Hemolytic uremic syndrome (HUS) is characterized by renal impairment, microangiopathic hemolytic anemia, and thrombocytopenia. It is typically caused by Shiga toxin-producing E. coli (STEC) infection, which can lead to diarrhea and hemorrhagic colitis. The Shiga toxins produced by STEC cause endothelial cell damage leading to microvascular thrombosis in the kidneys and other organs. Children are most at risk, and factors like bloody diarrhea and high white blood cell count increase the risk of HUS following STEC infection. The case report describes a 73-year-old man presenting with nausea, vomiting, diarrhea and abdominal pain who was diagnosed with extensive infectious
Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. It most commonly affects children under 10 and is increasing worldwide. The primary cause is infection by Shiga toxin-producing Escherichia coli, especially E. coli O157:H7. Symptoms include bloody diarrhea and renal impairment. Treatment is supportive with fluid management and dialysis if needed. Antibiotics are not recommended due to increased risk of HUS. Outcomes range from full recovery to chronic renal failure or death in severe cases.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. It is most commonly caused by infections from Shiga toxin-producing bacteria like E. coli O157:H7. The Shiga toxin damages endothelial cells and causes blood clots to form in the kidneys. Treatment involves fluid replacement, dialysis, and plasma exchange to support kidney function and replace lost blood cells. While the prognosis is generally good for typical HUS caused by infection, atypical non-infection related HUS has a worse prognosis.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. It is most commonly caused by infections from Shiga toxin-producing bacteria like E. coli O157:H7. The Shiga toxin damages endothelial cells and causes blood clots to form in the kidneys. Treatment involves fluid replacement, dialysis, and plasma exchange to support kidney function and replace lost blood cells. While HUS prognosis is generally good, some children may have long term kidney damage or rarely die from severe complications.
Bleeding, clotting,platelet disorder and it's managementRakhiYadav53
This document provides information on various bleeding, clotting, and platelet disorders and their nursing management. It discusses hemophilia, disseminated intravascular coagulation (DIC), hypoprothrombinemia, and idiopathic thrombocytopenic purpura. For each disorder, it covers definition, etiology, clinical manifestations, risk factors, diagnostic findings, medical management, complications, and nursing management. Hemophilia is defined as a hereditary coagulation disorder caused by a deficiency in clotting factor VIII or IX. DIC is an abnormal blood clotting response triggered by underlying diseases or conditions that causes clotting throughout the blood vessels. Nursing focuses on pain management, monitoring
The document discusses infections that are of concern in critical care patients. It outlines various community and hospital-acquired infections that patients in the ICU are at risk for, including sepsis, pneumonia, urinary tract infections, and device-associated infections. It also discusses infection control and monitoring in the ICU setting to prevent and properly treat infections and prevent antimicrobial resistance.
This document discusses alterations in hematologic function and childhood malignancies. It covers the following key points:
1. It describes the functions of red blood cells, white blood cells, and platelets and how they differ in children compared to adults.
2. It discusses common pediatric hematologic disorders like sickle cell disease and hemophilia, outlining their pathophysiology, clinical manifestations, diagnosis, and treatment.
3. It provides an overview of childhood cancers, including incidence, causes, signs, diagnostic tests, treatment goals like chemotherapy and bone marrow transplant, and the most common types.
Leukemia is cancer of the blood and bone marrow characterized by an overproduction of immature white blood cells. It is caused by mutations that transform lymphoid or myeloid stem cells. This leads to uncontrolled growth of lymphoblasts or leukemic cells. Symptoms include fatigue, infection, bruising/bleeding due to low blood cell counts. Diagnosis involves blood and bone marrow tests showing leukemic cells. Treatment consists of chemotherapy, blood transfusions, and sometimes stem cell transplant, with nursing focus on preventing infection and bleeding complications.
Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. It most commonly affects children under 10 and is increasing worldwide. The primary cause is infection by Shiga toxin-producing Escherichia coli, especially E. coli O157:H7. Symptoms include bloody diarrhea and renal impairment. Treatment is supportive with fluid management and dialysis if needed. Antibiotics are not recommended due to increased risk of HUS. Outcomes range from full recovery to chronic renal failure or death in severe cases.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. It is most commonly caused by infections from Shiga toxin-producing bacteria like E. coli O157:H7. The Shiga toxin damages endothelial cells and causes blood clots to form in the kidneys. Treatment involves fluid replacement, dialysis, and plasma exchange to support kidney function and replace lost blood cells. While the prognosis is generally good for typical HUS caused by infection, atypical non-infection related HUS has a worse prognosis.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. It is most commonly caused by infections from Shiga toxin-producing bacteria like E. coli O157:H7. The Shiga toxin damages endothelial cells and causes blood clots to form in the kidneys. Treatment involves fluid replacement, dialysis, and plasma exchange to support kidney function and replace lost blood cells. While HUS prognosis is generally good, some children may have long term kidney damage or rarely die from severe complications.
