Sanjiv M. Narayan, MD, PhD, is a Stanford cardiologist focused on developing novel approaches to the treatment of atrial fibrillation. Prior to becoming faculty at Stanford, Dr. Sanjiv Narayan spent more than a decade performing research in heart rhythm medicine at the University of California, San Diego. Today’s research in this field is largely focused of the application of modern technologies in the diagnosis and treatment of conditions like atrial fibrillation.
Cardiologist Sanjiv M. Narayan, MD, PhD, served as a professor of medicine at the University of California, San Diego, where he performed research into ways to treat patients with irregular heartbeats. Today, Dr. Sanjiv Narayan is developing a center for patients with atrial fibrillation at Stanford University.
Several treatments are now available to patients with atrial fibrillation, including electrical cardioversion, in which the patient is shocked with a defibrillator. The electric shock passes through the paddles of a defibrillator and sends a jolt of electricity into the patient's heart.
The doctor may alternately choose to use EKG-style patches on the back and chest to administer the electric shock. The purpose is to reset the rhythm of the patient's heartbeat.
Before the procedure, doctors must confirm that the patient has no blood clots in or around the heart. The patient may be required to take anticoagulants one to two months before the appointment. If a patient is not able to take anticoagulants, doctors will observe the patient's heart with a camera inserted through the mouth with a narrow tube.
Additional risks include heart attack, stroke, fluid in the lungs, and, in rare cases, death. In more than 90 percent of cases, the procedure is effective. Medicine to supplement the procedure increases the chance of success.
Cardiologist Sanjiv M. Narayan, MD, PhD, served as a professor of medicine at the University of California, San Diego, where he performed research into ways to treat patients with irregular heartbeats. Today, Dr. Sanjiv Narayan is developing a center for patients with atrial fibrillation at Stanford University.
Several treatments are now available to patients with atrial fibrillation, including electrical cardioversion, in which the patient is shocked with a defibrillator. The electric shock passes through the paddles of a defibrillator and sends a jolt of electricity into the patient's heart.
The doctor may alternately choose to use EKG-style patches on the back and chest to administer the electric shock. The purpose is to reset the rhythm of the patient's heartbeat.
Before the procedure, doctors must confirm that the patient has no blood clots in or around the heart. The patient may be required to take anticoagulants one to two months before the appointment. If a patient is not able to take anticoagulants, doctors will observe the patient's heart with a camera inserted through the mouth with a narrow tube.
Additional risks include heart attack, stroke, fluid in the lungs, and, in rare cases, death. In more than 90 percent of cases, the procedure is effective. Medicine to supplement the procedure increases the chance of success.
A presentation by Sven Erik Gisvold at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicySun Yai-Cheng
ACEP Clinical Policy
Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department
Ann Emerg Med. 2015;66:322-333
New Study Shows Smart Watches Can Measure Rapid Heart Beat AccuratelySanjiv Narayan (Abbott)
In his role as director of the Computational Arrhythmia Research Laboratory at Stanford University, cardiologist Sanjiv M. Narayan, MD, PhD, explores how cutting-edge technologies can help treat disorders like atrial fibrillation, the most common type of arrhythmia, currently affecting more than 5 million Americans. With a background including research at the University of California, San Diego, Dr. Sanjiv Narayan’s interests span many technologies, including wearable devices.
A presentation by Sven Erik Gisvold at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicySun Yai-Cheng
ACEP Clinical Policy
Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department
Ann Emerg Med. 2015;66:322-333
New Study Shows Smart Watches Can Measure Rapid Heart Beat AccuratelySanjiv Narayan (Abbott)
In his role as director of the Computational Arrhythmia Research Laboratory at Stanford University, cardiologist Sanjiv M. Narayan, MD, PhD, explores how cutting-edge technologies can help treat disorders like atrial fibrillation, the most common type of arrhythmia, currently affecting more than 5 million Americans. With a background including research at the University of California, San Diego, Dr. Sanjiv Narayan’s interests span many technologies, including wearable devices.
A cardiologist and researcher with decades of experience, Dr. Sanjiv M. Narayan serves as the director of the Stanford Arrhythmia Center. Formerly a professor of medicine at UC San Diego, Sanjiv Narayan, MD, PhD, has devoted the majority of his research career to the study of atrial fibrillation (AF).
Former professor of medicine at the University of California, San Diego, Sanjiv M. Narayan, MD, is a cardiologist and researcher in the field of cardiac electrophysiology. He serves as director of Electrophysiology Research at Stanford University and is currently developing the Stanford Arrhythmia Center. At the center, Sanjiv Narayan, PhD, intends to treat and research numerous cardiac afflictions, such as atrial fibrillation.
Atrial fibrillation, or afib, is an irregular heartbeat caused by confusion in the electric signals to the heart. The daylight savings time (DST) change was identified as a potentially exacerbating factor for the condition based on research presented in 2018 at the American Heart Association Scientific Sessions.
