The document discusses the clinical management of HIV infection and lessons from anti-tuberculosis therapy. It notes that combination antiretroviral therapy is effective at suppressing HIV due to its ability to prevent the selection of drug-resistant strains, in contrast to less effective single-drug regimens. Over time, combination therapy has resulted in more HIV-infected individuals achieving sufficient immune recovery to approach the life expectancy of the general population. However, non-AIDS comorbidities have become more prevalent as the HIV-infected population ages.
In this downloadable slideset, expert faculty members Andrew Carr, MBBS, MD, FRACP, FRCPA; Daniel R. Kuritzkes, MD; and Ian M. Sanne, MBBCH, FCP(SA), review key studies presented at the 2016 International AIDS Conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.28 MB
Date posted: 8/5/2016
High efficacy of grazoprevir/elbasvir in HCV genotype 1, 4, and 6-infected pa...Илья Антипин
Rockstroh J. и др. «High efficacy of grazoprevir/elbasvir in HCV genotype 1, 4, and 6-infected patients with HIV co-infection: the phase 3 C-EDGE co-infection study» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention, Vancouver, 2015. TUAB0206.
Dr.Ameet Dravid has made a significant contribution in Research & Treatment of HIV and AIDS medicine.Dr. Dravidis expert in successfully treating Diseases like: HIV,AIDS.He has treated & cured more than 25+ patient! Best practices in HIV at the district, international levels.
Ledipasvir/sofosbuvir for 12 weeks in patients co-infected with HCV and HIV-1Илья Антипин
Naggie S. И др. (докладчик Cooper.) «Ledipasvir/sofosbuvir for 12 weeks in patients co-infected with HCV and HIV-1» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention, Vancouver, 2015. TUAB0202.
Chair & Presenter, David R. Jones, MD, and Nathan A. Pennell, MD, PhD, FASCO, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC activity titled “Adjuvant EGFR-Targeted Therapy as a Game Changer: How to Implement New Standards of Care in Multimodal Management of Stage I-III EGFR-Mutated NSCLC.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/3mFfjji. CME/MOC credit will be available until December 2, 2022.
David R. Jones, MD, and Roy S. Herbst, MD, PhD, prepared useful practice aids pertaining to lung cancer for this CME activity titled "Turning Tides in Targeted Therapy for Early-Stage EGFR-Mutated NSCLC: Latest Data and Practical Guidance for Thoracic Surgeons and the Multidisciplinary Team on the Emerging Role of EGFR-Targeted Therapy in Resectable Lung Cancer." For the full presentation, complete CME information, and to apply for credit, please visit us at https://bit.ly/2PSVELG. CME credit will be available until November 9, 2021.
In this downloadable slideset, expert faculty members Andrew Carr, MBBS, MD, FRACP, FRCPA; Daniel R. Kuritzkes, MD; and Ian M. Sanne, MBBCH, FCP(SA), review key studies presented at the 2016 International AIDS Conference.
Format: Microsoft PowerPoint (.ppt)
File size: 1.28 MB
Date posted: 8/5/2016
High efficacy of grazoprevir/elbasvir in HCV genotype 1, 4, and 6-infected pa...Илья Антипин
Rockstroh J. и др. «High efficacy of grazoprevir/elbasvir in HCV genotype 1, 4, and 6-infected patients with HIV co-infection: the phase 3 C-EDGE co-infection study» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention, Vancouver, 2015. TUAB0206.
Dr.Ameet Dravid has made a significant contribution in Research & Treatment of HIV and AIDS medicine.Dr. Dravidis expert in successfully treating Diseases like: HIV,AIDS.He has treated & cured more than 25+ patient! Best practices in HIV at the district, international levels.
Ledipasvir/sofosbuvir for 12 weeks in patients co-infected with HCV and HIV-1Илья Антипин
Naggie S. И др. (докладчик Cooper.) «Ledipasvir/sofosbuvir for 12 weeks in patients co-infected with HCV and HIV-1» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention, Vancouver, 2015. TUAB0202.
Chair & Presenter, David R. Jones, MD, and Nathan A. Pennell, MD, PhD, FASCO, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC activity titled “Adjuvant EGFR-Targeted Therapy as a Game Changer: How to Implement New Standards of Care in Multimodal Management of Stage I-III EGFR-Mutated NSCLC.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/3mFfjji. CME/MOC credit will be available until December 2, 2022.
David R. Jones, MD, and Roy S. Herbst, MD, PhD, prepared useful practice aids pertaining to lung cancer for this CME activity titled "Turning Tides in Targeted Therapy for Early-Stage EGFR-Mutated NSCLC: Latest Data and Practical Guidance for Thoracic Surgeons and the Multidisciplinary Team on the Emerging Role of EGFR-Targeted Therapy in Resectable Lung Cancer." For the full presentation, complete CME information, and to apply for credit, please visit us at https://bit.ly/2PSVELG. CME credit will be available until November 9, 2021.