Bleeding, clotting,platelet disorder and it's managementRakhiYadav53
This document provides information on various bleeding, clotting, and platelet disorders and their nursing management. It discusses hemophilia, disseminated intravascular coagulation (DIC), hypoprothrombinemia, and idiopathic thrombocytopenic purpura. For each disorder, it covers definition, etiology, clinical manifestations, risk factors, diagnostic findings, medical management, complications, and nursing management. Hemophilia is defined as a hereditary coagulation disorder caused by a deficiency in clotting factor VIII or IX. DIC is an abnormal blood clotting response triggered by underlying diseases or conditions that causes clotting throughout the blood vessels. Nursing focuses on pain management, monitoring
The document discusses infections that are of concern in critical care patients. It outlines various community and hospital-acquired infections that patients in the ICU are at risk for, including sepsis, pneumonia, urinary tract infections, and device-associated infections. It also discusses infection control and monitoring in the ICU setting to prevent and properly treat infections and prevent antimicrobial resistance.
This document discusses alterations in hematologic function and childhood malignancies. It covers the following key points:
1. It describes the functions of red blood cells, white blood cells, and platelets and how they differ in children compared to adults.
2. It discusses common pediatric hematologic disorders like sickle cell disease and hemophilia, outlining their pathophysiology, clinical manifestations, diagnosis, and treatment.
3. It provides an overview of childhood cancers, including incidence, causes, signs, diagnostic tests, treatment goals like chemotherapy and bone marrow transplant, and the most common types.
Leukemia is cancer of the blood and bone marrow characterized by an overproduction of immature white blood cells. It is caused by mutations that transform lymphoid or myeloid stem cells. This leads to uncontrolled growth of lymphoblasts or leukemic cells. Symptoms include fatigue, infection, bruising/bleeding due to low blood cell counts. Diagnosis involves blood and bone marrow tests showing leukemic cells. Treatment consists of chemotherapy, blood transfusions, and sometimes stem cell transplant, with nursing focus on preventing infection and bleeding complications.
Poststreptococcal acute glomerulonephritis (AGN) is a common condition in childhood caused by a Streptococcus pyogenes infection. It involves an immune response that leads to inflammation of the glomeruli in the kidneys. Symptoms include edema, gross hematuria, hypertension, and acute renal insufficiency. Treatment focuses on controlling blood pressure, restricting fluid and salt intake, and administering antibiotics. While early AGN is often temporary and reversible, chronic glomerulonephritis can lead to permanent kidney damage if not properly managed.
Sickle cell anemia is a genetic blood disorder where red blood cells become misshapen and can clog small blood vessels. It is inherited from both parents and most common in those with African or Mediterranean ancestry. Symptoms include painful episodes, fatigue, infections, and organ damage. Treatment focuses on managing pain, preventing infections, blood transfusions, and for some, medications like hydroxyurea. Complications can include strokes, organ failure, and death if not properly managed.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal injury, most commonly caused by toxin-producing strains of E. coli. The toxins produced by these bacteria damage endothelial cells in the kidneys and other organs, leading to platelet aggregation and thrombosis. This causes fragmentation of red blood cells and kidney dysfunction. HUS diagnosis is based on laboratory findings of hemolytic anemia, low platelet count, and kidney involvement. Treatment is largely supportive through dialysis, blood transfusions, and controlling blood pressure and electrolyte abnormalities. Most patients recover renal function, but some are left with chronic kidney disease.
The document discusses splenectomy, a surgical procedure to remove the spleen. It provides details on preoperative management which involves stabilization of conditions like trauma, hemorrhage, or thrombocytopenia. Postoperative management focuses on preventing respiratory complications, monitoring for hemorrhage and fever, and daily platelet counts. Potential complications include pancreatitis, hemorrhage, infection, and overwhelming postsplenectomy infection. Nursing interventions are aimed at effective breathing, fluid monitoring, thrombosis prevention, infection prevention, and pain relief.
This document provides an overview of sepsis, including its epidemiology, etiology, signs and symptoms, diagnosis, management, and complications. It begins with an introduction defining sepsis as an unbalanced immune response to infection that can damage tissues and organs. It then discusses the typical bacterial causes of sepsis and risk factors. The document presents a case report of a child treated for sepsis and concludes that sepsis can damage multiple organs and in serious cases may require advanced organ support.
