Dermal fillers can help restore volume and fullness to the skin. Learn what happens in this cosmetic procedure as The Victorian Cosmetic Institute gives an overview on facial volume loss and dermal fillers.
Presentation I developed for one of my seminars on the Luxury Cruise Liner. I focused on reasons why one should get such procedures done. The upper management and Dr. Herman thought this was a brilliant seminar. It also cross-promoted other of the Spa\'s services.
Training for periorbital and upper face treatment with botox and JuvedermDokter Frodo Gaymans
Training for periorbital and upper face treatment with botox and Juvederm
Training for experienced injectors.
no rights may be derived from this training
The Art of Liquid Face Lift (Dermal Fillers)Osama Moawad
Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of rhytides or scars as a result of the injection of a dermal filler The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety. Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and autologous fat (one's own fat) among others. Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever. With the increasing desire for people to achieve a more youthful appearance, the aging baby boomer population, and the increased demand for "lunch-time procedures," the pharmaceutical market has responded by providing the cosmetic surgeon with an increasing number of options to meet the demands of the cosmetic patient.
RADIESSE® — For Volume and Contours
The treatment of individual wrinkles is often not enough to restore a youthful and fresh appearance. In order to counter the effects of gravity and regain a younger shape, the face needs real volume. This can be achieved with a dermal filler which also re-stimulates natural collagen production for effective and lasting volume.
Thanks to a special gel-matrix, Radiesse® volumising filler creates immediately visible results. With its fine calcium microspheres Radiesse® volumising filler stimulates the body's natural collagen formation to create long-lasting volume. The gel itself, as well as the microspheres, are completely broken down by the body over time.
Radiesse® volumising filler puts volume back exactly where it was. With gentle volumising deeper wrinkles and hollow or sagging cheeks disappear, and the natural facial contours return.
Dual effect volume formation
Immediate effect due to elastic gel-matrix
Long-acting effect thanks to collagen stimulation
Safe to use
Comprehensive clinical studies confirm effectiveness and tolerance
Ask your doctor what Radiesse® volumising filler can do for you
Presentation I developed for one of my seminars on the Luxury Cruise Liner. I focused on reasons why one should get such procedures done. The upper management and Dr. Herman thought this was a brilliant seminar. It also cross-promoted other of the Spa\'s services.
Training for periorbital and upper face treatment with botox and JuvedermDokter Frodo Gaymans
Training for periorbital and upper face treatment with botox and Juvederm
Training for experienced injectors.
no rights may be derived from this training
The Art of Liquid Face Lift (Dermal Fillers)Osama Moawad
Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of rhytides or scars as a result of the injection of a dermal filler The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety. Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and autologous fat (one's own fat) among others. Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever. With the increasing desire for people to achieve a more youthful appearance, the aging baby boomer population, and the increased demand for "lunch-time procedures," the pharmaceutical market has responded by providing the cosmetic surgeon with an increasing number of options to meet the demands of the cosmetic patient.
RADIESSE® — For Volume and Contours
The treatment of individual wrinkles is often not enough to restore a youthful and fresh appearance. In order to counter the effects of gravity and regain a younger shape, the face needs real volume. This can be achieved with a dermal filler which also re-stimulates natural collagen production for effective and lasting volume.
Thanks to a special gel-matrix, Radiesse® volumising filler creates immediately visible results. With its fine calcium microspheres Radiesse® volumising filler stimulates the body's natural collagen formation to create long-lasting volume. The gel itself, as well as the microspheres, are completely broken down by the body over time.
Radiesse® volumising filler puts volume back exactly where it was. With gentle volumising deeper wrinkles and hollow or sagging cheeks disappear, and the natural facial contours return.
