The document discusses the impact of COVID-19 on patients with endocrine diseases. It notes that people with diabetes are at high risk of serious illness if infected with COVID-19. Other conditions like obesity, malnutrition, and adrenal insufficiency may also be negatively impacted. It provides recommendations for people with diabetes to prevent infection and guidelines on what to do if infected, including maintaining good glycemic control and contacting healthcare providers. The document also discusses potential increased risks for those with severe obesity or undernourishment from COVID-19 infection.
#Covid19: Information guide for general Public.MADHUR VERMA
We have talked about the measures that have to be taken by the general public during the lockdown and what are the dos and don'ts during this pandemic. Also, we have talked about various bits and facts related to Coronavirus Disease.
Clinical Research Centre (CRC) Hospital Kuala Lumpur (HKL) just released their new e-newsletter. This edition focused on COVID-19 experiences by health care providers.
#Covid19: Information guide for general Public.MADHUR VERMA
We have talked about the measures that have to be taken by the general public during the lockdown and what are the dos and don'ts during this pandemic. Also, we have talked about various bits and facts related to Coronavirus Disease.
Clinical Research Centre (CRC) Hospital Kuala Lumpur (HKL) just released their new e-newsletter. This edition focused on COVID-19 experiences by health care providers.
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
This presentation showed the impact and the challenges of facing COVID-19 Pandemic and how the world becomes morbid, while the healthcare workforce tries to flatten the "curve".
Hello, this presentation is put together to gain general insight about the coronavirus disease (Covid-19) spread across the globe with graphical images, texts and information.
A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat. Most coronaviruses aren't dangerous.
In early 2020, after a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. The outbreak quickly spread around the world.
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
The Importance of Asymptomatic Coronavirus Disease-19 Patients: Never Trust a...asclepiuspdfs
The asymptomatic infectious case is a “silent client,” one of the most complex and damaging types of client: It is someone who does not provide information; of which we have no information. The silent client, as in the asymptomatic infection, can undermine the business by apparently not being able to address the problem. So how do you manage silent clients, asymptomatic cases? Identifying the points where asymptomatic (silent) cases occur and addressing the situation from a comprehensive perspective. This includes: (1) Preventing contagion and interrupting the transmission process immediately after contact with the virus: Test system, trace, and public health measures: Polymerase chain reaction testing on as many people as possible who have been in contact with infected people which allows the isolation of infected and the tracking and quarantine of their contacts; (2) universal public health measures: Wear a mask in public, wash your hands regularly, stay home when sick, keep a physical distance, and avoid meeting people outside of your home; (3) being so strict with negative cases as with positive ones: The consequences of high rates of false negatives are serious because they allow asymptomatic – and symptomatic – people to transmit diseases; follow-up is recommended, from a clinical point of view – epidemiological, as strict to negative cases as to positive ones; (4) trace back the contacts of the positive cases: search the source of a new case, together with the contacts of that person; and (5) massive and opportunistic tests for the detection of general and specific populations: Rapid response tests for coronavirus disease-19 available to everyone, especially those without symptoms, carried out as mass population screening, to certain groups such as health workers and students, as detection opportunistic in the general practitioner’s consultation, and even self-administered by anyone.
Covid-19 Pandemic, where are we now? Latest update on Covid-19 Second Wave 20...Shivam Parmar
Disclaimer -
The Content belongs to WHO (World Health Organisation). Sharing here is just to spread awareness about Covid-19.
