Have you ever experienced peripheral neuropathy? Did it feel like a numbness or tingling in your hands or feet? Did it last several weeks, or several years? Join us, as Cindy S. Tofthagen, PhD, ARNP, AOCNP, University of South Florida College of Nursing Assistant Professor and Concentration Director of Oncology, will discuss this important topic and ways to manage it.
Although peripheral neuropathy is a known common side effect of some chemotherapy regimens, there are many different types of peripheral neuropathy, and many different causes. Cindy will explain exactly what it is that's happening, why it happens, and what causes it to happen. And then, most importantly, will provide tips on the best ways to manage it. You're not going to want to miss this!
Nancy Campbell, MS, an exercise physiologist with Dana-Farber's Adult Survivorship Program, provides some tips and exercises that can help manage the symptoms of neuropathy. This presentation was originally given on March 27, 2013 through Dana-Farber's Blum Resource Center.
Chemotherapy Induced Peripheral Neuropathy (CIPN): A Song of Ice and FireChristopher B. Ralph
Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting neurotoxic effect affecting many patients receiving chemotherapy, characterized by pain and loss of sensation in the hands and feet. It can interfere with cancer patients’ treatment and significantly reduce their quality of life. With better treatment options like new anti-emetics and hematopoietic colony stimulating factors for other serious side-effects, CIPN emerges more often as a dose limiting factor. In this session, we will discuss prevention, monitoring, pharmaceutical treatment options, as well as other modalities to consider. We will also explore future management options for this pervasive, debilitating adverse effect of cancer treatment.
Author: Twitter @ChrisRalphRx
Audio and slides for this presentation are available on YouTube: http://youtu.be/dYRu8PVLU14
Cindy Tofthagen, PhD, ARNP, an assistant professor of nursing at the University of South Florida in Tampa and a post-doctoral fellow at the University of Massachusetts and Dana-Farber Cancer Institute, talks about chemotherapy-induced peripheral neuropathy (CIPN), the risk factors of CIPN, and how to manage the condition. This presentation was originally given at Dana-Farber Cancer Institute on Aug. 6, 2013 and put on by Dana-Farber's Blum Resource Center.
Nancy Campbell, MS, an exercise physiologist with Dana-Farber's Adult Survivorship Program, provides some tips and exercises that can help manage the symptoms of neuropathy. This presentation was originally given on March 27, 2013 through Dana-Farber's Blum Resource Center.
Chemotherapy Induced Peripheral Neuropathy (CIPN): A Song of Ice and FireChristopher B. Ralph
Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting neurotoxic effect affecting many patients receiving chemotherapy, characterized by pain and loss of sensation in the hands and feet. It can interfere with cancer patients’ treatment and significantly reduce their quality of life. With better treatment options like new anti-emetics and hematopoietic colony stimulating factors for other serious side-effects, CIPN emerges more often as a dose limiting factor. In this session, we will discuss prevention, monitoring, pharmaceutical treatment options, as well as other modalities to consider. We will also explore future management options for this pervasive, debilitating adverse effect of cancer treatment.
Author: Twitter @ChrisRalphRx
Audio and slides for this presentation are available on YouTube: http://youtu.be/dYRu8PVLU14
Cindy Tofthagen, PhD, ARNP, an assistant professor of nursing at the University of South Florida in Tampa and a post-doctoral fellow at the University of Massachusetts and Dana-Farber Cancer Institute, talks about chemotherapy-induced peripheral neuropathy (CIPN), the risk factors of CIPN, and how to manage the condition. This presentation was originally given at Dana-Farber Cancer Institute on Aug. 6, 2013 and put on by Dana-Farber's Blum Resource Center.
An apt yet detailed description of Polyarthritis for undergraduate level with basic definitions, classification, concept, clinical features along with descriptive images, diagnosis & assessment with distinguishing features along with differential diagnosis.
