Rabies caused by lyssavirus, transmitted via bites. In US, raccoons and bats most common carriers. Clinical stages include incubation, prodrome, neurological illness, death. Treatment includes wound washing, rabies immunoglobulin, vaccination.
Tick-borne illnesses discussed include Lyme disease caused by Borrelia burgdorferi transmitted by Ixodes ticks. It has 3 stages: localized rash, disseminated neuro/cardiac involvement, persistent arthritis. Rocky Mountain spotted fever caused by Rickettsia rickettsii transmitted by multiple tick species, seen in Southeast US. Symptoms include fever, rash. Ehrlichiosis and babesiosis cause malaria-like illness. Tulare
This lecture presentation contains description of arbovirus particularly detailing Dengue virus infections. Lecture outlined general characteristics of Arbovirus, classification of Arboviruses, salient features of Dengue virus, dengue pathogenesis, clinical course, laboratory diagnosis, complications of secondary dengue and some recent aspect of dengue vaccine preparation.
This lecture presentation contains description of arbovirus particularly detailing Dengue virus infections. Lecture outlined general characteristics of Arbovirus, classification of Arboviruses, salient features of Dengue virus, dengue pathogenesis, clinical course, laboratory diagnosis, complications of secondary dengue and some recent aspect of dengue vaccine preparation.
An introduction to Rhabdoviridae.Rabies is a viral disease that causes acute inflammation of the brain in humans and other mammals. Early symptoms can include fever and tingling at the site of exposure. These symptoms are followed by one or more of the following symptoms: violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is nearly always death. The time period between contracting the disease and the start of symptoms is usually one to three months; however, this time period can vary from less than one week to more than one year. The time is dependent on the distance the virus must travel to reach the central nervous system.
An introduction to Rhabdoviridae.Rabies is a viral disease that causes acute inflammation of the brain in humans and other mammals. Early symptoms can include fever and tingling at the site of exposure. These symptoms are followed by one or more of the following symptoms: violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is nearly always death. The time period between contracting the disease and the start of symptoms is usually one to three months; however, this time period can vary from less than one week to more than one year. The time is dependent on the distance the virus must travel to reach the central nervous system.
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
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
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.
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2. 1. Which of the following is true?
A. Worldwide, dogs are the most commonly rabiesinfected animals.
B. Despite similarities to dogs, foxes rarely carry rabies.
C. Skunks are the most common source of rabies in the US.
D. Due to efforts by the WHO, deaths from rabies have
dropped to less than 5000 cases/year.
E. Rabbits and other langomorphs almost never carry
rabies because they are herbivores.
3. 2. Regarding clinical rabies:
A. There are three distinct stages: prodrome, acute
neurological illness, death.
B. The incubation period is typically < 72 hours.
C. Hydrophobia is largely mythical and is almost never seen.
D. One-quarter of patients with clinically-evident rabies will
survive, although with neurologic sequelae.
E. The duration of the incubation period depends on the
severity of the bite.
4. 3. Post-exposure rabies prophylaxis
A. Includes gentle wound irrigation with saline only, so as not to
irritate tissues and increase the risk of viremia.
B. Should include immunoprophylaxis for a pt who awakens to
find a bat in her tent, even without a known bite.
C. Should include human rabies immunoglobin (HRIG) applied
topically to the wound.
D. Involves the same regimen worldwide regardless of the type
of exposure or country of origin.
5. 4. Which of the following is not commonly seen
with encephalitic, or “furious” rabies?
A.
B.
C.
D.
E.
Hydrophobia – the fear of being in contact with water
Aerophobia – the fear of air in motion
Hyperactivity in response to light exposure
Seizures
Excessive salivation
6. 5. Which is true in making the diagnosis of lyme disease?
A. Erythema chronicum migrans (ECM) is always a macular
rash with central clearing.
B. 10% of patients cannot recall the tick bite.
C. Arthritis of early Lyme disease is
episodic, symmetrical, polyarticular and attacks small
joints.
D. Common sites for ECM include ankles and skin folds.
E. ECM is seen in 50% of early Lyme disease.
7. 6. Which of the following is the correct pair?
A.
B.
C.
D.
E.
