Hwang Catherine noon conference
•Download as PPTX, PDF•
0 likes•100 views
This document provides an overview of a noon conference on gastroparesis. It discusses the objectives, definition, etiology, pathogenesis, clinical presentation, diagnostic tests, treatment, and illness script of gastroparesis. Diabetes mellitus is identified as the most common disease process associated with gastroparesis. Gastric emptying scintigraphy is highlighted as a diagnostic test that can confirm diabetic gastroparesis. Prokinetic agents are noted as one of the most effective treatments for diabetic gastroparesis.
Report
Share
Report
Share
Recommended
Exeter Drugs Update
The document discusses the use of aspirin for the primary prevention of cardiovascular disease in patients with diabetes. While aspirin is proven to be effective for secondary prevention, its benefits for primary prevention in patients without a history of vascular disease are unclear based on previous studies which have been underpowered. The document describes two recent clinical trials, POPADAD and JPAD, which also did not provide definitive evidence due to low event rates. It encourages participation in the ongoing ASCEND trial, which aims to recruit 10,000 patients, in order to help resolve the uncertainty around aspirin's role in primary prevention for patients with diabetes.
Journal club 72010
1) A meta-analysis of 27 randomized trials found that treating anemia in chronic kidney disease patients with erythropoiesis-stimulating agents (ESAs) to achieve higher hemoglobin levels increased risks of stroke, worsening hypertension, and vascular access thrombosis compared to lower hemoglobin targets.
2) No significant differences were found between higher and lower hemoglobin targets for risks of death, cardiovascular events, or progression to kidney failure requiring dialysis.
3) While higher hemoglobin targets reduced need for blood transfusions, they increased use of intravenous iron therapy.
Moghissi
The document discusses the importance of glycemic control for hospitalized patients with diabetes or hyperglycemia. It notes that hyperglycemia is common in hospitalized patients and associated with worse outcomes. The document reviews evidence that intensive insulin therapy to maintain tight glycemic control can reduce mortality, infection rates, and length of stay in intensive care units and improve outcomes for patients with acute myocardial infarction. It discusses guidelines developed for recommended glycemic targets in hospitals.
Effects of aspirin for primary prevention in persons with Diabetes mellitus
This study evaluated the effects of low-dose aspirin (100 mg daily) for primary prevention of vascular events in 15,480 adults with diabetes but no known cardiovascular disease. It found that aspirin led to a 12% lower risk of serious vascular events but also a 29% higher risk of major bleeding. The number of vascular events prevented was similar to the number of major bleeding events caused. Therefore, the benefits of aspirin did not clearly outweigh the risks for primary prevention among adults with diabetes but no known cardiovascular disease.
ASPREE Trial
Among 19,114 healthy elderly patients without cardiovascular disease who were randomized to low-dose aspirin or placebo, aspirin did not reduce the primary composite outcome of death, dementia or persistent physical disability compared to placebo after a median follow-up of 4.7 years. Aspirin was associated with a higher risk of major hemorrhage. Similar recent trials found no benefit of aspirin for primary prevention in diabetic patients or those at moderate cardiovascular risk without increasing bleeding risk. Guidelines do not recommend routine aspirin use for primary prevention in adults over 70 years old due to lack of benefit and risk of bleeding.
Erectile Dysfunction and Risk Factors in Male Peruvian Hemodialysis Patients
Introduction: Erectile dysfunction (ED) is a common condition in patients with renal disease, but little is known about the prevalence of ED in some specific groups of patients such as Peruvian hemodialysis (HD) patients. Materials and Methods: A cross‑sectional study was conducted to determine the frequency of ED in HD patients (n = 390) in Lima, Peru. The prevalence and severity of ED were assessed using the International Index of Erectile Function with the validated Peruvian version. The dependence of ED on independent variables was evaluated by logistic regression. P ≤ 0.05 was regarded as statistically significant.
Rotarians and Diabetes Prevention Developing Healthy Communities: Part 1 rag ...
he Rotarian Action Group for Diabetes is working to stop the global epidemic of the disease. Come learn how Rotarians can lead communities to better health and prevent children dying from lack of insulin. Learn about model programs of prevention and service that your club can institute to improve health in your own community.
Co-moderators:
C. Wayne Edwards, Past District Governor
Rotary Club of Tallahassee, Florida, USA
Larry C. Deeb, Member, The Rotary Foundation Cadre of Technical Advisers
Rotary Club of Tallahassee, Florida, USA
ueda2012 metabolic memory-d.mgahed
The document discusses the concept of "metabolic memory" where the risks of diabetic complications can persist even after glucose levels have returned to normal. It provides evidence from animal and human studies in the 1980s and 2000s supporting this concept. It then summarizes findings from several major clinical trials that compared intensive glucose control to standard control and found reductions in microvascular and macrovascular outcomes with intensive control, though the benefits took years to emerge after trial completion.
Recommended
Exeter Drugs Update
The document discusses the use of aspirin for the primary prevention of cardiovascular disease in patients with diabetes. While aspirin is proven to be effective for secondary prevention, its benefits for primary prevention in patients without a history of vascular disease are unclear based on previous studies which have been underpowered. The document describes two recent clinical trials, POPADAD and JPAD, which also did not provide definitive evidence due to low event rates. It encourages participation in the ongoing ASCEND trial, which aims to recruit 10,000 patients, in order to help resolve the uncertainty around aspirin's role in primary prevention for patients with diabetes.
Journal club 72010
1) A meta-analysis of 27 randomized trials found that treating anemia in chronic kidney disease patients with erythropoiesis-stimulating agents (ESAs) to achieve higher hemoglobin levels increased risks of stroke, worsening hypertension, and vascular access thrombosis compared to lower hemoglobin targets.
2) No significant differences were found between higher and lower hemoglobin targets for risks of death, cardiovascular events, or progression to kidney failure requiring dialysis.
3) While higher hemoglobin targets reduced need for blood transfusions, they increased use of intravenous iron therapy.
Moghissi
The document discusses the importance of glycemic control for hospitalized patients with diabetes or hyperglycemia. It notes that hyperglycemia is common in hospitalized patients and associated with worse outcomes. The document reviews evidence that intensive insulin therapy to maintain tight glycemic control can reduce mortality, infection rates, and length of stay in intensive care units and improve outcomes for patients with acute myocardial infarction. It discusses guidelines developed for recommended glycemic targets in hospitals.
