This document provides an overview of immunodeficiency. It defines immunodeficiency and discusses primary and secondary immunodeficiencies. It describes the immune system and its four arms. It discusses various types of primary immunodeficiencies that affect B cells, T cells, phagocytes, and complement pathways. It also discusses common variable immunodeficiency and selective IgA deficiency. Secondary immunodeficiencies caused by AIDS, cancer, diabetes, transplantation, autoimmune diseases, steroids, asplenia, and aging are summarized. Tests for evaluating immunodeficiency and treatment options are briefly outlined.
Immunological Disorders can be classified into 3 distinct categories.They are Hypersensitivity, Autoimmunity and Immunodeficiency.Here in this presentation we talk about Immunodeficiency disorders.Get more on our blog : http://dentistryandmedicine.blogspot.com/
ANTIGEN, HAPTEN, ALL TYPES OF ANTIGENS, IMMUNOGEN , ATTRIBUTES OF ANTIGENICITY, DETERMINANTS OF ANTIGENICITY,
IMMUNOLOGY KUBY, MEDICAL MICROBIOLOGY & IMMUNOLOGY OF PANIKER , LIPPINCOTT'S IMMUNOLOGY, OTHER SOURCES.
Type II Hypersensitivity-Antibody mediated cytotoxic HypersensitivityAnup Bajracharya
Type II Hypersensitivity is antibody-mediated immune reaction in which antibodies (IgG or IgM) are directed against cellular or extracellular matrix antigens with the resultant cellular destruction, functional loss, or damage to tissues.
Secondary Immunodeficiency
By Dr. Usama Ragab Youssif
Reference: Included in Slides
Include causes of secondary immunodeficiency including AIDS and other viral infections
Immunological Disorders can be classified into 3 distinct categories.They are Hypersensitivity, Autoimmunity and Immunodeficiency.Here in this presentation we talk about Immunodeficiency disorders.Get more on our blog : http://dentistryandmedicine.blogspot.com/
ANTIGEN, HAPTEN, ALL TYPES OF ANTIGENS, IMMUNOGEN , ATTRIBUTES OF ANTIGENICITY, DETERMINANTS OF ANTIGENICITY,
IMMUNOLOGY KUBY, MEDICAL MICROBIOLOGY & IMMUNOLOGY OF PANIKER , LIPPINCOTT'S IMMUNOLOGY, OTHER SOURCES.
Type II Hypersensitivity-Antibody mediated cytotoxic HypersensitivityAnup Bajracharya
Type II Hypersensitivity is antibody-mediated immune reaction in which antibodies (IgG or IgM) are directed against cellular or extracellular matrix antigens with the resultant cellular destruction, functional loss, or damage to tissues.
Secondary Immunodeficiency
By Dr. Usama Ragab Youssif
Reference: Included in Slides
Include causes of secondary immunodeficiency including AIDS and other viral infections
Planning is making current decisions in the light of their future effects.
Health planning is a process culminating in decisions regarding the future provisions of health facilities and services to meet health needs of the community.
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
- 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
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
6. Immunodeficiency
Definition
Immunodeficiency (or immune deficiency) is a
state in which the immune system 's ability to
fight infectious disease is compromised or
entirely absent. Immunodeficiency may also
decrease cancer immunosurveillance.
7.
8. Primary Immunodeficiencies
Stem Cell
Myeloid Lymphoid
Progenitor Progenitor
Severe combined
Congenital Immunodeficiency
Agranulocytosis SCID
Monocyte Pre-B Pre-T
Neutrophil
x-linked
aγglobulinemia
xLA Mature B Thymus
DiGeorge
Syndrome d
Mature
Plasma T
Cell Memory B
Common Variable Hypoγglobulinemia
Selective Ig deficiency
9. IMMUNE DEFICIENCY
OPPORTUNISTIC INFECTIONS:
Opportunistic infections are mild to severe
infectious diseases in a compromised host. The
infections are caused by microorganisms that
normally do not cause serious disease in healthy
people.
Viral, Bacterial, Fungal, Protozoan,
Helminthic
Opportunistic Malignancies: Kaposi's
Sarcoma and Lymphomas
10. T h e 1 0 w a r n i n g s i g n s o f
i m m u n e d e f i c i e n c y
11.
12. Common variable Immunodeficiency (CVI).
Heterogynous group that cause late - onset
hypogammaglobulinaemia.
Recurrent infections between 15 - 35 yrs.
Features:
1.Low IgG & IgA .
2.Impaired antibody responses.
3.Associated autoimmune diseases
•Recurring infections involving the ears, eyes,
sinuses, nose, bronchi, lungs, etc.
•The organisms commonly found in these infections
are bacteria that often cause pneumonia
(Haemophilus influenzae, pneumococci, and
staphylococci).
13. IgA deficiency (1:700)
Most are asymptomatic. ( but have
increased rate of (R.T.I.)
Some have recurrent R.T.I and G.I.T.
symptoms
Increased incidence of allergic manifestations.
anti- convlusant drugs (phenytoin) may cause
deficiency .
