Rubella is a directly transmitted immunizing infection that usually occurs during childhood and is associated with low morbidity and mortality. Infection of women during early pregnancy can lead to spontaneous abortion, fetal death or children born with congenital rubella syndrome (CRS), which is associated with multiple disabilities that can require lifelong care , including hearing impairment, cataracts and congenital heart disease
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Measles is an acute viral infection characterized by a final stage with a maculopapular rash erupting successively over the neck and face, trunk, arms, and legs, and accompanied by a high fever.
#Rubella #German measles
Rubella is also known as German measles because the disease was first described by German physicians, Friedrich Hoffmann, in the mid-eighteenth century.
Measles is an acute viral infection characterized by a final stage with a maculopapular rash erupting successively over the neck and face, trunk, arms, and legs, and accompanied by a high fever.
Do you know all about #measles pathogenesis, incubation period symptoms ?Ravi Dabas
Measles is most contagious infectious disease. in this slide I have described Pathogenesis, incubation period, prodromal period, recovery phase. if anyone get benefit from this slide then I will be happy.
Measles and its prevention - Slideset by professor EdwardsWAidid
In this study Professor Kathryn M. Edwards (Sarah H. Sell and Cornelius Vanderbilt Professor - Division of Pediatric Infectious Diseases - Vanderbilt University Medical Center) provides an update on measles and its prevention.
To learn more, please visit www.waidid.org!
CHICKEN POX is an important viral disease which is similar to small pox in its presentation. the characteristic feature of this disease is pleomorphic rash,meaning by all stages of rash are present at one point of time. it can be easily prevented by the use of a vaccine.
A brief discussion on different Viral ex anthems especially measles. In a simple and easy manner, the measles virus is explained with its clinical features, treatment, investigations, and vaccination. Helpful for clinicians, dermatologists and pediatricians. Helpful for exam preparation for FCPS, MCPS, MRCP and USMLE in the field of dermatology. Also helpful for med students and nurses.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
The SIR Model and the 2014 Ebola Virus Disease Outbreak in Guinea, Liberia an...CSCJournals
This research presents a mathematical model aimed at understanding the spread of the 2014 Ebola Virus Disease (EVD) using the standard SIR model. In modelling infectious disease dynamics, it is necessary to investigate whether the disease spread could attain an epidemic level or it could be wiped out. Data from the 2014 Ebola Virus Disease outbreak is used and Guinea where the outbreak started is considered in this study. A three dimensional non-linear differential equation is formulated and solved numerically using the Runge-Kutta 4th order method in the Vensim Personal Learning Edition Software. It is shown from the study that, with public health interventions, the effective reproductive number can be reduced making it possible for the outbreak to die out. It is also shown mathematically that the epidemic can only die out when there are no new infected individuals in the population.
Do you know all about #measles pathogenesis, incubation period symptoms ?Ravi Dabas
Measles is most contagious infectious disease. in this slide I have described Pathogenesis, incubation period, prodromal period, recovery phase. if anyone get benefit from this slide then I will be happy.
Measles and its prevention - Slideset by professor EdwardsWAidid
In this study Professor Kathryn M. Edwards (Sarah H. Sell and Cornelius Vanderbilt Professor - Division of Pediatric Infectious Diseases - Vanderbilt University Medical Center) provides an update on measles and its prevention.
To learn more, please visit www.waidid.org!
CHICKEN POX is an important viral disease which is similar to small pox in its presentation. the characteristic feature of this disease is pleomorphic rash,meaning by all stages of rash are present at one point of time. it can be easily prevented by the use of a vaccine.
A brief discussion on different Viral ex anthems especially measles. In a simple and easy manner, the measles virus is explained with its clinical features, treatment, investigations, and vaccination. Helpful for clinicians, dermatologists and pediatricians. Helpful for exam preparation for FCPS, MCPS, MRCP and USMLE in the field of dermatology. Also helpful for med students and nurses.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
The SIR Model and the 2014 Ebola Virus Disease Outbreak in Guinea, Liberia an...CSCJournals
This research presents a mathematical model aimed at understanding the spread of the 2014 Ebola Virus Disease (EVD) using the standard SIR model. In modelling infectious disease dynamics, it is necessary to investigate whether the disease spread could attain an epidemic level or it could be wiped out. Data from the 2014 Ebola Virus Disease outbreak is used and Guinea where the outbreak started is considered in this study. A three dimensional non-linear differential equation is formulated and solved numerically using the Runge-Kutta 4th order method in the Vensim Personal Learning Edition Software. It is shown from the study that, with public health interventions, the effective reproductive number can be reduced making it possible for the outbreak to die out. It is also shown mathematically that the epidemic can only die out when there are no new infected individuals in the population.