People living with HIV in 2018 now have normal life expectancy if receiving Anti-Retroviral Therapy (ART) and often require only one co-formulated pill every day to remain well. However there are still people living with HIV who are unaware of their diagnosis; who may present with a critical illness. Knowing who to test is essential. The population living with HIV are also ageing and often have comorbidities. It is vital that clinical conditions associated with HIV are recognised and for those receiving ART that significant drug-drug interactions are avoided. Pre Exposure prophylaxis (PREP) is widely used to prevent transmission and when to consider post exposure prophylaxis (PEP) should be understood. Although only one person has been cured of HIV ongoing research continues.
Hepatitis C treatment has been revolutionised with Direct Acting Antiretrovirals (DAAs) that are taken in an outpatient settings, however treatment rates in Australia are in decline. Patients living with Hepatitis C need to be identified to be treated. Those patients with established severe liver disease may remain at risk of decompensation and therefore it is considered vital to ensure linkage into adequate follow up. Drug interactions are important to recognise in patients completing DAAs and although Hepatitis C can be cured the management of any coinfections with blood borne viruses requires careful attention.
Serum Procalcitonin as a marker of infection in chronic kidney disease patien...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
HIV persists within the body despite successful suppression of virus replication with antiretroviral therapy (ART). HIV lurks in latent and active reservoirs, leading to rebound of virus spread if ART is interrupted. The latent HIV reservoir is a natural consequence of the lifecycle of HIV, with integration of HIV into the genomes of cells that are or later enter the resting state, resulting in transcriptionally quiescent provirus. Resting CD4 T cells comprise the majority of the latent reservoir. Multiple factors such as the degree of virus exposure, timing of ART, and host factors can influence the size and characteristics of the HIV reservoir. Constructing and testing effective strategies for HIV eradication and measuring their impact will require a sophisticated knowledge of the HIV reservoir, detailed understanding of the antiviral immune response, and of the diversity and kinetics of the latent viral reservoir.
Watch the video of the presentation on Youtube: https://www.youtube.com/watch?v=WRegqg5yvRs
El Dr Welte té nombroses publicacions en àrees diverses relacionades amb el malalt crític. Particularment interessants són els seus estudis en relació al trasplantament pulmonar, així com els seus estudis sobre pneumònia i sèpsia. Així mateix, participa activament en la xarxa alemanya Capnetz, emprada per a l'elaboració d'estudis multicèntrics relacionats amb la pneumònia adquirida a la comunitat.
dr Franciscus Ginting - Sepsis PIN PAPDI Surabaya WS-051019.pdfcorinafiqliyin
Penegakan diagnosis sepsis sangat diperlukan dalam kasus sepsis itu sendiri. Sepsis dapat disebabkan oleh beberapa hal. Salah satu komplikasi yang dapat timbul adalah syok sepis
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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
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.
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- 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
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
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Hot Selling Organic intermediates
3. 0
2
4
6
8
10
12
14
1997-‐1999
2000-‐2002
2003-‐2005
2006-‐2008
2009-‐2010
2011-‐2013
Incidence
of
death
by
cause
and
calendar
period
Cardio-‐cerebro-‐vascular
Drug
abuse
Hepa>c
HIV
related
Non
HIV
related
infec>ons
Non-‐AIDS
malignancies
(excluded
HCC)
Other
Suicide
Unknown
for
2013,
10
months
ICONA:
update
2013
4. 54,1
46,1
32,7
39,3
29,6
31,0
13,5
24,3
21,8
16,7
33,8
10,3
20,3
9,9
13,6
9,5
8,5
6,9
0
3,3
5,5
11,9
8,5
19,0
6,8
5,9
10,0
9,5
4,2
13,8
2,0
2,6
4,5
8,3
7,0
5,2
2,7
2,6
3,6
2,4
4,2
8,6
0,7
2,6
3,6
2,4
4,2
3,4
0
2,6
4,5
0
0
1,7
0%
10%
20%
30%
40%
50%
60%
1997-‐1999
n=148
2000-‐2002
n=152
2003-‐2005
n=110
2011-‐2013
n=84
2006-‐2008
n=71
2009-‐2010
n=58
Causes
of
death
according
to
calendar
period
of
death
HIV
related
HepaEc
Other
Non-‐AIDS
malignancies
(excluded
HCC)
Unknown
Cardio-‐cerebro-‐vascular
Suicide
Non
HIV
related
infecEons
Drug
abuse
for
2013,
10
months
ICONA:
update
2013
6. Persions
with
HIV
are
not
fully
immune
reconsEtuted
unEl
the
CD4
count
increases
to>750
cells/uL.
CID
2013
7.
8. JAIDS
Feb
2014
In
conclusion,
this
study
shows
that
within
the
HIV
infected
popula>on
the
propor>on
of
subjects
that
has
achieved
a
sa>sfactory
immune
recovery
has
increased
over
>me.
As
a
consequence,
a
higher
propor>on
of
pa>ents
approaches
life
expectancy
of
the
general
popula>on.
