There are six cell types in the anterior pituitary gland that secrete important hormones. The posterior pituitary, or neurohypophysis, stores hormones produced in the hypothalamus. Hyperpituitarism is oversecretion of pituitary hormones and can result in gigantism, acromegaly, hyperprolactinemia, or Cushing's syndrome. Hypopituitarism is hormone deficiency and causes panhypopituitarism or dwarfism. Common causes are non-secretory adenomas, Sheehan's syndrome from postpartum necrosis, and empty sella syndrome.
Porphyrias are difficult to diagnose . Here it is comprehensively explained to aid making diagnosis of porphyrias easier for the benefit of medical students and practitioners.
Porphyrias are difficult to diagnose . Here it is comprehensively explained to aid making diagnosis of porphyrias easier for the benefit of medical students and practitioners.
The pituitary gland is a small, bean-shaped gland situated at the base of your brain, somewhat behind your nose and between your ears. Despite its small size, the gland influences nearly every part of your body. The hormones it produces help regulate important functions, such as growth, blood pressure and reproduction.
The endocrine system is made up of glands that produce and secrete hormones, chemical substances produced in the body that regulate the activity of cells or organs. These hormones regulate the body's growth, metabolism (the physical and chemical processes of the body), and sexual development and function.
The endocrine system is a messenger system comprising feedback loops of the hormones released by internal glands of an organism directly into the circulatory system, regulating distant target organs. In vertebrates, the hypothalamus is the neural control center for all endocrine systems.
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.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
New Drug Discovery and Development .....NEHA GUPTA
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.
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
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
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.
2. NEUROENDOCRINE SYSTEM
• This system forms a link between endocrine
glands and nervous system.
• The cells of this system elaborate polypeptide
hormones; owing to these biochemical
properties, it has also been called as APUD cell
system (acronym for Amine Precursor Uptake
and Decarboxylation properties).
3. Cells comprising this system are as under:
1. Neuroendocrine cells which are present in the gastric
and intestinal mucosa and elaborate peptide
hormones.
2. Neuroganglia cells lie in the ganglia cells in the
sympathetic chain and elaborate amines.
3. Adrenal medulla elaborates epinephrine an
norepinephrine.
4. Parafollicular C cells of the thyroid secrete calcitonin.
5. Islets of Langerhans in the pancreas (included in both
endocrine and neuroendocrine systems) secrete
insulin.
6. Isolated cells in the left atrium of the heart secrete
atrial natriuretic (salt-losing) peptide hormone.
4. THE ENDOCRINE SYSTEM
• Anatomically, the endocrine system consists of
6 distinct organs: pituitary, adrenals, thyroid,
parathyroids, gonads, and pancreatic islets
(neuroendocrine system).
5. • Human hormones are divided into 5 major classes
which are further grouped under two headings
depending upon their site of interactions on the target
cell receptors (whether cell membrane or nuclear
receptor):
Group I: Those interacting with cell-surface membrane
receptors:
1. Amino acid derivatives: thyroid hormone,
catecholamines.
2. Small neuropeptides: gonadotropin-releasing hormone
(GnRH), thyrotropin-releasing hormone (TRH),
somatostatin, vasopressin.
6. Group II: Those interacting with intracellular nuclear
receptors:
3. Large proteins: insulin, luteinising hormone (LH),
parathormone hormone.
4. Steroid hormones: cortisol, estrogen.
5. Vitamin derivatives: retinol (vitamin A) and vitamin D.
• The synthesis of these hormones and their precursors
takes place through a prescribed genetic pathway that
involves: transcription → mRNA → protein synthesis →
post- translational protein processing → intracellular
sorting/ membrane integration → secretion.
7. • Endocrine organs and the presence of feedback controls.
• Both positive and negative feedback controls exist for
each endocrine gland having a regulating (R) and
stimulating (S) hormone.
• Those acting through hypothalamic-pituitary axis include:
thyroid hormones on TRH-TSH axis, cortisol on CRH-ACTH
axis, gonadal steroids on GnRH-LH/FSH axis and insulin-like
GH on GHRH-GH axis.
• Those independent of pituitary control (shown by
interrupted arrows) have also feedback controls by calcium
on PTH, and hypoglycaemia on insulin release by pancreatic
islets.
10. PITUITARY GLAND
• The pituitary gland is composed of two
morphologically and functionally distinct
components: the anterior lobe
(adenohypophysis) and the posterior lobe
(neurohypophysis).
