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Learning Objectives: Contrast the neural and local control of circulations through special regions. Compare the physiological significance of variation in circulations through special regions. Content Overview: This lecture provides a comprehensive exploration of circulation in specialized regions of the body, including coronary, cerebral, splanchnic, cutaneous, fetal, skeletal muscle, and pulmonary circulations. The physiological and anatomical considerations, regulation mechanisms, and unique features of each type of circulation are discussed. Key concepts such as autoregulation, local metabolic factors, and neural influences are covered in detail. Key Topics: Coronary Circulation: Anatomy and physiology of coronary blood supply. Phasic changes in blood flow during systole and diastole. Regulation by autonomic nervous system and local metabolic factors (hypoxia, adenosine). Cerebral Circulation: Control by local metabolic factors (CO2, H+). Autoregulation and hyperemia. Anatomy of cerebral blood supply and special features of cerebral blood vessels. Splanchnic Circulation: Anatomy and regulation of blood flow to the gastrointestinal organs. Role of sympathetic and parasympathetic nervous systems. Chemical factors and the concept of autoregulatory escape. Cutaneous Circulation: Thermoregulatory function and dense nervous innervation. Mechanisms of vasodilation and vasoconstriction. Blood reservoir function and responses to mechanical stimuli. Fetal Circulation: Unique aspects of fetal blood flow including umbilical vessels, ductus venosus, foramen ovale, and ductus arteriosus. Changes in circulation at birth and the stimuli for these changes. Skeletal Muscle Circulation: Regulation during rest and exercise. Role of nervous and local metabolic control. Circulatory adjustments during physical activity. Pulmonary Circulation: Characteristics and regulation of pulmonary blood flow. Zones of blood flow in the lungs and the effect of gravity. Response to hypoxia and other factors influencing pulmonary vascular resistance

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Overview of scleroderma manifestations, organ involvement, brief classifications (limited, diffuse, sine scleroderma). Overview of current treatment options, need for additional therapies. Overview of plan for multi-disciplinary scleroderma center at the University of Chicago. Potential future therapies in the literature at large. Planned trials/future treatment options at the University of Chicago. For more info about scleroderma and the foundation, head to www.stopscleroderma.org This talk was presented at the Scleroderma Patient Education Conference on May 4, 2024, hosted by the Scleroderma Foundation of Greater Chicago.

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- Video recording of this lecture in English language: https://www.youtube.com/watch?v=MA7nU5NWL2g&list=PLL7Q08IoVDSpg0VlGdvCHOHbXqMs0GFRe - Video recording of this lecture in Arabic language: https://www.youtube.com/watch?v=FiWabzTPFqY&list=PLL7Q08IoVDSrVcm6SmppQyefL_Ub2-xGY - 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

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Title: Application of Checklist-Based Nursing Care Process in Patients Undergoing Intervention for Coronary Chronic Total Occlusion: A Quasi-Randomized Study Presenter: Sonia Pal, M.Sc. Nursing 2nd Year Journal: BMC Nursing (2023) Authors: Xia Ge, Haiyang Wu, Zhe Zang, and Jiayi Xie DOI: 10.1186/s12872-023-03627-8 Study Overview: This presentation focuses on the effectiveness of a checklist-based nursing care process for patients undergoing interventions for coronary chronic total occlusion (CTO). The study employs a quasi-randomized design to assess improvements in patient care outcomes. Key Points: Background: CTO interventions are complex, and traditional nursing methods have not been highly effective, necessitating the exploration of new approaches. Objective: To investigate the effectiveness of a checklist-based nursing care process in improving care quality, reducing patient anxiety, increasing patient satisfaction, and minimizing adverse events. Methodology: Design: Quasi-randomized study Setting: Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang, China Participants: 120 patients undergoing CTO interventions Groups: Intervention group (checklist-based care) and control group (standard care) Tools: Preoperative and postoperative PCI nursing care checklists, Zung Self-Rating Anxiety Scale, satisfaction questionnaires for doctors and patients Ethical Considerations: The study adhered to the Declaration of Helsinki, with informed consent obtained from all participants. Results: The study aimed to demonstrate that checklist-based nursing care could enhance nursing efficiency and patient outcomes compared to conventional methods. Quality Control: A quality control team ensured adherence to the checklist and study protocol, with regular training and supervision of nursing staff. Conclusion: The presentation concludes with findings supporting the effectiveness of checklist-based nursing care in CTO interventions, suggesting improvements in patient care processes and outcomes. The study highlights the importance of structured nursing protocols in complex medical procedures.

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