A talk by Max Bell at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
- Recorded videos of the lecture:
English Language version of this lecture is available at: https://youtu.be/-Ynxvhbcl7U
Arabic Language version of this lecture is available at: https://youtu.be/QpK_toctVlw
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A talk by Max Bell at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
- Recorded videos of the lecture:
English Language version of this lecture is available at: https://youtu.be/-Ynxvhbcl7U
Arabic Language version of this lecture is available at: https://youtu.be/QpK_toctVlw
- Visit our website for more lectures: www.NephroTube.com
- Subscribe to our YouTube channel: www.youtube.com/NephroTube
- Join our facebook group: www.facebook.com/groups/NephroTube
- Like our facebook page: www.facebook.com/NephroTube
- Follow us on twitter: www.twitter.com/NephroTube
SEMS 2014: Augustine Tee - Inpatient Medical Emergency TeamsRahul Goswami
The Critical Care track of the Society for Emergency Medicine in Singapore Annual Scientific Meeting 2014.
For more information and conference videos, go to singem.blogspot.sg
SGLT2 Inhibitor therapy has opened up an exciting avenue for the Physicians to manage the patients with CKD . The slide set highlights the major trials on the drug showing remarkable benefits.
John B. Buse, MD, PhD; David Cherney, MD, PhD, FRCP(C); and Mikhail Kosiborod, MD, FACC, FAHA, prepared useful Practice Aids pertaining to SGLT2 inhibitors for this CME activity titled “Complex Cases in Contemporary Practice: Applying New Evidence for SGLT2 Inhibitors in the Management of Patients With Comorbid Cardiometabolic Diseases.” For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at https://bit.ly/3dFKZhs. CME credit will be available until July 22, 2021.
Effects of aspirin for primary prevention in persons with Diabetes mellitusShadab Ahmad
The ASCEND(A Study od Cardiovascular Events in Diabetes) randomized trial was performed to assess the efficacy and safety of enteric-coated aspirin at a dose of 100 mg daily, as compared with placebo, in person who had diabetes without manifest cardiovascular disease.
Review of 2 metaanalyses of RCTs on the effects of statins in the perioperative period. Watch my YouTube video describing these slides: http://youtu.be/wHYlf26AH00
Min kammerats præsentation til karriereforedrag i Rusugen på Handelshøjskolen i Aarhus 2009. Først hans idé og grove skitser for, hvad han vil have af slides og bagefter den endelige præsentation, hvor jeg har givet den en overhaling. Læs mere om præsentationer på min blog på http://praesentationer.blogspot.com/
SEMS 2014: Augustine Tee - Inpatient Medical Emergency TeamsRahul Goswami
The Critical Care track of the Society for Emergency Medicine in Singapore Annual Scientific Meeting 2014.
For more information and conference videos, go to singem.blogspot.sg
SGLT2 Inhibitor therapy has opened up an exciting avenue for the Physicians to manage the patients with CKD . The slide set highlights the major trials on the drug showing remarkable benefits.
John B. Buse, MD, PhD; David Cherney, MD, PhD, FRCP(C); and Mikhail Kosiborod, MD, FACC, FAHA, prepared useful Practice Aids pertaining to SGLT2 inhibitors for this CME activity titled “Complex Cases in Contemporary Practice: Applying New Evidence for SGLT2 Inhibitors in the Management of Patients With Comorbid Cardiometabolic Diseases.” For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at https://bit.ly/3dFKZhs. CME credit will be available until July 22, 2021.
Effects of aspirin for primary prevention in persons with Diabetes mellitusShadab Ahmad
The ASCEND(A Study od Cardiovascular Events in Diabetes) randomized trial was performed to assess the efficacy and safety of enteric-coated aspirin at a dose of 100 mg daily, as compared with placebo, in person who had diabetes without manifest cardiovascular disease.
Review of 2 metaanalyses of RCTs on the effects of statins in the perioperative period. Watch my YouTube video describing these slides: http://youtu.be/wHYlf26AH00
Min kammerats præsentation til karriereforedrag i Rusugen på Handelshøjskolen i Aarhus 2009. Først hans idé og grove skitser for, hvad han vil have af slides og bagefter den endelige præsentation, hvor jeg har givet den en overhaling. Læs mere om præsentationer på min blog på http://praesentationer.blogspot.com/
Why should you adopt gamification for marketing? Read about octalysis in gamification and its application with reference to Indian sub continent..
