This document discusses various pulmonary infections including viruses, bacteria, fungi, and their classifications. It describes bronchopneumonia as a patchy pneumonia localized around bronchioles and surrounding alveoli. Lobar pneumonia involves consolidation of an entire lobe and is often caused by pneumococcus. Interstitial pneumonia shows inflammation predominantly in alveolar walls. The document outlines etiologies, pathogenesis, histopathology, and clinical features of different pulmonary infections.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles. Or •Bronchiectasis is characterized by permanent, abnormal dilation of one or more large bronchBronchiectasis.
Despite modern anti-tuberculous chemotherapy, approximately 2% of all cases of pulmonary mycobacterial infection require surgical treatment.Therefore, surgical treatment of pulmonary mycobacterial disease is rarely necessary.Types of surgical procedures for PTB include: Collapse therapy, pulmonary resection, lung decortication, drainage procedures such as closed tube thoracostomy, rib resection and open window thoracotomy beside pulmonary resection+ collapse therapy (thoracoplasty). The decreasing morbidity and mortality of pulmonary resection for PTB is due to careful patient selection ( failure of chemotherapy, massive haemoptysis, BPF), improved anaesthetic techniques, stapling devices and better chemotherapy.The prognosis after successful resection is excellent ( 90% survive and remain disease free).
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles. Or •Bronchiectasis is characterized by permanent, abnormal dilation of one or more large bronchBronchiectasis.
Despite modern anti-tuberculous chemotherapy, approximately 2% of all cases of pulmonary mycobacterial infection require surgical treatment.Therefore, surgical treatment of pulmonary mycobacterial disease is rarely necessary.Types of surgical procedures for PTB include: Collapse therapy, pulmonary resection, lung decortication, drainage procedures such as closed tube thoracostomy, rib resection and open window thoracotomy beside pulmonary resection+ collapse therapy (thoracoplasty). The decreasing morbidity and mortality of pulmonary resection for PTB is due to careful patient selection ( failure of chemotherapy, massive haemoptysis, BPF), improved anaesthetic techniques, stapling devices and better chemotherapy.The prognosis after successful resection is excellent ( 90% survive and remain disease free).
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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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
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.
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
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
5. Bacterial pneumonia
• Bacterial invasion of the lung parenchyma
evokes exudative solidification (consolidation)
of the pulmonary tissue known as bacterial
pneumonia.
6. Pathogenesis
Defence mechanisms
1. Filtering function of nasopharynx
2. Mucociliary action of lower air passages
3. Phagocytosis and elimination by alveolar MØ
7. Pneumonia results when….
1. Clearing mechanisms are impaired
2. Resistance of the host in general is lowered.
8. Clearing mechanism interference
1.Loss or suppression of cough reflex
2.Injury to the mucociliary apparatus
3.Interference with phagocytic action of
alveolar MØ.
4.Pulmonary congestion and edema
5.Accumulation of secretions
9. Clearing mechanism interference
1- Loss or suppression of cough reflex
coma, anesthesia, neuromuscular disorders,
drugs / chest pain, aspiration of gastric
contents, Systemic sclerosis
10. Clearing mechanism interference
2.Injury to the mucociliary apparatus
impairment of ciliary function
destruction of ciliated epithelium
cigarette smoke, hot/corrossive gas
inhalation, viral diseases, immotile cilia
syndrome, Cystic fibrosis
15. Terminology
• If the consolidation is patchy and centered around the
terminal bronchiole the patient is said to have
bronchopneumonia.
• If the consolidation involves the whole of one or
more lobes, the disease is called lobar pneumonia.
• When the inflammation is predominantly in the
alveolar walls with only secondary changes in the
alveoli, the condition is termed interstitial
pneumonitis.
16. Bronchopnemonia
• Patchy consolidation of lung .
• Centered around the terminal bronchiole
• Common in extremes of age - infancy/old age
• An extension of bronchitis / bronchiolitis.
18. Gross pathology –
bronchopneumonia
1. Patchy distribution in ONE LOBE
2. Multiple, bilateral, and basal 3 to 4 cms,
slightly elevated dry granular grey red to
yellow with poor delimitation at margins.
3. Foci of consolidated areas of acute
suppurative inflammation
4. Confluence produces – lobar pneumonia.
19. Microscopy of bronchopneumonia
• Suppurative exudation involving, bronchi,
bronchioles and adjacent alveolar spaces -
PMN
• Central necrosis
• Abscess - fibrosis – resolution.
20.
21.
22.
23.
24.
25. This slice of lung with
bronchopneumonia.
Find a row of subpleural
centrilobular nodules.
Find rosettes (2 are marked).
Find tree-in-bud patterns (1
is marked).
26.
27.
28.
29. Complications of bronchopneumonia
1. Lung abscess
2. Spread to pleural cavity – empyema
3. Spread to pericardial cavity-suppurative
pericarditis.
4. Bacteremia – metastatic abscesses.
30. Bronchopneumonia
General Patchy pneumonia that is localized, often to the
Description bronchioles and surrounding alveoli.
One or more of the following symptoms:
coughing, chest pains, fever, blood-streaked
Clinical Signs
sputum, chills, and difficulty in breathing.
Signs of pulmonary congestion
Inhalation of organisms.
Pathophysiology
Scarring if alveoli destroyed.
Patchy distribution in and around small airways
Dense acute inflammatory exudate of PMNs,
fibrin and blood in bronchi, bronchioles and
Histopathology
adjacent alveoli.
FOCAL destruction of alveolar walls (you can
see normal parenchyma in other areas adjacent
31. Lobar pneumonia
Definition:
It’s an acute bacterial infection of a large
portion of a lobe or of an entire lobe, which
tends to occur at any age but relatively
uncommon in infancy and old age.
