Pancreatitis is a dreaded condition associated with development of acute and sudden inflammation of the pancreas.
Pancreatic enzymes are released in the abdomen and cause inflammation by the damage from digestion of normal body structures, especially fat in the abdomen.
Mortality ranges from 3 percent in patients with interstitial edematous pancreatitis to 17 percent in patients who develop pancreatic necrosis.
Pancreatitis is a dreaded condition associated with development of acute and sudden inflammation of the pancreas.
Pancreatic enzymes are released in the abdomen and cause inflammation by the damage from digestion of normal body structures, especially fat in the abdomen.
Mortality ranges from 3 percent in patients with interstitial edematous pancreatitis to 17 percent in patients who develop pancreatic necrosis.
severe acute pancreatitis has high mortality rate and there is always confusions in between physicians. This topic is about management of acute pancreatitis its complications and ongoing controvercies. hope this will help and clear the doubts among physicians, residents and medical students
Revised Atlanta classification of Acute PancreatitisDr M Venkatesh
The most important change in Atlanta classification is the categorization of the various pancreatic collections.
In acute IEP, collections that do not have an enhancing capsule are called APFCs; after development of a capsule, they are referred to as
pseudocysts
In necrotizing pancreatitis,a collection without an enhancing capsule is called an ANC (usually in the first 4 weeks) and thereafter a WON, which has an enhancing capsule.
The most important distinction between collections in necrotizing pancreatitis and those associated with acute IEP is the presence of nonliquefied material in collections due to necrotizing pancreatitis.
Pancreatitis -a detailed study ( medical information )martinshaji
Pancreatitis is the Inflammation of the pancreatic parenchyma. Acute condition of diffuse pancreatic inflammation & auto digestion, presents with abdominal pain, and is usually associated with raised pancreatic enzyme levels in the blood &urine. this is a detailed study pancreatitis describing factors such as definition , epidemiology , etiology , pathophysiology , treatment , prevention , imaging techniques , diagnosis , lab investigations , images , drugs , control etc
please comment
thank u
severe acute pancreatitis has high mortality rate and there is always confusions in between physicians. This topic is about management of acute pancreatitis its complications and ongoing controvercies. hope this will help and clear the doubts among physicians, residents and medical students
Revised Atlanta classification of Acute PancreatitisDr M Venkatesh
The most important change in Atlanta classification is the categorization of the various pancreatic collections.
In acute IEP, collections that do not have an enhancing capsule are called APFCs; after development of a capsule, they are referred to as
pseudocysts
In necrotizing pancreatitis,a collection without an enhancing capsule is called an ANC (usually in the first 4 weeks) and thereafter a WON, which has an enhancing capsule.
The most important distinction between collections in necrotizing pancreatitis and those associated with acute IEP is the presence of nonliquefied material in collections due to necrotizing pancreatitis.
Pancreatitis -a detailed study ( medical information )martinshaji
Pancreatitis is the Inflammation of the pancreatic parenchyma. Acute condition of diffuse pancreatic inflammation & auto digestion, presents with abdominal pain, and is usually associated with raised pancreatic enzyme levels in the blood &urine. this is a detailed study pancreatitis describing factors such as definition , epidemiology , etiology , pathophysiology , treatment , prevention , imaging techniques , diagnosis , lab investigations , images , drugs , control etc
please comment
thank u
Abnormal abdominal CT is best powerpoint presentation for radiologist, radiology resident and gastroenterologist, this include pancreatitis, all abdominal trauma grading with systemic manner. Thanks
Post cholecystectomy pancreatitis: a misleading entity KETAN VAGHOLKAR
Cholecystectomy is one of the commonest hepatobiliary procedures performed in general surgical practice. Both laparoscopic as well as open cholecystectomies have their place in modern-day surgical practice. Post cholecystectomy syndrome is a known entity affecting approximately 20% of patients who have undergone cholecystectomy. Post cholecystectomy pancreatitis is an uncommon and rare complication. A case of acute early post cholecystectomy pancreatitis is presented to create an awareness of this rare but misleading and morbid complication.
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
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
3. Imaging
golden rule
An early CT may be misleading
concerning the severity of the
pancreatitis, since it can underestimate
the presence and amount of necrosis.
Early CT is only recommended when the
diagnosis is uncertain, or in case of
suspected early complications such as
perforation or ischemia.
5. Alcoholic pancreatitis
special issue
The widespread clinical practice of relying solely on
hyperamylasemia to establish the diagnosis of acute alcoholic
pancreatitis is unjustified and should be abandoned.
Serum lipase was measured in 65 of these normoamylasemic cases and was
found to be elevated in 68%.thus increasing diagnostic sensitivity from 81% when
amylase alone is used to 94% for both enzymes.
7. Interstitial pancreatitis
there is normal enhancement of the entire pancreatic gland with
only mild surrounding fatty infiltration.