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update51_pandemic_overview_where_are_we_now.pdf?sfvrsn=709278aa_5
A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention o...ijtsrd
Objective To assess the knowledge, attitude and practice toward coronavirus disease COVID 19 Background The World Health Organization declared COVID 19 as a pandemic on the 11th of March 2020 and declared as a global health emergency. Since then, many efforts are being carried out to control the rapid spread of the ongoing COVID 19 epidemic in India. The control measures COVID 19 is affected by their knowledge, attitudes, and practices KAP towards COVID 19. Knowledge attitude and practice of people should be directed towards strict preventive practices in order to prevents the spread of the virus. Materials and Methods The aim of the current electronic cross sectional study is to assess the knowledge, attitude and practice among selected rural community. Structured questionnaire was created in the google forms, the link was generated and distributed among the people though email and other media to participate in the survey. A total 153 subject was enrolled through convenient sampling technique. Collected data was analysed using descriptive statistics including frequency, percentage, mean and standard deviation. Results Majority of participant 91.50 were having the adequate information regarding the covid 19 and most of participants, 52.28 were got the information from multimedia included television, radio and newspaper regarding COVID 19. About 52.28 participants were the aware about the online training program by the government .Among 153 participants, 115 had adequate knowledge, 23 had moderately adequate and 15 had inadequate knowledge. Most 75.16 of the participants had adequate knowledge, in 15.03 moderately adequate and in 9.80 inadequate knowledge found regarding prevention of COVID 19. The mean knowledge score was 15.54 with standard deviation of 2.93. Most of the 102 66.66 had most favourable attitude, 31 20.26 had favourable and 20 13.07 had unfavourable attitude . The mean attitude score was 34.76 with standard deviation of 2.86.Majority of the participants, 129 had good practice, 20 had average practice and 4 had bad practice . Most 84.31 of the participants had good practice, in 13.07 average practice and in 2.61 bad practice found regarding prevention of COVID 19. The mean practice score was 25.2 with standard deviation of 2.56. Lalan Kumar "A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention of Novel Coronavirus (COVID-19): An Electronic Cross-Sectional Survey among Selected Rural Community" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30657.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30657/a-study-to-assess-the-knowledge-attitude-and-practice-regarding-prevention-of-novel-coronavirus-covid19-an-electronic-crosssectional-survey-among-selected-rural-community/lalan-kumar
It's up to People and Governments, to reduce pandemic mortality by 50-60%! We have kea against pandemic and its Knowledge, that Oxidative Stress is in charge of more than half deaths! Please, show this file to your Health Minister and Premier Minister. You can start fight against pandemic with NEW, cheap and affordable weapon.
Investing in prevention will not only enhance quality of life (and lifespan), but also reduce national healthcare costs, which remove hundreds of euros from each citizen’s pocket every year. In recent years, prevention is increasingly gaining a priority status: with increases in life expectancy and the development of the so-called “diseases of affluence” (including obesity), the costs for national healthcare represent an increasing burden on the population. In Italy, over 40 billion euros are spent each year for the treatment of cardiovascular disease, diabetes and cancer: nearly 700 euros per capita.
Covid-19 is a disease caused by SARS-CoV-2 that can trigger what doctors call a respiratory tract infection. It can affect the upper respiratory tract, viz. sinuses, nose, and throat or lower respiratory tract, viz. windpipe, and lungs. Severe cases can lead to serious respiratory disease, and even pneumonia.
On January 30, 2020, the WHO declared the Covid-19 outbreak a global health emergency. On March 11, 2020, the WHO declared it a global pandemic.
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
This presentation showed the impact and the challenges of facing COVID-19 Pandemic and how the world becomes morbid, while the healthcare workforce tries to flatten the "curve".
Hello, this presentation is put together to gain general insight about the coronavirus disease (Covid-19) spread across the globe with graphical images, texts and information.
A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat. Most coronaviruses aren't dangerous.
In early 2020, after a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. The outbreak quickly spread around the world.
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
The Importance of Asymptomatic Coronavirus Disease-19 Patients: Never Trust a...asclepiuspdfs
The asymptomatic infectious case is a “silent client,” one of the most complex and damaging types of client: It is someone who does not provide information; of which we have no information. The silent client, as in the asymptomatic infection, can undermine the business by apparently not being able to address the problem. So how do you manage silent clients, asymptomatic cases? Identifying the points where asymptomatic (silent) cases occur and addressing the situation from a comprehensive perspective. This includes: (1) Preventing contagion and interrupting the transmission process immediately after contact with the virus: Test system, trace, and public health measures: Polymerase chain reaction testing on as many people as possible who have been in contact with infected people which allows the isolation of infected and the tracking and quarantine of their contacts; (2) universal public health measures: Wear a mask in public, wash your hands regularly, stay home when sick, keep a physical distance, and avoid meeting people outside of your home; (3) being so strict with negative cases as with positive ones: The consequences of high rates of false negatives are serious because they allow asymptomatic – and symptomatic – people to transmit diseases; follow-up is recommended, from a clinical point of view – epidemiological, as strict to negative cases as to positive ones; (4) trace back the contacts of the positive cases: search the source of a new case, together with the contacts of that person; and (5) massive and opportunistic tests for the detection of general and specific populations: Rapid response tests for coronavirus disease-19 available to everyone, especially those without symptoms, carried out as mass population screening, to certain groups such as health workers and students, as detection opportunistic in the general practitioner’s consultation, and even self-administered by anyone.
