This document discusses the superior vena cava syndrome (SVCS), which results from obstruction of the superior vena cava that decreases venous return from the upper extremities. SVCS most often has malignant causes such as lung cancer or lymphomas. It presents with facial edema, cyanosis, and visible collateral circulation. Diagnosis involves imaging like CT or MRI. Treatment depends on the cause but may include diuretics, steroids, radiation, or surgery to relieve obstruction in benign cases. Prognosis is typically poor at 6 months for malignant causes.
La sociedad de Fleischner define el patrón en vidrio deslustrado, ¨como un vago aumento de la densidad pulmonar, generalmente extenso, cuyo en su interior, los vasos pulmonares aparecen mal definidos¨ en el caso del Rx de tórax y ¨ como un vago aumento de la densidad pulmonar, generalmente extenso, cuyo en su interior, existen preservación de los márgenes de los vasos pulmonares y bronquios¨ para la TAC de tórax, siendo este patrón menos opaco que la consolidación alveolar.
Los Nódulos del tiroides es una entidad diagnóstica frecuente tanto como nódulos palpables como incidentalomas ,el problema mas importante es descartar la presencia de un cancer del tiroides ,aquí algunos alcances para su diagnóstico y tratamiento .
Conjunto de datos detectables en la radiografía de tórax simple y tomografía de tórax, comunes a un grupo de enfermedades.
Desarrollar el hábito de identificar patrones
Desarrollar Diagnostico diferencial moderadamente amplio
Reducirlo:
Análisis cuidadoso de la Radiografía.
Patrones evolutivos (Rx anteriores).
Correlación con clínica y laboratorio.
La sociedad de Fleischner define el patrón en vidrio deslustrado, ¨como un vago aumento de la densidad pulmonar, generalmente extenso, cuyo en su interior, los vasos pulmonares aparecen mal definidos¨ en el caso del Rx de tórax y ¨ como un vago aumento de la densidad pulmonar, generalmente extenso, cuyo en su interior, existen preservación de los márgenes de los vasos pulmonares y bronquios¨ para la TAC de tórax, siendo este patrón menos opaco que la consolidación alveolar.
Los Nódulos del tiroides es una entidad diagnóstica frecuente tanto como nódulos palpables como incidentalomas ,el problema mas importante es descartar la presencia de un cancer del tiroides ,aquí algunos alcances para su diagnóstico y tratamiento .
Conjunto de datos detectables en la radiografía de tórax simple y tomografía de tórax, comunes a un grupo de enfermedades.
Desarrollar el hábito de identificar patrones
Desarrollar Diagnostico diferencial moderadamente amplio
Reducirlo:
Análisis cuidadoso de la Radiografía.
Patrones evolutivos (Rx anteriores).
Correlación con clínica y laboratorio.
Los tumores hipofisiarios constituyen del 10 al 15% de las neoplasias intracraneales
Adenomas pequeños incidentales ocurren en hasta el 27% de las glándulas hipofisis examinadas en autopsia
Hasta un quinto de la población presenta anormalidades hipofisiarias en los estudios de RMN
SI DESCARGAS:BAJO LAS DIAPOSITIVAS VERAS NOTAS EXPLICATIVAS QUE FACILITARAN LS COMPRENSIÓN DEL TEMA
semiologia de cuello: inspección, palpación, auscultación y percusión ; signos y maniobras semiologicas
Los tumores hipofisiarios constituyen del 10 al 15% de las neoplasias intracraneales
Adenomas pequeños incidentales ocurren en hasta el 27% de las glándulas hipofisis examinadas en autopsia
Hasta un quinto de la población presenta anormalidades hipofisiarias en los estudios de RMN
SI DESCARGAS:BAJO LAS DIAPOSITIVAS VERAS NOTAS EXPLICATIVAS QUE FACILITARAN LS COMPRENSIÓN DEL TEMA
semiologia de cuello: inspección, palpación, auscultación y percusión ; signos y maniobras semiologicas
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Pneumonia
Lung Masses
Pulmonary Nodules
Hilar Lymphadenopathy
Aorto-enteric Fistula
Diaphragmatic Hernia
Intra-aortic Balloon Pump
Pacemaker
Impella
Case Series: Mediastinal Mass Misdiagnosed As Extra Pulmonary Tuberculosisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Should C2 Disease Classification Be Broken Down Further? Who Progresses to C4?Vein Global
By: Nick Morrison, MD, FACS, FACPh, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: September CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Aortic Transection
• Hemothorax
• Innominate Artery Transection
• Dextrocardia
• Situs Inversus
• Pneumonia
• Complete Lung Consolidation
• Septic Pulmonary Emboli
• Pulmonary Metastases
• Pneumothorax
Cholangiocarcinoma: Pathology, diagnosis and treatment.Marco Castillo
A brief description with many abdominal imaging of the Cholangiocarcinoma.