Dual effect volume formation
Immediate effect due to elastic gel-matrix
Long-acting effect thanks to collagen stimulation
Safe to use
Comprehensive clinical studies confirm effectiveness and tolerance
Ask your doctor what Radiesse® volumising filler can do for you
Dermal fillers are an excellent choice for minimizing wrinkles and restoring youthful fullness to the face. However, with all the different options available, choosing the right dermal filler can be overwhelming. To help you find the right dermal filler for you Images Med Spa has created a guide to help you through your decision.
Lecture by Dr. Patrick J. Treacy to Las Vegas Cosmetic Conference 2011 about his experiences and preferences with different European Botox and Dermal Fillers
The face, compared to any other body feature, is the reflection of personality. The appearance of the face and the associated expressions are analyzed for making judgements about an individual. Face is also the portion which showcases the initial signs of aging. Unfortunately, our cosmetic age largely differs from our physical age. Several factors can contribute to this unwanted aged appearance. They include prolonged exposure to sun's radiation, repeated facial expressions, delicate nature of the facial skin etc. This situation necessitates a procedure that can regain the youth of the face.
Whether you are a doctor or a medical researcher, details regarding the face anatomy can help you explain your patients about the latest surgeries and medical actions that are taking place. Further, using excellent Face anatomy PowerPoint Templates can instantly easy your effort and make the overall explanation process instant. More information: http://www.medicalppttemplates.com/medical-ppt-templates.aspx/Face-Anatomy-173
Reversal of a HLA dermal filler induced facial artery occlusionDr. Patrick J. Treacy
Please note there is a correction in the reversal procedure and adrenaline should not be used during an acute ischaemic event.
(1) Discontinue injection of HLA immediately
(2) Massage the affected area immediately
(3) Apply warm packs of gauze to area (microwave)
(4) Apply nitro-paste or 10mgs transderm-nitro patches (Novartis) for up to 12 hours
(5) Mix 300 units of hyalase (0.2mls) with 0.2mls (Wockhardt UK) of 2% lidocaine (Astra Zeneca)
(6) Inject hyalase in 5–6 lots of 75u to occluded area with caution to possible side effects (7) Hydrocortisone 100 mg IV stat if potential embolic signs and reticular formation happens the next day
(8) Dexamethasone 4mgs daily for three days f potential embolic signs and reticular formation happens the next day
Lignocaine with adrenaline is NOT to be used during an acute ischaemic event
Lignocaine with adrenaline is NOT to be used during an acute ischaemic event
ABSTRACT: Soft tissue augmentation with dermal fillers has become an integral part of most aesthetic practices. Fortunately, adverse reactions are usually mild and transient. However, significant adverse events such as vascular occlusion also occur. Vascular compromise occurs because of embolisation and or compression material into onto the vasculature. In this article, the author theorises that late onset vascular occlusion may occur not only due to embolisation but because hyaluronic acid (HA) expands due to its hydrophilic action and compresses the facial artery or its branches. He proposes that intravenous steroids should be added to the accepted reversal protocol. His goal is not to promote this as a definitive measure but rather to establish a discussion on treatment protocols that may be helpful to other physicians in the future.
How to Get Rid of Forehead Acne PermanentlySara Taylor
Discover How to Get Rid of Forehead Acne Naturally. This post will totally define you a complete homemade treatment of your forehead acne skin. To view complete review Ridblemishes.com
Discover how you can instantly prevent acne flare-ups with natural remediesAffiliate
Nonacne is a product supporting acne skin. Product ingredients help eliminate acne and prevent its reappearance. Taking this supplement regularly leads to a beautiful and smooth skin.
The product is very popular with teenagers and adults who also have to face the problem of acne.
If you run a website dedicated to acne or targeted at teenagers, Nonacne can be the perfect way to monetize this traffic. Do not hesitate and publish Nonacne promotional materials on your website today!
Discover how you can instantly prevent acne flare-ups with natural remediesAffiliate
Nonacne is a product supporting acne skin. Product ingredients help eliminate acne and prevent its reappearance. Taking this supplement regularly leads to a beautiful and smooth skin.