Effects of aspirin for primary prevention in persons with Diabetes mellitus
This study evaluated the effects of low-dose aspirin (100 mg daily) for primary prevention of vascular events in 15,480 adults with diabetes but no known cardiovascular disease. It found that aspirin led to a 12% lower risk of serious vascular events but also a 29% higher risk of major bleeding. The number of vascular events prevented was similar to the number of major bleeding events caused. Therefore, the benefits of aspirin did not clearly outweigh the risks for primary prevention among adults with diabetes but no known cardiovascular disease.
ASPREE Trial
Among 19,114 healthy elderly patients without cardiovascular disease who were randomized to low-dose aspirin or placebo, aspirin did not reduce the primary composite outcome of death, dementia or persistent physical disability compared to placebo after a median follow-up of 4.7 years. Aspirin was associated with a higher risk of major hemorrhage. Similar recent trials found no benefit of aspirin for primary prevention in diabetic patients or those at moderate cardiovascular risk without increasing bleeding risk. Guidelines do not recommend routine aspirin use for primary prevention in adults over 70 years old due to lack of benefit and risk of bleeding.
Erectile Dysfunction and Risk Factors in Male Peruvian Hemodialysis Patients
Introduction: Erectile dysfunction (ED) is a common condition in patients with renal disease, but little is known about the prevalence of ED in some specific groups of patients such as Peruvian hemodialysis (HD) patients. Materials and Methods: A cross‑sectional study was conducted to determine the frequency of ED in HD patients (n = 390) in Lima, Peru. The prevalence and severity of ED were assessed using the International Index of Erectile Function with the validated Peruvian version. The dependence of ED on independent variables was evaluated by logistic regression. P ≤ 0.05 was regarded as statistically significant.
Rotarians and Diabetes Prevention Developing Healthy Communities: Part 1 rag ...
he Rotarian Action Group for Diabetes is working to stop the global epidemic of the disease. Come learn how Rotarians can lead communities to better health and prevent children dying from lack of insulin. Learn about model programs of prevention and service that your club can institute to improve health in your own community.
Co-moderators:
C. Wayne Edwards, Past District Governor
Rotary Club of Tallahassee, Florida, USA
Larry C. Deeb, Member, The Rotary Foundation Cadre of Technical Advisers
Rotary Club of Tallahassee, Florida, USA
ueda2012 metabolic memory-d.mgahed
The document discusses the concept of "metabolic memory" where the risks of diabetic complications can persist even after glucose levels have returned to normal. It provides evidence from animal and human studies in the 1980s and 2000s supporting this concept. It then summarizes findings from several major clinical trials that compared intensive glucose control to standard control and found reductions in microvascular and macrovascular outcomes with intensive control, though the benefits took years to emerge after trial completion.
Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retros...
This document summarizes a study presented at a nephrology journal club that examined the association between proton pump inhibitor (PPI) use and the risk of acute kidney injury (AKI) and chronic kidney disease (CKD) using a large health insurance database. The study found that PPI use was associated with a 4-fold higher risk of AKI and a 20% higher risk of CKD compared to non-users. While the results strengthen evidence of this association, limitations include potential residual confounding and inability to account for over-the-counter medication use. The conclusion calls for provider education and deprescribing initiatives to reduce PPI overuse and potential kidney risks.
Aspirin as Prevention Therapy for Cardiovascular Events in patients with Diab...
The Role of Aspirin in the primary prevention of cardiovascular disease in patients with diabetes, especially T2DM - current knowledge and recommendations -
Aspirin for primary prevention of CVD
The document discusses several studies on the use of aspirin for primary prevention of cardiovascular events. The Antithrombotic Trialists Collaboration meta-analysis found a 12% reduction in serious vascular events but a 50% increase in bleeding risks. Subsequent trials had conflicting results, with some showing no benefit for certain groups. The newer ASCEND, ARRIVE, and ASPREE trials all found aspirin reduced nonfatal heart attacks but increased bleeding risks, with no clear benefit overall when weighing risks and benefits. Primary prevention with aspirin is unlikely to reduce total mortality and may increase bleeding risks according to these studies.
Aspirin for primary prevention in cad in type II DM
Recent studies have questioned the use of low-dose aspirin for primary prevention of cardiovascular disease in patients with type 2 diabetes. The JPAD trial found that aspirin did not reduce cardiovascular events and increased risk of gastrointestinal bleeding. Similarly, the ASCEND trial found aspirin reduced vascular events but increased major bleeding. A meta-analysis found aspirin was not associated with lower mortality and increased risk of major bleeding and intracranial hemorrhage. The ARRIVE and ASPREE trials also found aspirin increased bleeding risk without reduction in cardiovascular outcomes or mortality. Current recommendations are that aspirin may not be beneficial for those under 50 or at low risk, and risks vs benefits should be considered individually for other patients.
ueda2012 glycemic control cvd debate f-d.khalifa
- While observational studies had previously suggested tighter glycemic control could reduce cardiovascular risk, these randomized trials did not find evidence of cardiovascular benefit when tightly controlling glucose levels, indicating the risks of hypoglycemia outweigh any potential benefits.
Artist trial
Carvedilol was studied for its efficacy and safety in treating hypertension, especially in high-risk elderly patients and those with diabetes or renal disease. Over 12 weeks, carvedilol alone or combined with other drugs significantly reduced blood pressure from 168/95 mmHg to 144/83 mmHg. Nearly half of patients achieved their blood pressure goals. Carvedilol was well-tolerated with few side effects and did not negatively impact glucose or renal function in high-risk patients. The study concluded that carvedilol is an effective and safe option for treating hypertension, including in elderly patients and those with complications.
[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)
This is a 30min talk given at the RCPsych liaison conference 2011 on the topic of the failing (suboptimal) medical care provided to psychiatric patients by physicians and psychiatrists. Available in free full text PPT for a limited period.
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...Mubashar A Choudry MD
Dr. Mubashar A Choudry (MD) is a trusted cardiologist and he is explaining here about the use of aspirin for cardiovascular diseases.Warfarin Versus Rivaroxaban
This study compared treatment of provoked deep vein thrombosis (DVT) with rivaroxaban versus vitamin K antagonists (VKA). Patients receiving rivaroxaban required significantly fewer clinic visits than those on VKA (2.92 visits versus 14.58 visits). While on VKA, over a third of patients spent less than 60% of time within the therapeutic range and significant time above or below that range. The overall drug costs were similar between the two treatments, but rivaroxaban required less outpatient attendance. The study concludes that for provoked DVT, rivaroxaban results in safer anticoagulation and less clinic visits compared to VKA.
