1. Disseminated intravascular coagulation (DIC) is a condition where excessive blood clotting leads to formation of clots throughout the small blood vessels, consuming clotting factors and platelets and causing bleeding complications.
2. DIC can be caused by infections, cancer, trauma, pregnancy complications, and other medical conditions. It involves an imbalance between coagulation and anticoagulation pathways that leads to thrombosis and hemorrhage.
3. Treatment of DIC focuses on treating the underlying cause, replacing clotting factors, administering anticoagulants in some cases, and restoring natural anticoagulant pathways.
Disseminated intravascular coagulation (DIC) is a syndrome in which either the extrinsic or intrinsic or both pathways are activated to produce multiple fibrin clots in small blood vessels.
it consist introduction of DIC, definition, etiology and causes, pathophysiology, diagnostic evaluation and its management. it consist of complication too. easy to understand with the help of pictures.
Disseminated intravascular coagulation (DIC) is a syndrome in which either the extrinsic or intrinsic or both pathways are activated to produce multiple fibrin clots in small blood vessels.
it consist introduction of DIC, definition, etiology and causes, pathophysiology, diagnostic evaluation and its management. it consist of complication too. easy to understand with the help of pictures.
A presentation about DIC (Disseminated Intravascular Coagulopathy).
Done by 4th year medical students at the University of Science and Technology, Sana'a, Republic of Yemen, in October 2010.
Thrombophilias are hypercoagulable conditions that can be acquired or inherited. Most important hypercoagulable conditions =, testing procedures, duration of anticoagulation will be discussed here. Useful for Internal Medicine Boards and Hematology boards. Some aspects on duration of anticoagulation, HIT are high-yield for USMLE exams.
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
A presentation about DIC (Disseminated Intravascular Coagulopathy).
Done by 4th year medical students at the University of Science and Technology, Sana'a, Republic of Yemen, in October 2010.
Thrombophilias are hypercoagulable conditions that can be acquired or inherited. Most important hypercoagulable conditions =, testing procedures, duration of anticoagulation will be discussed here. Useful for Internal Medicine Boards and Hematology boards. Some aspects on duration of anticoagulation, HIT are high-yield for USMLE exams.
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
Investigations in hemorrhegic disorders ppt Prashant MunePrashant Munde
Clinical assessment, pertinent history, and family history are good indicators for determining patient's bleeding tendencies.
The most appropriate laboratory tests performed are Routine screening tests include a complete blood cell count, platelet count, and evaluation of a peripheral blood sample, a prothrombin time, and an activated partial thromboplastin time.
disseminated intravascular coagulation is an abnormal blood clot in the blood vessels called dic. causes of this are any infection, cancer, liver disease, abnormal pregnancy, etc. signs and symptoms of this fever, petechiae, purpura, etc .treatment of this id anticoagulant agent like aspirin, plasma transfusion, etc
In disseminated intravascular coagulation, abnormal clumps of thickened blood (clots) form inside blood vessels. These abnormal clots use up the blood's clotting factors, which can lead to massive bleeding in other places. Causes include inflammation, infection and cancer.
Symptoms include blood clots and bleeding, possibly from many sites in the body.
The goal is to treat the underlying cause and provide supportive care through intravenous fluids and blood transfusions.
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.
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
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
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
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
- 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
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.
3. Disseminated intravascular coagulation
(DIC) is a clinicopathologic syndrome
characterized by widespread
intravascular fibrin formation in
response to excessive blood protease
activity that overcomes the natural
anticoagulant mechanisms.
10. 1. Increased thrombin generation: Mediated predominantly by tissue
factor/factor VIIa pathway
2. Impaired function of physiological anticoagulant pathway
a) Reduction of antithrombin levels -- The result of a combination of increased
consumption, enzyme degradation, impaired liver synthesis and vascular
leakage
b) Depression of protein C system -- The result of a combination of increased
consumption, impaired liver synthesis, vascular leakage and down- regulation
of thrombomodulin
c) Insufficient tissue factor pathway inhibitor (TFPI)
3. Impaired fibrinolysis: Mediated by release of plasminogen activators from
endothelial cells immediately followed by an increase in the plasma levels of
plasminogen activator inhibitor type 1 (PAI-1)
4. Activation of inflammatory pathway: Mediated by activated coagulation
proteins and by depression of the protein C system
12. HISTORY
The symptoms of disseminated intravascular coagulation (DIC) are often those of
the underlying inciting condition
1. Bleeding
• GI bleed
• petechiae and ecchymosis,
• intravenous (IV) lines and catheters bleed
• surgical sites, drains, and tracheostomies and within serous cavities.
