Saving lives from sepsis - not the SCC guidelinesCoda Change
Evidence based medicine holds RCT's, Randomised Control Trials, as the highest level of evidence but they are often poorly constructed and misinterpreted. This talk by the world renowned clinical researcher Professor Simon Finfer analyses the common mistakes and failings of RCT's and describes way that we can do better.
Educative power point presentation for trainees / post graduate students/ fellows in paediatrics/ paediatric cardiology/ paediatric critical care/ neonatology / emergency paediatrics
Saving lives from sepsis - not the SCC guidelinesCoda Change
Evidence based medicine holds RCT's, Randomised Control Trials, as the highest level of evidence but they are often poorly constructed and misinterpreted. This talk by the world renowned clinical researcher Professor Simon Finfer analyses the common mistakes and failings of RCT's and describes way that we can do better.
Educative power point presentation for trainees / post graduate students/ fellows in paediatrics/ paediatric cardiology/ paediatric critical care/ neonatology / emergency paediatrics
Mental Health Disorders and Ageism Linked to DementiaBeth_Coleman
A person’s mental health and outlook on aging can affect his or her risk for dementia, studies show. Dementia, seen mostly in the elderly, is a mental deterioration that hinders them from performing even the simplest daily activities.
Focus on physical, social and emotional health of infants, children, adolescents and young adult from birth to 21 years.
a medical practitioner specializing in children and their diseases.
Focus on prevention, detection and management of physical and social behavioral problem that affect children.
Treat infection, injuries and all type of disease in children.
Cephalexin - Useful for Treating Bacterial InfectionsDV Medical Supply
DV Medical Supply, Inc., offers medical and veterinary clients a range of supplies, including hard-to-find medications, at affordable wholesale prices. Among the pharmaceuticals available via DV Medical Supply’s website is cephalexin.
Genetic counseling: Introduction, definition, purposes of genetic counseling, indications of genetic counseling, beneficiaries of genetic counseling, phases of genetic counseling, role of nurse in genetic counseling, application of genetic counseling.
Mental Health Disorders and Ageism Linked to DementiaBeth_Coleman
A person’s mental health and outlook on aging can affect his or her risk for dementia, studies show. Dementia, seen mostly in the elderly, is a mental deterioration that hinders them from performing even the simplest daily activities.
Focus on physical, social and emotional health of infants, children, adolescents and young adult from birth to 21 years.
a medical practitioner specializing in children and their diseases.
Focus on prevention, detection and management of physical and social behavioral problem that affect children.
Treat infection, injuries and all type of disease in children.
Cephalexin - Useful for Treating Bacterial InfectionsDV Medical Supply
DV Medical Supply, Inc., offers medical and veterinary clients a range of supplies, including hard-to-find medications, at affordable wholesale prices. Among the pharmaceuticals available via DV Medical Supply’s website is cephalexin.
Genetic counseling: Introduction, definition, purposes of genetic counseling, indications of genetic counseling, beneficiaries of genetic counseling, phases of genetic counseling, role of nurse in genetic counseling, application of genetic counseling.
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) - 12 Julai 2013
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi.
KEYNOTE presentation by professor Celso Arango (Hospital General Universitario Gregorio Marañón. IiSGM, Universidad Complutense, CIBERSAM. Madrid, Spain) on developmental trajectories in early-onset psychoses, held at the ESCAP 2015 Congress in Madrid, Monday June 22nd 2015
The Febrile Neonate and Young Infant: An Evidence Based Reviewdpark419
Objectives:
1) Discuss the wide variation in management of this patient population
2) Review the low risk criteria for infants deemed safe to be discharged from the emergency room
3) Review the medical evaluation of the febrile neonate and young infant
4) Discuss several difficult clinical situations one may encounter when managing the febrile neonate/young infant (traumatic/dry LP, hyperpyrexia, neonatal mastitis, concomitant viral infection)
5) Answer the question: Can you safely withhold a lumbar puncture from a febrile young infant (4-8 week old)
Consultant in Genreral Paediatrics at St Mary's Hospital, Padding, London talks at Meningitis Research Foundation's Pushing the Boundaries: Life beyond limb loss day in October 2014
C H A P T E R 1
Clinical reasoning, evidencebased
practice, and symptom analysis
Basic health assessment involves the application of the practitioner’s knowledge and skills to identify and
distinguish normal from abnormal findings. Basic assessment often moves from a general survey of a body
system to specific observations or tests of function. Such an approach to assessment and clinical decision
making uses a deductive process of reasoning. For example, a specialist examining a patient with known
hyperthyroidism would conduct a physical examination to test for deep tendon reflexes. Brisk or hyperreflexic
reflexes would lead the practitioner to conclude that a hyperthyroid state is a likely cause of these findings. This
would greatly narrow the choices of diagnostic tests and treatment decisions.