Review of the Diagnosis and Treatment of ParalysisYogeshIJTSRD
Paralysis is a complete loss of motor power in any muscle group. When paralysis affects all four extremities, it is called quadriplegia when it affects only the lower extremities, paraplegia and when it affects the extremities on one side of the body, hemiplegic. For this reason, the term paralysis is generally reserved for more focal, less stereotyped weakness, for instance, affecting all the muscles innervated by a peripheral nerve. Many different anatomical lesions and etiologies can cause paralysis and determine its treatment. Bikash Debsingha | Dr. Gourav Kr. Sharma | Dr. Kausal Kishore Chandrul "Review of the Diagnosis and Treatment of Paralysis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45108.pdf Paper URL: https://www.ijtsrd.com/pharmacy/pharmacology-/45108/review-of-the-diagnosis-and-treatment-of-paralysis/bikash-debsingha
The presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes is called diabetic peripheral neuropathy.
The diagnosis is principally a clinical one. Patients with type 1 diabetes for 5 or more years and all patients with type 2 diabetes should be assessed annually.Treatment goals include
good glycemic control,symptomatic treatment and halt progressive nerve damage.
Treatment Options for Drug-Resistant Epilepsy
In some people with drug resistant epilepsy, there are effective treatment options, with a high chance of seizure freedom. These include:
Resective Epilepsy Surgery
Resective epilepsy surgery consists of removing the area of the brain that is causing the seizures. However, for a patient to be a good candidate for surgery, the following conditions have to be met:
The area of the brain where seizures originate is clearly identified.
That area of the brain can be safely removed with surgery. In other words if the risk is greater than “minimal risk,” the patient is not a candidate.
The probability to achieve seizure freedom with epilepsy surgery varies depending on the structures of the brain involved. For example, patients whose seizures originate in the temporal lobe have a 50% to 70% chance of achieving seizure-freedom.
Today, newer, less-invasive techniques are being used in the place of resective surgery in appropriate cases. These include the use of laser, in which a laser probe burns the area of the brain causing the seizures. However, these new techniques may not work for all candidates for resective surgery.
Specific Metabolic Treatment
While metabolic causes of epilepsy are uncommon, identifying some of these conditions can lead to specific treatments to allow the body to compensate for the metabolic change.
Examples are treatment with a ketogenic diet for GLUT1 deficiency, treatment with pyridoxine or pyridoxal-5-phosphate for vitamin dependent epilepsies, and creatine supplementation for creatine deficiency syndromes.
Specific Genetic Causes
Identifying a specific genetic cause can help your doctor choose the best treatment for seizures.
For example, with SCN1A pathogenic variants, medications such as Oxcarbazepine (Trileptal), Carbamazepine (Tegretol) or Phenytoin (Dilantin) should be avoided. Whereas with other types of pathogenic variants, such as SCN2A and SCN8A variants, these medications can be very helpful.
Some specific treatments which target the underlying problem caused by the genetic variant are in clinical trials, and may improve learning and development as well as help with seizures.
Immunotherapy
In the last decade, the role of inflammatory processes in certain types of epilepsy has been recognized. In these cases, medications that counteract these processes have been used with success. However, they have to be used with caution as they are associated with a variety of adverse events.
Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate anywhere from the neck into the shoulder, arm, hand, or fingers. Pins-and-needles tingling and/or pain, which can range from achy to shock-like or burning, may also radiate down into the arm and/or hand.
Numbness, pain or burning are warning signals from our nerves that something is wrong. The goal of treatment is to find out what is wrong and to fix it, not to just mask or cover up the warning signs. View this presentation to learn more.
How can cancer patients and survivors manage the side effects of neuropathy? Learn about useful tips to mitigate pain and numbness, as well as safety tips to avoid injury.