The product is very popular with teenagers and adults who also have to face the problem of acne.
If you run a website dedicated to acne or targeted at teenagers, Nonacne can be the perfect way to monetize this traffic. Do not hesitate and publish Nonacne promotional materials on your website today!
Dr. Catrise Austin is an expert New York Cosmetic Dentist. In 1908, she opened an office under the banner "VIP Smiles", a modern dental practice that boasts an impressive loyal following, including some of the warmest smiles in the entertainment industry.
5 Steps To Regain Your Confidence - Courage and WisdomJenni Proctor
Making the decision to change your career requires courage, and making a smooth change requires wisdom, clarity and strategy. Anyone who chooses to change their career will face challenges, and this does not get easier with age. As we face the challenges our confidence can be eroded, bit by bit or through some nasty incident.
You’ve watched the countless late-night infomercials promising you the instant cure to your acne troubles.
the before and after photos showcasing the shocking results of those who have taken a leap of faith and handed over their credit card number for yet another shot at successfully eliminating acne from their lives forever. The problem is, you’ve tried all of those remedies, instant “cures”, solutions, treatments and creams. You
have been through the ringer having spent a small fortune on acne medications only to find yourself confused and frustrated as to why you have been unable to experience the same results that everyone else claims to have.
Dermal fillers are an excellent choice for minimizing wrinkles and restoring youthful fullness to the face. However, with all the different options available, choosing the right dermal filler can be overwhelming. To help you find the right dermal filler for you Images Med Spa has created a guide to help you through your decision.
Lecture by Dr. Patrick J. Treacy to Las Vegas Cosmetic Conference 2011 about his experiences and preferences with different European Botox and Dermal Fillers
The face, compared to any other body feature, is the reflection of personality. The appearance of the face and the associated expressions are analyzed for making judgements about an individual. Face is also the portion which showcases the initial signs of aging. Unfortunately, our cosmetic age largely differs from our physical age. Several factors can contribute to this unwanted aged appearance. They include prolonged exposure to sun's radiation, repeated facial expressions, delicate nature of the facial skin etc. This situation necessitates a procedure that can regain the youth of the face.
Whether you are a doctor or a medical researcher, details regarding the face anatomy can help you explain your patients about the latest surgeries and medical actions that are taking place. Further, using excellent Face anatomy PowerPoint Templates can instantly easy your effort and make the overall explanation process instant. More information: http://www.medicalppttemplates.com/medical-ppt-templates.aspx/Face-Anatomy-173
Reversal of a HLA dermal filler induced facial artery occlusionDr. Patrick J. Treacy
Please note there is a correction in the reversal procedure and adrenaline should not be used during an acute ischaemic event.
(1) Discontinue injection of HLA immediately
(2) Massage the affected area immediately
(3) Apply warm packs of gauze to area (microwave)
(4) Apply nitro-paste or 10mgs transderm-nitro patches (Novartis) for up to 12 hours
(5) Mix 300 units of hyalase (0.2mls) with 0.2mls (Wockhardt UK) of 2% lidocaine (Astra Zeneca)
(6) Inject hyalase in 5–6 lots of 75u to occluded area with caution to possible side effects (7) Hydrocortisone 100 mg IV stat if potential embolic signs and reticular formation happens the next day
(8) Dexamethasone 4mgs daily for three days f potential embolic signs and reticular formation happens the next day
Lignocaine with adrenaline is NOT to be used during an acute ischaemic event
Lignocaine with adrenaline is NOT to be used during an acute ischaemic event
ABSTRACT: Soft tissue augmentation with dermal fillers has become an integral part of most aesthetic practices. Fortunately, adverse reactions are usually mild and transient. However, significant adverse events such as vascular occlusion also occur. Vascular compromise occurs because of embolisation and or compression material into onto the vasculature. In this article, the author theorises that late onset vascular occlusion may occur not only due to embolisation but because hyaluronic acid (HA) expands due to its hydrophilic action and compresses the facial artery or its branches. He proposes that intravenous steroids should be added to the accepted reversal protocol. His goal is not to promote this as a definitive measure but rather to establish a discussion on treatment protocols that may be helpful to other physicians in the future.