11. HISTOLOGY AND FUNCTIONS
A. ANTERIOR LOBE (ADENOHYPOPHYSIS)
• It is composed of round to polygonal epithelial cells
arranged in cords and islands having fibrovascular stroma.
• These epithelial cells, depending upon their staining
characteristics and functions, are divided into 3 types, each
of which performs separate functions:
1. Chromophil cells with acidophilic granules ---comprise
about 40% of the anterior lobe and are chiefly located in
the lateral wings. The acidophils are further of 2 types:
i) Somatotrophs (GH cells) which produce growth hormone
(GH).
ii) Lactotrophs (PRL cells) which produce prolactin (PRL). Cells
containing both GH and PRL called mammosomatotrophs
are also present.
12. 2. Chromophil cells with basophilic granules----constitute about 10%
of the anterior lobe and are mainly found in the region of median
wedge.
The chromatophils include 3 types of cells:
i) Gonadotrophs (FSH-LH cells) which are the source of the FSH and LH
or interstitial cell stimulating hormone (ICSH).
ii) Thyrotrophs (TSH cells) are the cells producing TSH.
iii) Corticotrophs (ACTH-MSH cells) produce ACTH, melanocyte
stimulating hormone (MSH), β-lipoprotein and β-endorphin.
3. Chromophobe cells without visible granules----comprise the
remainder 50% of the adenohypophysis.
These cells by light microscopy contain no visible granules, but on
electron microscopy reveal sparsely granulated corticotrophs,
thyrotrophs and gonadotrophs.
13. B. POSTERIOR LOBE (NEUROHYPOPHYSIS)
• The neurohypophysis is composed mainly of interlacing
nerve fibres in which are scattered specialised glial cells
called pituicytes. These nerve fibres on electron
microscopy contain granules of neurosecretory
material made up of 2 octapeptides— vasopressin or
antidiuretic hormone (ADH), and oxytocin, both of
which are produced by neurosecretory cells of the
hypothalamus but are stored in the cells of posterior
pituitary.
1. ADH
2. Oxytocin
14. There are six terminally differentiated cell
types in the anterior pituitary, including:
• Somatotrophs, producing growth hormone (GH)
• Mammosomatotrophs, producing GH and prolactin (PRL)
• Lactotrophs, producing PRL
• Corticotrophs, producing adrenocorticotropic hormone (ACTH) and
pro-opiomelanocortin (POMC), melanocytestimulating hormone
(MSH)
• Thyrotrophs, producing thyroid-stimulating hormone (TSH)
• Gonadotrophs, producing follicle-stimulating hormone (FSH) and
luteinizing hormone (LH).
15. HYPERPITUITARISM
• Hyperpituitarism is characterised by oversecretion of one or more of
the pituitary hormones.
• Such hypersecretion may be due to diseases of the anterior
pituitary, posterior pituitary or hypothalamus.
16. HYPERPITUITARISM
A. HYPERFUNCTION OF ANTERIOR PITUITARY
• Three common syndromes of adenohypophyseal hyperfunction are:
gigantism and acromegaly, hyperprolactinaemia and Cushing’s
syndrome.
17. GIGANTISM AND ACROMEGALY
• Result from sustained excess of growth hormone (GH), most
commonly by somatotroph (GH-secreting) adenoma.
18. Gigantism
• When GH excess occurs prior to epiphyseal closure, gigantism is
produced.
• Occurs in prepubertal boys and girls and is much less frequent than
acromegaly.
• The main clinical feature in gigantism is the excessive and proportionate
growth of the child.
• There is enlargement as well as thickening of the bones resulting in
considerable increase in height and enlarged thoracic cage.
19. Acromegaly
• Overproduction of GH in adults following cessation of bone growth.
• The term ‘acromegaly’ means increased growth of extremities
(acro=extremity). There is enlargement of hands and feet, coarseness of
facial features with increase in soft tissues, prominent supraorbital
ridges and a more prominent lower jaw which when clenched results in
protrusion of the lower teeth in front of upper teeth (prognathism).
• Other features include enlargement of the tongue and lips, thickening of
the skin and kyphosis.
• Sometimes, a few associated features such as TSH excess resulting in
thyrotoxicosis, and gonadotropin insufficiency causing amenorrhoea in
the females and impotence in the male, are found.
