This document discusses contrast agents used in medical imaging. It begins by outlining the aims of discussing contrast agents, including why they are used and desirable features. The main types of contrast agents are then described - positive contrast agents like iodine and barium sulfate which increase attenuation, and negative contrast agents like air which decrease attenuation. Methods of administration and examples of examinations using contrast are provided. Risks associated with contrast agents like reactions and nephrotoxicity are also summarized.
VERY BASICS OF CONTRAST MEDIA IN RADIOLOGY.
CLASSIFICATION OF CONTRAST MEDIA.
APPLICATION OF CONTRAST MEDIA.
XRAY, CT, ULTRASOUND AND MRI CONTRAST AGENTS.
VERY BASICS OF CONTRAST MEDIA IN RADIOLOGY.
CLASSIFICATION OF CONTRAST MEDIA.
APPLICATION OF CONTRAST MEDIA.
XRAY, CT, ULTRASOUND AND MRI CONTRAST AGENTS.
Venography is a radiological procedure for the evaluation of the veins by the help of intravenous radiological contrast media. It is also known as phlebography. Contrast venography is the gold standard for judging diagnostic imaging methods for deep venous thrombosis; although, because of its cost, invasiveness, the increased sensitivity of sonography to demonstrate pathology and other limitations this test is rarely performed.
iodinated and gadolinium Contrast media are widely used in imaging. The radiologist and the physician should be familiar with the common side effects and the serious life threatening adverse reactions,
Venography is a radiological procedure for the evaluation of the veins by the help of intravenous radiological contrast media. It is also known as phlebography. Contrast venography is the gold standard for judging diagnostic imaging methods for deep venous thrombosis; although, because of its cost, invasiveness, the increased sensitivity of sonography to demonstrate pathology and other limitations this test is rarely performed.
iodinated and gadolinium Contrast media are widely used in imaging. The radiologist and the physician should be familiar with the common side effects and the serious life threatening adverse reactions,
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Radiographic Contrast Agents And Contrast-induced Nephropathy
All contrast agents have a basic structure of a benzene ring, which is composed of 6 joined carbon atoms, each of which has an attached hydrogen atom.
Contrast media consist of triiodinated benzene rings, whereby 3 hydrogen atoms are replaced with attached iodine atoms.
Monomers contain 1 triiodinated benzene ring, and dimers contain 2 triiodinated benzene rings
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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
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
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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.
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
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
2. Aims of this session
• Why contrast agents are used
• What are the desirable features of a
contrast agent
• Types of contrast agents used in clinical
settings
• Methods of administrating contrast agents
• Examples of examinations utilising contrast
agents
• Problems/issues associated with
administrating contrast agents
3. Why contrast agents are used
• Different tissues within the body attenuate
the beam of X-rays to different degrees.
• The degree of attenuation of an X-ray beam by
an element is complex, but one of the major
variables isthe number of electrons in the
path of the beam with which it can interact.
4. • The number of electrons in the path of the
beam is dependent upon three factors:
• The thickness of the substance being studied
• Its density
• The number of electrons per atom of the
element (which is equal to its atomic number)
5. Where there is inherent considerable
difference between the densities of
two organs
6. • However, if the two organs have similar
densities and similar average atomic numbers,
then it is not possible to distinguish them on a
radiograph, because no natural contrast exists.
• For example, it is not possible to identify
blood vessels within an organ, or to
demonstrate the internal structure of the
kidney, without artificially altering one of the
factors mentioned earlier
7.
8. Two of the factors important in organ
contrast can be artificially altered,
• the density of an organ, and,
• more usefully, the average atomic number of a
structure.
9. The density of a hollow organ can be reduced by
filling it with gas or air, providing negative contrast
• NEGATIVE CONTRAST
11. What are the desirable features of a
contrast agent
• Easy to administer
• No toxicity/carcinogenecity
• Stable compound
• Concentrates in area of interest
• Proper demonstration of the organ system
• Should have rapid elimination
• Minimal distress to patients (viscosity)
• Cost effective
12. Types of contrast media
CONTRAST
MEDIA
POSITIVE
CONTRAST
IODINE
BASED
BARIUM
SULPHATE
NEGATIVE
CONTRAST
13. NEGATIVE CONTRAST AGENTS
• Air
• CO2
• O2
• E.g.
• PEG
• Air arthrogram
• Double contrast barium examinations
14.
15. POSITIVE CONTRAST AGENTS
• BARIUM SULPHATE
• Radiological contrast media are usually water
soluble solutions, but there is one commonly
used variety that is based on a suspension of
large insoluble particles
• Examinations of the upper and lower
gastrointestinal tracts
16. • Barium sulphate suspensions have better
coating properties than the iodinated contrast
media, and tend to form thin layers spread
over the lining of the gut
WHY BARIUM IN GI SERIES
20. Enteroclysis
• Enteroclysis has shown to be very accurate in
diagnosing small bowel diseases, with a
sensitivity of 93.1% and specificity of 96.9%.