Ppi in cardiology
This document discusses proton pump inhibitors (PPIs) and their interaction with the blood thinner clopidogrel. It notes that PPIs and clopidogrel are among the most commonly prescribed medications. Studies have shown that the PPI omeprazole can reduce the effectiveness of clopidogrel by inhibiting the enzyme CYP2C19 needed to activate clopidogrel. Regulatory agencies now warn against combined use of clopidogrel and omeprazole. Alternative PPIs like pantoprazole may be safer options, and future research is still needed.
Hipotiroidismo
This document discusses hypothyroidism. It defines hypothyroidism as a hormonal deficiency caused by dysfunction of the thyroid gland that interrupts the synthesis and secretion of T4 and TSH. It discusses the epidemiology, risk factors, classifications, clinical manifestations, diagnosis, screening, and treatment of hypothyroidism. It notes that the prevalence is estimated to be 1-7% of the population and is more common in women and older adults. Diagnosis is based on elevated TSH and low free T4 levels. Treatment goals are to normalize TSH levels and improve symptoms.
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus
This document summarizes the results of the ASCEND trial, which investigated the effects of low-dose aspirin (100 mg daily) for primary prevention of cardiovascular events in 15,480 adults with diabetes but no history of cardiovascular disease. Over a mean follow-up of 7.4 years:
- Serious vascular events were lower in the aspirin group (8.5%) compared to placebo (9.6%), but major bleeding events were higher with aspirin (4.1% vs 3.2%).
- There was no significant difference in gastrointestinal cancer rates between groups.
- Aspirin prevented some vascular events but increased bleeding, largely offsetting the benefits. The absolute risks and benefits were closely balanced
Sugar Control in ICU
The document discusses blood sugar control in ICU patients. It presents two case studies of patients in the ICU with high blood sugar levels and questions around controlling their blood sugar. It then reviews literature showing that hyperglycemia is associated with worse outcomes in critically ill patients. A landmark study called the Leuven study showed that intensive insulin therapy to tightly control blood sugar reduced mortality in the ICU by 34%. However, a later large trial called NICE-SUGAR found that intensive control actually increased mortality compared to conventional control and had higher rates of severe hypoglycemia. The discrepancies in studies' findings may be due to differences in patient populations, treatment protocols, glucose goals achieved, and methods used to measure glucose.
Poster ISHRS 2013
Acute Telogen Efluvium is associated with the presence of female androgenetic alopecia. Potential Therapeutic Implications - A retrospective study of 503 female patients
Quantose and Diabetes Prevention_030316
The document discusses strategies for identifying and managing patients at high risk for diabetes. It finds that intensive lifestyle interventions or metformin treatment can significantly reduce the risk of developing diabetes in patients identified as having prediabetes, defined as impaired glucose tolerance and/or impaired fasting glucose based on oral glucose tolerance tests. However, A1C screening has become more common in primary care settings, but its ability to identify patients most likely to benefit from prevention programs is unclear since such programs have focused on patients identified through tolerance tests. The document advocates for further testing, such as with oral glucose tolerance tests or alternative tests like Quantose, of patients found to have A1C levels in the prediabetes range to better identify which patients have impaired glucose tolerance
Critical care ppt
This document provides information on managing diabetes in the intensive care unit (ICU). It discusses reasons for deteriorated glucose control during hospital admissions like stress hyperglycemia and corticosteroid therapy. It recommends maintaining blood glucose between 140-180 mg/dL based on studies showing increased mortality risks outside this range. Insulin protocols presented aim to gradually control hyperglycemia through hourly monitoring and titrating intravenous insulin doses based on blood glucose levels and rate of change.
Journal club On Proton Pump Inhibitors. ...
Context—Proton pump inhibitors (PPIs) are among the most commonly used drugs worldwide, and have been linked to acute interstitial nephritis. Less is known about the relationship between PPI use and chronic kidney disease (CKD).
Objective—To quantify the association between PPI use and incident CKD in a population based cohort.
In total, 144,032 participants in Communities study with an estimated glomerular filtration rate of at least 60 mL/min/1.73 m2 were followed from a baseline visit between February 1, 1996, and January 30, 1999, to December 31, 2011. The data was analysed from May 2015 to October 2015.
Low carbohydrate diets and mortality
This study from US (Simmons college and Harvard) shows that decreasing carbohydrate intake may also require restricting of animal fats and proteins and increasing vegetable based fats an proteins.
Daily Health Update 05-03-17 Rode Chiropractic Poway, CA
Daily Health Update 05-03-17 Rode Chiropractic Poway, CARode Chiropractic of Poway, CA 92064 (858)-391-1372
Rode Chiropractic
13248 Poway Rd B
Poway, CA 92064
https://www.chiropractor-poway.com
https://www.rodechiropractic.comUnderstanding Liver Disease - Cecilia Minano, MD, MPH - Livingston Library - ...
Learn more abut the body's largest gland and the causes and effects of liver diseases, such as fatty liver and hepatitis, on our overall health.
RunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Slides on Diabetes in the South Focus on Prevention.2018
Learn how to overcome common barriers to diabetes prevention with this downloadable slideset.
Richard E. Pratley, MD
Format: Microsoft PowerPoint (.ppt)
File Size: 3.16 MB
Released: October 23, 2018
More Related Content
What's hot
Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retros...
This document summarizes a study presented at a nephrology journal club that examined the association between proton pump inhibitor (PPI) use and the risk of acute kidney injury (AKI) and chronic kidney disease (CKD) using a large health insurance database. The study found that PPI use was associated with a 4-fold higher risk of AKI and a 20% higher risk of CKD compared to non-users. While the results strengthen evidence of this association, limitations include potential residual confounding and inability to account for over-the-counter medication use. The conclusion calls for provider education and deprescribing initiatives to reduce PPI overuse and potential kidney risks.
Aspirin as Prevention Therapy for Cardiovascular Events in patients with Diab...
The Role of Aspirin in the primary prevention of cardiovascular disease in patients with diabetes, especially T2DM - current knowledge and recommendations -
Aspirin for primary prevention of CVD
The document discusses several studies on the use of aspirin for primary prevention of cardiovascular events. The Antithrombotic Trialists Collaboration meta-analysis found a 12% reduction in serious vascular events but a 50% increase in bleeding risks. Subsequent trials had conflicting results, with some showing no benefit for certain groups. The newer ASCEND, ARRIVE, and ASPREE trials all found aspirin reduced nonfatal heart attacks but increased bleeding risks, with no clear benefit overall when weighing risks and benefits. Primary prevention with aspirin is unlikely to reduce total mortality and may increase bleeding risks according to these studies.