20. PROLACTINAEMIA
• Prolactinaemia is lactotroph (PRLsecreting) pituitary adenoma,
also called prolactinoma having excessive production of prolactin.
• Occasionally, hyperprolactinaemia results from hypothalamic inhibition of
PRL secretion by certain drugs (e.g. chlorpromazine, reserpine and
methyl-dopa).
• In the female, hyperprolactinaemia causes amenorrhoea-galactorrhoea
syndrome characterised clinically by infertility and expression of a drop
or two of milk from breast.
• In the male, it may cause impotence or reduced libido.
• These features result either from associated inhibition of gonadotropin
secretion or interference in gonadotropin effects.
21. CUSHING’S SYNDROME Pituitary-
dependent Cushing’s
• syndrome results from ACTH excess.
• Most frequently, it is caused by corticotroph (ACTH-secreting) adenoma.
22.
23. B. HYPERFUNCTION OF POSTERIOR
PITUITARY AND HYPOTHALAMUS
• Lesions of posterior pituitary and hypothalamus are uncommon.
• Two of the syndromes associated with hyper - function of the
posterior pituitary and hypothalamus are:
• inappropriate release of ADH
• and precocious puberty
24. INAPPROPRIATE RELEASE OF ADH
• manifests clinically by passage of concentrated urine due to
increased reabsorption of water and loss of sodium in the urine,
consequent hyponatraemia, haemodilution and expansion of
intra- and extracellular fluid volume.
• Inappropriate release of ADH occurs most often in paraneoplastic
syndrome e.g. in oat cell carcinoma of the lung, carcinoma of the
pancreas, lymphoma and thymoma.
• lesions of the hypothalamus such as trauma, haemorrhage & meningitis
may produce ADH hypersecretion.
• Rarely, pulmonary diseases such as tuberculosis, lung abscess,
pneumoconiosis, empyema and pneumonia may cause overproduction of
ADH.
25. PRECOCIOUS PUBERTY
• A tumour in the region of hypothalamus or the pineal gland may result
in premature release of gonadotropins causing the onset of pubertal
changes prior to the age of 9 years.
• The features include
• premature development of genitalia both in the male and in the female,
• growth of pubic hair and axillary hair.
• In the female, there is breast growth and onset of menstruation
27. HYPOPITUITARISM
• usually deficiency of one or more of the pituitary hormones affecting
either anterior pituitary, or posterior pituitary and hypothalamus.
28. A. HYPOFUNCTION OF ANTERIOR
PITUITARY
• Adenohypophyseal hypofunction is invariably due to destruction of the
anterior lobe of more than 75% because the anterior pituitary possesses
a large functional reserve.
• This may result from anterior pituitary lesions or pressure and
destruction from adjacent lesions.
• Lesions of the anterior pituitary include nonsecretory (chromophobe)
adenoma, metastatic carcinoma, craniopharyngioma, trauma,
postpartum ischaemic necrosis (Sheehan’s syndrome), emptysella
syndrome, and rarely, tuberculosis.
• deficiency of anterior pituitary hormones - two important syndromes are
panhypopituitarism & dwarfism
29. PANHYPOPITUITARISM
• major anterior pituitary insufficiency is called panhypopituitarism.
• 3 most common causes of panhypopituitarism are:
• non-secretory (chromophobe) adenoma (discussed later),
• Sheehan’s syndrome and Simmond’s disease,
• and empty-sella syndrome
30. Sheehan’s syndrome and Simmond’s
disease
• Pituitary insufficiency occurring due to postpartum pituitary (Sheehan’s)
necrosis is called Sheehan’s syndrome
• The main pathogenetic mechanism underlying Sheehan’s necrosis is the
enlargement of the pituitary occurring during pregnancy which may be
followed by hypotensive shock precipitating ischaemic necrosis of the
pituitary.
31. Sheehan’s syndrome and Simmond’s
disease
• Other mechanisms hypothesised are: DIC following delivery, traumatic
injury to vessels, and excessive haemorrhage.
• Patients with long-standing diabetes mellitus appear to be at greater
risk of developing this complication.
• The first clinical manifestation of Sheehan’s syndrome is failure of
lactation following delivery which is due to deficiency of prolactin.
• Subsequently, loss of axillary and pubic hair, amenorrhoea, sterility and
loss of libido.
• Concomitant deficiency of TSH and ACTH may result in hypothyroidism
and adrenocortical insufficiency.