9. Strategie
validate
per
ocmizzare
il
recupero
immunologico
in
soggec
a
rischio
di
risposta
immunologica
subocmale
17. Lessons
from
anE-‐TB
therapy
• INH 300 mg/die
• Rifampicin 600 mg/die
• Pyrazinamide 25 mg/kg/die
• (Ethambutol 15-25 mg/kg/die)
• INH 300 mg/die
• Rifampicin 600 mg/die
Why
a
combina>on
therapy?
1. Preven>on
of
selec>on
of
resistance
18. How drug resistance arises. Richman DD. Scientific American, July 1998.
How Drug-resistance Arises
When HIV replication is not completely blocked
• Sub-optimal therapy regimens eg monotherapy at initial stage
• Adherence problems
• Pharmacokinetic problems: poor drug absorption, inadequate dosing or drug-
drug interactions
These conditions can allow drug-resistant virus, already present in the population to
dominate
19. Less
(than
3)
Drug
Regimens
Ra>onale
Less
than
3
drugs
could
be
sufficient
to
maintain
viral
suppression
in
stable
pa>ents
(data
are
more
conflic>ng
in
naive)
Clinical
needs
Extensive-‐
resistance
and/or
toxicity
related
to
NRTIs
Preserva>on
of
future
therapu>cal
op>ons
Cost
saving
20. Among
pts
with
moderate
adherence
(80%
-‐
95%)
probability
of
VF
was
0.85
aner
12-‐months
suppression
and
0.08
aner
72-‐months
suppression
21. In
pazien>
seleziona>:
§ senza
storia
di
fallimento
virologico,
§ con
viremia
non
rilevabile
(<
50
copie/mL)
da
almeno
6
mesi,
§ buon
recupero
immunologico
e
nadir
dei
CD4+
>
100
cellule/μL,
§ non
anemici,
§ in
trapamento
con
IP
e
senza
mutazioni
di
resistenza
agli
IP
determinata
prima
dell’inizio
del
trapamento
an>retrovirale,
lo
switch
a
monoterapia
con
LPV/r
BID
o
DRV/r
QD
può
rappresentare
un’opzione
accepabile
in
un
contesto
di
ocmizzazione
della
terapia.
CRITERI
DI
SELEZIONE
DEI
PAZIENTI
CANDIDATI
A
MONOTERAPIA
(linee
guida
italiane
2013)
22. Dynamics
of
cellular
HIV-‐1
DNA
levels
over
144
weeks
of
darunavir/ritonavir
monotherapy
versus
triple
therapy
in
the
MONET
trial.
Gerec
AM,
Arribas
JR,
Lathouwers
E,
Foster
GM,
Yakoob
R,
Kinloch
S,
Hill
A,
van
Deln
Y,
Moecklinghoff
C.
§ In
this
substudy
of
the
MONET
trial,
HIV-‐1
DNA
levels
remained
stable
during
144
weeks
of
either
DRV/r
monotherapy
or
triple
therapy
with
DRV/r
+
2
NRTIs.
§ In
both
treatment
arms,
baseline
HIV-‐1
DNA
levels
were
predicted
by
the
nadir
CD4
cell
count
and
predic>ve
of
plasma
HIV-‐1
RNA
detec>on
during
follow-‐up.
23. Early
treatment
facilitated
the
achievement
of
undetectable
levels
of
plasma
viremia
and
cellular
HIV
DNA
and
a
beper
recovery
of
CD4
lymphocytes.
HIV
DNA
levels
before
and
during
highly
ac>ve
an>retroviral
therapy
may
be
used
as
a
new
tool
for
monitoring
treatment
efficacy
24. Lessons
from
anE-‐TB
therapy
• INH 300 mg/die
• Rifampicin 600 mg/die
• Pyrazinamide 25 mg/kg/die
• (Ethambutol 15-25 mg/kg/die)
• INH 300 mg/die
• Rifampicin 600 mg/die
Why
a
combina>on
therapy?
1. Preven>on
of
selec>on
of
resistance
2. Differen>al
papern
of
compartmentaliza>on
and
ac>vity
of
an>-‐TB
drugs
25. Hypothetical model of TB chemoterapy
0 1 2 3 4 5 6
A
B
C
Bactericidal
acEvity
and
sterilizing
effect
A = rapidly multiplying (extracell) INH>>SM>RIF>EMB
B = slowly multiplying (acid) PZA>>RIF>INH
C = sporadically multiplying (caseum) RIF>>INH
Rifampin
is
the
only
drug
ac>ve
on
dormant
bacilli
in
caseum,
allowing
cure
of
TB
and
preven>on
of
relapses
27. Ac>va>on
of
the
Latent
Viral
Reservoir
“Shock
and
Kill”
Key steps and assumptions of the induction and clearance approach:
n Activate viral replication by reversing latency,
n HIV RNA synthesis è viral protein production è release of HIV
particles,
n Killing of the infected cell by the virus cytopathic effect or the
patient’s immune system or both,
n Inhibition of released infectious virus by ART.
Deeks
SG.
Nature
2012;487:439-‐40.
HAART
must
block
majority
of
new
infec>on
events.
Are
ARVs
available
in
all
the
compartments
where
they
are
needed?