This document discusses the approach to interstitial lung diseases (ILD) and diffuse parenchymal lung diseases (DPLD). It begins by reviewing the spectrum of ILD and DPLD, identifying clues from clinical presentation to make a diagnosis, and reviewing common radiographic findings. Key points include that ILD involves the pulmonary interstitium located between the epithelial and endothelial basement membranes. Clinical presentation of DPLD/ILD often involves dyspnea, cough, and abnormal chest imaging. Diagnosis involves considering history, physical exam, pulmonary function tests, imaging like chest radiographs and CT, and tissue sampling. Management depends on the specific diagnosis but may include treatments like corticosteroids, immunosuppressants, anti
Practical approach to interstitial lung diseases Hamdi Turkey
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
Do Not Forget To Visit Our Pages On Facebook on the following Links:
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2 types (a) cellular NSIP
(b) Fibrotic NSIP (more common)
Fibrosis may involve alveolar septa, peribronchivascular interstitium, interlobular septa and visceral pleura.
Prognosis of fibrotic NSIP is worse , cellular NSIP has good prognosis.
HRCT finding may show both, airspace and interstitial patterns
Practical approach to interstitial lung diseases Hamdi Turkey
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
Do Not Forget To Visit Our Pages On Facebook on the following Links:
https://www.facebook.com/groups/569435236444761/
AND
https://www.facebook.com/groups/690331650977113/
2 types (a) cellular NSIP
(b) Fibrotic NSIP (more common)
Fibrosis may involve alveolar septa, peribronchivascular interstitium, interlobular septa and visceral pleura.
Prognosis of fibrotic NSIP is worse , cellular NSIP has good prognosis.
HRCT finding may show both, airspace and interstitial patterns
An approach to Interstitial Lung Disease / Diffuse Parenchymal Lung DiseaseThomas Kurian
YouTube link: https://youtu.be/gPr31qrivUc
An approach to Diffuse Parenchymal Lung disease / Interstitial Lung disease with emphasis on the idiopathic causes.
An approach to Interstitial Lung Disease / Diffuse Parenchymal Lung DiseaseThomas Kurian
YouTube link: https://youtu.be/gPr31qrivUc
An approach to Diffuse Parenchymal Lung disease / Interstitial Lung disease with emphasis on the idiopathic causes.
Interstitial Lung Diseases [ILD] Approach to ManagementArun Vasireddy
Diffuse (interstitial) lung disease includes a wide variety of relatively uncommon conditions presenting with characteristic clusters of clinical features and marked by an immune response. There are over 200 specific diffuse lung diseases, many of unknown etiology. The combined incidence is 50 per 100,000, or 1 in 2000 people. Because these conditions cause aberrant lung function, morbidity and mortality due to lung injury and fibrosis are not uncommon. Both environmental and genetic factors are believed to contribute to the development of diffuse lung disease. Antigen processing and presentation are important in the development of the immune response seen in the disease, and it is thought that the likely candidate genes predisposing patients to this category of disease are those of the major histocompatibility complex. Genes that affect the immune, inflammatory, and fibrotic processes may also influence who develops the disease. If we can identify the genes that cause diseases characterized by lung injury and fibrosis, we can eventually develop genetic interventional approaches to treatment.
Role of hrct in interstitial lung diseases pk uploadDr pradeep Kumar
Role of hrct in interstitial lung diseases pk , This is best powerpoint slides presentation including Latest American thoracic society and fleishners society guidelines . this includes radiographic images a well HRCT chest findings of various ILD. This will help alot for md pg radiology resident and radiologist. Thanks
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!
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
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
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
2. Objectives
Review the spectrum of ILD or DPLD
Identify clues on presentation to
make the diagnosis
Review common radiographic
findings in ILD
Diagnosis and management of DPLD
/ILD
3. Pulmonary Interstitium
Interstitial compartment is the portion of the lung
sandwiched between the epithelial and endothelial
basement membrane
The interstitium of the lung is not normally visible
radiographically; it becomes visible only when disease (e.g.,
edema, fibrosis, tumor) increases its volume and attenuation.
