1. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of auto-antibodies against components of the cell nucleus.
2. SLE affects multiple organ systems and is more common in females, with a female to male ratio of 9:1 before puberty.
3. Diagnosis of SLE requires meeting 4 out of 11 American College of Rheumatology diagnostic criteria, including at least 1 clinical and 1 immunological criterion. Common clinical manifestations include malar rash, arthritis, renal disease, and hematological abnormalities.
Systemic Lupus erythematous , is world wide health problem
Here we talk about criteria for diagnosis investigation , Management and complication
With some scenarios to about disease and complication
Systemic Lupus erythematous , is world wide health problem
Here we talk about criteria for diagnosis investigation , Management and complication
With some scenarios to about disease and complication
systemic lupuse rythematosus by formation of autoantibodiesssuser45f282
Systemic lupus erythematosus is a chronic, multisystem, inflammatory, autoimmune disorder characterized by formation of autoantibodies directed against self-antigens and immune-complex formation resulting in damage to essentially any organ.
SLE is a multisystem autoimmune disease that predominantly affects women of childbearing age and is the most common form of lupus.
The exact cause is still unknown.
For more informations you can read the following file.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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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
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
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.
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
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2. SLE has been classically described as a prototypic
autoimmune disease with a wide array of clinical
manifestations and characterized by the production
of auto-antibodies to components of the cell
nucleus.
Gilbert et al. Pediatric Rheumatology 2014, 12:16
Systemic Lupus Erythematosus
3. z
SLE - Historical
Classical
Neoclassical
Modern
First description of the cutaneous disorder;
term "lupus" was coined. "lupus" that means wolf in
Latin. 13th Century physician Rogerius
1872: Moriz Kaposi : description of the disease’s
systemic or disseminated manifestations,
two forms of the disease — what we know as systemic
lupus erythematosus and discoid lupus
Discovery of the LE cell in bone marrow in 1948 by
Malcolm Hargraves
1957 : first anti-DNA antibody
4. z
Female:Male = 9:1, but before puberty it is 3:15
pSLE makes 20% of all cases1
Incidence <15 yrs: 0.5-0.6 per 100,000 persons2
Prevalence 4 – 250 cases per 100, 000 persons3
More than 90% cases of SLE occur in women4
SLE - Epidemiology
7. z
SLE Pathology
The LE cell is a neutrophil that has
engulfed the antibody-coated nucleus of
another neutrophil.
LE cells may appear in rosettes where
there are several neutrophils vying for an
individual complement covered protein.
• Immune complexes within the dermal–
epidermal junction.
• “lupus band test” which is specific for SLE.
9. 1. Malar rash
2. Naso-oral ulcers
3. Photosensitive rash
4. Discoid rash
5. Arthritis
6. Pleuritis or pericarditis
7. Proteinuria (>500 mg/d) or evidence of nephritis in urinalysis
8. Hemolytic anemia, thrombocytopenia, leukopenia, or lymphopenia
9. Seizure or psychosis
10. Positive ANA finding
11. IMMUNOLOGIC ABNORMALITIES: Positive anti–dsDNA, anti-Smith, or
antiphospholipid antibody / lupus anticoagulant
The Systemic Lupus International Collaborative Clinics (SLICC) recently published a modification of
the ACR criteria.
Lupus patients meet 4 criteria with at least 1 clinical and 1 immunologic criterion or
with biopsy-proven nephritis in association with positive ANA and anti-dsDNA
The ACR’s ( American College of Rheumathology) diagnostic criteria for SLE :
20. z
SLE – Clinical
Neuropsychiatric Manifestations (20-40% )
• Second to nephritis as most common cause of
morbidity & mortality
• Can occur at any time; even at presentation
COMMON • Depression, organic brain
syndrome, functional psychosis,
headaches, seizures, cognitive
impairment, dementia, coma
OCCASIONAL • Cerebral vascular accidents,
aseptic meningitis, peripheral
neuropathy, cranial nerve palsies
RARE: • Paralysis, transverse myelopathy,
chore
21. z
SLE – Clinical
Hematologic Findings
• Leukopenia, especially lymphopenia
• Anemia
• mild to moderate, due to chronic disease and mild hemolysis
• severe, uncommon (5%), due to immune mediated hemolysis
(Coombs +)
• Thrombocytopenia
• Bone marrow suppression / arrest -- very rare
• Coagulopathy – prolonged PTT
22. z
SLE – Clinical
Renal Findings
Most common cause of morbidity & mortality
• Glomerulonephritis – at least 75%
• Microscopic or gross hematuria
• Proteinuria, including nephrotic syndrome
• Hypertension
• Decreased GFR
• Renal failure (up to 30-50% of children prior to 1980)
• Renal biopsy predictive of potential for renal damage
23. z
International Society of Nephrology 2003 Revised Classification of SLE Nephritis
Class Classification Features
Class I
Minimal mesangial Normal light microscopy findings; abnormal electron
microscopy findings
Class II
Mesangial
proliferative
Hypercellular on light microscopy
Class III Focal proliferative < 50% of glomeruli involved
Class IV Diffuse proliferative
=50% of glomeruli involved; classified segmental or
global;
to be treated aggressively
Class V Membranous
Predominantly nephrotic disease may occur with
class III or IV
Class VI Advanced
sclerosing
=90% of glomeruli involved without residual activity
Chronic lesions and sclerosis
25. z
NeonatalLupus
• Passive transplacental transfer of maternal
anti-Ro/SSA and anti-La/ SSB antibodies
causes the transient skin lesions
• Characteristic annular or macular rash typically
affecting the face, trunk & scalp – usually clear
by 6 mo age
• Ultraviolet light may exacerbate or initiate
cutaneous lesions.
• Cytopenias and
• Cholestatic liver disease
• Congenital heart block (30%)- most feared
complication
Annular plaque
27. z
Auto-antibodies
ANA - Sensitive but not specific, 95-98% pts positive
Against nuclear components of the cell
Other :
Anti dsDNA : high specificity for lupus (over 80%)
RNP assoc w/ MCTD (Mixed connective-tissue disease),
Anti Smith Abs : specific for SLE
Ro/ La (SS-a/ SS-b): neonatal lupus, Sjogren’s
Anti Histone Abs : drug induced lupus
29. z
SLE - Treatment
MODERATE DISEASE: MILD + OTHER SYSTEM
INVOLVEMENTS
Treatment:
Prednisone 1-2 mg/kg/day,
NSAIDS,
Antimalarials,
Azathioprine
30. z
SLE - Treatment
SEVERE DISEASE: Severe, life-threatening organ system
involvement (e.g. Class IV lupus nephritis, myocarditis,
encephalopathy)
High dose corticosteroids (2-3 mg/kg/day)
Immunosuppressives:
IV pulse methyl prednisolone / dexamethasone
OR
Monthly pulses of Cyclophosphamide),
Plasmapheresis,
Anticoagulation where appropriate
31. z
Management of Pediatric SLE
General Use high-SPF sunscreen throughout the year.
Encourage good sleep and nutritional patterns.
Address psychological aspects of disease/treatment.
Prescribe calcium and vitamin D supplements
Immunize against pneumococcus.
Anticoagulant if evidence of antiphospholipid antibody is
present
Perform annual ophthalmologic evaluations
Treat dyslipoproteinemia when present.
Maintain good blood pressure control in those with
hypertension