This slide includes various CT protocol , liver ct triple phase protocol , with important findings, this power-point presentation help a lot for radiologist, radiology resident, radiographers, technician. Thanks.
This slide includes various CT protocol , liver ct triple phase protocol , with important findings, this power-point presentation help a lot for radiologist, radiology resident, radiographers, technician. Thanks.
Surgery Resident clinical seminar on the management of a 60yr old male with upper gastrointestinal bleeding presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
Liver transplantation current status, controversies and mythsAbhishek Yadav
Details the present status, indications, techniques about liver transplantation. Also dispels some common myths surrounding liver transplantation. #liver transplantation # living donor liver transplantation #liver cirrhosis #liver failure#transplantation#live donor#drabhishekyadav.com#liversurgeon#myths#livedonorlivertransplantation#organtransplantation#alcohololiverdisease
This slide mainly based on complication of liver transplant and their interventional management and also renal(kidney) transplantation ad their complication and their intervention management. Good short review for radiologist
CT TRIPLE PHASE SHOWING LIVER ANATOMY THREE PHASES OF EXAMINATION LIKE ARTERIAL PHASE,VENOUS PHASE DELAYED PHASE AND PORTAL PHASE CLEARLY AND LOBS OF LIVER EXPLAINED WELL.SOME TRIPLEPHASE EXPLAINING TECHNIQUES PROTOCOLS AND QUESIONEERS
enal transplantation is the most effective treatment option in patients with end-stage renal disease.
Studies have shown that the 5-year survival after renal transplantation is 70%, as compared to 30% survival in patients receiving dialysis.
The use of appropriate diagnostic method in preoperative analysis and also in postoperative follow up protocol is necessary for accurate preparation and early diagnosis of complications and workflow efficiency .
The most important role of diagnostic radiological methods is to identify multiple complications in the posttransplant period
Generally, the transplanted kidney is placed heterotopically in an extraperitoneal space in the pelvis; that is, a right kidney is placed in the left iliac fossa and vice versa
The right iliac fossa is usually preferred, since the right iliac vein runs a more superficial and horizontal course on this side of the pelvis, making the creation of vascular anastomoses easier.
Surgery Resident clinical seminar on the management of a 60yr old male with upper gastrointestinal bleeding presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
Liver transplantation current status, controversies and mythsAbhishek Yadav
Details the present status, indications, techniques about liver transplantation. Also dispels some common myths surrounding liver transplantation. #liver transplantation # living donor liver transplantation #liver cirrhosis #liver failure#transplantation#live donor#drabhishekyadav.com#liversurgeon#myths#livedonorlivertransplantation#organtransplantation#alcohololiverdisease
This slide mainly based on complication of liver transplant and their interventional management and also renal(kidney) transplantation ad their complication and their intervention management. Good short review for radiologist
CT TRIPLE PHASE SHOWING LIVER ANATOMY THREE PHASES OF EXAMINATION LIKE ARTERIAL PHASE,VENOUS PHASE DELAYED PHASE AND PORTAL PHASE CLEARLY AND LOBS OF LIVER EXPLAINED WELL.SOME TRIPLEPHASE EXPLAINING TECHNIQUES PROTOCOLS AND QUESIONEERS
enal transplantation is the most effective treatment option in patients with end-stage renal disease.
Studies have shown that the 5-year survival after renal transplantation is 70%, as compared to 30% survival in patients receiving dialysis.
The use of appropriate diagnostic method in preoperative analysis and also in postoperative follow up protocol is necessary for accurate preparation and early diagnosis of complications and workflow efficiency .
The most important role of diagnostic radiological methods is to identify multiple complications in the posttransplant period
Generally, the transplanted kidney is placed heterotopically in an extraperitoneal space in the pelvis; that is, a right kidney is placed in the left iliac fossa and vice versa
The right iliac fossa is usually preferred, since the right iliac vein runs a more superficial and horizontal course on this side of the pelvis, making the creation of vascular anastomoses easier.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
5. An Introduction to Liver Imaging
o Liver :
the largest internal organ in the body, Located in the RUQ , consists of 2 main lobes
o Why different imaging modalities?
