The document provides an overview of different types of lung abnormalities visible on chest x-rays, including various pneumonias, masses, and other conditions. It describes lobar pneumonias, bronchopneumonias, segmental pneumonias, necrotizing pneumonias, round pneumonias, and diffuse pneumonias. For each type, it lists common causes and provides examples of chest x-rays demonstrating related pathologies.
This presentation aims to give a foundational knowledge in the art of radiological interpretation of the chest radiograph.
It includes some of the important anatomical structures visible on a chest X-ray along with technical aspects regarding image aquisition in correlation with lateral views and cross-sectional imaging to give a more complete sense of the structures in view.
This presentation aims to give a foundational knowledge in the art of radiological interpretation of the chest radiograph.
It includes some of the important anatomical structures visible on a chest X-ray along with technical aspects regarding image aquisition in correlation with lateral views and cross-sectional imaging to give a more complete sense of the structures in view.
COPD are chronic obstructive airway diseases usually need CT scans for early diagnosis and followup. this ppt will give you a brief idea about imaging in COPD.
- 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
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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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.
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.
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
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
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.
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
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
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2 Case Reports of Gastric Ultrasound
37. An Approach to Pneumonias 1. Lobar Pneumonias A lobe, or lobes, are consolidated
38. Radiological criteria for calling a shadow in CXR as consolidation are: 1.Lobar or Segmental Density The density should either correspond to lobe or segment of Lung. 2.Air Bronchogram presence of air bronchogram would confirm that it is an alveolar process. 3.No Loss of Lung Volume In early stages of consolidation the volume of lung increases. In later stages there can be some amount of loss of lung volume due to secretions obstructing airways. As a general rule there is no significant loss of lung volume in consolidation Consolidation
39. The silhouette sign : An intra-thoracic radio-opacity, if in anatomic contact with a border of heart or aorta, will obscure that border. An intra-thoracic lesion not anatomically contiguous with a border or a normal structure will not obliterate that border.
40. In the case of middle lobe disease (collapse), the right heart margin is lost.
41. Right lower lobe pneumonia will blur the diaphragm on the right side. The right heart margin remains distinct. The view shows air in the bronchi of the consolidated lobe and beginning abcess formation.
42.
43. • Haziness in the right mid lung field. •Right heart margin slightly hazy with intact silhouette of right diaphragm •Middle lobe density in lateral •No significant loss of lung volume in lateral •Air bronchogram in lateral
47. • Density in the left upper lung field •Loss of silhouette of left heart margin •Density in the projection of LUL in lateral view •Air bronchogram in PA view •No significant loss of lung volume
48. • Haziness in the left lower lung field •Blunting of left costophrenic angle •Loss of silhouette of left heart margin •Density in the projection of lingula in lateral view •Air bronchogram in lateral •No significant loss of lung volume
52. One whole lobe is consolidated with decreased crepitation. The size of the affected lobe is normal. However, the color is dark red. The cut surface may ooze fluid, which may be hemorrhagic or purulent. Airways of the affected lobe may contain pus. This gross photograph of a cut lung shows consolidation and discoloration of most of the lower lobe .
53. This low power photomicrograph shows many alveolar spaces filled with inflammatory infiltrate. This high power photomicrograph shows the infiltrate to be composed of neutrophils. Note that the alveolar septa are relatively normal. After complete resolution, the underlying lung architecture is preserved.
54. Lobar Pneumonia : Most common causes for lobar pneumonia are: 1.Pneumococcus 2.Mycoplasma 3.Gram negative organisms 4.Legionella
55.
56. • Histopathology •Patchy distribution in and around small airways •Dense acute inflammatory exudate of PMNs, fibrin and blood in bronchi, bronchioles and adjacent alveoli. •FOCAL destruction of alveolar walls (you can see normal parenchyma in other areas adjacent) Bronchopneumonias
62. Bronchopneumonia is a very common form of pneumonia. It presents differently from lobar pneumonia on the chest film. Lobar pneumonia tends to start at the periphery and involve a single lobe of the lung. However, bronchopneumonia starts centrally in the bronchi and may cause peripheral consolidation which is due either to infection or to atelectasis. Thus, a bronchopneumonia tends to be bilateral. There is associated peribronchial thickening and there are patchy areas of consolidation which involve both lungs. This consolidation is asymmetrical. It may involve a segment of the RUL and another in the lingula. The commonest organism to cause bronchopneumonia is staph aureus. Bronchopneumonias are also very common in children.