Includes definition, epidemiology, pathology, classification, clinical presentation, diagnosis, staging and treatment.
Drs. Escobar, Pikus, and Blackwell’s CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Daniel Escobar, Angela Pikus, and Alex Blackwell are Emergency Medicine Residents and interested in medical education. Lauren Ramsey, PA-C works with the Sanger Heart & Vascular Institute. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Atrial Myxoma
- Cardiac Lymphoma
- Small Cell Lung Cancer
- Metastatic Cervical Squamous Carcinoma
- Spontaneous Pneumothorax
Transfixant Injuries of the Mediastinum Always a Challengeijtsrd
Transfixant injuries of the mediastinum are those in which the aggressor object travels through the midline of the thorax, where the mediastinum is located, being associated with high morbidity and mortality. This review of the literature addressed several aspects of the theme, including diagnosis and treatment. A search was carried out in Pubmed, Scopus and Scielo databases, using indexed descriptors and selection of articles by peers. Mortality rates from 20 to 87 among the victims of this injury modality were observed, varying due to the proportion of unstable patients. In patients undergoing thoracotomy resuscitation, mortality rates between 85 100 . The treatment consisted of maintaining the patients hemodynamic status, so that patients with imminent death in the emergency service should undergo resuscitation thoracotomy, unstable patients should undergo emergency thoracotomy After a brief clinical diagnostic evaluation, while stable patients benefit from further investigation and in up to 60 of the cases, do not require a surgical approach. It was concluded, therefore, that such lesions are associated with high morbidity and mortality, and their approach differs according to the patients hemodynamic profile in the emergency room. Emergency services should be prepared to meet this new patient profile, which arrives at prompt care with severe injuries and increasingly critical clinical conditions. Wysterlânyo Kayo Pereira Barros | Isadora Priscila De Oliveira Sizenando | Tâmara Azevedo De Medeiros | Thomas Di Nardi Medeiros | Wagner Gomes Da Nóbrega Silva | Amália Cinthia Meneses Rêgo | Irami Araújo-Filho "Transfixant Injuries of the Mediastinum: Always a Challenge" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd25224.pdfPaper URL: https://www.ijtsrd.com/medicine/surgery/25224/transfixant-injuries-of-the-mediastinum-always-a-challenge/wysterl%C3%A2nyo-kayo-pereira-barros
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
1. Por: Grace Guadalupe
Ochoa Gameros
Universidad de Guadalajara
Centro Universitario de Ciencias de la Salud
Clínicas médicas
Síndrome de vena cava
superior
Síndrome de vena cava
superior
3. En vena cava proximal
Sx menos pronunciado, gracias a que el sistema
venoso de la ácigos reduce presión venosa superior
del cuerpo.
Circulación colateral: en las venas mamarias internas
y costoaxilares, visible la distensión de la vena
yugular derecha.
Altura de la obstrucción
Vena cava distal
El cuadro clínico es más evidente, ya que el retorno
venoso es a través de las venas abdominales sup y la
VCI con una mayor presión venosa,
Circulación colateral: toracoabdominal visible, y en
casos más graves, edema de miembros inferiores e
incluso ascitis.
4. Definición
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios de Medicina Interna (20 Ed.) Vol. 2.
Es un cuadro clínico que resulta
de la obstrucción de la vena cava
superior que se manifiesta por
una disminución intensa del
retorno venoso procedente de
las extremidades superiores
5. Epidemiología
❖ En México, de 458 pacientes con tumores de mediastino, 84 px
(18%) tuvieron SVCS y 80 de éstos la causa del sx fue un tumor
maligno
❖ El 87-97% de los px con SVCS tienen tumores malignos (+
frecuentes de pulmón y linfomas)
❖ Un 3% de todos los pacientes con Ca de pulmón van a desarrollar
este Sx
❖ Causas malignas, un 65-80% son secundarias a Ca de pulmón, un
20% a tumores mediastinales y el 5% restante a metástasis sólidas
Ibarra PC, Kelly GJ, Fernández CM. Guía diagnóstico-terapéutica: tumores y masas del mediastino. Rev Inst Nal Enf Resp Mex;14(3):172-177.
6. Etiología
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios de Medicina Interna (20 Ed.) Vol. 2.
Causas intrínsecas
• Trombosis de la VCS
Causas extrínsecas
• Masa localizada en el mediastino: adenopatías
paratraqueales derechas, linfomas, timomas,
neoplasias, procesos inflamatorios o un aneurisma
de aorta.
7. Etiología
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios de Medicina Interna (20 Ed.) Vol. 2.
Causas malignas
• Cáncer de pulmón, linfomas no Hodgkin,
lesiones metastásicas ganglionares de
otros tumores
Causas no malignas
• Trombosis por dispositivos IV
• Fibrosis mediastínica
• Tumores benignos
• Miscelánea
8. Manifestaciones clínicas
Munné, M. Reina, I (2013) Sindrome de la vena cava superior. Sociedad Española de Medicina de Familia y Comunitaria.