• Accurate diagnosis
• Precise staging
• Detecting Lesions
• Assessment of treatment response
• monitor the course of disease
o Liver carries out many functions
• Making bile. Fluid that helps break down fats and gets rid of wastes in the body
• Changing food into energy
• Clearing the blood of drugs and other poisonous substances
• Producing certain proteins for blood plasma
• Regulating blood clotting
Shokoofeh Mousavi Razi Hospital 5
15. Liver Diseases
o Hepatitis
• Inflammation of the liver, usually caused by viruses, types: A, B, and C. have also non-infectious
causes too, including heavy drinking, drugs, allergic reactions, or obesity.
o Cancer
• The most common type: hepatocellular carcinoma.
o Hemangioma
• Blood-filled vascular space, the most common liver tumor
• are frequent, often asymptomatic, very low rate of complications
o Liver Failure
• Has many causes including infection, genetic diseases, and excessive alcohol.
Shokoofeh Mousavi Razi Hospital 15
16. Liver Diseases (Cont.)
o Ascites
• As cirrhosis results, the liver leaks fluid into the belly.
o Gallstones
• If a gallstone becomes stuck in the bile duct draining the liver, hepatitis and bile duct
infection (cholangitis) can result.
o Hemochromatosis
• Allows iron to deposit in the liver, damaging it.
Shokoofeh Mousavi Razi Hospital 16
17. Liver Diseases (cont.)
o Fatty Liver
• Also known as hepatic steatosis, happens when fat builds up in the liver, can cause
liver inflammation
o Cirrhosis
• Long-term damage, lead to permanent scarring.
Shokoofeh Mousavi Razi Hospital
17
25. Multi Phasic CT
o Preparation
• Check pregnancy, allergies to any medicines, Kidney problems, Diabetes
• Fill out informed consent form
• Fasting before exam
o Injection
• Iodine-based contrast media
• 18 or 20 gauge needle, right antecubital vein
• Large amount of contrast material/ small amount of it followed by a saline bolus chaser
• Injection rate should be 2-5 mL/sec.
• Injected volume should be 100-150 cc
Shokoofeh Mousavi Razi Hospital 25
26. Multi Phasic CT (Cont.)
o Acquisition
Shokoofeh Mousavi Razi Hospital 26
Non-enhanced
Early arterial phase
Late arterial phase
Hepatic or late portal phase
Nephrogenic phase
Delayed phase
27. Shokoofeh Mousavi Razi Hospital 27
Helpful in detecting:
o Calcifications & stones
o fat in tumors/inflammation
o appendicitis
o diverticulitis
o etc.
28. Shokoofeh Mousavi Razi Hospital 28
o 15-20 sec p.i. or immediately after
bolustracking
o the contrast is still in the arteries
o has not enhanced the organs/other soft
tissues
Helpful in detecting:
o Arterial bleeding
o Dissection of Aorta
29. Shokoofeh Mousavi Razi Hospital 29
o 35-40 sec p.i. or 15-20 sec after bolustracking
o also called "arterial phase" or "early venous
portal phase“
o Enhancement of hypervascular lesions/
kidney outer cortex/ pancreas parenchyma
Helpful in detecting:
o HCC
o Adenoma
o Ischemia
o FNH
30. Shokoofeh Mousavi Razi Hospital 30
o 70-80 sec p.i. or 50-60 sec after bolustracking
o liver parenchyma enhances through blood
supply by the portal vein
Helpful in detecting:
o Cysts
o Abcess
o Metastases
o hypervascular lesions
31. Shokoofeh Mousavi Razi Hospital 31
o 100 sec p.i. or 80 sec after bolustracking
o all of the renal parenchyma including the
medulla enhances.
Helpful in detecting:
o small renal cell carcinomas.
32. Shokoofeh Mousavi Razi Hospital 32
o 6-10 minutes p.i. or 6-10 minutes after bolustracking
o So called "wash out phase" / "equilibrium phase“
o There is wash out of contrast in all abdominal
structures except for fibrotic tissue
Helpful in detecting:
o Transitional cell carcinoma in kidney
o Cholangiocarcinoma in liver
o Fibrotic metastasis
33. Contrast agent
Injection volume:
o Weight < 75kg : 100cc
o Weight 75-90kg: 120cc
o Weight > 90kg : 150cc
Injection rate:
o 5cc/sec through a 18 gauge i.v. catheter for all indications
o 3-4cc/sec through a 20 gauge pink venflon If 5cc/sec is not possible
Shokoofeh Mousavi Razi Hospital 33
34. Importance of timing
• Hyper vascular tumors (e.g. HCC) are best seen in late arterial phase
• Irregular enhancement Vs. Obvious multiple masses
Shokoofeh Mousavi Razi Hospital 34
35. Lesion Characterization
o Late arterial phase (at 35 sec):
o hypervascular lesions like HCC, FNH, adenoma and
hemangioma wiLl enhance optimally, while the normal
parenchyma shows only minimal enhancement.