Per contact probability of infection by Highly Pathogenic Avian InfluenzaHarm Kiezebrink
Estimates of the per-contact probability of transmission between farms of Highly Pathogenic Avian Influenza virus of H7N7 subtype during the 2003 epidemic in the Netherlands are important for the design of better control and biosecurity strategies.
We used standardized data collected during the epidemic and a model to extract data for untraced contacts based on the daily number of infectious farms within a given distance of a susceptible farm.
With these data, the ‘maximum likelihood estimation’ approach was used to estimate the transmission probabilities by the individual contact types, both traced and untraced.
The outcomes were validated against literature data on virus genetic sequences for outbreak farms. The findings highlight the need to
1) Understand the routes underlying the infections without traced contacts and
2) To review whether the contact-tracing protocol is exhaustive in relation to all the farm’s day-to-day activities and practices.
Modeling and Simulation of Spread and Effect of Malaria EpidemicWaqas Tariq
The purpose of this paper is to consider malaria infection (A) and the control of malaria (B) as the two sets of soldiers engage in a war. The principal objectives are to see if it is possible with time to reduce and eradicate malaria in our environment taking reasonable precaution. The methodology approach is to model a mathematical equation using battling method approach to find the time(t) that control malaria in our environment will conquer the malaria infection i.e. when A(t)=0. The number of provided facilities (n) for the protection of malaria is also considered and varied. The result shows that as the number of malaria control increases the control time is decreasing.
Your initial post regarding case study 3 is very informative and I enjoyed re...professordon2024
A nurse practitioner is consulting with a surgeon to determine the appropriate prophylactic antibiotic for a patient who is scheduled to undergo surgery. Which first-generation cephalosporin, known for its superior efficacy against gram-positive bacteria, should be selected for this purpose?
The Prevalence of Tuberculosis Among Internal Displaced Persons In Alsalam Ca...suppubs1pubs1
Tuberculosis (TB) continues to be one of the leading causes of death worldwide, and the largest prevalence of this disease is in Asia (59%) and Africa (26%).
: The COVID-19 pandemic is spreading across the globe at an alarming rate. Corona Virus is a large
family of positive-sense, single-stranded Ribo Nuclic Acid(RNA) viruses that belong to the Nidovirales order. It
was first started in Wuhan, Hubei Province, China and then subsequently spread to dozens of other countries
becoming a global pandemic. COVID-19 manifests with a wide clinical spectrum ranging from asymptomatic
patients to septic shock and multi organ dysfunction. The most common symptoms of patients include fever (98.
6%), fatigue (69.6%), dry cough, and diarrhea. The WHO recommends collecting samples from both the upper
and lower respiratory tracts. This can be achieved through expectorated sputum, broncho-alveolar lavage or
endotrachial aspirate, These samples are then assessed for viral RNA using polymerase chain reaction(PCR).
Patients with pre-existing co-morbidities have a higher case fatality rate. These co-morbidities include diabetes (7.
3%), respiratory disease(6.5%), cardiovascular disease(10.5%), hypertension(6%) and malignncy(5.6%). Patients
without co-morbidities have a lower case fatality rate(0.9%). Preventive measures must focus on optimizing
infection control protocols, self-isolation, and patient isolation during the provision of clinical care. No confirmed
medication or vaccine has been developed. Current treatment strategies are aimed at symptomatic care and
oxygen therapy. Chloroquine phosphate and lopinavir/ritonavir have been suggested. Other suggested anti-virals
include ribavirin and abidor. Usage of personal protective equipment, washing hands, sanitization, social distance
and general awareness can stop transmission of virus. Prophylactic vaccination is required for the future
prevention of COV-related epidemic or pandemic.
Modeling the Effect of Variation of Recruitment Rate on the Transmission Dyna...IOSR Journals
In this Paper, the effect of the variation of recruitment rate on the transmission dynamics of
tuberculosis was studied by modifying an existing model. While the recruitment rate into the susceptible class of
the existing model is constant, in our modified model we used a varying recruitment rate. The models were
analyzed analytically and numerically and these results were compared. The Disease Free Equilibrium (DFE)
state of the existing model was found to be
,0,0,0
, the DFE of the modified model was found to be
( ,0,0,0) * S where * S is arbitrary. While all the eigenvalue of the existing model are negative, one of the
eigenvalues of the modified model is zero. The basic reproduction number o R of both models are established to
be the same. The numerical experiments show a gradual decline in the infected and exposed populations as the
recruitment rates increase in both models but the decline is more in the modified model than in the existing
model. This implies that eradication will be achieved faster using the model with a varying recruitment rate.
