This document summarizes the anatomy of the circle of Willis and cerebral blood supply. It describes the circle of Willis as a polygonal anastomotic channel at the base of the brain supplied by the internal carotid and vertebral arteries. It then discusses the branches and functions of the circle of Willis, cortical and central arteries, lenticulostriate arteries, and the blood-brain barrier. Finally, it provides details on the regional arterial supply of different brain regions and applied anatomy related to various neurological syndromes.
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
understanding spinal cord, its bransches, lesions, functions and anatomy.
hope to give you better knowledge of spinal cord by the end of it.
plese review ans comment for my future updates and corrections that iw ill be needing in this.
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
understanding spinal cord, its bransches, lesions, functions and anatomy.
hope to give you better knowledge of spinal cord by the end of it.
plese review ans comment for my future updates and corrections that iw ill be needing in this.
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.
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
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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
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
2. Circle of Willis
(Circulus Arteriosus)
• Polygonal anastomotic channel
•Base of brain (interpeduncular fossa)
•2 sets of arteries
– Int Carotid - Frontal & parietal lobes
and parts of temporal & occipital
lobes
– Vertebrobasilar - brainstem,
cerebellum, parts of temporal
&occipital lobes
3. CIRCLE OF WILLIS (Circulus Arteriosus)
•Functions
–Equalizes blood flow to different parts of brain
–If 1 arterial system occluded, bld. passes via
communicating As to prevent infarction
4.
5. Branches:
•Anteromedial: from ant cerebral & ant
communicating As
•Paired Anterolateral: from ant & mid cerebral As
•Paired Posterolateral: from post cerebral A
•Posteromedial: from post cerebral & post comm. A
6.
7. Cortical & Central Arteries
Cortical Arteries
• Arise from ant, mid & post Cerebral As
• Ramify on pia, form anastomoses
• Supply grey matter & subjacent white matter
• Are in 2 sets
• Short cortical-extend upto middle of grey matter
• Long cortical – 3-4cm long, run upto superficial white matter
- NOT actual end-arteries
8. Central Arteries
• Branches of Circle of Willis
• Penetrate base of brain
• Supply int capsule, thalamus & basal ganglia
• Arranged in 4 sets
– Antero med
– paired anterolat
– Paired posterolat
– Postero med
• Both central & cortical As are surr. by pial sheath
upto pre-capillary level
9. Lenticulostriate Arteries
• Clinically - most important
• Central branches of MCA
• Pierce ant perforated substance & enter white matter
• Pass through lentiform nucleus to reach int. capsule
• Supply upper part of int capsule, lentiform & caudate
nuclei
• Some are long, slender, thin-walled & prone to rupture in
hypertension-called Charcot’s arteries of cerebral
hemorrhage.
10.
11. BLOOD BRAIN BARRIER
Exists at capillary level, from inside to outside
consists of:
• endothelial cells of capillaries with tight
junctions
• Basement membrane of endothelial cells
• Perivascular extensions of astrocytes
• Intercellular space filled with tissue fluid
• Neuronal cell membrane
16. Regional arterial supply of Brain
•Brain stem:
– Medulla oblongata: branches of vertebral, ant & post spinal, PICA and basilar A
which enter along ant med fissure and post med sulcus. Vs supplying central
substance enter along with rootlets of CN IX, X, XI and XII. Additional supply is
from pial plexus of same A.
– Pons: basilar A, AICA and PICA. Direct br from basilar A enter along ventral
median groove, others enter along CN V, VI, VII, VII and from pial plexus.
– Midbrain: PCA, SCA and basilar A, crura by Vs entering their med and lat sides.
Med Vs also supply sup-med part of tegmentum including CN III nucleus ; lat Vs -
lat part of crus and tegmentum. Colliculi by 3 Vs on each side from PCA and SCA.
Additional supply to crura, colliculi and their peduncles comes from post-lat group
of central br of PCA.
•Cerebellum: by PICA, AICA and SCA, which from superficial plexus on cortical surface,
anastomosis b/w deeper sub-cortical branches has been postulated. Choroid plexus of 4th
ventricle is supplied by PICA.
•Optic chiasma, tract and readiation: Chiasma – by ACA but median zone depends on
rami from ICA reaching it via pituitary stalk. Tract; ant choroidal and post comm A.
Radiation: deep br of MCA and PCA.
17. • Diencephalon:
– Thalamus: br from post comm A, PCA and basilar A; contribution from ant chorodial
A is doubtful.
– Median br from post choroidal A: supplies post commissure, habenular region, pineal
gland and medial parts of thalamus including pulvinar.
– Hypothalamus: Small central br from circle of willis and its br.
– Pituitary gland: hypophyseal br of ICA
– Lamina terminalis: ACA and ant comm A
– Choroid plexus of 3rd
and lat ventricles: br from ICA and PCA.
• Basal ganglia: majority from striate A from roots of ACA & MCA which enter brain from ant
perforated substance and also supply internal capsule.
– Caudate Nu: additional supply from ant and post choroidal A
– Post-inf part of lentiform complex: thalamo-striate br of PCA.
– Ant choroidal A, preterminal br of ICA supply both segments of globus pallidus and caudate Nu,
ligation of this VS (known by serendipity) alleciates the symptoms of parkinson’s disease by
infarction of globus pallidus (lead to initiation of pallidotomy).
• Internal Capsule: by central br of circle of willis and its br, mainly med and lat striate A which come
from either ACA or ACA and also supply basal ganglia.
– Lateral striate A: ant limb, genu and most of post limb. Commonly involved in ischemic and
hemorrhagic stroke.
– Charcot’s A of cerebral hemorrhage : larger striate br of MCA.
– Medial strate A: br of proximal part of MCA or ACA supplies ant limb, genu and basal ganglia.
– Ant choroidal A from ICA: contributes to ventral part of post limb and retrolentiform part of int
capsule.
20. Lateral medullary syndrome of Wallenberg
• Occlusion of PICA
• Posterolateral part of medulla is damaged
• Involvement of
– spinal nuc & tract of V nerve – ipsilateral loss of pain
& temp from face & forehead
– spinal lemniscus (lat spinothalamic tract) –
contralateral loss of pain & temp from body below face
– Nucleus ambiguus – paralysis of muscles of soft
palate, pharynx & larynx- dysarthria & dysphagia
– Vestibular nuclei- giddiness
• Crossed hemianesthesia
21. Medial Medullary Syndrome
• occlusion of ant spinal artery which supplies
medial part of medulla
• Involvement of
• CN XII nucleus – ipsilateral LMN paralysis of
tongue ; deviated to affected side
• Pyramidal fibres - contralateral UMN paralysis
• Medial lemniscus (post column fibres) –
contralateral loss of fine touch & discrimination
• Crossed motor paralysis
23. Pons
•Raymond’s syndrome: Alternating abducent hemiplegia
(lesion in medial cranial part of pons)
•Milalard Gubler syndrome: Alternating facial hemiplegia
(lesion in medial caudal part of pons)
•Lesions in lateral part of mid pons: alternating trigeminal
hemiplegia
Midbrain
•Weber’s syndrome: crossed III CN hemiplegia
•Benedikt’s syndrome: https://en.wikipedia.org/wiki/Benedikt_syndrome
•Parinaud’s syndrome: https://en.wikipedia.org/wiki/Parinaud%27s_syndrome