O Lt Eval Houston Grand Rounds
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The document discusses liver transplantation evaluation for patients with hepatitis C and other liver diseases. It provides details on the goals, components, and factors considered in the medical, surgical, psychosocial, and financial evaluations. Key aspects include determining patient eligibility and prognosis, ensuring treatment adherence, evaluating extrahepatic conditions, and assessing support systems and financial status. The evaluation determines if transplantation is warranted and the patient's priority on the waiting list.
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The document discusses blood transfusion, blood products, and safety protocols. It covers the components of blood including red cells, plasma, and platelets. It outlines the shelf life of different blood products and storage considerations. The document details eligibility requirements for blood donors and transfusion rules. It explains blood typing, matching blood to patients, and monitoring patients during transfusions. Key safety protocols for administering blood components and managing potential transfusion reactions are also summarized.
Acute pancreatitis
Acute pancreatitis is a common medical problem. Initial phase of acute pancreatitis is characterized by inflammation. This is caused by release of cytokines and other pro inflammatory mediators. These further cause vasodilatation, intravascular volume depletion, and end organ hypoperfusion. The etiology can be varied but common causes are biliary (stone in CBD) and alcohol. Other causes are drugs, infections, trauma, idiopathic, post ERCP etc. Patients with severe pancreatitis have high risk of mortality (10%) which can go upto 30% if necrosis gets infected, which occurs in about 40% patients. Further, persistent organ failure increases the mortality up to 34–55% as compared to 0.3% with transient organ failure. Traditionally as per Atlanta classification, acute pancreatitis has been classified as mild or severe depending upon organ failure or local complications. Acute pancreatitis is a hyper-catabolic state. Moreover some of these patients may be malnourished to begin with (alcoholics). Thus their nutritional requirements are much more than ordinary person. There are good quality studies available to show that in absence of cholangitis, there is no benefit of doing early ERCP. Also, technically it is more difficult to do in such situations, and procedure related complication may be more. If in doubt, it may be worthwhile to do endoscopic ultrasound to document the presence of CBD stone before attempting to cannulate the CBD.
2016 acute-lower-gi-bleeding
This document provides guidelines for managing patients with acute lower gastrointestinal bleeding (LGIB). It recommends initially assessing the patient's hemodynamic status and performing resuscitation if needed. Risk stratification should then be done to determine if the patient is at high or low risk of adverse outcomes. For most patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of presentation after adequate bowel preparation. Endoscopic hemostasis therapy is recommended for patients found to have active bleeding, non-bleeding visible vessels, or adherent clots during colonoscopy. Non-colonoscopic interventions like radiographic tests or surgery may be considered for high-risk patients who cannot undergo colonoscopy.
Anemia & transfusion
This document provides an overview of anemia, blood transfusion, and transfusion reactions. It defines anemia, describes common causes and classifications. Thresholds for anemia diagnosis are outlined for different populations. Indications for blood transfusion include increasing oxygen capacity and restoring blood volume. The document details donor eligibility, blood collection/screening processes, and guidelines for recognizing and managing transfusion reactions from mild to severe. Physician responsibilities in ordering and administering transfusions are also reviewed.
Transplantation immunology dr. ihsan alsaimary
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Selection and maintenance of a cadaver donor for liver transplantation
The need for the cadaver organ for liver transplant is increasing. Extended criteria/marginal donors can increase the donor pool significantly as ideal donors are very few. The combination of multiple marginal factors seems to be additive on graft injury. Although the organs from marginal donors may not be optimal, they are a viable alternative to dying while waiting for transplantation. In this review, the utility of various marginal donors in patients requiring liver transplantation will be described. It is inferred that older donors, mild to moderate steatosis, hypernatremia (preferably after correction), high ianotropic requirement, bacteremia, etc. are acceptable. Selected patients with low-grade malignancy may be accepted. Donors with positive viral serologies where transmission to the recipient is possible should be used only if the recipient is already infected with the same agent or the recipient has a critical need. The importance of liver biopsy and the goals of donor maintenance are also described. It is also concluded that the patients with high model for end-stage liver disease (MELD) score (>20) benefit the most with the marginal organs.
IndicationsLivertransplantation.ppt
The document discusses indications for liver transplantation. It begins by describing liver anatomy and function. Liver transplantation is indicated for complications of end-stage liver disease, such as variceal bleeding, hepatic encephalopathy, refractory ascites, and hepatopulmonary syndrome. The Child-Turcotte-Pugh and MELD scores are used to determine transplant urgency, with a MELD over 10 or the first major complication indicating need for transplant. Contraindications and the process for organ allocation are also reviewed.
