This document discusses inflammation and repair through regeneration and healing by connective tissue replacement. It begins by categorizing cell types by their regenerative ability and identifying conditions that favor regeneration versus repair. Repair occurs when the extracellular matrix is damaged and involves scar formation. The key stages of repair are inflammation, proliferation of fibroblasts and blood vessels to form granulation tissue, angiogenesis, collagen deposition and tissue remodeling. Factors that influence or impair healing are also reviewed.
INTRODUCTION
HISTORY
CAUSES OF INFLAMMATION
CLASSIFICATION
ACUTE INFLAMMATION
CHEMICAL MEDIATORS OF INFLAMMATION
OUTCOMES OF ACUTE INFLAMMATION
CHRONIC INFLAMMATION
INFLAMMATORY DISEASES
REFERENCES
INTRODUCTION
HISTORY
CAUSES OF INFLAMMATION
CLASSIFICATION
ACUTE INFLAMMATION
CHEMICAL MEDIATORS OF INFLAMMATION
OUTCOMES OF ACUTE INFLAMMATION
CHRONIC INFLAMMATION
INFLAMMATORY DISEASES
REFERENCES
may start early after tissue damage
regeneration
by parenchymal cells of the same type
reparation
replacement by connective tissue (fibrosis)
result - scar
Inflammation is a fundamental process for human survival, this lecture covers the basics of the process, its components and affects. Developing an understanding of this process will enable the student to comprehend this omnipresent process and how it is directly linked to our survival.
may start early after tissue damage
regeneration
by parenchymal cells of the same type
reparation
replacement by connective tissue (fibrosis)
result - scar
Inflammation is a fundamental process for human survival, this lecture covers the basics of the process, its components and affects. Developing an understanding of this process will enable the student to comprehend this omnipresent process and how it is directly linked to our survival.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Wound healing in Dentis...All Good Things
entist in pune. (BDS. MDS) - Dr. Amit T. Suryawanshi. Seminar- Wound healing in dentistry.
Email ID- amitsuryawanshi999@gmail.com
Contact -Ph no.-9405622455
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Introduction
Definition
Healing of skin wounds
Healing in bone
Healing of nervous tissue
Factors influencing healing
Complications of wound healing
Conclusion
References
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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!
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
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
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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
3. OBJECTIVES AND KEY PRINCIPLES TO BE
TAUGHT:
• Categorize cell types according to their regenerative ability
• Identify the conditions that favours healing by regeneration
• Enumerate molecular events involved in cell growth
• Enumerate the components of repair by connective tissue
• Identify the factors which favours healing by connective tissue.
• Define granulation tissue and describe how it is formed
• Describe the process of angiogenesis and enumerate its mediators
• Describe the process of fibrosis, identify the cells involved and
enumerate the mediators of this process
• Enumerate the enzymes involved in scar remodelling and identify
their function, and their inhibitors.
4. Tissue Renewal
• The healing process of tissue damage caused by any cause
e.g. surgical resection, wounds, and diverse types of chronic
injury can be broadly separated into two processes,
regeneration and repair
Regeneration
refers to growth of cells and tissues to replace lost structures
requires an intact connective tissue framework. Regeneration
results in restitution of lost tissues.
Repair
- occurs if the extracellular matrix (ECM) framework is
damaged, causing alterations of the tissue architecture.
- may restore original structures but involves collagen
deposition and scar formation.
5. Cell types
• Labile cells: continue to proliferate throughout life :
squamous, columnar, transitional epithelia;
hematopoitic and lymphoid tissues
• Stable cells: retain the capacity of proliferation but
they don’t replicate normally: parenchymal cells of
all glandular organs & mesenchymal cells e.g. liver
and kidney
• Permanent cells: cannot reproduce themselves
after birth: neurons and the skeletal and cardiac
muscle cells.
6. CELL CYCLE
• G0
– Quiescent (not a very long)
• G1
– PRE-synthetic, but cell GROWTH taking place
• S
– Cells which have continuous “turnover” have longer, or
larger S-phases, i.e., DNA synthesis
– S-phase of TUMOR CELLS can be prognostic
• G2
– PRE-mitotic
• M (Mitotic:, P,M,A,T, Cytokinesis)
10. Polypeptide growth factors
• Most Important Mediators affecting Cell
Growth
• Present in serum or produced locally
• Exert pleiotropic effects; proliferation, cell
migration, differentiation, tissue remodeling
• Regulate growth of cells by controlling
expression of genes that regulate cell
proliferation
12. Growth Factor-mediated Proliferation
• Platelet Derived Growth Factor (PDGF)
– promotes the chemotactic migration of fibroblasts and smooth muscles
– chemotactic for monocytes
– competence factor that promotes the proliferative response of fibroblasts and smooth
muscles upon concurrent stimulation with progression factors
• Epidermal Growth Factor (EGF)
– promotes growth for fibroblasts, endothelial and epithelial cells
– is a progession factor - promotes cell-cycle progression.
• Fibroblast Growth Factor (FGF)
– promote synthesis of fibronectin and other extracellular matrix proteins
– chemotactic for fibroblast and endothelial cells
– promotes angiogenesis
– links extracellular matrix components (collagen, proteoglycans) and macromulocules
(fibrin, heparin) to cell-surface integrins.
