The document discusses the Diaton® tonometer pen, a non-contact tonometer selected for measuring intraocular pressure in emergency departments. It can measure IOP through the eyelid, does not require anesthetic, and is unaffected by contact lenses or corneal thickness. The document provides detailed instructions on calibrating, operating, and taking accurate IOP measurements with the tonometer. Following the procedures outlined can provide important information to aid in triaging and managing patients with acute eye issues.
The document provides instructions for a module 4 project to create a personal website. It states that the website must have at least 6 pages including a homepage that links back to all other pages. The pages should provide basic personal information like hobbies, biography, family, music interests and movies. Photos with captions must be used and the site should be colorful, personal and show effort. Creativity and incorporating technology lessons are encouraged. A virtual tour of the completed site must then be presented to the class. It provides short examples of what a homepage, about me page, family page and holiday page may include.
A patent lawyer earns an average annual salary of $148,150. They typically have a bachelor's degree, law degree, and 2+ years of experience. Key skills include research, writing, and public speaking. Patent lawyers work in traditional law firms, biotech and engineering companies, public corporations, and their own law practices. They represent clients and have specialized qualifications in patent law.
Topics covered in these slides:
How to perform Zero Downtime Schema Changes
2 main methods: TOI and RSU
Total Order Isolation: predictability and consistency
Rolling Schema Upgrades
pt-online-schema-change
Schema synchronization with re-joining nodes
Recommended procedures
Common pitfalls/user errors
The document provides instructions for a module 4 project to create a personal website. It states that the website must have at least 6 pages including a homepage that links back to all other pages. The pages should provide basic personal information like hobbies, biography, family, music interests and movies. Photos with captions must be used and the site should be colorful, personal and show effort. Creativity and incorporating technology lessons are encouraged. A virtual tour of the completed site must then be presented to the class.
The document provides instructions for a module 4 project to create an individual website. It states that the website must have multiple pages linked to a homepage, include biographical information across at least 6 pages using photos and captions, be personalized, colorful and show effort. Students are encouraged to be creative and incorporate technological elements from the course into the project, then give a virtual tour of the completed site to the class. It includes sample pages for a homepage, about me, family and favorite holiday pages.
Gerak lurus berubah beraturan (GLBB) terjadi ketika percepatan suatu benda konstan. GLBB dapat berupa percepatan atau perlambatan dan dapat diamati dalam kejadian sehari-hari seperti apel jatuh, naik sepeda di turunan, atau lepas landas pesawat.
The document provides instructions for a module 4 project to create a personal website. It states that the website must have at least 6 pages including a homepage that links back to all other pages. The pages should provide basic personal information like hobbies, biography, family, music interests and movies. Photos with captions must be used and the site should be colorful, personal and show effort. Creativity and incorporating technology lessons are encouraged. A virtual tour of the completed site must then be presented to the class. It provides short examples of what a homepage, about me page, family page and holiday page may include.
A patent lawyer earns an average annual salary of $148,150. They typically have a bachelor's degree, law degree, and 2+ years of experience. Key skills include research, writing, and public speaking. Patent lawyers work in traditional law firms, biotech and engineering companies, public corporations, and their own law practices. They represent clients and have specialized qualifications in patent law.
Topics covered in these slides:
How to perform Zero Downtime Schema Changes
2 main methods: TOI and RSU
Total Order Isolation: predictability and consistency
Rolling Schema Upgrades
pt-online-schema-change
Schema synchronization with re-joining nodes
Recommended procedures
Common pitfalls/user errors
The document provides instructions for a module 4 project to create a personal website. It states that the website must have at least 6 pages including a homepage that links back to all other pages. The pages should provide basic personal information like hobbies, biography, family, music interests and movies. Photos with captions must be used and the site should be colorful, personal and show effort. Creativity and incorporating technology lessons are encouraged. A virtual tour of the completed site must then be presented to the class.
The document provides instructions for a module 4 project to create an individual website. It states that the website must have multiple pages linked to a homepage, include biographical information across at least 6 pages using photos and captions, be personalized, colorful and show effort. Students are encouraged to be creative and incorporate technological elements from the course into the project, then give a virtual tour of the completed site to the class. It includes sample pages for a homepage, about me, family and favorite holiday pages.