Advanced assessment builds on basic health assessment yet is performed more often using an inductive or
inferential process, that is, moving from a specific physical finding or patient concern to a more general
diagnosis or possible diagnoses based on history, physical findings, and the results of laboratory and diagnostic
tests. The practitioner gathers further evidence and analyzes this evidence to arrive at a hypothesis that will lead
to a further narrowing of possibilities. This is known as the process of diagnostic reasoning.
Diagnostic reasoning
Diagnostic reasoning is a scientific process in which the practitioner suspects the cause of a patient’s symptoms
and signs based on previous knowledge. The practitioner gathers relevant information, selects necessary tests,
makes an accurate diagnosis, and recommends therapy. The difference between an average and an excellent
practitioner is the speed and focus used to arrive at the correct conclusion and initiate the best course of
evidencebased treatment with minimum harm, cost, inconvenience, and delay. This expertise of the
practitioner is acquired through knowledge and a skill set developed through experience in clinical practice.
Repeated practice with real cases helps to develop memory schemes for relating clinical problems and store
them in longterm memory.
By using diagnostic reasoning, the practitioner is able to accomplish the following:
• Determines and focuses on what needs to be asked, what data need to be obtained, and what needs to
be examined
• Performs examinations and diagnostic tests accurately
• Clusters all pertinent findings
• Analyzes and interprets the findings
• Develops a list of likely or differential diagnoses
The diagnostic process
The primary care context
The process of assessment in the primary care setting begins with the patient or caregiver stating a reason for
the visit or a chief concern. Most visits to primary care providers involve concerns or symptoms presented by
the patient, such as an earache, vomiting, or fatigue. The initial evidence is collected through a patient history.
Demographic information, such as gend ...
Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists, or physicians
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
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.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
4. Prognosis – risk of epilepsy
What do we tell our patients?
Whilst generally agreed that seizure recurrence is
most likely within the first 6 months, estimates of the
overall risk of recurrence vary widely, from 29 to 71%
at 2 to 3 years3-9
Working number 40-50% at 2-3 yrs, 60-70% if
epileptogenic lesion/remote symptomatic
Why is the range so wide?
Flawed follow up, most trials based on 1st seizure
clinic data
Too long – waitlist 6 months in Perth
Time to ascertainment bias
Patients who have a second
seizure may go somewhere
else
Patients who don’t have a
second event may just not turn
up
8. Aim of the first-ever seizure
project
Aims: To assess risk of recurrence after a first-
ever seizure in adults.
Hypothesis: The risk of seizure recurrence at
2 years is 50% (i.e., the mid-point of prior
studies’ upper and lower risk estimates.)
9. Method
Study type: Prospective cohort study of adults
with first-ever seizure.
Participants: Adults (aged 18 years or over)
with first-ever seizure. Patients with prior
seizures or non-epileptic events that mimic
seizures (eg convulsive syncope) will be
excluded.
10. Patient presents with ?first
seizure episode
Clinical Assessment by
ED physician
Not a first seizure episode
Patient is not given handout, no EDIS
code allocated, not referred to clinic
Likely first seizure episode
Referred to First
seizure Clinic
Given first seizure handout
Discharged home
EDIS CODE ALLOCATED
24
hrs
later
PI accesses EDIS coding
PI phones patient, confirms consent verbally
Questionnaire completed
PCIF mailed out
Patient enrolled
Yes, eligible for
enrolment
No, not eligible for
enrolment
Follow-up as planned in 1st
seizure clinic
No further contact with PI/AI
Patient Enters
study
11. How will this impact on ED?
EDIS coding
First seizure = D12755
Generalised tonic-clonic seizure = D00469
First Seizure handout – slightly different
See handout
Box with study mentioned on it