• Transforming Growth Factors (TGFs)
– TGF-α - similar to EGF
– TGF-β - mitosis inhibitor that aids in modulating the repair process. May be responsible
for hypertrophy by preventing cell division. Chemotactic for macropahges and fibroblasts
• Macrophage-derived cytokines (IL-1 and TNF)
– promote proliferation of fibroblasts, smooth muscle and endothelial cells
13. VE(Vascular Endothelial) GF
• Made in mesenchymal cells
• Increases vascular permeability
• Mitogenic for endothelial cells
• KEY substance in promoting
“granulation” tissue
17. Extracellular matrix (ECM) regulates
cell behavior
• It is not just a scaffold for cells to grow on
• Regulates cell growth, motility and
differentiation
• Insoluble elements of the ECM include
collagens, laminin and fibronectin
• Soluble elements include polypeptide growth
factors
24. The repair process
Three main phases of cutaneous wound
healing:
(1) Inflammation (Removal of debris, by tissue
macrophages).
(2) formation of granulation tissue
(3) ECM deposition (scar formation) and
remodeling
26. Granulation tissue
• As early as 24 hr. after injury, fibroblasts and
vascular endothelial cells begin proliferating to
form (by 3-5 days) granulation tissue :pink
soft granular appearance on the surface of
the wound.
• histologically : granulation tissue is composed
of :
• proliferation of new small blood vessels
• proliferation of fibroblasts
27.
28. • Scaring: as the amount of collagen in
granulation tissue progressively increase, the
tissue become gradually less vascular and less
cellular
29.
30. Factors that Impede Repair
• Retention of debris or foreign body
• Impaired circulation
• Persistent infection
• Metabolic disorders
– diabetes
• Dietary deficiency
– ascorbic acid
– protein
31. Continuous assessment
All the following are correct regarding
granulation tissue EXCEPT:
A) Formed mainly of fibroblasts and capillary buds.
B) It is a specialized type of tissue that is a
characteristic of healing by fibrosis.
C) It indicates tuberculosis infection. (T.B.)
D) Gradually it accumulates connective tissue
matrix and form scar.
34. OBJECTIVES AND KEY PRINCIPLES TO BE
TAUGHT:
Upon completion of this lecture, the student should:
1- Compare and contrast the difference between healing by
primary intention and healing by secondary intention.
2- Define tensile strength and identify the timing and strength of
the scar.
2- List factors which are associated with delayed wound healing.
3- List complication of wound healing.
35. Wound healing
1. Primary union (healing by 1st intention)
clean surgical incision
no significant bacterial contamination
minimal loss of tissue
clot formation
scab formation
36. Wound healing
Primary union (healing by 1st intention)
Events:
24 hr.: neutrophils,mitotic activity
of basal layer, thin epithelial
layer
day 3: macrophages, granulation
tissue
day 5: collagen bridges the
incision, epidermis thickens
2nd week: continued collagen
and fibroblasts, blanching
End of 1st month: scar(cellular
connective tissue, intact
epidermis, lost appendages).
37. Wound healing
2. Secondary union (healing by 2nd intention)
Occurs when there is :
more extensive necrosis and laceration
with inability to achieve apposition of wound
margins and in the presence of foreign body and
infection .
38. Wound healing
Secondary union (healing by
2nd intention)
Differs from primary healing:
1. inflammatory reaction is
more intense
2. larger amounts of
granulation tissue are
formed
3. wound contraction reaching
5-10%of the original
one,achieved by
myofibroblasts
4.re-epithelialization may take
several weeks and may need
skin grafting
39. DIFFERENCES BETWEEN PRIMARY AND
SECONDARY UNION OF WOUNDS
Feature Primary Union Secondary Union
Cleanliness of wound Clean Unclean
Infection Generally uninfected May be infected
Margins Surgical clean Irregular
Sutures Used Not used
Healing Scanty granulation Exuberant
tissue at the incised granulation tissue
gap and along suture to fill the gap
Outcome Neat linear scar Contracted irregular
wound
40. Scar Formation and remodeling
• In both types of healing, the wound contracts in the
later stages due to the presence of the
myofibroblast, a contractile cell that has properties
of both fibroblasts and smooth muscle cells.
• Tensile strength of the wound in both kinds of
healing gradually increases with more fibroblast
activity and the laying down of collagen.
41. Tensile Wound Strength
• After sutures are removed at one week,
wound strength is only 10% of unwounded
skin
• By the third month, wound strength is about
80% of unwounded skin
• Result from the excess of collagen synthesis
during the first 2 months , and later from
structural modifications as cross linking and
increase collagen fiber size .
42. Causes of delayed wound healing
(LOCAL)
• Local Infection
• Decreased blood supply
• Foreign bodies and necrotic tissue
• Mechanical stress
• Irradiation
44. Complications of wound healing
• 1.Retarded wound healing and deficient scar formation
may cause wound separation at wound margin: a wound
dehiscence.
• 2.If a large wound cannot be totally covered by epithelium,
the resulting ulcer may require a skin graft.
• 3. The laying down of excessive collagen results in keloid
which is prominent raised scar covered by thin epithelium
• 4. Exuberant granulation tissue “ Proud Flesh”: excessive
granulation tissue growth Protrudes above skin not covered
by epithelium
• 5. Wound contractures is related to the action of
myofibroblasts. This is seen especially following burns.
46. Continuous assessment
Following laparotomy with a midline abdominal
incision, the maximum tensile strength to be
obtained in wound healing in skin is achieved
within:
A) One week
B) Two weeks.
C) Three months
D) One year