This document discusses the importance of optic disc evaluation in diagnosing and monitoring glaucoma. It outlines the key parameters to examine including disc size and shape, cup size and shape, neuroretinal rim characteristics, presence of hemorrhages, nerve fiber layer defects, parapapillary atrophy, and retinal artery attenuation. Evaluating these seven parameters allows clinicians to distinguish healthy from damaged discs, quantify the amount of damage, monitor changes over time, and determine the rate of progression. Careful optic disc analysis through biomicroscopy, photography, and standardized scales can detect pre-perimetric and early glaucomatous changes important for diagnosis and treatment.
Recent advances in diagnosis of glaucoma includes all the newer trends in the fields of measuring increased IOP, anterior chamber angle and depth assessment and optic nerve head assessment including RNFL thickness.
Recent advances in diagnosis of glaucoma includes all the newer trends in the fields of measuring increased IOP, anterior chamber angle and depth assessment and optic nerve head assessment including RNFL thickness.
thesis statement is a sentence that sums up the central point of your paper or essay. It usually comes near the end of your introduction.
Your thesis will look a bit different depending on the type of essay you’re writing. But the thesis statement should always clearly state the main idea you want to get across. Everything else in your essay should relate back to this idea.
Example: Thesis statement
Despite Oscar Wilde’s Aestheticist claims that art needs no justification or purpose, his work advocates Irish nationalism, women’s suffrage, and socialism.
You can write your thesis statement by following four simple step
thesis statement is a sentence that sums up the central point of your paper or essay. It usually comes near the end of your introduction.
Your thesis will look a bit different depending on the type of essay you’re writing. But the thesis statement should always clearly state the main idea you want to get across. Everything else in your essay should relate back to this idea.
Example: Thesis statement
Despite Oscar Wilde’s Aestheticist claims that art needs no justification or purpose, his work advocates Irish nationalism, women’s suffrage, and socialism.
You can write your thesis statement by following four simple step
Approach to Disc Pallor and Automated Fields in Neuro-ophthalmology Dr. Shah Noor Hassan
Visual field assessment is important in the evaluation of lesions involving the visual pathways and should be performed at baseline and periodically in the follow-up. Standard automated perimetry has been shown to be adequate in neuro-ophthalmic practise and is now the technique of choice for a majority of practitioners.
normal fundus , the retina how it works & how it is visualised is described here.
the procedure of direct ophthalmoscopy how the image is seen.
Abnormalities of retina how are they seen.
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
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.
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.
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
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.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
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.
3. Glaucoma =Optic neuropathy
• The evaluation of the appearance of the optic
disc is central to the diagnosis and
management of Glaucoma
• Optic Disc Evaluation:
– Why..?
– How..?
– What to look for..?
4. The 4 goals of optic disc evaluation
• Distinguishing between the healthy and the
sick =Diagnosing.
• Quantifying the amount of damage:
Healthy,Mild,Moderate,Advanced Disease
• Monitoring Change,for better or for worse
• Quantitating the rate of change
7. The 7 parameters to look for…
1)Disc: Size and Shape
2)Cup: Size and Shape in relation to the optic disc
size,
-Vertical C/ D Ratio, Cup depth / Excavation
3)Neuroretinal Rim (NRR):
Size,Shape,Pallor
ISNT rule
4) Optic Disc Hemorrhage: Presence & Location
9. All these variables can be measured
semiquantitavively by ophthalmoscopy
without applying sophisticated techniques
10. 1)Optic Disc: Size & Shape
• Determining the size of the disc =Crucial
– Helps to differentiate Physiological cupping from
Pathological.
• Large discs have big physiological cups.
• Small Discs have small cups or no cups
• Measurement of Vertical Disc diameter :
– Length of the vertical beam of slit lamp light
– Multiplied by correction factor of the condensing lens
– Volk 60 D= X 1
– Volk 90D= X 1.5
11. Cup: Size, Shape, location in relation to the
disc size
• Optic Cup= Excavation in the optic nerve head
– Stereoscopic evaluation
• In normal eyes= Areas of optic disc & Optic cup are
corelated
• Large optic discs=Large cup
• Small optic disc =Small cup or no cup
• Early & moderate glaucomatous damage in small disc
may be missed because of the erroneously low cup
disc ratios
14. Early & moderate glaucomatous damage in small disc may be missed
because of the erroneously low cup disc ratios
15.
16. 2) Vertical Cup Disc Ratio
• Vertically oval optic disc
• Horizontally oval optic cup
• In normal eyes: Horizontal CD ratio > than
vertical CD ratio
• In Glaucomatous eyes: Vertical CD ratio > than
the horizontal CD ratio
19. • Thinning of the NRR
• Pallor of NRR
• Notching:
– A notch is a localized
defect in the
Neuroretinal rim on the
cup side of the rim
20. The Neurretinal rim loss in Glaucoma
• Usual sequence of NRR loss in Glaucoma:
– Inferotemporal
– Superotemporal
– Horizontal temporal
– Inferonasal
– Superonasal
• In contrast,in the non glaucomatous optic nerve
damage, the NRR is not always affected and hence
contour of NRR is maintained.
24. 4) Optic Disc Hemorrhage
• Splinter or Flame shaped
hemorrhages
• At the margin of the disc
• Hallmark of Glaucomatous
optic nerve damage
• 4 to 7 % of eyes with
galucoma
• Found in early &
moderately advanced
Glaucoma and rare in very
advanced stage
• Located usually in the
inferotemporal &
superotemporal disc
margins
• Associated with localized
RNFL defect and
neuroretinal rim notches .
• Suggests Progression.
• More common in NTG
28. 5) Retinal Nerve Fibre Layer Defect
• RNFL contains retinal ganglion cells axons
covered by astrocytes and bundled by
processes of muller cells
• Seen as bright fine striations fanning off from
the disc to the periphery.
• Dilated pupil, green light, clear optical media
aids the evaluation of RNFL
29. Retinal Nerve Fibre Layer Defect
• Localized RNFL defects:
– Can be detected before visual field defect has developed
– Focal type of NTG
– Early to medium advanced Glaucomatous damage
• Diffuse loss of RNFL:
– More difficult to detect
– Peripapillary retinal vessels appear bare
– Underlying Choroidal vessels more clearly seen
.
33. 6) Parapapillary Chorioretinal atrophy
• 2 zones
– Central Beta zone
– Peripheral alpha zone
• Beta zone occurs more often in glaucomatous
eyes than in normal eyes.
• Helps to differentiate various subtypes of
POAG
• Helps to differentiate from nonglaucomatous
optic nerve damage
35. 7) Retinal Artery attenuation
• Diffuse narrowing:
– Decreasing NRR
– Increased RNFL loss
– Increased Visual field
defects
• Focal Attenuation
– More common in NTG
– Degree of narrowing
increases with amount
of damage.
41. Pre Perimetric Diagnosis of Glaucomatous Optic
Nerve damage
• Most important Variables
– Shape of the NRR
– Size of the cup in relation to the optic disc
– Diffuse or focal RNFL defects
– Disc Hemorrhages