How to Get Rid of Forehead Acne PermanentlySara Taylor
Discover How to Get Rid of Forehead Acne Naturally. This post will totally define you a complete homemade treatment of your forehead acne skin. To view complete review Ridblemishes.com
Discover how you can instantly prevent acne flare-ups with natural remediesAffiliate
Nonacne is a product supporting acne skin. Product ingredients help eliminate acne and prevent its reappearance. Taking this supplement regularly leads to a beautiful and smooth skin.
The product is very popular with teenagers and adults who also have to face the problem of acne.
If you run a website dedicated to acne or targeted at teenagers, Nonacne can be the perfect way to monetize this traffic. Do not hesitate and publish Nonacne promotional materials on your website today!
Discover how you can instantly prevent acne flare-ups with natural remediesAffiliate
Nonacne is a product supporting acne skin. Product ingredients help eliminate acne and prevent its reappearance. Taking this supplement regularly leads to a beautiful and smooth skin.
The product is very popular with teenagers and adults who also have to face the problem of acne.
If you run a website dedicated to acne or targeted at teenagers, Nonacne can be the perfect way to monetize this traffic. Do not hesitate and publish Nonacne promotional materials on your website today!
Dr. Catrise Austin is an expert New York Cosmetic Dentist. In 1908, she opened an office under the banner "VIP Smiles", a modern dental practice that boasts an impressive loyal following, including some of the warmest smiles in the entertainment industry.
5 Steps To Regain Your Confidence - Courage and WisdomJenni Proctor
Making the decision to change your career requires courage, and making a smooth change requires wisdom, clarity and strategy. Anyone who chooses to change their career will face challenges, and this does not get easier with age. As we face the challenges our confidence can be eroded, bit by bit or through some nasty incident.
You’ve watched the countless late-night infomercials promising you the instant cure to your acne troubles.
the before and after photos showcasing the shocking results of those who have taken a leap of faith and handed over their credit card number for yet another shot at successfully eliminating acne from their lives forever. The problem is, you’ve tried all of those remedies, instant “cures”, solutions, treatments and creams. You
have been through the ringer having spent a small fortune on acne medications only to find yourself confused and frustrated as to why you have been unable to experience the same results that everyone else claims to have.
While 92% of all cosmetic surgery patients are women, men are becoming
patients more often as well. Your appearance matters in the business world
as well as in your personal life, so why not take steps to secure your looks
for as long as you can?
1. How to reverse your bad habits and stick to good ones.
2. The science of how your brain processes habits.
3. The common mistakes most people make (and how to avoid them).
4. How to overcome a lack of motivation and willpower.
5. How to develop a stronger identity and believe in yourself.
6. How to make time for new habits (even when your life gets crazy).
7. How to design your environment to make success easier.
8. How to make big changes in your life without overwhelming yourself.
9. How to get back on track when you get off course with your goals.
10. And most importantly, how to put these ideas into practice in real life.
We do not realize that our eyes need to be exercised for a healthy vision. Exercising your eyes reduces eye strain. If you are wondering how to exercise your eyes, here is the answer.
Mindful monday: jack canfield, activate the law of attraction immensely socialHilary Overcash
The things that determine your comfort zone:
Your Beliefs
Your Self-Talk
Your Self-Image
Visit for more: http://immenselysocial.com/mindful-monday-activate-law-of-attraction/
Australian Period Homes: A Quick Guide for BeginnersDeborah Davis
Period homes can differ greatly and those found in Australia are typically influenced by British and American homes of yesteryear. Renovating a period home can be extremely rewarding, but you want to make sure that it’s done right to preserve the value of the property. In this guide we explain about the common types of period homes as well as some great tips for starting and carrying out a renovation project.
