Syncope
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Syncope, or fainting, is the abrupt loss of consciousness resulting from transient reduced blood flow to the brain. It accounts for 1-3% of pediatric emergency visits, with 80% being neurocardiogenic syncope. A history focused on hydration, activity preceding fainting, and medications can help determine if the syncope was neurocardiogenic or due to other causes like seizures or cardiac issues which account for 10-15% of cases. Evaluation may include ECG, chest x-ray, blood tests and orthostatic vital signs to check for low blood pressure upon standing.
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Syncope
This document provides an overview of syncope, also known as fainting. It defines syncope as a transient loss of consciousness due to brief cerebral ischemia. The document discusses the epidemiology, predisposing factors, clinical manifestations, pathophysiology, and management of syncope. It notes that syncope accounts for 1% of hospital admissions and 3% of emergency visits. The document emphasizes the importance of proper positioning of patients in preventing syncope, such as placing patients in a supine, anti-trendelenberg position if symptoms occur. It also outlines the presyncopal, syncopal, and postsyncopal phases and recommended treatments during each phase.
Syncope
1) Syncope accounts for 1-2% of ED visits and 6% of hospital admissions. The cause remains unknown in around 40% of cases even after investigation.
2) Common causes include vasovagal (21%), cardiac (10%), orthostatic (9%), medications (7%), and neurological (4%). Cardiac causes carry the highest risk of death.
3) Evaluation involves detailed history, physical exam including orthostatic vital signs, ECG, and testing as indicated based on risk stratification scores. High risk features suggest further cardiac workup while low risk features may not require extensive testing.
Syncope
The document summarizes information about syncope in the elderly, including its epidemiology, pathophysiology, risk factors, causes, evaluation, and management. The incidence of syncope increases dramatically with age due to physiological changes that impair cerebral blood flow regulation. Common causes include neurally-mediated reflex syncope, orthostatic hypotension, and cardiac arrhythmias. Evaluation involves obtaining a detailed history, physical exam, ECG, and potentially tilt table testing, event monitoring, or carotid sinus massage to diagnose the underlying cause.
Seminar syncope
Syncope is defined as a transient loss of consciousness and postural tone due to decreased cerebral blood flow. The main causes of true syncope include orthostatic, cardiac, neurally-mediated, and situational. Neurally-mediated syncope accounts for around 66% of cases and includes vasovagal syncope and carotid sinus syndrome. Treatment depends on the underlying cause but may include lifestyle modifications, medication, pacing, or ablation. Diagnostic tests for evaluating syncope include cardiac monitoring, tilt table testing, electrophysiological study, and implantable loop recorder.
Syncope medical emergency
Vasovagal syncope is fainting caused by a drop in heart rate and blood pressure. It can be triggered by emotional stress, pain, hunger, heat, or prolonged standing. During an episode, blood pools in the extremities instead of returning to the heart, reducing blood flow to the brain and causing loss of consciousness. Prevention focuses on avoiding triggers. When symptoms first appear, the person should lie down and raise their legs to improve blood flow. If they faint, placing them in the recovery position provides proper airway support and circulation until they regain consciousness.
Syncope
Dr. Charles Nelson's document discusses the evaluation of syncope. Syncope is defined as a transient loss of consciousness due to global cerebral hypoperfusion. The document outlines common causes of syncope including neurally-mediated reflex causes, orthostatic, and cardiac causes. Evaluation involves determining if the event was true syncope, ruling out mimics, and assessing for underlying heart disease or clues to specific diagnoses. Testing may include EKG, echocardiogram, stress test, holter monitor, or tilt table testing depending on clinical features. Specialist referral is recommended if significant heart disease is found or the cause remains uncertain with recurrent events.
Approach to syncope
Syncope is a transient loss of consciousness due to transient global cerebral hypoperfusion. It is characterized by rapid onset, short duration, and spontaneous recovery. The most common causes are reflex-mediated syncope and orthostatic hypotension, which account for one-third of syncopal episodes. Evaluation involves detailed history taking and physical examination, including orthostatic vital signs and carotid sinus massage. Tilt table testing can be used to confirm neurogenic causes when initial evaluation is insufficient.
