Humeral shaft fractures are common and can be associated with radial nerve injury. They are usually treated conservatively with hanging casts or braces, though surgery is sometimes needed for displaced or complex fractures. Key complications include non-union, joint stiffness, and radial nerve palsy. Careful clinical and radiographic examination is important to evaluate fracture pattern and nerve function.
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
Presentation outlining the fundamentals of spinal injury exclusively focusing on vertebral column injury. Principles of diagnosis and definitive treatment protocol described in a precise manner in algorithm format for easy and better understanding at undergraduate level.
paediatric injuries around the elbow
supracondylar elbow injuries
pulled elbow in paediatric age r
radiological signs around elbow in supracondylar fracture humerus
Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles.
Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension.
Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands.
Patella Fractures are traumatic knee injuries caused by direct trauma or rapid contracture of the quadriceps with a flexed knee that can lead to loss of the extensor mechanism.
Diagnosis can be made clinically with the inability to perform a straight leg raise and confirmed with radiographs of the knee.
Treatment is either immobilization or surgical fixation depending on fracture displacement and integrity of the extensor mechanism.
Proximal third tibia fractures are relatively common fractures of the proximal tibial shaft that are associated with high rates of soft tissue compromise and malunion (valgus and procurvatum).
Diagnosis is made with orthogonal radiographs of the tibia with CT scan often required to assess for intra-articular extension.
Treatment generally consists of surgical open reduction and internal fixation (ORIF) versus intramedullary nail fixation.
this ppt is based on clinical anatomy related with upper limb which will help all medical students to understand the upper limb related clinical situations for the diagnostic purposes.
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
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.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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.
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Humerus Shaft Fractur-OSCE.pptx
1. Humeral Shaft Fracture and
Principles of Management
Presented by :
(
Ismael Othman Mahmood (KBMS trainee – 2nd stage
Supervised by :
Dr. Aso Ali Bakir
2. Are common
fractures of the
diaphysis of the
humerus , which
may be
associated with
radial nerve
injury.
3. Epidemiology
• Incidence : 3-5 % of all fractures
•
• Demographics :
Bimodal age distribution
Young pt. ; high energy
Elderly pt. ; low energy
4. Anatomy
• extends from the surgical neck proximally to
the humeral condyles distally.
• Cylindrical shape proximally
• conical in its middle 1/3
• Flattened dramatically in the coronal plane
distally .
5.
6.
7.
8. • muscles are divided into anterior flexor and
posterior extensor compartments .
9.
10.
11. Radial Nerve Anatomy
• Largest branch of the brachial plexus
• Arises from posterior cord ( C5 – T1 )
• Motor and Sensory ( mixed )
12.
13.
14.
15.
16. Radial n.
Courses along spiral groove
14 cm proximal to the lateral epicondyle and 20
cm proximal to the medial epicondyle .
17. Radial nerve
At the junction of the middle and distal third of
the humerus, about a handbreadth above the
lateral epicondyle, the radial nerve perforates
the lateral intermuscular septum.
Here the nerve is less mobile and more
vulnerable when displacement of fragments
occurs.
18. Radial nerve palsy
High Radial nerve palsy :
• Elbow extension spared
• Lost: Wrist , thumb and
finger extension ; Sensation
over 1st web space
19.
20.
21.
22. Mechanism of injury
*A fall on the hand may twist the humerus, causing a spiral fracture .
*A fall on the elbow with the arm abducted
exerts a bending force, resulting in an oblique or transverse fracture.
*A direct blow to the arm causes a fracture which is either transverse
or comminuted.
*Fracture of the shaft in an elderly patient may be due to a metastasis
(Pathological ).
23. Pathological anatomy
• With fractures above the deltoid insertion- the
proximal fragment is adducted by pectoralis major and
the distal fragment laterally displaced .
• With fractures lower down- the proximal fragment is
abducted by the deltoid.