There are no fluid collections or necrosis
(Balthazar grade C, CTSI: 2).
8. Exudative Pancreatitis
on day 18 there is expansion of
the peripancreatic collections.
There are two or more
collections, but no pancreatic
necrosis.
(Balthazar grade E, CTSI: 4)
In exudative pancreatitis, or better
called EXPN, there is normal
enhancement of the entire
pancreas associated with extensive
peripancreatic collections.
These are often heterogeneous in
appearance and may be
progressive.
EXPN consists of necrosis of
peripancreatic fat, extravasated
pancreatic fluid and inflammatory
and hemorrhagic components.
When peripancreatic collections
persist or increase, it is usually due
to the presence of fat necrosis (i.e.
EXPN).
Since fat does not enhance on CT,
we cannot diagnose fat necrosis.
9. Necrotizing Pancreatitis
There are 2 or more fluid collections
and more than 50% of the gland does
not enhance
(Balthazar grade E, CTSI :10).
10. Necrotizing Pancreatitis
Body and tail of the
pancreas do not enhance
after i.v. contrast (blue
arrows).
There is however normal
enhancement of the
pancreatic head (yellow
arrow).
More than 50% of the
pancreas is necrotic and
there are at least two
collections (CTSI : 10)
11. Central gland necrosis
Central gland necrosis is a
subtype of necrotizing
pancreatitis.
It represents necrosis between
the pancreatic head and tail
and is nearly always
associated with disruption of
the pancreatic duct.
This leads to persistent
collections as the viable
pancreatic tail continues to
secrete pancreatic juices.
These collections react poorly to
endoscopic or percutaneous
drainage.
serious Dx
12. Central gland necrosis
Two weeks later the
collection in the omental
bursa and pancreatic
body has increased
significantly.
The pancreatic tail still
enhances and so does
the pancreatic head
(arrows).
14. Based on imaging
alone it is often not
possible to determine
whether these
collections contain fluid
or necrotic tissue and
whether they are
infected or not.
Consequently, instead
of naming them as
'pseudocysts',
'abscesses' or
'necrosis', it is better to
describe them as
'peripancreatic
collections'.
There is a collection in the area of the pancreatic head in the right anterior pararenal space.
On a follow up scan the collection is larger.
One day later the patient developed septicaemia and percutaneous drainage was performed.
After drainage the collection has barely diminished in size and consequently there was suspicion of necrotic
tissue.
The patient therefore underwent surgery and the collection was found to consist of necrotic debris,
The necrotic debris was too thick for successful percutaneous drainage.
15. Infected necrosis
infected necrosis is:
Infection of necrotic pancreatic
parenchyma
And/or necrotic extrapancreatic fatty
tissue
Usually occurs in the 2nd-3rd week.
Most severe local complication of
acute pancreatitis
Most common cause of death in
patients with acute pancreatitis
Air bubbles are seen in 20% of
cases with infected necrosis.
==
16. Infected necrosis (2)
• here is a normal
enhancement of the
pancreas with
surrounding septated
heterogeneous
peripancreatic collections
with fluid- and fat
densities .
• Two weeks later there
are air bubbles in the
peripancreatic collection,
consistent with infected
necrosis.
2 weeks
later
17. Pseudocyst
•
•
•
•
•
Collection of pancreatic juice
enclosed by a wall of fibrous
tissue
Absence of necrotic tissue is
imperative for its diagnosis
Often communication with the
pancreatic duct
Requires 4 or more weeks to
develop
On CT we cannot diagnose a
collection with certainty as a
pseudocyst, since it is usually
not possible to determine what
the content of a collection is
18. During endoscopic
debridement this
collection contained fluid
and necrotic tissue which
was removed from the
area of the pancreas
CT of an ICU patient on day
40 with central gland
necrosis with a spiking
fever.
The CT shows a similar
collection to that of the
previous patient, exept for
its pancreatic location.
The collection is
homogeneous and welldemarcated with a thin wall
abutting the stomach.
19. another example
25 d...Homogeneous
pancreatic and
peripancreatic collection,
well-demarcated with an
enhancing wall.
Since this patient had
fever and multiple
organ failure, this
collection was suspected
to be infected necrosis
and not a pseudocyst.
At surgery the collection
contained a lot of
necrotic debris, which
was not recognizable on
CT.
30. Take home messages
•
•
•
•
•
•
Severity of acute pancreatitis and pancreatic necrosis can only
be reliably assessed by imaging after 72 hours.
Absence of pancreatic parenchymal necrosis does not
preclude a serious course of the illness.
CT can not reliably differentiate between collections that
consist of fluid and those that contain solid debris.
In these cases MRI can be of additional value.
Name collections always according to 2012 Atlanta definitions.
Central gland necrosis is a subtype of necrotizing pancreatitis
with important implications.