g., premature mortality, co morbidities such as diabetes, hospitalization, and heart failures Aim To find the relation between obesity and other chronic diseases among home health care patients. Methodology A file based comparative case control study among 200 of obese patients versus 200 non obese all under the umbrella of home health care at Armed Forces Hospitals Southern Region, Saudi Arabia, 2019. Results Regarding DM higher prevalence among obese, P 0.004 with higher risk among obese, odds ratio 1.8 1.2 2.7 .Hyper tension also showed significant difference with higher risk of incidence among obese OR 1.55 1.02 2.35 , Although bronchial asthma showed no significant difference among both groups but higher risk OR 1.97 among obese. Hyperlipidemia also showed significant difference and higher risk among obese OR 2.02 1.83 2.2 . Conclusion Obesity among elderly leads to increased risk of diseases as DM, Hypertension, thyroid disorders, Bronchial asthma, Arthritis, liver disease and hyperlipidemia while lower risk of osteoporosis, and prostatic enlargement and some neurological disorders like depression and dementia and parkinsonism. Shaima Mohammed Mashhour | Mohamad Kamal Alsharief | Ahmed Mohammed Almodeer | Abdullah Mohamed Almodeer | Abdullah Mohamed Alqahtani | Lojain Mohamed Al Modeer | Omar Mohammad Alzahrani | Abdulmohsen Mohammed Alqahtani | Dr. Ahmed Youssef Abouelyazid "The Relation of Obesity and Chronic Diseases among Home Health Care Patients" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd38188.pdf Paper URL : https://www.ijtsrd.com/medicine/other/38188/the-relation-of-obesity-and-chronic-diseases-among-home-health-care-patients/shaima-mohammed-mashhour
This document summarizes information about scleroderma in children and young people. It discusses the different subtypes of juvenile scleroderma, including localized scleroderma (morphea) and systemic sclerosis. Localized scleroderma is more common than systemic sclerosis. The document reviews epidemiological data on incidence rates and clinical manifestations. It also discusses disease assessment, treatments such as methotrexate for localized scleroderma, and outcomes. Prognosis is generally better for juvenile scleroderma compared to adult-onset disease, but internal organ involvement can still lead to mortality in severe cases. The document advocates for more collaborative research to improve understanding and treatment of scleroderma in children
Management of Fournier’s Gangrene in a Low Resource Settingasclepiuspdfs
external genitalia and perineum. Although the condition is rare in absolute terms, over 1726 cases have been reported in English literature, with a male/female ratio of 10:1. There have been 502 cases from Africa, which ranks second to the USA/Canada. At present, there is only one published literature on the management of FG in Liberia. Objective: This study highlig hts the late presentation and the challenges in the management of FG at the John F. Kennedy Medical Center. Methodology: This is a retrospective study of 30 patients with FG who were admitted and managed by our division of urology, from January 2018 to May 2019. The patient’s records were retrieved and reviewed for age, sex, onset of disease, sites of the disease, management, duration of stay, and outcome. The frequency and percentage of various parameters were displayed in tables.
A Study on Mood Disorders in Acne among Patients Attending Skin Opdiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study examined 186 treated leprosy patients in the Diamer district of Gilgit-Baltistan, Pakistan to document their clinical status and disabilities. The majority of patients were male (75.8%) with a mean age of 53 years. Borderline tuberculoid leprosy was the most common subtype (43.54%). Many patients still had disabilities after treatment, including claw hand (11.82%), foot drop (10.21%), and visual impairment (11.29-6.9%). The results suggest leprosy remains prevalent in the area and a significant number of treated patients still have disabling effects of the disease. Addressing disabilities through an integrated healthcare approach is recommended.
This document summarizes a study on nasopharyngeal carcinoma (NPC) conducted at a Nigerian tertiary hospital. The study found that NPC accounted for 8.33% of head and neck cancers seen over 14 years. Most patients were male, with a mean age of 54.5 years. The most common presentations were neck swelling, nasal obstruction, and epistaxis. 75% of patients presented with late stage 4 disease. Treatment was primarily radiotherapy, but 46.88% of patients defaulted treatment due to financial constraints. Prognosis was very poor, with 1-year and 5-year survival rates of 21.9% and 9.25% respectively. The study concluded that late presentation and inability to
Epidemiology and its relevance in physiotherapyMuskan Rastogi
This document discusses the relevance of epidemiology in physiotherapy. It begins by defining epidemiology as the study of disease frequency, distribution, and determinants in human populations. The basic components of epidemiology include studying data systematically, determining disease frequency and distribution, and identifying causal factors. Historically, epidemiology focused on infectious diseases, but its focus has shifted to lifestyle-related non-communicable diseases that physiotherapists often treat, like cardiovascular disease, obesity, diabetes, and musculoskeletal problems. Understanding epidemiology allows physiotherapists to identify disease risk factors and work to prevent conditions in communities through lifestyle interventions.