Gerak lurus berubah beraturan (GLBB) terjadi ketika percepatan suatu benda konstan. GLBB dapat berupa percepatan atau perlambatan dan dapat diamati dalam kejadian sehari-hari seperti apel jatuh, naik sepeda di turunan, atau lepas landas pesawat.
Τα οχυρωματικά έργα της Κωνσταντινούπολης.tsakalilia
Τα οχυρωματικά έργα της Κωνσταντινούπολης (τα χερσαία και παράκτια τείχη). Ενδεικτική εργασία στο φύλλο εργασίας 4. Σενάριο διδασκαλίας Ιστορίας Β' Λυκείου "Βυζάντιο και Άραβες στη Μεσόγειο".
This is a power point Project showing the amazing "powers of language". Without language, how could we communicate?, without language what would our personality look like? therefore it is important to realize that language is actually a gift given to us by GOD, and we should be grateful for this amazing gift!!!
Enjoy the power point project!!!
The document provides information on several case studies related to physical geography, including volcanic eruptions on Montserrat, earthquakes in Italy and Haiti, flooding in the UK and Bangladesh, and glaciation and tourism in the Alps. It describes the causes and effects of each event as well as immediate and long-term responses. Key details include over 300,000 deaths from the Haiti earthquake, widespread destruction from the Montserrat eruption, and millions displaced by flooding in Bangladesh each year.
Hướng dẫn sử dụng Testo 511
https://testostore.vn/danh-muc/do-ap-suat/may-do-ap-suat-tuyet-doi/
https://testostore.vn/san-pham/may-do-ap-suat-tuyet-doi-testo-511/
Hướng dẫn sử dụng máy đo tốc độ vòng quay testo 460Tenmars Việt Nam
Hướng dẫn sử dụng máy đo tốc độ vòng quay testo 460. Cách sử dụng Testo 460 đo tốc độ, gia tốc, vận tốc vòng quay động cơ mô tơ.
https://testostore.vn/san-pham/may-do-toc-do-vong-quay-testo-460/
https://testostore.vn/danh-muc/may-do-toc-do-vong-quay/
- 90% non-condensing
years under normal use
This document provides instructions for using an IF 4K device, which delivers interferential therapy for conditions involving inflammation. It produces low frequency currents by interfering two medium frequency currents. The device includes electrodes, leads, a battery, and adapter. It has multiple programs and settings for intensity, frequency, timer and more. Contraindications, warnings, and precautions are also outlined.
O-Two eSeries e700 Ventilator fFunction and OperationRian Lins
The document describes the e700 automatic transport ventilator. It is lightweight at 2.4kg and has a long battery life of 18 hours. It has multiple ventilation modes and a single screen for live parameter monitoring and waveform display. It has a compact design and is easy to use while also being economical.
Liemke Merlin Clip On 35 Instruction Manual | Optics TradeOptics-Trade
This document provides specifications and operating instructions for the Merlin 35 thermal imaging clip-on device. Key details include:
- The device should be handled carefully and lenses kept clean to avoid damage.
- Batteries may need recharging if not used for long periods and should be removed for storage.
- Various menu and display options are accessible through the control buttons for settings like brightness, palettes, and zoom.
- Proper installation and handling of batteries is described.
- Technical specifications for the detector, optics, display, power, and environmental compatibility are provided.
The document discusses various techniques used to measure intraocular pressure (IOP), including:
1) Digital tonometry which involves applying gentle pressure to the eyeball with a finger, though it is subjective.
2) Indentation tonometry like the Schiotz tonometer which measures corneal indentation from a known weight on a plunger, though readings require correction for ocular rigidity.
3) Applanation tonometry like the Goldmann tonometer which flattens a small corneal area to balance internal and external pressure, providing a more accurate IOP reading less influenced by ocular rigidity factors.
