This document discusses heart failure, including its pathophysiology, types, and causes. Heart failure occurs when the heart cannot maintain adequate output or can only do so at the expense of elevated ventricular pressures. It may result from systolic or diastolic dysfunction. Types include left, right, and bi-ventricular failure. Acute pulmonary edema is treated with oxygen, nitrates, and diuretics. Chronic heart failure is managed with drugs like diuretics, ACE inhibitors, ARBs, and beta-blockers to improve outcomes.
Heart failure is a clinical syndrome that develops when –
The heart can not maintain adequate output
or
Can do so only at the expense of elevated ventricular filling pressure
Dr Vivek Baliga - Diastolic heart failure - A complete overviewDr Vivek Baliga
In this presentation, Dr Vivek Baliga, Consultant Internal Medicine, discusses a common problem in medical practice that often confuses many - diastolic heart failure. Now a misnomer, it is referred to as heart failure with preserved ejection fraction. For patient articles - http://heartsense.in/author/dr-vivek-baliga-b/ . LinkedIn - https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125
Heart failure is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return.
Definition
Causes
Pathophysiology
Types Of Heart Failure
Symptoms
Signs
Complications
Investigations
Treatment
Heart failure is a clinical syndrome that develops when –
The heart can not maintain adequate output
or
Can do so only at the expense of elevated ventricular filling pressure
Dr Vivek Baliga - Diastolic heart failure - A complete overviewDr Vivek Baliga
In this presentation, Dr Vivek Baliga, Consultant Internal Medicine, discusses a common problem in medical practice that often confuses many - diastolic heart failure. Now a misnomer, it is referred to as heart failure with preserved ejection fraction. For patient articles - http://heartsense.in/author/dr-vivek-baliga-b/ . LinkedIn - https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125
Heart failure is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return.
Definition
Causes
Pathophysiology
Types Of Heart Failure
Symptoms
Signs
Complications
Investigations
Treatment
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
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
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.
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
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.
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
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2. Heart failure describes the clinical syndrome that
develops when the heart cannot maintain
adequate output, or can do so only at the
expense of elevated ventricular filling pressure.
In mild to moderate forms of heart failure, cardiac
output is normal at rest and only becomes
impaired when the metabolic demand increases
during exercise or some other form of stress.
3. Pathophysiology
Cardiac output is determined by preload (the
volume and pressure of blood in the ventricles
at the end of diastole), afterload (the volume
and pressure of blood in the ventricles during
systole) and myocardial contractility; this is
the basis of Starling’s Law.
4. In patients without valvular disease, the primary
abnormality is impairment of ventricular
myocardial function, leading to a fall in cardiac
output. This can occur because of impaired
systolic contraction, impaired diastolic
relaxation, or both. This activates
counterregulatory neurohumoral mechanisms
that, in normal physiological circumstances,
would support cardiac function but, in the
setting of impaired ventricular function, can
lead to a deleterious increase in both
afterload and preload
5.
6.
7. Types of heart failure Left,
right and biventricular heart failure
The left side of the heart comprises the functional
unit of the LA and LV, together with the mitral and
aortic valves; the right heart comprises the RA, RV,
and tricuspid and pulmonary valves.
8. Left-sided heart failure.
There is a reduction in left ventricular output and an
increase in left atrial and pulmonary venous
pressure. An acute increase in left atrial pressure
causes pulmonary congestion or pulmonary
oedema; a more gradual increase in left atrial
pressure, as occurs with mitral stenosis, leads to
reflex pulmonary vasoconstriction, which protects
the patient from pulmonary oedema. This increases
pulmonary vascular resistance and causes
pulmonary hypertension, which can, in turn, impair
right ventricular function.
9. Right-sided heart failure. There is a reduction in right
ventricular output and an increase in right atrial and
systemic venous pressure. Causes of isolated right
heart failure include chronic lung disease (cor
pulmonale), pulmonary embolism and pulmonary
valvular stenosis.
Biventricular heart failure. Failure of the left and right
heart may develop because the disease process,
such as dilated cardiomyopathy or ischaemic heart
disease, affects both ventricles or because disease
of the left heart leads to chronic elevation of the
left atrial pressure, pulmonary hypertension and
right heart failure
10. Diastolic and systolic dysfunction
Heart failure may develop as a result of impaired
myocardial contraction (systolic dysfunction) but
can also be due to poor ventricular filling and high
filling pressures stemming from abnormal
ventricular relaxation (diastolic dysfunction). The
latter is caused by a stiff, noncompliant ventricle
and is commonly found in patients with left
ventricular hypertrophy. Systolic and diastolic
dysfunction often coexist, particularly in patients
with coronary artery disease.
