- Recorded videos of the lecture:
English Language version of this lecture is available at: https://youtu.be/-Ynxvhbcl7U
Arabic Language version of this lecture is available at: https://youtu.be/QpK_toctVlw
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/XRD-QqGFP18
- Arabic version of this lecture is available at:
https://youtu.be/c9PoavAtNKM
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/i_bUFU-p43Q
Arabic Language version of this lecture is available at:
https://youtu.be/RaIP09m4XMY
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/JQllk5Ad07E
Arabic Language version of this lecture is available at:
https://youtu.be/KXlJoMDi3ko
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/XRD-QqGFP18
- Arabic version of this lecture is available at:
https://youtu.be/c9PoavAtNKM
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/i_bUFU-p43Q
Arabic Language version of this lecture is available at:
https://youtu.be/RaIP09m4XMY
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/JQllk5Ad07E
Arabic Language version of this lecture is available at:
https://youtu.be/KXlJoMDi3ko
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
An update of this lecture is available at: https://www.slideshare.net/MohammedGawad/membranous-nephropathy-234601451
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/lvcXwE0fb-w
- Arabic version of this lecture is available at:
https://youtu.be/r-fG8bSCqZo
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/V3UGzJTwAWw
- Arabic version of this lecture is available at:
https://youtu.be/hGLaUde2ue4
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Presentation given to our fellowship program about diabetic kidney disease.
2022 update discussing SGLT2i, MRA (e.g. finerenone), health economics and beyond
Diabetes Mellitus Management in CKD (Clinical Tips) - Dr. GawadNephroTube - Dr.Gawad
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/h3HRvWGUj5A
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Cardiorenal Syndrome (Clinical Implications and Treatment Strategies) - Dr. G...NephroTube - Dr.Gawad
- Recorded videos of this lecture:
Arabic Language version of this lecture is available at:
https://youtu.be/8eePyMbbK_g
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
An update of this lecture is available at: https://www.slideshare.net/MohammedGawad/membranous-nephropathy-234601451
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/lvcXwE0fb-w
- Arabic version of this lecture is available at:
https://youtu.be/r-fG8bSCqZo
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/V3UGzJTwAWw
- Arabic version of this lecture is available at:
https://youtu.be/hGLaUde2ue4
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Presentation given to our fellowship program about diabetic kidney disease.
2022 update discussing SGLT2i, MRA (e.g. finerenone), health economics and beyond
Diabetes Mellitus Management in CKD (Clinical Tips) - Dr. GawadNephroTube - Dr.Gawad
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/h3HRvWGUj5A
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Cardiorenal Syndrome (Clinical Implications and Treatment Strategies) - Dr. G...NephroTube - Dr.Gawad
- Recorded videos of this lecture:
Arabic Language version of this lecture is available at:
https://youtu.be/8eePyMbbK_g
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- A new version of this lecture is available at: https://www.slideshare.net/MohammedGawad/thrombotic-microangiopathy-tma-in-adults-and-acute-kidney-injury-dr-gawad
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at: https://youtu.be/0tIlVJEyNOk
Arabic Language version of this lecture is available at: https://youtu.be/2QT68lgSDCM
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
The most common lysosomal storage disease,
Incidence: approximately 1 in 40,000 for non-Jewish populations
Caused by a deficiency of the enzyme glucocerebrosidase
The glycolipid glucocerebroside accumulates in lysosomes of macrophages
Lipid-filled Gaucher cells displace normal cells in
Bone marrow
Spleen
Liver
Lungs
CNS
Skeletal disease is slow to respond to ERT and widely varies.
Some patients describe symptomatic improvement within the first year of treatment, although a much longer period of ERT is required to achieve a radiologic response.
Liver failure after major hepatic resection.pptxGian Luca Grazi
Liver failure after hepatic resection has a multifactorial origin. However, the volume of the removed liver, technical problems during the procedure and the development of infections in the post-operative period certainly play a primary role.
The surgeon plays an important role in implementing all those surgical and radiological procedures to prevent the onset of this severe complication.
However, the treatment of liver failure that occurs after a hepatectomy requires multidisciplinary management, including intensive care physicians, neurologists, nephrologists, and others.
In order not to incur in the failure to recognize the complication and to avoid not implementing all the therapeutic measures necessary for the treatment of post-resection liver failure, it is essential that the hospital where the operation is performed is equipped with all professionalism and all the necessary technological tools.
These are the characteristics needed to define where liver surgery can be performed safely.
- 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
- Video recording of this lecture in English language: https://youtu.be/gnlRvJ1TTr8
- Video recording of this lecture in Arabic language: https://youtu.be/KdVvfP7JIFI
- 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
- Video recording of this lecture in English language: https://www.youtube.com/watch?v=MA7nU5NWL2g&list=PLL7Q08IoVDSpg0VlGdvCHOHbXqMs0GFRe
- Video recording of this lecture in Arabic language: https://www.youtube.com/watch?v=FiWabzTPFqY&list=PLL7Q08IoVDSrVcm6SmppQyefL_Ub2-xGY
- 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
- Recorded video of this lecture is available at:
https://youtu.be/4MCu1C5xjvE
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at: https://youtu.be/YT5IlPs6F0I
Arabic Language version of this lecture is available at: https://youtu.be/HUZt4ahXlxo
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Thrombotic Microangiopathy (TMA) in Adults and Acute Kidney Injury - Dr. GawadNephroTube - Dr.Gawad
- English version of this lecture is available at:
https://youtu.be/zrFm0hAZk2A
- Arabic version of this lecture is available at:
https://youtu.be/M_BV8WJVbx0
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at:
https://youtu.be/t7N2GSXhYwA
- Arabic version of this lecture is available at:
https://youtu.be/WzFZym9hDtQ
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Infection-related Glomerulonephritis (KDIGO 2021 Guidelines) - Dr. GawadNephroTube - Dr.Gawad
- English version of this lecture is available at:
https://youtu.be/qItQlXUC2-Q
- Arabic version of this lecture is available at:
https://youtu.be/goKWRFbA4uc
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version video of this lecture is available at:
https://youtu.be/z9P_1IiFR5I
- Arabic version video of this lecture is available at:
https://youtu.be/qmDeWgsAY9Q
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at: https://youtu.be/_Efu52kZRS4
- Arabic version of this lecture is available at: https://youtu.be/8eGHpjQIy3I
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- English version of this lecture is available at: https://youtu.be/WHu05hmExBY
- Arabic version of this lecture is available at: https://youtu.be/GIvZjcq2Eis
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
Insights from the FIGARO-DKD and FIDELIO-DKD trials - Dr. GawadNephroTube - Dr.Gawad
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/kanEHVsStsI
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/71ud0njUrFc
Arabic Language version of this lecture is available at:
https://youtu.be/s8dQwB76bFM
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
- Recorded videos of this lecture:
English Language version of this lecture is available at:
https://youtu.be/_i1H_i3tOuw
Arabic Language version of this lecture is available at:
https://youtu.be/SYmZ9CmmN5g
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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
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
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.
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.
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
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.
Follow us on: Pinterest
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
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Is it Hepatorenal Syndrome? - Dr. Gawad
1. Mohammed Abdel Gawad
Nephrology Specialist
Kidney & Urology Center (KUC)
Alexandria - EGY
drgawad@gmail.com
How to Prevent?
How to Treat?
How to Diagnose?
Is it Hepato-Renal Syndrome?
4th KUC Club – May 2014
2. Potentially reversible and functional
renal failure
In patients with advanced liver failure (acute
or chronic) and portal hypertension
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
In the absence of any identifiable causes of renal
impairment.
A DIAGNOSIS OF EXCLUSION
Hepato-Renal Syndrome is:
3. Not all concomitant renal and hepatic
impairment is due to the HRS
It isn’t even on top of the list
A DIAGNOSIS OF EXCLUSION
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
4. 4
Levenson D, Korecki KL.. In: Brenner BM, Lazarus JM, eds. Acute Renal
Failure. New York: Churchill Livingstone; 1988:535-580.
A DIAGNOSIS OF EXCLUSION
6. Increased production or activity of vasodilators (with
nitric oxide thought to be most important)
Ginès P, Schrier RW. N Engl J Med. 2009;361(13):1279.
Iwakiri Y. J Clin Gastroenterol. 2007;41 Suppl 3:S288.
Splanchnic Steal Syndrome
pooling of blood in the
splanchnic vascular bed
Pathogenesis
of HRS
7. Stadlbauer VP, Wright GA, Banaji M, et al. Gastroenterology 2008;134:111–119.
Pathogenesis
of HRS
10. Pathogenesis
of HRS
+ Loss of renal
autoregulation
Decrease MAP below the normal
range that the autoregulation
mechanism can act.