Donor selection and blood collection
This document discusses donor selection and blood collection procedures. It outlines strategies for donor recruitment including voluntary, social persuasion, and remunerated donations. The donor selection process involves counseling, screening donors using a questionnaire and health check, and determining temporary or permanent deferrals. Blood collection follows standard safety procedures using approved equipment and materials while monitoring the donor's health.
Rational use of blood
Blood transfusion guidelines provide recommendations for appropriate clinical use of blood and components to reduce risks. The risks of transfusion can be lowered through effective donor selection, screening, testing, component separation, storage, and clinical use. Transfusion is recommended when the hemoglobin is less than 7g/dL or the platelet count is less than 10,000/uL, depending on the clinical situation. Alternatives to allogenic transfusion include autologous donation prior to surgery, acute normovolemic hemodilution, erythropoietin, and blood salvage to reduce transfusion needs.
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快速制作美国迈阿密大学牛津分校毕业证文凭证书英文原版一模一样
原版一模一样【微信：741003700 】【美国迈阿密大学牛津分校毕业证文凭证书】【微信：741003700 】学位证，留信认证（真实可查，永久存档）offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
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1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
Fabular Frames and the Four Ratio Problem
Digital, interactive art showing the struggle of a society in providing for its present population while also saving planetary resources for future generations. Spread across several frames, the art is actually the rendering of real and speculative data. The stereographic projections change shape in response to prompts and provocations. Visitors interact with the model through speculative statements about how to increase savings across communities, regions, ecosystems and environments. Their fabulations combined with random noise, i.e. factors beyond control, have a dramatic effect on the societal transition. Things get better. Things get worse. The aim is to give visitors a new grasp and feel of the ongoing struggles in democracies around the world.
Stunning art in the small multiples format brings out the spatiotemporal nature of societal transitions, against backdrop issues such as energy, housing, waste, farmland and forest. In each frame we see hopeful and frightful interplays between spending and saving. Problems emerge when one of the two parts of the existential anaglyph rapidly shrinks like Arctic ice, as factors cross thresholds. Ecological wealth and intergenerational equity areFour at stake. Not enough spending could mean economic stress, social unrest and political conflict. Not enough saving and there will be climate breakdown and ‘bankruptcy’. So where does speculative design start and the gambling and betting end? Behind each fabular frame is a four ratio problem. Each ratio reflects the level of sacrifice and self-restraint a society is willing to accept, against promises of prosperity and freedom. Some values seem to stabilise a frame while others cause collapse. Get the ratios right and we can have it all. Get them wrong and things get more desperate.
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快速办理(SMU毕业证书)南卫理公会大学毕业证毕业完成信一模一样
学校原件一模一样【微信：741003700 】《(SMU毕业证书)南卫理公会大学毕业证》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
【主营项目】
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三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微741003700】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
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真实可查(nwu毕业证书)美国西北大学毕业证学位证书范本原版一模一样
原版定制【微信:bwp0011】《(nwu毕业证书)美国西北大学毕业证学位证书》【微信:bwp0011】成绩单 、雅思、外壳、留信学历认证永久存档查询，采用学校原版纸张、特殊工艺完全按照原版一比一制作（包括：隐形水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠，文字图案浮雕，激光镭射，紫外荧光，温感，复印防伪）行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备，十五年致力于帮助留学生解决难题，业务范围有加拿大、英国、澳洲、韩国、美国、新加坡，新西兰等学历材料，包您满意。
【业务选择办理准则】
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二、回国进私企、外企、自己做生意的情况，这些单位是不查询毕业证真伪的，而且国内没有渠道去查询国外文凭的真假，也不需要提供真实教育部认证。鉴于此，办理一份毕业证【微信bwp0011】即可
三、进国企，银行，事业单位，考公务员等等，这些单位是必需要提供真实教育部认证的，办理教育部认证所需资料众多且烦琐，所有材料您都必须提供原件，我们凭借丰富的经验，快捷的绿色通道帮您快速整合材料，让您少走弯路。
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
【关于价格问题（保证一手价格）】
我们所定的价格是非常合理的，而且我们现在做得单子大多数都是代理和回头客户介绍的所以一般现在有新的单子 我给客户的都是第一手的代理价格，因为我想坦诚对待大家 不想跟大家在价格方面浪费时间
对于老客户或者被老客户介绍过来的朋友，我们都会适当给一些优惠。
Who Is Abhay Bhutada, MD of Poonawalla Fincorp
Abhay Bhutada, the Managing Director of Poonawalla Fincorp Limited, is an accomplished leader with over 15 years of experience in commercial and retail lending. A Qualified Chartered Accountant, he has been pivotal in leveraging technology to enhance financial services. Starting his career at Bank of India, he later founded TAB Capital Limited and co-founded Poonawalla Finance Private Limited, emphasizing digital lending. Under his leadership, Poonawalla Fincorp achieved a 'AAA' credit rating, integrating acquisitions and emphasizing corporate governance. Actively involved in industry forums and CSR initiatives, Abhay has been recognized with awards like "Young Entrepreneur of India 2017" and "40 under 40 Most Influential Leader for 2020-21." Personally, he values mindfulness, enjoys gardening, yoga, and sees every day as an opportunity for growth and improvement.