Aspirin for primary prevention in cad in type II DM
Recent studies have questioned the use of low-dose aspirin for primary prevention of cardiovascular disease in patients with type 2 diabetes. The JPAD trial found that aspirin did not reduce cardiovascular events and increased risk of gastrointestinal bleeding. Similarly, the ASCEND trial found aspirin reduced vascular events but increased major bleeding. A meta-analysis found aspirin was not associated with lower mortality and increased risk of major bleeding and intracranial hemorrhage. The ARRIVE and ASPREE trials also found aspirin increased bleeding risk without reduction in cardiovascular outcomes or mortality. Current recommendations are that aspirin may not be beneficial for those under 50 or at low risk, and risks vs benefits should be considered individually for other patients.
ueda2012 glycemic control cvd debate f-d.khalifa
- While observational studies had previously suggested tighter glycemic control could reduce cardiovascular risk, these randomized trials did not find evidence of cardiovascular benefit when tightly controlling glucose levels, indicating the risks of hypoglycemia outweigh any potential benefits.
Artist trial
Carvedilol was studied for its efficacy and safety in treating hypertension, especially in high-risk elderly patients and those with diabetes or renal disease. Over 12 weeks, carvedilol alone or combined with other drugs significantly reduced blood pressure from 168/95 mmHg to 144/83 mmHg. Nearly half of patients achieved their blood pressure goals. Carvedilol was well-tolerated with few side effects and did not negatively impact glucose or renal function in high-risk patients. The study concluded that carvedilol is an effective and safe option for treating hypertension, including in elderly patients and those with complications.
[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)
This is a 30min talk given at the RCPsych liaison conference 2011 on the topic of the failing (suboptimal) medical care provided to psychiatric patients by physicians and psychiatrists. Available in free full text PPT for a limited period.
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...Mubashar A Choudry MD
Dr. Mubashar A Choudry (MD) is a trusted cardiologist and he is explaining here about the use of aspirin for cardiovascular diseases.Warfarin Versus Rivaroxaban
This study compared treatment of provoked deep vein thrombosis (DVT) with rivaroxaban versus vitamin K antagonists (VKA). Patients receiving rivaroxaban required significantly fewer clinic visits than those on VKA (2.92 visits versus 14.58 visits). While on VKA, over a third of patients spent less than 60% of time within the therapeutic range and significant time above or below that range. The overall drug costs were similar between the two treatments, but rivaroxaban required less outpatient attendance. The study concludes that for provoked DVT, rivaroxaban results in safer anticoagulation and less clinic visits compared to VKA.
Ppi in cardiology
This document discusses proton pump inhibitors (PPIs) and their interaction with the blood thinner clopidogrel. It notes that PPIs and clopidogrel are among the most commonly prescribed medications. Studies have shown that the PPI omeprazole can reduce the effectiveness of clopidogrel by inhibiting the enzyme CYP2C19 needed to activate clopidogrel. Regulatory agencies now warn against combined use of clopidogrel and omeprazole. Alternative PPIs like pantoprazole may be safer options, and future research is still needed.
Hipotiroidismo
This document discusses hypothyroidism. It defines hypothyroidism as a hormonal deficiency caused by dysfunction of the thyroid gland that interrupts the synthesis and secretion of T4 and TSH. It discusses the epidemiology, risk factors, classifications, clinical manifestations, diagnosis, screening, and treatment of hypothyroidism. It notes that the prevalence is estimated to be 1-7% of the population and is more common in women and older adults. Diagnosis is based on elevated TSH and low free T4 levels. Treatment goals are to normalize TSH levels and improve symptoms.
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus
This document summarizes the results of the ASCEND trial, which investigated the effects of low-dose aspirin (100 mg daily) for primary prevention of cardiovascular events in 15,480 adults with diabetes but no history of cardiovascular disease. Over a mean follow-up of 7.4 years:
- Serious vascular events were lower in the aspirin group (8.5%) compared to placebo (9.6%), but major bleeding events were higher with aspirin (4.1% vs 3.2%).
- There was no significant difference in gastrointestinal cancer rates between groups.
- Aspirin prevented some vascular events but increased bleeding, largely offsetting the benefits. The absolute risks and benefits were closely balanced
Sugar Control in ICU
The document discusses blood sugar control in ICU patients. It presents two case studies of patients in the ICU with high blood sugar levels and questions around controlling their blood sugar. It then reviews literature showing that hyperglycemia is associated with worse outcomes in critically ill patients. A landmark study called the Leuven study showed that intensive insulin therapy to tightly control blood sugar reduced mortality in the ICU by 34%. However, a later large trial called NICE-SUGAR found that intensive control actually increased mortality compared to conventional control and had higher rates of severe hypoglycemia. The discrepancies in studies' findings may be due to differences in patient populations, treatment protocols, glucose goals achieved, and methods used to measure glucose.
Poster ISHRS 2013
Acute Telogen Efluvium is associated with the presence of female androgenetic alopecia. Potential Therapeutic Implications - A retrospective study of 503 female patients
Quantose and Diabetes Prevention_030316
The document discusses strategies for identifying and managing patients at high risk for diabetes. It finds that intensive lifestyle interventions or metformin treatment can significantly reduce the risk of developing diabetes in patients identified as having prediabetes, defined as impaired glucose tolerance and/or impaired fasting glucose based on oral glucose tolerance tests. However, A1C screening has become more common in primary care settings, but its ability to identify patients most likely to benefit from prevention programs is unclear since such programs have focused on patients identified through tolerance tests. The document advocates for further testing, such as with oral glucose tolerance tests or alternative tests like Quantose, of patients found to have A1C levels in the prediabetes range to better identify which patients have impaired glucose tolerance
Critical care ppt
This document provides information on managing diabetes in the intensive care unit (ICU). It discusses reasons for deteriorated glucose control during hospital admissions like stress hyperglycemia and corticosteroid therapy. It recommends maintaining blood glucose between 140-180 mg/dL based on studies showing increased mortality risks outside this range. Insulin protocols presented aim to gradually control hyperglycemia through hourly monitoring and titrating intravenous insulin doses based on blood glucose levels and rate of change.
Journal club On Proton Pump Inhibitors. ...
Context—Proton pump inhibitors (PPIs) are among the most commonly used drugs worldwide, and have been linked to acute interstitial nephritis. Less is known about the relationship between PPI use and chronic kidney disease (CKD).
Objective—To quantify the association between PPI use and incident CKD in a population based cohort.
