Making Decisions About Hip and Knee Joint Pain
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African-Americans are more likely to have hip and knee osteoarthritis, but also more likely to delay treatment. Know your options and get back to the life you enjoy.
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© Lake Forest Graduate School of Management - 2010 .docx
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FIRST GENERATION ANTIHISTAMINICS-
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TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
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Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
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The directors of the UON are concerned about the possible overlap of efforts with other organizations. They view most of
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2nd-generation Antihistaminic Part I.pptx
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
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Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
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Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
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- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
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This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
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2nd generation Antihistaminic-Part II.pptx
Fexofenadine is sold under the brand name Allegra.
It is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the blood–brain barrier and causes lesser sedation, as compared to first-generation antihistamines.
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Making Decisions About Hip and Knee Joint Pain
- 1. Isjointreplacementsurgeryright foryou? Findtheright surgeon Talktoother patients-they canbeagreat resource! Discussoptions withfamilyand lovedones Considerthe impactpost- surgeryrecovery mayhaveon: www.bonesmart.org/ clinics www.bonesmart.org/ forum Ì Work Ì Homelife Ì Hobbiesand activities JointReplacement ImplantsperformedinayearintheUnitedStates 721,000 285,000 kneereplacements3 hipreplacements4 & 95% aresatisfiedwith theirprocedure.5 Hipandkneereplacement implantscanlastmorethan 20years 7 9outof10kneereplacementpatients experienceimmediaterelieffromjointpain.5 Broughttoyouby: FARM,TheFoundationfortheAdvancementinResearchinMedicine,Inc.,andBoneSmart.org, theworld'sleadingknee&hipreplacementpatientadvocacyorganization&onlinecommunity. BoneSmart.org Sources 1. AAOS:Timingafactorinoutcomesdisparities:Someminoritygroupswaittoolongforsurgery (http://www.aaos.org/news/aaosnow/mar09/clinical4.asp) 2. Timingoftotaljointreplacementaffectsclinicaloutcomesamongpatientswithosteoarthritisofthehiporknee. 3. HCUPnet,aserviceoftheUSDepartmentofHealth&HumanServices(hcupnet.ahrq.gov) 4. AAOS:TotalHipReplacement 5.5. Fawzi,Natalie,andKrucik,George,MD,“KneeReplacementStasticsInfographic”(healthline.com) 6. DorothyD.Dunlop,JingSong,LarryM.ManheimandRowlandW.Chang MedicalCare,Vol.41,No.2(Feb.,2003),pp.288-298 7. About.com:HowLongDoKneeReplacementsLast(http://orthopedics.about.com/od/kneereplacement/f/How-Long- Do-Knee-Replacements-Last.htm),HowLongDoHipReplacementsLast (http://orthopedics.about.com/od/hipreplacementsurgery/f/How-Long-Do-Hip-Replacements-Last.htm) Ifyoudoneedsurgery,don’tdelay Havingsurgeryearlierinthecourseoffunctional declinemaybeassociatedwithabetter outcome.2 Minoritiesarelesslikelytoseejointreplacement astreatmentforosteoarthritisthanwhiteswith comparablehealthneedsandeconomicaccess.6 African-Americankneereplacementpatientshad worsejointfunctionbeforesurgeryduelargelyto avoidingkneereplacementwhiletheirjointwas stillsomewhatfunctional.1 Patientswhopostponesurgeryuntiljointfunction excessivelydegradesdonotdoaswellafter surgery.1 Getjointpainundercontrol Talkto otherpatients www.bonesmart.org/ forum Geta secondopinion, ifneeded. Consult withyourprimary- caredoctor. Review treatment recommendations withfamilyandloved ones Myqualityoflifehassuffered becauseofmyjointpain. Ihavemorepainfuldays thanIusedtohave. I’m relyingmoreandmoreon prescriptionpainrelievers. Ihavetolimitmyactivities becauseofjointpain. Ithinkmybadhiporkneewill continuetogetworse. I’m reluctanttoconsidersurgery becauseI’veheardbadthingsaboutit. Doesthissoundlikeyou? Earlyonset Advanced Severe painmanagement painmanagement painmanagement Ì Over-the-counterdrugs: Tylenol,Advil,etc. Ì HotorColdcompresses easeswelling Ì Supportivekneebrace Ì Lightexerciselessens pain Ì Weightlossreduces pressureonyourjoints Whenpainisnoteffectively managedby“light”methods yourdoctormaysuggest: Ì “JointFluid”injections intothepainfuljoint Ì Cortisoneinjectionsto reduceinflammation Injectionscanbeeffective forseveralweekstoafew months Painisgreatlycompromising yourlife: Ì Avoidingstairs&walking Ì Sittingmore,moving less Ì Stayingathome ÌÌ Feelinglikethereisno solutiontoyourjoint issues ManagingYourJointPain Symptoms Pain Swelling Stiffness Tenderness Redness Warmth Osteoarthritis Ì Mostcommonformof arthritis Ì Deteriorationofthecartilage withinthejoints Ì Ascartilagedeteriorates paininthejointincreases WhatisOsteoarthritis? WhohasOsteoarthritis? 26.9Million AmericanshavesomeformofOsteoarthritis(sourceCDC) Osteoarthritisaffects (sourceCDC) 13.9% adultsage 25years 33.6% adultsage 65yearsandolder Osteoarthritisismore commonamongAfrican- AmericansthanWhites Making AboutYourJointPain Overcomingdoubtsabouttreating HiporKneeOsteoarthritis Overcomingdoubtsabouttreating HiporKneeOsteoarthritis