This document discusses research on the risk of fractures from inhaled corticosteroid (ICS) use. It finds that studies without extensive adjustment for respiratory disease severity show a positive association between ICS use and fracture risk, but studies that adjust for indicators of disease severity find no significantly increased risk. The study presented used a large UK database to quantify bronchodilator exposure and adjust for multiple severity indicators, finding no increased risk of hip or vertebral fractures with higher ICS doses after adjustment. While RCTs are limited, observational studies that stratify by disease severity adjustment provide evidence against a true positive association between ICS use and fractures.
The In Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Co...ijtsrd
Lung diseases have been a worldwide health problem, with high endemicity in developing countries. Bronchopneumonia remains the main disease of the lung. Despite advances in modern medicines, there is no effective drug available that stimulate lung function, offer protection to the lung from damage or help to regenerate pulmonary cells destroyed by disseminated bacteria. There is an urgent need for effective drugs to replace supplement those in current use. This study was embacked upon to evaluate the effect of Asplenium bulbiferum leaf extracts on nosily infected mice with streptococcus pneumoniae isolate of suspension containing 5x106 cells ul. Streptococcus pneumoniae was obtained from human specimen, identified through cultural, morphological and biochemical examination, in addition, polymerase chain reaction PCR technique was performed using universal primers to support the identification process. The antibacterial activity was carried out using agar well diffusion technique. Tube dilution technique was used to determine the minimum Inhibition Concentration MIC and Minimum Bactericidal Concentration MBC using double fold serial dilution at concentrations of 400mg ml to 25mg ml. The effect of the leaf extract was evaluated by treating mus musculus mice WBC count 4.5x103 with sub MIC of A. bulbiferum extracts after nosily infected with S. pneumoniae and appearance of disease septum with 11.3x103 WBC count after 5days from infection. The photochemical analysis revealed the presence of alkaloids phenolics, tannins, saponins, flavonoids, steroids and glycosides. The ethanolic extract exhibited more activity than the aqueous extract against S. aureus most followed by S. pneumoniae, H. influenza and K. pneumoniae was the least. After treating the infected mice with the plant extract and after 6 days from infection, the WBC count reduced to 5.1x103 l which is normal range and the mice were healthy with good physiological behaviour. The infected mice and untreated with extracts, the WBC and other immunological parameters remain high even after 16 days from infection. The study showed that Asplenium bulbiferum possessed antibacterial properties and should serve as alternative therapy for ameliorating lung infections. Eze, H. C | Ajogwu, T. M | Ozor C. N | Gloria, C. I | Soludo, O. C "The In-Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Common Bacteria Associated with Lung Diseases" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47622.pdf Paper URL : https://www.ijtsrd.com/biological-science/microbiology/47622/the-invivo-effects-of-asplenum-bulbiferum-ethanolic-leaf-extracts-on-four-common-bacteria-associated-with-lung-diseases/eze-h-c
The In Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Co...ijtsrd
Lung diseases have been a worldwide health problem, with high endemicity in developing countries. Bronchopneumonia remains the main disease of the lung. Despite advances in modern medicines, there is no effective drug available that stimulate lung function, offer protection to the lung from damage or help to regenerate pulmonary cells destroyed by disseminated bacteria. There is an urgent need for effective drugs to replace supplement those in current use. This study was embacked upon to evaluate the effect of Asplenium bulbiferum leaf extracts on nosily infected mice with streptococcus pneumoniae isolate of suspension containing 5x106 cells ul. Streptococcus pneumoniae was obtained from human specimen, identified through cultural, morphological and biochemical examination, in addition, polymerase chain reaction PCR technique was performed using universal primers to support the identification process. The antibacterial activity was carried out using agar well diffusion technique. Tube dilution technique was used to determine the minimum Inhibition Concentration MIC and Minimum Bactericidal Concentration MBC using double fold serial dilution at concentrations of 400mg ml to 25mg ml. The effect of the leaf extract was evaluated by treating mus musculus mice WBC count 4.5x103 with sub MIC of A. bulbiferum extracts after nosily infected with S. pneumoniae and appearance of disease septum with 11.3x103 WBC count after 5days from infection. The photochemical analysis revealed the presence of alkaloids phenolics, tannins, saponins, flavonoids, steroids