First Urinary Tract Infection Episode in Children: Are Procalcitonin Values & US Examination of Importance in the Diagnosis of Upper Urinary Tract Infection ?
Recurrent urinary tract infection-Evidence based approachWafaa Benjamin
Recurrent UTI is a common problem encountered in many areas of clinical practice.
It is a cause of significant morbidity: urinary infection is one of the commonest indications for antibiotic prescription in community and hospital settings.
The majority of cases are uncomplicated and respond rapidly to appropriate treatment.
In the management of women with any type of UTI, it is important to have an appreciation of the pathogenesis, host and bacterial interaction, methods of diagnosis, treatment algorithms and local antibiotic sensitivities.
It should be remembered that 20-30% of women with UTI develop at least one recurrent infection
Recurrent urinary tract infection-Evidence based approachWafaa Benjamin
Recurrent UTI is a common problem encountered in many areas of clinical practice.
It is a cause of significant morbidity: urinary infection is one of the commonest indications for antibiotic prescription in community and hospital settings.
The majority of cases are uncomplicated and respond rapidly to appropriate treatment.
In the management of women with any type of UTI, it is important to have an appreciation of the pathogenesis, host and bacterial interaction, methods of diagnosis, treatment algorithms and local antibiotic sensitivities.
It should be remembered that 20-30% of women with UTI develop at least one recurrent infection
A urinary tract infection (UTI) is an infection in any part of your urinary system that is your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.
A urinary tract infection (UTI) is an infection in any part of your urinary system that is your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.
Εχινόκκοκος Κύστη Ήπατος Μεταβατικού Τύπου (CE3) και η εξελιξή της απο Τύπου CE1Radiology Archives
Εχινόκκοκος Κύστη Ήπατος Μεταβατικού Τύπου (CE3) και η eξελιξή της απο Τύπου CE1 - Παρουσίαση Εντυπωσιακού Περιστατικού - Η σημασία της έγκαιρης Διάγνωσης και η θέση της PAIR
Πρόκειται για οξεία ή χρόνια φλεγμονή του παγκρέατος η οποία μπορεi να συνοδεύεται με καταστροφή του παγκρεατικού παρεγχύματος, σοβαρές επιπλοκές, σε συνδυασμό με αύξηση των παγκρεατικών ενζύμων στο αίμα και τα ούρα
Απεικονιστικά καθοδηγούμενες παρεμβάσεις για αντιμετώπιση του έντονου άλγους από συμπιεστικά κατάγματα σπονδύλων που δεν υφίεται με συντηρητική θεραπεία
ΙΩΔΙΟΥΧΑ, ΙΩΔΙΩΜΕΝΑ, ΣΚΙΑΓΡΑΦΙΚΑ ΜΕΣΑ, ΑΚΤΙΝΟΛΟΓΙΑ, ΣΚΙΑΓΡΑΦΙΚΑ, ΑΘΑΝΑΣΙΟΣ Ν. ΧΑΛΑΖΩΝΙΤΗΣ,ΑΛΛΕΡΓΙΕΣ, Ιωδιωμένα Μέσα Σκιαγραφικής Αντίθεσης,όλα όσα θέλατε να μάθετε και δεν τολμούσατε να ρωτήσετε…
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
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!
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
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
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.
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
First Urinary Tract Infection Episode in Children
1. “ First urinary tract infection episode in children:
Are procalcitonin values
& ultrasound examination of importance
in the diagnosis of upper urinary tract infection ? ”
S.P. Deftereos, A. Kotoula, E. Vranou, A. Zisimopoulos, A. Chadjimichail, P. Prassopoulos
Democritus University of Thrace, Department of Radiology, Alexandroupolis, Greece
3. GENERAL APPROACH until today…
Clinical evaluation
Temperature ≥38oC, presence of vomiting or
diarrhea, decreased oral intake
Laboratory investigation
ESR, CRP, leukocyte count, positive culture
of urine speciment
4. 116-amino-acid propeptide
of calcitonin
New marker of bacterial
infections
Under physiological
conditions undetectable
Very high levels in
response to bacterial
infections
Decreases within 48h of the
administration of antibiotics
PROCALCITONIN (PCT)
5. DMSA
Gold standard method but
Costs
Limit availability
Inability to differentiate old scarring
from acute
Exposure of patients to radiation
ULTRASOUND
Noninvasive with no risk to
the patient
Easily performed method
No exposure to radiation but
Strongly dependent on the operator
Children are not always cooperative
VCUG
Information for VUR but
Performed after UTI treatment
Radiation exposure (gonads)
Invasive method
7. AIM
To examine the efficacy of ultrasonography
(US) findings in combination with
procalcitonin (PCT) values in predicting renal
parenchymal involvement (RPI) in children
with urinary tract infection (UTI)
8. PATIENTS AND METHODS
Prospective study
57 children (mean age: 12months, range: 2 -
108months)
First episode of UTI
Children with a history of prior UTI were not included
N=43 N=14
9. Clinical evaluation:
Temperature ≥38oC, vomiting / diarrhea,
decrease oral intake
Laboratory investigation includes:
Urine specimens culture
Leukocyte count
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP) and
serum PCT
PATIENTS AND METHODS
10. Imaging evaluation includes:
US: within 48h
DMSA: within 7 days and
VCUG: after 4-5 weeks (n:51/57pts)
A follow up DMSA was performed after 6 months to
examine possible persistent renal lesions
PATIENTS AND METHODS
11. RESULTS
Upper UTI (group A, n: 27 children)
DMSA positive, abnormal US (n=15, 55.6%)
Lower UTI (group B, n: 30 children)
DMSA negative, US no abnormalities
(except 4 pts with urinary bladder thickening)
N=8
N=21
N=18
N=12
N=27 N=30
PCT
+
+
14. Hyperechoic renal parenchyma
Collecting system dilatation
Increased total kidney volume
Scars (congenital, others)
CDS- irregular vascularity
ULTRASOUND FINDINGS
15. All infection markers, except LC, have the same diagnostic value
PROGNOSTIC VALUE ?
Group A (N=27) median (range) Group B (N=30) median (range) P value
Leukocyte count (/μl) 19,000 (8,000-27,000) 12,750 (4,500-23,500) 0.056
ESR (mm/h) 40 (27-98) 17.5 (2-75) <0.001
CRP (mg/dl) 9 (1.9-35) 0.5 (0.1-6.5) <0.001
PCT (ng/ml) 4.8 (0.5-13.2) 0.3 (0.1-0.9) <0.001
RESULTS
16. PCT levels were significantly higher in patients with
persistent renal lesions or/and VUR (n=8) * than in those
with total regression of RPI (n=15) (p=0,004)
*Vesicoureteral reflux (VUR) was
disclosed by VCUGin 14/51(27,4%, 8
group A, 6 group B) cases
PCT cut off:
>0.5ng/ml NPV
>0.85ng/ml NPPV
>1.2ng/ml PPV
RESULTS
17. DMSA is required in patients
with high PCT levels and
negative US examined
CONCLUSIONS
The combination of high PCT
levels and positive US findings
is an indication of upper UTI
18. CONCLUSIONS
Normal US and PCT levels
can exclude upper UTI
…and thus protect small patient from unnecessary DMSA