Bronchial Thermoplasty (BT) Novel Treatment for Patients with Severe AsthmaBassel Ericsoussi, MD
Do our Asthma Patients Know What They Are Missing?Now, A Revolutionary Procedure Can Help Them Lead A Fuller Life.
Bronchial Thermoplasty (BT) Novel Treatment For Patients With Severe Asthma
New technology called Electromagnetic Navigation Bronchoscopy® (ENB) that uses virtual bronchoscopy and real time 3-dimensional CT images that enable me to localize these peripheral lung nodules for diagnosis and treatment. This outpatient procedure is minimally invasive and therefore has a small risk of pneumothorax (2-3%) and its published diagnostic yield rates range from 67% - 86%
Bronchial Thermoplasty (BT) Novel Treatment for Patients with Severe AsthmaBassel Ericsoussi, MD
Do our Asthma Patients Know What They Are Missing?Now, A Revolutionary Procedure Can Help Them Lead A Fuller Life.
Bronchial Thermoplasty (BT) Novel Treatment For Patients With Severe Asthma
New technology called Electromagnetic Navigation Bronchoscopy® (ENB) that uses virtual bronchoscopy and real time 3-dimensional CT images that enable me to localize these peripheral lung nodules for diagnosis and treatment. This outpatient procedure is minimally invasive and therefore has a small risk of pneumothorax (2-3%) and its published diagnostic yield rates range from 67% - 86%
This presentation describes the indications, contraindications, methods of performing spirometry. It explains the interpretation of spirometry with examples.
This presentation describes the indications, contraindications, methods of performing spirometry. It explains the interpretation of spirometry with examples.
Natasha from UCD Metabolic Medicine department talks about her work on gut hormones, how they impact our hunger and some clinical trials being carried out in UCD currently.
http://www.ucd.ie/medicine/lifewithus/ourpeople/featuredstaff/professorcarelleroux/
Road to the Artificial Pancreas (2014 Update)Kevin McMahon
A presentation designed to inform patients on the current status of artificial pancreas research, what they can expect to come along on the way toward realizing its promises and what they can do now to benefit from this field of research.
Irritable Bowel Syndrome (IBS) and Fecal Microbiota Transplant. A new hope fo...Find Good Health
IBDs including irritable bowel syndrome (ibs) or ulcerative colitis (uc) are a set of diseases developing into an epidemic. The unusual and recent rise in these kind of diseases most notably on developed countries point to a recent and area specific etiology, not a better healthcare and diagnosis.
Recent researchs are pointing to a healthier immune system and intestinal flora in undeveloped countries' population and an imbalance in our gut flora caused by excessive use of antibiotics.
For more information about health and wellbeing visit our site at:
http://findgoodhealth.org/
- 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
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.
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
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
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.
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
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
2. Introduction
• Asthma is a chronic inflammatory disease of the airways
• Patients with more severe asthma, which accounts for 5–10%
of cases, experience considerable morbidity and generate high
healthcare costs despite current therapies.
• Bronchial thermoplasty, which involves the delivery of radio
frequency energy to the airways, is a non pharmacological
intervention developed for the treatment of moderate-to-severe
asthma
3. Mode of ACTION
• Asthma:
• Acute and chronic airway inflammation
• Thickened airway walls
• Increased mucous glands and goblet cells
• Increased blood vessels
• Thickening of airway smooth muscle (ASM)
4. • Acute asthma attack
• Allergic stimuli
• Nonallergic – infection, cold, exercise, irritant
• Cascade always leads to ASM contraction
• Which airways cause the problem in asthma ?
• Most baseline airway resistance lies in the conducting airways > 2 mm
• Primary site of resistance uncertain in acute asthma
• Diffuse narrowing of small airways ?
• Narrowing of large airways ?
• Generalized narrowing of all airways ?
11. Equipment
• The Alair bronchial thermoplasty system comprises an Alair
radiofrequency controller, an Alair catheter with an expandable
electrode array, a patient return electrode and a suitable flexible
bronchoscope.
• The Alair controller contains a radiofrequency generator and
additional elements which regulate the energy applied to theairways
to allow effective treatment without unwanted tissue damage.
• The controller is activated by a footswitch which triggers a timed
period of radiofrequency energy delivered via the Alair catheter.
12. • The Alair catheter is a single use catheter which is connected to the controller via
an integral electrical cable.
• The catheter has a basket electrode at its distal end which can be progressively
expanded and retracted by a handle-grip control.
• The catheter has markings at 5 mm intervals to facilitate endobronchial spacing
of treatment activations.
• The patient return electrode completes the electrical circuit.
• A CE-marked gel type electrode for adult use is suitable.
• Treatment requires a radiofrequency compatible flexible bronchoscope with an
insertion diameter of 4.9–5.3 mm and a working channel of at least 2 mm.
• Larger bronchoscopes are less suitable because of reduced flexibility and reduced
access to the smaller, distal airways.
13. Pre procedure
• Oral corticosteroids: administer prophylactic prednisolone or equivalent at
a dose of 50 mg per day for the 3 days before the procedure, the day of the
procedure and the day after the procedure to minimise post-procedure
inflammation.
• This is the dose used in the clinical trials.
• Locally -use 40 or 50 mg prednisolone depending on the asthma severity
and body weight, for 2 days prior to the procedure, the day of the
bronchial thermoplasty and 2 days after the procedure.
• We provide patients with a further 5-days’supply of prednisolone and
advise them to use it only in the event of significant worsening of asthma
symptoms post-procedure
14. • Pre-procedure spirometry: on the day of procedure, perform a post-
bronchodilator FEV1 to assess the patient’s stability pre- and post-
procedure.
• Pre-procedure FEV1 value should be o 85% of the patient’s recent
value when stable.
• As with other bronchoscopy procedures,patients should stop taking
anticoagulants,antiplatelet agents, aspirin and non-steroidalanti-
inflammatory drugs before the procedure with physician guidance
15. Postponement of Procedure
• Prescribed prednisolone was not taken on the days before
bronchoscopy
• Arterial oxygen saturation measured by pulse oximetry , 90% on
room air
• Increase in asthma symptoms in last 48 h requiring . 4 puffs per day
on average of rescue bronchodilator over pretreatment usage
• Asthma exacerbation or changing dose of systemic corticosteroids
for asthma in the past 14 days
• Active respiratory infection or active allergic sinusitis
• Any other reason for clinical instability
18. Post procedure
• 1) 4 h recovery/ monitoring period following each procedure
• 2) spirometry,breath sounds and vital signs (heart rate,blood
pressure, temperature, respiratory rate,pulse oximetry) prior to
discharge.
• Criteria fordischarge include a post-bronchodilator FEV1 within 80%
of the pre-procedure value and that the patient is feeling well.
19. Short term adverse effects
• The main adverse effects in the treatment phase are wheeze, cough,
chest discomfort, night awakening and discoloured sputum with most
adverse events occurring in the first day after bronchoscopy and
resolving within a week.
• In the AIR study there were more hospitalisations in the bronchial
thermoplasty group in the treatment phase of the study (six
hospitalizations in four subjects) compared with the control group.