2. Renal Failure
3. Pulmonary involvement
• dyspnea, hemoptysis, and cough
4. Jaundice
13. SYMPTOMS
Circulatory signs include the following:
1. Signs of spontaneous and life-threatening hemorrhage
2. Signs of subacute bleeding
3. Signs of diffuse or localized thrombosis
4. Bleeding into serous cavities
Central nervous system signs include the following:
1. Nonspecific altered consciousness or stupor
2. Transient focal or neurologic deficits
Cardiovascular signs include the following:
1. Hypotension
2. Tachycardia
3. Circulatory collapse
Respiratory signs include the following:
1. Pleural friction rub
2. Signs of acute respiratory distress syndrome (ARDS)
14. GI signs include the following:
1. Hematemesis
2. Hematochezia
Genitourinary signs include the following:
1. Signs of azotemia and renal failure
2. Acidosis
3. Hematuria
4. Oliguria
5. Metrorrhagia
6. Uterine hemorrhage
Dermatologic signs include the following:
1. Petechiae
2. Jaundice (liver dysfunction or hemolysis)
3. Purpura
4. Hemorrhagic bullae
5. Acral cyanosis
6. Skin necrosis of lower limbs (purpura fulminans)
7. Localized infarction and gangrene
8. Wound bleeding and deep subcutaneous hematomas
9. Thrombosis
19. •Platelet -- moderate-to-severe thrombocytopenia is present in DIC.
•Activated partial thromboplastin time [aPTT] and prothrombin time
[PT]) are typically prolonged.
•Protein C and antithrombin are 2 natural anticoagulants that are
frequently decreased in DIC.
•Elevated levels D-dimer and FDPs
•Thrombomodulin is elevated in DIC, a marker for early identification
and monitoring of DIC.
•Chronic DIC diagnosis when the schistocytes are seen in concert with
normal coagulation values and increased D-dimer levels.
20.
21. Clinical conditions that should be ruled out
Thrombocytopenia
Dilution and abnormal distribution
Massive blood loss, massive infusion
ITP, TTP-HUS, HIT, HELLP syndrome
Disorders of hematopoiesis
Liver disease
Hypothermia
Spurious laboratory results
Diagnostic algorithm for SIRS
Temperature >38°C or < 36°C
Heart rate >90 beats/min
Respiratory rate >20 breaths/min or PaCO2 < 32 mm Hg (< 4.3 kPa)
WBC count >12,000 cells/µL, < 4000 cells/ µL, or 10% immature (band) forms
Diagnostic algorithm
SIRS criteria
Score
>3
1
0-2
0
Platelet count (× 109/L)
< 80 or >50 % decrease within 24 hours
3
>80 and < 120 or >30% decrease within 24 hours
1
>120
0
Prothrombin time (value of patient/normal value)
>1.2
1
< 1.2
0
Fibrin/FDPs (mg/L)
>25
3
>10 and < 25
1
< 10
0
Diagnosis
4 points or more
DIC
23. 1) Replacement therapy
- Fresh-frozen plasma
2) Anticoagulants
- Unfractionated and low-molecular-weight
heparin
- Danaparoid sodium
- Recombinant hirudin
- Recombinant tissue factor pathway inhibitor
- Recombinant nematode anticoagulant protein
c2
3) Restoration of anticoagulant pathways
- Antithrombin
- Recombinant human activated protein C
4) Other agents
- Recombinant activated factor VII
- Antifibrinolytic agents
- Antiselectin antibodies
- Recombinant interleukin-10
- Monoclonal antibodies against TNF and CD14
24. Management of Underlying Disease
•The management of acute and chronic forms of disseminated intravascular
coagulation (DIC) should primarily be directed at treatment of the underlying
disorder.
Administration of Blood Components and Coagulation Factors
•Platelet transfusion may be considered in patients with DIC and severe
thrombocytopenia, in particular, in patients with bleeding or in patients at risk
for bleeding
•The PT (>1.5 times the normal) Replacement with FFP is indicated
•Low levels of fibrinogen (<100 mg/dL) or brisk hyperfibrinolysis will require
infusion of cryoprecipitate. The replacement of 10 U of cryoprecipitate for every
2–3 U of FFP is sufficient to correct the hemostasis.
•In case of a (relative) vitamin K deficiency in the face of consumption,
administration of vitamin K may be required.
25. Anticoagulation
•Experimental studies have suggested that heparin can at least partly inhibit
the activation of coagulation in cases of sepsis and other causes of
DIC. However, a beneficial effect of heparin on clinically important outcome
events in patients with DIC has not yet been demonstrated in controlled
clinical trials.
•Therapeutic doses of heparin are indicated in cases of obvious
thromboembolic disease or where fibrin deposition predominates
(eg, purpura fulminans or acral ischemia).
• A dose of 4-5 U/kg constant infusion without a 80-U/kg bolus is a safe
means to deliver heparin to the DIC without increasing the bleeding risk.
Restoration of Anticoagulant Pathways
•Antithrombin concentrate, recombinant human APC, tissue factor (TF)
pathway inhibitor (TFPI) and recombinant thrombomodulin (rTM)
26. Antifibrinolytic treatment
In the coagulopathy associated with acute promyelocytic leukemia
(AML-M3) and in some cases of DIC secondary to malignancies (e.g.
prostate carcinoma) lysine analogues such as tranexamic acid can be
utilized
Investigational Treatments
Tissue factor (TF)-VIIa complex include inactivated factor VII and
recombinant nematode anticoagulant peptide (NAPc2)
Editor's Notes
International Society on Thrombosis and Haemostasis (ISTH)