This document provides an overview of paediatric HIV/AIDS and challenges of management in Nigeria. It discusses the epidemiology of HIV globally and in Nigeria, where the disease burden is highest. It covers pathogenesis, transmission, clinical manifestations, diagnosis, treatment including antiretroviral therapy, and challenges in management. In Nigeria, paediatric HIV care began in 2004 and the strategic plan aims to scale up access to care, treatment and support for infected and exposed children. Management of paediatric HIV presents many challenges.
Pattern of Head and Neck Cancer in a Tertiary Institution in Lagos Nigeriaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Similar to Manaement of Psoriasis in Low Income Countries (20)
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
IFPMA-TFDA Workshop on Couterfeit Medicines
‘Integrated Approach Against Fake Medicines’
Session 3: Practices and Technologies for Prevention, Detection, Control and Monitoring of Fake Medicines
On 6th February 2015
At Taipei International Convention Center
Taipei, Taiwan
Maurice Mayrides discusses the importance of the patient voice in regulating biosimilars. He summarizes the value of biosimilars from different stakeholder perspectives including patients, clinicians, industry, and governments. While biosimilars offer potential cost savings and innovation, patients will only feel comfortable with interchangeability if regulations are sophisticated and harmonized internationally. Regulations must ensure safety, efficacy, and quality to gain patient trust especially in emerging markets and lower-resource countries. Continued advocacy is needed to refine regulations and gather real-world evidence to demonstrate biosimilar interchangeability. The ultimate goal is ensuring patients can access effective treatments.
Este documento presenta información sobre biotecnológicos y biosimilares. Explica que los biosimilares no son genéricos ni copias idénticas de los biológicos originales debido a la complejidad de estas moléculas. Los biosimilares deben someterse a pruebas clínicas rigurosas para demostrar su eficacia y seguridad antes de su aprobación. La farmacovigilancia continua es fundamental para monitorear cualquier efecto adverso potencial de los biosimilares.
Biosimilars are complex biologic drugs that are similar but not identical to innovative biologic reference products. Several key points are made:
- Biosimilars are regulated differently than small molecule generics due to biologics' larger size and more complex manufacturing processes.
- While some regulators may designate a biosimilar as interchangeable, decisions on substitution are made separately at a national or state level.
- Health Canada does not declare any drug interchangeable and leaves substitution decisions to provinces, whereas the FDA may designate a biosimilar interchangeable if it is biosimilar and switching poses no greater risk to patients.
- Automatic substitution is not recommended and interchangeability requires specifically designed clinical trials for each
The document summarizes key points about the WHO International Nonproprietary Name (INN) Programme:
- The INN Programme assigns a single international nonproprietary name to pharmaceutical substances to ensure consistency worldwide and promote safe use of medicines globally.
- It aims to develop, establish, and promote international standards for naming pharmaceutical and biological products, including biotherapeutics.
- There is an ongoing discussion around developing a system for distinguishing biosimilar products through INN naming to promote unambiguous identification of reference products globally.
This document discusses the challenges of pharmacovigilance for biotherapeutic medicines. It notes that pharmacovigilance systems are developing at different rates globally, with inconsistent naming approaches for biotherapeutics. This can weaken signal detection. The document outlines five key challenges for biotherapeutics: 1) They are more complex and sensitive than small molecule drugs. 2) They can potentially elicit an immune response. 3) They can have complex pharmacology through multiple mechanisms. 4) Their properties are not fully predictable through preclinical studies. 5) They may follow different regulatory pathways than originator biologics like biosimilars. Comprehensive pharmacovigilance is needed due to potential safety differences between
The document discusses the work of the Uppsala Monitoring Centre (UMC), the WHO Collaborating Centre for International Drug Monitoring. The UMC collects and analyzes safety reports on medicines from around the world to identify potential safety issues and communicates these to improve patient safety. It maintains the VigiBase database and WHO drug dictionaries to support pharmacovigilance. The presentation highlights UMC's role in monitoring biotherapeutics and biosimilars, including the number of reports received on various biologic medicines over time and by region. It also discusses challenges in analyzing reports that only include the active substance versus those that specify the trade name or reference product.
