ADHD is one of the most common neurodevelopmental disorders of childhood that is characterized by inattention, hyperactivity, and impulsivity. It is caused by abnormalities in dopamine neurotransmission in the brain. The symptoms must be present before age 7 and in multiple environments. It is diagnosed through clinical interviews and behavioral rating scales. Treatments include behavioral therapy, medication, and accommodations to help those with ADHD function better. ADHD often persists into adulthood if not properly treated as a child.
ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child's age and development.
PubMed Health
Topic 8 - Treatment for ADHD.
Autism, Asperger's and ADHD.
The views expressed in this presentation are those of the individual Simon Bignell and not University of Derby.
ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child's age and development.
PubMed Health
Topic 8 - Treatment for ADHD.
Autism, Asperger's and ADHD.
The views expressed in this presentation are those of the individual Simon Bignell and not University of Derby.
What is we made a mistake, and told parents their kid has ADHD when in fact they just can't breathe properly? It may be that up to half of kids labelled as having ADHD actually have something else entirely.
Attention Deficit disorder with its etiology, types and pathophysiology clinical features, Diagnosis, Assessment, differential Diagnosis and treatment , Medical Treatment and prognosis
Nelson is the reference of choice for all those who decide to specialize or sub-specialize in pediatrics. While the field of general pediatrics moves relatively slowly, the sub-specialty areas – most of which have a great impact on the practice of general pediatrics – tend to move more quickly. Nelson offers thorough coverage of the entire specialty
Check out a sample of Chapter 30 in the latest 19th edition. For purchase, please visit www.asia.elsevierhealth.com
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.
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- 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
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!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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
3. It is the most common neurobehavioral
disorder of childhood.
One of the most prevalent chronic health
conditions affecting school-aged children
It is the most extensively studied mental
disorder of childhood
5. Directly affects Dopamine
Neurotransmission.
Dopamine Transporter
Gene (DAT1)
Dopamine 4 Receptor Gene
(DRD4)
Additional genes that may
contribute to ADHD include
DOCK2 - involved in
cytokine regulation,
A sodium-hydrogen
exchange gene, and
DRD5, SLC6A3, DBH,
SNAP25, SLC6A4, and
HTR1B.
Toxins:
Alcohol
Tobacco
Lead
Organophosphates
Abnormal brain structure and traumatic
brain injury.
Psychosocial family stressors : Increase
symptoms
6. Reduction in brain volume with proportional decrease in left sided pre-frontal
cortex.
Connection tracts between prefrontal cortex and striatum are also lost.
Loss Of Executive
Functions,
Personality
& Mood
*The criteria for an executive function deficit
are met in 30–50% of children and
adolescents with ADHD
9. The behavior must be developmentally inappropriate.
Must begin before age 7 years, must be present for at least 6 months, must be
present in 2 or more settings.
Must not be secondary to another disorder.
3 Sub Types of
ADHD
11. Motor restlessness
Aggressive and
disruptive behavior
preschool children
Disorganized,
distractible, and
inattentive symptoms
12.
13. A systematic clinical interview is mandatory for a comprehensive
understanding of whether the symptoms meet the diagnostic
criteria for ADHD
Behavioral Rating Scale
Behavior rating scales are useful in establishing the magnitude and
pervasiveness of the symptoms, but are not sufficient alone to make a
diagnosis of ADHD.
There are a variety of well-established behavior rating scales
The Conner Rating Scale
The ADHD Index
The Swanson, Nolan, and Pelham Checklist (SNAP)
The ADD-H: Comprehensive Teacher Rating Scale (AcTERS).
16. There are no laboratory tests available to
identify ADHD in children.
Considering a Tox-screen in children with
suspected exposure.
Behavior in the structured laboratory setting
may not reflect the child's typical behavior in
the home or school environment. Therefore,
reliance on observed behavior in a physician's
office may result in an incorrect diagnosis.
Computerized attentional tasks and
electroencephalographic assessments are not
needed to make the diagnosis.
17. This study focused on 35 adults who were diagnosed with ADHD as children; 13 of them
still have the disorder, while the rest have recovered.
Shifting brain patterns
If it can be confirmed, this pattern could become a target for potential modification to
help patients learn to compensate for the disorder without changing their genetic
makeup.
