Enfrentamiento inicial de paciente intoxicado no difiere tanto del enfrentamiento habitual de un paciente enfermo, por lo tanto no debemos tenerle miedo! El tratamiento y acciones deben ir enfocadas al paciente, no a los tóxicos.
Paciente que tomó benzodiacepinas es de muy bajo riesgo, no hagan de más!
No hacer lavado gástrico, NO utilizar carbón activado.
Si el envenenamiento es reconocido de forma temprana y reciben una atención medica adecuada, el pronostico es favorable.
La exposición a toxinas puede ocurrir por accidente (es decir, incidentes o interacciones medicamentosas) o intencionalmente (es decir, el abuso de sustancias o ingestas intencionales).
El envenenamiento depende de numerosos factores, como el tipo de sustancia, la dosis, el tiempo de exposición a la presentación a un centro de atención a la salud y el estado de salud preexistente del paciente.
Clinical Toxicology by dr.tayyaba rphpptBIANOOR123
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants.
Preview - Health and Disease Begin in the ColonSheldon Stein
Health and Disease Begin in the Colon A preview of Professor Serge Jurasunas' new book, now available on Amazon in eBook and paperback formats. www.sergejurasunas.com
Inquiries: sergejurasunas@hotmail.com
Si el envenenamiento es reconocido de forma temprana y reciben una atención medica adecuada, el pronostico es favorable.
La exposición a toxinas puede ocurrir por accidente (es decir, incidentes o interacciones medicamentosas) o intencionalmente (es decir, el abuso de sustancias o ingestas intencionales).
El envenenamiento depende de numerosos factores, como el tipo de sustancia, la dosis, el tiempo de exposición a la presentación a un centro de atención a la salud y el estado de salud preexistente del paciente.
Clinical Toxicology by dr.tayyaba rphpptBIANOOR123
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants.
Preview - Health and Disease Begin in the ColonSheldon Stein
Health and Disease Begin in the Colon A preview of Professor Serge Jurasunas' new book, now available on Amazon in eBook and paperback formats. www.sergejurasunas.com
Inquiries: sergejurasunas@hotmail.com
Diagnostic Testing & Likelihood Ratios: how we should be ordering tests!nfpineda
https://vimeo.com/152035436
How do you decide if you are going to treat a patient with strep throat, or send a test to rule in or rule out the disease or just send him home on NSAIDs? What if instead of strep throat you are suspecting a pulmonary embolism, what do yo do?
One of the key things before thinking in ordering a specific test, is assigning that particular disease PRETEST probability, and then knowing what your therapeutic and diagnostic threshold are for that specific disease. It is the only way of knowing if the test you ordered is good enough to rule in or rule out that disease!
Test diagnósticos & LR's: como deberíamos pedir exámenes!nfpineda
https://vimeo.com/151980029
Cuando debemos pedir un test diagnóstico a un paciente? Una vez que tenemos el resultado, como utilizamos ese resultado en nuestro paciente? Como sé si no es un falso positivo o un falso negativo? Qué es un Likelihood Ratio y como lo utilizamos?
El pedir exámenes por pedirlos, nos va a meter siempre en más problemas que beneficios. No existe un test diagnóstico perfecto, por lo que debemos conocer cual es su rendimiento y como lo utilizamos en nuestro paciente.
En este video, que no pretende ser una clase de estadística, esperamos contestar todas estas dudas y más!
Introducción a ventilación mecánica, hecha realmente simple, teniendo en mente cuales son nuestros objetivos al ofrecer a nuestro paciente este tratamiento.
La tabla espinal debe ser considerada una intervención como cualquier otra. Esto quiere decir, que debemos tener en mente cual es nuestro objetivo en utilizarla, cuales son los beneficios y cuales son los posibles efectos adversos.
No todo paciente que ha sufrido trauma necesita que usemos una tabla espinal! Piensen y discútanlo con su regulador o sus colegas
Soporte Vital, mal llamado básico. Es considerado fácil y barato, tal vez por eso todos lo hacen bien. La mejor manera de darle mayor probabilidad de sobrevida a nuestro paciente, es realizando masaje cardíaco externo y realizarlo bien!
No es necesario ventilar en el sitio del PCR, puedes hacer reanimación solo con compresiones.
Como seguimos una vez que logramos sacar a nuestro paciente del PCR? Termina nuestro trabajo aquí?
Tenemos que anticiparnos a la debacle, tenemos que mantener la esperanza y tenemos que saber que no existe ningún buen marcador de pronóstico neurológico antes de las 72 horas!
Trauma torácico debe enfrentarse siempre en el contexto del trauma indiferenciado o el paciente politraumatizado. Muchas de las causas reversibles de mortalidad en trauma se encuentran en el tórax.
Conocer las diferencias entre el trauma abierto y cerrado, saber que hacer y que no hacer en el paciente en PCR después de haber sufrido trauma.
Con lo que nos gusta hacer procedimientos, este es quizás el que nunca esperamos ni queremos hacer. La cesárea perimortem está dentro de las recomendaciones de la AHA para reanimación en embarazadas. Quizás más importante que saber como hacerla, es saber en quien hacer y en quien NO HACERLA.
Dr. Pineda hace una revisión de algunos concepto claves en reanimación en la embarazada y el cuando, en quien y por que debemos realizar este procedimiento!