o Hepatic phase (at 70 sec p.i. ):
o Hypovascular lesions like metastases, cysts and abscesses
will not enhance and are best seen
o Delayed phase (at 600 sec p.i.):
o Fibrotic lesions like cholangiocarcinoma and fibrotic
metastases hold the contrast much longer than normal
parenchyma. They are best seen in the
Shokoofeh Mousavi Razi Hospital 35
37. Dynamic MRI
o Supine, head first
o Spine coil, Body coil from nipple down to iliac crest
o Laser beam center over xiphoid process of sternum
o Using respiratory trigger device
o Proper breathing instruction
o Navigator and blade sequences (if possible)
Shokoofeh Mousavi Razi Hospital 37
38. Dynamic MRI (cont.)
o Injection
• Gd-based contrast agents
Best liver-to-lesion contrast within 90. sec p.i.
• Hepatocyte targeted contrast agents
Best normal-to-abnormal contrast within 10-
40 min p.i.
Shokoofeh Mousavi Razi Hospital 38
o Suggested Dynamic Protocol:
• Flash 3D sequence
• Consists of 3 flash 3mm 3D scan
• 10s delay between first (arterial) and
second scan (portal venous phase)
• 5min delay after second, for third phase
(equilibrium)
40. Proper arterial phase
Marked enhancement of hepatic arteries, pancreas, spleen
No enhancement of hepatic veins
Maximum enhancement of tumor and hypervascular lesions
Guess timing method: Start about 20sec p.i , scan time less than 30 sec
Care bolus technique: start liver scan immediately after CM reaching the heart
Shokoofeh Mousavi Razi Hospital 40
41. Proper portal phase
Maximum enhancement of liver parenchyma
Easily detection of hypo vascular tumor
Guess timing method: Start about 60 sec p.i , scan time less than 30 sec
Care bolus technique: 15s scan delay after finishing arterial scan
Shokoofeh Mousavi Razi Hospital 41
42. Proper Equilibrium phase
Contrast has moved away from liver parenchyma
2-5 min after injection
Shokoofeh Mousavi Razi Hospital 42
Golden choice rUQ pain
Limited utility in fatty liver
5cc/sec through a 18 gauge i.v. catheter for all indications
Test by fast injection of 10cc NaCl manually.
Hold the arm stretched.
The upper images are of a patient with liver cirrhosis and multifocal hepatocellular carcinoma examined after contrast injection at 2.5ml/sec.Because of poor enhancement the examination was repeated at 5ml/sec.There is far better contrast enhancement and better tumor detection
When we give i.v. contrast, it is important to understand, that there is a dual blood supply to the liver.Normal parenchyma is supplied for 80% by the portal vein and only for 20% by the hepatic artery, so the normal parenchyma will enhance maximally in the hepatic phase at 70-80 sec p.i. and only a little bit in the late arterial phase at 35-40 sec p.i..
All liver tumors however get 100% of their blood supply from the hepatic artery.So a hypervascular tumor will be best seen in the late arterial phase
If you want to characterize a liver lesion, you need maximum contrast at a maximum flow rate, i.e. 150cc contrast at 5cc/sec. through a 18 gauge green venflon.
In most cases you also want to scan the whole abdomen.You can do this either at 35 sec or 70 sec p.i.
We do not routinely perform a NECT in order keep the radiation dose as low as possible.
When you know in advance, that you are dealing with hypovascular metastases, a hepathic phase at 70 sec p.i. is sufficient.
Arterial dominant phase: during 20-50 sec p.i.
Heart to hepatic artery about 4 sec
Arterial dominant phase: during 20-50 sec p.i.
Heart to hepatic artery about 4 sec
Hepatic vein dominant phase:
Occurs 60-90 sec from the start of injection
Strat after20+ 25 arterial scan time+15 delay
here is severe gallbladder wall T2 hyperintensity in keeping with oedema, which compresses the mucosa of the gallbladder.
Cystic duct, CBD pancreatic duct are within normal limits with no obstructing lesions seen.Marked high T2 signal is also demonstrated within the periportal spaces consistent with oedema.
Liver also appears slightly enlarged with recanalisation of the umbilical vein noted. Overall findings suggestive of acute hepatitis and could account for the markedly deranged LFTs.
alcoholic/viral/autoimune