This document discusses general concepts of biomedical instrumentation and provides examples of direct and indirect measurement methods. It describes direct measurement using a clinical thermometer and indirect non-contact measurement using an infrared pyrometer. It also discusses direct measurement of intraocular pressure using a Goldmann applanation tonometer and indirect measurement using a non-contact air puff tonometer. Finally, it introduces a new direct measurement technique for intraocular pressure using a rebound tonometer that provides a more patient-friendly alternative.
The document discusses intraocular pressure (IOP) and methods of measuring IOP (tonometry). It defines IOP as the fluid pressure inside the eye and notes the normal range is 10.5-20.5 mmHg. Factors that can influence IOP include heredity, age, drugs, and blockage of aqueous circulation. Common tonometry methods are discussed - indentation tonometry uses a plunger like the Schiotz tonometer, while applanation tonometry is based on flattening the cornea and includes Goldmann, Perkins, and air puff tonometers. Accurate IOP measurement is important for evaluating glaucoma patients.
Manual de usuario ultrasonido focalizadoJorgeCobo11
The document provides instructions for operating a multi-dimensional ultrasonic instrument, detailing the various probe types, operation modes, and user interface. Precautions are outlined for safe use and proper care of the instrument and probes. Users are guided through setup, screen introduction, probe selection and replacement, treatment modes, and maintenance to optimize results from the multi-functional device.
Hướng dẫn sử dụng máy đo nhiệt độ Testo 610
https://testostore.vn/danh-muc/do-nhiet-do-do-am/
https://testostore.vn/san-pham/may-do-nhiet-do-testo-610/
This document provides an operations manual for different types of custom hearing instruments, including ITE (In-The-Ear), ITC (In-The-Canal), CIC (Completely-In-Canal), and IIC (Invisible-In-The-Canal) devices. It describes the features, controls, battery types, insertion and removal process, operation including on/off, volume control, programs, telephone use, care, maintenance and troubleshooting of these devices. The manual provides details to help users effectively use and care for their specific hearing instrument.
This document discusses various techniques for measuring intraocular pressure (IOP), including manometry, digital tonometry, Schiotz tonometry, Goldmann applanation tonometry, non-contact tonometry, and Pascal's dynamic contour tonometry. It provides details on the principles, procedures, advantages, and limitations of each technique. Goldmann applanation tonometry remains the gold standard method, though newer techniques like Pascal's dynamic contour tonometry may provide a more accurate measurement by reducing the influence of corneal biomechanical properties. An ideal tonometer would accurately measure IOP, be convenient and easy to use, and not be affected by factors like corneal thickness.
The instruction manual provides step-by-step instructions on how to use the Sendo blood pressure monitor, including how to take measurements, install batteries, store readings in memory, and basic troubleshooting. It also explains blood pressure fundamentals and maintenance of the monitor. The monitor has a 5 year guarantee on electrical components and 2 years on other parts.
1) The document provides instructions for use of the SENDO Primo aneroid sphygmomanometer kit for measuring blood pressure, including how to fit the cuff and stethoscope, take measurements, and understand blood pressure classifications.
2) Key steps to take a measurement involve placing the cuff on the upper arm and stethoscope over the brachial artery, inflating the cuff until 30 mmHg above normal blood pressure, and listening through the stethoscope as the cuff deflates to determine systolic and diastolic pressures.
3) The kit is guaranteed for 24 months against defects but not damage from misuse or repairs by unauthorized services.
This document discusses tonometry and different types of tonometers used to measure intraocular pressure (IOP). It describes indentation tonometers like the Schiotz tonometer which measures IOP based on corneal indentation. It also discusses applanation tonometers like the Goldmann tonometer which are considered the gold standard. The Goldmann tonometer uses the Imbert-Fick principle to measure IOP by applanating a fixed area of the cornea with a variable force. Factors affecting IOP measurements and proper use of the Goldmann tonometer are also outlined.
The document discusses various techniques for measuring intraocular pressure (IOP), including Goldmann applanation tonometry, Perkins tonometry, non-contact tonometry, and digital evaluation. Goldmann applanation tonometry is described as the most accurate method. The document provides details on properly using Goldmann tonometry, including preparing the patient, aligning the probe, applying the correct amount of force, and interpreting the results. Contraindications and sources of error are also reviewed.
