Hypernatremia is defined as a plasma sodium concentration over 145 mEq/L. It can be caused by sodium gain, water loss, or a combination of both. Symptoms range from mild to severe and include altered mental status, weakness, and seizures. Treatment involves gradually correcting the sodium level and addressing the underlying cause, such as giving water orally to replace free water deficit. Rapid correction can cause dangerous brain cell shrinkage. Diabetes insipidus requires treating the specific cause and may involve vasopressin analogs or thiazide diuretics.
09.30.08(b): Approach to the Patient with Disorders of OsmoregulationOpen.Michigan
Slideshow is from the University of Michigan Medical School's M2 Renal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Renal
09.30.08(b): Approach to the Patient with Disorders of OsmoregulationOpen.Michigan
Slideshow is from the University of Michigan Medical School's M2 Renal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Renal
Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New 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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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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
2. Definition
Hypernatremia is defined as a plasma [Na+] >145 mEq/L and represents a state
of hyperosmolality
Etiology
Hypernatremia caused by a primary Na+ gain or a water deficit(more common).
Hyperosmolar state stimulates thirst and the excretion of a maximally
concentrated urine.
In hypernatremia these compensatory mechanisms are impaired.
Impaired thirst response may occur in situations where access to water is
limited,often due to physical restrictions (institutionalized, handicapped,
postoperative, orintubated patients) or the mentally impaired (delirium, dementia).
3. Hypernatremia due to water loss.
Nonrenal water loss may be due to evaporation from the skin and respiratory tract
(insensible losses) or loss from the GI tract.
Diarrhea is the most common GI cause of hypernatremia.
Osmotic diarrhea (induced by lactulose, sorbitol, or malabsorption of carbohydrate) and
viral gastroenteritis result in disproportional water loss.
Renal water loss results from either osmotic diuresis or diabetes insipidus
Osmotic diuresis is frequently associated with glycosuria.
Increased urea generation from accelerated catabolism, high protein feeds, and stress-
dose steroids can also result in an osmotic diuresis.
4. Hypernatremia secondary to nonosmotic urinary water loss is caused by
(a) impaired vasopressin secretion (central diabetes insipidus [CDI]) or
(b) resistance to the actions of vasopressin (nephrogenic diabetes insipidus
[NDI]).
Cause of CDI is destruction of the neurohypophysis from trauma, neurosurgery,
granulomatous disease, neoplasms, vascular accidents, or infection.
NDI may either be inherited or acquired.
Disruption to the renal concentrating mechanism due to drugs
(lithium,demeclocycline, amphotericin), electrolyte disorders (hypercalcemia,
hypokalemia),medullary washout (loop diuretics), and intrinsic renal diseases.
5. Hypernatremia due to primary Na+ gain can rarely occur after repetitive
hypertonic saline administration or chronic mineralocorticoid excess.
Transcellular water shift from ECF to ICF can occur in circumstances of
transient intracellular hyperosmolality, as in seizures or rhabdomyolysis
6. DIAGNOSIS
Clinical Presentation
Hypernatremia results in contraction of brain cells as water shifts to attenuate the
rising ECF osmolality.
Symptoms includes altered mental status, weakness, neuromuscular
irritability,focal neurologic deficits, and, occasionally, coma or seizures.
Chronic hypernatremia is generally less symptomatic as a result of adaptive
mechanisms designed to defend cell volume.
CDI and NDI generally present with complaints of polyuria and thirst. Signs of
volume depletion or neurologic dysfunction are generally absent unless the patient
has an associated thirst abnormality.
7. DIAGNOSTIC TESTING
Laboratories
Urine osmolality and the response to desmopressin acetate (DDAVP) narrow the differential
diagnosis for hypernatremia.
The appropriate renal response is a small volume of concentrated (urine osmolality >800 mOsm/L)
urine.
Submaximal urine osmolality (<800 mOsm/L) suggests a defect in renal water conservation.
A urine osmolality <300 mOsm/L in the setting of hypernatremia suggests complete forms of CDI
and NDI.
8. Urine osmolality between 300 and 800 mOsm/L can occur from partial formsof
diabetes insipidus (DI) as well as osmotic diuresis.
The two can be differentiated by quantifying the daily solute excretion.
A daily solute excretion >900 mOsm/L defines an osmotic diuresis.
Response to DDAVP. Complete forms of CDI and NDI can be distinguished by
administering the vasopressin analog DDAVP (10 mcg intranasally) after careful
water restriction.
The urine osmolality should increase by at least 50% in complete DI and does not
change in NDI.
9.
10. TREATMENT
Aggressive correction of hypernatremia is potentially dangerous. The rapid shift of water
into brain cells increases the risk of seizures or permanent neurologic damage.
Therefore, the water deficit should be reduced gradually by roughly 10 to 12 mEq/L/d.
In chronic asymptomatic hypernatremia, due to the cerebral adaptation to the chronic
hyperosmolar state, the plasma [Na+] should be lowered at a more moderate rate
(between 5 and 8 mEq/L/d).
11. Intervention
The mainstay of management is the administration of water, preferably by mouth
or nasogastric tube.
Alternatively, 5% dextrose in water (D5W) or quarter NS can be given i/v.
Traditionally, correction of hypernatremia has been accomplished by calculating
free water deficit by the equation:
Free water deficit = {([Na+] -140)/140} x (TBW)
12. Specific therapies for the underlying cause:-
Hypovolemic hypernatremia
In patients with mild volume depletion,Na+-containing solutions, such as 0.45%
NS, can be used to replenish the ECF as well as the water deficit.
If patients have severe or symptomatic volume depletion, correction of volume
status with isotonic fluid should take precedence over correction of the
hyperosmolar state.
Once the patient is hemodynamicallystable, administration of hypotonic fluid can
be given to replace the free water deficit.
Hypernatremia from primary Na+ gain is unusual.
Cessation of iatrogenic Na+ is typically sufficient.
13. DI with hypernatremia. DI is best treated by removing the underlying cause.
CDI. Because the polyuria is the result of impaired secretion of vasopressin,
treatment is best accomplished with the administration of DDAVP, a vasopressin
analog.
NDI. A low-Na+ diet combined with thiazide diuretics will decrease polyuria
through inducing mild volume depletion. This enhances proximal reabsorption
of salt and water, thus decreasing urinary free water loss. Decreasing protein
intake will further decrease urine output by minimizing the solute load that
must be excreted.