This document discusses systemic lupus erythematosus (SLE), also known as lupus. It is an autoimmune disorder where antibodies attack the body's own tissues, causing inflammation. It predominantly affects women aged 12-45. The exact cause is unknown but genetic and environmental factors are involved. Symptoms can include joint and skin issues. Complications can impact the kidneys, brain, blood, lungs and heart. Diagnosis involves blood tests, urine tests, and imaging. Treatment includes medications to reduce inflammation and suppress the immune system like NSAIDs, antimalarials, corticosteroids, and immunosuppressants. Management also involves lifestyle measures and developing a support system.
- Systemic lupus erythematosus (SLE) is an autoimmune disorder where the immune system attacks the body's own tissues, causing inflammation in many organs. It predominantly affects women of childbearing age.
- SLE has a female to male ratio of 9:1. Common symptoms include arthritis, rashes, oral ulcers, and fatigue. Long-term complications can include kidney failure, heart disease, and neurological issues.
- Diagnosis involves blood tests to detect autoantibodies and complement levels. Treatment seeks to reduce inflammation and suppress the immune system using medications like NSAIDs, antimalarials, corticosteroids, and immunosuppressants. Managing SLE requires a healthy
The document discusses hydrops fetalis, which refers to fluid accumulation in fetal tissues. It describes the two main types - immune and non-immune hydrops fetalis. Immune hydrops is caused by maternal-fetal blood group incompatibilities producing antibodies, while non-immune has many potential causes including genetic conditions, infections, cardiac abnormalities, and tumors. The document provides details on mechanisms, risk factors, pathophysiology, diagnostic features, and management approaches for different causes of hydrops fetalis.
Hereditary angioedema (HAE) is a rare disease caused by C1 inhibitor deficiency and characterized by recurrent episodes of non-pruritic swelling in the skin, gastrointestinal tract, and airways. The disease has an autosomal dominant pattern of inheritance and is caused by mutations in the C1 inhibitor gene. Diagnosis involves evaluating family history, symptoms of recurrent non-pitting edema, and laboratory tests showing low C4 and C1 inhibitor levels. Proper diagnosis is important to distinguish it from other causes of angioedema and manage attacks.
- Pancytopenia in neonates is defined as hemoglobin <13g/dl in males and <12g/dl in females, absolute neutrophil count <1500 cells/mm3, and platelet count <150×103 cells/mm3.
- The causes of pancytopenia can be inherited or acquired and include aplastic anemia, myelodysplastic syndrome, infections, medications, and nutritional deficiencies.
- Clinical manifestations include fatigue, infections, bruising, and bleeding. Diagnosis involves blood tests, bone marrow biopsy, and ruling out other causes through differential diagnosis.
- Treatment depends on the underlying cause but may include blood transfusions, medications, managing infections, and stem
This document discusses the approach to diagnosing and treating histiocytosis syndromes in childhood. It is a diverse group of disorders involving an abnormal proliferation of histiocytes (monocyte-macrophage cells). The main types discussed are Langerhans cell histiocytosis (LCH), hemophagocytic lymphohistiocytosis (HLH), and reactive histiocytosis. LCH is characterized by Langerhans cells with Birbeck granules, while HLH involves an uncontrolled activation of macrophages and T-cells. Diagnosis involves biopsy and immunochemistry. Treatment depends on risk stratification and number of organ systems involved, ranging from monitoring to chemotherapy. Long-term follow-up is important due to the disease
Hematology oncology-nurs 3340 fall 2017Shepard Joy
This document outlines learning outcomes and content related to alterations in hematologic function and childhood malignancies. It begins by describing the functions of red blood cells, white blood cells, and platelets. It then discusses differences in pediatric hematopoiesis compared to adults. Specific topics covered include anemia, sickle cell disease, hemophilia, and childhood cancers. Nursing care is discussed for conditions such as vaso-occlusive crises, bleeding episodes, and cancer diagnosis and treatment.
This document discusses peptic ulcers, including acute stress ulcers and chronic gastric and duodenal ulcers. It covers the etiology, pathogenesis, incidence, and complications of peptic ulcers. The main causes of acute stress ulcers are severe physiological stress, while chronic ulcers are caused by factors like H. pylori infection, NSAID use, and acid-pepsin secretions. Complications of peptic ulcers include obstruction from scarring, hemorrhage from eroded blood vessels, and perforation of the stomach or duodenal wall.
The spleen filters blood and mounts immune responses. It produces blood cells before birth but later filters out old red blood cells and mounts immune responses via white pulp and macrophages in red pulp. Congenital asplenia or splenectomy reduce immunity. Hyposplenism results in slower adaptive immunity and increased infection risk like overwhelming sepsis from pneumococcus. Diagnosis examines anatomy and function via imaging and blood smears. Complications include lifelong risk of sepsis.