Τα οχυρωματικά έργα της Κωνσταντινούπολης.tsakalilia
Τα οχυρωματικά έργα της Κωνσταντινούπολης (τα χερσαία και παράκτια τείχη). Ενδεικτική εργασία στο φύλλο εργασίας 4. Σενάριο διδασκαλίας Ιστορίας Β' Λυκείου "Βυζάντιο και Άραβες στη Μεσόγειο".
This is a power point Project showing the amazing "powers of language". Without language, how could we communicate?, without language what would our personality look like? therefore it is important to realize that language is actually a gift given to us by GOD, and we should be grateful for this amazing gift!!!
Enjoy the power point project!!!
The document provides information on several case studies related to physical geography, including volcanic eruptions on Montserrat, earthquakes in Italy and Haiti, flooding in the UK and Bangladesh, and glaciation and tourism in the Alps. It describes the causes and effects of each event as well as immediate and long-term responses. Key details include over 300,000 deaths from the Haiti earthquake, widespread destruction from the Montserrat eruption, and millions displaced by flooding in Bangladesh each year.
Hướng dẫn sử dụng Testo 511
https://testostore.vn/danh-muc/do-ap-suat/may-do-ap-suat-tuyet-doi/
https://testostore.vn/san-pham/may-do-ap-suat-tuyet-doi-testo-511/
Hướng dẫn sử dụng máy đo tốc độ vòng quay testo 460Tenmars Việt Nam
Hướng dẫn sử dụng máy đo tốc độ vòng quay testo 460. Cách sử dụng Testo 460 đo tốc độ, gia tốc, vận tốc vòng quay động cơ mô tơ.
https://testostore.vn/san-pham/may-do-toc-do-vong-quay-testo-460/
https://testostore.vn/danh-muc/may-do-toc-do-vong-quay/
- 90% non-condensing
years under normal use
This document provides instructions for using an IF 4K device, which delivers interferential therapy for conditions involving inflammation. It produces low frequency currents by interfering two medium frequency currents. The device includes electrodes, leads, a battery, and adapter. It has multiple programs and settings for intensity, frequency, timer and more. Contraindications, warnings, and precautions are also outlined.
O-Two eSeries e700 Ventilator fFunction and OperationRian Lins
The document describes the e700 automatic transport ventilator. It is lightweight at 2.4kg and has a long battery life of 18 hours. It has multiple ventilation modes and a single screen for live parameter monitoring and waveform display. It has a compact design and is easy to use while also being economical.
Liemke Merlin Clip On 35 Instruction Manual | Optics TradeOptics-Trade
This document provides specifications and operating instructions for the Merlin 35 thermal imaging clip-on device. Key details include:
- The device should be handled carefully and lenses kept clean to avoid damage.
- Batteries may need recharging if not used for long periods and should be removed for storage.
- Various menu and display options are accessible through the control buttons for settings like brightness, palettes, and zoom.
- Proper installation and handling of batteries is described.
- Technical specifications for the detector, optics, display, power, and environmental compatibility are provided.
The document discusses various techniques used to measure intraocular pressure (IOP), including:
1) Digital tonometry which involves applying gentle pressure to the eyeball with a finger, though it is subjective.
2) Indentation tonometry like the Schiotz tonometer which measures corneal indentation from a known weight on a plunger, though readings require correction for ocular rigidity.
3) Applanation tonometry like the Goldmann tonometer which flattens a small corneal area to balance internal and external pressure, providing a more accurate IOP reading less influenced by ocular rigidity factors.
This document discusses general concepts of biomedical instrumentation and provides examples of direct and indirect measurement methods. It describes direct measurement using a clinical thermometer and indirect non-contact measurement using an infrared pyrometer. It also discusses direct measurement of intraocular pressure using a Goldmann applanation tonometer and indirect measurement using a non-contact air puff tonometer. Finally, it introduces a new direct measurement technique for intraocular pressure using a rebound tonometer that provides a more patient-friendly alternative.
