This document discusses different types of Aspergillus infections including allergic bronchopulmonary aspergillosis (ABPA), semi-invasive aspergillosis, and invasive pulmonary aspergillosis. ABPA is an allergic reaction seen in patients with asthma or cystic fibrosis and results in bronchial wall damage and bronchiectasis. Semi-invasive aspergillosis typically occurs in patients with mild immunosuppression and results in thick-walled cavities in the lungs. Invasive pulmonary aspergillosis is seen in severely immunocompromised patients like those with leukemia and causes multiple or single ill-defined lung opacities or consolidations.
Adenoviruses (members of the family Adenoviridae) are medium-sized (90–100 nm), nonenveloped (without an outer lipid bilayer) viruses with an icosahedral nucleocapsid containing a double-stranded DNA genome. Their name derives from their initial isolation from human adenoids in 1953.
The presentation includes disease, treatment and management.
Microbiology of E coli giving basic of Escherichia coli, its morphology, cultural and biochemical characteristics, Antigenic character, pathogenesis, laboratory diagnosis, prevention and control
Adenoviruses (members of the family Adenoviridae) are medium-sized (90–100 nm), nonenveloped (without an outer lipid bilayer) viruses with an icosahedral nucleocapsid containing a double-stranded DNA genome. Their name derives from their initial isolation from human adenoids in 1953.
The presentation includes disease, treatment and management.
Microbiology of E coli giving basic of Escherichia coli, its morphology, cultural and biochemical characteristics, Antigenic character, pathogenesis, laboratory diagnosis, prevention and control
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
PNEUMONIA,
DEFINITION
Pneumonia is an infection of the pulmonary parenchyma.
To the pathologist, pneumonia is an infection of the alveoli ,distal airways, and interstitium of the lung that is manifested by increased weight of the lungs, replacement of normal lung’s sponginess by consolidation ,and alveoli filled with white blood cells ,red blood cells and fibrin .To the clinician, pneumonia is a constellation of symptoms and signs in combination with at least one opacity on CXR.
Epidemiology
Between 5 and 10 million cases of infectious pneumonia occur annually in the United States and result in more than 1 million hospitalizations.
Pneumonia is a leading cause of death worldwide, the sixth leading cause of death in the United States, and the most common lethal infectious disease.
Presentation by S.K Jindal on Hypersensitivity Pneumonitis: Approach to diagn...Jindal Chest Clinic
Hypersensitivity pneumonitis is an immune system disorder causing lungs to become inflamed due to allergic reactions to inhaled microorganisms, plant and animal proteins, or chemicals. In this presentation "Hypersensitivity Pneumonitis" has been described including their Causes, Diagnosis, Management, etc. For more information, please contact us: 9779030507.
evaluation of fetal anatomy in 1st trimester.pptxdypradio
EVALUATION OF FETAL ANATOMY IN FIRST TRIMESTER .
FETAL DEVELOPMENT IN FIRST YAER.
NORMAL ULTRASOUND FINDINGS IN THE FIRST TRIMESTER.Evaluation of fetal anatomy, including a detailed fetal cardiac examination, is possible in the late first trimester.
Many anatomic abnormalities can be detected in the first trimester, giving families time to make important decisions regarding pregnancy management and the opportunity for early termination of pregnancy to reduce maternal morbidity risks.Week 6: By the 6th week, the limb buds begin to differentiate into upper and lower limbs with large hand plates, which develop primordial digits. The lower extremities lag behind the upper limbs by approximately 4 to 5 days. The primordial ear develops and the eyes become obvious as the retina becomes pigmented. The fetal liver occupies the majority of the abdominal cavity at the 6th week. As the rapid growth of the intestines exceeds the growth of the abdominal cavity the physiologic herniation of the intestines into the umbilical cord occurs. Spontaneous twitching movements and reflex responses to touch begin to take place.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
2. ASPERGILLUS INFECTION
INTRODUCTION:
• Aspergillus infections of the lung are caused by Aspergillus fumigatus
which are ubiquitous fungi found throughout nature.
• Results in disease in susceptible hosts when inhaled.
• The pathogenesis of Aspergillus infection varies with quality and
virulence of the inhaled organism and the status of the host defence
mechanisms.
• Characterised by spectrum of pathology related to an immune
response of individual to the organism.
5. • MYCETOMA:
• Is non invasive colonization of preexisting cavity in immunologically normal
pt with cavitatory disease
• Mycetoma is a ball of coalscent mycelial hhyphae that typically colonize pre-
existing cavity.
• Clinical features :
1. Cough and expectoration
2. Hemoptysis-frequently seen in almost ½ of cases
Bleeding is usually due to friction between fungal ball and hypervascular wall
which releases endotoxins from fungus and causes type-3 reaction in cavity
wall.
6.
7. • LOCATION :
• UPPER LOBES
• SUPERIOR SEGMENT OF LOWER LOBE
9. XRAY CT SCAN
Round to oval mass of soft tissue density
lying within preexisting cavity.
Taken in supine and prone position
Air crescent sign Mass within the cavity
Decubitus xray – to demonstrate mobility
of fungal ball
Air crescent sign
Thickening of cavity wall –s/o signs of
early aspergillus infection
Mobile intracavitatory mass is
characteristic of aspergilloma.