and glycosides. The ethanolic extract exhibited more activity than the aqueous extract against S. aureus most followed by S. pneumoniae, H. influenza and K. pneumoniae was the least. After treating the infected mice with the plant extract and after 6 days from infection, the WBC count reduced to 5.1x103 l which is normal range and the mice were healthy with good physiological behaviour. The infected mice and untreated with extracts, the WBC and other immunological parameters remain high even after 16 days from infection. The study showed that Asplenium bulbiferum possessed antibacterial properties and should serve as alternative therapy for ameliorating lung infections. Eze, H. C | Ajogwu, T. M | Ozor C. N | Gloria, C. I | Soludo, O. C "The In-Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Common Bacteria Associated with Lung Diseases" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47622.pdf Paper URL : https://www.ijtsrd.com/biological-science/microbiology/47622/the-invivo-effects-of-asplenum-bulbiferum-ethanolic-leaf-extracts-on-four-common-bacteria-associated-with-lung-diseases/eze-h-c
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
Novel respiratory viruses in the context of mass gathering events: A systemat...Jamie Ranse
Ranse J. (2021). Novel respiratory viruses in the context of mass gathering events: A systematic review to inform event planning from a health perspective; invited speaker for Qatar Health 2021, Doha, Qatar, 21st January [online]
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
Studies dispel the stigma on uv rays and prove its cardiovascular health bene...Jackie_Harmon
It has long been common knowledge that prolonged exposure to the sun is harmful to the skin. Dermatologists always advise wearing high-SPF sunscreen to keep UVA and UVB rays from penetrating the cells. These are said to cause sunburn, premature deterioration, and genetic damage (all of which manifest as photoaging, hyperpigmentation, wrinkle formation, sunburn, sagging, and dryness).
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
Novel respiratory viruses in the context of mass gathering events: A systemat...Jamie Ranse
Ranse J. (2021). Novel respiratory viruses in the context of mass gathering events: A systematic review to inform event planning from a health perspective; invited speaker for Qatar Health 2021, Doha, Qatar, 21st January [online]
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
Studies dispel the stigma on uv rays and prove its cardiovascular health bene...Jackie_Harmon
It has long been common knowledge that prolonged exposure to the sun is harmful to the skin. Dermatologists always advise wearing high-SPF sunscreen to keep UVA and UVB rays from penetrating the cells. These are said to cause sunburn, premature deterioration, and genetic damage (all of which manifest as photoaging, hyperpigmentation, wrinkle formation, sunburn, sagging, and dryness).
This slideshow provides a brief introduction to the concepts of epidemiology, the key historical figures and events that played a role in the evolution of epidemiology and finally an overview of key epidemiological study designs.
Exacerbations in chronic obstructive pulmonary disease (COPD) are major contributors to worsening lung function, impaired quality of life, emergency healthcare use and COPD-related mortality. COPD exacerbations are heterogeneous in terms of airway inflammation and aetiology. About 60% of COPD patients have blood eosinophil counts of ≥2%, which appears to be associated with an increased risk of exacerbations [1–3]. However, the association between blood eosinophil counts at stable disease and COPD exacerbations in the subsequent year is incompletely understood.
Read the full paper: https://doi.org/10.1183/13993003.00761-2017
Presented at 'Changing Perspectives: 1st International Conference on Transport and Health', London, 6 -8 July 2015
Haneen Khreis, Charlotte Kelly, James Tate, Roger Parslow, Karen Lucas
Similar to Seminar 09-04-2008 -inhaled corticosteroids & fracture risk (20)
IWO Meeting 1 November 2023 - Stopping with Denosumab and Romosozumab, basic mechanisms and clinical aspects door Prof. dr. S. Ferrari, Geneva, Switzerland. (Engelstalige lezing)
IWO Meeting 16 November 2022 - ASBMR young talent: Silvia Storoni (Amsterdam): Prevalence and Hospital Admissions in Patients With Osteogenesis Imperfecta in The Netherlands: A Nationwide Registry Study
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.
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
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.
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.
- 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
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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
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
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
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.
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
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.