For more information on neuropathy, visit: http://blog.dana-farber.org/insight/2013/08/chemotherapy-related-neuropathy-managing-this-nerve-wracking-problem/
An apt yet detailed description of Polyarthritis for undergraduate level with basic definitions, classification, concept, clinical features along with descriptive images, diagnosis & assessment with distinguishing features along with differential diagnosis.
Review of the Diagnosis and Treatment of ParalysisYogeshIJTSRD
Paralysis is a complete loss of motor power in any muscle group. When paralysis affects all four extremities, it is called quadriplegia when it affects only the lower extremities, paraplegia and when it affects the extremities on one side of the body, hemiplegic. For this reason, the term paralysis is generally reserved for more focal, less stereotyped weakness, for instance, affecting all the muscles innervated by a peripheral nerve. Many different anatomical lesions and etiologies can cause paralysis and determine its treatment. Bikash Debsingha | Dr. Gourav Kr. Sharma | Dr. Kausal Kishore Chandrul "Review of the Diagnosis and Treatment of Paralysis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45108.pdf Paper URL: https://www.ijtsrd.com/pharmacy/pharmacology-/45108/review-of-the-diagnosis-and-treatment-of-paralysis/bikash-debsingha
The presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes is called diabetic peripheral neuropathy.
The diagnosis is principally a clinical one. Patients with type 1 diabetes for 5 or more years and all patients with type 2 diabetes should be assessed annually.Treatment goals include
good glycemic control,symptomatic treatment and halt progressive nerve damage.
Treatment Options for Drug-Resistant Epilepsy
In some people with drug resistant epilepsy, there are effective treatment options, with a high chance of seizure freedom. These include:
Resective Epilepsy Surgery
Resective epilepsy surgery consists of removing the area of the brain that is causing the seizures. However, for a patient to be a good candidate for surgery, the following conditions have to be met:
The area of the brain where seizures originate is clearly identified.
That area of the brain can be safely removed with surgery. In other words if the risk is greater than “minimal risk,” the patient is not a candidate.
The probability to achieve seizure freedom with epilepsy surgery varies depending on the structures of the brain involved. For example, patients whose seizures originate in the temporal lobe have a 50% to 70% chance of achieving seizure-freedom.
Today, newer, less-invasive techniques are being used in the place of resective surgery in appropriate cases. These include the use of laser, in which a laser probe burns the area of the brain causing the seizures. However, these new techniques may not work for all candidates for resective surgery.
Specific Metabolic Treatment
While metabolic causes of epilepsy are uncommon, identifying some of these conditions can lead to specific treatments to allow the body to compensate for the metabolic change.
Examples are treatment with a ketogenic diet for GLUT1 deficiency, treatment with pyridoxine or pyridoxal-5-phosphate for vitamin dependent epilepsies, and creatine supplementation for creatine deficiency syndromes.
Specific Genetic Causes
Identifying a specific genetic cause can help your doctor choose the best treatment for seizures.
For example, with SCN1A pathogenic variants, medications such as Oxcarbazepine (Trileptal), Carbamazepine (Tegretol) or Phenytoin (Dilantin) should be avoided. Whereas with other types of pathogenic variants, such as SCN2A and SCN8A variants, these medications can be very helpful.
Some specific treatments which target the underlying problem caused by the genetic variant are in clinical trials, and may improve learning and development as well as help with seizures.
Immunotherapy
In the last decade, the role of inflammatory processes in certain types of epilepsy has been recognized. In these cases, medications that counteract these processes have been used with success. However, they have to be used with caution as they are associated with a variety of adverse events.
Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate anywhere from the neck into the shoulder, arm, hand, or fingers. Pins-and-needles tingling and/or pain, which can range from achy to shock-like or burning, may also radiate down into the arm and/or hand.
Numbness, pain or burning are warning signals from our nerves that something is wrong. The goal of treatment is to find out what is wrong and to fix it, not to just mask or cover up the warning signs. View this presentation to learn more.
How can cancer patients and survivors manage the side effects of neuropathy? Learn about useful tips to mitigate pain and numbness, as well as safety tips to avoid injury.
For more information on neuropathy, visit: http://blog.dana-farber.org/insight/2013/08/chemotherapy-related-neuropathy-managing-this-nerve-wracking-problem/
Many colorectal cancer patients take chemotherapy as part of their treatment plan. Join Ashley Glode, Pharm.D, as she discusses chemo information and education, supportive care management for patients, and toxicity monitoring. She will discuss the importance of communicating with your doctors and care team to ensure you stay safe and comfortable throughout your treatment plan.
Pain is a warning signal that something is wrong. Our bones should not hurt when they grow and our legs should not hurt when we exercise. View this presentation to learn more.
National Aspergillosis Centre Doctor Livingstone Chishimba holds a Q&A sessionGraham Atherton
Livingstone Chishimba specialises in aspergillosis (amongst other things) and works at the National Aspergillosis Centre, Manchester, UK.
This is a regular monthly support meeting held at the NAC for patients living with aspergillosis.
Benefits of Physical Activities (PA) in Cancer SurvivorsRajat Chauhan
On 4th March 2012, I had the privelege of talking at Asian Breast Cancer Conference. But I wasn't planning on going there and be a yes man.
I took the oncology fraternity to task. If they have known for a long time that exercise and physical activity reduces cancer risk by 25-50% and side effects in survivors from inactivity is as bad as disease itself, then why don't they talk and promote more about it. Only a quarter bring up exercise to their patients. I was looking to get a reaction, whether it be a shoe thrown at me or saying, wow... Let's work together on this... But the audience was very sedated... courtesy the pharmaceutical industry that sponsors conferences like these. There was no response. I finished my talk by saying "my role model is Lance Armstrong, a man who did amazing things in world of sports after he was diagnosed, treated and then survived cancer."
Enjoy the presentation.
Dr Catherine Hayle - Regional ELC - Complex decision making Innovation Agency
Presentation by Dr Catherine Hayle - Arrowe Park Hospital - Regional Emergency Laparotomy Collaborative - Complex decision making collaborative at Arrowe Park Hospital on 24 January 2020
CASE REPORT ON osteomyelitis.
Osteomyelitis (Femur debridement & Bone cement Spacer with External fixator).
Femur Deridement-
Doctors may recommend a procedure called debridement to remove dead or damaged bone tissue in people with osteomyelitis. During this procedure, the doctor cuts away dead or damaged bone tissue. He or she also washes the wound to remove any dead or loose tissue.
Osteomyelitis: Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs.
Cancer Survivorship: longer term issues and the role of primary care - Prof E...Irish Cancer Society
A presentation given at the Irish Cancer Society's Survivorship Research Day at the Aviva Stadium, Dublin on Thursday, September 20th, 2013.
Cancer Survivorship: longer term issues and the role of primary care - Prof Eila Watson (Oxford Brookes University).
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
Many complementary therapies, used along with conventional medicine, can support cancer treatments, reduce some of the adverse effects of cancer treatment, ease tension and pain, and contribute to overall health. This is known as integrative medicine. Integrative medicine can be a part of your plan throughout the entire treatment and survivorship experience. In this webinar, we will talk about how integration can be helpful to you after a colorectal cancer diagnosis and your journey forward.
Presented by Dr. Lisa Corbin: a board-certified internist, Associate Professor in the Department of Internal Medicine at the University of Colorado School of Medicine. In 2001, she helped the University of Colorado Hospital establish the Center for Integrative Medicine (TCFIM) and has served as the Medical Director ever since.
Oral Cancer is an uncontrollable growth of cells which invades the vital structure. It can occur anywhere in the mouth. It occurs due to tobacco use, Areca nut, Alcohol, Poor nutrition, HPV virus, Genetic factors, Chronic trauma.
A red and white patches on lips or gum tongue or Buccal Mucosa having symptoms of pain, hoarseness of voices, loosening of teeth, Biopsy, Endoscopy, Imaging Technique are some way of examination.
Treated by Surgery , Radiation Therapy, Chemotherapy, Brachial Therapy.
Habit Cessation and Maintenance of oral hygiene prevents Cancer.
Call us regarding Oral cancer and its Treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
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In this presentation, we will discuss Chemotherapy Induced Peripheral Neuropathy with strict application of Evidence based medicine about the magnitude of the problem, how to diagnose, how to prevent and how to treat?
Complementary Therapies for Mesothelioma presented by Kathleen Wesa, MD, of Memorial Sloan-Kettering Cancer Center at the Mesothelioma Applied Research Foundation's conference in New York, NY on September 28, 2012. www.curemeso.org
Similar to Peripheral Neuropathy: Will it ever go away? Problems, Causes, Solutions (20)
Dr. Murphy presents slides discussing general screening trends in the US, including how the US compares to other countries, different screening modalities, and differences in screening by:
-Age
-Gender
-Geography
-Race/Ethnicity
Looking to kick start your physical activity? Hoping to learn about how body movement can be a huge benefit for CRC patients and survivors? Curious about Climb for a Cure? Join this interactive webinar featuring Karia Coleman, MSK, personal trainer and athletic strength coach, and Fight CRC advocates as they discuss the importance, challenges, and joys of physical activity.
From bowel frequency, pain, and more, many colorectal cancer treatments lead to digestive side effects. Join this webinar with Dr. Cathy Eng to learn all about the digestive system, the side effects that are common due to CRC treatment, and how to manage those side effects.
Maine recently passed major colorectal cancer (CRC) policy at the state level. Join us to listen to their story and learn what worked well for CRC state advocacy!
Indiana just passed major colorectal cancer (CRC) policy this year. Join us to listen to their story and learn what worked well for CRC advocacy in Indiana!
Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!
Join Fight CRC in a webinar about biomarkers. In this session, Dr. Chris Lieu will focus the discussion on the NTRK biomarker, in addition to ctDNA, and Next-Generation Sequencing.
Join us as Eden Stotsky-Himelfarb, BSN, RN from Johns Hopkins Medicine discusses how to manage after a colorectal cancer diagnosis. In this session, she will cover understanding diagnoses, shared decision making, managing mental health, talking to family and colleagues, and more.
Some colorectal cancer treatments lead to side effects of the skin. In this webinar, Dr. Nicole LeBoeuf will discuss these specific side effects. She will talk about why they occur, how to prepare for them, and how to manage them.
Hear about the latest breaking colorectal cancer research! Fight CRC will be joined by Dr. Axel Grothey who will spend the hour detailing the research presented at the 2020 Gastrointestinal (GI) Cancers Symposium hosted by the American Society of Clinical Oncology.
Anticipating the end of life and making decisions about medical care at this time can be difficult and distressing for people with cancer and their loved ones. However, it is incredibly important to plan for the transition to end-of-life care.
In this webinar, we will discuss questions to ask when considering an end to curative treatment, what to expect with hospice and end-of-life care, a new medical care team, advance directives and healthcare proxies, options for pain, the role of caregivers and loved ones, and more.
In this webinar, Dr. Angela Nicholas, Dr. Chris Heery, and Wenora Johnson discuss all things clinical trials. Dr. Nicholas, a family practitioner and caregiver to her late husband, John MacCleod will dive into her experience searching for clinical trials along with advice to those currently searching, or planning on searching in the future. Dr. Heery, Chief Medical Officer for Precision Biosciences will spend time dispelling myths around clinical trials and challenges to enrollment, and Wenora Johnson, a stage III colon cancer survivor will describe the process and her point of view curating trials in the Fight CRC trial finder.
In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
May 2019 – What You Need to Know About Chemotherapy Induced Neuropathy WebinarFight Colorectal Cancer
Neuropathy is a common side effect for colorectal cancer patients. It is a side effect that can be incredibly challenging to manage, and can affect daily living. Join this informative webinar to learn all about neuropathy—why it happens, how to prepare for it, and methods to try and reduce its effects. This is an important webinar for all survivors and patients! Dana will speak from both the medical professional and patient angle, as she is a colon cancer survivor herself!
A cancer diagnosis and cancer treatment can be traumatic. An experience with cancer can lead to serious psychological distress that should be addressed. In this webinar, Schuyler Cunningham, Clinical Social Worker, talks about what trauma is, how to identify it, and what steps to take next.
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
Peripheral Neuropathy: Will it ever go away? Problems, Causes, Solutions
1. Welcome!
Peripheral Neuropathy: Will it ever go away?
Problems, Causes, Solutions
Part of Fight Colorectal Cancer’s Monthly Patient Webinar Series
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Cindy Tofthagen, PhD, ARNP, AOCNP, FAANP
University of South Florida
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7. Topics of Discussion
• What is chemotherapy induced
peripheral neuropathy (CIPN)?
• What are the risk factors?
• What can we do about it?
8. What is CIPN?
A group of neuromuscular symptoms that result from
nerve damage caused by drug therapies used in the
treatment of cancer.
Affects 30-100% of patients getting specific neurotoxic
chemotherapy drugs.
The most commonly used classes of drugs causing
peripheral neuropathy are taxanes (Taxol and Taxotere)
and platinum based drugs (cisplatin and oxaliplatin).
9. Symptoms
•Sensory, motor, or autonomic
•Vary from person to person based on type of
treatment and individual differences
•Numbness, tingling, and discomfort in the upper
or lower extremities are the hallmarks of
peripheral neuropathy
10. Problem
CIPN can last for months to years after
chemotherapy and sometimes is
permanent.
It can interfere with the ability to perform
usual activities.
11. • Increasing dose
• Pretreatment or concurrent treatment with other
neurotoxic chemotherapies
• Diabetes
• Hypothyroidism
• HIV infection
• Charcot-Marie-Tooth disease
• Autoimmune disorders
• Vitamin B12 deficiency
• Chronic alcohol abuse
• Shingles
12. Supposedly chemotherapy increased my chances of living 5
years by 8%. I don’t want to live for another 5 years like this.
My hands and fingers are numb. My feet are numb. My legs are
numb from my knees to the bottom of my feet. I have pain,
gnawing, burning, and cramping most of the time. My legs
ache and feel stiff and heavy all the time. Driving is a problem,
walking is a problem, Being on my feet is a problem. My hands
don’t work. I feel collapsed, dizzy, and weak all day, every
day, all the time. I have disabling fatigue. I feel like I have been
poisoned.
-written in 2008 by Sue, colorectal cancer survivor.
(Tofthagen, 2010)
15. 1) Prevent it
2) Recognize it early
3) Control the pain
4) Minimize effects on quality of life
16. A variety of preventative strategies have been
evaluated thus far with varying degrees of success,
including:
Calcium/Magnesium Infusions
Alpha-lipoic acid
B Vitamins
Glutamine/glutathione
Vitamin E
17. • Numerous clinical trials supporting its use
• One trial was closed because of safety concerns
• Recent meta-analysis confirmed safety and efficacy of
Calcium and Magnesium infusions for prevention of
neuropathy caused by oxaliplatin only
• Reduces the incidence of grade 2 but not grade 1
neuropathy
(Grothey et al., 2011; Hochster, Grothey, & Childs, 2007; Ishibashi, Okada, Miyazaki, Sano, & Ishida, 2010; Wen et al., 2012)
18. • Neurotoxicity may be directly related to
individual variations in neurotoxic drug
metabolism, distribution, and elimination.