It is one of three type of hearing loss
Hearing loss due to defect in the sensory apparatus cochlea (sensory)
Or in the pathway of conduction of nerve impulses to the brain (neural)
Neural causes can be
peripheral:8 nerve
Central:auditory pathway or cortex
A hernia happens when an organ or maybe fatty tissue squeezes through a weak
spot in a surrounding muscle or connective tissue called fascia.
Hernias were
once the leading cause of acute intestinal obstruction.
Public alertness of early
repair has markedly reduced the frequency of incarceration of intestine in these
musculofascial defects.
The common sites for these defects, in order of frequency,
are inguinal, umbilical, incisional and femoral. Techniques of repair continue to
evolve but tension-free, mesh repairs are the current standard.
You may have a hernia if you can feel a soft lump in your belly or groin or in a
scar where you had surgery in the past. The lump may go away when you press on
it or lie down. It may be painful, especially when you cough, bend over, or lift
something heavy.
Möbius syndrome: is rare congenital neurological disorder
There are four group: Simple hypoplasia, Primary lesions in CNs, Focal necrosis in brainstem nuclei and Primary myopathy.
Signs and symptoms: Limb abnormalities, Chest-wall abnormalities, Crossed eyes and Difficulty in breathing and/or in swallowing.
It results from a vascular disruption, The use of drugs and a traumatic pregnancy associated with development of Möbius syndrome.
There is no single course of medical treatment for Möbius syndrome.
Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders
Schizophrenia , psychosis, bipolar disorder are different type of psychiatric disorder
Features of schizophrenia are delusions and hallucinations
Bipolar affective disorder is one of the most common psychiatric illness
elevated mood and pressured speech are clinical features of bipolar disorder
Hearing loss is one of the most frequent sensory deficient in human population. It affects more than 360 million people.
Consequences of hearing impairment include reduced ability to communicate, economic and educational disadvantage, social isolation and stigmatization.
we will talk also about the common types & causes of hearing loss and the possible applicable methods to treat these conditions.
Define rheumatic fever.
what are the main causes of rheumatic fever.
List the clinical finding of rheumatic fever.
To list and identify the most commonly used laboratory tests to detect the rheumatic fever.
How to treat rheumatic fever .
To list some of the procedures that are used for the prevention of the rheumatic fever .
Can be defined as a dense loss of memory for recent events but with preserved intelligence and personality ,memory can be either totally or partially lost according to the extent of damage that was caused .
Can be defined as a dense loss of memory for recent events but with preserved intelligence and personality ,memory can be either totally or partially lost according to the extent of damage that was caused .
Define rheumatic fever.
what are the main causes of rheumatic fever.
List the clinical finding of rheumatic fever.
To list and identify the most commonly used laboratory tests to detect the rheumatic fever.
How to treat rheumatic fever .
To list some of the procedures that are used for the prevention of the rheumatic fever .
Hepatitis is generally refer to inflammation of liver, it is resulted from infectious causes (such as viral, bacterial and fungal causes ) or noninfectious ( such as alcohol drugs, autoimmune diseases and metabolic diseases) , in this research , I’m going to focus on viral hepatitis because it is the most common cause of acute hepatitis in USA ( 50% of cases ).
The commonness and important viruses that cause viral hepatitis are (A,B,C,D,E) types, approximately 4.4 million Americans are currently living with chronic hepatitis B and C.
The liver continuously filters blood which circulates throughout the body, converting nutrients and drugs absorbed from the digestive tract into ready for using chemicals. The
liver performs many other important functions, such as removing toxins and other chemical waste products from the blood and readying them for excretion. Because all the
blood in the body must pass through it, the liver is unusually accessible to cancer cells traveling in the bloodstream.
We all Know that the most dangerous medical condition in our modern life is cancer!
There are two types of this awful condition, BENIGN and MALIGNANT. The first is safe
and can be removed by many ways without large effects on the patients, but the last
one is very killing and can cause a lot of consequences on the patient, even death.
In my report, I will discuss one of the cancer's types that occur in the human body,
which is "Melanocytes tumors".
