This document discusses thrombosis and thrombus formation. It defines thrombosis as the formation of a solid mass or thrombus in the circulation from blood components. It notes that thrombi can cause harmful effects like ischemic injury by decreasing blood flow or thromboembolism by breaking off and lodging in distant vessels. It describes the pathophysiology of thrombus formation including endothelial injury, altered blood flow, hypercoagulability, platelet activation, and coagulation system activation. It discusses different types of thrombi, their morphology, composition and distinguishing features. It also covers hypercoagulable states, causes of thrombosis, and the potential fates of thrombi.
The terms leukopenia and neutropenia are often used interchangeably. However, they refer to slightly different conditions. Leukopenia is an umbrella term that refers to a reducation in any of the white blood cell types.
Neutropenia is a type of leukopenia but refers specifically to a decrease in neutrophils, the most common type of white blood cell. A person’s neutrophil count is an important indicator of their infection risk.
The terms leukopenia and neutropenia are often used interchangeably. However, they refer to slightly different conditions. Leukopenia is an umbrella term that refers to a reducation in any of the white blood cell types.
Neutropenia is a type of leukopenia but refers specifically to a decrease in neutrophils, the most common type of white blood cell. A person’s neutrophil count is an important indicator of their infection risk.
Definition of inflammation, Causes, Signs of inflammation, Types of inflammation, Triple response, Phagocytosis, Transudate or Exudate, Difference between transudate and exudate, Granuloma and Granulomatous inflammation
This presentation is for those who want to understand the basics of reversible cell injury.
You can also get more idea from my youtube channel:
Harshit Jadav I Medical Wala
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
Definition of inflammation, Causes, Signs of inflammation, Types of inflammation, Triple response, Phagocytosis, Transudate or Exudate, Difference between transudate and exudate, Granuloma and Granulomatous inflammation
This presentation is for those who want to understand the basics of reversible cell injury.
You can also get more idea from my youtube channel:
Harshit Jadav I Medical Wala
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
This is the power point that explains about the blood and blood cells. Power point describes about the mechanism of coagulation and defense cells of our circulatory system.
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Similar to CIRCULATORY DISTURBANCES OF OBSTRUCTIVE NATURE - THROMBOSIS (20)
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.
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.
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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
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- Prix Galien International Awards Ceremony
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
2. THROMBOSIS
• Thrombosis is the process of formation of solid mass in
circulation from the constituents of flowing blood; the mass
itself is called a thrombus.
3. • Haematoma is the extravascular accumulation of blood e.g. into the
tissues.
• Haemostatic plugs are the blood clots formed in healthy individuals at
the site of bleeding e.g. in injury to the blood vessel.
• Haemostatic plugs are useful as they stop escape of blood and
plasma, whereas thrombi developing in the unruptured
cardiovascular system may be life-threatening by causing one of the
following harmful effects:
1. Ischaemic injury- Thrombi may decrease or stop the blood supply to
part of an organ or tissue and cause ischaemia which may
subsequently result in infarction.
2. Thromboembolism- Thrombus or its part may get dislodged and be
carried along in the bloodstream as embolus to lodge in a distant
vessel.
4. Pathophysiology
• Injury to the blood vessel initiates haemostatic repair
mechanism or thrombogenesis.
• Virchow described three primary events which predispose to
thrombus formation (Virchow’s triad): endothelial injury,
altered blood flow, and hypercoagulability of blood.
• To this are added the activation processes that follow these
primary events: activation of platelets and of clotting system.
6. 1. ENDOTHELIAL INJURY
• The integrity of blood vessel wall is important for maintaining normal
blood flow.
• An intact endothelium has the following functions:
i) It protects the flowing blood from thrombogenic influence of
subendothelium.
ii) Few anti-thrombotic factors (thrombosis inhibitory factors) as follows:
a) Heparin-like substance
b) Thrombomodulin
c) Inhibitors of platelet aggregation such as ADPase, PGI2 (or prostacyclin).
d) Tissue plasminogen activator which accelerates fibrinolytic activity.
iii) It releases a few prothrombotic factors which have procoagulant
properties (thrombosis favouring factors) as under:
a) Thromboplastin or tissue factor
b) von Willebrand factor
c) Platelet activating factor
d) Inhibitor of plasminogen activator
7. • Vascular injury exposes the subendothelial extracellular
matrix or ECM (e.g. collagen, elastin, fibronectin, laminin
and glycosaminoglycans) which is thrombogenic and thus
plays an important role in initiating haemostasis as well as
thrombosis.
• Injury to vessel wall also causes vasoconstriction of small
blood vessels briefly so as to reduce the blood loss.