This presentation provides an overview of the regulation of biotherapeutic medicines in Brazil. It discusses the development of regulations from 1976 to the current 2010 regulation, which takes specific approaches for biosimilars. The presentation outlines the pathways for approval, including an individual development pathway requiring full clinical data and a comparability pathway allowing reduced data if comparability to an existing product is shown. It provides details on non-clinical and clinical report requirements and considerations for both pathways. Finally, it discusses guidelines, partnerships and future perspectives on biological product regulation in Brazil.
This document provides an overview of biosimilars and their development process according to international guidance. It begins with definitions of biosimilars and their differences compared to generic small molecule drugs. It then describes the two key steps in biosimilar development: 1) Developing a highly similar product through extensive analytical comparison to the reference product, and 2) Confirming biosimilarity through a targeted clinical program. It reviews guidelines from the WHO, EMA, and FDA on evaluating biosimilarity and the need for analytical, nonclinical and clinical comparisons. The document aims to explain the rigorous process of demonstrating biosimilarity that biosimilar developers must undergo to obtain regulatory approval.
The document discusses the importance of selecting sensitive patient populations for clinical trials of biosimilar monoclonal antibodies to properly assess clinical similarity to the reference product. It provides examples of indications and populations that are more sensitive for detecting differences based on effect size, such as rheumatoid arthritis patients for assessing ACR20 response to anti-TNF antibodies. The document cautions that clinical trials must be designed appropriately to demonstrate equivalence or non-inferiority and should obtain data on relevant endpoints in sensitive populations as well as long-term safety and immunogenicity follow-up to justify extrapolation to other indications. It critiques examples of biosimilar clinical trials that failed to use a sensitive population or design.
More from International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) (13)
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
1. MANAGEMENT
OF PSORIASIS
IN LOW INCOME
COUNTRIES
An overview of Psoriasis
management, situation analysis
in the Middle East & Africa May 9th, 2014
Mahira Hamdy El Sayed
Professor of Dermatology andVenereology Ain Shams
University
2. 2|
Goeckerman
“The comparative frequency
with which psoriasis occurs
demands that not only the
specialist but the general
practitioner should be
familiar with effective
therapeutic measures
directed against it.”
4. 4|
• Overview of Psoriasis
• Psoriasis in the Middle East & Africa (Egypt)
• Challenges and gaps
• Suggestion of a national strategy
Key Points
4
1
2
3
06
page
30
page
48
page
51
page
• Management of psoriasis with limited resources3 46
page
6. 6|
Multifactorial
1-3% of the world
population
Psoriasis Patient
Systemic
Finger nail pit
Polygenic
Hyperproliferative
Chronic Disabling Relapsing
Total body skin
involvement
Disabling
Arthritis
Comorbidities
11. 11|
Smoking increases the
incedince of psoriais
Psoriasis patients smoke
more as a coping
mechanism
Obesity increases the
incidence and the
severity of psoriasis
Psoriasis patients eat
more as a coping
mechanism
Alcohol
Consumption
Obesity Smoking
Additional factors
Alcohol consumption
increases the incidence
and the severity of
psoriasis
Psoriasis patients drink
more as a coping mechanism
15. 15|
Arthritis
1 in 4 patients
develop
arthritis
Disfiguring
& mutilating
Early
intervention
Inflammatory sero-ve arthritis
associated with psoriasis.
Enthesitis,dactylitis &axial disease
16. 16|
Genetic factors
drive disease
specific process
Comorbidity
results from
chronic
inflammation
Triggered by
environmental
factors involving
innate &adaptive
immunity
.
Leading to disease
expression
Genetic
factors
Environment
al factors
Expression Comorbidity
How the march of
psoriasis unfolds
from gene to clinic
Griffiths &Barker (2007)lancet
17. 17|
Impact of Psoriasis
on QOL
Significant impact on QOL
Negative physical impact.
Negative psychological impact
Stigmatized
Insensitive reactions from
people
18. 18|
QOL
Withdrawal, anxietyand depression
Very low QOL, worse than patients
with stroke,COPD, heart disease &
diabetes
Survey by theUS National Psoriasis
Foundation
Psoriasis has a moderate to large
Impact on QOL in 75% of Psoriasis
patients
19. 19|
Disease severity
Age of onset
Gender
Location
Factors
affecting QOL
QOL
Underestimated by disease severity score .
Weak association between PASI score and impairedQOL
Lesions located on visible body parts
20. 20|
QOL
Scalp psoriasis is visible , persistent
& inconvenient so it is the most
difficult aspect of the disease, with
marked negative Impact on the QOL.
Psoriasis doesn’t
have to be severe
to impair the
quality of life!
21. 21|
Cumulative Life
Course Impairment
“CLCI “
Cumulativeimpairmentacquired
by the psoriasis patientovera
life time.
