Scoring systems aim to reduce large amounts of clinical data into simple grades or numbers. Several trauma scoring systems exist for use in children, including the Glasgow Coma Scale, Pediatric Trauma Score, Revised Trauma Score, Abbreviated Injury Score, Injury Severity Score, and APACHE III Score. These systems evaluate factors such as airway status, respiratory rate, blood pressure, Glasgow Coma Scale, and age to predict patient outcomes following trauma.
Pulmonary arterial hypertension in congenital heart disease Ramachandra Barik
Pulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance and heart failure. It was first identified by Ernst von Romberg in 1891. According to the most recent classification, it can be one of five different types: arterial, venous, hypoxic, thromboembolic or miscellaneous.
Pulmonary arterial hypertension in congenital heart disease Ramachandra Barik
Pulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance and heart failure. It was first identified by Ernst von Romberg in 1891. According to the most recent classification, it can be one of five different types: arterial, venous, hypoxic, thromboembolic or miscellaneous.
a cardiac surgery presentation about Atrioventricular septal defect,Definition, Prevalence,Anatomy,Classification,presentation ,diagnosis and management
a cardiac surgery presentation about Atrioventricular septal defect,Definition, Prevalence,Anatomy,Classification,presentation ,diagnosis and management
relative risk, odds ratio, attributable fractions and lots of statistical measurements which can improve epidemiological problems have been discussed. Besides, some reliability instruments' description have been added.
R software codes for ICC, Kappa, Lin's agreement and Bland agreement is exist.
Power in Rowing Symposium: Stephen SeilerRebecca Caroe
Power, Pulse rate and Perception as a telling trinity in training monitoring of endurance athletes.
The full video and audio presentation are on www.rowing.chat podcast network.
Stephen Seiler received his doctoral degree from the University of Texas at Austin. He is past Vice-Rector for Research and Innovation and past Dean of the Faculty of Health and Sport Sciences at the University of Agder in Kristiansand, Norway. Currently, he is working as a full professor at the same institution. His research interests include exercise physiology and training adaptations, particularly to endurance training for cyclists, rowers, XC skiers, orienteers and distance runners.
Targeting Progession: The Progressive MS AllianceMS Trust
This presentation by Alan Thompson looks at defining progressive MS, exploring interventions, current studies and future international direction.
It was presented at the MS Trust Annual Conference in November 2013.
Proposing statistical medicine as a new medical specialty that uses scores, indexes, and decision trees, for diagnosis, treatment and prognosis of individuals in a clinic setup.
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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.
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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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.
6. Glasgow Coma Scale (adults)
PointsResponseBehavior
4
3
2
1
Spontaneous
To speech
To pain
Nil
Eye opening
5
4
3
2
1
Oriented
Confused conversation
Inappropriate words
Incomprehensive sounds
Nil
Verbal response
6
5
4
3
2
1
Obeys
Localizes
Withdraws
Abnormal flexion
Extends
Nil
Motor response
7. Modification of Glasgow Coma Scale For Children
Score
5
4
3
2
1
Best Verbal Response :
-Appropriate words or social smiles,
fixes on and follows objects
-Cries but consolable
-Persistantly irritable
-Restless, agitated
-Silent
Eye and Motor Responses:
Scored as in the scale for adults
8. Pediatric Trauma Score
Tubelirer et al (1990)
-1+1+2Component
<1010 - 20> 20Size (kg)
< 5050 - 90> 90SBP (mmHg)
Difficult to maintainCan be
maintained
NormalAirway
Coma or decerebrateObtundedAwakeCNS
Open or multiple
fractures
Closed fractureNoneSkeletal
Major or penetratingMinorNoneCutaneous
9. Age-Specific Pediatric Trauma Score
(Potoka et al 2001)
Coded
Score
RRPulseSBPGCS
3NormalNormalNormal14-15
2Tachypnea
(RR>mean+SD)
Tachycardia
(Pulse>mean+SD)
Mild to moderate
hypotension
(SBP<mean-2SD)
10-13
1Hypoventilation
(RR<mean-SD)
Bradycardia
(Pulse<mean-SD)
Severe
hypotension
(SBP<mean-3SD)
4-9
00 or intubated003
10. ScoreVariableScoreVariable
Capillary RefillRespiratory Rate
2
1
0
Normal
Delayed (>2 s)
Non
5
4
3
2
1
10 – 24 / min
25 – 35 / min
>35 / min
>10 / min
0 / min
Glasgow Coma Scale
5
4
3
2
1
14 – 15
11 – 13
8 – 10
5 – 7
3 – 4
Respiratory Effort
1
0
Normal
Shallow or retractive
Systolic Blood Pressure
Total Score
4
3
2
1
0
> 90 mmHg
70 – 90 mmHg
50 – 69 mmHg
< 50 mmHg
0 mmHg
Trauma Score (adults)
12. The Abbreviated Injury Score (AIS)
Division of the body into six regions:
1- Thorax 2- Abdomen and viscera
3- Head and Neck 4- Face
5- Bony pelvis and extremities
6- External structures
Scoring for each region injury as:
No injury (0), minor (1), moderate (2), serious (3), severe (4),
critical (5), incompatible with life (6)
13. The sum of squares from the highest AIS
grades in each of the three most severely
injured areas.