In total, 144,032 participants in Communities study with an estimated glomerular filtration rate of at least 60 mL/min/1.73 m2 were followed from a baseline visit between February 1, 1996, and January 30, 1999, to December 31, 2011. The data was analysed from May 2015 to October 2015.
Low carbohydrate diets and mortality
This study from US (Simmons college and Harvard) shows that decreasing carbohydrate intake may also require restricting of animal fats and proteins and increasing vegetable based fats an proteins.
Daily Health Update 05-03-17 Rode Chiropractic Poway, CA
Daily Health Update 05-03-17 Rode Chiropractic Poway, CARode Chiropractic of Poway, CA 92064 (858)-391-1372
Rode Chiropractic
13248 Poway Rd B
Poway, CA 92064
https://www.chiropractor-poway.com
https://www.rodechiropractic.comWhat's hot (19)
Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retros...
Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retros...
Aspirin as Prevention Therapy for Cardiovascular Events in patients with Diab...
Aspirin as Prevention Therapy for Cardiovascular Events in patients with Diab...
Aspirin for primary prevention in cad in type II DM
Aspirin for primary prevention in cad in type II DM
[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)
[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...
The Use of Aspirin for Primary Prevention of Cardiovascular Diseases - Dr. Mu...
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus
Daily Health Update 05-03-17 Rode Chiropractic Poway, CA
Daily Health Update 05-03-17 Rode Chiropractic Poway, CA
Similar to Hwang Catherine noon conference
Understanding Liver Disease - Cecilia Minano, MD, MPH - Livingston Library - ...
Learn more abut the body's largest gland and the causes and effects of liver diseases, such as fatty liver and hepatitis, on our overall health.
RunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Slides on Diabetes in the South Focus on Prevention.2018
Learn how to overcome common barriers to diabetes prevention with this downloadable slideset.
Richard E. Pratley, MD
Format: Microsoft PowerPoint (.ppt)
File Size: 3.16 MB
Released: October 23, 2018
Diabetes presentation nosscr 112011 san antonio 2
The document discusses diabetes, including:
1) Diabetes affects over 25 million Americans and is increasing, with some areas having higher rates.
2) The SSA is eliminating the diabetes listing due to advances in treatment, but complications can still be disabling.
3) Diabetes has two main types (1 and 2) and can cause many serious complications affecting multiple body systems if not properly managed.
sitagliptin for diabetics
Recent studies have highlighted the growing global burden of type 2 diabetes, with over 600 million people projected to have the disease by 2045. In particular, Egypt will face explosive growth in cases. While control of blood sugar levels is important for reducing complications, most patients do not achieve treatment goals. Intensifying treatment in a timely manner when blood sugar is poorly controlled can reduce cardiovascular risks. Inertia on the part of both physicians and healthcare systems often limits timely treatment changes needed to improve outcomes for patients with type 2 diabetes.
Managing DM and thyroid disease in shift workers
Shift work is associated with higher risks of subclinical hypothyroidism and diabetes due to changes in circadian rhythm. Night shift work can increase TSH levels and the risk of subclinical hypothyroidism in women. It is also associated with higher risks of obesity, type 2 diabetes, and poorer glucose control, possibly because shift work promotes unhealthy eating behaviors and weight gain over time. Screening for thyroid disorders and managing weight are important for shift workers' health.
Intestinal angioedema-case-report-and-literature-review-jgds-18
This article presents a case report of a 26-year-old woman diagnosed with hereditary angioedema (HAE) with intestinal involvement after 13 years of recurrent abdominal pain, diarrhea, nausea, and swelling of the hands, lips and eyelids. Over this period, she underwent six laparoscopic surgeries that revealed small amounts of free intraperitoneal fluid but no definitive cause of her symptoms. Biochemical testing found decreased levels of C1 esterase inhibitor and C4, confirming the diagnosis of HAE. Treatment with oxandrolone has partially controlled her abdominal pain attacks by decreasing their frequency. The case report discusses the challenges of diagnosing intestinal angioedema and highlights the importance of considering HAE
Benjamin Bearnot - New treatments for the infectious complications of substan...
Benjamin Bearnot - New treatments for the infectious complications of substan...Benjamin Bearnot, MD
New treatments for infectious complications of substance use disorders and barriers to implementation were discussed. The scope of substance use disorder problems was reviewed. New highly effective treatments for Hepatitis C like Harvoni and Viekira Pak were presented along with barriers like cost and side effects. New treatments for skin and soft tissue infections like dalbavancin were also discussed. Two case studies were then presented to demonstrate management of patients with these issues. Barriers to treatment included access to care, adherence, and cost. Future directions around integrating care and new treatments were proposed.Liver disease (Case study,definition,indication,treatment,recovery )
A small presentation about definition,indications , treatment , recovery of liver disease .Hope this small attempt would be helpful to you .
Diabetes of stout people
* Case presentation: hyperosmolar hyperglycemic state (HHS)
Mortality attributed to hyperosmolar hyperglycemic state (HHS) is considerably higher than that attributed to DKA, with recent mortality rates of 5–20%.
* Agenda:
Historical perspectives and diagnosis.
Pathophysiology.
Treatment issues.
Rhabdomyolysis: an overlooked complication.
Final bottom line and take home message.
ueda2012 cost effective diabetes treatment-d.edwin
The document discusses effective and cost-effective treatment for diabetes. It examines the goals of treatment, which include achieving near-normal glucose control, life expectancy, and quality of life. However, intensified glucose control alone offers limited benefits for type 2 diabetes patients and has not been shown to improve life expectancy. Early intervention is most beneficial. The document advocates considering a patient's prognosis, comorbidities, and preferences when determining a diabetes treatment plan. It also stresses the importance of lifestyle modifications in addition to pharmacotherapy.
Wjg 15-1613
This randomized controlled trial compared the efficacy of pentoxifylline and prednisolone in treating severe alcoholic hepatitis. 68 patients were divided into two groups - one received pentoxifylline and the other received prednisolone for 4 weeks, followed by a tapering dose of prednisolone over 7 weeks. More patients died in the prednisolone group (12 patients) compared to the pentoxifylline group (5 patients) by 3 months. Patients receiving prednisolone also had more life-threatening complications like hepatorenal syndrome and gastrointestinal bleeding. The study suggests pentoxifylline is superior to prednisolone for treating severe alcoholic hepatitis due to its reduced mortality and renopro
Strict Glycemic Control in Critically ill patients: The Demise of another ver...