Covid-19 Pandemic, where are we now? Latest update on Covid-19 Second Wave 20...Shivam Parmar
Disclaimer -
The Content belongs to WHO (World Health Organisation). Sharing here is just to spread awareness about Covid-19.
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update51_pandemic_overview_where_are_we_now.pdf?sfvrsn=709278aa_5
A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention o...ijtsrd
Objective To assess the knowledge, attitude and practice toward coronavirus disease COVID 19 Background The World Health Organization declared COVID 19 as a pandemic on the 11th of March 2020 and declared as a global health emergency. Since then, many efforts are being carried out to control the rapid spread of the ongoing COVID 19 epidemic in India. The control measures COVID 19 is affected by their knowledge, attitudes, and practices KAP towards COVID 19. Knowledge attitude and practice of people should be directed towards strict preventive practices in order to prevents the spread of the virus. Materials and Methods The aim of the current electronic cross sectional study is to assess the knowledge, attitude and practice among selected rural community. Structured questionnaire was created in the google forms, the link was generated and distributed among the people though email and other media to participate in the survey. A total 153 subject was enrolled through convenient sampling technique. Collected data was analysed using descriptive statistics including frequency, percentage, mean and standard deviation. Results Majority of participant 91.50 were having the adequate information regarding the covid 19 and most of participants, 52.28 were got the information from multimedia included television, radio and newspaper regarding COVID 19. About 52.28 participants were the aware about the online training program by the government .Among 153 participants, 115 had adequate knowledge, 23 had moderately adequate and 15 had inadequate knowledge. Most 75.16 of the participants had adequate knowledge, in 15.03 moderately adequate and in 9.80 inadequate knowledge found regarding prevention of COVID 19. The mean knowledge score was 15.54 with standard deviation of 2.93. Most of the 102 66.66 had most favourable attitude, 31 20.26 had favourable and 20 13.07 had unfavourable attitude . The mean attitude score was 34.76 with standard deviation of 2.86.Majority of the participants, 129 had good practice, 20 had average practice and 4 had bad practice . Most 84.31 of the participants had good practice, in 13.07 average practice and in 2.61 bad practice found regarding prevention of COVID 19. The mean practice score was 25.2 with standard deviation of 2.56. Lalan Kumar "A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention of Novel Coronavirus (COVID-19): An Electronic Cross-Sectional Survey among Selected Rural Community" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30657.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30657/a-study-to-assess-the-knowledge-attitude-and-practice-regarding-prevention-of-novel-coronavirus-covid19-an-electronic-crosssectional-survey-among-selected-rural-community/lalan-kumar
It's up to People and Governments, to reduce pandemic mortality by 50-60%! We have kea against pandemic and its Knowledge, that Oxidative Stress is in charge of more than half deaths! Please, show this file to your Health Minister and Premier Minister. You can start fight against pandemic with NEW, cheap and affordable weapon.
Investing in prevention will not only enhance quality of life (and lifespan), but also reduce national healthcare costs, which remove hundreds of euros from each citizen’s pocket every year. In recent years, prevention is increasingly gaining a priority status: with increases in life expectancy and the development of the so-called “diseases of affluence” (including obesity), the costs for national healthcare represent an increasing burden on the population. In Italy, over 40 billion euros are spent each year for the treatment of cardiovascular disease, diabetes and cancer: nearly 700 euros per capita.