According to the research, people who are diagnosed with afib may be at a significantly increased risk of stroke during the period immediately following the springtime transition to DST. The data also showed that women may be disproportionately affected, and the risk was highest in women over the age of 65. StopAfib.org, an atrial fibrillation patient organization, has called for the end of the DST practice on the basis of this data.
Formerly an instructor at the University of California, San Diego, Sanjiv M. Narayan, MD, PhD, is a research cardiologist and Stanford University faculty member who has devoted his work to studying atrial fibrillation (abnormal heart rhythms). To further this work, he co-founded the Stanford Arrhythmia Center. Additionally, Dr. Sanjiv Narayan belongs to the Heart Rhythm Society, a professional organization dedicated to connecting and supporting health care providers who work with cardiac arrhythmia patients.
Scientists at NUI Galway are conducting clinical trials
with a new 'smart vest' to try to establish whether
diabetes can have a damaging effect on the heart.
The sensor-packed garment can wirelessly and
remotely monitor a patient's heart activity and other
vital signs in real time over a prolonged period.
The device, developed by Israeli company Healthwatch, is
a sleeveless vest that has electrocardiograph sensors
woven into the fabric. It is also capable of recording a
range of other variables, including the patient's
respiratory rate, temperature and whether they are
moving, sitting or lying down. The data is collected in real
time in a pack built into the vest and transferred wirelessly
via a smartphone to a cloud based storage server. Once
there, doctors, researchers and the patient can view the
information on either a laptop or smartphone.
"It allows the cardiologist to have a really in-depth
Sanjiv M. Narayan, MD, PhD, is a California-based professor of medicine at Stanford University’s Arrhythmia Center. He previously spent 13 years as a professor of medicine at the University of California, San Diego. In addition to his work as a professor, Sanjiv Narayan, MD, PhD, has trained as a cardiologist and established himself as a member of professional organizations such as the Heart Rhythm Society.
The Heart Rhythm Society (HRS) is a registered 501(c)(3) non-profit organization operating internationally. Founded in 1979, the organization has established several professional publications as a means of sharing information with medical professionals around the world.
The Heart Rhythm Journal serves as the organization’s official medical journal. Non-members can subscribe to the journal at heartrhythmjournal.org, while HRS members have complimentary access to both print and online versions of the magazine. In addition to the magazine, readers can enhance their engagement with relevant topics through the monthly Heart Rhythm Podcast, hosted by editor-in-chief Dr. Peng-Sheng Chen. The podcast features interviews with article writers.
The Cardiovascular Digital Health Journal, meanwhile, is a peer-reviewed, open-access journal with a specific focus on how digital medicine is changing the field of cardiology. The journal features an array of topics, all of which promote the ethical use of technologies and scientific data to better serve the more than 14 million Americans living with heart rhythm disorders.
Additional HRS publications include Heart Rhythm O2, an online-only companion to Heart Rhythm Journal, and an archive of heart rhythm case reports, which can be accessed by HRS members at hrsonline.org.
Former director of electrophysiology at the Veterans Affairs Medical Center in San Diego, Sanjiv M Narayan MD Ph.D. is currently a professor of medicine at Stanford University. Experienced cardiologist Sanjiv Narayan is a member of several groups and organizations, such as the Heart Rhythm Society (HRS).
Formerly called the North American Society of Pacing and Electrophysiology (NASPE), the Heart Rhythm Society was founded in 1979 by four doctors. It is a non-profit international organization whose mission is to improve patient care through research, education, and optimal health care policies and standards.
The HRS organizes several events, and from time to time holds awareness campaigns, the purpose of which is to shed more light on heart diseases. There are three familiar campaigns:
Atrial Fibrillation Awareness Month
Through its efforts during this campaign in September and throughout the year, the HRS works to increase public awareness of atrial fibrillation symptoms, warning signs, and treatments.
Sudden Cardiac Arrest Awareness Month
This is a Heart Rhythm Society initiative to raise awareness on sudden cardiac arrest. The campaign focuses on heart attack survivors, who are most at risk of sudden cardiac arrest, and emphasizes the importance of leading a healthy heart lifestyle.
Arrest the Weak
This multi-year national campaign was launched in October 2012. HRS made an effort to raise awareness of the importance of preventing sudden cardiac arrest, early intervention, and appropriate treatment to help reduce the mortality rate.
Sanjiv Narayan, Ph.D. is a practicing cardiologist who completed his MD at the University of Birmingham in the United Kingdom. A former director of electrophysiology at Veterans Affairs Medical Center in San Diego, Sanjiv M. Narayan serves as a professor of medicine at Stanford University in California. In his free time, he enjoys swimming, skateboarding, and cycling.
Cycling is an activity or sport that involves riding a bicycle. Here are essential techniques every cyclist must use to improve efficiency:
1. Relax the upper body
Stress in the body will gradually lead to discomfort and pain, and without feeling comfortable on the bike, the cyclist will eventually slow down. While tweaking position may help, relaxing the hands, elbows, and shoulders using a light grip on the handlebars makes over-corrections less likely.
