Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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
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 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
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.
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
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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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.
2. Overview
• Organism
• History
• Epidemiology
• Transmission
• Disease in Humans
• Disease in Animals
• Prevention and Control
Center for Food Security and Public Health, Iowa State University, 2011
4. Yersinia pestis
• Family Enterobacteriaceae
– Gram negative
– Pleomorphic coccobacillus
– Aerobic, facultatively anaerobic,
facultatively intracellular
• One serotype
– Three biovars
• Multiple plasmids and virulence
factors
Center for Food Security and Public Health, Iowa State University, 2011
5. Yersinia pestis
• Destroyed by
– Sunlight
– Desiccation
• Survival
– 1 hour in air
– Briefly in soil
– 1 week in soft tissue
– Years when frozen
Center for Food Security and Public Health, Iowa State University, 2011
7. History
• 540-590 AD: Justinian’s pandemic
– 10,000 deaths per day
– Fall of the Roman Empire
• 1346~1400: Black Death pandemic
– Quarantine
– 1/3 of European population died
– Fall of the feudal system
• 1665: Great Plague of London
Center for Food Security and Public Health, Iowa State University, 2011
8. “Ring Around The Rosy
A Pocket Full Of Posies
Ashes, Ashes
All Fall Down”
Center for Food Security and Public Health, Iowa State University, 2011
9. Discovery
• 1894: Hong Kong
• Alexandre Yersin
– Identified Gram
negative bacillus
• 1896
– Developed
antiserum
Center for Food Security and Public Health, Iowa State University, 2011
10. History: U.S.
• 1899: Hawaii
– From ship rats to sylvatic rodents
– Spread throughout the western U.S.
• 1924: Los Angeles
– Last person-to-person case
– 32 pneumonic cases; 31 deaths
• Currently established in southwest
Center for Food Security and Public Health, Iowa State University, 2011
11. Plague as a Disease
• CDC Division of Quarantine
• Reportable disease in the U.S.
• All U.S. cases reported to the WHO
Center for Food Security and Public Health, Iowa State University, 2011
13. Transmission
• Flea bite
• Direct animal contact
– Tissues, body fluids, scratches, bites
– Enters through break in skin
• Aerosol
• Human cases
– April through November
– Increased activity of fleas and hosts
Center for Food Security and Public Health, Iowa State University, 2011
14. Flea Vectors
• Can live off host for months
• Many species can serve as vector
• Oropsylla montana
– Rock squirrels, California ground
squirrels, prairie dogs
– Most important flea vector in U.S.
• Xenopsylla cheopis
– Epidemics in Asia, Africa, South America
Center for Food Security and Public Health, Iowa State University, 2011
15. Flea Transmission
• 27°C (80°F)
– Blood clots in gut of flea
– Y. pestis trapped
– Clotted blood regurgitated
– Enters wound from flea bite
• 27°C
– Blood clot in gut of flea dissolves
– Y. pestis passes through
Center for Food Security and Public Health, Iowa State University, 2011
17. Distribution: U.S.
• Southwest (87%)
– Northern New Mexico
– Southern Colorado
– Northern Arizona
– California
• 1925-1964
– ~2 cases/yr
• Since 1970
– ~13 cases/yr
Center for Food Security and Public Health, Iowa State University, 2011
18. Distribution: U.S.
Center for Food Security and Public Health, Iowa State University, 2011
Reported
Cases
Year
MMWR
45
40
35
30
25
20
15
10
5
0
1972 1977 1982 1987 1992 1997 2002
19. Center for Food Security and Public Health, Iowa State University, 2011
21. Sylvatic Plague
• Enzootic
– Steady level of disease
– Low rodent mortality
• Epizootic
– Increased rodent mortality
– Fleas seek out new hosts
– Expansion into human occupied areas
– Greatest threat to humans
Center for Food Security and Public Health, Iowa State University, 2011
22. Urban Plague
• Infected fleas or rodents move into
urban areas
• Domestic rodents
infected
– High rodent mortality
• Fleas seek new host
– Domestic cats or humans
• Associated with poverty in humans
Center for Food Security and Public Health, Iowa State University, 2011
23. Center for Food Security and Public Health, Iowa State University, 2011
Robert B. Crave. Plague. Infectious Diseases, 5th ed. J.B. Lippincott Co. 1994.