The liver is commonly injured in abdominal trauma, with blunt injuries more frequent than penetrating injuries. Liver trauma can cause contusions, lacerations, or avulsions. Management involves addressing associated injuries, resuscitation, injury assessment with imaging, and treatment such as correcting coagulopathy, suturing lacerations, or resection for major vascular injuries. Complications include hematoma, abscess, bile collections, or fistulas.
approach to a bleeding child with blood disorders.pptxtsholanangmaoka
This document describes the approach to three cases of bleeding in children. Case 1 involves a 5-month-old male with intracranial bleeding and seizures who was found to have a subdural hematoma requiring surgery. Despite resuscitation efforts, the child did not survive the surgery. Case 2 is a 2-year-old male with bruising and a very low platelet count, consistent with thrombocytopenia. Case 3 involves a 1-year-old male with knee swelling and fever, who was found to have a low platelet count, consistent with disseminated intravascular coagulation. The document provides definitions of types of bleeding, the stages of hemostasis, differential diagnoses, and management strategies for bleeding
NON HODGKIN LYMPHOMA by Veronica Kanick, Resident paediatricsVeronica Kaniki
This document summarizes a case of Burkitt lymphoma in a 6-year-old female patient presenting with abdominal swelling and left jaw swelling. Key findings included abdominal masses, ascites, and a left jaw mass. Biopsy results confirmed Burkitt lymphoma. The patient received chemotherapy and was discharged with improvement of symptoms. The document also provides a literature review on non-Hodgkin lymphoma subtypes, epidemiology, risk factors, pathogenesis, clinical presentation, diagnosis, and treatment approaches.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
Are you looking for a long-lasting solution to your missing tooth?
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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Poststreptococcal acute glomerulonephritis (AGN) is a common condition in childhood caused by a Streptococcus pyogenes infection. It involves an immune response that leads to inflammation of the glomeruli in the kidneys. Symptoms include edema, gross hematuria, hypertension, and acute renal insufficiency. Treatment focuses on controlling blood pressure, restricting fluid and salt intake, and administering antibiotics. While early AGN is often temporary and reversible, chronic glomerulonephritis can lead to permanent kidney damage if not properly managed.
Sickle cell anemia is a genetic blood disorder where red blood cells become misshapen and can clog small blood vessels. It is inherited from both parents and most common in those with African or Mediterranean ancestry. Symptoms include painful episodes, fatigue, infections, and organ damage. Treatment focuses on managing pain, preventing infections, blood transfusions, and for some, medications like hydroxyurea. Complications can include strokes, organ failure, and death if not properly managed.
Hemolytic uremic syndrome (HUS) is a disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal injury, most commonly caused by toxin-producing strains of E. coli. The toxins produced by these bacteria damage endothelial cells in the kidneys and other organs, leading to platelet aggregation and thrombosis. This causes fragmentation of red blood cells and kidney dysfunction. HUS diagnosis is based on laboratory findings of hemolytic anemia, low platelet count, and kidney involvement. Treatment is largely supportive through dialysis, blood transfusions, and controlling blood pressure and electrolyte abnormalities. Most patients recover renal function, but some are left with chronic kidney disease.
The document discusses splenectomy, a surgical procedure to remove the spleen. It provides details on preoperative management which involves stabilization of conditions like trauma, hemorrhage, or thrombocytopenia. Postoperative management focuses on preventing respiratory complications, monitoring for hemorrhage and fever, and daily platelet counts. Potential complications include pancreatitis, hemorrhage, infection, and overwhelming postsplenectomy infection. Nursing interventions are aimed at effective breathing, fluid monitoring, thrombosis prevention, infection prevention, and pain relief.
This document provides an overview of sepsis, including its epidemiology, etiology, signs and symptoms, diagnosis, management, and complications. It begins with an introduction defining sepsis as an unbalanced immune response to infection that can damage tissues and organs. It then discusses the typical bacterial causes of sepsis and risk factors. The document presents a case report of a child treated for sepsis and concludes that sepsis can damage multiple organs and in serious cases may require advanced organ support.
This document discusses systemic lupus erythematosus (SLE), also known as lupus. It is an autoimmune disorder where antibodies attack the body's own tissues, causing inflammation. It predominantly affects women aged 12-45. The exact cause is unknown but genetic and environmental factors are involved. Symptoms can include joint and skin issues. Complications can impact the kidneys, brain, blood, lungs and heart. Diagnosis involves blood tests, urine tests, and imaging. Treatment includes medications to reduce inflammation and suppress the immune system like NSAIDs, antimalarials, corticosteroids, and immunosuppressants. Management also involves lifestyle measures and developing a support system.
