This document discusses the classification and definitions related to acute pancreatitis. It covers the major causes of acute pancreatitis, which are biliary tract disease (50-70% of cases) and alcoholism (25% of cases). It defines acute pancreatitis as the acute inflammation of the pancreas that is usually reversible. The document outlines the 1992 Atlanta Classification of acute pancreatitis as mild or severe. Severe acute pancreatitis is associated with organ failure and/or local complications. It also discusses revisions to the classification in 2008 and 2012, including definitions of interstitial edematous pancreatitis, necrotizing pancreatitis, sterile vs infected necrosis, and organizational of severity based on local necrosis and systemic organ failure.
This topic is very important for an MBBS Students as it is one of the common cases a Medical Officer will come across during their Surgical Postings. Moreover it is always a Debate in treating the patient either an Physician or a Surgeon...Always it is one of the Devastating conditions of abdomen...
This topic is very important for an MBBS Students as it is one of the common cases a Medical Officer will come across during their Surgical Postings. Moreover it is always a Debate in treating the patient either an Physician or a Surgeon...Always it is one of the Devastating conditions of abdomen...
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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5th edition of the Diagnostic and Statistical Manual of Mental Disorders
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disorder called alcohol use disorder (AUD), with mild, moderate,
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In the DSM-5, all types of substance abuse and dependence have been
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The four main behavioral effects of AUD are impaired control over
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the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
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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
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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.
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
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.
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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.
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.
2. Definition :
Acute pancreatitis is an acute inflammation of
the prior normal gland parenchyma which is
usually reversible.
It may be first attack or relapsing attacks with
an apparently normal gland in between.
6. Definition of diagnosis of acute
pancreatitis :
The diagnosis of acute pancreatitis requires two of the
following three features:
1. abdominal pain consistent with acute pancreatitis
(acute onset of a persistent, severe, epigastric pain
often radiating to the back).
2. serum lipase activity (or amylase activity) at least
three times greater than the upper limit of normal.
3. characteristic findings of acute pancreatitis on
contrast-enhanced computed tomography (CECT).
7. Summary of the 1992 Atlanta
Classification of AP :
• Mild AP : Associated with minimal organ
dysfunction and an uneventful recovery; lacks
the features of severe AP.
• Severe AP : Associated with organ failure
and/or local complications.
8. Organ failure and systemic complications
:
Shock: SBP < 90 mmHg.
Pulmonary insufficiency: PaO2 ≤ 60 mmHg.
Renal failure: Creatinine ≥ 170 µmol/L (≥ 2 mg/dL) after
rehydration.
Gastrointestinal bleeding: 500 mL in 24 hours.
Disseminated intravascular coagulation:
Platelets ≤ 100,000/mm3, fibrinogen < 1.0 g/L and fibrin-split
products > 80 µg/L.
Severe metabolic disturbances: Calcium ≤ 1.87 mmol/L or ≤
7.5 mg/dL.
10. Revision of The Atlanta
Classification of AP (2008):
1st week :
(early phase) (clinical classification )
• Non-severe AP: absence of organ failure or
the presence of organ failure that does not
exceed 48 hours in duration.
• Severe AP: persistence of organ failure that
exceeds 48 hours duration.
11. After 1st week :
(subsequent phase) (morphologic classification)
• Interstitial edematous pancreatitis (IEP) (80%):
CECT demonstrates diffuse or localized enlargement
of the pancreas and normal, homogeneous
enhancement of the pancreatic parenchyma.
• Necrotizing pancreatitis (10%):
CECT demonstrates the presence of necrosis in
either the pancreatic parenchyma or the extra
pancreatic tissues. The necrosis should be further
classified into Sterile or Infected.
12. Acute interstitial pancreatitis.
Normal enhancing pancreas with
swelling and little peripancreatic fat
stranding (arrows).
Acute necrotizing pancreatitis. CT shows
nonenhancing parts of pancreatic head, neck,
and body (arrows) with normal enhancing tail
(asterisk). Note, stones in the gallbladder.
14. Local Determinant :
The local determinant of severity is necrosis of the
pancreas and/or peripancreatic tissue.
15. Definitions
(Peri) pancreatic necrosis : is nonviable tissue
located in the pancreas alone, or in the pancreas
and peripancreatic tissues, or in peripancreatic
tissues alone.
It can be solid or semisolid (partially liquefied).
Sterile (peri) pancreatic necrosis : is the
absence of proven infection in necrosis.
16. Infected (peri) pancreatic necrosis : is defined
when at least one of the following is present:
1. Gas bubbles within (peri) pancreatic necrosis on
computed tomography.
2. A positive culture of (peri) pancreatic necrosis
obtained by image-guided fine-needle aspiration.
3. A positive culture of (peri) pancreatic necrosis
obtained during the first drainage and/or
necrosectomy.
17. Systemic Determinant :
The systemic determinant of severity is a certain
degree of distant organ dysfunction due to Acute
Pancreatitis. This is covered by the term organ
failure.
18. Definitions
Organ failure is defined for 3 organ systems
(cardiovascular, renal, and respiratory) on the
basis of the worst measurement over a 24-hour
period.
In patients without preexisting organ dysfunction,
organ failure is defined as either a score of 2 or
more for the assessed organ system according
to the SOFA (Sepsis-related Organ Failure
Assessment) score or when the relevant
threshold is breached, as shown:
19. Cardiovascular: need for inotropic agent.
Renal: creatinine ≥ 171 µmol/L ( ≥ 2.0 mg/dL).
Respiratory: PaO2/FiO2 ≤ 300 mmHg (40 kPa).
Persistent organ failure : is the evidence of
organ failure in the same organ system for 48
hours or longer.
Transient organ failure : is the evidence of
organ failure in the same organ system for less
than 48 hours.
20. Classification by prognostic
scoring systems :
Balthazar score :
Also called the Computed Tomography Severity
Index (CTSI) is a grading system used to
determine the severity of acute pancreatitis.
has a maximum of ten points, and is the sum of
the Balthazar grade points and pancreatic
necrosis grade points: