Asthma is a chronic inflammatory lung disease characterized by reversible airway obstruction. It is triggered by allergens, irritants, and infections. Chronic inflammation leads to narrowing of the airways. The signs and symptoms include wheezing, coughing, shortness of breath, and chest tightness. Risk factors include genetic and environmental factors. Triggers include allergens, viruses, exercise, and air pollutants. Chronic inflammation involves immune cells like mast cells, eosinophils, and T cells that release inflammatory mediators causing symptoms. Over time, structural changes in the airways can develop due to remodeling.
Definition and introduction to bronchial asthma - classification of bronchial asthma - pathophysiology and risk factors for bronchial asthma - diagnosis of bronchial asthma - clinical manifestations - investigations - management of bronchial asthma
Asthma vs COPD - A quick summary of the differences between themLGM Pharma
Asthma is a lung disease that affects almost 20 million Americans. COPD, or chronic obstructive pulmonary disease is a chronic lung disease that afflicts 24 million patients in the U.S. COPD is mainly caused by smoking or secondhand smoke, while asthma can by caused by exposure to allergens, dust and air pollutants. Innovative treatments are needed to combat both asthma and COPD, and LGM Pharma provides quality API's for the R&D needs of clients seeking treatments for these lung diseases.
Hypertension is defined as persistently elevated arterial blood pressure (BP).
JNC7 Guidelines: Seventh Report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure
JNC7 is the national clinical guideline that was developed to aid clinicians in the management of hypertension.
Myocardial Infarction Treatment
Classes of drugs used in the treatment of myocardial infarction
Vasodilators
General Pharmacology
Cardiac depressant drugs
Antiarrhythmics
Anti-thrombotics
Thrombolytics
Analgesics
General Mechanisms of Action
Definition and introduction to bronchial asthma - classification of bronchial asthma - pathophysiology and risk factors for bronchial asthma - diagnosis of bronchial asthma - clinical manifestations - investigations - management of bronchial asthma
Asthma vs COPD - A quick summary of the differences between themLGM Pharma
Asthma is a lung disease that affects almost 20 million Americans. COPD, or chronic obstructive pulmonary disease is a chronic lung disease that afflicts 24 million patients in the U.S. COPD is mainly caused by smoking or secondhand smoke, while asthma can by caused by exposure to allergens, dust and air pollutants. Innovative treatments are needed to combat both asthma and COPD, and LGM Pharma provides quality API's for the R&D needs of clients seeking treatments for these lung diseases.
Hypertension is defined as persistently elevated arterial blood pressure (BP).
JNC7 Guidelines: Seventh Report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure
JNC7 is the national clinical guideline that was developed to aid clinicians in the management of hypertension.
Myocardial Infarction Treatment
Classes of drugs used in the treatment of myocardial infarction
Vasodilators
General Pharmacology
Cardiac depressant drugs
Antiarrhythmics
Anti-thrombotics
Thrombolytics
Analgesics
General Mechanisms of Action
Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. It can be triggered by various factors including allergens, respiratory infections, exercise, smoke, and pollutants. Management involves medication, identifying triggers, creating an action plan, monitoring symptoms, staying active, maintaining a healthy lifestyle, getting vaccinated, and regular check-ups with healthcare providers. Effective management aims to control symptoms, prevent flare-ups, and improve overall quality of life.
Etiopathogenesis and pharmacotherapy of Asthma
the pathophysiology of selected disease states and the rationale for drug therapy;
b. the therapeutic approach to management of these diseases;
c. the controversies in drug therapy;
d. the importance of preparation of individualised therapeutic plans based on diagnosis;
e. needs to identify the patient-specific parameters relevant in initiating drug therapy,
and monitoring therapy (including alternatives, time-course of clinical and laboratory
indices of therapeutic response and adverse effects);
f. describe the pathophysiology of selected disease states and explain the rationale for
drug therapy;
g. summarise the therapeutic approach to management of these diseases including
reference to the latest available evidence;
h. discuss the controversies in drug therapy;
i. discuss the preparation of individualised therapeutic plans based on diagnosis; and
j. identify the patient-specific parameters relevant in initiating drug therapy, and
monitoring therapy (including alternatives, time-course of clinical and laboratory indices of therapeutic response and adverse effects).
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
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
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.
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.
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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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
2. Definition
• Reactive airway disease
• Chronic inflammatory lung disease
Inflammation causes varying degrees ofInflammation causes varying degrees of
obstruction in the airwaysobstruction in the airways
• Asthma is reversible in early stages
3.
4. Signs and Symptoms
• Wheezing
• Coughing
• Shortness of breathe
• Chest tightness or pain
7. Types of asthma
• Atopic asthma-classical type I IgE mediated
hypersensitivity, allergen sensitization, seen from
childhood, +ve history of asthma in family, skin test
+ve
• Non-atopic asthma-no allergen sensitization, no such
history, skin test –ve, virus infection?