32. Etiology and pathogenesis
• Pneumococci ( streptococcus pneumoniae)
1,3,7 and 2
type 3 is virulent form
Staphylococci, Streptococci
Gram negative: Pseudomonas, Proteus,
Klebsiella, Haemophilus influenzae.
33. Pathogenesis of lobar pneumonia
• Exudate spread through pores of Kohn
• Mucoid encapsulation- protection from
phagocytosis. (Pneumococcus, Klebsiella,
Hemophilus)
Which disease is associated with recurrent
infections by capsulated organisms?
41. Microscopy of lobar pneumonia
• Wide spread fibrinosuppurative
consolidation of large areas and even whole
lobes of lung.
• Serous exudation
• Vascular engorgement
• Fibrinocellular exudation - resolution /
organisation.
42.
43.
44.
45.
46. Comparison of bronchopneumonia vs. lobar pneumonia
Bronchopneumonia Lobar Pneumonia
Location 1. often bilateral large area, even whole lobe involvement
2. basal (i.e. lower lobes)
Route of infection spreads from bronchioles to nearby both alveoli and bronchioles
alveoli
Spread of infection consolidation is patchy Whole lobe becomes consolidated
Susceptible group infants, elderly Adults especially alcoholics and
vagrants.
Causative Organism Dependent on circumstances Often caused by Pneumococcus or
predisposing to infection(i.e. Klebsiella.
nosocomial or community
acquired)
Recovery If treated, recovery usually involves If treated promptly, many recover with
focal organisation of lung by lungs returning to normal structure and
fibrosis. functioning by resolution. In other cases
the exudate in alveoli is organised,
leading to lung scarring and permanent
lung dysfunction.
Notes Patients who are immobile develop Patient are severely ill and usually
retention of secretions; thus, most associated bacteriemia.
commonly involves the lower
lobes.
49. Community acquired
atypical pneumonia
• Mycoplasma pneumonia
• Chlamydia species
• Viruses --- RSV, parainfluenza,
Influenza A and B.
Adenovirus, SARS
54. Chronic pneumonia
• Nocardia, Actinomycosis
• Granulomatous:
Mycobacterium TB, Atypical mycobacteria,
Histoplasma, coccidides.
Note: Chronic bacterial pneumonias are usually caused by
obstrution of the bronchus supplying the region involved.
It’s most common in the part of a lung obstructed by a
bronchogenic carcinoma.
56. Four stages
1. Stage of congestion
2. Stage of red hepatization
3. Stage of grey hepatization
4. Stage of resolution.
57. Stage of congestion
• Represents bacterial infection
• Lasts for 24 hrs
• Vascular engorgement
• Intraalveolar fluid with few PMN + bacteria
• Grossly: heavy, boggy, red and subcrepitant.
58.
59. Stage of red hepatization
• Neutrophils + fibrin precipitation
• Red cell extravasation
• Exudate confluence - obscures pulmonary
architecture
• Grossly: Lung appears distinctly red, firm
airless with liver like consistency.
60.
61. Stage of grey hepatization
• Accumulation of fibrin
• Disintegration of WBCs and RBCs.
• Clear zone adjacent to alveolar septa.
• Grossly: grayish brown dry surface.
• Spread to pleural cavity – empyema.
62.
63. Stage of resolution
• Progressive enzymatic digestion to produce
granular semifluid debris - resorbed.
• Ingestion by MØ -- coughed up .
• Gross: normal lung
• Pleura: fibrous thickening.
64. Complications of lobar pneumonia
1. Abundant mucinous secretion
2. Abscess formation
3. Organization of exudate.
4. Bacterial dissemination.
65.
66. Clinical features of lobar pneumonia
1. Rusty sputum
2. X-ray opaque shadows
3. Limitation of breath sounds
4. Bronchial breath sounds.
5. Fever.
67. Viral / Mycoplasma pneumonia
• Primary atypical pneumonia (PAP)
• Acute febrile respiratory disease
characterized by patchy inflammatory
changes in the lungs, largely confined to
alveolar septa and pulmonary interstitium.
• Atypical – lacks alveolar exudate.
68. Etiology of PAP
• Mycoplasma pneumonia
• RSV
• Influenza virus type A & B
• Adenovirus
• Rhinovirus
• Rubeola
• Varicella
• Chlamydia
• Coxiella burnetti (Q fever)
69. Morphology of PAP
• Patchy, may involve whole lobe
unilateral / bilateral.
• Red blue, congested, subcrepitant
• No obvious consolidation
• Pleura – normal.
70. Microscopy of PAP
• Interstitial inflammatory reaction
• Alveolar septa widened, edematous, L,Hi,pl cells.
• Alveoli are free of exudate. NO EXUDATE.
• Intraalveolar proteinacious material, cellular
exudate.
• Characteristic PINK HYALINE EMEMBRANE
LINING alveolar damage similar to ARDS.
86. Morphology of lung abscess
• mm to 5 to 6 cms
• Common on right side, mostly single.
• In pneumonia / bronchiectasis
– Multiple, basal, diffusely scattered.
• Cavity with or without suppurative debris
• Contd infection-large fetid, green black multilocular
cavity with poor margins
• GANGRENE OF LUNG.
87.
88.
89.
90.
91.
92.
93.
94. Causes of pulmonary infiltrates in
immunocompromised hosts
Diffuse infiltrates Focal infiltrates
Common Common
CMV, P.carinii, Drugs GN rods, Staph.aureus
Aspergillus, Candida, Malignancy
UNCOMMON UNCOMMON
Bacteria, Aspergillus, Cryptococcus, Mucor, P.carinii,
Cryptococcus, Malignancy Legionella pneumophila.