11.
12. Acute left heart failure
Acute de novo left ventricular failure presents with a
sudden onset of dyspnoea at rest that rapidly
progresses to acute respiratory distress, orthopnoea
pparent from the history. The patient appears
agitated, pale and clammy. The peripheries are cool
to the touch and the pulse is rapid. Inappropriate
bradycardia or excessive tachycardia should be
identified promptly, as this may be the precipitant
for the acute episode of heart failure
13. Chronic heart failure
Patients with chronic heart failure commonly follow a
relapsing and remitting course, with periods of
stability and episodes of decompensation, leading
to worsening symptoms that may necessitate
hospitalisation
14. Low cardiac output causes fatigue, listlessness and a
poor effort tolerance; the peripheries are cold and
the BP is low. To maintain perfusion of vital organs,
blood flow is diverted away from skeletal muscle
and this may contribute to fatigue and weakness.
Poor renal perfusion leads to oliguria and uraemia.
Pulmonary oedema due to left heart failure
presents as above and with inspiratory crepitations
over the lung bases. In contrast, right heart failure
produces a high JVP with hepatic congestion and
dependent peripheral oedema. In ambulant
patients, the oedema affects the ankles, whereas, in
bed-bound patients, it collects around the thighs
and sacrum. Ascites or pleural effusion may occur
16. Investigations
Serum urea, creatinine and electrolytes,
haemoglobin, thyroid function, ECG and chest X-ray
may help to establish the nature and severity of the
underlying heart disease and detect any
complications. Brain natriuretic peptide (BNP) is
elevated in heart failure and is a marker of risk; it is
useful in the investigation of patients with
breathlessness or peripheral oedema.
Echocardiography is very useful and should be
considered in all patients with heart failure
17.
18. Management of acute pulmonary oedema
This is an acute medical emergency:
1. Sit the patient up to reduce pulmonary congestion.
2. Give oxygen (high-flow, high-concentration).
3. Administer nitrates, such as IV glyceryl trinitrate
(10–200 µg/min or buccal glyceryl trinitrate 2–5 mg,
titrated upwards every 10 minutes), until clinical
improvement occurs or systolic BP falls to less than
110 mmHg.
4. Administer a loop diuretic, such as furosemide
(50–100 mg IV)
19.
20.
21. Management of chronic heart failure
Drug therapy
Diuretic therapy
In heart failure, diuretics produce an increase in
urinary sodium and water excretion, leading to
reduction in blood and plasma volume . Diuretic
therapy reduces preload and improves pulmonary
and systemic venous congestion. It may also reduce
afterload and ventricular volume, leading to a fall in
ventricular wall tension and increased cardiac
efficiency.Loop duiretic is used, combining a loop
diuretic with a thiazide diuretic (e.g.
bendroflumethiazide 5 mg daily) may prove
effective, but this can cause an excessive diuresis.
22. Angiotensin-converting enzyme inhibition therapy
diuretic therapy. In moderate and severe heart
failure, ACE inhibitors can produce a substantial
improvement in effort tolerance and in mortality.
They can also improve outcome and prevent the
onset of overt heart failure in patients with poor
residual left ventricular function following MI.
‘ACE inhibitors in chronic heart failure due to
ventricular dysfunction reduce mortality and re-
admission rates
23. Angiotensin receptor blocker therapy
Angiotensin receptor blockers (ARBs; act by
blocking the action of angiotensin II on the heart,
peripheral vasculature and kidney. In heart
failure, they produce beneficial haemodynamic
changes that are similar to the effects of ACE
inhibitors but are generally better tolerated.
24. Beta-blockers and treatment of chronic heart failure
Adding oral β-blockers gradually in small incremental
doses to standard therapy, including ACE
inhibitors, in people with heart failure reduces the
rate of death or hospital admission.
Beta-adrenoceptor blocker therapy Beta-blockade
helps to counteract the deleterious effects of
enhanced sympathetic stimulation and reduces
the risk of arrhythmias and sudden death.
Low dose is started & gradually increased.
Choose Beta blocker safe in HF