• Drug induced asthma-sensitive to certain drugs like
aspirin, NSAIDS etc
• Occupational asthma-stimulants such as fumes,
organic and chemical dusts(wood, cotton),
gas(toluene), penicillin products etc
• Exercise induced asthma-begins after exercise and
stops after 30 minutes, worsen in cold and dry climate
9. Early-Phase ResponseEarly-Phase Response
– PPeaks 30-60 minutes post exposure, subsides 30-
90 minutes later
– Characterized primarily by bronchospasm
– Increased mucous secretion, edema formation,
and increased amounts of tenacious sputum
– Patient experiences wheezing, cough, chest
tightness, and dyspnea
10. Late-Phase ResponseLate-Phase Response
• Characterized primarily by inflammationCharacterized primarily by inflammation
• Histamine and other mediators set up a self-
sustaining cycle increasing airway reactivity causing
hyperresponsiveness to allergens and other stimuli
• Increased airway resistance leads to air trapping in
alveoli and hyperinflation of the lungs
• If airway inflammation is not treated or does not
resolve, may lead to irreversible lung damage
12. Pathophysiology
• The pathophysiology of asthma is complex
and involves the following components:
• Airway inflammation
• Intermittent airflow obstruction
• Bronchial hyperresponsiveness
• Airway remodelling
13. Airway inflammation
• Chronic inflammation of the airways is
associated with increased bronchial
hyperresponsiveness, which leads to
bronchospasm and typical symptoms of
wheezing, shortness of breath, and coughing
after exposure to allergens, environmental
irritants, viruses, cold air, or exercise. In some
patients with chronic asthma, airflow
limitation may be only partially reversible
14. • Airway inflammation in asthma may represent
a loss of normal balance between two
"opposing" populations of Th lymphocytes.
Two types of Th lymphocytes have been
characterized: Th1 and Th2. Th1 cells produce
interleukin (IL)-2 and IFN-α, which are critical
in cellular defense mechanisms in response to
infection. Th2, in contrast, generates a family
of cytokines (IL-4, IL-5, IL-6, IL-9, and IL-13)
that can mediate allergic inflammation
15. Cells involved in inflammation
• Mast Cells: activated by IgE dependant
mechanism, initiate acute bronchoconstriction
action by releasing histamine,
prostaglandinD2,leukotrienes etc
• Macrophages: activated by low affinity IgE
receptor, produce various inflammatory
mediators
• Dendritic cell-macrophage like major APC in
airways, TSLP(Thymic stromal lymphopoietin) by
epithelial cell induced chemokine release for TH2
cells
16. • Eosinophils: infiltration is characteristic
feature of asthma, activated by IL-5, causes
exacerbation of asthma by producing
mediators
• Neutrophils: activated and infiltration.
• T cell: release cytokines, causes recruitment of
eosinophils, also causes maintenance of mast
cells, in asthma TH2 cell produce IL-
5(eosinophil recruitment) IL-4, IL-13(increase
IgE production and mucus secretion).CD4+ cell
also involved
17. Inflamatory mediators
• Histamine, prostaglandin D2, cysteinly
leukotrienes-cause smooth muscle contraction,
increased microvascular leakage, increased
mucus secretion, act as chemoattractant for
inflammatory cells
• Cytokines- IL-4, IL-5, IL-13-causes allergic
inflammation, IL-1beta, TNF-alpha-amplification
of inflammation, TSLP(Tymic stromal
lmphopoietin)- from epithelial cells act as
chemoattractant for TH2 cells, IL-10, IL-12-anti
inflammatory
18. • Chemokines-attract inflammatory cells,
Eotaxin(CCL11) attract eosinophil via CCR3
receptor, TARC(CCL17) and MDC (CCL 22)
from epithelial cell attract TH2 cell via CCR4.
• Oxidative stress-increase in ROS production
NO-act as relaxant but mainly causes
vasodilatation leading to leakage.
• Transcription factor-NF-kB, activator protein-1
20. Effects of inflammation
• Epithelium-dysfunction, damage, loss of enzyme,
loss of relaxant factors, loss of barrier function
• Fibrosis- subepithelial fibrosis, basement
membrane thickening, deposition of III and V
collagen(by factors release from eosinophil)
• Smooth muscle- increased responsiveness to
constrictor mediators, in chronic cases
hypertrophy/hyperplasia by growth factors
released by inflammatory mediators
• Vascular response-vasodilation, angiogenesis,
microvascular leakage
21. • Mucus hypersecrection- by goblet cell
hyperplasia, increase in mucus plug, leading to
blocking of airway
• Neural effect-reflex cholinergic
bronchoconstriction by increased muscarinic
action
22.
23. Air flow obstruction
• Airflow obstruction can be caused by a variety of changes, including
acute bronchoconstriction, airway edema, chronic mucous plug
formation, and airway remodeling.
• Acute bronchoconstriction is the consequence of immunoglobulin
E-dependent mediator release upon exposure to aeroallergens and
is the primary component of the early asthmatic response. Airway
edema occurs 6-24 hours following an allergen challenge and is
referred to as the late asthmatic response. Chronic mucous plug
formation consists of an exudate of serum proteins and cell debris
that may take weeks to resolve. Airway remodeling is associated
with structural changes due to long-standing inflammation and may
profoundly affect the extent of reversibility of airway obstruction.[9]
24. • Airway obstruction causes increased
resistance to airflow and decreased expiratory
flow rates. These changes lead to a decreased
ability to expel air and may result in
hyperinflation. The resulting overdistention
helps maintain airway patency, thereby
improving expiratory flow; however, it also
alters pulmonary mechanics and increases the
work of breathing.
26. Bronchial Hyperresponsiveness
• Hyperinflation compensates for the airflow
obstruction, but this compensation is limited when the
tidal volume approaches the volume of the pulmonary
dead space; the result is alveolar hypoventilation.
Uneven changes in airflow resistance, the resulting
uneven distribution of air, and alterations in circulation
from increased intra-alveolar pressure due to
hyperinflation all lead to ventilation-perfusion
mismatch. Vasoconstriction due to alveolar hypoxia
also contributes to this mismatch. Vasoconstriction is
also considered an adaptive response to
ventilation/perfusion mismatch.
27. Airway remodelling
• Several changes can be seen
• Irreversible narrowing of lumen
• Decline in lung function
• Smooth muscle hyperplasia
• Fibrosis