Aims:
Determine how many patients presented to a single center Vein Specialty Clinic with varicose veins despite prior surgical intervention.
Identify the site and cause of varicose veins in patients with prior surgical intervention.
Assess the role of endovenous laser ablation in the retreatment of varicose veins in patients with prior intervention.
Venous Thromboembolic Disease and Current ManagementOmar Haqqani
Authored by Dr. Jimmy Haouilou, MD. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2016, Midland Country Club, Midland, MI.
Myocardial protection in redo surgery with patent left internal mammary arteryVijay Anand
Myocardial protection in redo surgery with patent left internal mammary artery. various technique described in literature was discussed a with 2 case report which we operated
Complicated Open Carotid InterventionsOmar Haqqani
Authored by Dr. Jeffrey Rubin, MD. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2016, Midland Country Club, Midland, MI.
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
Venous Thromboembolic Disease and Current ManagementOmar Haqqani
Authored by Dr. Jimmy Haouilou, MD. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2016, Midland Country Club, Midland, MI.
Myocardial protection in redo surgery with patent left internal mammary arteryVijay Anand
Myocardial protection in redo surgery with patent left internal mammary artery. various technique described in literature was discussed a with 2 case report which we operated
Complicated Open Carotid InterventionsOmar Haqqani
Authored by Dr. Jeffrey Rubin, MD. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2016, Midland Country Club, Midland, MI.
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
Endovenous treatment for varicose veins – the first choice (laser, radiofre...Michał Molski
There are different methods of treatment of varicose veins. Is there one "best method for all"? I believe there are different options for different patients. The key to sucess is surgeon's experience in handling different methods, and availability of those methods in specific medical center.
Who Needs More Testing Beyond Venous Duplex?Vein Global
By: William Marston, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Mark Meissner, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Thigh, Calf & Ankle Perforators: Are They Different?Vein Global
By: Nicos Labropoulos, PhD, RVT
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
How do Laser Wavelengths & Fibers Differ Clinically?Vein Global
By: Thomas M. Proebstle, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Steve Elias MD FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
2 Things New! 1290nm Laser & New Saphenous Vein Closure DeviceVein Global
By: Lowell S. Kabnick, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Does All Saphenous Reflux Need Ablation?Vein Global
By: Paul M. McNeill, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Polidocanol Endovenous Microfoam: Where Are We?Vein Global
By: Nick Morrison, MD, FACS, FACPh, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Thomas M. Proebstle, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
This presentation will be very helpful for interventional radiologist, vascualr sergeons and sonographers. We will discuss the basic concept of varicosities and then step by step their thermal ablation under US guiadance.
Future of RF Ablation: Continuous or Segmental?Vein Global
By: Alan M. Dietzek, MD, RVT, RPVI, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Should C2 Disease Classification Be Broken Down Further? Who Progresses to C4?Vein Global
By: Nick Morrison, MD, FACS, FACPh, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Centralization of flow in aortic dissectionIvo Petrov
New concept of totally endovascular treatment of complex cases of type A and B aortic dissection.
Modern minimally invasive approach to treat aortic dissection.
Endovenous Ablation of Varicose Veins. Treat painful varicose veins by Laser ...Saurabh Joshi
Varicose Veins is a very common medical condition affecting more than 30 % of the population. If left untreated, this can cause painful skin ulceration and a significant loss of quality of life.
Treatment is an office procedure, a small needle prick is all that is needed to position the Laser / RFA fiber within the vein and treat this disease once and for all.
Find out more and contact Dr.Joshi for details.
Presentation made by Dr. Hiranya A. Rajasinghe about Popliteal Artery Aneurysms: When to Treat Inclusion and Exclusion Criteria for Endovascular Repair
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
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.
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.
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.
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
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
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
Surgical Site Infections, pathophysiology, and prevention.pptx
Endovenous Laser Ablation in the Treatment of Recurrent Varicose Veins
1. Endovenous laser ablation in the treatment of recurrent
varicose veins.
Lütfi Kirdar International Congress and Exhibition Centre Istanbul, Turkey
Primepares G. Pal, MD, RPVI, Jacqueline S. Pal, CNP, RPhS, Rachel Isaak, BA, RVT.
