Food safety expert and attorney William Marler gives an in depth presentation on a 2011 Listeria outbreak linked to cantaloupe produced by Colorado-based Jensen Farms. Killing over 32 people, the outbreak became the deadliest the nation has seen in decades.
How To Lobby in an Era of Divided Government with Bill MarlerBill Marler
Food safety attorney Bill Marler's presentation at the 2011 Guiding Lights Weekend in Seattle on how to lobby for your cause in an era of divided government.
2011 IAFP Meeting Speech with Bill MarlerBill Marler
Food safety advocate and leading food poisoning attorney Bill Marler's presentation on the progression of food safety in America at the 100th annual 2011 IAFP conference in Milwaukee, WI.
Learning Objectives:
James gave us our overview of the following points:
1. Why security is dead and rugged is the new currency.
2. Why automating security tests and putting them in your deployment pipelines is where security can add business value.
3. And, learn more about Gauntlt, the open source framework that helps you accomplish the technical side of automating security tests.
How To Lobby in an Era of Divided Government with Bill MarlerBill Marler
Food safety attorney Bill Marler's presentation at the 2011 Guiding Lights Weekend in Seattle on how to lobby for your cause in an era of divided government.
2011 IAFP Meeting Speech with Bill MarlerBill Marler
Food safety advocate and leading food poisoning attorney Bill Marler's presentation on the progression of food safety in America at the 100th annual 2011 IAFP conference in Milwaukee, WI.
Learning Objectives:
James gave us our overview of the following points:
1. Why security is dead and rugged is the new currency.
2. Why automating security tests and putting them in your deployment pipelines is where security can add business value.
3. And, learn more about Gauntlt, the open source framework that helps you accomplish the technical side of automating security tests.
I will be giving a talk on the 2011 Listeria Outbreak in the US that sickened 147 and killed at least 33. Over 100 have died from Listeria in South Africa in the last year.
CDC Webinar: Foodborne illness Outbreaks and Law with Attorney Bill MarlerBill Marler
Attorney and food safety expert William Marler give a May 2012, Centers for Disease Control and Prevention webinar on foodborne illness litigation and the role of public health officials.
Managing risks in emerging pork markets: Safe food in informal marketsILRI
Presentation by Delia Grace, Lucy Lapar, Iheanacho Okike, V Padmakumar and Anna Fahrion at an international South-South symposium on managing risks in emerging pork markets, Hanoi, Vietnam, 23-25 April 2012.
Preventing Residues in Tissues and Milk- Craig ShultzDAIReXNET
Dr. Shultz presented this material on November 10, 2011 as part of DAIReXNET's webinar entitled "Appropriate Drug Use and Residue Avoidance Practices".
Acute hemolytic uremic syndrome (HUS).
Post-diarrheal hemolytic uremic syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin-producing (Stx) E. coli (STEC).
The cascade of events leading to HUS begins with ingestion of Stx-producing E. coli (e.g., E. coli O157: H7) in contaminated food, beverages, animal to person, or person-to-person transmission. The bacteria rapidly multiply in the gut, causing inflammation and diarrhea (colitis) as they tightly bind to cells that line the large intestine. This snug attachment becomes a route for the toxin to travel from the gut into the bloodstream, where it attaches to weak receptors on white blood cells (WBCs). From there, WBCs carry the toxin to the kidneys and other organs.
To induce toxicity in target cells, Shiga toxins must first bind to specific receptors on their surface (Gb3 receptors). Organ injury is primarily a function of Gb3 receptor location and density. They are found on epithelial, endothelial, mesangial, and glomerular cells of the kidney, as well as microvascular endothelial cells of the brain and intestine. Because this attachment causes these organs to be susceptible to the toxicity of Shiga toxins, this distribution explains the involvement of the gut, kidney, and brain in STEC-associated hemolytic uremic syndrome (HUS).
Within the target organ, Shiga toxins disrupt the cellular machinery, resulting in cell injury and/or death. Within the intestine, infectious bacterial lesions cause derangements in the intestinal lining, disrupting the structure of the villi, affecting absorption in the gut, and eventually leading to watery diarrhea. Damage to the intestinal endothelium also causes mucosal/submucosal edema and, hemorrhage, introducing blood into the diarrhea.
Within the circulatory system, Shiga toxins are directly involved in platelet activation and aggregation (clot formation). The thrombotic microangiopathy that characterizes hemolytic uremic syndrome (HUS) occurs when platelet microthrombi (tiny clots) form in the walls of small blood vessels (arterioles and capillaries) causing platelet consumption. This pathologic reduction in platelets is called thrombocytopenia and is one of the hallmarks of HUS. Within the microvasculature of the kidney these clots disturb blood flow to the organ, causing acute kidney injury and kidney failure.
