Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Definition
• Immunization refers to the artificial
induction of immunity. It can be by
Active Immunization: the use of live
attenuated infectious agents or
inactivated toxins, or antigens obtained
by genetic recombination OR
Passive Immunization: temporary
immunity obtained by the administration
of immunoglobulins or antitoxins.
6/23/2017 2
4. • Smallpox eradicated in 1978 from
India
• polio eradication.
• Infant/Childhood immunization –
one of the top public health success
stories of the 20th century
• The prevalence of Diphtheria,
Pertussis, tetanus, measles, mumps,
rubella, poliomyelitis are reduced.
6/23/2017 4
5. Why Adult Immunization ???
• Build on success of infant/childhood, adolescent
immunization program.
• Not vaccinated earlier, booster.
• New vaccines targeted at adults.
• Ageing : more susceptible.
• Increasing Antimicrobial Resistance.
• Recognition of the burden of adult vaccine-
preventable disease.
• No equivalent “Vaccines for Adults” program.
6/23/2017 5
6. Adult Immunization recommended in
india
Tdap MMR
Influenza Pneumococcal
Hepatitis B Hepatitis A
Varicella HPV (cervical cancer)
Meningococcal Herpes Zoster
6/23/2017 6
7. Diphtheria, Tetanus, Pertussis
Vaccines
• Two Tdap Vaccines are available for use in those
who are more than 10 years of age.
-Efficacy of Tdap vaccine - 92%
Recommendations
- for all adults who have not received Tdap or for
whom vaccine status is not known
6/23/2017 7
8. Measles, Mumps And Rubella
Vaccines
• In India the measles, mumps, rubella (MMR) live
attenuated vaccine is manufactured using the
following strains:
• The measles and the rubella components are
produced using human diploid cells while the
mumps component is produced from chick
embryo.
• The MMR vaccine should be administered
subcutaneously into the upper arm.
6/23/2017 8
9. Indications
• Adolesents and adults
• Women of childbearing age who is not
pregnant
FREQUENCY
• Two doses at interval of 4 weeks
• Subcutaneously in upper arm
10. Varicella (Chickenpox)
6/23/2017 10
Vaccines
• Two Live attenuated VZV (Oka strain)
vaccines for varicella virus are
currently available in India.
– Varilrix (GlaxoSmithKline, Belgium) and
– Okavax (Pasteur Mérieux, France).
Schedule
- Interval between 2 doses should be 4–
8wks.
11. Recommendations
• All susceptible adults and adolescents should
be vaccinated.(18-49yrs)
• It is especially important to susceptible
persons
– Health care workers
– Family contacts of immunocompromised persons
– High risk of exposure (e.g., teachers, day care
employees, military personnel, and international
travelers).
6/23/2017 11
12. Human Papilloma Virus
• Papilloma virus infection is precursor to cervical
cancer
– Types 16, 18 account for 70% of cervical
cancers
Vaccines
• Two types HPV vaccines are available.
– Gardasil (Merck, USA), a quadrivalent vaccine
containing HPV virus L1 protein like particles of
HPV 6,11,16, and 18
– Cervarix (GlaxoSmithKline, Belgium) is a
bivalent vaccine containing L1 VLPs of HPV
16,18.
6/23/2017 12
13.
14. Recommendations
• The vaccine has to be delivered prior to
exposure to the HPV virus. Therefore, the
immunization must precede the sexual debut.
• Age for initiation for vaccination to be 10 - 12
years.
• Catch-up vaccination can be advised up to the
age of 26 years for Gardasil vaccine and 45
years for Cervarix vaccine.
6/23/2017 14
15. • Schedule
– BHPV – 0,1,6 months
– QHPV – 0,2,6 months
For male HPV 4 is recommanded
16. Hepatitis B
Vaccines
• For immunocompetent adults, 1ml (20 μg) of
recombinant vaccine is administered at 0, 1, and 6
months as an intramuscular.
• Protection (anti-HBs antibody titer of 10mIU/ml or
higher) after recombinant vaccine
– After first dose - 20% to 30%
– After second dose - 75% to 80%
– After third doses - 90% to 95%
Recommendations
• All unvaccinated adult risk for HBV infection and
• All adults seeking protection from HBV infection
including post-exposure prophylaxis.
6/23/2017 16
17. • Booster doses of HBV vaccine are not
indicated in persons with normal immune
status .
• For CKD patients, the need for booster
doses should be assessed by annual anti-
HBs antibody titre testing.
• A booster dose should be administered
when anti-HBs levels decline to less than 10
mIU/ml & <100 mIU/ml in patients on
dialysis.
.