Minnesota Vein Center, North Oaks, Minnesota 55127 USA
email: dr.p.pal@mnveincenter.com
1
3. Endovenous laser ablation in the treatment of recurrent
varicose veins.
Aims:
1. Determine how many patients presented to a single center Vein
Specialty Clinic with varicose veins despite prior surgical
intervention.
2. Identify the site and cause of varicose veins in patients with prior
surgical intervention.
3. Assess the role of endovenous laser ablation in the retreatment of
varicose veins in patients with prior intervention.
3
4. Recurrence of varicose veins after vein “stripping”
4% of patients evaluated had vein “stripping” after 2000
2,347
Patients Evaluated for Leg Vein Problems (2007 – 2012)
369
Had Prior Intervention
9%
219
150
Surgery
EVA
Primarily
vein “stripping”
Endovenous
Thermal Ablation
6%
Survey Group – 71 Patients
• Presence of varicose veins
• Vein “stripping” surgery after 2000
• Excluded phlebectomies
4
5. Presence of varicose veins despite prior Vein “Stripping”
2,347
Patients Evaluated for Leg Vein Problems (2007 – 2012)
369
Had Prior Intervention
219
150
Surgery
EVA
Primarily
vein “stripping”
Endovenous
Thermal Ablation
9%
6%
Survey Group – 71 Patients
95 Limbs
Patients with
one limb
Patients with
two limbs
5
6. Patient Demographics and Clinical Characteristics
Patients with Varicose Veins – Despite Prior Vein “Stripping “after
Year 2000
• 49.4 years (range, 32-74)
• 84% female
• Surgery occurred median of 7 years previously (1-12 yrs)
• Deep venous insufficiency: 10/95 limbs (11 %)
6
7. Clinical Distribution: C Classification
72% are C2 and C3
45
44
40
35
30
24
25
19
20
15
10
5
5
3
0
0
C2
C3
C 4a
C4b
C5
C6
7
8. Presence of varicose veins despite surgery
VV associated with saphenous veins, perforator veins or accessory veins
Segmental or Fully
Intact GSV
Perforator vein(s)
61 (64%)
Accessory vein reflux
28 (30%)
26 (27%)
37 segmental
24 intact
21 thigh
16 calf
Small saphenous vein reflux
20 (21 %)
Neovascularization/pelvic veins
12 (13 %)
8
9. Limbs (%) with prior vein “stripping”
VV associated with saphenous veins, perforator veins or accessory veins
80
64
60
40
20
30
27
20
13
0
9
10. Treatment of patients with recurrent varicose veins
95 Limbs
Patients with
one limb
(CoolTouch CTEV™ 1320mm)
% Patients
Microphlebectomy
7%
20%
Foam
73%
Plus
received
concurrent
adjunctive
treatment
Foam & Microphleb.
Second vein treated in
23 cases
Complete Treatment Received
69 Treated with EVLA
Patients with
two limbs
26 EVLA not possible
7%
46%
Received
treatment
46%
10
11. Saphenous veins treated with EVLA
EVLA was feasible in 69 limbs (73%). When intact GSV excluded,
EVLA still feasible in 57 limbs (60%).
First vein ablated
GSV segmental
GSV intact
SSV
Accessory vein
Second vein ablated
23
24
13
9
–––
69
GSV segmental
SSV
Accessory vein
1
7
15
–––
23
11
12. Saphenous veins treated with EVLA
Treated vein
mean (SD, range)
GSV segmental (n=23)
GSV intact (n=24)
SSV (n=20
Accessory (n=24)
21.2 cm (
41.9 cm (
16.3 cm (
14.4 cm (
6.1; 12-35)
8.1; 25-58)
4.1;; 9-25)
4.4; 6-22)
12
14. Summary
1. 15% of patients presenting for evaluation of leg vein
problems had prior intervention. 9% had prior surgery.
2. Presence of varicose veins associated with segmental or
fully intact great saphenous vein, perforator vein
pathology, and accessory vein reflux.
3. Short-term, EVLA is feasible and effective in the majority
of patients with varicose veins and prior saphenous vein
surgery.
4. The majority of EVLA-retreated patients reported
symptomatic improvement.
14