Espero que les guste y les sea de ayuda
Hace algún tiempo me pidieron que realizara una presentación titulada: "arritmias letales". En mi estilo propio, Me parece que es justo asumir nuestra responsabilidad y aceptar que la mayoría de las veces no son las arritmias las letales, si no que nuestras intervenciones y decisiones que tomamos con el paciente con arritmias.
Espero que les sea de utilidad, saludos!
El compromiso de conciencia es un motivo de consulta muy frecuente, mucho más de lo que todos creen! Tengan un enfrentamiento estructurado, para todos iguales, sin importar si la alteración es cuantitativa o cualitativa.
Tengan comprensión, cuidado, cariño y paciencia con el paciente alcohólico, tanto agudo como el crónico. El paciente OH Dios lo puso para recordarnos la humildad! (Dr. JM Mardonez)
Siempre nos han repetido que la AESP y la asistolía tienen altísima mortalidad, llegando a un 98% o más! Será que estamos manejando de manera inadecuada? Quien es capaz, en el momento del paro de acordares de 5H y 5T?
A continuación les dejamos una nueva manera de pensar y enfrentarse a la actividad eléctrica sin pulso. La idea es que no memoricen, si no que entiendan lo que estamos buscando y de que manera podemos tratarlo.
Esperamos que les sea de ayuda!
#CABAS2015
Muchas veces tenemos que hacerlas, pocas veces nos han enseñado como hacerlas!
En el siguiente video, les entrego algunos consejos y tips sobre como hacer que tu presentación sea realmente efectiva y exitosa.
Si les interesa el tema y les gusta, vamos a tener una serie de video más cortos, ampliando un poco más cada una de las partes de esta presentación!
Espero que les sea de ayuda!
Debemos cambiar el paradigma! Para la reanimación del paciente politraumatizado en shock hemorrágico, debemos ser tremendamente cuidadosos y conservadores con el aporte de cristaloides o coloides!
Shock hemorrágico en el paciente politraumatizado, no debe tratarse con fisiológico, Ringer o gelatinas! Mientras más de estos productos reciban, peor pronóstico tiene nuestro paciente.
En este contexto, no debe administrarse nada que no aporte a transportar oxigeno o que colabore con la coagulación!
No más reanimación tipo ATLS, donde se recomendaba 2lt de suero fisiológico y solicitar exámenes para evaluar coagulación y ver necesidad de productos sanguíneos... NO MÁS!!!
Conceptos Claves:
- politraumatizado + shock = hemorrágico (abdomen, tórax, extremidades)
- control anatómico del sangrado es vital!
- no reanimar contra presión arterial, reanimar contra perfusión
- si necesita volumen; aportar fluidos que aporten a la coagulación o a transportar oxígeno
- recuerden calcio y ácido tranexámico
- hosp pequeño, o 1rio o 2ndario: esfuerzos en traslado
- hospital cuidado definitivo: protocolo transfusión masiva, hipotensión permisiva, cirugía control de daño, UCI
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!
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
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.
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.
- 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
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.
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
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
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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.
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
18. No debe ser usado de forma
rutinaria…
Podría estar justificado en caso de sustancia
altamente toxica…
No se ha demostrado beneficio clínico
significativo…
Mortalidad
21. Dosis única de carbón activado no debe ser
administrado en forma rutinaria en el manejo de
pacientes intoxicados…
22. Puede ser considerado su uso
Pacientes con ingesta de un toxico potencialmente
letal
Características del toxico
Dosis ingerida (historia / clínica)
Antes de 1 hora post-ingesta
Contra-indicado en caso de compromiso vía
respiratoria…
23.
24.
25.
26.
27.
28.
29.
30. En Box Reanimación
Compromiso conciencia
Glasgow Coma Scale
No en intoxicados…
Evaluación Compuesta
Nivel conciencia
Sopor superficial
Sopor profundo
Coma
Protección vía aérea
Reflejos protección
31. En Box Reanimación
En caso intubar…
Revisar estado Acido/base
Acidosis Metabólica
Compensación respiratoria…
Luego de sedación y
parálisis
Perdida compensación
Aumento acidosis
PCR…
36. 3.- Descontaminación / Adsorción
972 J. B. Mowry et al.
Table 16B. Decontamination Trends: Total Human and Pediatric
Exposures 5Yearsa.
Human
exposures
Exposures
children 5 y
Therapy N % N %
Activated charcoal
administered
57,888 2.54 11,284 1.02
Cathartic 12,357 0.54 1,259 0.11
Ipecac administered 193 0.01 83 0.01
Lavage 3,510 0.15 116 0.01
Other Emetic 13,130 0.58 6,241 0.57
WholeBowel Irrigation 1,838 0.08 101 0.01
Total 88,916 3.91 19,084 1.73
aHuman exposures 2,275,141; Pediatric exposures 1,102,307.
of single-substance exposure fatalities for that category—
miscellaneous sedative/hypnotics/antipsychotics, miscel-
laneous cardiovascular drugs, opioids, and acetaminophen
combination products, lead this list followed by miscel-
946 analges
acetaminophen/
morphine, 53
24 acetaminoph
559 stimulan
amine, 87 cocai
182 cardiova
20 verapamil, 1
12 cardiac glyco
149 antidepr
citalopram, 12
and 9 venlafaxi
110 sedative
alprazolam, 9 b
and 5 pentobarb
Theexposure
chronic in 260 (
and U unknow
A total of 1,2
analytes were r
6on12/23/13
1 / 650
1 / 40