- Systemic lupus erythematosus (SLE) is an autoimmune disorder where the immune system attacks the body's own tissues, causing inflammation in many organs. It predominantly affects women of childbearing age.
- SLE has a female to male ratio of 9:1. Common symptoms include arthritis, rashes, oral ulcers, and fatigue. Long-term complications can include kidney failure, heart disease, and neurological issues.
- Diagnosis involves blood tests to detect autoantibodies and complement levels. Treatment seeks to reduce inflammation and suppress the immune system using medications like NSAIDs, antimalarials, corticosteroids, and immunosuppressants. Managing SLE requires a healthy
The document discusses hydrops fetalis, which refers to fluid accumulation in fetal tissues. It describes the two main types - immune and non-immune hydrops fetalis. Immune hydrops is caused by maternal-fetal blood group incompatibilities producing antibodies, while non-immune has many potential causes including genetic conditions, infections, cardiac abnormalities, and tumors. The document provides details on mechanisms, risk factors, pathophysiology, diagnostic features, and management approaches for different causes of hydrops fetalis.
Hereditary angioedema (HAE) is a rare disease caused by C1 inhibitor deficiency and characterized by recurrent episodes of non-pruritic swelling in the skin, gastrointestinal tract, and airways. The disease has an autosomal dominant pattern of inheritance and is caused by mutations in the C1 inhibitor gene. Diagnosis involves evaluating family history, symptoms of recurrent non-pitting edema, and laboratory tests showing low C4 and C1 inhibitor levels. Proper diagnosis is important to distinguish it from other causes of angioedema and manage attacks.
- Pancytopenia in neonates is defined as hemoglobin <13g/dl in males and <12g/dl in females, absolute neutrophil count <1500 cells/mm3, and platelet count <150×103 cells/mm3.
- The causes of pancytopenia can be inherited or acquired and include aplastic anemia, myelodysplastic syndrome, infections, medications, and nutritional deficiencies.
- Clinical manifestations include fatigue, infections, bruising, and bleeding. Diagnosis involves blood tests, bone marrow biopsy, and ruling out other causes through differential diagnosis.
- Treatment depends on the underlying cause but may include blood transfusions, medications, managing infections, and stem
This document discusses the approach to diagnosing and treating histiocytosis syndromes in childhood. It is a diverse group of disorders involving an abnormal proliferation of histiocytes (monocyte-macrophage cells). The main types discussed are Langerhans cell histiocytosis (LCH), hemophagocytic lymphohistiocytosis (HLH), and reactive histiocytosis. LCH is characterized by Langerhans cells with Birbeck granules, while HLH involves an uncontrolled activation of macrophages and T-cells. Diagnosis involves biopsy and immunochemistry. Treatment depends on risk stratification and number of organ systems involved, ranging from monitoring to chemotherapy. Long-term follow-up is important due to the disease
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This document outlines learning outcomes and content related to alterations in hematologic function and childhood malignancies. It begins by describing the functions of red blood cells, white blood cells, and platelets. It then discusses differences in pediatric hematopoiesis compared to adults. Specific topics covered include anemia, sickle cell disease, hemophilia, and childhood cancers. Nursing care is discussed for conditions such as vaso-occlusive crises, bleeding episodes, and cancer diagnosis and treatment.
This document discusses peptic ulcers, including acute stress ulcers and chronic gastric and duodenal ulcers. It covers the etiology, pathogenesis, incidence, and complications of peptic ulcers. The main causes of acute stress ulcers are severe physiological stress, while chronic ulcers are caused by factors like H. pylori infection, NSAID use, and acid-pepsin secretions. Complications of peptic ulcers include obstruction from scarring, hemorrhage from eroded blood vessels, and perforation of the stomach or duodenal wall.
The spleen filters blood and mounts immune responses. It produces blood cells before birth but later filters out old red blood cells and mounts immune responses via white pulp and macrophages in red pulp. Congenital asplenia or splenectomy reduce immunity. Hyposplenism results in slower adaptive immunity and increased infection risk like overwhelming sepsis from pneumococcus. Diagnosis examines anatomy and function via imaging and blood smears. Complications include lifelong risk of sepsis.
The liver is commonly injured in abdominal trauma, with blunt injuries more frequent than penetrating injuries. Liver trauma can cause contusions, lacerations, or avulsions. Management involves addressing associated injuries, resuscitation, injury assessment with imaging, and treatment such as correcting coagulopathy, suturing lacerations, or resection for major vascular injuries. Complications include hematoma, abscess, bile collections, or fistulas.
