1) The document provides guidance on interpreting chest x-rays by focusing on patterns of lung abnormalities including consolidation, pulmonary nodules and masses, and cavitary lesions.
2) Consolidation is described according to its contents, pattern of distribution, and chronicity which helps limit differential diagnoses. Common causes of lobar and diffuse consolidation are also outlined.
3) Pulmonary nodules and masses are differentiated and important characteristics for assessing each such as edges, number, density, and vascular pedicles are highlighted.
4) Cavitary lesions are described based on internal contents and location to suggest potential etiologies such as abscess, ruptured cyst, or pneumatocele.
In this presentation all images of Chapter 18 from Grainger and Allison have been discussed.
Our aim is to discuss authentic material .
This is only for educational purposes.
In this chapter air space infilteration have been discussed. Ground glass haze and consolidation are discussed in detail.
In this presentation all images of Chapter 18 from Grainger and Allison have been discussed.
Our aim is to discuss authentic material .
This is only for educational purposes.
In this chapter air space infilteration have been discussed. Ground glass haze and consolidation are discussed in detail.
Chest XRay and other imaging investigations of chest, CT chest, HRCT ChestBishnu Khatiwada
Chest x ray and other imaging investigations of chest, Basics of Chest Xray, PA view, Lateral view, CT chest, HRCT Chest, MRI Chest, USG Chest, PET/CT Chest, V/Q Scan, Silhouette sign, Cervicothoracic sign, Abdominothoracic sign, Golden S sign, Luftsichel sign, Air Bronchogram
Chest XRay and other imaging investigations of chest, CT chest, HRCT ChestBishnu Khatiwada
Chest x ray and other imaging investigations of chest, Basics of Chest Xray, PA view, Lateral view, CT chest, HRCT Chest, MRI Chest, USG Chest, PET/CT Chest, V/Q Scan, Silhouette sign, Cervicothoracic sign, Abdominothoracic sign, Golden S sign, Luftsichel sign, Air Bronchogram
COPD are chronic obstructive airway diseases usually need CT scans for early diagnosis and followup. this ppt will give you a brief idea about imaging in COPD.
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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
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
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
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.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
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.
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.
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.
1. Basic approach to chest X-ray
interpretation
Lecture 6
Dr. Kosar kamal ahmed
HD diagnostic radiology
2. Courtesy of :
• Prof. Dr. mamdouh mahfouz
• Radiology assistant ( chest radiology basic interpretation , chest
radiology lung diseases )
3. Let’s go back to where we skipped
• Technical adequacy
• Cardiothoracic ratio + CP angles
• Mediastinal contour and para vertebral lines
• Lung zones
• Hidden areas
• Bony stuctures
6. Let’s go back to where we skipped
• Technical adequacy
• Cardiothoracic ratio + CP angles
• Mediastinal contour and para
vertebral lines
• Lung zones
• Hidden areas
• Bony stuctures
9. Pattern approach
On a chest x-ray :
• lung abnormalities will either present as areas of
– increased density or as areas of decreased density.
• Lung abnormalities with an increased density also called opacities are the
most common.
• A practical approach is to divide these into four patterns:
– 1. Consolidation ( + opacity of without air bronchogram )
– 2. Interstitial infiltration
– 3. Nodules or masses
– 4. cavitary lesion
10. Important points to keep in mind
• You have to realize that it is not always possible to divide lung abnormalities
into one of these four patterns .
• Sometimes you are confronted with an abnormality that looks like a mass, but
it could also be a consolidation.
– Just do the workup of both the differential diagnosis of masses and consolidation.
– In such a case information from clinical data, old films or follow up films and CT scan will usually
solve the problem.
• Finally in some cases only biopsy will provide a diagnosis .
11. Consolidations
• They can be small or large
• Focal or multifocal
• Central or peripheral
According to the pathogenesis
12.
13. Consolidation
• Consolidation is the result of
replacement of air in the alveoli by
transudate, pus, blood, cells or other
substances.
• Pneumonia is by far the most
common cause of consolidation.
• The disease usually starts within the
alveoli and spreads from one alveolus
to another.
• When it reaches a fissure the spread
stops there .
14. Consolidation
• The keyfindings on the X ray
are :
1. ill defined , homogeneous
opacity obscuring vessels
2. Silhouette sign: loss of lung/soft
tissue interface
3. Air bronchogram
4. Extension to the pleura or
fissure, but not crossing it
5. No volume loss .
18. Consolidation
• It is very important to differentiate between acute consolidation and chronic
consolidation, because it will limit the differential diagnosis.
In chronic consolidation we think of :
i. Neoplasm with lobar or segmental post-obstructive pneumonia.
ii. Lung neoplasms like bronchoalveolar carcinoma and lymphoma.
iii. Chronic post-infection diseases like organizing pneumonia (OP) or chronic
eosinophilic pneumonia, which both present with multiple peripheral
consolidations.
iv. Sarcoidosis is the great mimicker and sometimes the granulomatous noduli
are so small and diffuse that they can present as consolidation ,This is
known as alveolar sarcoidosis .
v. Alveolar proteinosis is a rare chronic disease that is characterized by filling
of the alveoli with proteinaceous material.
19. Consolidation
• The most common presentation of consolidation is lobar or segmental.
The most common diagnosis is lobar pneumonia.
20. Lobar consolidation
• increased density with ill defined borders in the left lung
• the heart silhouette is still visible, which means that the density is in the
lower lobe
• Air bronchogram
21. Lobar consolidation
• In consolidation there should be
no or only minimal volume loss,
which differentiates consolidation
from atelectasis.