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I will be giving a talk on the 2011 Listeria Outbreak in the US that sickened 147 and killed at least 33. Over 100 have died from Listeria in South Africa in the last year.
CDC Webinar: Foodborne illness Outbreaks and Law with Attorney Bill MarlerBill Marler
Attorney and food safety expert William Marler give a May 2012, Centers for Disease Control and Prevention webinar on foodborne illness litigation and the role of public health officials.
Managing risks in emerging pork markets: Safe food in informal marketsILRI
Presentation by Delia Grace, Lucy Lapar, Iheanacho Okike, V Padmakumar and Anna Fahrion at an international South-South symposium on managing risks in emerging pork markets, Hanoi, Vietnam, 23-25 April 2012.
Preventing Residues in Tissues and Milk- Craig ShultzDAIReXNET
Dr. Shultz presented this material on November 10, 2011 as part of DAIReXNET's webinar entitled "Appropriate Drug Use and Residue Avoidance Practices".
Acute hemolytic uremic syndrome (HUS).
Post-diarrheal hemolytic uremic syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin-producing (Stx) E. coli (STEC).
The cascade of events leading to HUS begins with ingestion of Stx-producing E. coli (e.g., E. coli O157: H7) in contaminated food, beverages, animal to person, or person-to-person transmission. The bacteria rapidly multiply in the gut, causing inflammation and diarrhea (colitis) as they tightly bind to cells that line the large intestine. This snug attachment becomes a route for the toxin to travel from the gut into the bloodstream, where it attaches to weak receptors on white blood cells (WBCs). From there, WBCs carry the toxin to the kidneys and other organs.
To induce toxicity in target cells, Shiga toxins must first bind to specific receptors on their surface (Gb3 receptors). Organ injury is primarily a function of Gb3 receptor location and density. They are found on epithelial, endothelial, mesangial, and glomerular cells of the kidney, as well as microvascular endothelial cells of the brain and intestine. Because this attachment causes these organs to be susceptible to the toxicity of Shiga toxins, this distribution explains the involvement of the gut, kidney, and brain in STEC-associated hemolytic uremic syndrome (HUS).
Within the target organ, Shiga toxins disrupt the cellular machinery, resulting in cell injury and/or death. Within the intestine, infectious bacterial lesions cause derangements in the intestinal lining, disrupting the structure of the villi, affecting absorption in the gut, and eventually leading to watery diarrhea. Damage to the intestinal endothelium also causes mucosal/submucosal edema and, hemorrhage, introducing blood into the diarrhea.
Within the circulatory system, Shiga toxins are directly involved in platelet activation and aggregation (clot formation). The thrombotic microangiopathy that characterizes hemolytic uremic syndrome (HUS) occurs when platelet microthrombi (tiny clots) form in the walls of small blood vessels (arterioles and capillaries) causing platelet consumption. This pathologic reduction in platelets is called thrombocytopenia and is one of the hallmarks of HUS. Within the microvasculature of the kidney these clots disturb blood flow to the organ, causing acute kidney injury and kidney failure.
Hemolytic Uremic Syndrome (HUS) chris edits 7.31.23.pptxBill Marler
Acute hemolytic uremic syndrome (HUS).
Post-diarrheal hemolytic uremic syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin-producing (Stx) E. coli (STEC).
The cascade of events leading to HUS begins with ingestion of Stx-producing E. coli (e.g., E. coli O157: H7) in contaminated food, beverages, animal to person, or person-to-person transmission. The bacteria rapidly multiply in the gut, causing inflammation and diarrhea (colitis) as they tightly bind to cells that line the large intestine. This snug attachment becomes a route for the toxin to travel from the gut into the bloodstream, where it attaches to weak receptors on white blood cells (WBCs). From there, WBCs carry the toxin to the kidneys and other organs.
To induce toxicity in target cells, Shiga toxins must first bind to specific receptors on their surface (Gb3 receptors). Organ injury is primarily a function of Gb3 receptor location and density. They are found on epithelial, endothelial, mesangial, and glomerular cells of the kidney, as well as microvascular endothelial cells of the brain and intestine. Because this attachment causes these organs to be susceptible to the toxicity of Shiga toxins, this distribution explains the involvement of the gut, kidney, and brain in STEC-associated hemolytic uremic syndrome (HUS).