Lyme disease – caused by a virus
Rocky Mountain Spotted Fever – Ixodes sp. ticks
Tularemia – lagomorph reservoir
Tick paralysis – Rickettsia rickettsii
Relapsing fever – parasitic (protozoal)
8. 7. You suspect tick paralysis (TP) in an 8-year-old boy.
A. Treatment of choice is doxycycline for 3 weeks.
B. TP is an ascending flaccid paralysis 4-7 days after tick
attachment.
C. TP is commonly seen in the southwest, distinguishing it
from other tick-borne illnesses.
D. A single dose of antibiotics is needed to kill the bacteria
that produce the neurotoxin.
E. The neurotoxin prevents acetylcholine breakdown.
9. 8. A 35-year-old “outdoorsy” male presents to your
ED in upstate NY after syncope. You see a HR of
40-bpm with occasional p-waves. You realize:
A.
B.
C.
D.
E.
This cannot be due to Lyme disease as you see no ECM rash.
You should administer aspirin immediately.
This conduction abnormality can be managed outpatient.
This patient needs a temporary cardiac pacemaker.
The treatment of choice is still oral doxycycline.
10. 9. Which of the following is true regarding Lyme disease?
A.
B.
C.
D.
E.
Cattle are the preferred hosts of Ixodes scapularis
Culture of blood/tissue is the gold standard for diagnosis
Borrelia burgdorferi, a spirochete, spreads to all tissues
Skin lesions on the palms and soles are common
Once chronic symptoms develop, antibiotics are no
longer useful
11. 10. Regarding Rocky Mountain spotted fever (RMSF):
A. A maculopapular rash is the most common symptom.
B. It is most commonly seen in Montana, Idaho, Colorado and
Utah.
C. Rickettsia rickettsii are obligate intracellular bacteria that
live in platelets. This leads to thrombocytopenia / petechiae.
D. Early RMSF mimics any self-limited febrile viral illnesses.
E. A triad of fever, rash and tick bite is seen in 33% of cases.
12.
13. 1. Which of the following is true?
A. Worldwide, dogs are the most commonly rabiesinfected animals.
B. Despite similarities to dogs, foxes rarely carry rabies.
C. Skunks are the most common source of rabies in the US.
D. Due to efforts by the WHO, deaths from rabies have
dropped to less than 5000 cases/year.
E. Rabbits and other lagomorphs almost never carry rabies
because they are herbivores.
14. 2. Regarding clinical rabies:
A. There are three distinct stages: prodrome, acute
neurological illness, death.
B. The incubation period is typically < 72 hours.
C. Hydrophobia is largely mythical and is almost never seen.
D. One-quarter of patients with clinically-evident rabies will
survive, although with neurologic sequelae.
E. The duration of the incubation period depends on the
severity of the bite.
15. 3. Post-exposure rabies prophylaxis
A. Includes gentle wound irrigation with saline only, so as not to
irritate tissues and increase the risk of viremia.
B. Should include immunoprophylaxis for a pt who awakens to
find a bat in her tent, even without a known bite.
C. Should include human rabies immunoglobin (HRIG) applied
topically to the wound.
D. Involves the same regimen worldwide regardless of the type
of exposure or country of origin.
16. 4. Which of the following is not commonly seen
with encephalitic, or “furious” rabies?
A.
B.
C.
D.
E.
Hydrophobia – the fear of being in contact with water
Aerophobia – the fear of air in motion
Hyperactivity in response to light exposure
Seizures
Excessive salivation
17. 5. Which is true in making the diagnosis of lyme disease?
A. Erythema chronicum migrans (ECM) is always a macular
rash with central clearing.
B. 10% of patients cannot recall the tick bite.
C. Arthritis of early Lyme disease is
episodic, symmetrical, polyarticular and attacks small
joints.
D. Common sites for ECM include ankles and skin folds.
E. ECM is seen in 50% of early Lyme disease.
18. 6. Which of the following is the correct pair?
A.
B.
C.
D.
E.
Lyme disease – caused by a virus
Rocky Mountain Spotted Fever – Ixodes sp. ticks
Tularemia – lagomorph reservoir
Tick paralysis – Rickettsia rickettsii
Relapsing fever – parasitic (protozoal)
19. 7. You suspect tick paralysis (TP) in an 8-year-old boy.
A. Treatment of choice is doxycycline for 3 weeks.
B. TP is an ascending flaccid paralysis 4-7 days after tick
attachment.