8. • A number of factors and conditions may cause vascular
injury and predispose to the formation of thrombi:
i) Endocardial injury in myocardial infarction, myocarditis,
cardiac surgery, prosthetic valves.
ii) Ulcerated plaques in advanced atherosclerosis.
iii) Haemodynamic stress in hypertension.
iv) Arterial diseases.
v) Diabetes mellitus.
vi) Endogenous chemical agents such as
hypercholesterolaemia, endotoxins.
vii) Exogenous chemical agents such as cigarette smoke.
9. 2. ROLE OF PLATELETS
• Endothelial cell injury, platelets come to play a central role in
normal haemostasis as well as in thrombosis. The sequence of
events is as under:
i) Platelet adhesion Glycoprotein Ib (GpIb) receptor on the
platelets recognises the site of endothelial injury
ii) ii) Platelet release reaction- Activated platelets then undergo
release reaction by which the platelet granules are released to
the exterior.
• Two main types of platelet granules are released:
a) Dense bodies -Their release liberates ADP (adenosine diphosphate), ionic
calcium, 5-HT (serotonin), histamine and epinephrine.
b) Alpha granules -Their release produces fibrinogen, fibronectin, platelet-
derived growth factor (PDGF), platelet factor 4 (an antiheparin) and
thrombospondin.
10. iii) Platelet aggregation
• Following release of ADP, a potent platelet aggregating
agent, aggregation of additional platelets takes place
(secondary aggregation). This results in formation of
temporary haemostatic plug.
12. 3. ROLE OF COAGULATION SYSTEM
• Coagulation mechanism is the conversion of the plasma
fibrinogen into solid mass of fibrin. The coagulation system is
involved in both haemostatic process and thrombus
formation.
i) In the intrinsic pathway, contact with abnormal surface
(e.g. ECM in the subendothelium) leads to activation of
factor XII and the sequential interactions of factors XI, IX,
VIII and finally factor X, along with calcium ions (factor IV)
and platelet factor 3.
13. ii) In the extrinsic pathway, tissue damage results in
release of tissue factor or thromboplastin. Tissue factor on
interaction with factor VII activates factor X.
iii) The common pathway begins where both intrinsic and
extrinsic pathways converge to activate factor X which forms
a complex with factor Va and platelet factor 3, in the
presence of calcium ions.
15. Regulation of coagulation system
• Normally, the blood is kept in fluid state and the coagulation system is
kept in check by controlling mechanisms.
• These are as under:
i) Protease inhibitors -to oppose the formation of thrombin e.g.
Antithrombin III, protein C, C1 inactivator, α1-antitrypsin, α2-
macroglobulin.
ii) Fibrinolytic system- Plasmin, a potent fibrinolytic enzyme, is formed by
the action of plasminogen activator on plasminogen present in the
normal plasma.
• Two types of plasminogen activators (PA) are identified:
a) Tissue-type PA derived from endothelial cells and leucocytes.
b) Urokinase-like PA present in the plasma.
17. 5. HYPERCOAGULABLE STATES
(THROMBOPHILIA)
• Thrombophilia or hypercoagulable states are a group of
conditions having increased risk or predisposition to develop
venous thrombosis.
• These conditions may be hereditary (or primary) or
acquired (or secondary) causes.
20. CAPILLARY THROMBI
• Minute thrombi composed mainly of packed
red cells are formed in the capillaries in acute
inflammatory lesions, vasculitis and in
disseminated intravascular coagulation (DIC).
21. Morphologic Features
• Grossly,
• thrombi may be of various shapes, sizes and composition
depending upon the site of origin.
• Arterial thrombi tend to be white and mural while the
venous thrombi are red and occlusive. Mixed or
laminated
• Thrombi are also common and consist of alternate white
and red layers called lines of Zahn.
• Red thrombi are soft, red and gelatinous whereas white
thrombi are firm and pale.
22. Morphologic Features
• Microscopically,
• the composition of thrombus is determined by the rate of
flow of blood i.e. whether it is formed in the rapid arterial
and cardiac circulation, or in the slow moving flow in veins.
• Red (venous) thrombi have more abundant red cells,
leucocytes and platelets entrapped in fibrin meshwork.
Thus, red thrombi closely resemble blood clots in vitro.
23. Thrombus in an artery.
The thrombus is adherent to the arterial wall and is seen occluding most
of the lumen. It shows lines of Zahn composed of granular-looking
platelets and fibrin meshwork with entangled red cells and leucocytes
25. Fate of Thrombus
1. RESOLUTION
• Thrombus activates the fibrinolytic system with consequent release of
plasmin which may dissolve the thrombus completely resulting in
resolution.
2. ORGANISATION
• If the thrombus is not removed, it starts getting organised.
3. PROPAGATION
• The thrombus may enlarge in size due to more and more deposition from
the constituents of flowing blood.
• In this way, it may ultimately cause obstruction of some important vessel.
4. THROMBOEMBOLISM
• The thrombi in early stage and infected thrombi are quite friable and may
get detached from the vessel wall.
• These are released in part or completely in blood-stream as emboli which
produce ill-effects at the site of their lodgement.