14. Common Variable Immunodeficiency (Late-
Onset Hypogammaglobulinemia)
Onset usually in 2nd to 4th decade of life
Slow decline in all classes of immunoglobulin
Recurrent sinopulmonary infections (usually
bacterial in origin)
Gastrointestinal, endocrine, hematologic and
autoimmune disorders can be associated
May follow Epstein-Barr infection
Increased incidence of lymphoreticular
malignancies
17. SECONDARY IMMUNE
DEFICIENCY
1. Acquired Immune Deficiency Syndrome
(AIDS)
2. Cancer / Chemotherapy:
3. Immunosuppression In Diabetes
4. Immunosuppression In Transplant Pts
5. Autoimmune disease
6. Immunosuppression Related to Steroid Use
7. Immunosuppression In Asplenic Pts
8. Effect of Aging On Immune Competence
9. pregnancy
18. 1. Acquired Immune Deficiency Syndrome (AIDS)
a) Etiology& presentation
b) Defect: Inversion of T helper/inducer cells
(OKT4) to cytotoxic/suppressor cell (OKT8) ratio
Normal T4/T8 = 2/1
In AIDS it is 0.5.
19.
20. CD4 Count
Greater than 500 / ul - Almost normal
defense mechanisms
Less than 200 / ul - Opportunistic AIDS
related infections
Less than 100 / ul - Life threatening
complications
22. 2. Cancer / Chemotherapy:
Unfortunately in cancer, both the disease
and the treatment can cause
immunosuppression :
Neutropenia
Cell Mediated Immunity
Humoral factors
23. Neutropenia
Occurs approximately two weeks after the last
dose of chemotherapy
an absolute neutrophil count of less than 1,000
cells/mm3 on the way down are at increased risk
for a serious bacterial infection.
Management strategy:
1. All patients with anticipated severe neutropenia
(ANC < 0.5 x 109/l), should receive prophylaxis
against bacteria, fungi,viruses&G-CSF
2. Neutropenic patients who present with fever
require a prompt switch to an appropriate treatment
regime
24. Cyclic neutropenia
is a form of neutropenia that tends to occur
every three weeks and lasting three to six
days at a time due to changing rates of cell
production by the bone marrow.
It is often present among several members of
the same family. Treatment includes G-CSF
and usually improves after puberty.
25. 3. Immunosuppression In Diabetes
Humoral Immunity:
normal Ab levels & vaccination responses.
Impaired Cellular Immunity:
Impaired Innate Cellular Defenses:
o PMN abnormalities - adherence, chemotaxis,
o Phagocytosis.
Infections In Diabetics
rhinocerebral mucormycosis
oral &esophageal candidiasis
surgical / wound infection
T.B
29. 6. Immunosuppression Related to Steroid Use
Glucocorticoids (corticosteroids) have inhibitory
effects on T cells and B cells, as well as
phagocytes.
Infections depend on route of administration,
dose, & duration of therapy.
30. Infections Related to Steroid Use
increased susceptibility to all types of
infection.
Prolonged CMI suppression important for
opportunistic infection to occur.
Fever may be absent
delayed wound healing & wound infections:
steroids interfere with fibroblast proliferation &
collagen synthesis.
31. 7. Immunosuppression In Asplenic Pts
• lower C3 levels & defective responses to encapsulated
bacterial pathogens
• decreased phagocytosis
• failure to recognize polysaccharide Ag’s.
• impaired IgM synthesis early in infection.
Pathogen:
-S. pneumoniae ,H influenzae ,N. meningitidis
Sickle Cell
Functionally aspenic (ask about immunizations!)
32. 8. Effect of Aging On Immune Competence
Declining :
Innate, Humoral & Cellular Immune
Responses
Increased Susceptibility to Pneumonias &
Chronic Infections
34. Initial Evaluation of Possible
Immunodeficiency
Make sure that what seems to be infections are not
really: ATOPY, ALLERGY, ASTHMA
Exclude other conditions
Hold off on any live viral vaccines or transfusions until
situation well defined
Document that there have been multiple infections
Look for other, non-immune features of
immunodeficiency: rash, hypocalcemia, facial
characteristics
Family history
35. Initial screening tests for
immunodeficiency
CBC: WBC,function
Quantitative immunoglobulins: IgG, A & M
Total lymphocyte count
T-cell enumeration, with subsets
CD4, CD8
Evaluate for current infections:
CULTURES, ESR, CRP, X-RAYS.
36. Tests for B cell,antibody deficiency:
Total ,lymphocyte count
Total serum immunoglobulins
IgG subclasses, Antibodies for pervious vaccination
Immunoglobulin function& survival
Tests for cellular deficiency:
Total lymphocyte count
T-cell enumeration, with subsets CD4, CD8
Functional assays: antigens response to mitogens,
cytokines assay.
Delayed hypersensitivity reaction for Tuberculin and
Candida antigen
37. Tests for other deficiency:
Phagocyte:
i. Neutrophil count
ii. NBT test for screening.
Complement:
Total and specific complement
count.
39. 1. IVIG .( IV infusion of immunoglobulin.)
For : a. agammaglbulinaemia . b. CVI. c. WAS
2. Periodic antibiotic treatment.
3. Bone marrow transplantation .
For : a. SCID . b. WAS.
4. Enzyme replacement .
For : ADA deficiency.
5-CSF.(colony stimulating factor ) For : neutropenia
6. Thymus transplantation .
For : DiGeorge syndrome.
7. IFN – gamma . For : CGD.
8-gene therapy
40. 1) Which one of the following does 3) Which of the following
not predispose to superficial tests may assess
Candida albicans infection?
cellular immune
A Pregnancy
B Lymphoma
dysfunction;
C Diabetes mellitus a) CD4, CD8.
D Vegetarian diet
b) Total serum
2) Which of the following is not
commonly associated with immunoglobulins
marked secondary antibody
deficiency? c) IgG subclasses
a) Multiple myeloma.
d) Immunoglobulin
b) autoimmune diseases.
c) HIV infection. response
d) hypersplinism.