Hypersensitivity pneumonitis is a lung disease caused by an allergic reaction to inhaled organic dusts or chemicals. It can present acutely with fever and respiratory symptoms or chronically with fibrosis. The diagnosis is based on exposure history, symptoms improving away from exposure, and radiologic/pathologic findings. Treatment involves identifying and removing the causative agent along with corticosteroids in more severe cases. Prognosis depends on the severity and duration of exposure, with chronic forms at higher risk of permanent lung damage.
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
What are the pulmonary function tests used?
What are the indications?
What are the contraindications?
How to perform each and prepare patients?
How to interpret and reach a diagnosis?
How to clean and calibrate devices?
Presentation by S.K Jindal on Hypersensitivity Pneumonitis: Approach to diagn...Jindal Chest Clinic
Hypersensitivity pneumonitis is an immune system disorder causing lungs to become inflamed due to allergic reactions to inhaled microorganisms, plant and animal proteins, or chemicals. In this presentation "Hypersensitivity Pneumonitis" has been described including their Causes, Diagnosis, Management, etc. For more information, please contact us: 9779030507.
What are the pulmonary function tests used?
What are the indications?
What are the contraindications?
How to perform each and prepare patients?
How to interpret and reach a diagnosis?
How to clean and calibrate devices?
Presentation by S.K Jindal on Hypersensitivity Pneumonitis: Approach to diagn...Jindal Chest Clinic
Hypersensitivity pneumonitis is an immune system disorder causing lungs to become inflamed due to allergic reactions to inhaled microorganisms, plant and animal proteins, or chemicals. In this presentation "Hypersensitivity Pneumonitis" has been described including their Causes, Diagnosis, Management, etc. For more information, please contact us: 9779030507.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
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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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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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
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.
4. Background
• 1st described in early 1900s
Farmer’s lung: fermers who reported febrile
episodes after exposure to mouldy grains,hay or
straw
Reed and barbee in 1965
pigeon breeder’s lung:relationship between hp
and exposure to avian antigens
Hendrik and colleagues in 1978
Budgerigar fancier’s lung
5. DEFINITION
• Hypersensitivity pneumonitis (HP), also called
extrinsic allergic alveolitis, is a respiratory
syndrome involving the lung parenchyma and
specifically the alveoli, terminal bronchioli, and
alveolar interstitium, due to a delayed allergic
reaction.
• Such reaction is secondary to a repeated and
prolonged inhalation of different types of organic
dusts or other substances to which the patient is
sensitized and hyper responsive,
6. PREVALENCE
• In the US HP accounted for less than 2% of the
patients with interstitial lung disease (ILD),
whose yearly incidence was calculated to be
about 30 per 100,000 .
• In Europe, according to ILD registries, HP
affects from 4 to 15% of all ILD cases .
7. CAUSATIVE AGENT
• Hypersensitivity pneumonitis can be caused
by multiple agents that are present in work
places and in the home, such as microbes,
animal and plant proteins, organic and
inorganic chemicals.
13. CLINICAL FEATURES
13
• Depends upon nature of the inhaled dust,
such as antigenicity, particle size, intensity and
frequency of exposure to the antigens, the
immunological response of the host and
concomitant bacterial or viral infections.
• Clinically HP can be categorised into acute,
subacute, and chronic forms.
14. The acute form
• Presents after a high-level of exposure to the
offending antigen over a short period of time.
• Symptoms usually develop within 4 to 8 hours
and are similar to acute viral infection.
• Symptoms may include high fever up to 40 oC,
chills, myalgia, fatigue, dyspnoea, and non-
productive cough.
• Bibasilar end inspiratory rales are prominent
and may persist for weeks after the fever
subsides.
15. Subacute Form
• The symptoms are more insidious in the subacute
form of HP due to the repeated low-level exposure.
• progressive respiratory symptoms over weeks-to-
months without acute systemic symptoms as noted
with the acute form.
• Physical examination often reveals crepitant rales
and hypoxemia especially with exertion.
16. Chronic HP
• Results from prolonged and continuous exposure
to low-levels of antigens leading to irreversible
pulmonary damage without major acute attacks.