Santa Ana is a beautiful California city known for its diverse communities, interesting places to visit, and fun things to do. It has a relatively low crime rate compared to other US cities, as well as a low unemployment rate.
Check out these slides to learn more amazing facts about the city of Santa Ana.
Apart from creating a gap in your smile, missing teeth can affect your speech, nutrition, bone health and overall appearance. While teeth loss can't always be avoided, its serious effects can be minimised with the aid of dental implants. These are teeth root replacements which act as a strong foundation for crowns and teeth replacements. Keen to find out how to prepare for a dental implant procedure if you qualify? Flip through these slides.
The 4 degrees of separation between pain and pleasureDeborah Davis
Do you feel any sort of foot pain whenever you go for a walk? There are a number of things you can do either to prevent or lessen the pain. For starters, you should regularly exercise your feet by doing some morning stretches. You can also use some orthotics or shoe inserts. To learn more about foot pain, check out these slides from Docpods.
Do you want to beat the heat this summer? There are a number of ways that you can easily do it. For starters, wear light colored clothes as these reflect light better than darker ones. And choose cotton whenever possible as it easily wicks away moisture from your body. Another tip is to maintain your air conditioning unit by checking and changing the filters when needed. Not only will it cool the room better, it will also help save on electricity cost. For more tips on staying cool during summer, take a look at these slides from Bourne Bathrooms.
When it comes to having a garden this summer season, nothing beats having some flowers and shrubs around. There are many types of these plants that you can add to your garden. Lavenders are great for their lovely scent and healing qualities. They love the sun and a well-drained soil. For the border areas of your garden you can plant some butterfly bushes. They also thrive in the sun but can also grow in the shade. For more flowers and shrubs ideas this summer, take a look at these slides from Enchanted Landscapes.
5 Essential Tips for Safe Mobile Crane OperationsDeborah Davis
Sometimes a crane is necessary in order to get a job done. It’s a powerful machine so requires essential safety measures when in operation. First thing to do is identify all existing and new hazards like site size, loose materials and weather conditions that can affect crane operations. Another essential factor to implement is the safety of workers in the area to ensure a smooth and accident-free operation. Discover more tips for safe mobile crane operation in this presentation by Excel Cranes.
Do I Have PTSD? - The Signs & Symptoms of Post-Traumatic Stress DisorderDeborah Davis
A lot of people can suffer from PTSD (or post-traumatic stress disorder) after experiencing a traumatic event like natural disasters and serious accidents. Among the most common of the many symptoms are: experiencing flashbacks, bad dreams and having difficulty sleeping. Learn the other symptoms of PTSD in order to help someone you know who might be suffering from it. Check out these slides from Nungkari Treatment Centre.
Essential Equine Supplies for First-Time Horse OwnersDeborah Davis
First-time horse owners tend to purchase too many supplies too soon. Start off by getting only the basics at first. It's best to get the essential first then build on your supplies from there, for example: a really good shampoo and conditioner, general cleaning stuff like a comb for the mane, and a hoof pick for your horse's hooves. To get more ideas about which items to get first, check out these slides from Horseland.
Are you working on a project that needs a crane? Before you decide to hire the first one you see, you should take some important factors into account. For instance, where will the crane be travelling? In some areas of the country, permits are required for large machines, like truck-mounted cranes, before they are allowed on a highway. Such permits will need to be applied for ahead of time. For more tips about hiring cranes, take a look at these slides from Excel Cranes.
Taking Care of Your Mind, Body and Soul: 4 Steps to Achieving Overall WellbeingDeborah Davis
Do you want to know how you can stay healthy? It’s really a lot easier than you think. For one thing, you need to know how to relax. Take a vacation and use the time to recharge your mind and body. Another tip is to eat the freshest and most natural food you can get. To find out more tips on how to be healthy, check out these slides by Beacon Cove Dental.
