Pvd and lipid panel
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The document compares the key differences between arterial and venous insufficiency. Arterial insufficiency is characterized by symptoms in one or both extremities, dependent rubor and pallor on elevation, claudication pain relieved by dependency, decreased or absent pulses, and cool skin temperature. Ulcers occur in 20% of cases and are located at pressure points or the tips of toes and are circular and dry. Venous insufficiency presents with symptoms confined to the affected leg which is larger, cyanosis and brown pigmentation and scaling, dull ache and heaviness relieved by elevation, edema, increased pulses, warm skin, and ulcers around the ankle with irregular borders that are moist occurring in 75% of cases.
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Prolonged immobility can lead to several negative cardiovascular, respiratory, musculoskeletal, and other effects. It can cause blood to pool in the lungs and veins, leading to increased capillary pressure and edema. It also decreases arterial blood flow and nutrient exchange. Respiratory issues include decreased chest expansion and gas exchange. Prolonged immobility increases risks of pressure ulcers, constipation, poor healing, osteoporosis, and other bone diseases like rickets due to decreased mobility and nutrient deficiencies.
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Pharmacology of 5-hydroxytryptamine and Antagonist
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
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Osteoporosis is an increasing cause of morbidity among the elderly.
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The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
What are the different types of Dental implants.
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Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
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chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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More than 20 participants took part everyday !
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Your smile is beautiful.
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
Pvd and lipid panel
- 1. ARTERIAL VENOUS SYMMETRY One or both extremities Affected leg larger COLOR Dependent rubor, pallor Cyanosis, brown on elevation pigment, scaling PAIN Claudication c exercise, Dull ache, heaviness, relieved c dependency relieved c elevation EDEMA - + PULSES Decreased or absent + TEMP Cool Warm ULCERS 20% 75% Pressure points, tips of Around ankle c irreg. toes, circular & dry border, moist
- 3. Varicose Veins • Dilated, tortuous veins of lower extremities – no valves in • inferior vena cava • common iliac veins – superficial saphenous vein only covered by fat & skin (no muscles) • Predisposing factors – Heredity – Standing – High intraabdominal pressures (pregnancy)
- 5. Deep Vein Thrombosis (DVT) Risk Factors • Prolonged immobility • Varicose veins – bed rest • Deficiencies of naturally – hip fracture occurring – “Economy class anticoagulants syndrome” – Antithrombin III • Dehydration – Protein C • Smoking – Protein S • Oral contraceptives • Postpartum period – increased coagulation factors
- 6. Clot from vein travels through RIGHT heart
- 7. Artery (arterio) Arteriosclerosis Atherosclerosis • Elderly, diabetics • Atheromas “plaques” • Loss of vessel elasticity • fat & fibrin (Cholesterol) • Thick & hard “hardening of arteries” • narrows
- 8. Fibrous Athermatous Plaque Patho • Intra/extra cellular lipid accumulation • smooth muscle cells proliferation • scar tissue formation • vessel intima thickening • lead to… – Platelet aggregation – Occlusion – Aneurysm
- 10. Atherosclerosis/CAD Risk Factors Modifiable Unmodifiable • Cigarette smoking • Heredity • HTN • Gender • DM – > risk males- until women • Hyperlipidemia hit menopause • Upper body obesity – = incidence by 70-80 • Sedentary lifestyle • Age • Stress/Type A personality – CRP
- 11. Normal Lipid Panel • Cholesterol < 200 mg/dl • LDL < 100 mg/dl • HDL > 60 mg/dl • Triglycerides < 165 mg/dl
- 13. Familial Hypercholesterolemia Autosomal dominant disorder • Homozygotes – xanthomas & arteriosclerosis in childhood – many die of MI by 20 • Heterozygotes 1 in 500 – cholesterol elevated from birth – 2 to 3 fold serum cholesterol increase – xanthomas & arteriosclerosis in adulthood
Editor's Notes
- Not enough anticoagulants ( not enough bleeding)
- HDL protects women