• Progressive dyspnoea, cough, malaise, weakness,
anorexia, and weight loss are common. Fever is
often not present.
• Interstitial fibrosis is prominent.
• Lung examination may demonstrate dry crackles,
but wheezing is uncommon.
End-stage disease: cyanosis & right-sided
HF
17. Laboratory Diagnosis
↑ Specific IgG against the offending antigen
↑ ESR & CRP
↑ IgM , IgA, IgG
↑ ANA
IgE:Normal
Eosinophil count:Normal
BAL fluid study: ↑Lymphocyte count
↑ IgG
17
18. PFT
There is no single characteristic pattern of
pulmonary function abnormalities .
Acute HP : restrictive pattern
Subacute and chronic HP : air way obstruction or
mixed
↓ DLCO (most sensitive physiologic test in early HP )
18
20. Ground glass pattern
Most common in acute HP (but may also be seen in
subacute and chronic HP)
Middle lung zone
PFT: restrictive , ↓DLCO
May resolve with removal from exposure
20
24. Centrilobular nodules
Round, poorly defined, less than 5 mm in diameter
Typically centrilobular
Profuse throughout the lung,but a middle to lower
lung zone predominance.
Most frequent HRCT finding in HP
Centrilobular nodules + ground glass
opacification are highly suggestive for HP.
PFT : May be normal
24
25. Fibrosis
Chronic HP (subacute HP)
Irregular linear opacities
Traction bronchiectasis
Honeycombing
25
26. Emphysema
Chronic HP
Emphysema occurred more commonly than
fibrosis in chronic farmer’s lung.
26
38. Clinical Prediction
• 1. Exposure to known offending antigen
• 2. Positive precipitating antibody to the
offending antigen
• 3. Recurrent episodes of symptoms
• 4. Respiratory crackles in physical examination
• 5. Symptoms occurring between 4 to 8 hours
after exposure
• 6. Weight loss
39. • Major Criteria (Four major criteria need
to be present)
• 1. H/O symptoms compatible with HP
• 2. Evidence of exposure to the offending antigen
by history or through detection in serum or BAL
fluid antibody
• 3. Changes of characteristic HP on chest
radiograph or HRCT of chest
• 4.BAL fluid lymphocytosis,
• 5. Demonstration of histologic changes consistent
with HP
• 6. Positive ‘natural challenge’ that produces
symptoms
Diagnostic criteria for hp:
Adapted from Schuyler and Cormier (1997)
40. Minor Criteria (Two minor criteria
need to be present)
• 1. Bibasilar rales
• 2. Decreased diffusion capacity
• 3. Arterial hypoxemia, either at rest or with
exercise
41. TREATMENT
Cornerstone of therapy → removal from exposure
Respirators are used when removal from exposure is
impossible.
Oxygen (hypoxemic patients)
Opoids:Control of cough
Airflow limitation:
Inhaled steroids
β-agonists
Oral corticosteroids (40–60 mg/day of oral prednisone)
in severe or progressive disease.
In refractory cases:
Cyclophosphamide & Azathioprine
No evidence on the efficacy of anti-fibrotic agents in
the treatment of chronic HP. 41
42. PROGNOSIS
The clinical course of HP is variable
Acute HP generally resolves without sequelae
But progressive impairment may occur with recurrent
attacks or with a single severe attack.
Subacute or chronic forms of HP present with
insidious symptoms
More subtle clinical abnormalities
Frequently recognized later in the disease course
Long-term mortality rates for patients with chronic
HP range from 1% to 10%.
42
43. Poor Prognostic factors
Older Age
Exposure for a longer period
Greater intensity of exposure
Digital clubbing
Histologic pattern of NSIP or UIP
43
44. Take home message
• HP results from an exacerbated immunologic
response to inhaled antigens.
• Menifestation ranging from infection-like acute
symtoms to subacute &chronic interstitial disease
• When exposure to antigen persists,permanent lung
damage may occur
• 1st line Rx for HP is withdrawl of contact with the
offending Ag.
• Oral corticosteroids,depending on the severity of
presentation.