Equine Dentistry: Equine Teeth Cleaning with Equine Dentist Mark BurnellDeborah Davis
Cleaning your horse's teeth can have an impact on his health and well-being. Learn the importance of equine teeth cleaning in this presentation from Horseland.com.au with equine dentist Mark Burnell.
Internal Diseases in Horses - Common Symptoms and TreatmentsDeborah Davis
Does your horse appear dull and lethargic? If yes, he might be suffering from an internal disease. There are other symptoms to watch out for, that's why it's best to be aware when your horse needs medical attention. Learn more about the common symptoms of internal diseases and what you should do to keep your horse well in this document from Horseland.com.au.
Quick Guide to Solve Minor Housekeeping ConcernsDeborah Davis
Some people rely on professional cleaners and handymen to keep their houses in check. To save on dollars however, it is essential to learn some basic cleaning and repair work yourself before calling experts to do the job for you. Check out this document from Oldfields.com.au and learn how to solve minor home maintenance concerns.
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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Let's talk about volume loss. I like the idea of a deflated
balloon. Everyone's obsessed with looking at their lines, but if I
took a photo of a ninety year old, if I airbrushed her wrinkles
off and showed you a picture of her, do you think you would
look at the photo and think she looked twenty-one again? No.
Why? She's got no fat left in her face. When we see people
and how our mind ages them, we see these contours and
hollows. That's why people start to look older or tired.
3. So what's the solution there? You can put on ten kilos, that
helps. Not really, it relocates after a certain point, doesn’t it?
That's right, it doesn't go in to your face. That was my theory.
After a certain point, my backside ate my cheeks. Everything
started to head south and sucked it all out.
These are the fat pads we have on our face, you can see
they’re everywhere. Some shrink at faster raters than others
and it also depends on your genetics. Others hollow out faster
4. than others and it also depends on how much you exercise. If
you go and watch the Melbourne marathon, you'll see that
some of those people there aren’t aging that well because
running really takes it off the cheeks and the temples.
So dermal fillers have come to save us. I used to think and I
think this is an evolution of the collective female conscience, I
thought if I could just suck it out off my bottom and put it back
on my cheeks. The answer is we can, at least Dr. Chan can
and it is one of his main specialties every Thursday and Friday.
But not everybody wants to go to those lengths, not everyone
5. wants to have a liposuction and a fat reinjection. So this is
where dermal fillers come into it. Dermal fillers are like re-
inflating the balloon.
Dermal fillers that we use here are largely made of hyaluronic
acid which is a glyco protein or a sugar that's found in our
bodies already and in all of the animal kingdom I think. The
ones we inject now are actually harnessed from bacteria. It
was found that the basic sub-unit is the same, no matter which
organism is producing it. So to make a lot of bacteria, they
harness it in the lab. They found that there is a very low rate of
6. allergy because it’s essentially the same as we've already got
in our skin and it makes up the jelly in our eyeballs.
It’s a lot safer than the fillers were twenty years ago. They had
huge problems with allergic reactions twenty years ago and
many of the fillers were irreversible. So once they were in, they
were in. If you had a reaction, it was almost too bad. If they
were permanent and you got an infection, you know it could
end up in surgery, scarring, it was a bit of a disaster.
So, that is why these new fillers have such a huge uptake
7. because they're low allergy, very safe and completely
reversible, which is fantastic. If you don't like the way you look,
we can actually inject an enzyme and completely dissolve the
filler, and you’ll go back to exactly the way you were.
Here are commonly asked questions about our dermal fillers.
How do we do it and does it hurt? There are two main ways
dermal fillers can be injected. You can either place it straight
into the skin with a needle or you can make a little entry point.
For example if I was going to fill a cheek, I could make a little
entry point out here and normally, I'd put a little bit of
anesthetic on the skin. Then, I would make a tiny little entry
8. hole. Then I would take that little needle out and I would use a
cannula which is a blunt needle. I could just gently slide that
under the skin to deposit the filler which significantly reduces
your chance of bruising and swelling.