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This document describes the approach to three cases of bleeding in children. Case 1 involves a 5-month-old male with intracranial bleeding and seizures who was found to have a subdural hematoma requiring surgery. Despite resuscitation efforts, the child did not survive the surgery. Case 2 is a 2-year-old male with bruising and a very low platelet count, consistent with thrombocytopenia. Case 3 involves a 1-year-old male with knee swelling and fever, who was found to have a low platelet count, consistent with disseminated intravascular coagulation. The document provides definitions of types of bleeding, the stages of hemostasis, differential diagnoses, and management strategies for bleeding
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This document summarizes a case of Burkitt lymphoma in a 6-year-old female patient presenting with abdominal swelling and left jaw swelling. Key findings included abdominal masses, ascites, and a left jaw mass. Biopsy results confirmed Burkitt lymphoma. The patient received chemotherapy and was discharged with improvement of symptoms. The document also provides a literature review on non-Hodgkin lymphoma subtypes, epidemiology, risk factors, pathogenesis, clinical presentation, diagnosis, and treatment approaches.
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PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
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.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
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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.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
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- Shiga toxin-producing E. coli 0157:H7
- Nonenteric infections (especially Streptococcus
pneumoniae)
- Malignancies, pregnancy, transplantation, anticancer
molecules, immunosuppressive agents, and antiplatelet
agents.
Triggers of HUS include :
CHAPTER 37 Gastrointestinal and Hepatic Manifestations of Systemic Diseases 5. PART IV Topics Involving Multiple Organs.
Sleisenger_and_Fordtran's_Gastrointestinal_and_Liver_Disease_11th.pdf.
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CHAPTER 110 Infectious Enteritis and Proctocolitis. PART X Small and Large Intestine. Sleisenger_and_Fordtran's_Gastrointestinal_and_Liver_Disease_11th.pdf.
Shiga toxin 2 is more potent and
much more frequently associated
with severe human disease
(bloody diarrhea and HUS risk)
than Shiga toxin.
STEC that do not contain a gene
encoding Shiga toxin 2 rarely, if
ever, cause HUS.
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● It was named the enterohemorrhagic E. coli.
● In 2017, FoodNet suggested STEC infections increased by 28% compared with 2014
to 2016.
● In Latin America, E. coli 0157:H7 remains the predominant strain (>70 percent).
● The incidence of STEC-HUS in Latin America remains ten times higher than in
other continents.
In 1982, a new outbreak of acute
hemorrhagic colitis emerged in
Michigan and Ohio
https://www.uptodate.com/contents/treatment-and-prognosis-of-shiga-toxin-producing-escherichia-coli-stec-hemolytic-uremic-syndrome-hus-ichildren
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● Transmission -> fecal-oral route.
● Children are predominantly involved.
● Incubation period of 3 days
○ Abdominal cramps, nausea, vomiting, fever or chills, and diarrhea
that becomes hemorrhagic in 70% of cases.
● The median duration of diarrhea is 3 to 8 days,
Shiga toxin-producing E. coli (STEC)
0157:H7 Infection
CHAPTER 37 Gastrointestinal and Hepatic Manifestations of Systemic Diseases 5. PART IV Topics Involving Multiple Organs.
Sleisenger_and_Fordtran's_Gastrointestinal_and_Liver_Disease_11th.pdf.
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Typical clinical course of Escherichia coli O157:H7
infections
Risk factors for HUS:
- Age less than 5 years
- Attendance at a large day care
center
- Presence of bloody diarrhea
- High WBC count.
https://www.uptodate.com/contents/treatment-and-prognosis-of-shiga-toxin-producing-escherichia-coli-stec-hemolytic-uremic-syndrome-hus-ichildren
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● Transport of Shiga toxins to the submucosa, with binding to endothelial cells.
○ Microvascular damage
○ Platelet aggregation
○ Microvascular fibrin thrombi
○ Clinical and histologic picture that resembles ischemic colitis.
● Shiga toxins bind to PMNs and circulate to other organs such as the kidneys,
causing direct damage to kidney epithelial cells (podocytes and tubular cells),
kidney mesangial cells, and vascular endothelial cells.
Physiopathology
CHAPTER 110 Infectious Enteritis and Proctocolitis. PART X Small and Large Intestine. Sleisenger_and_Fordtran's_Gastrointestinal_and_Liver_Disease_11th.pdf.
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● Peripheral blood smear with a large number of schistocytes
and helmet cells.
● Elevation of the serum indirect bilirubin concentration.
● Reduction in the serum haptoglobin concentration.
● Elevation of the serum lactate dehydrogenase (LDH) levels.