63. This case shows a woman with bronchopneumonia. Note that there is bilateral patchy consolidation with obliteration of the apex of the heart and portions of the right and left diaphragm on the PA view. Areas of increased density can be seen in the right upper lobe, right lower lobe and in the left lower lobe. These should represent areas of consolidation.
64.
65. On the lateral view portions of the left and right hemidiaphragm are incompletely seen and there is increased density in the region of the middle lobe. Additionally, the major fissure is very prominent and consolidation can be seen adjacent to this fissure on the lateral view. This likely represents a consolidation in the right upper lobe. This appearance is typical for a bronchopneumonia. Usually there is discrete peribronchial cuffing in the hilar region as well. We do not see this on these films .
66.
67. This next patient had a head and neck cancer (notice bilateral apical fibrosis secondary to radiation therapy) and developed a lung abscess in the left lower lobe superior segment secondary to aspiration pneumonia. The first film shows an infiltrate in the left lower lobe extending from the hilum to the retrocardiac and midlung zones. The midlung zone opacity is more prominent and has a more or less rounded, but poorly marginated contour suggesting the possibility of an abscess.
68.
69. A film taken 8 days later shows a large lucency replacing the opacity in the midlung zone. This occurs when the abscess communicates with an airway. An air fluid level is seen in the cavity. The surrounding infiltrates have improved. This case illustrates a classic location of lung abscess and aspiration pneumonia, the superior segment of either lower lobe. Patients with swallowing difficulty and impaired consciousness are particularly susceptible.
70.
71. One last bronchopneumonia: this is an aspiration pneumonia such as we commonly see in the ICU following drug O.D.
72. Okay, we’ve done lobar pneumonias, and bronchopneumonias. Now, how about: 3. Necrotizing Pneumonias
73. Most common causes for Necrotizing pneumonia are: •Staphylococcal •Anaerobic infection •Gram negative organisms
74. But this one was caused by pneumococcus ...which lobe?
93. Acute fire-eater pneumonia in a 21-year-old man who had aspirated petroleum during a performance. Posteroanterior chest radiograph shows ill-defined nodular areas of increased opacity in both lower lobes (arrows).
116. And this is a pseudotumor, or so-called phantom tumor
117. Now, back to pneumonias, and on to Diffuse Alveolar Pneumonia Most common causes for diffuse alveolar pneumonia are: 1.Pneumocystis 2.Cytomegalovirus
125. Here is a viral, interstitial pneumonia with some extension into the alveolar spaces (more about this later)
126. It’s helpful to think histologically when looking at chest films of pneumonia: Here is normal lung
127. Lobar Pneumonia Remember that bacteria (as a rule of thumb) elicit a neutrophilic inflammatory response. Here you can see the alveolar air spaces are full of PMNs as well of exsanguinated RBCs. It shouldn't surprise you then that hemoptysis (coughing up blood) can be a symptom of pneumonia. Notice that the interstitial space is left relatively normal.
128. Lobar Pneumonia PMNs only live for 2 or 3 days. So (although you may not be able to make the distinction at this magnification) macrophages have replaced the PMNs. At the same time, the alveolar exudate has become fibrotic. This complication of lobar pneumonia is called "organizing pneumonia."
129. Interstitial Pneumonia Viral pneumonias manifest themselves in the interstitium rather than the alveolar air spaces. Notice that the interstitial space is greatly expanded with lymphocytes while the alveolar spaces are relatively normal. Does it make sense to you that viral pneumonias are usually less problematic than bacterial pneumonias? A common complication of viral pneumonia, however, is a secondary bacterial superinfection.
130. And then the chest film gets more confusing, and the patient, sicker:
132. Really advanced stuff: •With viral pneumonias, chest radiographic findings usually are nonspecific-they cause an interstitial infiltrate, but some features are characteristic of individual viruses. •HSV can produce focal lesions on chest x-ray that begin as small nodules in the periphery. As the disease progresses, the nodules coalesce to form extensive infiltrates. Usually see this in newborns, or in immunocompromised patients.