Strict Glycemic Control in Critically ill patients: The Demise of another ver...Prof. Mridul Panditrao
Prof. Mridul M. Panditrao tries to explain the pros and cons about the good strategy, whcih became controversial and almost obsolete. He also tries to tract the whole aspect of the phenomenon and reviews/ RCTs/
Strict (Tight) Glycemic control (SGC/TGC), as it is called, was and still is a good strategy. It can be defined as maintenance of the blood glucose level in the range of 80-110 mg /dl. with help of dose variable and intensive insulin therapy (IIT). Since its introduction, there have been conflicting reports of its efficacy and complications. This resulted in slow but steady neglect of this very good idea leading to its almost complete demise.
An effort has been made in this review, to impartially analyze all the available evidence and try to find the reasons for the negative publicity which led to the neglect or worse still, the wrong use of this protocol. Some suggestions for fair and proper implementation of the strategy are put forward.
etc/
Understanding Liver Disease - Dr. Cecilia Minano - 9.19.18
Dr. Cecilia Minano presented “Understanding Liver Disease,” at the Montclair Public Library. We learned that over 10 million people are at risk for chronic liver disease (CLD). Non-Alcoholic Fatty Liver Disease (NAFLD) presents in 30 percent of adults. Lifestyle changes such as adapting a healthy diet, exercise and weight loss can help manage the condition.
Am 10.40 gardner
Here are my recommendations for the 56 year old woman with subclinical hypothyroidism:
1. Her diagnosis is subclinical hypothyroidism based on an elevated TSH of 7.1 and normal free T4.
2. Given her age (56), fatigue, and 3-4 lb weight gain, I would recommend a trial of levothyroxine therapy. Treatment is reasonable for patients with TSH >10 or positive thyroid antibodies, which she does not have data for. However, treatment may modestly improve her lipids and symptoms.
3. She should be monitored every 6 months with TSH checks to ensure her TSH is maintained between 0.5-2.0 and that she does not
SIN SARGATA (ISS), PIED DIABÉTIQUE, GOOD, 17 A.pdf
The study retrospectively analyzed 180 cases of diabetic foot treated at a Cambodian hospital between 2011-2015. Most patients were older farmers over 60 years old. The majority (70%) underwent debridement, while amputation was required for 31%. High blood pressure was present in 46% of patients and end-stage renal failure in 6.1%. The study found diabetic foot complications occurred in both younger and older diabetic patients and were related not only to glycemic control and diabetes duration, but also patient knowledge.
Non-alcoholic Fatty Liver Disease (NAFLD) and its association with metabolic ...
Non-alcoholic Fatty Liver Disease (NAFLD) and its association with metabolic ...International Multispeciality Journal of Health
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD. Healthy weight it is not a diet, it is a lifestyle!
Involuntary weight loss
Angel Carlos Matía Cubillo
Family and Community Medicine Specialist
Health Technician. GAP Valladolid East
The Global Strategy and Teamwork for Periodontal Health and Overall Health - ...
HOT TOPIC SESSION
The Global Strategy and Teamwork for Periodontal Health and Overall Health
Filippo Graziani
FDI World Dental Congress 2016 Poznań
09-rwcc18-sherman-keyslides.pptx
This document discusses issues in liver health and disease for non-hepatologists. It provides an overview of the changing epidemiology of viral hepatitis and new hepatitis B vaccines. It also addresses non-alcoholic fatty liver disease (NAFLD) and how increased recognition of this condition has led to new screening and potential therapy approaches. The document uses audience response questions to highlight clinical cases involving liver disease in HIV patients and discusses topics like viral hepatitis coinfections, hepatitis B vaccine strengths and limitations, and the natural history and risk factors associated with NAFLD.
Similar to Hwang Catherine noon conference (20)
Understanding Liver Disease - Cecilia Minano, MD, MPH - Livingston Library - ...
Understanding Liver Disease - Cecilia Minano, MD, MPH - Livingston Library - ...
RunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead PICOT Question1RunningHead PICOT Question7.docx
Slides on Diabetes in the South Focus on Prevention.2018
Slides on Diabetes in the South Focus on Prevention.2018
Intestinal angioedema-case-report-and-literature-review-jgds-18
Intestinal angioedema-case-report-and-literature-review-jgds-18
Benjamin Bearnot - New treatments for the infectious complications of substan...
Benjamin Bearnot - New treatments for the infectious complications of substan...
Liver disease (Case study,definition,indication,treatment,recovery )
Liver disease (Case study,definition,indication,treatment,recovery )
ueda2012 cost effective diabetes treatment-d.edwin
ueda2012 cost effective diabetes treatment-d.edwin
Strict Glycemic Control in Critically ill patients: The Demise of another ver...
Strict Glycemic Control in Critically ill patients: The Demise of another ver...
Understanding Liver Disease - Dr. Cecilia Minano - 9.19.18
Understanding Liver Disease - Dr. Cecilia Minano - 9.19.18
SIN SARGATA (ISS), PIED DIABÉTIQUE, GOOD, 17 A.pdf
SIN SARGATA (ISS), PIED DIABÉTIQUE, GOOD, 17 A.pdf
Non-alcoholic Fatty Liver Disease (NAFLD) and its association with metabolic ...
Non-alcoholic Fatty Liver Disease (NAFLD) and its association with metabolic ...
Healthy weight it is not a diet, it is a lifestyle!
Healthy weight it is not a diet, it is a lifestyle!
The Global Strategy and Teamwork for Periodontal Health and Overall Health - ...
The Global Strategy and Teamwork for Periodontal Health and Overall Health - ...
More from Virginia Mason Internal Medicine Residency
Noon conference specialty talk ccu 5-7-19
Critical care involves managing organ system failures while considering the overall clinical picture of the patient. Less invasive interventions are preferred when possible to avoid iatrogenic harm. Prognostication is difficult, and outcomes depend on the individual patient's values and preferences. Family meetings require skilled communication to make difficult end-of-life decisions. The goal is providing humane care that aligns with patient priorities through a team-based approach.