6. Approach to
DPLD/ILD
Granulomatous
Lung Diseases
(Sarcoidosis)
DPLD of known
Cause
Idiopathic Interstitial
Pneumonias
Others
LAM
Histiocytosis X
Malignancy
Drugs Exposure CTD IPF IIP other than IPF
Hypersensitivity
Pneumonitis
Desquamative Interstitial
Pneumonia
Respiratory Bronchiolitis-
Interstitial Lung disease
Pneumoconiosis
IPF: 47-64%
NSIP: 14 to 36%
RBILD/DIP: 10-
17%Cryptogenic Organizing
Pneumonia
Acute Interstitial
Pneumonia
Toxic Inhalation Radiation
COP: 4-12%
AIP: 2%
LIP: 2%
Lymphocytic Interstitial
Pneumonia
Non Specific Interstitial
Pneumonia
7. Clinical Presentation
• Dyspnea on exertion or a persistent
productive cough
Abnormal CXR,CT chest
non
•
• Pulmonary symptoms associated with
another disease, such as CVD
PFT abnormalities•
8. DIAGNOSIS OF DPLD/ILD
•
•
•
•
History
Physical Exam
Chest Radiograph,HRCT
Pulmonary Function
– At Rest
– Exercise
Serologic Studies
Tissue examination,
BAL, TBr, VATS, Open lung biopsy ,
Testing
•
•
9. History: Smoking
• All of the following
DPLD are associated
• In Goodpasture’s
syndrome
with smoking : 100% of smokers vs. 20%
of nonsmokers
experience pulmonary
hemorrhage
Individuals exposed to
asbestos who smoke are
more likely to develop
asbestosis
–
a)
b)
c)
d)
IPF
RBILD, DIP
Histiocytosis
•
X
Syndrome of IPF
emphysema
&
16. Drug induced lung
diseases
Immunologic reaction to drugs
• Interstitial pattern similar to interstitial edema
which progresses to alveolar pattern
[busulfan, bleomycin, cytoxan,..]
Alveolar in filtrates similar to pulmonary
edema [penicillin, sulfonamides,..]
•
• Pleural and pericardial effusion + basal
infilterates [isonaizid,…]
Hilar adenopathy [antionvulsant,..]•
Busulfan
interstitial lung disease
19. Diffuse pulmonary
hemorrhage
Hemoptysis, anemia and air space opacities
Appear rapidly and clear within few days
Spare the lung apex and peripheral zones
Bilateral, may be asymmetric, air bronchogram
Repeated attacks → pulmonary fibrosis
Pulmonary
hemorrhage(normal heart) [3 days,
6days, one
month]
21. Silicosis
Inhalation of high concentrations of silicon
dioxide
•
•
Fine interstitial opacities with B Kerley’s lines (early)
Multiple nodular shadows scattered in the lungs (classic)
•
•
Sparing apex and base
Calcification may occur
22. Complicated silicosis. PA chest radiograph shows multiple
nodules involving the upper and middle lungs, with coalescence
of nodules in the left upper lobe resulting in early progressive
massive fibrosis
23. CXR: LlMITATIONS
• CXR is normal:
– in 10 to 15 % of symptomatic patients with
proven
30% of
~ 60 %
infiltrative lung disease
those with bronchiectasis
of patients with emphysema
–
–
• CXR has a sensitivity of 80% and a
specificity of 82% percent for detection
of DPLD
CXR can provide a confident diagnosis
in ~ 23 % of cases
•
28. Ground glass pattern
[ Increased attenuation of the lung with
preserved
broncho vascular marking
]
Patients with AIDS, ground glass
opacities= P.carinii pneumonia
Patients
ground
with lung transplant
opacities=glass
cytomegalovirus pneumonia or
rejection
P.carinii pneumonia
in
an AIDS patient
38. Probability of Histologic Diagnosis of Diffuse
Transbronchial
Biopsy
Diseases
Surgical
Biopsy
Sometimes
Courtesy ofKevin O. Leslie, MD.
1. Granulomatous diseases
2. Malignant tumors/lymphangitic
3. DAD (any cause)
4. Certain infections Often
5. Alveolar proteinosis
6. Eosinophilic pneumonia
7. Vasculitis
8. Amyloidosis
9. EG/HX/PLCH Some
10. LAM
11. RB/RBILD/DIP
12. UIP/NSIP/LIP COP
13. Small airways disease Never
14. PHT and PVOD
39. s.no ILD type Current therapy* Additional and/or
alternative
therapies
1. IPF Supportive care
Consider anti-reflux
measures
Anti-reflux surgery
Acid suppressants
(e.g. PPI)
Pirfenidone
Lung transplantation
Anti-reflux therapy
N-acetylcysteine
2. SARCOIDOSIS Observation
(mild/stable disease
Corticosteroids
Methotrexate
Infliximab
Other IS agent
Lung transplantation
3. NSIP Lung
transplantation
Mycophenolate
Lung
transplantation
40. 4. COP Corticosteroids Other IS drugs
Macrolides
5. HP Exposure cessation
Corticosteroids
Other IS drugs
Lung transplantation
6. Eosinophilic
pneumonia
Corticosteroids Other IS drugs
Lung
transplantation
7. CTD-ILD Corticosteroids
Mycophenolate
Other DMARD
agent(s)
Anti-reflux therapy
Treatment of PH
8 AIP/DAD Corticosteroids Cytotoxic drugs
41. Resting Tachypnea
Shallow breathing
Dry crackles
Digital clubbing
Pulmonary HTN
Non-pulmonary
findings
ILD/DPLD
• 81 in 100,000 prevalence in men
• 67 in 100,000 in women
• 32.5 in 100,000 incidence in men
• 26 in 100,000 in women
• 200 in 100,000 incidence in age >75
• 30-40% of all ILD “IPF”
