Osteoarthritis and rheumatoid arthritis are chronic joint disorders. Osteoarthritis involves the progressive breakdown of articular cartilage in a joint. It is associated with aging and risk factors like obesity, joint injury, and genetics. Rheumatoid arthritis is an autoimmune disease where the immune system attacks the joints, causing pain, stiffness, and swelling. It can eventually damage cartilage and bone within joints and may affect other organs. Both diseases are diagnosed based on symptoms, physical exam, x-rays, and blood tests. Treatment focuses on reducing pain and inflammation, maintaining joint mobility, and may include medications, weight loss, or joint replacement surgery.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
Osteoporosis is a progressive systemic skeletal disease characterized by low bone mass and microarchitecture deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk.
RHEUMATOID ARTHRITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE SOPO...Prof Dr Bashir Ahmed Dar
Dr Bashir ahmed dar associate professor medicine chinkipora sopore kashmir presently working in medical college malaysia describes rheumatoid arthritis which is a autoimmune disorder in which Immune system identifies the synovial membrane as "foreign" and begins attacking it.
These slides are for Yoga Teachers or students of Yoga for understanding the disease and what Yoga program we can offer to our client when they reach you for help. Although every individual is unique and Yoga Therapy should also be made considering what level of disease they are going through.
Disclaimer: We dont take any responsibility if someone starts to follow the program as mentioned in the PPT for any harm or injury.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
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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
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Osteoarthritis : Definition
• A chronic joint disorder in which there a
progressive softening and disintegration of
articular cartilage accompanied by new
growth of cartilage and bone at the joint
margins and capsular fibrosis.
3. CAUSES
• The most obvious feature of OA: it increases with
age. – shows that it takes many years to develop.
• OA results from disparity between stress applied
to articular cartilage and the ability of the cartilage
to withstand cartilage
• Due to combination of 2 processes:
- Genetic defect in Type II collagen
- Increased mechanical stress in the articular
surface (from excessive impact load or reduced
articular contact area)
4.
5. RISK FACTORS
• Older Age
- Osteoarthritis typically occurs in older adults. People under 40
rarely experience osteoarthritis.
• Sex
- Women are more likely to develop osteoarthritis, though it
isn't clear why.
• Bone deformities
- Some people are born with malformed joints or defective
cartilage, which can increase the risk of osteoarthritis.
• Joint injuries
- Injuries, such as those that occur when playing sports or from
an accident, may increase the risk of osteoarthritis.
• Obesity
- Carrying more body weight places more stress on weight-
bearing joints, such as knees. But obesity has also been linked
to an increased risk of osteoarthritis in the hands, as well.
6. CLINICAL FEATURES
• Pt usually presents after middle age
• Symptoms may confined to 1 or 2 large joints or
involves multiple joints.
• Pain starts insidiously, increases slowly over
months or years
• It is aggravated by exertion and relieved by rest.
• Stiffness is worst after period of rest
• Unlike Inflammatory Joint Disease ( i.e RA),
Osteoarthritis is not assoc. with systemic
manifestations.
7. Features of Advanced Disease
Swelling
Deformity
Tenderness
Crepitus on movement
Muscle wasting
8. CLINICAL VARIANT OF OA
1) Monoarticular & Pauciarticular OA
• Classically, presents with pain and dysfunction
in 1 or 2 large weight-bearing joints.
• There may be obvious underlying
abnormalities : Acetabular dysplasia, Old
Perthes Disease/Slipped Epiphysis, long
standing joint deformity, previous fracture.
• In many cases the abnormality is subtle
9. CLINICAL VARIANT OF OA
2) Polyarticular (generalized) OA
• Most common form of OA.
• Typically, Pt is middle aged woman presents with
pain, swelling, and stiffness of distal finger joints.
• The changes are obvious in the hands
- Interphalangeal joints become swollen &
tender .
- Heberden’s Nodes. Knobbly appearance of distal IP
joints d/t osteophytes & soft tissues swelling over
the years.
- Bouchard’s Nodes. Proximal IP Joints
10.
11. CLINICAL VARIANT OF OA
3) OA in Unusual Sites
• OA is uncommon in shoulder, elbow, wrist and
ankle.
• If any of this joints is affected one should
suspect a previous abnormality (congenital or
traumatic) or an associated generalized
disease such as crystal antropathy.
12. TESTS AND DIAGNOSIS
History & Clinical examination
· X-rays. X-ray images of the affected joint may reveal a
narrowing space within a joint, which indicates that the
cartilage is breaking down and bone spurs around a joint.
· Blood tests. To rule out other causes of joint pain, such
as rheumatoid arthritis.
· Joint fluid analysis. To determine if pain is caused by
gout or an infection.
· Arthroscopy. In some cases ,arthroscopy to see inside
the joint in order to determine the cause of pain.
14. (Left) In this x-ray of a normal hip, the space between the ball and
socket indicates healthy cartilage. (Right) This x-ray of an arthritic
hip shows severe loss of joint space and bone spurs.
15. Bilateral Hip Osteoarthritis – Pelvis radiograph reveals severe bilateral hip
osteoarthritis characterized by joint spaced narrowing, cystic changes and severe
osseous productive changes and remodeling of the femoral head and acetabulum.
16. CT-Arthrography shows superior and anterior joint space narrowing (blue circle) with
denuded chondral surface (yellow arrow), subchondral cysts and sclerosis. No
femoroacetabular impingement or associated labral tear. Normal mineralization.
17. (Left) In this x-ray of a normal knee, the space between the bones indicates healthy
cartilage (arrows). (Right) This x-ray of an arthritic knee shows severe loss of joint space.
19. TREATMENT
INTERMEDIATE TREATMENT
Indication: If sx increases despite conservative treatment.
This will usually be a “holding” procedure, esp. in younger
patients who are not yet ready for joint replacement.
• Joint debridement (Knee)
- Removal of interfering osteophytes, cartilage tags &
loose bodies
• Realignment Osteotomy (Hip & Knee)
- Provide vascular decompression of subchondral bone
redistribution of load forces to less damaged parts.
20. TREATMENT
LATE TREATMENT
Joint Replacement
• Procedure of Choice for
- Patient with severe symptoms
- Marked loss of function
- Significant restriction of daily activities
• Total joint replacement by modern techniques promises
improvement lasting for 15 years or longer.
22. DEFINITION
Rheumatoid Arthritis (RA) is a chronic
inflammatory disorder that may affect many
tissues and organs, but mainly attacks the
joints producing an inflammatory synovitis.
23. ETIOLOGY
• The cause is unknown
• It is believed that a foreign antigen sets off a
a chain of events culminating in a chronic
inflammatory disorder in which immunological
reactions are prominent.
• Production of auto antibodies (IgM & IgG) that
attacks body own’s antibodies
• This abnormal immune response may be
genetically pre-determined – RA patients assoc
with increased frequency of HLA-DR4
26. CLINICAL FEATURES
EARLY STAGE
• Swelling, Stiffness, Increased Warmth, Tenderness of
proximal finger joints and the wrists
• X-ray shows soft tissue swelling and periarticular
osteoporosis
DISEASE PROGRESSION
• Joint movement becomes restricted
• Isolated tendon ruptures at the wrists
• Subcutaneous nodule felt Olecranon process –
Pathognomonic of RA
28. LATER STAGES
• Joint deformity becomes apparent
• Acute pain of synovitis is replaced by more
constant ache of joint destruction
• “Rheumatoid Deformities”:
- Ulnar deviation of fingers
- Radial displacement of wrists
- Valgus Knees
- Clawed Toes
• Function is increasingly disturbed. Pt need help
dressing, eating.
29.
30. EXTRA- ARTICULAR SURFACES
(Apparent in pt with severe disease)
• Muscle wasting
• Lymphadenopathy
• Skin atrophy/ulceration
• Scleritis
• Vasculitis
• Peripheral sensory neuropathy
31.
32. X-RAY CHANGES IN RA
• In Early Stages, X-rays show only the features of
synovitis : soft tissue swelling and periarticular
osteoporosis
• Later Stages are marked by appearance of
marginal body erosions and narrowing of the
articular space esp. in proximal joints of hands
and feet
• In Advanced Disease, articular destruction and
joint deformity are obvious.
33.
34. TESTS
• X Rays
– X rays of hands and feet are generally performed
in people with RA.
• Magnetic Resonance Imaging (MRI)
• Ultrasounds
35. • Blood Tests
– Rheumatoid Factor (RF)
• RF is a specific antibody in the blood.
• A negative RF does not rule out RA. The arthritis is then
called seronegative, most common during the first year of
illness and converting to seropositive status over time.
– Anti-citrullinated Protein Antibodies (ACPAs)
• Like RF, this testing is only positive in a proportion of all
RA cases.
• Unlike RF, this test is rarely found positive if RA is NOT
present, giving it a specificity of about 95%.
36. • At least FOUR criteria MUST be met for
classification of RA.
– Morning stiffness of more than 1 hour most mornings
for at least 6 weeks.
– Arthritis and soft-tissue swelling of more than 3 of 14
joints, present for at least 6 weeks.
– Arthritis of the hand joints, present for at least 6 weeks.
– Symmetric arthritis, present for at least 6 weeks.
– Subcutaneous nodules in specific places.
– Rheumatoid Factor at a level above the 95th percentile.
– Radiological changes suggestive of joint erosion.
DIAGNOSIS
37. PROGNOSIS
• Disability
– Daily living activities are impaired.
– After 5 years of disease, approximately 33% of
sufferers can no longer work.
– After 10 years of disease, approximately 50% of
sufferers have substantial functional disability.
• Some people have mild or short-term symptoms,
but in most cases, the disease is progressive for
life.
• The life shortening effect of RA varies. Most
sources cite a lifespan reduction of 5 to 10 years
38. COMPLICATIONS
• Infections
- Pt with RA, even more so with steroid tx are
susceptible to infection. Sudden deterioration
or increased pain -> alert for septic arthritis
• Tendon Rupture
- Seen most often at wrist
• Joint Rupture
- Occasionally, joint lining ruptures and synovial
contents spill into soft tissues.
• Secondary Osteoarthritis
39. TREATMENT
There is NO cure for RA
Medical Management
Aim: Control Inflammation as rapidly as possible
• Corticosteroids
- Rapid action, oral 30mg Prednisolone followed
with IM 120mg Methyprednisolone. Tapered dose
• DMARDs
- 10-25mg /week Methotrexate
• NSAIDs
- To control pain & stiffness
• Biological Therapies (TNF inhibitors: Infliximab)
40. Physiotherapy and Occupational Therapy
• To maintain muscle tone and joint mobility
• Measures:
- Balanced programme of exercise
- Advice on coping with daily living activities
- Preventive splinting
- Orthotic devices
41. Surgical Management
Indication: Indicated at any stage of disease. If
conservative measures alone are not effective.
Early stage (Soft tissues procedures):
• Synovectomy
• Tendon repair/replacement
• Joint Stabilization
Late Stage
Indications for Reconstructive Surgery:
Severe joint destruction, fixed deformity and loss of
Function
• Antrodesis
• Osteotomy
• Arthroplasty
42. • Apley and Solomon’s Concise System of
Orthopedics and Trauma 4th Edition. CRC Press
REFERENCES