Jgk noon conference 5.7.19
This document summarizes a bioethics case discussion involving a 68-year-old female patient with metastatic lung cancer. The patient was admitted for pneumonia and influenza and experienced a complex clinical course involving recurrent infections, malnutrition, and declining functional status. Discussions with family focused on unclear goals of care and difficulty accepting a transition to comfort measures. An ethics consult recommended a one-week trial of aggressive care with clear outcomes to help guide decision making. After the trial failed and a deathbed visit from her son, the family agreed to transition to comfort care, where the patient later passed away. The document reviews key challenges, outcomes, and bioethics considerations around medically appropriate treatment and incorporating patient perspectives when decisional capacity is lacking
Organism potpourri 5 6-2019
The document summarizes several infectious disease cases presented at a noon conference. The first case discusses a male presenting with cough and fever who was diagnosed with blastomycosis after cytology found Blastomyces dermatitidis. The second case involves a pregnant woman from Nigeria with malaria diagnosed on peripheral smear after visiting a rural village. The third case is about a man returning from Saint Martin with joint pains and fever, possibly due to arboviral infections like chikungunya or dengue. The last two cases discuss a man with L4-L5 osteomyelitis and sacroiliitis diagnosed with brucellosis, and a woman with cervical lymphadenopathy possibly having toxoplasmosis
Noon conference 2 caballero
Meghan Caballero presented a noon conference on factitious disorder. The objectives were to review definitions, epidemiology, pathogenesis, clinical features, diagnosis, and treatment options for factitious disorder. Factitious disorder involves patients deceiving doctors by misrepresenting or inducing medical symptoms without an obvious reward. It affects about 1% of clinical settings and usually presents in adults in their 30s or 40s following hospitalization. Diagnosis requires falsified symptoms and deception according to DSM-5 criteria. Treatment focuses on psychotherapy but many patients refuse or do not follow up with psychiatric care.
Clinical osa evaluation (residents)
This document discusses obstructive sleep apnea (OSA) in women. It notes several anatomical factors that can contribute to OSA in women, such as a smaller airway size, elongated airway, and micrognathia. It compares the costs, convenience, accuracy, and comfort of different diagnostic tests for OSA, including home sleep tests, in-lab polysomnography (PSG), and PSG with positive airway pressure titration (PAP). The document also images several CPAP mask options and oral appliance therapies that can be used to treat OSA. It concludes by providing contact information for a sleep physician.
Noon conference opheim 050219
A 38-year-old woman presents with abnormally heavy menstrual bleeding. Her periods are now 10 days long compared to her normal 5 days. She has lower abdominal cramping and mild dizziness. Exam is normal. Initial testing shows a hemoglobin of 10.5 (down from 12 six months ago). Pelvic ultrasound reveals a left-sided submucosal fibroid. The patient is prescribed a course of progesterone which does not fully resolve her bleeding. She is referred for hysteroscopic or laparoscopic myomectomy to treat her symptomatic submucosal fibroid.
Tb answer sheet
The document discusses guidelines for tuberculosis (TB) testing and treatment. It provides criteria for positive TB test results based on induration size and risk factors. It notes that interferon gamma release assays (IGRAs) are at least as sensitive as the tuberculin skin test (TST) for detecting TB infection. Both tests detect exposure to TB but cannot differentiate between active disease and latent infection. IGRAs are preferred in those with BCG vaccination or nontuberculous mycobacterium infection history. Treatment options for latent TB infection include various combinations of isoniazid and rifampin administered for 3-9 months, depending on medications and patient risk factors such as HIV status.
Latent tb worksheet
A 42-year-old healthcare worker presents for follow-up of a recent tuberculin skin test (TST) which showed 12mm of induration. He has no symptoms of active tuberculosis such as cough, fever, or night sweats. The next most appropriate step in management is to start isoniazid treatment for latent tuberculosis.
Intro to ct head prr
This document provides guidance on performing and interpreting CT head scans. It outlines the basic search pattern for a CT head, including examining for hemorrhage, signs of infarct, brain parenchyma, and other structures. It also lists some blind spots on CT head scans. The document then describes several case examples of acute stroke, subdural hemorrhages of different ages, epidural hematomas including a special venous type, subarachnoid hemorrhage, fat embolism after injury, and interpreting gunshot wound head CTs.
2019 04-30 noon conference [stephen slade]
This document summarizes information about subacute granulomatous (De Quervain) thyroiditis and compares it to Adult Stills disease. Subacute thyroiditis is often caused by a viral infection and presents with neck or jaw pain, a tender thyroid, and elevated inflammatory markers. It follows a path of varying thyroid hormone levels and typically resolves with follicular regeneration. Adult Stills disease has an unclear trigger but presents with quotidian fevers, arthritis, and an evanescent rash, requiring immunosuppression for treatment. Key differences between the conditions are highlighted regarding epidemiology, clinical presentation, diagnostics, and therapeutics.
Noon conference banta
This document summarizes a noon conference on cerebellar infarcts. It discusses the cerebellum's anatomy and circuitry, the clinical presentation of cerebellar infarcts including limb ataxia and gait imbalance. Physical exam techniques like HINTS are covered. Diagnostic tests like MRI are discussed as the gold standard. Treatment options like tPA are mentioned. An illness script compares cerebellar infarct to vestibular neuritis, outlining their differences in pathophysiology, epidemiology, clinical presentation, diagnostics and therapeutics.
Mm 4 29-19
This document summarizes a case presentation of a patient with recurrent diabetic foot infections and osteomyelitis leading to multiple amputations over several years. Despite aggressive treatments including multiple debridements and long-term IV antibiotics, the patient continued to experience complications from non-adherence to wound care and medications. A discussion of the case highlighted potential errors like lack of standardized treatment protocols, fragmented care coordination, and challenges providing consistent care for a patient in a rural area with psychiatric issues. Lessons focused on the need for multidisciplinary teams and addressing both medical and social factors to best manage these complex cases.
Migraine headache presentation resident
This document provides information on common primary headaches including migraine, tension-type headache, and cluster headache. It discusses prevalence, diagnostic criteria, pathophysiology, comorbidities, and treatment approaches for each headache type. For migraine specifically, it notes higher prevalence in women ages 25-55 and common comorbidities like depression and anxiety. Treatment involves both acute and preventive options.
Noon conference Lobaton
This document discusses Wernecke's encephalopathy, a neurological condition caused by thiamine (vitamin B1) deficiency. It begins by outlining the objectives and importance of thiamine. The classic triad of signs includes encephalopathy, oculomotor dysfunction, and gait ataxia, though this full triad is only seen in about 33% of cases. Diagnosis is clinical but may include MRI showing lesions in the thalamus, mamillary bodies, and periaqueductal region. Treatment involves high-dose intravenous or intramuscular thiamine supplementation. Wernecke's encephalopathy is commonly associated with chronic alcoholism but can occur in other conditions involving malnutrition
Noon conference kaylee park
1) The objectives of the noon conference were to review warm autoimmune hemolytic anemia (AIHA), including diagnostic criteria, clinical presentation, and treatment.