Does it hurt? Again it depends which technique is being used.
Also I think anti-wrinkle injections hurt more than having filler
done. Things that can be used to help keep you comfortable
are nitrous gas, ice and topical anesthetic. The dermal fillers
themselves have anesthetic in them now, so you can't have it
if you have an allergy to local anesthetic. But as you inject,
you find that area becomes more and more numb and more
9. and more comfortable. That numbness usually lasts anywhere
from thirty to forty minutes.
So is it reversible? As I've said, absolutely, that's why there's
such a huge uptake of these products now.
When does this start to work? Compared to anti-wrinkle
injections, it starts to work immediately because we're re-
inflating the area.
How long does it last? This depends on where it’s being
injected, your metabolism and which kind of filler is being
10. used. But generally, we will say a filler will last six months if
you're unlucky. Depending on which filler you use it actually
can last anywhere up to two years now, so, usually twelve
months to two years.
I think this is a good thing because permanent procedures are
scary to me, that's why I'm comfortable working with this
reversible product. If you're in your late thirties and you decide
to have a cheek implant, right up here, up nice and high, what
is that going to look like when you're seventy when everything
else is sagging around it? It’s going to look a bit weird. I like
the idea that we can tailor things to your age as we go. I think
11. it improves our chances that we're going to get nice, natural,
fresh results.
When should I start? This will depend on whether we're using
it for beautification or rejuvenation. When do I start with
rejuvenation? It’s as soon as I start to get hollowing. If you're
unlucky, it might be in your early twenties. If you're lucky, you
mightn’t start until your mid thirties or late thirties.
What are the risks involved? A dermal filler is incredibly safe
but at the end of the day, we're still putting an implant into the
skin. So, we always warn there is a risk of swelling, a risk of
12. bruising that can last up to two weeks, a risk of infection
because we're working with needles. That risk is low and we
would normally cleanse the area with alcohol before you do
any procedure. But if you got an injector who is not
cleanliness-conscious, you want to be a little bit nervous about
that sort of thing.
Then there are a few very rare risks that I won't go into now,
but do include things like potential auto immune reaction that
can lead to a permanent little lump under the skin. But these
are very uncommon with the new fillers that are out; they were
lot more common with the older fillers. I certainly wouldn't let
13. it stop you because the rates are incredibly low. Most women
will have these procedures done without any problems at all.
As I said, if there was any complication it’s usually a treatable
one because we can reverse the products with a dissolver.
How much do I need? It’s self-examination time. You are going
to draw your own little diagram on your face chart, and I'll
teach you few of the tricks and describe some of the changes
we see as we age.
So start with the upper face, your forehead. When we're
young, our foreheads are usually convex and have a nice
14. curve through there. That keeps our eyebrows up and stops
these wrinkles from forming when we lift our brows. As we
age, if I come back to that picture of the fat pads, as these
disintegrate, as these shrink, you end up with a flattening in
the forehead and there's less support when you raise your
brows, so we see the wrinkles then.
From a side profile particularly for a woman, it can start to look
a bit masculine. If your brow starts to look bigger here, and
you’re flatter here, that's actually more a masculine
characteristic. Men can get away with a bit of a heavier brow
and a flatter head, but women generally do look more youthful
15. with a curved forehead and that keeps to help your eyebrows
up. That’s another reason our eyebrows start to drop down,
because we lose the fat in the forehead there.
Our temples. This is something that I struggle with because
normally, when I'm not pregnant, I have a very scrawny upper
body, face and neck. Any weight loss means that I take weight
off my forehead and my temples. That's a really aging look
when you've got hollow temples. It happens to all runners. It
means that a after certain age, your eyebrows are going to
start to turn the corner, and rather than seeing them like this,
they literally will follow your temples around to the side. Then,
16. your cheekbones can look a little bit different because you've
got a bit concavity sitting right through there.