• Fractures proximal to the Brachioradialis and
extensor muscles, the distal fragment rotated laterally.
• Distal fractures tend to fall into varus.
27. Radial nerve function test:
( pre- and post-
reduction )
assessment is very
important.
How to do ?
- by assessing active
extension of the MCP
joints.
28. Active extension of
the wrist can be
misleading.
Why ?
Extensor carpi radialis
longus is sometimes
supplied by a branch
arising proximal to the
injury.
29. Radiographs:
AP and Lateral
( joint above and below )
Shows:
1- site of fracture
2- pattern ;
Transverse
Spiral
Oblique
Comminuted
3-Displacement
30. USG of ARM:
To detect the
radial continuity
or entrapment.
36. Non-Operative mx:
• Fracture of the humerus heals readily.
• The weight of the arm with an external cast is
usually enough to pull the fragments into
alignment.
37. Hanging Cast
• applied from shoulder to wrist with the elbow
flexed 90 degrees.
• the forearm section is suspended by a sling
around the patient’s neck.
• may be replaced by a short (shoulder to elbow)
cast or a functional polypropylene brace after 2–3
weeks which is worn for a further 6 weeks .
41. Advantages of non-operative Mx:
• The wrist and fingers exercises can be done
from the start easily .
• Pendulum exercises of the shoulder are
begun within a week .
42.
43. Operative vs. non-operative mx:
• (1) the complication rate after internal fixation
of the humerus is high
• (2) that the great majority of humeral
fractures unite with non-operative treatment
• (3) there is no good evidence that the union
rate is higher with fixation (and the rate may
be lower if there is distraction with nailing or
periosteal stripping with plating).
44. Operative treatment
indications for surgery:
1- severe multiple injuries
2- an open fracture
3- segmental fractures
4- displaced intra-articular extension
5- a pathological fracture
6- a ‘floating elbow’
7- radial nerve palsy after manipulation
8- non-union
9- problems with nursing care in a dependent person
45. Methods
Fixation can be achieved with:
(1) a compression plate and screws
(2) an interlocking intramedullary nail or semi-
flexible pins
(3) an external fixator
46. Compression plate and screw
Advantage :
1-excellent reduction and
fixation.
2-does not interfere with
shoulder or elbow function.
Disadvantage:
1- Radial nerve injury
2- too much periosteal
stripping >> non- union
51. Holstein-Lewis Fracture
A spiral fracture of the distal 1/3
of the humeral shaft commonly
associated with injury to radial
nerve ( 22% ).
52. Special features in children
• Uncommon .
• in under 3 years of age
possibility of child abuse to
be considered and tactful
examination needed for
other injuries .
53. Special features in children
Mx:
Conservative :
* can usually be treated by
applying a collar and cuff
bandage for 3–4 weeks.
*manipulation may be needed, If
there is gross shortening.
*Older children may require a
short plaster splint.
54. Special features in children
Operative :
ORIF with flexible
intramedullary nail fixation
55. References:
• Apley and Solomon’s Concise system of
Orthopaedics and Trauma 10th Edition
• AO Principles of fracture Management 3rd Edition
• www.orthobullets.com
• www.slideshare.net
Editor's Notes
https://www.earthslab.com/anatomy/humerus/
The brachial artery and vein as well as the median and ulnar
nerves traverse the anterior compartment medial to the
coracobrachialis muscle proximally and the brachialis muscle
distallyThe brachial artery and vein as well as the median and ulnar
nerves traverse the anterior compartment medial to the
coracobrachialis muscle proximally and the brachialis muscle
distally
OTA : Orthopedic trauma association
, but active abduction is postponed
until the fracture has united (about 6 weeks for
spiral fractures but often twice as long for other
types); once united, only a sling is needed until the
fracture is consolidated.
a ‘floating elbow’ (simultaneous unstable humeral
and forearm fractures
Taking advantage of the robust periosteum and the
power of rapid healing in children, the humeral fracture