• Expansion of a consolidated lobe
is not so common and is seen in
Klebsiella pneumoniae and
sometimes in Streptococcus
pneumoniae, TB and lung cancer
with obstructive pneumonia.
22. Lobar consolidation
• Based on the images alone, it is usually not possible to determine the cause of the consolidation.
• Other things need to be considered, like acute or chronic illness, clinical data and other non pulmonary
findings.
• Here we have a number of xrays with consolidation ; Notice the similarity between these chest x rays
Lobar pneumonia in a patient with cough and feverPulmonary hemorrhage in a patient with hemorrhageOrganizing pneumonia (OP) multiple chronic consolidations
Infarction : peripheral consolidation in a patient with acute
shortness of breath with low oxygen level and high D-dimer
23. Lobar consolidation
• Based on the images alone, it is usually not possible to determine the cause of the consolidation.
• Other things need to be considered, like acute or chronic illness, clinical data and other non pulmonary
findings.
• Here we have a number of xrays with consolidation ; Notice the similarity between these chest x rays
Pumonary cardiogenic edema filling of the alveoli with transudate in a
patient with congestive heart failure.
Sarcoidosis : at first glance this looks like consolidation, but in fact this is
nodular interstitial lung disease, that is so widespread that it looks like
consolidation .
24. Diffuse consolidation
• The most common cause of diffuse consolidation is pulmonary edema due to heart
failure.
25. Diffuse consolidation
• bilateral perihilar consolidation with air bronchograms and ill defined borders
• an increased heart size
• subtle interstitial markings
• probably a large vascular pedicle.
26. Diffuse consolidation
• Unlike lobar pneumonia, which starts in the alveoli, bronchopneumonia starts in the airways as acute
bronchitis.
• It will lead to multifocal ill defined densities.
• When it progresses it can produce diffuse consolidation.
• The disease does not cross the fissures, but usually starts in multiple segments.
• Bronchopneumonia can be caused by many microorganisms.
• This proved to be legionella pneumonia
27. Diffuse consolidation
• The chest x ray shows diffuse consolidation with 'white out' of the left lung with an airbronchogram.
• This patient had a chronic disease with progressive consolidation.
• The disease started as a persitent consolidation in the left lung and finally spread to the right lung.
29. • A bilateral perihilar distribution of
consolidation is also called a
Batwing distribution.
• The sparing of the periphery of the
lung is attributed to a better
lymphatic drainage in this area.
• It is most typical of pulmonary
edema, both cardiogenic and
noncardiogenic.
• Sometimes it is seen in
pneumonias
• Peripheral or subpleural
consolidation is called reverse
Batwing distribution.
• It is frequently seen in chronic
lung disease .
30. • Multifocal consolidations are also described as
multifocal ill defined opacities or densities.
• In most cases these are the result of airspace
consolidations due to bronchopneumonia.
• Bronchopneumonia starts in the bronchi and then
spreads into the lung parenchyma.
• This can lead to segmental, diffuse or multifocal ill
defined densities.
• In some cases however the underlying pathology of
multiple ill defined densities is interstitial disease , like
in the alveolar form of sarcoidosis in which the
granulomas are very small and fill up the alveoli .
31. This patient had a several month history of chronic nonproductive
cough, that did not respond to antibiotics
• Probably we are dealing with multifocal consolidations
• but one might also consider the possibility of multiple ill defined masses
• Biopsy revealed the diagnosis of organizing pneumonia (OP)
32. Summary :
acute focal consolidation can be
pneumonia or infarction
Pneumonia Infarction
33. Pulmonary nodules and masses
• A well defined opacity that is < 3 cm on a CXR is a nodule
• A well defined opacity that is > 3 cm in a CXR is a mass
37. Pulmonary nodule
how to asses ?
• Number : multiple nodules are usually metastatic or less likely H. cysts
• A well defined edge is usually on the benign while spiculated edge is
malignant
• Presence of calcification or especially pop corn calcification is benign .
• Density : usually assessed by CT
– Fat --- pathognomonic for hamartoma
– Fluid --- H. cyst
– Soft tissue --- metastasis or primary carcinoma
• Vascular pedicle ---- AVM
38. Some nodules can be indeterminate and need
CT or FNA for further evaluation
40. Pulmonary masses
• Any pulmonary mass in an adult is carcinoma until proved otherwise
• Presence of calcification is benign in nodule while not in mass
• Multiplicity of the masses can be metastases or multiple hydatids
41. How to differentiate multiple pulmonary masses
from multiple pulmonary metastases ?
• There are three signs that make
the diagnosis of H. possible by
CXR :
1. Extreme sharp margin
2. Air in the wall ( halo sign )
3. Air / fluid level ( water lilly
sign )
42. Cavitary lesions
• A cavity is defined as a ‘gas-filled space,
seen as a lucency or low attenuation area .
• The cavity is usually the result of the
expulsion or drainage of a necrotic part of
the lesion via the bronchial tree.
• Although air–fluid levels may be seen in
cavitations, the term is not synonymous with
abscess .
47. Cavitary lesions
hyatid cyst
• Only three signs are
dependable in CT to diagnose
H. cyst :
– Floating shadows within the
cyst
– Calcification in the wall
– Daughter cysts
48. Cavitary lesions
• Thick walled cavity
• Containing air + mass
• They can be :
– Fungal ball ( mycetoma )
– Ruptured hydatid
– Necrotic tumor
– Blood clot
49. Cavitary lesions
• Thin walled cavity
• Containing air
• Look for the location of the
cavity :
– Central ( in lung parenchyma ) –
pneumatocele
– Peripheral ( sub-pleural) –
emphysematous bulla