Covid-19 is a disease caused by SARS-CoV-2 that can trigger what doctors call a respiratory tract infection. It can affect the upper respiratory tract, viz. sinuses, nose, and throat or lower respiratory tract, viz. windpipe, and lungs. Severe cases can lead to serious respiratory disease, and even pneumonia.
On January 30, 2020, the WHO declared the Covid-19 outbreak a global health emergency. On March 11, 2020, the WHO declared it a global pandemic.
https://www.biomedscidirect.com/2829/an-overview-of-coronavirus-disease-covid-19?utm=articles
An overview of coronavirus disease (covid-19)
Authors:Emy Jancy Rani J.
Int J Biol Med Res. 2023; 14(4): 7687-7691 | Abstract | PDF File
Covid-19: Summary Recommendations - Brazilian Medical Association (AMB)
Authors: S. E. TANNI, H.A. BACHA, C. E. FERNANDES, J. E. L. DOLCI, A.N. BARBOSA, W. BERNARDO
Publication date: 2021
Journal: World Medical Journal
ISSN: 2256-0580
Volume: 2
Pages: 37-52
Publisher
World Medical Association
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Rizah Mazzuin Razali, the head of Geriatric Unit and Internal Medicine Physician working in Kuala Lumpur Hospital, Ministry of Health Malaysia.
Similar to endocrinediseasesas COVID - Dr. Freddy Flores Malpartida (20)
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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
2. COVID-19 infection and diabetes mellitus
Increased risk of morbidity and mortality in patients
with diabetes regarding COVID-19 infection
Older adults and those with serious chronic medical con-
ditions like heart disease, lung disease, and diabetes are at
the highest risk for complications from COVID-19 infec-
tion. Chronic hyperglycemia negatively affects immune
function and increases the risk of morbidity and mortality
due to any infection and is associated to organic compli-
cations. This is also the case for COVID-19 infection [1].
During the Influenza A (H1N1) pandemic, the presence of
diabetes tripled the risk of hospitalization and quadrupled
the risk of ICU admission once hospitalized. Among
COVID-19 mortality cases in Wuhan, China, major asso-
ciated comorbidities included hypertension (53.8%), dia-
betes (42.3%), previous heart disease (19.2%), and cerebral
infarction (15.4%) [2]. In addition, as for seasonal influenza,
new data regarding COVID-19 indicate that the infection
potentiates myocardial damage and identifies underlying
heart disorders as a new risk factor for severe complications
and worsening of prognosis [3].
Among the confirmed COVID-19 cases in China by Feb
11, 2020, the overall mortality reported is 2.3% [4]. This
data refers mostly to hospitalized patients [4, 5]. Among
persons with no underlying medical conditions, the reported
mortality in China is 0.9%.
There is a lack of data regarding the number of non-
symptomatic cases, as in most countries universal micro-
biological screening has not been performed. It is presumed
that the prevalence of the infection is probably high or very
high in the community, thus leading to an overestimation of
the prevalence of case fatality. However, mortality is
strongly increased with the presence of comorbid diseases,
including previous cardiovascular disease (10.5%), diabetes
(7.3%), chronic respiratory disease, hypertension, and can-
cer, each at 6%. Among 60-year-old people and older,
mortality has been reported to be 14.8% in those >80 years,
8% for those between 70 and 79 years and 3.6% in the
group of 60–69 years. Compared with non-ICU patients,
critically ill patients are older (median age 66 vs. 51 years)
and have more previous comorbidities (72% vs. 37%) [6].
Worldwide mortality rates may vary by region, but this
information is not yet consistently available and compar-
able, as public health policies applied and health registers
used in every region of the world are not homogeneous.
What people with diabetes should do to prevent
infection by COVID-19
Social distancing as well as home confinement of the whole
population are now widely adopted in many countries in
Europe and worldwide as measures hopefully effective in
contrast to the spread of infection. We recommend that due to
the increased dangers of developing COVID-19, persons with
diabetes should strictly adhere to these preventive measures
and adopt them also within their homes in order to avoid
being in contact with their relatives. Therefore, under these
circumstances, it is recommended that people with diabetes
try to plan ahead of time what to do in case they get ill. It is
important to maintain a good glycemic control, because it
might help reduce the risk of infection itself and may also
modulate the severity of the clinical expression of the disease.