The document discusses intraocular pressure (IOP) and methods of measuring IOP (tonometry). It defines IOP as the fluid pressure inside the eye and notes the normal range is 10.5-20.5 mmHg. Factors that can influence IOP include heredity, age, drugs, and blockage of aqueous circulation. Common tonometry methods are discussed - indentation tonometry uses a plunger like the Schiotz tonometer, while applanation tonometry is based on flattening the cornea and includes Goldmann, Perkins, and air puff tonometers. Accurate IOP measurement is important for evaluating glaucoma patients.
Manual de usuario ultrasonido focalizadoJorgeCobo11
The document provides instructions for operating a multi-dimensional ultrasonic instrument, detailing the various probe types, operation modes, and user interface. Precautions are outlined for safe use and proper care of the instrument and probes. Users are guided through setup, screen introduction, probe selection and replacement, treatment modes, and maintenance to optimize results from the multi-functional device.
Hướng dẫn sử dụng máy đo nhiệt độ Testo 610
https://testostore.vn/danh-muc/do-nhiet-do-do-am/
https://testostore.vn/san-pham/may-do-nhiet-do-testo-610/
This document provides an operations manual for different types of custom hearing instruments, including ITE (In-The-Ear), ITC (In-The-Canal), CIC (Completely-In-Canal), and IIC (Invisible-In-The-Canal) devices. It describes the features, controls, battery types, insertion and removal process, operation including on/off, volume control, programs, telephone use, care, maintenance and troubleshooting of these devices. The manual provides details to help users effectively use and care for their specific hearing instrument.
This document discusses various techniques for measuring intraocular pressure (IOP), including manometry, digital tonometry, Schiotz tonometry, Goldmann applanation tonometry, non-contact tonometry, and Pascal's dynamic contour tonometry. It provides details on the principles, procedures, advantages, and limitations of each technique. Goldmann applanation tonometry remains the gold standard method, though newer techniques like Pascal's dynamic contour tonometry may provide a more accurate measurement by reducing the influence of corneal biomechanical properties. An ideal tonometer would accurately measure IOP, be convenient and easy to use, and not be affected by factors like corneal thickness.
The instruction manual provides step-by-step instructions on how to use the Sendo blood pressure monitor, including how to take measurements, install batteries, store readings in memory, and basic troubleshooting. It also explains blood pressure fundamentals and maintenance of the monitor. The monitor has a 5 year guarantee on electrical components and 2 years on other parts.
1) The document provides instructions for use of the SENDO Primo aneroid sphygmomanometer kit for measuring blood pressure, including how to fit the cuff and stethoscope, take measurements, and understand blood pressure classifications.
2) Key steps to take a measurement involve placing the cuff on the upper arm and stethoscope over the brachial artery, inflating the cuff until 30 mmHg above normal blood pressure, and listening through the stethoscope as the cuff deflates to determine systolic and diastolic pressures.
3) The kit is guaranteed for 24 months against defects but not damage from misuse or repairs by unauthorized services.
This document discusses tonometry and different types of tonometers used to measure intraocular pressure (IOP). It describes indentation tonometers like the Schiotz tonometer which measures IOP based on corneal indentation. It also discusses applanation tonometers like the Goldmann tonometer which are considered the gold standard. The Goldmann tonometer uses the Imbert-Fick principle to measure IOP by applanating a fixed area of the cornea with a variable force. Factors affecting IOP measurements and proper use of the Goldmann tonometer are also outlined.
The document discusses various techniques for measuring intraocular pressure (IOP), including Goldmann applanation tonometry, Perkins tonometry, non-contact tonometry, and digital evaluation. Goldmann applanation tonometry is described as the most accurate method. The document provides details on properly using Goldmann tonometry, including preparing the patient, aligning the probe, applying the correct amount of force, and interpreting the results. Contraindications and sources of error are also reviewed.