I mentioned everything about Melanocytes tumor, starting with signs and symptoms,
and finishing with diagnosis and treatment.
The Melanocytes are found in two areas of the human body, (Eye and skin). It can be
hidden for a lot of time without discovering by patients or doctors, so all people need
to be checked every month or years to be sure that they are safe from this killing
condition.
Also, this condition can be normal without problems and found in all people
approximately, such we called it "Nevus" or "Shama" in Arabic language which is one of
the beauty sings.
ARDS is a widespread acute inflammatory lung injury with various degrees of intensity that occurs in response to a pulmonary or systemic insult and invariably leads to abnormalities in gas exchange (predominantly hypoxemia) and in pulmonary mechanics. It is a prototypical disease of reduced lung compliance that causes acute respiratory failure in both children and adults.
In effect, ARDS impairs the lungs' ability to exchange oxygen and carbon dioxide with the blood across a thin layer of the lungs' microscopic air sacs known as alveoli. The syndrome is associated with a death rate between 20 and 50% .
Stroke is sudden death of brain cells result from deprivation of oxygen ,that caused from
blockage of blood flow or rapture of an essential artery of brain or by cerebral thrombosis that may caused the stroke ,that occurs in varying signs and symptoms from temporary paralysis and loss of speech to the brain damage and death .
Stroke also called brain attack or CVA (Cerebrovascular Accident),it is one of the most risky and critical neurological disorder and also it is the third most common cause of
death in development country(after heart disease and cancers) .it is cause of death in people that younger than 45 years ,that cases account 3000 annually ,stroke also is one of 10
causes of death children and that include 5-10% cases of stroke.
Stroke is clinical syndrome that’s clinical features develops rapidly through minutes because
of a vascular causes
Syphilis is a sexually transmitted disease (STD) caused by an infection with spirochete
bacteria known as Treponema pallidum.
Like other STDs, syphilis can be spread by any type of sexual contact. Syphilis can also be
spread from an infected mother to the fetus during pregnancy or to the baby at the time of
birth.
The signs and symptoms of syphilis vary depending in which of the four stages it presents
(primary, secondary, latent, and tertiary)
Hashimoto's thyroiditis (HT) is one of the most common human autoimmune
diseases responsible for numerous morbidity in women. Hashimoto’s disease
is also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or
autoimmune thyroiditis. Hashimoto’s disease is at least 8 times more common
in women than men. Although the disease may occur in teens or young women,
it more often appears between ages 40 and 60. Your possibility of developing
Hashimoto’s thyroiditis increases if other family members have the disease.
It is an organ-specific T-cell mediated disease that affects the thyroid gland,
and genetics play a contributory role in its complexity. To date, significant
progress has been made in identifying and characterizing those genes involved
in the disease.
The hearing impairment is one of the most frequent sensory deficient in human population.
Consequences of hearing impairment include inability to interpret speech sounds, often producing a reduced ability to communicate, delay in language acquisition, economic and educational disadvantage, social isolation and stigmatization. The function of the ear and the hearing process play an important role in the verbal communication between individuals and make a noticeable impact on individual’s life. So, we decide here to talk about hearing function of the ear from many different points of view. These points of view will include mainly the anatomical, physiological and pathological basis of ear and hearing process. After that, we will talk about the common types and causes of hearing loss and the possible applicable methods to treat these conditions.
Hypopituitarism is defined as a diminished function of the pituitary gland. First described in 1914 by Simmonds, it is
also known as Simmonds’ disease. There are two main reasons for the hypofunction of the pituitary gland: it can
result from pituitary dysfunction per se or from hypothalamic damage. In both cases, the production of pituitary
hormones is diminished. When a single pituitary hormone is affected, this is called isolated pituitary deficiency.
When two or more pituitary hormones are affected, this is referred to as multiple pituitary hormone deficiency.
Panhypopituitarism is a state of reduction of all pituitary hormones.
The multiple aspects of normal pituitary function serve to predict the wide range of clinical manifestations of hypopituitarism which are determined by the severity, extent and duration of the condition.
The discovery of antibiotics existed one of the significant events in medical history and said to have added a decade to the life expectancy of human beings. Antibiotics also known as antibacterial medications that inhibits or slows down
the growth of bacteria. Bacteria are microscopic organisms that cause many types of infection in the human beings.
We have special white blood cells that attack the harmful bacteria and this is the main function of our immune system. In some cases the body can’t defend itself
and needs the help of antibiotics with the immune system to attack the harmful bacteria.