Sympathetic mass reflex action
15. HRS is a FUNCTIONAL renal
impairment
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
+ Loss of renal
autoregulation
16. What Is The Prove That The Kidney Is
Functionally Normal ?
16
A, Renal angiogram (the arrow marks the edge of the kidney).
B, The angiogram carried out in the same kidney at autopsy.
Epstein M, Berk DP, Hollenberg NK, et al. Am J Med. 1970; 49:175-185.
20. How To Prevent?
Who At Risk How To Prevent
1- Large volume paracentesis without plasma
expansion
Give 100 ml 20% human albumin per 1.5L
ascities removed
2- Over-Diuresis (weight loss >500g/day for
several days in ascitic patient without (or
1kg/day in those with) peripheral edema
Judicious use of diuretics, starting with low
dose and titrate up slowly.
3- Laxative abuse diarrhea is a dose limiting sign for lactulose
4- GI bleeding Fluid & blood replacement till euvolemia.
5- SBP (any cirrhotic patient + ascities with
deteriorating general condition is SBP till
proven otherwise)
A- antibiotics.
B- IV albumin 1.5g/kg at diagnosis and 1g/kg
48hrs later.
6- Alcoholic hepatitis Pentoxifylline (a TNF inhibitor) 400mg tds
orally.
7- The use of Nephrotoxic drugs Avoid.
8- Treatment of bleeding and esophageal
varices (beta blockers, somatostatin) reduce
GFR
Monitored carefully
24. Major Diagnostic Criteria Of HRS
(All Must Be Present)
1- Presence of liver disease.
2- Presence of renal impairment.
3- In absence of renal cause.
4- In absence of pre-renal cause.
5- In absence of post-renal cause.
24
A DIAGNOSIS OF EXCLUSION
25. • 1- Presence of liver disease:
- Chronic or acute liver disease with advanced hepatic failure
and portal hypertension
• 2- Presence of renal impairment:
- Low GFR as indicated by a 24-hr creatinine clearance of
< 40 mL/min or serum creatinine > 1.5 mg/dL
25Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
Arroyo V, Gines P, Gerbes AL, et al. Hepatology. 1996;23:164-176.
Major Diagnostic Criteria Of HRS
(All Must Be Present)
26. 3- In absence of renal cause:
26
Major Diagnostic Criteria Of HRS
(All Must Be Present)
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
Arroyo V, Gines P, Gerbes AL, et al. Hepatology. 1996;23:164-176.
Imaging: No ultrasonographic findings
of parenchymal renal disease.
Lab: Proteinuria < 500 mg/dL.History: No exposure to nephrotoxins
27. 4- In absence of Pre-renal cause:
27
Major Diagnostic Criteria Of HRS
(All Must Be Present)
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
Arroyo V, Gines P, Gerbes AL, et al. Hepatology. 1996;23:164-176.
Absence of
Shock Sepsis Volume depletion
28. 4- In absence of Pre-renal cause:
Major Diagnostic Criteria Of HRS
(All Must Be Present)
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
Arroyo V, Gines P, Gerbes AL, et al. Hepatology. 1996;23:164-176.
Stop
diuretics +
Albumin
(1 g/kg body weight/day
up to 100 g maximum)
1.5 L of
normal
saline
or
No sustained improvement in renal function
(to creatinine < 1.5 mg/dL or 24-hr CrCl to > 40 mL/min)
29. 4- In absence of Post-renal cause:
Major Diagnostic Criteria Of HRS
(All Must Be Present)
Salerno F, Gerbes A, Gines P, et al. Gut 2007;56:1310–1318.
Arroyo V, Gines P, Gerbes AL, et al. Hepatology. 1996;23:164-176.
No ultrasonographic findings of
obstructive uropathy
30. Take Care !!!
Use of CREATININE for Renal Function
Estimation In HRS
30Silkensen JR, Kasiske BL. Brenner and Rector’s The Kidney, 7th ed. Philadelphia: Saunders, 2004.