Syncope 1
Syncope refers to a transient loss of consciousness due to decreased cerebral blood flow. It accounts for 1% of hospital admissions. The main causes are neurally mediated syncope and cardiac syncope. Neurally mediated syncope involves a sudden change in autonomic activity leading to bradycardia and vasodilation. Orthostatic hypotension is a manifestation of sympathetic vasoconstrictor failure and involves a drop in blood pressure within 3 minutes of standing. Treatment focuses on fluid intake, avoidance of triggers, and medication in refractory cases.
Recommended
Syncope
This document provides an overview of syncope, also known as fainting. It defines syncope as a transient loss of consciousness due to brief cerebral ischemia. The document discusses the epidemiology, predisposing factors, clinical manifestations, pathophysiology, and management of syncope. It notes that syncope accounts for 1% of hospital admissions and 3% of emergency visits. The document emphasizes the importance of proper positioning of patients in preventing syncope, such as placing patients in a supine, anti-trendelenberg position if symptoms occur. It also outlines the presyncopal, syncopal, and postsyncopal phases and recommended treatments during each phase.
Syncope
1) Syncope accounts for 1-2% of ED visits and 6% of hospital admissions. The cause remains unknown in around 40% of cases even after investigation.
2) Common causes include vasovagal (21%), cardiac (10%), orthostatic (9%), medications (7%), and neurological (4%). Cardiac causes carry the highest risk of death.
3) Evaluation involves detailed history, physical exam including orthostatic vital signs, ECG, and testing as indicated based on risk stratification scores. High risk features suggest further cardiac workup while low risk features may not require extensive testing.
Syncope
The document summarizes information about syncope in the elderly, including its epidemiology, pathophysiology, risk factors, causes, evaluation, and management. The incidence of syncope increases dramatically with age due to physiological changes that impair cerebral blood flow regulation. Common causes include neurally-mediated reflex syncope, orthostatic hypotension, and cardiac arrhythmias. Evaluation involves obtaining a detailed history, physical exam, ECG, and potentially tilt table testing, event monitoring, or carotid sinus massage to diagnose the underlying cause.
Seminar syncope
Syncope is defined as a transient loss of consciousness and postural tone due to decreased cerebral blood flow. The main causes of true syncope include orthostatic, cardiac, neurally-mediated, and situational. Neurally-mediated syncope accounts for around 66% of cases and includes vasovagal syncope and carotid sinus syndrome. Treatment depends on the underlying cause but may include lifestyle modifications, medication, pacing, or ablation. Diagnostic tests for evaluating syncope include cardiac monitoring, tilt table testing, electrophysiological study, and implantable loop recorder.
Syncope medical emergency
Vasovagal syncope is fainting caused by a drop in heart rate and blood pressure. It can be triggered by emotional stress, pain, hunger, heat, or prolonged standing. During an episode, blood pools in the extremities instead of returning to the heart, reducing blood flow to the brain and causing loss of consciousness. Prevention focuses on avoiding triggers. When symptoms first appear, the person should lie down and raise their legs to improve blood flow. If they faint, placing them in the recovery position provides proper airway support and circulation until they regain consciousness.
Syncope
Dr. Charles Nelson's document discusses the evaluation of syncope. Syncope is defined as a transient loss of consciousness due to global cerebral hypoperfusion. The document outlines common causes of syncope including neurally-mediated reflex causes, orthostatic, and cardiac causes. Evaluation involves determining if the event was true syncope, ruling out mimics, and assessing for underlying heart disease or clues to specific diagnoses. Testing may include EKG, echocardiogram, stress test, holter monitor, or tilt table testing depending on clinical features. Specialist referral is recommended if significant heart disease is found or the cause remains uncertain with recurrent events.
Approach to syncope
Syncope is a transient loss of consciousness due to transient global cerebral hypoperfusion. It is characterized by rapid onset, short duration, and spontaneous recovery. The most common causes are reflex-mediated syncope and orthostatic hypotension, which account for one-third of syncopal episodes. Evaluation involves detailed history taking and physical examination, including orthostatic vital signs and carotid sinus massage. Tilt table testing can be used to confirm neurogenic causes when initial evaluation is insufficient.