• Genetic polymorphisms associated with CIPN
may lead to genetic tests to help identify
individuals likely to develop severe
neuropathy
Bergmann, et al., 2011; Sissung, et al., 2006; Renbarger, et. al., 2008;
Hertz, et al., 2012; Kroetz, et al., 2010; Schneider, et al., 2011.
19. • Early recognition is key because dose adjustments
may be required that may lesson severity and
minimize long-term nerve damage.
20. What to tell your healthcare
team
1. What symptoms are you
having?
2. Are the symptoms on one or
both sides?
3. How much of the extremity is
involved?
4. How severe and distressing is
each symptom?
5. Are symptoms constant or do
they come and go?
6. How are your activities and
lifestyle being affected?
21.
22. Controlling
Neuropathic Pain
Neuropathic pain is
severe, difficult to
treat, and may not
respond well to
narcotic analgesics.
Image retrieved from http://www.topnews.in/health/files/chronic-pain.jpg
24. • Based on primary results (n=220)
Duloxetine 60mg daily:
• Diminishes CIPN pain in the majority
• Improves function & QOL
• One of the few drugs recommended
that has data to support its use for
painful CIPN
25. First Line
Tricyclic Antidepressants
Gapapentin or Pregabalin
Second Line
Serotonin-norepinephrine reuptake inhibitors
Lidocaine Patch
Third Line
Tramadol or Controlled Release Opioid
Fourth Line
Cannabinoids, methadone, lamotrigine, topiramate,
valproic acid
Moulin, et al., 2007
26. Drug /Class
Starting Dose
Titration
Maximum
Dose
Trial Duration
Nortriptyline/T
CA
25mg at
bedtime
Increase by
25mg every 3-7
days as tol
150mg/day
6-8 weeks
Desipramine/T
CA
25mg at
bedtime
Increase by
25mg every 3-7
days as tol
150mg/day
6-8 weeks
Increase to
60mg/day in 7
days
60mg /BID
4 weeks
Duloxetine/SSN 30mg/day
RI
Venlafaxine/SS
NRI
37.7mg once or Increase by 75
twice a day
mg/week
225mg/day
4-6 weeks
Gabapentin
100-300mg TID
100-300mg TID
every 1-7 days
as tolerated
3600 mg/d
(1200 mg 3
times daily)
3-8 wk for
Titration and 2 weeks
at max dose
Pregabalin
50mg TID or
75mg BID
Increase to
300mg/day
after 3-7 days,
then by
150mg/d every
3-7 days
600mg/d
4 weeks
Dworkin, et al., 2010
29. Treatment of Foot Neuropathy
Patients with numbness in the feet should:
•
•
•
•
•
•
wear comfortable, properly fitting shoes
avoid sandals, open toed or open heeled shoes
inspect feet daily for injury
avoid walking barefoot or in socks alone
always check for foreign objects in shoes before putting them on
change shoes in the middle of the day to avoid continued pressure in
the same locations
(Plummer & Albert, 2008).
30. Home Safety
• Water temperature for bathing should be carefully
assesses and the thermostat on the water heater
should be adjusted to a maximum of 100 degrees
Fahrenheit
• Run cold water first
• Use protective gloves when washing dishes
• Always use pot holders
(Armstrong, Almadrones, & Gilbert, 2005; Hot Water Burns Like Fire Campaign, 2006).
31. Home Safety
• Living areas should be kept well lit
• Keep walkways clear
• Nightlights should be kept on in hallways,
bathrooms and bedrooms, nonskid mats in the
shower or bathtub
(Armstrong, Almadrones, & Gilbert, 2005; Visovsky, Collins, Abbott,
Aschenbrenner, & Hart, 2007).