Cuadro clínico progresivo en unas semanas.
Síntoma más frecuente y precoz es la disnea,
seguida de la tríada clásica:
edema en esclavina
cianosis facial
circulación colateral
Signo de Boterman, puede acompañar el cuadro.
Aumento de la cianosis, del edema facial y de la
congestión cefálica al elevar los brazos por encima
de la cabeza,
9. Manifestaciones clínicas
Munné, M. Reina, I (2013) Sindrome de la vena cava superior. Sociedad Española de Medicina de Familia y Comunitaria.
Según la localización
• Edema de la cabeza, el cuello y los brazos
• Compromiso funcional de la laringe y la faringe, que se
manifiesta con tos, ronquera, disnea, estridor, disfagia,
dolor torácico y en ocasiones, hemoptisis.
• Si existe edema cerebral, aparecerá cefalea, confusión y
coma. El edema de la papila se manifestará con visión
borrosa e inyección conjuntival.
• Compromiso hemodinámico por disminución del
retorno venoso
Síntomas empeoran al inclinarse hacia delante o al
tumbarse,
10. Manifestaciones clínicas
Munné, M. Reina, I (2013) Sindrome de la vena cava superior. Sociedad Española de Medicina de Familia y Comunitaria.
11. Diagnóstico
Baltazar B (2018) Síndrome de la vena cava superior: diagnóstico y tratamiento. Med. interna Méx. vol.34 no.3 Ciudad de México .
Causa benigna vs maligna
Paciente de 49 años con SVCS
benigno por aneurisma de
vena subclavia derecha
secundario a colocación de
catéter (Mahurkar®
) de
hemodiálisis.
12. Diagnóstico
Baltazar B (2018) Síndrome de la vena cava superior: diagnóstico y tratamiento. Med. interna Méx. vol.34 no.3 Ciudad de México .
Tomografía de tórax
contrastada de una
paciente de 62 años
de edad con timoma
epitelioide.
13. Otros diagnósticos
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios de Medicina Interna (20 Ed.) Vol. 2.
o RM: px alérgicos, ERC, 🚫 UV
o Broncoscopia, biopsia percutánea,
mediastinoscopia, toracotomía
o Se puede corroborar con aguja guiada
por ecografía endobronquial o
esofágica.
o Venografía y ecografía doppler
14. Clasificación por gravedad
Munné, M. Reina, I (2013) Sindrome de la vena cava superior. Sociedad Española de Medicina de Familia y Comunitaria.
15.
16. Facie venosa
• Consecuencia del Sx de la vena cava superior
• Se caracteriza por:
Rostro vultuoso, cianótico, turgencia de las venas
frontales del cuello, gran número de
telangiectasias pletóricas de la nariz y pómulos,
edema facial, cuello y parte sup del tronco
Camacho, E(2013)Examen Clínico, Propedéutica, Semiología y Metodología diagnóstica, Editorial En buen plan, Colima, México
17. Tratamiento
• Los diuréticos + alimentación con poca sal,
elevación de la cabeza
• Los glucocorticoides quizá sean útiles para
disminuir el volumen de las masas del
linfoma
• La radioterapia es el tratamiento básico en
el SVCS debido a un Ca pulmonar
• Con la cx se obtiene alivio inmediato en
pacientes con un cuadro benigno de origen
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios de Medicina Interna (20 Ed.) Vol. 2.
18. Pronóstico
La esperanza media: 6 meses
La supervivencia asociada a las causas malignas
no difiere significativamente de la de los
pacientes con el mismo tipo de tumor y grado,
pero sin SVCS.
Este recurre en un 10-30% de los pacientes.
19. Bibliografía
Baltazar B (2018) Síndrome de la vena cava superior: diagnóstico y tratamiento. Med.
interna Méx. vol.34 no.3 Ciudad de México
Alvarado E (2014) Sindrome de vena cava superior: una emergencia medica quirúrgica.
Revista Clinica de la Escuela de Medicina
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (2018) Harrison-Principios
de Medicina Interna (20 Ed.) Vol. 2
Munné, M. Reina, I (2013) Sindrome de la vena cava superior. Sociedad Española de
Medicina de Familia y Comunitaria.
20. DATO CURIOSO
Se publicó en British Journal
of Hematology el caso de un
varón de 61 años de UK, que
sufría de Linfoma de
Hodgkin fase III donde se vio
reducida su enfermedad, al
descubrir que había casi
desaparecido 4 meses
después de haberse
contagiado y tener COVID 19.
Parece ser que al haberse
infectado, su cuerpo
desarrolló una respuesta
fuertemente antitumoral.
https://www.bbc.com/mundo/noticias-55797043