Syncope 1
Syncope refers to a transient loss of consciousness due to decreased cerebral blood flow. It accounts for 1% of hospital admissions. The main causes are neurally mediated syncope and cardiac syncope. Neurally mediated syncope involves a sudden change in autonomic activity leading to bradycardia and vasodilation. Orthostatic hypotension is a manifestation of sympathetic vasoconstrictor failure and involves a drop in blood pressure within 3 minutes of standing. Treatment focuses on fluid intake, avoidance of triggers, and medication in refractory cases.
Syncope
This document provides an outline on syncope (transient loss of consciousness). It defines syncope, describes the mechanisms, classifications, clinical features, diagnosis and treatment. Key points include:
- Syncope is caused by transient global hypoperfusion of the brain due to low cardiac output or systemic vascular resistance.
- Causes are classified as cardiac (e.g. arrhythmias, structural issues), non-cardiac (e.g. neurological, metabolic), or unknown.
- Common causes include vasovagal, orthostatic hypotension, arrhythmias, and carotid sinus hypersensitivity.
- Evaluation involves history, physical exam, ECG and sometimes tilt table testing or cardiac
Syncope 160319195211 (1)
Syncope
Presented by- Dr. Mohammad Rehan
DNB Medicine
SDMH Jaipur
Moderator- Dr. Madhulika Sharma
HOD (General Medicine)
approach to Syncope patient in ED
Syncope, or fainting, is defined as a transient loss of consciousness associated with loss of postural tone that resolves spontaneously. It accounts for 0.8% of ED visits and has a prevalence of 19% in the general population. Common causes include vasovagal, cardiac, orthostatic, and medication-related reactions. A thorough history and physical exam can suggest a diagnosis in 45% of cases and help determine appropriate disposition, whether inpatient for high-risk patients or outpatient follow up for low-risk cases.
Syncope
This document provides an overview of syncope by Dr. Mohammed Lukman Abolaji. It defines syncope and discusses the pathophysiology, including how a loss of cerebral blood flow can cause loss of consciousness. It outlines the most common causes or etiologies of syncope including reflex or neurally mediated syncope, orthostatic hypotension, and cardiac syncope. It emphasizes that obtaining a thorough history and physical examination is important for evaluating syncope and determining its underlying cause in 50-85% of patients.
Approach to Syncope
This document provides an overview of syncope (transient loss of consciousness). It defines syncope and discusses mechanisms and common causes. Cardiac causes include arrhythmias and structural heart issues. Common non-cardiac causes are neurocardiogenic syncope and orthostatic hypotension. The document outlines how to take a history and perform an exam for a syncope patient. It recommends ECG, monitoring, and risk stratification. The summary emphasizes differentiating cardiac from non-cardiac syncope, as cardiac causes have higher mortality and recommends not missing life-threatening conditions.
Syncope in children
This document discusses syncope (fainting), including its definition, causes, pathophysiology, history and examination, investigations, and treatment. Syncope is defined as a sudden, transient loss of consciousness due to cerebral hypoperfusion. It can be caused by neurological, cardiovascular, orthostatic hypotension, or other factors like anemia or hypoglycemia. Evaluation involves taking a history of symptoms and potential triggers, physical exam including orthostatic vital signs, ECG, echocardiogram if needed, and lab tests like glucose and electrolytes. Treatment depends on the identified cause, and may include rehydration, non-pharmacological approaches, or referral to a cardiologist for potential arr
Syncope dr yate
Syncope is defined as a brief, self-limited loss of consciousness due to reduced cerebral blood flow. It is characterized by rapid onset, short duration, and spontaneous recovery. The document discusses the various causes of syncope including neurally-mediated (vasovagal), orthostatic, cardiac, and others. It outlines the evaluation process including history, physical exam, ECG, and cardiac monitoring. Further tests like tilt table testing and electrophysiology studies may be used depending on the suspected cause to determine the etiology and appropriate treatment. The history is critical to differentiate syncope from other mimics and identify high-risk patients who require more extensive cardiac evaluation and monitoring.