Less Reliable
Sever hyperbilirubinemia
interfers with the Jaffe
reaction for creatinine
quantitification and may
cause low results
Renal impairment may
be present despite a
normal serum creatinine
(because these patients are
malnourished, with reduced
lean body mass)
31. Take Care !!!
Use of CREATININE for Renal Function
Estimation
31
Serum Cr 2mg/dl Serum Cr 2mg/dl
32. Take Care !!!
Use of UREA for Renal Function
Estimation In HRS
32
Less Reliable
Presence of
gastrointestinal bleeding
Low hepatic urea
production
35. 35
Clinical Types of HRS
Prognosis
Without treatment
Median survival
time of type 1
HRS is less than
2 weeks
Median survival
time of type 2
HRS about
6 months
Alessandria C, Ozdogan O, Guevara M, et al. Hepatology 2005;41:1282–1289.
41. Treatment Principles
Regarding Pathophysiology
Salerno F, Gerbes A, Gines P, et al. Gut. 2007;56:1310-1318.
Kiser TH, Fish DN, Obritsch MD, et al. Nephrol Dial Transplant. 2005;20:1813-1820.
Martin-Llahi M, Pepin MN, Guevara M, et al. J Hepatol 2007;46:S36.
Wong F. Nat Clin Pract Gastroenterol Hepatol 2007;4:43–51.
All patients should
receive ALBUMIN
1 g/kg up to 100 g
in the first day
20 to 40 g/day
afterward
42. Treatment Principles
Miscellaneous
Vasodilators:
• Low-dose dopamine
• Prostaglandin E1 analogues (misoprostol)
• Endothelin receptor antagonists.
No proven efficacy
Angeli P, Volpin R, Gerunda G, et al. Hepatology 1999;29:1690–1697.
Gines A, Salmeron JM, Gines P, et al. J Hepatol 1993;17:220–226.
Wong F, Moore K, Dingemanse J, Jalan R. Hepatology 2008;47:160–168.
43. Treatment Principles
Miscellaneous
N-acetylcysteine (NAC)
in combination with systemic vasoconstrictors or
endothelin-receptor antagonists
Based on a small case study of 12 patients with HRS who
showed an improvement in serum creatinine after
intravenous infusion of NAC, but it is not standard clinical
practice at this time.
Holt S, Goodier D, Marley R, et al. Lancet 1999;353:294–295.
Izzedine H, Kheder-Elfekih R, Deray G. J Hepatol 2009;50:1055–1056.
Sen S, Mookerjee RP, Jalan R. Gastroenterology 2002;123:2160–2161.
47. Transjugular Intrahepatic Portosystemic
Stent-Shunt (TIPS)
The track is dilated (arrow) and stented, creating a shunt as demonstrated on shuntogram.
(Courtesy Dr. W. K. Tso, Queen Mary Hospital, Hong Kong.)
52. Renal Replacement Therapy
Hemodialysis has been used as a short-term
bridge to liver transplantation.
Witzke O, Baumann M, Patschan D, et al. J Gastroenterol Hepatol 2004;19(12):1369–1373.
There is no evidence that it increases long-
term survival without transplantation.
53. Renal Replacement Therapy
UF : Take care of systemic hypotension
Filter size: Use small sized filters
Anticoagulation:
Should be avoided. If needed use LMWH.
Catheterization:
Right jugular and right femoral veins should be
preserved for cannulation when going into bypass at
the time of liver transplantation.
CVVH is preferred
56. Liver Transplantation
Most patients have high GFR after transplantation,
although the majority don’t regain normal renal function,
10% incidence of ESRD at 11 years.
56
The only effective
treatment
Marik PE, Wood K, Starzl TE. Nephrol Dial Transplant 2006;21:478–482.
57. Liver Transplantation
57
Pretransplantation reversal of HRS allows achieving
better outcome after transplantation
Marik PE, Wood K, Starzl TE. Nephrol Dial Transplant 2006;21:478–482.
The only effective
treatment
62. Not all concomitant renal and hepatic
impairment is due to the HRS
It isn’t even on top of the list
63. Major Diagnostic Criteria Of HRS
(All Must Be Present)
1- Presence of liver disease.
2- Presence of renal impairment.
3- In absence of renal cause.
4- In absence of pre-renal cause.
5- In absence of post-renal cause.
68. Hemodialysis has been used as a short-
term bridge to liver transplantation.
There is no evidence that it increases long-
term survival without transplantation.
69. Catheterization:
Right jugular and right femoral veins should be
preserved for cannulation when going into bypass at
the time of liver transplantation.