Children and infants represents a large part of population in the developing
nations and those groups are usually prone to recurrent attacks of gastrointestinal and respiratory infections of viral origin and usually misuse of antibiotics in these groups have been reported
Oxygen is an essential and fundamental term for life. Cells use oxygen to
produce energy for normal cell activities, Free radicals are normal
consequence of ATP production in the mitochondria. These by-products
are in general reactive oxygen species (ROS) and reactive nitrogen
species (RNS). These two species are referred collectively as ROS/RNS.
The phrases "free radicals" and "reactive oxygen species" (ROS) are
frequently used interchangeably although this is not always correct. The
physiological state of increased steady-state ROS level along with certain
physiological effects has been called oxidative stress. These species play
a dual role. As benefit compounds at low or moderate levels. And as toxic
compounds at high concentrations by generation of oxidative stress .The
delicate balance between their two antagonistic effects is clearly an
important aspect of life [1-5]. Free radicals are, by definition, species
which contain an odd number of electrons. They may be positively
charged, negatively charged, or neutral and all three types are important
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
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.
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!
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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
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
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.
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
German measles (rubella) 2018
1. University of Baghdad
college of medicine
German measles (Rubella)
CLS-Pathology
Ali Hussein Ahmed
Second grade
Student selected components
2017/2018
3. 3
INTRODUCTION:
Rubella is a directly transmitted immunizing infection that usually occurs
during childhood and is associated with low morbidity and mortality. Infection of
women during early pregnancy can lead to spontaneous abortion, fetal death or
children born with congenital rubella syndrome (CRS), which is associated with
multiple disabilities that can require lifelong care [1], including hearing
impairment, cataracts and congenital heart disease. [2]
A relatively inexpensive, high efficacy vaccine that provides lifelong
immunity to rubella and can easily be combined as measles–rubella (MR), or
measles–mumps–rubella (MMR) has been available for 50 years. Although
routine rubella vaccination can prevent CRS, inadequate vaccination coverage
may actually increase CRS cases by increasing the average age of infection [3];
this occurs because vaccination short of the threshold required for elimination
effectively reduces incidence in the population, thus reducing the risk of infection
and delaying time to the first infection (figure 1). Consequently, introduction of
rubella-containing vaccine (RCV) has been limited globally. Recent efforts for the
control and elimination of measles have spurred renewed interest in the potential
for rubella control, because the two vaccines are easily combined, and overall
measles vaccination coverage levels have been climbing [4]. In addition, the
Global Alliance for Vaccines Initiative (GAVI) has recently opened a funding
window for rubella vaccination [5]. Madagascar is one of the countries that has
successfully applied for this funding.
4. 4
Fig(1). Theoretical expectations for RCV coverage and the burden of CRS. In a classic SIR
framework, the dynamics of susceptibles are captured by dS/dt = μ(1 − v) − βSI − μS; and infected
by dI/dt = βSI − gI − μI; where μ is the birth and death rate, total population size as taken as N = 1,
v is vaccination coverage of the birth cohort, g is the generation time of the infection and the
transmission rate is β = R0(g + μ). To capture rubella dynamics, we set g to 18 days−1, R0 = 5,
and chose μ = 30 per 1000 per year. (a) The equilibrium proportion of infected individuals I* (y-
axis) is defined by I* = μ[(1 − v)R0 − 1]/β and thus declines with increasing vaccination coverage
(x-axis). (b) Conversely, the average age of infection A (y-axis) increases, following R0 = G/A,
where G is the inverse of the unvaccinated birth rate, G = 1/[μ(1 − v)]. (c) This conjunction of
declining incidence but increasing average age of infection has the potential to yield a situation
where more cases are occurring in women of childbearing age, even though the total number of
cases is declining. As a result, the ratio of the equilibrium burden of CRS in the presence of
vaccination relative to the equilibrium burden of CRS if no vaccination has occurred (y-axis) may
first increase with vaccination coverage relative to the scenario of no vaccination (indicated by the
horizontal grey line); eventually declining when incidence is sufficiently low to offset the increase
in the average age of infection. (Results in the last panel are hypothetical; exact values will depend
on the variance and skew of the distribution of age of infection; as well as pattern of fertility over
age). This pattern of increasing CRS burden with increasing vaccination coverage has been called
‘the paradoxical increase of rubella’.