Diagnosis (HUS)
https://www.uptodate.com/contents/treatment-and-prognosis-of-shiga-toxin-producing-escherichia-coli-stec-hemolytic-uremic-syndrome-hus-ichildren
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● CDC recommends a combination of culture for O157 STEC and a nonculture
Stx assay.
● Because most isolates of E. coli O157:H7 do not ferment sorbitol, screening
for this pathogen usually is done with sorbitol-MacConkey agar.
● Shiga toxin protein assay.
● DNA testing for Shiga toxin genes may be done using polymerase chain
reaction (PCR) to amplify Shiga toxin genes (STX1 and STX2).
Diagnosis (STEC)
Thrombotic microangiopathies (TMAs) with acute kidney injury (AKI) in adults: CM-TMA and ST-HUS. Uptodate. https://www.uptodate.com/contents/thrombotic-microangiopathies-tmas-with-acute-
kidney-injury-aki-in-adults-cm-tma-and-st-hus?search=sindrome%20hemolitico%20uremico%20en%20adultoss&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
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CT-patterns of mural enhancement in patients with
bowel wall thickening.
https://radiologyassistant.nl/abdomen/bowel/bowel-wall-thickening-ct-pattern#type-3-water-target-sign-infectious-colitis
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Treatment
● The risk of HUS is increased by antimicrobial therapy.
● The use of ST-HUS implies that recovery will occur spontaneously.
● Supportive cares involve hydration and transfusion for severe anemia.
● Renal replacement therapy is frequently required in the acute phase
and chronic kidney disease may result in some.
● Transfusion of platelets when a patient with a platelet count of
<50,000/microL requires an invasive procedure or has clinically
important bleeding.
https://www.uptodate.com/contents/treatment-and-prognosis-of-shiga-toxin-producing-escherichia-coli-stec-hemolytic-uremic-syndrome-hus-ichildren
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The subjects who received antibiotics were also
more likely to develop HUS (24% vs 8%)
Exposures to antibiotics within the first week of
illness also tripled the risk of developing HUS (aOR
3.62; 95% CI, 1.23–10.6; P = .02; Table 4).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493180/
Exposure to trimethoprim-sulfamethoxazole or metronidazole
was each statistically significantly associated with HUS.
Wong CS, Mooney JC, Brandt JR, Staples AO, Jelacic S, Boster DR, Watkins SL, Tarr PI. Risk factors for the hemolytic uremic syndrome in children infected with Escherichia coli O157:H7: a multivariable analysis. Clin Infect Dis.
2012 Jul;55(1):33-41. doi: 10.1093/cid/cis299.
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Preventive measures.
● Cooking of ground beef, avoiding unpasteurized fruit
juices, and hand hygiene if contact with farm animals
occurs (e.g., state or county fairs).
https://www.uptodate.com/contents/shiga-toxin-producing-escherichia-coli-microbiology-pathogenesis-epidemiology-and-prevention?sectionName=Transmission&search=sindrome%20hemolitico%20uremico%20en%20adultoss
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Clinical Case
Masculine 73 y/o
Past Medical History: hypothyroidism, rectal abscess
and rectocutaneous fistula treated (02/2019).
Chief Complaint: Nausea, vomiting and diarrhea >10
episodes/ day. Abdominal pain. Started 3 days ago.
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● HEENT: normocephalic and atraumatic without tenderness, visible or palpable masses,
depressions, or scarring. Hair is of normal texture and evenly distributed. Conjunctivae are clear
without exudates or hemorrhage. Sclera is non-icteric. No signs of nystagmus. Eyelids are normal
in appearance without swelling or lesions. External ear and ear canal are non-tender and without
swelling. Nares are patent bilaterally. Oral mucosa appears dehydrated. Tongue normal in
appearance without lesions and with good symmetrical movement. No buccal nodules or lesions
are noted. The pharynx is normal in appearance without tonsillar swelling or exudates. The neck
is supple without adenopathy. Trachea is midline. Carotid pulse 2+ bilaterally without bruit. No
JVD.
● Cardiac: The external chest is normal in appearance without lifts, heaves, or thrills. PMI is not
visible and is palpated in the 5th intercostal space at the midclavicular line. Heart rate and rhythm
are normal. No murmurs, gallops, or rubs are auscultated. S1 and S2 are heard and are of
normal intensity.
● Respiratory: The chest wall is symmetric and without deformity. No signs of trauma. Chest wall
is non-tender. No signs of respiratory distress. Lung sounds are clear in all lobes bilaterally
without rales, ronchi, or wheezes. Resonance is normal upon percussion of all lung fields.
VITAL SIGNS BP 120/80mmHg Pulse 90 bpm RR 16 O2: 99% T 37.1C
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● Abdominal: Abdomen is soft, symmetric, presence of distention and tenderness to
palpation in hypogastric and left lumbar region. There are no visible lesions or scars. The
aorta is midline without bruit or visible pulsation. Umbilicus is midline without herniation. Bowel
sounds are present and normoactive in all four quadrants. No masses, hepatomegaly, or
splenomegaly are noted.
● Genital/Rectal: Normal rectal sphincter tone. No external masses or lesions. Stool is watery
and with presence of red blood striae. Genitalia: normal.
● Extremities: Upper and lower extremities are atraumatic in appearance without tenderness or
deformity. No swelling or erythema. Full range of motion is noted to all joints. Muscle strength is
5/5 bilaterally. Tendon function is normal. Capillary refill is less than 3 seconds in all extremities.
Pulses palpable. Steady gait noted.
● Neurological: The patient is awake, alert and oriented to person, place, and time with normal
speech. Motor function is normal with muscle strength 5/5 bilaterally to upper and lower
extremities. Sensation is intact bilaterally. Reflexes 2+ bilaterally. Cranial nerves are intact.
Cerebellar function is intact. Memory is normal and thought process is intact. No gait
abnormalities are appreciated.
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ABDOMINAL AND PELVIC CT
Importante edema de toda la
mucosa del colon, con
múltiples dilataciones
diverticulares, en relación a
Colitis extensa. Datos de
Colelitiasis Crónica.
Aortoesclerosis.`
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- GEA SECUNDARIA A INFECCION
POR ENTAMOEBA HYSTGOLITICA Y
E. DIPAR RESUELTA
- COLITIS INFECCIOSA EXTENSA
SECUNDARIA A E. COLI – STEC
RESUELTA
- AKIN PB PRERENAL VS
SECUNDARIO A MICROANGIOPATIA
TROMBOTICA POR SHU INCIPIENTE
RESUELTO.
Shiga toxin-producing E. coli 0157:H7 accounts for the majority of cases of HUS.
E Coli ENTEROPATOGENICA EPEC / ENTEROTOXIGENICA ETEC / ENTEROINVASIVA EIEC / ENTEROAGREGATIVA / enteroadherente DIFUSA / Y LA TOXINA SHIGA.
typically classified as O157 and non-O157 with O157 classically associated with the HUS, although non-O157 strains also can trigger HUS.
Toxinas shiga 1y 2.
- Productora de una verotoxina.
Metodos dx moleculares.
STEC remains less common than Campylobacter, Salmonella, and Shigella.
- Undercooked hamburger is the most common vector, with other foods (e.g., apple juice, lettuce) also implicated. Consumo de Agua Contaminada.
The leading vehicle of infection for STEC is hamburger meat, although outbreaks have been associated with fresh-pressed apple cider, produce, and unpasteurized milk.
Uptodate bibliografia
Uptodate bibliografia
QUE MAS NOS PUEDE AYUDAR AL DX, APARTE DEL HHCTO PLAQ Y CR.?
Ddx con Coag Intrtavasc Diseminada.
DIC typically have thrombocytopenia, elevated D-dimer, normal haptoglobin levels, low circulating levels of fibrinogen and factors V and VIII, and prolongation of the prothrombin and partial thromboplastin times (PT and aPTT, respectively), which is not generally seen in patients with HUS
INFECCION
Within 2 days of onset, virtually all stool specimens from O157-infected patients are positive, whereas after 7 days, only one third are positive.
CT-patterns of mural enhancement in patients with bowel wall thickening.
CT shows colonic wall thickening, often with a target sign and pericolonic stranding
It appears that maintaining adequate hydration may be reduce the risk of STEC-HUS.
259 subjects con clinica y ecoli + de los cuales , 36 (14%) developed HUS. 5 estados.
Esstos , diferencian entre bacteriostaticos y bactericidas. Liberan toxinas. El tipo de cepa.
Desshidratado, con Mala tolerancia oral, >15 evacuaciones al día sanguinolentas.
Se ingresa con medidas generales. Hidratacion ev, Metronidazol, ondansetron, sertal.
Luego de 36-48hr de ingressado por persistencia de la clinica. Asi como aumento de la distension abdominal, disminucion de la persistalsis, se decide realizar Panel GI y TC de abdomen contrastada.
Luego de 36hr de ingressado por persistencia de la clinica. Asi como aumento de la distension abdominal, disminucion de la persistalsis, se decide realizar Panel GI y TC de abdomen contrastada.
Se decide…
IC NEFROLOGIA E INFECTOLOGIA.
Continuaba aSX, menos dolor abdominal, negaba nauseas,