Irregular air spaces within
Fungal strands bridging the fungus ball
&cavity wall maybe seen.
IMAGING FINDINGS:
13. • Allergic aspergillosis is a result of hypersensitivity reaction that produce ABPA or
less commonly extrinsic allergic pneumonitis or Loeffler syndrome.
• It is airway disease.
• Only seen in patients with asthma and cystic fibrosis.
• There is airway colonization -> complex hypersensitivity reaction (1 > III).
ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS:
C/F:
1. Cough
2. Wheezing
3. a/s allergic symptoms
14. • Eosinophil derived inflammation (fleeting infiltration).
• Plugging of bronchial wall with mucus plugs (contain septate hyphae)
• Th2 mediated inflammation (IL-5, 4,13) of bronchial wall
• cough with sputum (hyphae)
• Longterm- Irreversible dilatation
• Bronchiectasis.
Pathogenesis:
15. • Bronchiectasis – more in upper lobe , central, proximal airways and is B/L
• Mucus plugging with hyphae can also lead to atelectatsis.
• Adherence of conidia to respiratory epithelial cells
• cellular dysfunction
• Initially cilial disruption
• The fungal colony grows,hyphae are produced invade between & through epithelialcells
• Leading to substantial tissue disruption
Pathogenesis:
17. • Pathology
• Allergic bronchopulmonary aspergillosis is the result of hypersensitivity
(esp fumigatus) .
• It grows within the lumen of the bronchi, without invasion.
• The hypersensitivity initially causes bronchospasm and bronchial wall
• Ultimately, there is bronchial wall damage with loss of muscle and bronchial
in bronchiectasis (typically central bronchiectasis) 7.
• Both types I and III allergic reactions have been implicated 4.
18. XRAY CT SCAN
Non segmental consolidation in upper
lobe
Bronchiectasis
Lobar collapse Mucoid impaction
Branching thick tubular opacity bronchial wall thickening: common
Pul cavitation cavitation: 10%
Hyperinflated lung fields
Gloved finger sign
Central bronchiectasis
ACUTE ABPA:
25. CHRONIC ABPA:
IMAGING FEATURES:
• Bronchiectasis :
1. Bronchial wall thickening
2. Tramline shawdows
3. Ring formation
• Fibrosis: linear fibrotic band , can also cause traction bronchiectasis
• Loss of volume in upper lobe
26. A clinical staging system has been developed :
•stage I: acute
•stage II: remission
•stage III: recurrent exacerbation
•stage IV: steroid-dependent asthma
•stage V: pulmonary fibrosis
Major and minor criteria have also been established .
•major criteria
• clinical
• asthma (approximately 90% of patient may have asthma )
• radiographic features
• pulmonary opacities (transient or chronic)
• central bronchiectasis
• immune system
• blood eosinophilia
• immediate skin reactivity to Aspergillus antigen (elevated IgG and/or IgE against A.
fumigatus)
• increased serum IgE (>1000 IU/ml)
•minor criteria
• fungal elements in sputum
• expectoration of brown plugs/flecks
• delayed skin reactivity to fungal antigens
27. This form typically occurs in patients with a depressed immune system, but not as profoundly
immunocompromised as bone marrow patients who more frequently develop angioinvasive
aspergillosis. Patients are typically middle-aged. Risk factors, therefore, include 1-3:
•corticosteroids - most common systemic immunodepressant 3
•diabetes mellitus
•alcoholism
•chronic liver disease
•malnutrition
SEMI-INVASIVE(CHRONIC
NECROTIZING ASPERGILLOSIS)
28. IMAGING
FEATURES :
• AREA OF CONSOLIDATION IN UPPER LOBE
• PROGRESSES TO THICK WALLED CAVITY
• ADJACENT PLEURAL THICKENING .
29.
30. • CONFINED TO IMMUNOCOMPROMISED HOST.
INVASIVE PULMONARY
ASPERGILLOSIS:
IMAGING FEATURES:
• MULTIPLE/ SINGLE ILLDEFINED OPACITIES
• DIFFUSE B/L CONSOLIDATION
• LARGE WEDGE SHAPED PLEURAL BASED LESION
• CAVITATION OF NODULE
• AIR CRESCENT SIGN
2.Collection of cresentric air which seperates wall of cavity from inner mass
Gravity dependent fungal ball in cavity
Gloved finger sign:mucoid impaction seen typically as branching opacities u/s central,upper lobe distribution
Gloved finger sign
Chest x-ray demonstrates tubular branching opacities in the right upper lobe. In the left upper lobe a number of parallel lines extending from the hilum (tram track) suggest bronchiectasis.
CT reveals a branching lesion in the superior segment of the left lower lobe with classic finger in glove appearance which represents mucous filling dilated bronchi (i.e. bronchoceles).
Bilateral upper lobar, right middle lobar and to less extent left lower lobar bronchiectasis with endobronchial hyperdense mucoid impaction giving the finger in glove appearance most evident in the right middle lobe with subsequent middle lobe collapse
b/l central bronchiectasis with mucous filled bronchi