The presentation contains the following
Gamification introduction
Reasons to adopt Gamification
Original Octalysis
Indian Specific Changes Octalysis of Coca Cola Chok Campaign
Octalysis of Chennai Express app
"A Project Report on The Impact of Celebrity Endorsement on Brand Personality...Raj Ray
“The Impact of Celebrity Endorsement on Brand Personality: An Empirical Study on Unilever’s Lux on Being Beauty Bar of Film Stars!” An effort to analyze the relationship between celebrity endorsements and brands, the impact of Celebrity personality on Brand personality and buying behavior."
Liver failure after major hepatic resection.pptxGian Luca Grazi
Liver failure after hepatic resection has a multifactorial origin. However, the volume of the removed liver, technical problems during the procedure and the development of infections in the post-operative period certainly play a primary role.
The surgeon plays an important role in implementing all those surgical and radiological procedures to prevent the onset of this severe complication.
However, the treatment of liver failure that occurs after a hepatectomy requires multidisciplinary management, including intensive care physicians, neurologists, nephrologists, and others.
In order not to incur in the failure to recognize the complication and to avoid not implementing all the therapeutic measures necessary for the treatment of post-resection liver failure, it is essential that the hospital where the operation is performed is equipped with all professionalism and all the necessary technological tools.
These are the characteristics needed to define where liver surgery can be performed safely.
Sudden impairment of kidney function occurring over a period of hours to days.
AKI is present in 7% of all hospitalized patients, and up to 30% of patients in ICU
The incidence is increasing at an alarming rate
That's why we need ideal biomarker to diagnose the AKI as early as possible and deliver better treatment to the patient.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
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.
- 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
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
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.
1. John R Prowle MA MSc MD MRCP FFICM
Senior Lecturer in Intensive Care
Consultant in Intensive Care
& Renal Medicine
AKI: The long-term effects?
2. Modes of Recovery from AKI
J Clin Invest. 2011;121(11):4210–4221.
Good
Bad
3. Outcomes after AKI
• Is AKI a risk factor for CKD?
• What are this implications of this association?
• What should we do during follow-up?
– How do we recognise patients for treatment and follow-
up?
– What treatments are available?
4. Long-term risk of mortality and acute kidney injury during
hospitalization after major surgery
Bihorac A, et al (2009) Annals of surgery 249: 851-858
6. Cumulative Incidence of CKD by Exposure Status
(Recovered AKI vs. Controls) in Patients With
Normal Baseline Kidney Function
Bucaloiu ID, Kirchner HL, Norfolk ER et al. Kidney Int. 2012 Mar;81(5):477-85.
1.0
0.8
0.6
0.4
0.2
0
ProportionofPatientsWithoutCKD
Months Since Index Hospitalization
0 6 12 18 24 30 36 42 48 54 60 66 72
AKI
Controls
Apparent ‘recovery’ after AKI does not remove association with later CKD
7. J Am Soc Nephrol 25: 2014. doi: 10.1681/ASN.2013060610
AKI is a major risk factor for
Cardiovascular morbidity
8. CKD, GFR Proteinuria and Population Morbidity/Mortality
Alb ++
Alb +
Alb -
Kidney International (2011) 80, 17–28;
9. Estimated glomerular filtration rate and albuminuria for
prediction of cardiovascular outcomes: a collaborative
meta-analysis of individual participant data
Kunihiro Matsushita et al
The Lancet Diabetes & Endocrinology May 2015
DOI: 10.1016/S2213-8587(15)00040-6
Adjusted for age, sex, race or ethnic origin, smoking, systolic blood pressure,
antihypertensive drugs, diabetes, total and HDL cholesterol concentrations, and
albuminuria (ACR or dipstick) or eGFR.