25. Human Disease
• Three major forms of plague
– Bubonic
– Septicemic
– Pneumonic
• Primary
• Secondary
Center for Food Security and Public Health, Iowa State University, 2011
26. Bubonic Plague
• Most common form
– ~80% of cases
• Incubation
– 2 to 6 days
• Clinical signs
– Fever, malaise, chills, headache
– Bubo: swollen, painful lymph node
• Mortality (untreated): 50-60%
Center for Food Security and Public Health, Iowa State University, 2011
27. Septicemic Plague
• Primary or secondary
• Rapid onset
• Clinical signs
– Signs of sepsis ± bubo
– Necrosis of extremities
• Microthrombi block capillaries
• “Black Death”
• Mortality (untreated): 100%
Center for Food Security and Public Health, Iowa State University, 2011
28. Pneumonic Plague
• Incubation: 1 to 6 days
• Primary—Y. pestis inhaled
• Secondary—septicemic form spreads
• Clinical signs
– Fever, chills, headache, septicemia
– Respiratory distress, hemoptysis
• Person-to-person possible
• Potential use as bioweapon
Center for Food Security and Public Health, Iowa State University, 2011
29. Diagnosis
• Identification of organism
• Serology
• Isolation of organism
• Differential diagnoses
– Tularemia
– Hantavirus
– Streptococcus
– Staphylococcus aureus
Center for Food Security and Public Health, Iowa State University, 2011
30. Treatment
• Early treatment, survival ~100%
• Supportive care
• Antibiotics
– Aminoglycosides
– Doxycycline, tetracycline,
chloramphenicol
– Penicillins and cephalosporins
are NOT effective
Center for Food Security and Public Health, Iowa State University, 2011
31. Case Report
• New York, 2002
– Married couple from New Mexico
– Fever, unilateral inguinal adenopathy
– Bubonic plague diagnosed
– Antibiotic treatment
– Deteriorated (septicemic spread)
– Sent to ICU
– Recovered after 6 weeks
Center for Food Security and Public Health, Iowa State University, 2011
32. Case Report: Importance
• NMDPH and CDC investigation
– Trapped rodents and fleas around home
– Y. pestis isolated
• Importance
– Plague outside of endemic area
• Should raise suspicion
– Prompt detection important
Center for Food Security and Public Health, Iowa State University, 2011
34. Animals
• Host species
– Rodents, lagomorphs
– No clinical signs
• Other mammals
– Most infections incidental
• Felids very susceptible
– Housecats
– Wild cats
• Ungulates, canids
– Occasional infections reported
Center for Food Security and Public Health, Iowa State University, 2011
35. Center for Food Security and Public Health, Iowa State University, 2011
Animal Sources of
Human Infection in the U.S.
1970 -1993
109
24
23
1
14
110
20 18
Undetermined
Carnivores
Rabbits
Antelope
Prairie Dogs
Rock Squirrels
CA Ground Sq.