Santamedical products offer clinically proven technology and are used by physicians and hospitals around the world. Compact, portable and simple-to-use, the Santamedical blood pressure monitor is an advanced wrist cuff monitor with advanced technology that automatically inflates to the appropriate level (no adjustments required) while reducing measurement time. This advanced capability adds convenience and ease of use to those with conditions (such as arrhythmia) that lead to fluctuating blood pressure. With ample memory, the Santamedical blood pressure monitor stores up to 60 blood pressure readings with date and time memory recall. Based on a wrist cuff design, the santamedical blood pressure monitor is especially helpful for users with above average arm sizes. Backed by a 1 year warranty, the santamedical blood pressure monitor ships with 2 aaa batteries included, and user manual. Specifications-large lcd size, 60 groups memory function; date and time function; automatically inflate; power: 2 AAA size alkaline batteries; automatic power-off function; measuring range: pressure: 30 mmhg-280 mmhg; pulse: 40 to 199 times/min; measuring accuracy: pressure: 3 mmhg; pulse: 4 percent of reading. For safety purpose, this device is also equipped with the function of emergency stop. This function can make users have the feeling of trust when operating this device, especially for elders.
The document provides details on test programs that can be run on ERBE ICC 50, ICC 80, and ICC BIPOLAR electrosurgical units, including programs to check components, calibrate outputs, and set user preferences. It also lists error codes that the units can display, providing explanations of possible issues and guidance on troubleshooting and resolving problems.
InfiRay Thermal E3 Max V2 Instruction Manual - Optics TradeOptics-Trade
This document provides instructions for operating an infrared thermal monocular device. It describes how to power on and off the device, enter standby mode, switch image modes, use digital and optical zoom, take photos and videos, track hot spots, use the laser pointer and rangefinder, access device settings and calibration modes, connect to WiFi, and charge the battery. The document also provides technical specifications for the device such as resolution, field of view, detection range, and battery life. Safety and operation notes are also included.
Similar to EMERGENCY MEDICINE UPDATE: TONOMETER DIATON SELECTED FOREMERGENCY DEPARTMENT (ED) / EMERGENCY ROOM (ER) (20)
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- 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
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
The Nervous and Chemical Regulation of Respiration
EMERGENCY MEDICINE UPDATE: TONOMETER DIATON SELECTED FOREMERGENCY DEPARTMENT (ED) / EMERGENCY ROOM (ER)
1. EMERGENCY MEDICINE UPDATE:
TONOMETER DIATON® SELECTED FOR
EMERGENCY DEPARTMENT (ED) / EMERGENCY ROOM (ER)
INTRAOCULAR PRESSURE (IOP) MEASUREMENT WITH DIATON® PEN
TONOMETER
INTRODUCTION:
DIATON® Tonometer Pen ( BiCOM Inc, USA) is Non-corneal, Non-contact, Transpalpebral
(through eyelid) handheld tonometer.
DIATON® PEN TONOMETER is a handheld, pen-shaped device used for measuring
intraocular pressures (IOP). The DIATON Pen tonometer calculates pressure by measuring the
response of a free-falling floater, as it rebounds against the tarsal plate of the eyelid and the
sclera.
The patient is positioned so that the tip of the device and lid are overlying sclera, in either sitting
or supine position.
Non-corneal and transpalpebral tonometry does not involve contact with the cornea and does not
require topical anesthetic during routine use. Contact lenses do not need to be taken out and
central corneal thickness (CCT) and other corneal properties do not influence the IOP
measurement.
In Emergency Department and Acute Care settings IOP measurement is indicated in cases of
acute eye injury, acute eye pain, red eye, and acute loss of visual acuity. Normal intraocular
pressure ranges between 10-20 mmHg.
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EQUIPMENT, SUPPLIES & MAINTENANCE:
To measure intraocular pressure with a DIATON® Tonometer Pen, the following equipment is
needed: a pen tonometer, alcohol swab – to wipe off the tip of the tonometer between patients.
NO need for topical anesthetic (either properacaine or tetracaine) or tip covers since the
measurement is taken over upper eyelid.
DIATON® Tonometer Pens are battery operated devices.
Tonometer will indicate “U” on the display if the battery is low. Batteries are button CR2032.
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The parts of the tonometer are: the stainless steel tip, the operation button, and an LCD display.
The operation button is used for turning the device ON and OFF and to obtain AVERAGE aget
measurements.
The LCD screen provides information about the sequence of readings, possible errors and tells
you the pressure reading.