6/23/2017 17
19. Hepatitis A
Vaccines
• Inactivated-single antigen (HAV antigen) vaccines,
– Havrix (GlaxoSmithKline) and
– Vaqta (Merck & Co)
– Dose : 1440ELU
Schedule
• Two doses of 1ml at 6 month interval.
• Immune status for hepatitis A should be checked
6/23/2017 19
20. Pneumococcal Infection
Vaccines
Two types
• The pneumococcal polysaccharide
vaccine (PPV23), contains 25 μg each of
purified capsular polysaccharide from 23
serotypes of Streptococcus pneumoniae.
• Pneumococcal conjugate vaccine (PCV 13)
– This vaccine can be co-administered with
live vaccines such as the influenza
vaccine.
6/23/2017 20
21. Schedule
–A single standard dose (0.5 ml) is
administered by the intramuscular or
subcutaneous route.
–Revaccination: 0.5ml IM or SC at least
after 5 years of 1st dose in case of High
risk people.
6/23/2017 21
22. Influenza
Vaccines
– Trivalent inactivated influenza vaccine (TIV) and
– Live attenuated influenza vaccine (LAIV)
• The TIV contains
– A/17/California/2009/38(H1N1),
– A/Brisbane/ 10/2007 (H3N2), and
– B/Brisbane/60/2008 strains.
• Live attenuated influenza vaccine (LAIV) –
Nasovac contains
– A/17/California/2009/38 like strain
• Schedule
– The TIV - annual, single dose of 0.5 ml IM.
– The LAIV – 0.5 ml intranasal (spray 0.25 ml per
nostril)
6/23/2017 22
23. Meningococcal Meningitis
Vaccines
• Types
– Polysaccharide vaccines
• Bivalent (A&C)
• Quadrivalent (A,C,Y & W135)
– Conjugate vaccines.
• The vaccine does not induce herd immunity
and has no effect on nasopharyngeal
carriage.
• Containing 50 μg of polysaccharide per dose.
• After reconstitution use within 8-12 hours.
6/23/2017 23
24. Schedule
• A single dose of 0.5 ml SC in deltoid region.
• Used in selected population
• Age 2- 3 yrs
• Congenital deficiencs in complement
components
• Travellers to hajj
• Lab persons
6/23/2017 24
25. Documentation
• Provide copy of Vaccine
Information Statement (VIS)to
patient
• Documents to be maintained
– Date vaccination & next dose
– Vaccine manufacturer
– Lot number
– Dose & site of vaccine
6/23/2017 25
26. Vaccine Administration
• Health care personnel should get proper
training before administrating vaccine.
• Always prepare and check the following for
every vaccination you give:
– Right Patient
– Right Drug (vaccine)
– Right Dose
– Right Route (intramuscular, SC,intradermal)
– Right Time (is scheduling correct)
6/23/2017 26
27. Vaccine / Age group 19-26 yrs 27-49 yrs 50-59 yrs 60-64 yrs > 65 yrs
Tetanus, Diptheria, Pertussis (Tdap)
Substitude one time dose of Tdap with Td,
then booster with Td every 10 years
Td booster
every 10 yrs
Human Papiloma Vaccine 3 doses
Varicella 2 doses
Zoster 1 dose
Measles, Mumps, Rubella 1 or 2 doses 1 dose
Influenza 1 dose annually
Pnemococcal (Polysaccharide) 1 or 2 doses 1 dose
Hepatitis A 2 doses
Hepatitis B 3 doses
Meninngicoccal 1 or more doses
6/23/2017 27
ACIP Adult Immunization Schedule, Age-Based Recommendations, INDIA
Recommended if some risk factor is present
All persons who meet the age criteria
No recommendation
28. 6/23/2017 28
Adult Immunization based on medical and other indications (INDIA)
Indications
Pregnancy
Immunoco
mpromise
d
conditions
(Excluding
HIV)
HIV infection
with CD4
count
Diabetes,
heart
disease,
chronic
lung
disease
Asplenia
(excluding
elective
splenectomy
)
Chronic
liver
disease
Kidney
failure, end
stage renal
disease, on
hemodialysi
s
Health
care
professi
onals
Vaccine <200
cells/ µl
>200
cells/ µl
Tetanus, Diptheria,
Pertussis (Tdap)
Td
Substitute one time dose of Tdap with Td, then booster with Td every 10
years
Human Pappiloma
Vaccine
3 doses for females through age 26 years
Varicella Contraindication 2 doses
Zoster Contraindication 1 dose
Measles, Mumps, Rubella Contraindication 1 or 2 doses
Influenza 1 dose TIV annually 1 dose TIV
or LAIV
Pnemococcal
(Polysaccharide)
1 or 2 doses
Hepatitis A 2 doses
Hepatitis B 3 doses
Meninngicoccal 1 or more doses
Recommended if some risk factor is present
All persons who meet the age criteria
Contraindication