2) A case study was presented of a 27-year-old woman with systemic lupus erythematosus (SLE) and new onset fatigue and shortness of breath. Her lab results were consistent with warm AIHA.
3) Warm AIHA was discussed in detail, including diagnostic criteria of anemia, elevated LDH, low haptoglobin, positive direct antiglobulin test; clinical presentation of anemia, hemolysis, associated conditions; and first-line treatment of high dose corticosteroids.
Uri presentation 4 23-19
Upper Respiratory Tract Infections: Pharyngitis, Epiglottitis, Deep Infections in Head and Neck
The document discusses various upper respiratory tract infections including pharyngitis, epiglottitis, and deep neck space infections. It provides guidelines for evaluating and diagnosing pharyngitis using the Centor criteria to determine if testing for Group A streptococcus is needed. It also discusses non-streptococcal causes of pharyngitis and outlines considerations and workup for dangerous deep neck space infections like epiglottitis and peritonsillar abscesses. The goal is to appropriately diagnose and treat conditions like streptococcal pharyngitis while excluding
Case report 4 23-19
This document summarizes a presentation on Cyclic Vomiting Syndrome (CVS). It discusses the clinical manifestations of CVS including stereotypical vomiting episodes, intervals of good health between episodes, and absence of an organic cause. It outlines the diagnostic criteria per Rome IV as having stereotypical episodes of vomiting at least 3 times in the past year, with varying intervals of good health in between. The pathogenesis of CVS is unknown but has been associated with migraines. Treatment involves abortive medications like sumatriptan for mild episodes and prophylactic tricyclic antidepressants for more frequent/severe episodes. An illness script compares CVS to Cannabinoid Hyperemesis Syndrome.
Crc talk for residents 2019
Colorectal cancer screening aims to detect cancer early and prevent cancer by removing precancerous polyps. Screening decreases colorectal cancer incidence and mortality in those over 50 by finding cancer at earlier stages. However, incidence and mortality have increased in younger adults in recent decades. Current guidelines recommend starting screening at 45 or 50 depending on risk factors, but starting at 45 is controversial due to costs and potential strain on resources. The main objectives of screening are detecting cancer early and removing polyps to prevent cancer.
Noon conference mgus
This document discusses multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS). It defines MGUS and describes its three distinct types. It outlines the workup, disease course, and monitoring for MGUS. Complications of MGUS discussed include anemia, fractures, and thrombosis. MM is then reviewed, including typical presentations and complications like renal disease. Renal disease in MM is further explained, focusing on light chain cast nephropathy.
19 im resident future of rectal cancer
The document summarizes recent developments in the treatment of rectal cancer. It notes that standard therapy involving total mesorectal excision and chemoradiation leads to permanent ostomy in 25% of patients and late toxicity. New studies are exploring non-operative management for patients who achieve a clinical complete response after neoadjuvant therapy, with similar survival outcomes but higher rectal preservation rates compared to surgery. Biomarkers such as dMMR status and neuroendocrine histology may help personalize treatment approaches for rectal cancer patients.
More from Virginia Mason Internal Medicine Residency (20)
Recently uploaded
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
STIs may cause PID. For the both disease, herbal medicine Fuyan Pill can be a solution.
ABDOMINAL TRAUMA in pediatrics part one.
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Top Effective Soaps for Fungal Skin Infections in India
Swisschem Dermacare has mentioned the List of The Best Antifungal Soap In India 2022. All of these soaps are trusted by various Dermatology Experts.
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
Recently uploaded (20)
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Hwang Catherine noon conference
- 2. Objectives • Definition • Etiology • Pathogenesis • Clinical presentation • Diagnostic tests • Treatment • Illness script • Extras (if time permits) 2
- 3. Definition 3
- 4. Etiology 4 What is the most common disease process associated with gastroparesis? a) Damage to the vagus nerve during surgery b) Diabetes mellitus c) Infection d) Medications
- 7. Diagnostic Tests Which of the following diagnostic tests can be used to confirm our suspicion of diabetic gastroparesis? a) Gastric emptying scintigraphy b) Swallowed capsule telemetry c) Hemoglobin A1c d) All of the above 7
- 9. Treatment Which of the following is most effective in treating diabetic gastroparesis? a) Tight glycemic control b) Prokinetic agents c) Antiemetic medications d) Gastric electrical stimulation 9
- 10. Illness Script 10 Gastroparesis Mechanical Obstruction Pathophysiology Motility problem Blockage problem Epidemiology Female to male ratio = 4:1 Patients with diabetes mellitus Age > 65 years Post-surgical patients Time course Chronic Acute Clinical presentation Early satiety, postprandial fullness, nausea, vomiting, bloating, and upper abdominal pain Abdominal pain, nausea, vomiting, abdominal distention, rebound tenderness, localized severe abdominal tenderness Diagnostics Gastric emptying scintigraphy CT abdomen or pelvis Fever, leukocytosis, metabolic acidosis, tachycardia (if strangulation) Therapeutics Treat underlying cause Symptomatic management with prokinetic and antiemetic medications Surgery Conservative treatment with NG tube, antibiotics, and oral triple therapy if indicated
- 12. Medications to Prevent Complications of Diabetes 12
- 13. Decrease in Hemoglobin A1c 13Source: Bailey et al. Int J Clin Pract. 2011;65(3):314-322.
- 14. Goal Glycemic Control 14 𝟐 𝟑 𝟏 𝟐 HbA1c < 7.0% Premature Cardiovascular Death Source: Bailey et al. Int J Clin Pract. 2011;65(3):314-322.
- 15. Risk Factors 15 Non-Modifiable Modifiable Socially Determined Age Insufficient physical activity Education Ethnicity Smoke cigarettes Income Gender Obesity Family history High cholesterol High blood pressure
- 16. Medication Adherence 16Source: IMS Health, July 2010.
- 17. Hospitalizations and ED Visits Associated with Non-Adherence to Diabetes Medications 17Source: Jha et al. Health Aff. 2012;31(8):1836-1846.
- 18. Costs of Non-Adherence Improving adherence to diabetes medication – Prevents 699,000 emergency department visits annually – Prevents 341,000 hospitalizations annually – Saves $4.7 billion annually Eliminating the loss of adherence to diabetes medication – Saves $3.6 billion annually 18Source: Jha et al. Health Aff. 2012;31(8):1836-1846.
- 19. Prevalence of Diabetes in the U.S. 19Source: United States Centers for Disease Control and Prevention, April 2017
- 20. Impact of Diabetes in the U.S. 20Source: United States Centers for Disease Control and Prevention, May 2015