Contact with healthcare providers, such as endocrinologists
in the case of type 1 diabetes, and including also internal
medicine specialists and general practitioners for type 2 dia-
betes patients may be advisable. However, routine appoint-
ments in person are not recommended for people with
diabetes, as they should avoid crowds (waiting rooms).
Therefore, we recommend phone calls, video calls, and emails
as the main way for patients to keep in touch with their
healthcare provider team, in order to guarantee an optimal
control of the disease. Moreover, it is advised to ensure
adequate stock of medications and supplies for monitoring
blood glucose during the period of home confinement.
What people with diabetes should do if they are
infected by COVID-19
People with diabetes who are infected with COVID-19 may
experience a deterioration of glycemic control during the
illness, like in any other infectious episodes. Implementa-
tion of “Sick day rules” is therefore mandatory to overcome
potential diabetes decompensation. Contacting the health-
care provider team by telephone, email, or videoconference
is also mandatory in case of possible symptoms of COVID-
19 infection in order to seek advice concerning the mea-
sures to avoid risk of deterioration of diabetes control or the
possibility to be referred to another specialist (pneumologist
or infectious disease doctor) or in the Emergency Services
of the referral hospital to avoid the most serious systemic
complication of the viral infection itself.
COVID-19 and other endocrine and
metabolic disorders
Obesity
There is a general lack of data regarding the impact of
COVID -19 in people suffering from obesity. However, as
for what is currently being the experience in some hospitals
in Spain, cases of young people in which severe obesity is
present may evolve toward destructive alveolitis with
respiratory failure and death (Puig-Domingo M, personal
Endocrine
3. experience). There is no current explanation for this clinical
presentation, although it is well known that severe obesity is
associated to sleep-apnea syndrome, as well as to surfactant
dysfunction, which may contribute to a worse scenario in
the case of COVID-19 infection. Also, deterioration of
glycemic control is associated with an impairment of ven-
tilatory function and thus may contribute to a worse prog-
nosis in these patients. In addition, type 2 diabetes and
obesity may concur in a given patient, which typically is
also frequently accompanied by an age >65. In summary,
these patients may be at a higher risk of impaired outcomes
in the case of COVID-19 infection.
Undernourishment
Regarding undernourished subjects, COVID-19 infection is
associated to a high risk of malnutrition development,
mostly related to increased requirements and the presence of
a severe acute inflammatory status. These patients show
also a hyporexic state, thus contributing to a negative
nutritional balance. Estimated nutritional requirements are
25–30 kcal/kg of weight and 1.5 g protein/kg/day [7]. A
nutrient dense diet is recommended in hospitalized cases
including high protein supplements (2–3 intakes per day)
containing at least 18 g of protein per intake. Adequate
supplementation of vitamin D is recommended particularly
in areas with large known prevalence of hypovitaminosis D
and due to the decreased sun exposure [8, 9]. If nutritional
requirements are not met, complementary or complete ent-
eral feeding may be required, and in case that enteral
feeding may not be possible due to inadequate gastro-
intestinal tolerance, the patient should be put on parenteral
nutrition. COVID-19 patients’ outcome is expected to
improve with nutritional support [10].
Adrenal insufficiency
Adrenal insufficiency is a chronic condition of lack of
cortisol production. Live-long replacement treatment aim-
ing to mimic physiologic plasma cortisol concentrations is
not easy for these patients.
Based on current data, there is no evidence that patients
with adrenal insufficiency are at increased risk of con-
tracting COVID-19. However, it is known that patients with
Addison’s disease (primary adrenal insufficiency) and
congenital adrenal hyperplasia have a slightly increased
overall risk of catching infections. Moreover, primary
adrenal insufficiency is associated to an impaired natural
immunity function with a defective action of neutrophils
and natural killer cells [11]. This may explain, in part, this
slightly increased rate of infectious diseases in these
patients, as well as an overall increased mortality. This latter
could also be accounted by an insufficient compensatory
increase of the hydrocortisone dosage at the time of the
beginning of an episode of infection. For all these reasons,
patients with adrenal insufficiency may be at higher risk of
medical complications and eventually at increased mortality
risk in the case of COVID-19 infection. So far, there are no
reported data on the outcomes of COVID-19 infection in
adrenal insufficient subjects.