CALIBRATION:
DIATON® Tonometer Pen comes with a carry case which includes Pressure Selector Testing
Device. To check for calibration, simply take the measurement on the Testing Plate. Results
should be within ±2mm of 20mm. LCD display will also indicate any other errors or if the
device needs to be cleaned.
Frequency of testing – once a day.
MEASURING IOP:
The patient should be relaxed and seated at the edge of the chair and reclining back, with head
titled back as horizontal as possible or lying down flat prior to beginning. Tight shirt collars
should be loosened. Patient should extend a thumb forward at appx 45º to center the eye. User
should guide the patients to be in the correct position.
Putting the rod into working position
The working position of the rod is its fixed inside the device (the rod is not seen in the tip
area).
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Fig. 1
If the rod is seen in the tip area, it's necessary to put it into working position.
Keep the tonometer vertically with its tip downwards, as it is shown in fig.1.
Fig. 2
Turn the tonometer with its tip upwards, as it is shown in fig. 2.
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The rod automatically falls inside the tonometer.
Fig. 3
Turn the tonometer with its tip downwards.
The rod is fixed inside the device, as it is shown in fig.3; it means that it is in the proper
working position.
Turning the tonometer ON
Fig. 4
Press momentarily the OPERATION button once.
"0000" symbol appears on the display as it is shown in fig. 4.
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If after turning ON the tonometer produces an interrupted sound signal it means that its body deviates
from vertical position. Move the device so it reaches the vertical position of the tonometer and the
sound signal will stop.
IOP measuring must be realized with the tonometer's position being strictly vertical!
To get the reliable results it is important to learn how to reach the vertical position of the
tonometer before starting IOP measurement in patients.
Practicing with the tonometer on the test plate
Fig. 5
The testing device is built in the tonometer's case (Fig.5). Its main assignment is checking the
tonometer's capacity for work before starting the operation and when necessary.
Use the testing device to easily find the vertical position and practice Test measurements.
Prepare the tonometer for work — the rod is in the working position, the tonometer is turned
ON.
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Fig. 6
Place the tonometer's tip in the indents of the testing device as it is shown in fig.6.
Reach the tonometer's vertical position when there's no interrupted sound signal.
Fig. 7
Fluently lower the tonometer's body down until the rod falls. The display must show the test
value from 18 to 22, as it is shown in fig.7. The checking is finished.
At other test values the tonometer is considered inoperative.
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During checking the tonometer's capacity for work keep it in the vertical position, there should
be no sound signal. If after the measurement the display shows L symbol it means that user took
the measurement while the device was beeping. It is necessary to put the rod into the working
position again and repeat the operation on the testing device.
Measuring of IOP
It is possible to measure IOP with the patient being in sitting or reclining position. Horizontal
position of the patient's head is required.
Disinfect the tip of the tonometer with alcohol swab according to the directions of the Operation
Manual.
Fig. 8a
Fig. 8b
If you are Right Handed - Stand at the LEFT hand side of the patient as it is shown in fig.8.
Put the rod into working position, turn the tonometer ON.
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Fig. 9
Place and fix the patient's glance using the test object (extend patients Thumb forward) the
patient's glance line being oriented approximately at the angle of 45° as it is shown in fig.9.
Fig. 10
Stretch the upper eyelid with a finger of a free hand so that the edge of the upper eyelid
coincides with the limb (fig.10). Keep the eyelid in this position.
Do not press the eyeball.
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Fig. 11
Place the edge of your palm with the tonometer on the patient's forehead. With the other hand
keep holding the eyelid in the necessary position (edge of the lid should be 1mm above the edge
of the limbus) (fig.11).
Place the tonometer's tip on the
eyelid in such a way that the front
part of the tip is as close to the front
edge of the upper eyelid as possible
without touching the eyelashes.
(fig.12, 13).
The influence zone of the tonometer's
rod must be the part of sclera
corresponding to сorona ciliaris in
12 o'clock meridian. Secure the
tonometer's vertical position (there's
no sound signal).
Fig. 12
Gently lower the tonometer's body
keeping its vertical position until the
rod falls on the eyelid which is
accompanied with the short sound
signal.
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Fig. 13
Do NOT let Eyelid slide onto the cornea during IOP measuring
IOP measurement is reliable only in sclera area!