10. PLOS Medicine | www.plosmedicine.org 1 February 2014 | Volume 11 | Issue 2 | e1001601
Follow-up of patients from the RENAL study
11. PLOS Medicine | www.plosmedicine.org 1
February 2014 | Volume 11 | Issue 2 | e1001601
45%
12. Venkatachalam M A et al.
Am J Physiol Renal Physiol
2010;298:F1078-F1094
Histology after AKI
14. Summary 1
• CKD is common after AKI
• More severe AKI is associated with more severe CKD
• Development of CKD is associated with adverse outcomes
– Death
– Cardiovascular disease
• Overt CKD may be delayed
• Development of Proteinuria may be associated with
adverse outcomes
15. Prevention of CKD after AKI
• Prevent AKI
• Minimise severity of initial episode
• Prevent recurrent AKI
16. • 624 patients, 296 (47%) had AKI and 216 (73%) recovered
• Of these, 68 (31%) developed Recurrent AKI
J Trauma Acute Care Surg 76:
17. Recurrent AKI & Development of CKD 4
Thakar C V et al. CJASN
20. East London ICU
CRRT Follow-up
• 5544 ICU admissions, 394 RRT survivors, 219 ‘de-novo’
AKI for follow-up
• 182/219 (83%) were offered a hospital follow-up
appointment
• 142/182 (78%) attended their appointment
• Only 78 of those (55% of those attending) had their
creatinine measured at this visit.
• Only twenty-six patients (12%) were reviewed in
nephrology out-patients (creatinine was checked in all)
21. 104 RRT Survivors with Baseline and 6/12 eGFR
0 30 60 90 120 150
0
30
60
90
120
150
Baseline eGFR
eGFRatsixmonths
Median 60
Median 49
22. Reasons for poor rates of follow-up
• Perception of renal recovery
• Lack of specialist nephrology input as in-patient
• Misapprehension of longer term implications of
AKI
26. 0.20.51.02.05.010.0
Creatinine(mg/dl)
No AKI AKI 1 AKI 2 AKI 3
Admission
Peak
Discharge
** ** **
**** **
**
NS
Versus Admission: NS p > 0.05; * p < 0.05; ** p < 0.01
Prowle, J.R. et al.
Clin J Am Soc Nephrol 9, 1015-23 (2014).
33. Managing Patients after AKI
• Minimise severity of initial injury
• Avoid secondary injury
– Provide least harmful RRT
– Avoid fluid overload
• Recognize incidence and severity of CKD
• Arrange appropriate follow-up
• Treat CKD risk factors
• Avoid recurrent AKI
34. UK / Aus&NZ Fluid Removal Survey…….
https://www.surveymonkey.com/r/VPNT8XB
Editor's Notes
The severity of AKI has been linked with the risk of subsequent CKD in another analysis of US Veterans Health Administration patients [12], with greater odds of CKD associated with the a more severe AKI category in the RIFLE classification, and with the greatest odds for those patients requiring RRT.
In a cohort of 1610 patients who had AKI and recovered to normal serum creatinine, half developed CKD after 36 months. In addition, these patients had a 1.5-fold higher risk of death during follow-up compared to matched controls without AKI [14]
A total of 45 cohorts, including 1,555,332 people, were included in the meta-analyses, grouped into four study populations: a general population with ascertainment of albuminuria as ACR, a general population with ascertain- ment of albuminuria by dipstick, a high-risk population, and a chronic kidney disease population.
Sections of kidneys 14 days after right nephrectomy to remove 50% of renal mass and 45 min of ischemia of left kidney followed by reperfusion (right) or corresponding nonischemic nephrectomy controls (left). Paraffin sections of tissue perfusion fixed with periodic acid-lysine-paraformaldehyde were stained with hematoxylin and eosin (H&E; top) or immunohistochemically stained for the differentiation marker Na+-K+-ATPase (middle) or PDGF-B (red) and PDGFR-β (green; bottom). The images are from the outer stripe of the outer medulla, chief site of original ischemic damage. Top and middle: reproduced from Ref. 48 with permission from the American Society for Investigative Pathology. Bottom: unpublished archival tissue from Ref. 48. Original magnifications: ×100 (top); ×200 (middle and bottom).
Relationship between sodium intake by intravenous infusion of isotonic saline and mean arterial blood pressure (top), creatinine clearance rate (middle), and albumin excretion rate (bottom) in sham or I/R rats 35 days after surgery. *P < 0.05 compared with I/R rats at the same sodium intake.
For example, in a cohort of 3679 patients with diabetes followed for 10 years, hospitalization complicated by AKI of any severity was associated with an independent 3.6-fold increase in rate of developing CKD stage 4, with a doubling of risk for each further AKI episode [13].
Figure 2: Hospital Admission, Peak and Hospital Discharge Creatinine (log scale) in 700 hospitalizations involving an ICU stay of 5 or more days with survival to hospital discharge.
Boxes 25% to 75% centiles with solid line at median, whiskers 1.5x interquartile range from box. Non-overlap of notches suggests significant difference in medians at the 0.05 level. Asterisks indicate statistical difference between paired creatinine values, Wilcoxon Signed Rank Test.