Within the target organ, Shiga toxins disrupt the cellular machinery, resulting in cell injury and/or death. Within the intestine, infectious bacterial lesions cause derangements in the intestinal lining, disrupting the structure of the villi, affecting absorption in the gut, and eventually leading to watery diarrhea. Damage to the intestinal endothelium also causes mucosal/submucosal edema and, hemorrhage, introducing blood into the diarrhea.
Within the circulatory system, Shiga toxins are directly involved in platelet activation and aggregation (clot formation). The thrombotic microangiopathy that characterizes hemolytic uremic syndrome (HUS) occurs when platelet microthrombi (tiny clots) form in the walls of small blood vessels (arterioles and capillaries) causing platelet consumption. This pathologic reduction in platelets is called thrombocytopenia and is one of the hallmarks of HUS. Within the microvasculature of the kidney these clots disturb blood flow to the organ, causing acute kidney injury and kidney failure.
31 of the Biggest Recalls in Food Safety HistoryBill Marler
In November 2018 Cheyenne Buckingham and John Harrington wrote “31 Food Recalls That Poisoned the Most People.” Here is the Marler Clark view of the same list.
2018 Royal Society for Public Health SpeechBill Marler
Later this month I will be giving a talk to the Royal Society for Public Health. The talk will be a bit of history of E. coli and the Jack in the Box case.
The Fresh Produce Safety Centre (FPSC) provides open access to actionable information for fresh produce businesses and government to continually enhance the safety and quality of fruit and vegetables.
We aim to raise awareness and to increase the collaboration between stakeholders of the Australian and New Zealand fresh produce industry, as well as establish global partnerships to better utilise the information available.
Any outbreak of foodborne illness will impact the entire fresh produce sector, therefore fresh produce safety and traceability is of the utmost importance for all levels of the supply chain including growers, packers, processors, distributors, wholesalers and retailers.
The FPSC website covers all aspects of fresh produce safety by supplying valuable information and resources, providing research with practical application, and identifying knowledge gaps in fresh produce safety.
Horticulture New Zealand Incorporated, in conjunction with Pipfruit New Zealand Incorporated and industry association partners: Process Vegetables New Zealand, Tomatoes New Zealand Incorporated and Vegetables New Zealand Incorporated, are pleased to announce our joint conference in 2016. We are delighted to host the inaugural New Zealand Horticulture Conference at the Rutherford Hotel, Nelson from the 3rd to the 5th August 2016.
The theme "Innovate from seed to plate" aims to interest and benefit the widest range of growers and horticulturalists and will have an emphasis on technology and innovations that can assist us to further improve our growth and delivery of the world's best fruit and vegetables.
New Zealand horticulture leads the world in third party assurance and HortNZ invited a selection of high calibre experts to come and talk about where we can go next to continue to satisfy consumer and trade needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Cantaloupe Listeria Outbreak and Recall: The Good, the Bad, and the Ugly
1. The “Rocky Ford”
Listeria Cantaloupe
Outbreak – The Good,
the Bad and the Ugly
William D. Marler, Esq.
Marler Clark LLP PS
The Food Safety Law Firm
2. Before we start – A Raffle
"Just in time for BBQ
season, an investigative
journalist traces the path of
a devastating outbreak of
food-borne illness linked to
hamburger meat.”
"A stunningly researched
work, "Poisoned" reads as
though Clarence Darrow
had written "The Jungle.”
3. Cantaloupe Outbreaks – A Bit(e) of History
Confirmed
Year State(s) Pathogen
Illnesses
1985 Wisconsin 16 Campylobacter
1990 30 states 245 Salmonella
1991 International, including U.S. 400 Salmonella
1997 California 24 Salmonella
1998 Ontario, Canada 22 Salmonella
1999 Iowa 61 Norovirus
2000 California, Oregon, Colorado, Washington, New Mexico, Nevada 47 Salmonella
2001 Multi-state and International 50 Salmonella
2002 California, Minnesota, Oregon, Arkansas, Vermont, Nevada, Texas 58 Salmonella
2003 New York, Ohio, New Mexico, Massachusetts, Connecticut, 58 Salmonella
Missouri
2006 Multi-State and International 41 Salmonella
2007 California 11 Salmonella
2008 Multi-State 53 Salmonella
2008 California 23 Norovirus
2011 Multi-State 20 Salmonella
5. First Listeria Outbreak Linked to Cantaloupe
• 146 persons infected with any
of the four outbreak-associated
strains of Listeria
monocytogenes.