Reflects chronicnatureof the
disease.
Repercussions including
stigmatizationphysical
&psychologicalcomorbidities
Factorsplayingamoderating
role makingpatientless
vulnerable.
30. Psoriasis in the
Middle East &
Africa.
Limitedliterature
EgyptianExperience
The Egyptianstudy
StudiesintheMiddleEast
onQOL
DifferentCases
31. 31|
Limited literature
Literature regarding
psoriasis & its
management in the
geographically
large, culturally
diverse &
heterogeneous
regions of the
Middle East & Africa
is limited, compared
with the large
volume of data from
the western World.
32. 32|
Studies in the Middle
East &Africa on
Incidence of
psoriasis
2 small single centre
studies inSaudiArabia
2004,2005
1.5% inSouthWestern
SA.
3.4% in EasternSA.
Shelleh et al SMJ 2004, Alakloby et al SMJ 2005
Larger study across 5
hospitals inJohannesburg
SA .
9.6% in Indian patients.
Hartshorne Clin Exp Derm 2003
33. 33|
Studies in the Middle
East on QOL
Kuwait, Iran &Tunisia.
Same findings asWestern
countries .
Psoriasis affected
physical activities and
social relationships in ≥
50% & sexual activity in
33% of 330 Kuwaiti
outpatients as measured
by the DermatologyQOL
scale.
Al-Mazeedi et al.2006 Int.J.Derm
35. 35|
Objectives
Griffiths et al.(2007) BJD,Mallbris et al.(2005)JID,
Stuart el al.(2002)Arch.Derm.Res.
Classification and clinical
characterisation of
psoriasisin Egyptian
patients (phenotypes)
Multicentre studies
Protocol for treatment
Difficult cases (HCV)
EgyptFact:
Population85 million
40%under povertyline
39. 39|
Study population
Overall 1181 questionnaires were completed at university
hospitals.
SPSS was performed on all patients except those presenting single
episode of psoriasis(n=97 patients) and those with missing data or
inaccurate history data (n=44 patients).
181 subjects were excluded from the typology development.
Some dermatologists reported erythroderma not only for total
body area involvement but even for limited lesions.Thus
erythroderma data were also excluded from the analysis
40. 40|
Description of
personal and family
history among study
cases
MaximumMinimum±SDMean
81.01.018.041.1Age
70.4%732Male
Gender
29.6%308Female
27.9%290Yes
Smoking
72.1%750No
2.9%30Yes
Alcoholism
97.1%1010No
21.0%218Yes
Personal antecedents of atopy
79.0%822No
14.6%152Yes
Familial antecedents of psoriasis
85.4%888No
8.1%84Yes
Familial antecedents of psoriasis arthritis
91.9%956No
5.8%60Yes
Familial antecedents of atopy
94.2%980No
41. 41|
Description of
personal and family
history among study
cases
Males represented the
majority of cases
(70.4%), smokers and
alcoholics represented
about 28% and 3% of
cases respectively.
70%
Males
79%
Personal History
of Atopy
28%
Smokers
43. 43|
Ageofonset
50%
30%
20%
< 30 years 30 - 49 years ≥ 50 years
The mean age among
study cases was 41.1
± 18 ranging
between 1-81 years.
Data
73%
Psoriatic Arthritis
52%
Pruritus
52. 52|
Where do we stand
Weekly clinic
Follow up of patients
NoGovernmental funding
Non governmental funding
Charities,Pharmaceuticalindustry,NGOs
Generic treatment
Phototherapy
Difficulty in obtaining newer drugs
54. 54|
Challenges and
gaps
Severe social & economic burden
of the disease.
Co-morbidities.
Unmet needs facing the
dermatologists with limited
resources.
Lack of resources .
HCV.
Ministry of Health budgets.
57. 57|
National Strategy including all health care sectors in
Egypt.
National registry.
Larger epidemiological studies to know the true size
& impact of the problem.
Awareness program to all health care providers
&primary health physicians.
Specalized referral centres.
Suggestion of a
national Strategy
4
1
2
3
5
58. 58|
Patients advocacy groups.
Fill the research gaps.
Management of Co-morbidities.
Research and clinical trials in special population
groups.
Guidelines &treatment protocols implementing
changes to current management practice.
Suggestion of a
national Strategy
9
6
7
8
10
59. 59|
Collaboration with international experts
Modelling studies for cost-effective treatment .
Media Campaigns.
Long term research data so governments recognize
psoriasis as a disabling disease needing early
diagnosis &treatment .
Involve stake holders for support.
Suggestion of a
national Strategy
14
11
12
13
15