C. TP is commonly seen in the southwest, distinguishing it
from other tick-borne illnesses.
D. A single dose of antibiotics is needed to kill the bacteria
that produce the neurotoxin.
E. The neurotoxin prevents acetylcholine breakdown.
20. 8. A 35-year-old “outdoorsy” male presents to your
ED in upstate NY after syncope. You see a HR of
40-bpm with occasional p-waves. You realize:
A.
B.
C.
D.
E.
This cannot be due to Lyme disease as you see no ECM rash.
You should administer aspirin immediately.
This conduction abnormality can be managed outpatient.
This patient needs a temporary cardiac pacemaker.
The treatment of choice is still oral doxycycline.
21. 9. Which of the following is true regarding Lyme disease?
A.
B.
C.
D.
E.
Cattle are the preferred hosts of Ixodes scapularis
Culture of blood/tissue is the gold standard for diagnosis
Borrelia burgdorferi, a spirochete, spreads to all tissues
Skin lesions on the palms and soles are common
Once chronic symptoms develop, antibiotics are no
longer useful
22. 10. Regarding Rocky Mountain spotted fever (RMSF):
A. A maculopapular rash is the most common symptom.
B. It is most commonly seen in Montana, Idaho, Colorado and
Utah.
C. Rickettsia rickettsii are obligate intracellular bacteria that
live in platelets. This leads to thrombocytopenia / petechiae.
D. Early RMSF mimics any self-limited febrile viral illnesses.
E. A triad of fever, rash and tick bite is seen in 33% of cases.
23.
24. RABIES
• Lyssavirus (rhabdoviridae) – RNA
• Preference for CNS tissue
• In US:
•
•
Raccoons most common carrier
Bats most common infector
• Worldwide: Dogs most common
RABIES
Background
Clinical
Treatment
TICK ILLNESS
25. RABIES SYNDROME
• 5 stages of rabies infection:
• Incubation (30-90) days
• Prodrome – flu-like syndrome
• Acute neurological illness
•
•
•
•
Excitement
Opisthotonus
Hydrophobia
Salivation, lacrimation, unste
ady gait
• Coma
• Death
RABIES
Background
Clinical
Treatment
TICK ILLNESS
26. RABIES TREATMENT
• Aggressive wound washing
•
Virucidal agent
•
HRIG 20 IU/kg (local if poss)
• Human rabies immune globulin
• Human diploid cell vaccine
•
HDCV days 0, 3, 7, 14, 28
• In US treat:
•
skunk, raccoon, fox, bat
RABIES
Background
Clinical
Treatment
TICK ILLNESS
A. B. Foxes commonly carry rabies.C. Raccoons are the most common source of rabies in the US.D. Estimated 55,000 cases/year worldwide.E. Lagomorphs can carry rabies.
A. 5 stages: incubation, prodrome, acute neurological illness, coma, deathB. Incubation period 30-90 days although 7yrs has been describedC. Hydrophobia = laryngospasm/diaphargm in response to trying to drink. Leads to overwhelming “terror” of water.D. Only 8 cases of survivors ever.E.
A. Aggressive wound scrubbing with virucidal agent.B.C. HRIG is injected IM.D. Regimen varies in different countries. Antigenically distinct viruses.E.
A.B.C.D.E.
A. There are multiple variations of ECM including linear/triangular.B. 2/3C. D.E. 90%
A. BorreliaburgdorferiB. Rickettsia rickettsii – Dermacentor ticksC. D. TP – neurotoxin – Dermacentor ticksE. Borreliahermsii
A. Treatment is removal of the tick.B. C. Commonly seen in SE and NWD. No abx neededE. Prevents Ach release
A. Carditis occurs 3-5 weeks after infection – ECM often goneB. No indication for aspirinC. NoD.E. Unstable pts require IV ceftriaxone or PCN
A. White tailed deer and white field mouseB. Serology is gold standard. Cx rarely positive.C.D. Palms and soles often sparedE. Antibiotics are indicated in all phases of disease
A. Fever is the most common Sx (99%) rash in 88%B. Most common in SEC. Platelets aren’t cells. The vasculitis is what leads to thrombocytopenia and petechiaeD. E. Triad only seen in 3%
Spares face
Spares face
Obligate intracellular bacteria that attack and kill white blood cells. Ehrlichiosis refers to 3 species of bacteria.