• Alabama (1), Arkansas (1),
California (4), Colorado (40),
Idaho (2), Illinois (4), Indiana
(3), Iowa (1), Kansas (11),
Louisiana (2), Maryland (1),
Missouri (7), Montana (1),
Nebraska (6), Nevada (1), New
Mexico (15), New York (2),
North Dakota (2), Oklahoma
(12), Oregon (1), Pennsylvania
(1), South Dakota (1), Texas
(18), Utah (1), Virginia (1),
West Virginia (1), Wisconsin
(2), and Wyoming (4). One
miscarriage was reported.
6. Largest Foodborne Death Toll in a Century
• Ages ranged from <1 to 96 years,
with a median age of 77 years.
• 99% were hospitalized.
• Thirty deaths were reported:
Colorado (8), Indiana (1), Kansas
(3), Louisiana (2), Maryland (1),
Missouri (3), Nebraska (1), New
Mexico (5), New York (2), Oklahoma
(1), Texas (2), and Wyoming (1).
Number is at least 36 to date.
• Seven of the illnesses were related to
a pregnancy; three were diagnosed
in newborns and four were diagnosed
in pregnant women.
8. Strict Product Liability
• Strict Liability
– Are they a
manufacturer?
– Was the product
unsafe?
– Did product
cause injury?
• Negligence
• Punitive Damages
/Criminal Liability – Are they a
product seller?
– Did they act with
conscious disregard – Did they act
“reasonably”?
of a known safety risk?
9. Who is a Manufacturer?
A “manufacturer” is
defined as a “product
seller who designs,
produces, makes,
fabricates, constructs,
or remanufactures the
relevant product or
component part of a
product before its sale
to a user or consumer.”
10. It’s called STRICT Liability for a Reason
• The only defense is
prevention.
• It does not matter if
the manufacturer took
all reasonable
precautions.
• If they manufacture a
product that makes
someone sick they are
going to pay.
• Wishful thinking does
not help.
11. Well, unless you are an “Innocent” Seller
In Colorado:
• “No product liability
action shall be
commenced or
maintained against any
seller of a product
unless said seller is also
the manufacturer of said
product or the
manufacturer of the part
thereof giving rise to the
product liability action.”
12. Well, perhaps not so fast
However:
• “If Jurisdiction cannot be
obtained over a particular
manufacturer of a product
or a part of a product
alleged to be defective,
than that manufacturer’s
principal distributor or
seller over who jurisdiction
can be obtained shall be
deemed, for the purposes
of this section, the
manufacturer of the
product.”
13. Environmental Investigation
• 13 positive
Listeria
monocytogenes
with matching
PFGE to outbreak
from processing
line, cold storage
area, packing
area.
• Home cantaloupe
samples tested
positive for
Listeria
monocytogenes.
14. “Root Cause” Investigation
• Introduction: 1) There could have been low level
sporadic Listeria monocytogenes in the field where the
cantaloupe were grown, which could have been
introduced into the packing facility; 2) A truck used to
haul culled cantaloupe to a cattle operation was parked
adjacent to the packing facility and could have
introduced contamination into the facility.
• Spread: 1) The packing facility’s design allowed water
to pool on the floor near equipment and employee
walkways; 2) The packing facility floor was
constructed in a manner that made it difficult to clean;
3) The packing equipment was not easily cleaned and
sanitized; 4) Washing and drying equipment used for
cantaloupe packing was previously used for postharvest
handling of another raw agricultural commodity.
• Growth: 1) There was no pre-cooling step to remove
field heat from the cantaloupes before cold storage; 2)
As the cantaloupes cooled there may have been
condensation that promoted the growth of Listeria
monocytogenes.
15. FDA Recommendations
• Using packing equipment designed
to facilitate cleaning and sanitation
of melon contact surfaces and
constructed of materials that may
be easily cleaned and sanitized;
• Validating and verifying that melon
wetting and brushing operations are
not a potential source of melon
contamination or cross-
contamination; and
• Cooling and cold storing melons as
soon as possible after harvest
because delays in cooling when
melons with netted rinds (such as
cantaloupe) are wet from washing
operations may allow for
multiplication of human pathogens
on the rind surface.
16. Blame enough to spread around
• Frontera – Broker – visited Jensen Farms during 2011 and
suggested Primus to do audit.
• Primus Labs – Auditor - subcontracted audit to Bio Food
Safety, which gave Jensen Farms a “Superior” rating of 96%!
• Pepper Equipment – Sold and installed equipment not
designed for cantaloupe.
• Retailers – Where to even start?
17. So, where are things today?
• Jensen Farms – Bankrupt with
money in trust.
• Bio Food Safety – Bankrupt
with money in trust.
• Pepper Equipment – Settled
with known victims.
• Frontera – Waiting on what
retailers do.
• Primus Labs – Waiting on
what Frontera does.