Epidemiology:
Under-reporting in the incidence data affected our ability to estimate the
proportion of the population susceptible to rubella (see figure 2a and the electronic
supplementary material, S1). However, the TSIR model indicated a clear pattern
of seasonality in transmission, with low transmission in February, June and
October, which was robust to the range of assumptions about starting proportion
susceptible. Surprisingly, the timing of low transmission does not align with
summer school holidays, in contrast to what has been reported for rubella and
other immunizing childhood infections in many other parts of the world.[6][7][8]
Given low reported incidence, we focused our initial descriptive analysis of the
epidemiology of rubella in Madagascar at the largest administrative scale
available, the six provinces of Madagascar. The average age of infection of rubella
is slightly variable across these provinces, ranging from 6.4 years in the province
of Antananarivo to 8.8 years in Antsiranana. Average age broadly negatively
correlates with province population size (Pearson's correlation between log
population size and average age of infection yields ρ = −0.82, n = 6, p < 0.05),
suggesting an underlying biological driver for this pattern. Two possible drivers of
this average infection age distribution include (i) extinction–recolonization
dynamics, which drive up the average age of infection in smaller population
provinces [9]—implying that provinces with smaller populations also have
5. 5
smaller focal population centres, precluding persistence of rubella or (ii) a higher
R0 for rubella in provinces with larger populations (although see [8] for evidence
that measles, a similar directly transmitted infections, shows no signature of
density-dependent transmission). With the data available, it is not possible to
distinguish between these two possibilities. Using the approximation R0 = G/A
(which assumes negligible stochastic dynamics), where G is the inverse of the
birth rate, and A is the average age of infection, the average age of infection in the
data yields estimates of R0 between 3.9 in Antsiranana province and 5.5 in
Antananarivo province. This range is broadly in line with values previously
reported for this infection.[10][11][12]
Fig(2). The epidemiology of rubella in Madagascar. (a) Reported number of cases through time for
the entire country; (b) associated estimates of transmission from the TSIR model; (c) age
distribution of infection, and average age of infection (vertical lines) associated with each of the
six provinces and (d) Map of incidence in regions of Madagascar across the country with colours
showing incidence per 1000 inhabitants
6. 6
Signs and symptoms:
Rubella has symptoms that are similar to those of flu. However, the primary
symptom of rubella virus infection is the appearance of a rash (exanthem) on the
face which spreads to the trunk and limbs and usually fades after three days (that
is why it is often referred to as three-day measles). The facial rash usually clears
as it spreads to other parts of the body. Other symptoms include low grade fever,
swollen glands (sub-occipital and posterior cervical lymphadenopathy), joint
pains, headache, and conjunctivitis.[13]
The swollen glands or lymph nodes can persist for up to a week and the fever
rarely rises above 38 °C (100.4 °F). The rash of German measles is typically pink
or light red. The rash causes itching and often lasts for about three days. The rash
disappears after a few days with no staining or peeling of the skin. When the rash
clears up, the skin might shed in very small flakes where the rash covered it.
Forchheimer's sign occurs in 20% of cases, and is characterized by small, red
papules on the area of the soft palate.[14]
Rubella can affect anyone of any age and is generally a mild disease, rare in
infants or those over the age of 40. The older the person is the more severe the
symptoms are likely to be. Up to 60% of older girls or women experience joint
pain or arthritic type symptoms with rubella.[15]
In children rubella normally causes symptoms which last two days and
include:[16]
Rash beginning on the face which spreads to the rest of the body.
Low fever of less than 38.3 °C (101 °F.)
Posterior cervical lymphadenopathy.[17]
In older children and adults additional symptoms may be
present including:
Swollen glands
Coryza (cold-like symptoms)
Aching joints (especially in young women)
Rare problems can occur including the following:
Brain inflammation
Fig 3
7. 7
Ear infection [18]
Coryza in rubella may convert to pneumonia, either direct viral pneumonia or
secondary bacterial pneumonia, and bronchitis (either viral bronchitis or
secondary bacterial bronchitis).[19]
Causes:
The disease is caused by rubella virus, a togavirus that is enveloped and has a
single-stranded RNA genome.[20] The virus is transmitted by the respiratory
route and replicates in the nasopharynx and lymph nodes. The virus is found in the
blood 5 to 7 days after infection and spreads throughout the body. The virus has
teratogenic properties and is capable of crossing the placenta and infecting the
fetus where it stops cells from developing or destroys them.[21] During this
incubation period, the patient is contagious typically for about one week before
he/she develops a rash and for about one week thereafter.