• It permits detection of lesion which may not
be seen with other imaging techniques.
• no significant difference Enteroclysis and
Computer tomographic enterography.
24. IODINE BASED
• Early 1920s to treat syphilis with high doses of
sodium iodide. The urine in the bladder was
observed to become radio-opaque during this
treatment. Sodium iodide was too toxic.
• The first suitable structure was a derivative called
pyridine, to which a single iodine atom could be
bound in order to render it radio-opaque.
• The first radiological contrast medium that could
produce safe and reliable intravenous urograms
in patients was Uroselectan
25. • In the 1950s, contrast media were developed
that were based on the six-carbon benzoic
acid ring rather than the five-carbon pyridine
ring. This structure was able to carry three
atoms of iodine, and therefore was even more
radio-opaque.
• Had a very high osmolality
26. WATER VS OIL BASED
• OIL BASED
• NEVER INJECTED
• ONLY DUCTS
• NOT INGESTED
• WATER BASED
• INJECTED VESSELLS/DUCTS
• INGESTED
• Organ function/flow
27. All contrast media are not the same
• Viscosity
• Osmolality
• Chemotoxicity
• LD50
28. Viscosity
• The practical importance of viscosity of a
contrast medium relates chiefly to the force
that is required to inject
• The viscosity can be reduced by lowering the
concentration of the contrast medium, but
result in unsatisfactory opacification. Since
viscosity is inversely related to temperature,
warming the contrast medium may partly
resolve this problem
29. Osmolality
• In general, the higher the osmotic pressure the
poorer the tolerance. Ionic contrast media
undergo this dissociation, whilst newer, non-ionic
contrast media do not.
• Osmolality is directly responsible for a number of
clinically important effects
• The sensations of heat and discomfort or even
pain
• damage to the blood-brain barrier, renal damage
and disturbance or electrolyte balance in small
children.
30. • Both the viscosity of a contrast medium and
its osmolality are INVERSELY related to
tolerance but directly to degree of
opacification.
• With increasing strength of contrast medium,
the opacifying power of the solution
increases, but so, of course, do the osmolality
and viscosity, while tolerance tends to decline.
31. Ways of reducing osmolality, whilst
maintaining satisfactory radio-opacity
• two contrast medium molecules together,
producing a much larger molecule, which still
ionises, but possesses six atoms of iodine per
molecule
• replace the dissociating cationic portion of the
contrast medium molecule completely with a
non-dissociating organic chain
32. CHEMOTOXICITY/LD50
• mechanism responsible for causing the toxic
effects of contrast media that cannot be
explained by other means (e.g. osmolality,
electrical charge).
• There are a number of properties of contrast
media that relate to this tem (e.g.
hydrophilicity/lipophilicity, protein-binding,
histamine release).
35. Examples of examinations utilising
contrast agents
• Angiography
• Intravenous urography (IVU), intravenous
pyelography (IVP)
• Computed tomography (CT)
• Interventional techniques
• GI series
• Other examinations
36.
37. Choice of contrast
• Infants (introduction of hyperosmolar fluid into the bodies
of very young children can cause
• problems of fluid balance)
• The elderly (for the same reason)
• Diabetics
• Patients with cardiac impairment
• Patients with renal impairment
• Asthmatics
• Patients who have previously reacted adversely to a
contrast medium
• Patients with a history of allergy
• Patients who are unduly anxious
38. Safety of contrast media
• Contrast media are among the safest of all of
the pharmaceutical products available to the
doctor today. They are not intended to have
therapeutic activity: indeed, the ideal contrast
medium would have no pharmacological
activity at all.
• rate of adverse reactions to iodinated contrast
media on the market is extremely low, but
such reactions do occur - just as they do with
every pharmaceutical product.
39. two groups
• Those reactions that are clearly dependent on
the dose and concentration of the contrast
medium administered......... heat,
pain,vasodilation, cardiac depression and
hypotension,CIN
• and those that are almost independent of
dose and concentration........ allergy-like or
hypersensitive reactions
40. • Most contrast media reactions are minor and need
no treatment. Moderate reactions are encountered
rarely (about 1%) and severe reactions very rarely
(about 0.1%), but all moderate and severe reactions
require adequate treatment. Deaths following
contrast media administration are extremely rare.
• Reported mortality rates vary between 1 in 10,000
and 1 in 169,000 averaging around 1 in 75,000.
• Katayama et al. (Radiology 1990; 175: 621-628)
found that there is a reduction in adverse reaction
rate of about four times using(LOCM) for intravenous
injection compared to HOCM