133. .•In influenza pneumonia, radiographic findings are similar to those described for other respiratory viral infections. Perihilar and peribronchial infiltrates occur commonly, while progression to diffuse interstitial infiltrates is observed with severe disease. Other findings of influenza pneumonia include hyperexpansion of the lungs, subsegmental atelectasis of multiple lobes, and lobar atelectasis, particularly of the right-upper or right-middle lobe
134. .•In CMV pneumonia, chest radiographs show interstitial infiltrates predominantly in the lower lobes. Advancement to diffuse interstitial infiltrates is observed in patients with organ transplant.
135. • In RSV, chest radiographs show bilateral interstitial or patchy infiltrates. Lobar consolidation and pleural effusions are present in 25% and 5% of cases, respectively. Here’s an infant with RSV pneumonia:
136. • In PIV, chest radiographs may reveal findings ranging from focal infection to diffuse interstitial infiltrates or diffuse mixed alveolar-interstitial infiltrates consistent with acute lung injury
137. .•In varicella pneumonia, radiographic findings are diffuse, fluffy, reticular or nodular infiltrates that can be rapidly progressive. Pleural effusion and peripheral adenopathy can occur. Radiographic abnormalities are more prominent during the peak of the rash and resolve rapidly with clinical improvement. Long-term respiratory sequelae are infrequent in survivors, although small, diffusely scattered, punctate lung calcifications may persist on chest films An early varicella pneumonia
138. .•Hantavirus infection may result in normal chest radiograph findings during early disease. This is followed by signs of interstitial edema, Kerley B lines, peribronchial cuffing, and indistinct hila. Progression to the pulmonary edema phase over the subsequent 48 hours is indicated by centrally located dense alveolar infiltrates unlike the more peripheral infiltrates of adult respiratory distress syndrome from other causes. With further progression, pleural effusions also may develop.
144. Bronchopneumonias pneumonia that is localized, often to the bronchioles and surrounding alveoli Most common causes for bronchopneumonia are: 1.Streptococcus 2.Viral 3.Staph
146. Segmental Pneumonias involve part of one lobe, i.e. are “sub-lobar” Most common causes for segmental pneumonia are: 1.Post obstructive 2.Aspiration
147. A patient with aspiration pneumonia If the organism necrotizes tissue, this could develop into a necrotizing segmental pneumonia, aka lung abscess
148. Necrotizing pneumonias ‘eat’ away at the lung parenchyma because of the causative organism’s propensity for doing so. They may start as lobar, segmental, or bronchopneumonias. ¿Claro?
149. Most common causes for Necrotizing pneumonia are: •Staphylococcal •Anaerobic infection •Gram negative organisms
150. These pneumonias, as well as the round pneumonias we just saw, involve the alveolar spaces in a more or less focal manner, as opposed to the diffuse alveolar pneumonias seen with CMV and pneumocystis
157. ...and here is blood SLE-microangiitis leading to Pulmonary hemorrhage
158. And another patient with diffuse alveolar hemorrhage, in this case a marrow transplant patient with no platelets
159. Finally, the alveolar spaces may not be infected all, at least not initially, as with most viral (interstitial) pneumonias
160.
161. Finally, we should talk about Bronchiolitis obliterans organizing pneumonia or: BOOP
162. Patients with BOOP are usually between the ages of 40-70, and present with a history of dry cough and SOB of two weeks to two months in duration. These symptoms persist despite antibiotic therapy. On auscultation of the lungs late inspiratory crackles are heard. The patient often has an elevated ESR, and PFTs demonstrate a decreased diffusion capacity and a restrictive pattern (diminished FC and TLC with a normal FEV/FV ratio). The etiology of BOOP may be idiopathic or secondary to viral illness (RSV, adenovirus), collagen vascular disease, (RA, SLE), caustic inhalation (sulfur dioxide, chlorine), heart-lung transplant and chronic aspiration..
163. The diagnosis is made histologically, via open lung biopsy since transbronchial biopsy frequently yields inadequate tissue specimens. Fibrous plugs and granulation tissue are present within terminal bronchioles as well as alveolar ducts and alveoli. In addition, perivascular mononuclear cell infiltrates are also seen. The interstitium is commonly involved, distinguishing BOOP from pulmonary fibrosis. The most common chest x-ray finding is bilateral, patchy subpleural air-space opacities (69%), which can mimic lung masses. Pleural effusions and cavitations are rare. Similar radiographic appearances are typical for eosinophilic pneumonia, PE, septic emboli, bronchoalveolar carcinoma, metastatic disease and sarcoidosis