Genomics can improve reproduction in several ways:
1) Tools like PCR, microarrays, and next generation sequencing can detect single gene disorders and polygenic disorders from genomes.
2) Non-invasive preimplantation testing from maternal blood and preimplantation genetic testing of embryos can screen for inherited disorders and aneuploidies before pregnancy.
3) In vitro fertilization with preimplantation genetic testing allows transferring only unaffected embryos and avoiding genetic diseases for conditions like cancers and blood disorders.
May occur very early on during the attachment or migration stages (No objective evidence e.g. –ve hCG)
May also occur at a later stage (+ve hCG) but process becomes disrupted
Definition: Refers to the failure of the embryo to reach a stage when an intrauterine gestational sac is recognized by ultrasonography.
Implantation failure can apply to patients undergoing ART and patients trying to conceive without any fertility treatment.
It is a separate entity from RPL
Orvieto et al - 3 failed IVF-ET cycles with good quality embryos transferred .
Zeyneloglu et al. - 3 unsuccessful IVF specifically with two embryos of high quality
Simon and Laufer - embryo & endometrium can both play an active role in RIF
Coughlan et al. suggest a more complete working definition taking into account maternal age, number of embryos transferred, and number of cycles completed.
They define RIF as the failure of clinical pregnancy after 4 good quality embryo transfers, with at least three fresh or frozen IVF cycles, and in women under the age of 40
RIF is a complex problem with a wide variety of etiologies / mechanisms/ treatment options.
Recommendations vary depending on the source of their problem. Perhaps the best and yet most complex answer is personalized medicine, a personal approach to each patient depending on her unique set of characteristics.
It would help to establish a set of standardized tests to use, in order to do a preliminary evaluation on each patient, which would then hopefully direct the approach of treatment for each individual couple.
This can be implemented when we have well designed studies that will help us to establish new protocols.
May occur very early on during the attachment or migration stages (No objective evidence e.g. –ve hCG)
May also occur at a later stage (+ve hCG) but process becomes disrupted
Definition: Refers to the failure of the embryo to reach a stage when an intrauterine gestational sac is recognized by ultrasonography.
Implantation failure can apply to patients undergoing ART and patients trying to conceive without any fertility treatment.
It is a separate entity from RPL
Orvieto et al - 3 failed IVF-ET cycles with good quality embryos transferred .
Zeyneloglu et al. - 3 unsuccessful IVF specifically with two embryos of high quality
Simon and Laufer - embryo & endometrium can both play an active role in RIF
Coughlan et al. suggest a more complete working definition taking into account maternal age, number of embryos transferred, and number of cycles completed.
They define RIF as the failure of clinical pregnancy after 4 good quality embryo transfers, with at least three fresh or frozen IVF cycles, and in women under the age of 40
RIF is a complex problem with a wide variety of etiologies / mechanisms/ treatment options.
Recommendations vary depending on the source of their problem. Perhaps the best and yet most complex answer is personalized medicine, a personal approach to each patient depending on her unique set of characteristics.
It would help to establish a set of standardized tests to use, in order to do a preliminary evaluation on each patient, which would then hopefully direct the approach of treatment for each individual couple.
This can be implemented when we have well designed studies that will help us to establish new protocols.
Advance in diagnosis & treatment of cancers has led to high cure rate & longer survival.
Nearly 1 in 12 cases detected before 40 years age.
Survivors have to face infertility or early menopause.
PGD combines advances in Molecular genetics and in assisted reproductive technology and is conducted before the embryo is placed inside the womb of the woman.Pre implantation genetic diagnosis was introduced to prevent the inheritance of sex linked diseases
Advance in diagnosis & treatment of cancers has led to high cure rate & longer survival.
Nearly 1 in 12 cases detected before 40 years age.
Survivors have to face infertility or early menopause.
PGD combines advances in Molecular genetics and in assisted reproductive technology and is conducted before the embryo is placed inside the womb of the woman.Pre implantation genetic diagnosis was introduced to prevent the inheritance of sex linked diseases
Fiona McKay-Diagnóstico prenatal no invasivo y diagnóstico genético reproductivoFundación Ramón Areces
Los días 8 y 9 de junio de 2017 organizamos en la Fundación Ramón Areces con el Ciberer y la Fundación Jiménez Díaz un simposio internacional sobre 'Diagnóstico prenatal no invasivo y diagnóstico genético reproductivo'. Coordinado por la doctora Ana Bustamante, del servicio de Genética del Hospital Universitario Fundación Jiménez Díaz, tuvo como objetivo mostrar los últimos avances en el campo de la genética reproductiva a nivel preimplantacional, prenatal, e, incluso, preconcepcional.
we need to update our knowledge regarding management of endometriosis.