The tonometer's display shows the number of a single IOP measurement
(fig.14), the digital result is recorded automatically in the tonometer's
memory.
Fig. 14
Fig. 15
Keeping the eyelid in the same position tilt the tonometer back and
forward so the rod in the working position and proceed with the
measurement series until you hear one long sound signal (or two long sound
signals). Press the OPERATION button and you'll get the digital IOP value
on the display (fig.15).
During carrying out the measuring series do not look aside the display showings!
You will see the IOP value only after finishing the measuring series and pressing the
OPERATION button.
Interpretation of the obtained IOP values
Display indication
Symbol "А" and IOP
value in nonflickering mode.
Result evaluation
The result is reliable
Notes
The IOP measuring of the eye
being studied is finished
Symbol "А" in a
The result should be considered as If necessary carry out the
flickering mode and approximate, but if IOP is equal or new series of IOP measuring
IOP value in a
less than 20 mm Hg it can be
strictly following the
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TONOMETER DIATON® SELECTED FOR
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flickering mode.
considered as reliable.
Symbol "А 00" in a
flickering mode.
The result is considered erroneous. Carry out the new series of
IOP measuring strictly
following the methodology.
methodology.
The tonometer is turned OFF by momentarily pressing of the OPERATION button, or it is
turned OFF automatically in 30 seconds.
Attention! If you keep the OPERATION button pressed for more than 3 seconds the tonometer
enters the auxiliary mode the auxiliary information being displayed. It is easy to be corrected;
the detailed information can be found in Part II of Operation Manual. (To get out of this mode:
Press and hold the ON button until the countdown starts 1-7, Release once you reach #7. )
Continue taking measurements on another eye.
Possible mistakes during IOP measuring
The most common mistakes
These are the most common mistakes during mastering the measuring methodology and lead to
significant underestimation of the tonometry results.
Incorrect!
The measurement is taken not on the sclera (but on
the limb or on the cornea).
Correct!
The edge of the upper eyelid coincides
with the limb
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13. EMERGENCY MEDICINE UPDATE:
TONOMETER DIATON® SELECTED FOR
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The situation can arise due the following reasons:
•
•
You did not coincide the patient's upper eyelid with the edge of the limb. The eyelid slightly
moved to the limb even before the measurement that's why the IOP measurement was realized
not in the sclera area but on the limb or on the cornea.
You did not fix the eyelid with the finger so during the measurement under the pressure of the
rod the eyelid moved to the cornea and the measurement was carried out not in the sclera
area.
Incorrect!
During the IOP measurement the tonometer's tip is
placed beyond the eyelid cartilage that is not close
to the ciliary edge but indented for 1 mm or more.
Correct!
The front part of the tip is close to the front
edge of the upper eyelid without touching
the eyelashes.
In this case the result underestimation is connected with the influence of the eyelid viscosity
because this influence increases significantly while moving further from the ciliary edge and
disfigures the tonometry results.
Please pay attention once again to the correct position of the eyelid and the tonometer's tipthis is the most important condition of receiving the reliable results!
Other mistakes
- nonhorizontal position of the patient's head
- the neck's squeeze with the collar
- the prolonged throwing the head back while there's the pathology of the
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Result
underestimation
Result overestimation
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spine's cervical section
Result overestimation
- non-vertical position of the tonometer
Result
underestimation
- the edge of the eyelid is above the corneal limb
- the eyelid's extrophy while pulling it strongly
Result
underestimation
Result
underestimation
More detailed information on IOP measuring methodology and the meaning of the displayed
symbols you can find in the Operation Manual and in the Training Video at:
http://tonometerdiaton.com/index.php?do=home.training
SUMMARY
DIATON® Tonometer Pen ( BiCOM Inc, USA) transpalpebral (through the eyelid, non-corneal)
tonometry is an easy, quick and accurate way of measuring intraocular pressures (IOP) in
patients presenting with acute eye problems. By becoming proficient with this skill, important
information can be obtained which may aid in the appropriate triage and management of these
challenging eye patients.
More information about Diaton tonometer can be obtained here:
http://www.TonometerDiaton.com
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