2. Consider your aerodynamics
Since cycling is essentially a fight against the wind, improving aerodynamics would boost efficiency. Spending more time cycling in the drops, wearing tight-fitted cycling clothes, and using aerodynamic devices like helmets and wheelsets are things that can help to slice through the wind effectively.
3. Use different hand positions
Many cyclists often use one hand position than others. Although this technique is okay as long as they are comfortable with it, switching hand position is usually recommended. This technique helps prevent stiffness in the neck and back, and in some cases, helps to generate more power.
Sanjiv M. Narayan, MD, PhD, is a cardiologist, a professor of medicine, and the director of electrophysiology research at Stanford University. He previously served as a professor of medicine at the University of California, San Diego. Dr. Sanjiv Narayan has pioneered therapies for atrial fibrillation that involved identifying localized regions or drivers, called Focal Impulse and Rotor Modulation, which is one of several 'AF Mapping" approaches to identify drivers now used in clinical practice..
Cardiac arrhythmia is a disorder that results in the heart beating irregularly, too slowly, or too quickly. The condition is caused by the malfunction of electrical impulses that coordinate or control the heartbeat.
There are different types of cardiac arrhythmia, depending on the speed and the location in the heart they occur. Cardiac arrhythmia based on the rate of the heartbeat includes tachycardia and bradycardia.
With tachycardia, the heart beats more than 100 times per minute. With bradycardia, the heart beats fewer than 60 times per minute. However, these heartbeat rates can occur in normal situations, such as exercise or sleep. They are a concern only when they are recurrent or they are a symptom of an underlying heart condition.
A member of the Royal College of Physicians of London, Sanjiv Narayan is a professor of cardiovascular medicine at Stanford University. Dr. Sanjiv Narayan is dedicated to developing innovative and advanced solutions for treating atrial fibrillation.
When an episode of atrial fibrillation (characterized as an irregular beat in the upper heart chamber) lasts for less than a week, it is known as a paroxysmal atrial fibrillation. In patients with paroxysmal atrial fibrillation, the heartbeat typically returns to normal within a seven-day period. Episodes of paroxysmal atrial fibrillation may recur a few times each year, or more often. The symptoms of paroxysmal atrial fibrillation may include chest pain or pressure, heart palpitations, dizziness, fatigue, and shortness of breath.
Diagnosing paroxysmal atrial fibrillation requires studying the heart when an episode of abnormal heart rhythms is occurring. However, these episodes can be elusive and therefore difficult to track. In addition, not all episodes of paroxysmal atrial fibrillation result in symptoms, so it is quite possible to monitor a patient’s condition outside of an episode if monitoring is performed on a periodic basis. One way in which doctors overcome this challenge is by placing an event monitor (a portable electrocardiogram that measures heart activity continuously) on the patient’s chest. Other tests, such as blood tests, stress tests, or X-rays can also be performed, although these tests typically produce less conclusive information.
Cardiologist Sanjiv M. Narayan, MD, PhD, a graduate of the University of Birmingham in England, completed training in internal medicine at Mount Auburn Hospital/Harvard Medical School, then trained in cardiology/electrophysiology at Washington University. Sanjiv Narayan was then faculty at the University of California San Diego and director of electrophysiology at the Veterans Affairs Medical Center. Currently, he is at Stanford University and holds titles including co-Director of the Arrhythmia Center, Director of electrophysiological research and the atrial fibrillation program.
A bioengineer and cardiologist with wide-ranging experience in artificial intelligence and machine learning, Dr. Sanjiv M. Narayan serves as a professor of medicine at Stanford University. In addition, as the director of the Computational Arrhythmia Research Laboratory, Dr. Sanjiv Narayan is developing the new Stanford Arrhythmia Center.
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
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
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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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
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.
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
2. Introduction
Sanjiv M. Narayan, MD, PhD, is a Stanford cardiologist focused
on developing novel approaches to the treatment of atrial
fibrillation. Prior to becoming faculty at Stanford, Dr. Sanjiv
Narayan spent more than a decade performing research in heart
rhythm medicine at the University of California, San Diego.
Today’s research in this field is largely focused of the application
of modern technologies in the diagnosis and treatment of
conditions like atrial fibrillation.
Recently, a trial in Belgium successfully screened more than
60,000 individuals using only smartphones, which represents an
effective way of identifying patients with the condition without
putting a significant strain on medical resources. Participants
used an app that tracks rhythm disorders with pulse-
plethysmography through the smartphone camera.
3. Atrial Fibrillation
In the study, individuals were reminded to measure
heart rhythm twice daily, and then whenever they
experienced symptoms over the course of 8 days.
Irregular measurements were analyzed by medical
technologists working in collaboration with
cardiologists.
Overall, 62,821 people enrolled and 61,730 individuals
completed the trial. In the end, 791 individuals had
measurements that were concerning for atrial
fibrillation, but 72 percent of these participants
reported no symptoms, which reinforces the
importance of screening measures.