In the case of suspicion of COVID-19, a prompt mod-
ification of the replacement treatment as indicated for the
“Sick days” should be established when minor symptoms
appear. This means in the first instance to at least double the
usual doses of glucocorticoid replacement, to avoid adrenal
crisis. In addition, patients are also recommended to have
sufficient stock at home of steroid pills and injections in order
to maintain the social confinement that is required in most of
the countries for impeding the COVID-19 outbreak spread.
Actions to be taken if infection by COVID-19
is suspected
If a person with endocrine and metabolic diseases has fever
with cough or trouble breathing and may have been exposed
to COVID-19 (if living in or visited a country affected in
the 14 days before getting sick, or if having been around a
person who may have had the virus), a call to the physician
or nurse for advice should be made. Some countries have
set up COVID-19 phone lines for the public. The personnel
in charge of these phone lines will prioritize arrangements,
if needed, regarding what should be the next step in the
healthcare protocol. If the person is advised to go to the
hospital, it is recommended to put on a face mask. In
countries with explosive outbreak, most of the people have
already bought a face mask by their own initiative. Fluid
samples taken from the nose or throat will be used for
microbiologic diagnosis. There is currently no specific
treatment for COVID-19, but since the majority of cases are
mild, only a limited amount of people will require hospi-
talization for supportive care. However, in most of the
countries in which the outbreak has been declared and
recognized, particularly in China, the Northern regions of
Italy, Iran, and Spain, the situation has been very challen-
ging and the requirement of hospitalization has led national
health systems to the limit of their capacities [12].
What to do in case of confinement at home?
Individuals and families affected or suspected to be affected
by COVID-19 that stay at home should follow proper
measures for infection prevention and control. Management
should focus on prevention of transmission to others and
monitoring for clinical deterioration, which may prompt
Endocrine
4. hospitalization. Affected persons should be placed in a well-
ventilated single room, while household members should
stay in a different room or, if that is not possible, maintain a
distance of at least one meter from the person affected (e.g.,
sleep in a separate bed) and perform hand hygiene (washing
hands with soap and water) after any type of contact with
the affected person or their immediate environment. When
washing hands, it is preferable to use disposable paper
towels to dry them. If these are not available, clean cloth
towels should be used and replaced when wet. To contain
respiratory secretions, a medical mask should be provided
to the person affected and worn as much as possible.
Individuals who cannot tolerate a medical mask should use
rigorous respiratory hygiene—i.e., the mouth and nose
should be covered with a disposable paper tissue when
coughing or sneezing. Caregivers should also wear a tightly
fitted medical mask that cover their mouth and nose when in
the same room is present the person affected.
Conclusions
An ESE “decalog” for endocrinologists in the COVID-
19 pandemic
1. Adequately protect yourself and ask for COVID-19
testing if exposed.
2. Avoid unnecessary routine appointments in person.
3. Put in place online/email/phone consultation services.
4. Closely monitor glycemic control in patients with
diabetes.
5. Recommend to persons with diabetes a strict adher-
ence to general preventive measures.
6. Counsel persons with diabetes about specific mea-
sures related to their disease management (sick day
rules) in case of infection by COVID-19.
7. Counsel persons with diabetes particularly if aged
over 65 and obese about referrals for management in
case of suspected infection by COVID-19.
8. Avoid undernourishment with dietary or adjunctive
measures if clinically indicated.
9. Closely monitor clinical conditions of patients with
adrenal insufficiency.
10. Adapt increased replacement treatment if clinically
indicated in patients with adrenal insufficiency.
Compliance with ethical standards
Conflict of interest The authors declare that they have no conflict of
interest.
Publisher’s note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.
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