Which is better: medications or surgery? let's see what can this talk tell us about
what is the efficacy of Dienogest for management of endometriosis? let's see what research can tell us
Is it better that other modalities of management?
How to prevent occurrence of severe ovarian hyperstimulation in IVF. Is there a way ? this talk will present a pilot randomised study that may shed the light on this
IVF will remain the solution for infertile couples. But its future will dramatically be directed to fertile couples !!!! This talk will discuss these issues
platelet rich plasma is being used in infertility management extensively without sound evidence of its value. In this talk, we will discuss the real impact of using PRP in IVF
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
- 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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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12. • NIPT(Non invasive prenatal testing)
•asinglematernal blood draw
••PGT(Preimplantation genetic Testing)
•~70%-80% of total testing
•PGD
•Screensfor inherited disorders
such asCystic Fibrosis
•20-30% of total testing
13. NIPT measures circulating cell-free DNA (cffDNA)
from placenta present in maternal blood
Comprises ~10% of DNA in maternal blood
Increases with gestational age
As early as 9 weeks gestation
(NIPT)
15. Increased maternal age
Increased risk on Combination or triple
test
Anxiety for invasive procedure (AC /
CVS)
Indications
16. PGTPGT
Avoidance of miscarriageAvoidance of miscarriage ??
Avoidance of aneuploidy at birthAvoidance of aneuploidy at birth YESYES
Improved live birth rate....Improved live birth rate.... NONO (?)(?)
Avoidance of genetic diseaseAvoidance of genetic disease YESYES
17. Miscarriagerateafter PGT do not increasewith
age
*SART, ** Harton et al. (2013) Fertil Steril
PGS **
No PGS *
Maternal age
18.
19. Does PGT help increase pregnancy rate in
IVF?
21 April 20173rt GANNA Annual Meeting
19
Moniek Twisk et al., Hum
Reprod; 20013
20. So How to use it ?
Doctors successfully screened embryos for
gene mutation linked to early onset
Alzheimer's disease JAMA, 2002
22. Families with Cancer
Familial Adenomatous Polyposis
(FAP)
Multiple Endocrine Neoplasia 2
Breast cancer (BRCA1 and BRCA2
genes )
Hereditary non-polyposis colorectal
cancer
All these cancers are autosomal
dominant traits
23. Reality : Two IVF-PGS children without BRCA1 mutation
26. Using FISH for PGS of
X-linked disorders
Three colour FISH
X ( green)
Y (red)
Chromosome 18 to
control for normal
diploidy
Male
Female
27.
28. 10 oocytes
8 fertilized
5 survive biopsy
6 cleave to 8-16 cell
1 no diagnosis
1 aneuploid
2 males
1 embryo for replacement
Practical realities
Attrition of embryos
Practical realities
Attrition of embryos
Example for a sex linked disorder
e.g. Haemophilia / Duchenne MD
29. IVF associated risks
- high cost
- risk of not getting pregnant
- increased risk of a multiple birth
- risk of OHSS (Difficult to balance
adequate egg numbers and the risk of
OHSS ).
IF THIS IMAGE HAS BEEN PROVIDED BY OR IS OWNED BY A THIRD PARTY, AS INDICATED IN THE CAPTION LINE, THEN FURTHER PERMISSION MAY BE NEEDED BEFORE ANY FURTHER USE. PLEASE CONTACT WILEY'S PERMISSIONS DEPARTMENT ON PERMISSIONS@WILEY.COM OR USE THE RIGHTSLINK SERVICE BY CLICKING ON THE 'REQUEST PERMISSIONS' LINK ACCOMPANYING THIS ARTICLE. WILEY OR AUTHOR OWNED IMAGES MAY BE USED FOR NON-COMMERCIAL PURPOSES, SUBJECT TO PROPER CITATION OF THE ARTICLE, AUTHOR, AND PUBLISHER.
Comparison 3 Good prognosis patients, Outcome 7 Miscarriage rate per woman randomised.