Bridging the gap: Online job postings, survey data and the assessment of job ...
Bridging the gap: Online job postings, survey data and the assessment of job ...Labour Market Information Council | Conseil de l’information sur le marché du travail
OJP data from firms like Vicinity Jobs have emerged as a complement to traditional sources of labour demand data, such as the Job Vacancy and Wages Survey (JVWS). Ibrahim Abuallail, PhD Candidate, University of Ottawa, presented research relating to bias in OJPs and a proposed approach to effectively adjust OJP data to complement existing official data (such as from the JVWS) and improve the measurement of labour demand.在线办理(UMASS毕业证书)马萨诸塞大学阿默斯特分校毕业证完成信一模一样
学校原件一模一样【微信：741003700 】《(UMASS毕业证书)马萨诸塞大学阿默斯特分校毕业证》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
【主营项目】
一.毕业证【q微741003700】成绩单、使馆认证、教育部认证、雅思托福成绩单、学生卡等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微741003700】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
South Dakota State University degree offer diploma Transcript
办理美国SDSU毕业证书制作南达科他州立大学假文凭定制Q微168899991做SDSU留信网教留服认证海牙认证改SDSU成绩单GPA做SDSU假学位证假文凭高仿毕业证GRE代考如何申请南达科他州立大学South Dakota State University degree offer diploma Transcript
1.2 Business Ideas Business Ideas Busine
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Enhancing Asset Quality: Strategies for Financial Institutions
Ensuring robust asset quality is not just a mere aspect but a critical cornerstone for the stability and success of financial institutions worldwide. It serves as the bedrock upon which profitability is built and investor confidence is sustained. Therefore, in this presentation, we delve into a comprehensive exploration of strategies that can aid financial institutions in achieving and maintaining superior asset quality.
在线办理(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单一模一样
学校原件一模一样【微信：741003700 】《(TAMU毕业证书)美国德州农工大学毕业证PDF成绩单》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
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留信网认证的作用:
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3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
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The state of welfare Resolution Foundation Event
How has Britain’s safety net changed since 2010 and what comes next?
Optimizing Net Interest Margin (NIM) in the Financial Sector (With Examples).pdf
NIM is calculated as the difference between interest income earned and interest expenses paid, divided by interest-earning assets.
Importance: NIM serves as a critical measure of a financial institution's profitability and operational efficiency. It reflects how effectively the institution is utilizing its interest-earning assets to generate income while managing interest costs.
International Sustainability Standards Board
Issb standards
New standard for reporting sustainability on lines of tcfd
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- 1. Liver Transplantation and Hepatitis C A Clinical Update Joseph S. Galati, M.D Medical Director St. Luke’s Texas Liver Institute
- 3. Liver Transplant Evaluation RISK BENEFIT
- 5. Components of the Evaluation Liver Transplant Surgery Medical evaluation Psycho-social Evaluation Financial Evaluation Nutritional Evaluation Radiology Pharmacy
- 6. Liver Transplant Evaluation Transplant Nurse Coordinator Medical Evaluation Financial evaluation Psychosocial evaluation
- 15. Survival After Liver Transplantation By Pre-Transplant Length of Abstinence
- 20. Liver Transplant Evaluation Acceptable candidate P lace on waiting list Unacceptable candidate Able to modify negative factors Unable to modify negative factors Reject for liver transplant
- 22. Deaths on the Waiting List 1990/1995/2000 This accounts for a 25% death rate on the liver list
- 23. Cadaveric Donors, Cadaveric Transplants, and Number on Waiting List Source: Donors from OPTN data as of 9/5/00; transplants from Scientific Registry data as of 9/5/00; snapshot of OPTN waiting list on the last day of each year. Donors Transplants Waiting List at Year’s End
- 25. Liver Graft Survival Rates by Waiting List Status at Transplant Note: Waiting list status for 1-year survival reported for codes 1, 2A, 2B, and 3; 5-year survival reported for codes 1, 2, 3, and 4. Source: Scientific Registry data as of 9/5/00. 1 Year (1998 Cohort) 5 Years (1992-97 Cohort)
- 26. So…when is the proper time to refer for transplant?
- 27. Never too early