•75 points = worst outcome
•AIS of any region : 6 points = worst outcome
•30-40 points = 50% survival
Injury Severity Score (ISS)
(Baker et al 1974)
14. New Injury Severity Score (NISS)
(Osler et al 1997)
• The AIS is the frame.
• Based on the three most severe
injuries regardless the body regions.
• Useful for penetrating injuries.
16. Score 1 2 3 4
Region
affected
Skin /
extremity
Back Chest /
abdomen
Head / neck
Type of
injury
Laceration /
contusion
Stab Blunt Missile
Cardiac
vascular
Hemorrhage
present
BP<100
HR>100
BP<80
HR>140
Pulse less
CNS Drowsy
Chest pain
Stupor Focal
exam
Coma
Respiratory Dyspnea /
hemoptysis
Aspiration Apena/
cyanosis
Trauma index
Kirkpatrick and Yeoman’s, (1971)
17. Variable Score
Circulation
Capillary refill normal
BP>100 mmHg
Delayed capillary refill or
BP 85 – 100 mmHg
No capillary refill or
BP<85 mmHg
2
1
0
Respiratory
Normal
Labored or Shallow
Absent
2
1
0
Abdomen / Thorax
Abdomen & thorax non-tender
Abdomen or thorax tender
Abdomen rigid, flail chest, or Penetrating injury
2
1
0
Motor
Normal
Responds only to pain
Decerebrate or no response
2
1
0
Speech
Normal
Confused
No intelligible words
2
1
0
CRAMS Scale Gormican, (1982).
18. APACHE II
• A) 12 physiological variables: 60 points
• B) Age:
• 44 yrs = 0 points
• >75 yrs = 6 points
• C) Chronic Health points :
• -Non-oper or emerg. Postop. ….. 5 points
• -Elective postop. ….. 2 points
20. (R / 1-R) = -3.517 + (APACHE II x 0.146 + S + D)
R = Risk of hospital death
S = Risk of emergency surgery
D = Risk of specific disease
APACHE II equation :
21. APACHE III Score
- Variables & weights:
Added weights to APS, Age, and CHE
Refined Glasgow Coma Scale
-Interactions
PH , PaCO2 Creatinine , U.O.
R.R , Ventilator
- 5 new variables:
BUN U.O
Albumin Bilirubin
Glucose
23. ( R / 1-R ) =( APACHE III x 0.053 )+ S+D+L
R = Risk of hospital death
S = Risk of emergency surgery
D = Risk of specific disease
L = Risk of patient location
APACHE III equation :
24. Pediatric Trauma BIG Score
Borgman MA et al .Pediatrics 2011 ;127 : 892 -7
BIG Score = (BD) + (2.5xINR) + (15 - GCS)
10+(2.5x3.5)+6=26= Predicted mortality : 50%
IRAQ & AFGANESTAN Military study
Penetrating & blunt injuries
BIG Score needs laboratory
BIG Score is suitable for research
25. Determination of outcome :
Outcome
Age
Diagnosis
Illness severity
Treatment
Chronic illness
Biological reserve
26. Key points
• Trauma scoring systems in children can
play a complementary role in deciding
patient outcome.
• Some trauma scoring systems are useful for
triaging of traumatized children and also
for testing quality assurance of trauma
centers or comparing their performance.