Lingering problems
The researchers now plan to investigate how ADHD medications influence the brain's
default mode network, in hopes that this might allow them to predict which drugs will
work best for individual patients
18.
19. Chronic illnesses : migraine headaches, absence seizures, asthma and allergies,
hematologic disorders, diabetes, childhood cancer affect up to 20% of children in the U.S.
and may impair children's attention and school performance.
Substance abuse : In older children and adolescents it may result in declining school
performance and inattentive behavior.
Sleep disorders : including those secondary to chronic upper airway obstruction from
enlarged tonsils and adenoids, frequently result in behavioral and emotional symptoms.
Behavioral and emotional disorders may cause disrupted sleep patterns.
Depression and anxiety : may cause many of the same symptoms as ADHD (inattention,
restlessness, inability to focus and concentrate on work, poor organization, forgetfulness),
but may also be comorbid conditions.
Although ADHD is believed to be due to primary impairment of attention, impulse
control, and motor activity, there is also a high prevalence of comorbidity with other
psychiatric disorders.
20.
21. The parents and child should be educated with regard to the ways in which ADHD can affect learning,
behavior, self-esteem, social skills, and family function.
Goals must be set for the family to improve the child's interpersonal relationships, develop study skills,
and decrease disruptive behaviors.
Such treatments occur in the time frame of 8–12 sessions.
The goal of such treatment is for the clinician to identify targeted behaviors that cause
impairment in the child's life and for the child to work on progressively improving his
or her skill in these areas.
The clinician should guide the parents and teachers in implementing rules,
consequences, and rewards to encourage desired behaviors.
22. METHYLPHENIDATE :
Mechanism – Unclear.
Methylphenidate is a norepinephrine and dopamine reuptake inhibitor DAT4 inh.
DEXMETHYLPHENIDATE
Increases catecholaminergic neurotransmission by inhibiting the dopamine transporter (DAT)
and norepinephrine transporter (NET) particularly in the striatum and meso-limbic system
DEXTROAMPHETAMINE
Activation of TAAR1 increases cAMP production via adenylyl cyclase activation and inhibits the
function of the dopamine transporter, norepinephrine transporter, and serotonin transporter, as
well as inducing the release of these monoamine neurotransmitters
TRICYCLIC ANTIDEPRESSANTS
Are currently being replaced by SSRI’s and SNRI’s
by blocking the serotonin transporter (SERT) and the norepinephrine transporter(NET)
Selective Nor-epinephrine Reuptake Inhibitors [NRI’s]
Alpha Agonists:
Clonidine: Presynaptic Alpha-2 Blockers.
23.
24. A childhood diagnosis of ADHD often leads to persistent ADHD throughout the life span.
From 60–80% of children diagnosed with ADHD continue to experience symptoms in
adolescence, and up to 40–60% of adolescents exhibit ADHD symptoms into adulthood.
In children diagnosed with ADHD, a reduction in hyperactive behavior often occurs with
age. However, other symptoms associated with ADHD can become more prominent with
age, such as inattention, impulsivity, and disorganization, and these exact a heavy toll on
young adult functioning.
A variety of risk factors can affect children with untreated ADHD as they become adults.
These risk factors include engaging in risk-taking behaviors (sexual activity, delinquent
behaviors, substance use), educational underachievement or employment difficulties, and
relationship difficulties. With proper treatment, the risks associated with the disorder
can be significantly reduced.
25. Literature:
• Natoshia Raishevich Peter Jensen : Nelson’s Textbook Of Pediatrics 8th Edition
• Parthasarathy A : IAP Textbook Of Pediatrics 4th Edition
Online References:
Aaron T. Mattfeld, John D.e. Gabrieli, Joseph Biederman, Thomas Spencer, Ariel Brown,
Amelia Kotte, Elana Kagan, and Susan Whitfield-Gabrieli. Brain differences between
persistent and remitted attention deficit hyperactivity disorder. Brain, June 2014
DOI: 10.1093/brain/awu137
Brookhaven National Laboratory: http://www.bnl.gov/newsroom/news.php?a=1565
Center of Disease Control : http://www.cdc.gov/ncbddd/adhd/
WebMD: http://www.webmd.com/add-adhd/default.htm?names-dropdown
National Institute of Mental Health : http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-
disorder-adhd/index.shtml
Wikipedia : http://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder
http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders