Nomenclatura e Conceituação em Técnica CirúrgicaGustavo Santos
Nomenclatura e Conceituação dos Termos Usados em Técnica Cirúrgica
Aula de Bases da Técnica Cirúrgica - Medicina
Prof. Gustavo Santos
FACIME (UESPI) / FACID
Resuscitation in Paediatric Cardiac Patients: Michele DomicoSMACC Conference
Michele Domico presents a talk on the pitfalls of common paediatric resuscitative manoeuvres in paediatric cardiac patients. Emergency and critical care physicians are all well accustomed to items such as oxygen, bolus adrenaline, intubation and cardioversion. However, as Michele explains, these ‘go to’ interventions may in fact be harmful for the paediatric cardiac patient presenting to the emergency department in extremis. Due to the physiology of certain complex congenital heart diseases, the usual resuscitation manoeuvres may in fact kill the patient instead of helping.
Supplemental oxygen can worsen the pulmonary to systemic blood flow ratio in single ventricle patients and cause them to have rising lactate levels and cardiac arrest from low systemic cardiac output. Intubation and positive pressure ventilation may impede pulmonary blood flow in patients with a Glenn shunt and the patient can become more desaturated. With increasing PEEP and higher respiratory rates, the patients will continue to deteriorate and desaturate. Regular dosing of adrenaline boluses in patients with single ventricle physiology who are nearly arrest, can worsen their systemic output by increasing systemic vascular resistance and promoting pulmonary overcirculation. Cardioversion of a previously healthy paediatric patient might be tempting when you see what looks like a stable ventricular tachycardia. This wide complex rhythm has fooled many people into shocking it. You might in fact be dealing with something else and can make the patient infinitely worse by shocking.
In her talk, Michele highlights the importance of understanding the physiology of your patients. This particularly applies to paediatric cardiac patients. In this population, the change from typical physiology means standard models of care are harmful. Tune in to hear what not to do!
For more like this, head to our podcast page. #CodaPodcast
Nomenclatura e Conceituação em Técnica CirúrgicaGustavo Santos
Nomenclatura e Conceituação dos Termos Usados em Técnica Cirúrgica
Aula de Bases da Técnica Cirúrgica - Medicina
Prof. Gustavo Santos
FACIME (UESPI) / FACID
Resuscitation in Paediatric Cardiac Patients: Michele DomicoSMACC Conference
Michele Domico presents a talk on the pitfalls of common paediatric resuscitative manoeuvres in paediatric cardiac patients. Emergency and critical care physicians are all well accustomed to items such as oxygen, bolus adrenaline, intubation and cardioversion. However, as Michele explains, these ‘go to’ interventions may in fact be harmful for the paediatric cardiac patient presenting to the emergency department in extremis. Due to the physiology of certain complex congenital heart diseases, the usual resuscitation manoeuvres may in fact kill the patient instead of helping.
Supplemental oxygen can worsen the pulmonary to systemic blood flow ratio in single ventricle patients and cause them to have rising lactate levels and cardiac arrest from low systemic cardiac output. Intubation and positive pressure ventilation may impede pulmonary blood flow in patients with a Glenn shunt and the patient can become more desaturated. With increasing PEEP and higher respiratory rates, the patients will continue to deteriorate and desaturate. Regular dosing of adrenaline boluses in patients with single ventricle physiology who are nearly arrest, can worsen their systemic output by increasing systemic vascular resistance and promoting pulmonary overcirculation. Cardioversion of a previously healthy paediatric patient might be tempting when you see what looks like a stable ventricular tachycardia. This wide complex rhythm has fooled many people into shocking it. You might in fact be dealing with something else and can make the patient infinitely worse by shocking.
In her talk, Michele highlights the importance of understanding the physiology of your patients. This particularly applies to paediatric cardiac patients. In this population, the change from typical physiology means standard models of care are harmful. Tune in to hear what not to do!
For more like this, head to our podcast page. #CodaPodcast
Weight loss surgery/ Bariatric surgery is a very exciting field which has revolutionized the process of weight loss. It has not only given new lease of life to the patients who are severely obese but has also helped tremendously in controlling type-2 diabetes, hypertension, dyslipidemia, infertility and obstructive sleep apnea. [www.delhiobesityclinic.com/weight-loss-surgery-in-delhi/]
“My subject is War, and the pity of War.
The Poetry is in the pity …
All a poet can do today is warn."
Benjamin Britten
Original on iCloud: http://ow.ly/3jZPSd on iCloud, via #jordanconductor
more at http://www.jordanrsmith.com
Nutrition and rehabilitation are very important aspect of cancer treatment. Sadly many a times they are not given utmost importance from patients, family and even doctors.
I have summarised the international guidelines for nutrition on treatment of cancer.
Dr. K.S.Chhajer is the best hair transplant, cosmetic surgeon, nose, breast surgery, open rhinoplasty, cleft lip & palate and burn contracture doctor in Kolkata.
Because today every time we choose an algorithm, a dataset, a framework, even a plugin, our decision may have tremendous consequences on people near and far around us.
As we, in the tech industry, slowly come to realise the power we wield, we urgently need to train our brains into an ethical decision-making framework.
How can we make sure our choices won't harm others?
Weight loss surgery/ Bariatric surgery is a very exciting field which has revolutionized the process of weight loss. It has not only given new lease of life to the patients who are severely obese but has also helped tremendously in controlling type-2 diabetes, hypertension, dyslipidemia, infertility and obstructive sleep apnea. [www.delhiobesityclinic.com/weight-loss-surgery-in-delhi/]
“My subject is War, and the pity of War.
The Poetry is in the pity …
All a poet can do today is warn."
Benjamin Britten
Original on iCloud: http://ow.ly/3jZPSd on iCloud, via #jordanconductor
more at http://www.jordanrsmith.com
Nutrition and rehabilitation are very important aspect of cancer treatment. Sadly many a times they are not given utmost importance from patients, family and even doctors.
I have summarised the international guidelines for nutrition on treatment of cancer.
Dr. K.S.Chhajer is the best hair transplant, cosmetic surgeon, nose, breast surgery, open rhinoplasty, cleft lip & palate and burn contracture doctor in Kolkata.
Because today every time we choose an algorithm, a dataset, a framework, even a plugin, our decision may have tremendous consequences on people near and far around us.
As we, in the tech industry, slowly come to realise the power we wield, we urgently need to train our brains into an ethical decision-making framework.
How can we make sure our choices won't harm others?
Diagnóstico diferencial de etiología bacteriana y viral, con las complicaciones más frecuentes por infección de Streptococcus Beta hemofílico del grupo A.
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
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.
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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 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.
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.
Couples presenting to the infertility clinic- Do they really have infertility...
Cáncer Vesical
1. C Á N C E R D E V E J I G A
A L E J A N D R O B A U T I S T A J I M É N E Z
2. E P I D E M I O L O G Í A
I N C I D E N C I A
3 V E C E S M Á S
F R E C U E N T E E N
H O M B R E S
6 . 6 % D E T O D O S
L O S C Á N C E R E S
E N M U J E R E S ,
2 . 4 %
P R E V A L E N C I A
S E G U N D O M Á S F R E C U E N T E E N
A D U L T O S D E M E D I A N A Y E D A D
A V A N Z A D A .
T I E N E M Á S
R E C U R R E N C I A S
M O R T A L I D A D
9 ª C A U S A D E M U E R T E E N H O M B R E S Y 1 . 5 % D E
M U E R T E S E N M U J E R E S .
E D A D
E N C U A L Q U I E R
E D A D
I N C I D E N C I A
A U M E N T A
C O N F O R M E A L A
E D A D
E D A D P R O M E D I O
6 9 H O M B R E S
7 1 M U J E R E S
P R E S E N T A C I Ó
N
7 5 - 8 5 % D E L O S P A C I E N T E S C O N C A D E V E J I G A , S E
C O N F I N A A L A M U C O S A O S U B M U C O S A
3. F A C T O R E S D E R I E S G O
14%
9%
9%
11%
9%
21%
9%
11%
9%
E X P O S I C I Ó N
O C U P A C I O N A L
G A S E S
N I T R I T O S Y
N I T R A T O S
T A B A Q U I S M O
F E N A C E T I N A
C I S T I T I S
C R Ó N I C A
R A D I O T E R A P I A
H E R E N C I A
4. D I A G N Ó S T I C O
• Exploración física.
• USG.
• Urografía excretora.
• TAC.
• RM.
• Citología Urinaria.
• Cistoscopia.
• Resección endoscópica
transureteral.
• Biopsias ureterales y
prostáticas.
• RTUV para
reestadificación.
5. M A R C A D O R E S T U M O R A L E S
• Sensibilidad de 64 a 85% y especificidad de 71 a 95%.
• Valor Predictivo Positivo: 49 a 85% - VPN: 79 a 95%.
• Útiles en detección precoz de Ca de vejiga, evaluar
respuesta a tratamiento y recurrencia tumoral.
N M P 2 2
I N M U N O C Y T / U
C Y T +
B T A F I S H
Á C I D O
H I A L U R Ó N I C O Y
H I A L U R O N I D A S A
T E L O M E R A S A B C L A 4
6.
7. A N A T O M I A P A T O L Ó G I C A
• Normal:
• 3 a 7 capas de espesor.
• Células basales, intermedias y
superficiales.
• Focalidad:
• Son únicos en su mayoría.
• Papilares multicéntricos.
9. C L A S I F I C A C I Ó N
H I S T O P A T O L Ó G I C A
10. C A R C I N O M A U R O T E L I A L
C Á N C E R I N S I T U
• Foco aterciopelado de
mucosa eritematosa.
• Multifocal limitado al urotelio.
• Progresan a Ca músculo
invasivo.
• Configuración plana no
papilar.
11. C A R C I N O M A D E C É L U L A S
T R A N S I C I O N A L E S
• 90% de Ca de vejiga.
• Pérdida de la polaridad celular.
• Maduración de células anormales desde capa basal
hasta superficial.
• Número de capas elevado con plegamientos papilares
de la mucosa.
12. C L A S I F I C A C I Ó N O M S 1 9 7 3
B A S A D O E N G R A D O D E A N A P L A S I A
13. C L A S I F I C A C I Ó N O M S 1 9 7 3
B A S A D O E N G R A D O D E A N A P L A S I A
• Tumor bien diferenciado:
• Grado 1 - llamados papilares de bajo potencial maligno.
• Tumor moderadamente diferenciado:
• Grado 2 - Llamados de bajo ó alto grado.
• Tumor poco diferenciado:
• Grado 3 - Denominados de alto grado.
14. G R A D O S D E M A L I G N I D A D D E C A D E
V E J I G A
15. G R A D U A C I Ó N D E L A O M S 1 9 7 3 -
2 0 0 3
V I G E N T E
16. C A R C I N O M A D E C É L U L A S
E S C A M O S A S
• 3-7% de los Ca de vejiga.
• Asociado a infección crónica por Schistosoma
haematobium.
• Consiste en islotes queratinizados que contienen
agregados denominados “Perlas escamosas”.
• Produce secreción de psoriasina.
17. A D E N O C A R C I N O M A
• 2% de los Ca de vejiga.
• Vesical Primario:
• Presente en base o cúpula, productor de Mucina, Lesión exofítica.
• Del uraco:
• Raro, presente fuera de la vejiga, con gran infiltración en la pared
vesical.
• Metastásico: de recto, estómago, endometrio, mama, ovario ó
prostata.
18. O T R O S C Á N C E R E S N O U R O T E L I A L E S
D E L A V E J I G A
19. O T R O S C Á N C E R E S N O U R O T E L I A L E S
D E L A V E J I G A
29. P A T R O N E S D E I N V E S T I G A C I Ó N Y
M E T Á S T A S I S
30. P A T R O N E S D E I N V E S T I G A C I Ó N Y
M E T Á S T A S I S
31. D I S T R I B U C I Ó N D E M E T Á S T A S I S A
G A N G L I O S L I N F Á T I C O S
32. R E L A C I Ó N P R O N Ó S T I C A D E L N Ú M E R O
T O T A L D E G A N G L I O S E X T I R P A D O S
• Densidad ganglionar:
• 20% o menos: 43% de supervivencia.
• Mayor de 20%: 17% de supervivencia.
34. G R U P O S D E R I E S G O D E C A D E
V E J I G A
S E G U I M I E N T O
35. R E C O M E N D A C I O N E S P A R A T U M O R D E
R I E S G O I N T E R M E D I O
36. T R A T A M I E N T O
A L T E R N A T I V A S T E R A P É U T I C A S P A R A N O I N V A S I V O S
37. T R A T A M I E N T O
A L T E R N A T I V A S T E R A P É U T I C A S P A R A N O I N V A S I V O S
38. E S Q U E M A D E A D M I N I S T R A C I Ó N D E
B C G I N T R A V E S I C A L
39. C I S T E C T O M Í A P A R C I A L
• Tumor único en parte móvil de la vejiga.
• Tumor no asociado a CIS.
• Ausencia de lesiones multifocales previas.
• Que quede una vejiga funcional posterior a la
resección del tumor con 2 cm de margen libre.
40. C I S T E C T O M Í A P O R M Ú S C U L O
I N V A S I V O S
• Tumores múltiples recurrentes de alto grado.
• Tumor T1 de alto grado.
• Tumores de alto grado con CIS concomitante.
• En pacientes con fracaso de BCG.
41. Q U I M I O T E R A P I A I N T R A V E S I C A L
• QT inmediata.
• Iniciar después de 24hrs de la resección.
• En tumores de bajo grado.
• No usarla si se realizó un resección extensa o ante perforación vesical.
• QT inmediata.
• Iniciar de 3 a 4 semanas después de la resección.
• Máximo 2 inducciones sin respuesta completa.
• El papel de la terapia de mantenimiento es incierto.
43. P A C I E N T E S C A N D I D A T O S P A R A
P R E S E R V A C I Ó N D E V E J I G A
• Tumor pequeño, menor de 5cm.
• Estadio T2, en el que se puede lograr RTU completa.
• Ausencia de CIS.
• Enfermedad que invade músculo son hidronefrosis.
• Medicamento apto para recibir QT.
• Sin metástasis.
44. Q U I M I O T E R A P I A
• Primera línea.
• Neoadyuvante, adyuvante y metastásico
• Segunda línea:
• Metastásico.
D O S I S
Q U I M I O T E R A P I
A
45. P R O B A B I L I D A D D E R E C U R R E N C I A Y
P R O G R E S I Ó N