Filling your temples is something that needs to be done by a
very advanced injector for safety purposes. But it can make a
huge change to an upper face and again, helps to support
those eyebrows, helps to support the crows’ feet and really
rejuvenate that upper face.
Eyes. You'll find your eyes will age in one of two main ways.
Either you're going to be a sagger, and your lids will start to
sag down over your eyes, or you're going to be a receder. I'm
17. I'm a receder and I'll show you, to make it a little bit more
clear.
When I lose weight on my face and as I get older, this fat pad
up here shrinks and I get what we call the A- frame deformity
forming right above my eye. It makes my eye sockets look
really hollow. If you have a look at Miranda Kerr and any of
those models, you'll see they've got a nice full upper lid there.
So for a receder like myself, that's a really great trick. It’s an
area that gets missed in a lot in dermal filling and it needs to
be done by very experienced injector. You wouldn't let your
friend who’s done a two hour evening course come at you in
18. in that location. That really makes a beautiful difference to the
upper face.
Coming around to your mid face now, under the eye, tear
troughs worry almost everyone. It can be a tricky area to fill,
and it can't be overdone or you will end up with a big, puffy
eyebag. You need to be able to assess whether you have a
true tear trough or whether you're missing your cheek under
the tear trough. A lot of people will fill a tear trough and not
their mid-cheek and they end up with a big puffy eye and a flat
face and it’s not a good look. So often the two areas need to
be done in combination.
19. When we're young, the junction between our lower lid and our
cheek is really short and as we age it gets longer and longer
and longer. You've probably seen pictures of ninety year old
men and it’s all the way down here, the eyelid there, the cheek
starts there. Once again, these are things we can use dermal
filler for to keep everything lifted and to soften those
transitions, between those few areas. Again, this is an area for
very experienced injectors. If the Botox hasn't lifted your
eyebrows enough, this area here can start to sag down and in
and we can actually use a little bit of filler through there to lift
that glabella again and support those tissues. That helps your
anti-wrinkle injection to work better because it rejuvenates that
mid face area.
20. We can put dermal filler in noses. A lot of people choose to do
this instead of having a full rhinoplasty procedure. Those who
are scared to go under the knife, might have a bit of a hump
on their nose and we can actually blend it in with dermal filler.
It’s another area for advanced injectors.
Cheeks, one of my favorite areas to do are mid cheek, lateral
cheek because I find that's one of the key areas that flattens
out in a lot of people. People who have really high, wide
cheekbones age a lot better than everyone else; they’re really
lucky. If you're not, we get to cheat and we re-inflate you there
and there. When people look at you, they see that middle
21. of your face first. So there's no point having big lips and a flat
cheek, you’re not going to do yourself any favors.
We can fill the sides of the cheeks, if these buccal fat pads
here start to deteriorate. We can fill the hollowings that appear
down under your lips and above the chin. Nasal labial folds,
these lines here, courtesy of my grandmother, are a concern
for a lot of people. But if you overfill them, you'll look like a
monkey. So I would say treat your cheeks and soften these
gently but don't overdo them, because I have seen a few
patients, not under my own work, but they have come in
looking a bit like a monkey.
22. Lips can be done with filler. A lot of women are really scared to
have their lips treated, but with the new fillers in particular that
are out now, they're really hydrating to the lips. As we age, our
lips turn in and if you treat every other area on your face and
you leave the lips, you've really giving yourself a way a little
bit. A little bit of filler into the lips if nothing else, just hydrates
and plumps and just gives you that little bit of softness that you
used to have in there, which is great. You'll find your lipstick, if
you're female, will sit a lot better.
Now I think, I've covered all those areas. We can use filler to
fill the back of your hands in. If you get everything else done,
23. and you've got really hollow backs of hands, really wrinkly,
filler can be injected and soften out the back of your hands.
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