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1. Inhaled corticosteroids & fracture
risk: disease or drugs
• Frank de Vries
• Utrecht Institute for Pharmaceutical Sciences
– (Bert Leufkens, Tjeerd van Staa)
• MRC Epidemiology Resource Centre, Southampton
General Hospital, Southampton
– (Cyrus Cooper)
• General Practice Research Database, MHRA, London
UK
2. Conflict of Interest
• The dept of Pharmacoepidemiology &
pharmacotherapy, Universiteit Utrecht has
received an unconditional educational
grant for the conduct of pharmaco-
epidemiological research from GSK
• Dr de Vries & Van Staa conduct
commissioned studies using GPRD for
several pharmaceutical companies
3. History
• Late ’60s: first studies with inhaled
corticosteroids in asthmatic children to
avoid severe corticosteroid-induced side
effects
• Mid ’80s: 400 – 600 ug beclomethasone
equivalents / day
4. 16 yr old girl
Asthma since 18
months old
On systemic steroids
for 11 year
Before (left) & after
(right) 5 months on
ICS
+ Less depressed
+ 11 kg weight loss
+ 1.3 cm length gain
Source: Morrow
Brown, BMJ 1973, 3
161-164
5. History
• Late ’90s: well accepted treatment for
reductions of airway hyperresponsiveness,
asthma symptoms & lung function
• ’90 – ’97: ICS use doubled in UK &
Netherlands
• Start high, go low approach (800-1000
ug/day)
• 1998: est. 60% of COPD patients used
ICS in the Netherlands
6. History
• Early 2000s: long acting beta-2 agonists,
leukotriene receptor antagonists:
alternatives.
increased attention for potential side
effects of ICS, including cataract &
osteoporosis.
8. Evidence from RCTs (’99-’07):
ICS use & risk of any fracture
Mantel Haenzel OR 1.16 (0.94-1.44)
Sources: Torch Trial, NEJM Jan 2007, Euroscop NEJM Jun 1999
9. Epi studies
• Inhaled corticosteroids have been
associated with
• low bone mineral density [1]
• increased risk of hip fracture [2]
• Severity of OAD is associated with
• low bone mineral density [3,4]
UIPS Utrecht Institute fo r
Pharmaceutical Sciences
[1] Israel et al. NEJM 1999
[2] Hubbard et al. Am. J. Resp. Crit. Care 2002
[3] Van Staa et al. Am J Respir Crit Care Med.
2003
[4] Sin et al. Am. J. Med. 2003
10. Objective
• Does severity of obstructive airway
disease confounds the relationship
between inhaled corticosteroids and risk
of osteoporotic fracture?
UIPS Utrecht Institute fo r
Pharmaceutical SciencesSource: de Vries et al. Eur Respir J May 2005
11. Study population
UIPS Utrecht Institute fo r
Pharmaceutical Sciences
• Case-control study
• General Practice Research Database (GPRD)
• 6% of the UK population
• 1987 – July 1999
• Age: 18 and older
Source: de Vries et al. Eur Respir J May 2005
12. Adjustment for Indicators of Severity of
Obstructive Airway Disease
• Adjustment for:
• Specific indicators of severity of obstructive airway
disease 6 or 12 months prior:
• Average daily dose of bronchodilators
• Use of oral corticosteroids
• Exacerbations
• Use of oxygen
• Body mass index
• Respiratory symptoms (i.e.chest infections)
UIPS Utrecht Institute fo r
Pharmaceutical Sciences
Source: de Vries et al. Eur Respir J May 2005
15. Discussion
• Severity of obstructive airway disease confounds
the relationship between inhaled corticosteroids and risk
of osteoporotic fracture.
• Limitations:
• No lung function measurements available
• Mechanism of severity and fracture risk unclear
• Strengths:
• First study that quantified bronchodilator exposure
concisely
• First study that adjusts for a wide range of indicators of
severity
UIPS Utrecht Institute fo r
Pharmaceutical Sciences
18. Epi studies: ICS & fracture risk
• Observational studies, stratified by extensive
adjustment of respiratory disease severity
– No, or only limited adjustments: positive association
ICS use & fracture risk.
– Adjustment for disease severity: no significantly
increased association between ICS use & fracture risk
Source: de Vries et al. Universiteit Utrecht 2007, PhD
thesis general discussion f.devries@uu.nl
19. Limitations
• RCTs (fracture risk): limited no. of highly
selected patients
• Epi studies (fracture risk)
– Respiratory disease severity: black box
– Epi studies: limited data on smoking, BMI, muscle
strengths
– Methodological issue: overadjustment may have
masked a true positive association
– No data available on e.g. lifetime corticosteroid
exposure (alternative explanation for positive
association)
20. Clinical implications
• Discontinuation of ICS in patients using
high (>800 ug/ becl. Eq. day) dosages of
ICS is probably not indicated
• Fracture risk assessment may be
indicated among patients using high daily
dosages of ICS, e.g. 1600 ug becl. Eq. &
higher.
21. Hartelijk dank voor uw aandacht
• Frank de Vries
• Universiteit Utrecht
• f.devries@uu.nl