Increased susceptibility to infection might be inherited as there is some indication
that HLA-A1 or factors surrounding A1 on extended haplotypes are involved in
virus infection or non-resolution of the disease.[22]
Laboratory Diagnostics:
Clinical specimens for the diagnosis of rubella by virus detection usually
consist of throat swabs (TS), oral fluids (OF) or nasopharyngeal secretions,
and by antibody detection are usually sera or OF.[23] The virus has also been
found in other specimens, including cataract tissue and urine. Urine and TSs or
OFs are about equivalent as sources of viral RNA, but the ease of obtaining
TSs or OFs make these specimens the primary ones that are collected.[24]
Urine is often a source of infectious virus from CRS patients. Specimens for
virus detection and for IgM/IgG detection can be transported by standard
methods.
8. 8
The timing of specimen collection is
important in postnatal rubella. Rubella
virus-specific IgM is present in sera in
only about 50% of rubella cases on the
day of rash, but, at five days after rash,
most rubella cases have detectable
rubella-specific IgM. Most rubella cases
are virus positive on the day of rash and
may be positive from seven to ten days
post rash.[25] Since postnatal rubella is a mild disease of short duration, special
effort is required to obtain samples on the day of rash or shortly thereafter.
Patients with CRS and congenital rubella infection (CRI) are IgM and virus
positive for months; therefore, timing is less critical for individuals suspected of
having CRS or CRI.[26]
Alternative specimens, such as dried blood spots (DBS) and OF, have recently
been shown to be adequate for surveillance of rubella using IgM detection (DBS
and OF) and virus detection (OF).[27] Note that diagnostic kits are usually not
approved for use with DBS, and low IgM levels in OF necessitate the use of
sensitive detection assays.
Amplification of rubella virus RNA directly from a clinical specimen using RT-
PCR is now common. Assays that can reliably detect 3 to 10 copies of rubella
virus RNA are necessary since many specimens have small amounts of rubella
RNA. Real-time and nested RT-PCR assays often have this level of
sensitivity.[28]
Rubella virus specific IgM antibodies are present in people recently infected by
rubella virus, but these antibodies can persist for over a year, and a positive test
result needs to be interpreted with caution.[29] The presence of these antibodies
along with, or a short time after, the characteristic rash confirms the diagnosis.[30]
Rubella Vaccine Immunogenetics:
The current live rubella virus vaccine strain licensed for use in the United
States is the RA27/3 strain. It was first isolated from an infected fetus in the
1960s, and further passaged for attenuation through either the WI-38 or MRC-5
Fig 4
9. 9
human diploid cell lines.[31] It is currently administered as a two-dose series in
the U.S. as part of the measles-mumps-rubella (MMR-II) vaccine. RA27/3 elicits
a robust humoral and cellular immune response. As noted above, correlate
protective levels of anti-rubella antibodies are defined as titers at or above 10
IU/ml.70 However, the measurement of rubella-specific humoral immunity using
serum antibodies can result in a false positives due to a previous parvovirus or
Epstein-Barr virus infection, or the presence of Rh factor.[32] Measuring the
response of rubella-specific memory B cells in vaccinees may be an alternative
correlate and might explain protective immunity in those individuals with low
levels of serum antibodies.81 The seroconversion rate after two doses of MMR-II
approaches 99% and antibodies persist for at least 21 years.[33] The high
seroconversion rate of 99% is observed as early as 9-months-old after receiving
the Wistar RA 27/3 live rubella virus vaccine strain.84 With a calculated half-life
of 114 years, rubella-specific antibodies may even persist for an entire
lifetime.[34] Although excellent seroconversion rates are obtained with RA27/3
vaccination, there are limited occurrences of vaccine failure, and this is thought to
arise when preexisting antibodies neutralize the live viral vaccine strain.[35]
Treatment:
There is no specific treatment for rubella; however, management is a matter of
responding to symptoms to diminish discomfort. Treatment of newborn babies is
focused on management of the complications. Congenital heart defectsand
cataracts can be corrected by direct surgery.[36]
Management for ocular congenital rubella syndrome (CRS) is similar to that for
age-related macular degeneration, including counseling, regular monitoring, and
the provision of low vision devices, if required.[37]
Pregnant women may be treated with antibodies called hyperimmune globulin that
can fight off the virus. This can help reduce your symptoms. However, there’s still
a chance that your baby will develop congenital rubella syndrome. Babies who are
born with congenital rubella will require treatment from a team of specialists. Talk
to your doctor if you’re concerned about passing German measles on to your
baby.[38]
10. 10
History:
Rubella was first described in the mid-eighteenth century. Friedrich Hoffmann