32. Home Safety
•
•
•
•
•
•
•
•
•
Store frequently used items in easy-to-reach locations
Remove throw rugs and mats
Use sturdy chairs with arm rests
Use a long handled reacher to pick up items from the floor
Remove clutter around the house
Install hand rails in the tub and beside the toilet
Use a shower chair and a hand held shower
Use hand railing when climbing stairs,
Add a strip of brightly colored tape to the steps so that the outline of
each step is clearly visible,
• Keep walkways and stairs in good repair and free of clutter and
debris
33. Self-Care Techniques
• A study of self-reported self care techniques used by patients with
related neuropathy (n=450) indicate techniques that patients found
helpful in relieving symptoms include:
•
•
•
•
•
•
•
•
warm baths (66%)
walking (60%)
massage (41%)
rubbing cream on the feet (47%)
elevating feet (57%)
staying off the feet (59%)
acupuncture (12%)
meditation (20
(Nicholas et al., 2007)
34. • Compared to healthy people, persons with
neuropathy have reduced proprioception, lower
extremity sensation, and reduced ankle strength
predisposing them to falls
• Strength and balance training results in fewer falls
• Safe for people with peripheral neuropathy
• Tai Chi, a low impact form of Chinese martial art, may
help reduce falls and improve balance
(Gillespie et al., 2009; Morrison, Colberg, Mariano, Parson, & Vinik, 2010; Allet, et al., 2010; Kruse
et al., 2010).
35. • Neurologist to establish/confirm diagnosis
• Pain management
• Physiatrist-physician who specialize in cancer rehabilitation, locate
one at http://www.cancer.net/survivorship/rehabilitation
• Physical therapist -specific exercises designed to help improve
muscle strength and balance
• Occupational therapists -maintain your independence, adjust to
physical limitations
• Support groups and mental health professionals
• Podiatrists –recommend footwear, and fit for orthotics
(Tofthagen, 2012)
36.
37. Summary
• Neuropathy is an uncomfortable and distressing symptom that
can interfere with your ability to do the activities you want
and need to do on a daily basis.
• Scientists are looking for ways to prevent neuropathy caused
by chemotherapy.
• Patients can get better control of neuropathy symptoms and
their effects on quality of life by being aware of treatment
options, communicating with their healthcare team and
seeking out resources within their community.
38.
39. Fight Colorectal Cancer
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Editor's Notes
Preventative strategies have been the primary focus of research to date but have so far failed to provide effective methods to prevent it.Prevention may differ depending on neurotoxic agents the patient is receiving.Target underlying mechanisms behind CIPN, which are not well understood.
More research still needed because of small sample sizes in each study.
To measure side-effects associated with cancer treatments, large scale clinical trials often use grading scales, such as the National Cancer Institute’s (NCI) Common Toxicity Criteria for Adverse Events (CTCAE), WHO and ECOG scales.These criteria have been used to establish cut points for treatment toxicity, delays and/or reductions, rather than as comprehensive measures of the patient’s symptom experience. There are no guidelines for training of evaluators, no standardization of agreement as to what constitutes some subjective assessment of “weakness interfering with function”, ensuring wide variation ion scoring for the same patient presentation.In general, grading scales lack the sensitivity needed to capture the full impact of CIPN.
NP is often described as burning, shooting, stabbing, electric like, or pins and needles. An aggressive approach to pain management should be taken and may involve use of several different classes of medications.Pain is whatever the person says it is, experienced whenever the person says it is.
Requires aggressive treatment approach and frequent communication with the patientCaution: Even though these guidelines have been developed by experts and are evidence based, they may be of limited benefit for CIPN.A combination approach will probably be required.Add additional agents sequentially if partial but inadequate pain relief
Fall risk increases with each cycle of chemotherapy
These techniques may provide symptomatic relief ofnumbness and tingling for patients with CIPN with minimal foreseeable risks.
Allet and colleagues (2010) reported significantly improved balance and strength, increased walking speed, and decreased fear of falling in participants a 60 minute, twice a week for 12 weeks, strength, balance, and functional training program. The results were sustained for a period of six months. Furthermore, the training program was feasible and safe for persons with peripheral neuropathy.