Other Squirrels
N=319
36. Carnivore Source of Human
Plague Infection, 1970-98
23
4
2 2
1
0
5
10
15
20
25
Cat Bobcat Coyote Gray Fox Badger
Center for Food Security and Public Health, Iowa State University, 2011
37. Cats and Plague
• Human cases from cats
unknown prior to 1977
• By 1998
– 23 cases; 5 fatal
• Cats develop severe illness and die
• Can transfer disease to humans
– Owners, veterinarians or staff
– Pneumonic, fleas, bite, scratch
Center for Food Security and Public Health, Iowa State University, 2011
38. Cats and Plague
• Clinical signs
– Severe illness
– Signs mimic human illness
– Bubonic, septicemic, pneumonic
– Fever, lethargy, anorexia
– Lymphadenopathy
• Submandibular, cervical, others
– DIC, death
Center for Food Security and Public Health, Iowa State University, 2011
39. Cats and Plague:
Experimental Infection
• 16 cats
– Each fed a plague infected mouse
– All showed illness by day 3-4
– Lymphadenopathy by days 4-6
• 6 cats died (37.5%)
• 75%
– Blood culture positive
– Culture positive throat/oral cavity
Center for Food Security and Public Health, Iowa State University, 2011
40. Case Report: Cat to Human
• New Mexico, 1977
– 6 yr. old boy
• September 6
– Fever, chills, vomiting, bilateral axillary pain
– Insect bites & scratches on arms
– Hospitalized with delirium
• September 8
– Needle aspirate of lymph node
• Positive on staining and FA for plague
– IV antibiotics
Center for Food Security and Public Health, Iowa State University, 2011
41. Case Report: Cat to Human
• Improved, fever continued for 8 days
• Buboes incised & drained on day 13
• Released on day 16
• History
– Grandfather shot rabbits
• Fed to cats and dogs
– Boy took one cat home
• Bit and scratched him
• Cat later died of plague
Center for Food Security and Public Health, Iowa State University, 2011
42. Dogs and Plague
• Rarely show signs
– Fever, lethargy, oral lesions,
lymph node lesions
• May seroconvert
• May carry infected fleas
• Diagnosis and treatment
– Same as cats
• Sentinels
Center for Food Security and Public Health, Iowa State University, 2011
43. Diagnosis
• Contact state public health
laboratory or CDC before sampling
• Diagnosis
– Identification of organism
– Serology
– Isolation of organism
• Treatment
– Aminoglycosides, tetracyclines
Center for Food Security and Public Health, Iowa State University, 2011
45. Prevention and Control
• Isolate infected animals
– Limit number of people in contact
– Personal protection
• Surgical mask, gloves, eye protection
• Flea control
– Dogs and cats
• Spring to fall
– Environment
Center for Food Security and Public Health, Iowa State University, 2011
46. Prevention and Control
• Prevent roaming or hunting of pets
• Rodent control
– Eliminate rodent habitat around home
• Brush, food sources, firewood, junk
– Undertaken only after insecticide use
• Insect repellents for skin & clothes
• Insecticide use in epizootic areas
Center for Food Security and Public Health, Iowa State University, 2011
47. Center for Food Security and Public Health, Iowa State University, 2011
48. Prevention and Control
• Public health education
• Prophylactic antibiotics
– Plague outbreak/flea bites
– Handled infected animal
– Close contact with plague case
• Vaccine
– Live and killed developed
– No longer available in the U.S.
Center for Food Security and Public Health, Iowa State University, 2011
49. Prevention and Awareness
• Report suspected animal cases
– State health department
– State veterinarian
– Animals may serve as sentinels
• Education of clients and public
– Risks, transmission, prevention
• Take precautions in enzootic and
epizootic areas
Center for Food Security and Public Health, Iowa State University, 2011
50. Plague as a Biological Weapon
• 1970 WHO estimate
– 50 kg agent on city of 5 million
• 150,000 pneumonic cases
– 36,000 deaths
• 80,000 to 100,000 hospitalized
• 500,000 secondary cases
– Up to 100,000 deaths total
Center for Food Security and Public Health, Iowa State University, 2011
51. Additional Resources
• World Organization for Animal Health
(OIE)
– www.oie.int
• U.S. Department of Agriculture (USDA)
– www.aphis.usda.gov
• Center for Food Security and Public Health
– www.cfsph.iastate.edu
• USAHA Foreign Animal Diseases
(“The Gray Book”)
– www.usaha.org/pubs/fad.pdf
Center for Food Security and Public Health, Iowa State University, 2011
52. Additional Resources
• CDC - Division of Vector-borne Infectious
Diseases
– www.cdc.gov/ncidod/dvbid/index.htm
• CDC - Plague information
– www.bt.cdc.gov/agent/plague/index.asp
Center for Food Security and Public Health, Iowa State University, 2011
53. Acknowledgments
Development of this presentation
was funded by grants from
the Centers for Disease Control and Prevention,
the Iowa Homeland Security and Emergency
Management Division, and the Iowa Department
of Agriculture and Land Stewardship
to the Center for Food Security and Public
Health at Iowa State University.
Authors: Radford Davis, DVM, MPH; Glenda Dvorak, DVM, MS, MPH, DACVPM
Reviewers: Nichollette Rider, MS; Jean Gladon, BS; Kerry Leedom Larson, DVM, MPH,
PhD
Center for Food Security and Public Health, Iowa State University, 2011