made the first clinical description of rubella in 1740,which was confirmed by de
Bergen in 1752 and Orlow in 1758.[39]
In 1814, George de Maton first suggested that it be considered a disease distinct
from both measles and scarlet fever. All these physicians were German, and the
disease was known as Rötheln (contemporary German Röteln), hence the common
name of "German measles".[40] Henry Veale, an English Royal Artillery surgeon,
described an outbreak in India. He coined the name "rubella" (from the Latin
word, meaning "little red") in 1866.[41]
It was formally recognised as an individual entity in 1881, at the International
Congress of Medicine in London.[42] In 1914, Alfred Fabian Hess theorised that
rubella was caused by a virus, based on work with monkeys.[43] In 1938, Hiro
and Tosaka confirmed this by passing the disease to children using filtered nasal
washings from acute cases.[44]
In 1940, there was a widespread epidemic of rubella in Australia. Subsequently,
ophthalmologist Norman McAllister Gregg found 78 cases of congenital cataracts
in infants and 68 of them were born to mothers who had caught rubella in early
pregnancy.[45] Gregg published an account, Congenital Cataract Following
German Measles in the Mother, in 1941. He described a variety of problems now
known as congenital rubella syndrome (CRS) and noticed that the earlier the
mother was infected, the worse the damage was. Since no vaccine was yet
available, some popular magazines promoted the idea of "German measles
parties" for infected children to spread the disease to other children (especially
girls) to immunize them for life and protect them from later catching the disease
when pregnant.[46] The virus was isolated in tissue culture in 1962 by two
separate groups led by physicians Parkman and Weller.[47]
11. 11
Prevention:
Rubella infections are prevented by active immunisation programs using live
attenuated virus vaccines. Two live attenuated virus vaccines, RA 27/3 and
Cendehill strains, were effective in the prevention of adult disease. However their
use in prepubertal females did not produce a significant fall in the overall
incidence rate of CRS in the UK. Reductions were only achieved by immunisation
of all children.[48]
The vaccine is now usually given as part of the MMR vaccine. The WHO
recommends the first dose be given at 12 to 18 months of age with a second dose
at 36 months. Pregnant women are usually tested for immunity to rubella early on.
Women found to be susceptible are not vaccinated until after the baby is born
because the vaccine contains live virus.[49]
The immunisation program has been quite successful. Cuba declared the disease
eliminated in the 1990s, and in 2004 the Centers for Disease Control and
Prevention announced that both the congenital and acquired forms of rubella had
been eliminated from the United States.[50]
Screening for rubella susceptibility by history of vaccination or by serology is
recommended in the United States for all women of childbearing age at their first
preconception counseling visit to reduce incidence of congenital rubella syndrome
(CRS). It is recommended that all susceptible non-pregnant women of
childbearing age should be offered rubella vaccination.[51] Due to concerns about
possible teratogenicity, use of MMR vaccine is not recommended during
pregnancy. Instead, susceptible pregnant women should be vaccinated as soon as
possible in the postpartum period.[52]
12. 12
Etymology:
The name rubella is sometimes confused with rubeola, an alternative name for
measles in English-speaking countries; the diseases are unrelated.[53][54] In some
other European languages, like Spanish, rubella and rubeola are synonyms, and
rubeola is not an alternative name for measles.[55] Thus, in Spanish, "rubeola"
refers to rubella and "sarampión" refers to measles.
Summary:
Rubella remains an important pathogen globally with approximately 100,000
cases of congenital rubella syndrome estimated to occur each year. Rubella
vaccine is highly effective and safe when used across a population and, as a result,
endemic rubella transmission has been interrupted in the Americas since 2009.
Incomplete rubella vaccination programs result in continued disease transmission
as evidenced by recent large outbreaks in Japan and elsewhere. Herein, we
provide current results regarding rubella control, elimination and eradication
policies, and a brief review of new laboratory diagnostics. In addition, we provide
novel information regarding rubella vaccine immunogenetics and review the
emerging evidence of inter-individual variability in humoral and cell-mediated
innate and adaptive immune responses to rubella vaccine and their association
with HLA alleles, haplotypes, and single nucleotide polymorphisms across the
human genome. Finally, we conclude with a call for further research in rubella
vaccine immunogenetics and its ability to inform a vaccinomics-level approach to
novel vaccine candidate development and the need for a next generation vaccine
that is affordable, easy to administer, and does not require a cold chain for optimal
immunogenicity.
13. 13
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