Syncope
This document provides an overview of syncope, including its definition, causes, evaluation, and treatment. Syncope is defined as a brief loss of consciousness due to decreased blood flow to the brain. Evaluation involves taking a thorough history and physical exam, with ECG, carotid sinus massage, tilt table testing, and monitoring tests used as indicated. Causes include reflex or neurally-mediated syncope, orthostatic hypotension, cardiac arrhythmias, and structural heart issues. Treatment focuses on managing the underlying cause, lifestyle modifications, and medications depending on the type of syncope. Syncope can be serious if cardiac in origin, so risk stratification helps determine need for further testing and guide management.
Syncope
Vasovagal syncope is a sudden loss of consciousness caused by a drop in heart rate and blood pressure. It can be triggered by pain, stress, or the sight of blood. Symptoms include dizziness, weakness, and vision changes before losing consciousness. After fainting, recovery involves nausea, sweating, and confusion. Prevention focuses on reducing anxiety, ensuring adequate fluid/food intake, and positioning patients supine or semi-reclined during dental procedures.
APPROACH TO SYNCOPE ,DIAGNOSIS AND MANAGEMENT
This document discusses the management of two patients presenting with syncope.
Case 1 is a 42-year-old female with a history of passing out at work. Her workup including physical exam, EKG, labs and tilt table test was normal. She was diagnosed with vasovagal syncope as her tilt table test induced syncope.
Case 2 is an 82-year-old male found unresponsive. His workup in the ER was negative but he was admitted where 2 hours later he developed nonsustained VTach on ECG monitoring. An EP study showed inducible VTach and he received an ICD. He was found to have diffuse coronary artery disease on cardiac cath.
Syncope
Syncope is defined as a transient loss of consciousness due to decreased cerebral blood flow. It is commonly caused by neurally-mediated reflexes, orthostatic hypotension, or cardiac arrhythmias. Evaluation involves determining the cause through history, physical exam, ECG and tests like tilt table testing, echocardiogram, and cardiac monitoring. Treatment depends on the underlying cause and may include lifestyle changes, medications, pacemakers, or defibrillators.
Syncope
Syncope is defined as a transient loss of consciousness and postural tone caused by a fall in cerebral blood flow. The document outlines the various causes of syncope including neurally-mediated, orthostatic, cardiac, metabolic, neurological/psychiatric disorders, and unexplained causes. It emphasizes obtaining a detailed history of the syncopal episode including circumstances, symptoms, age of onset, drugs, and pregnancy to help determine the underlying cause, which guides further testing and management.
Syncope
This document provides an overview of syncope (fainting), including definitions, causes, diagnostic approaches, and management. The main points are:
1. Syncope is defined as a brief loss of consciousness due to reduced blood flow to the brain. It has many potential causes including cardiac arrhythmias, orthostatic hypotension, and vasovagal responses.
2. The diagnostic approach involves taking a medical history and conducting tests like an ECG, tilt table test, or Holter monitor depending on the situation.
3. Syncope has both cardiac and reflex causes. Cardiac causes are more serious and require prompt treatment, while reflex syncope often has identifiable triggers and presentations.
Syncope: Etiology & Pathophysiology
Transient loss of consciousness can be caused by reduced cerebral blood flow (syncope). There are three main etiologies of syncope: cardiogenic, neurocardiogenic, and metabolic. Cardiogenic syncope is caused by structural heart issues or arrhythmias like bradycardia or tachycardia. Neurocardiogenic, or vasovagal, syncope is the most common type and caused by pain, fear, or anxiety triggering a vagal response and hypotension. Metabolic syncope is rare and caused by issues like hypoxia or hypoglycemia. Neurocardiogenic syncope may serve as a protective mechanism for the heart during times of central hypovolemia.
Aproach to syncope
Syncope, or fainting, is caused by insufficient blood flow to the brain. It is usually brief and self-limited. Evaluation of syncope involves obtaining a detailed history, physical exam, ECG, and testing based on risk factors. Causes are categorized as benign if due to things like vasovagal response, or dangerous if due to cardiac arrhythmias. High-risk patients warrant further cardiac workup and monitoring, while low-risk patients can often be evaluated as outpatients.
Syncope
Syncope is a common medical problem that causes a brief loss of consciousness. It affects 15-39% of the general population annually. The main causes are vasovagal, orthostatic hypotension, cardiac issues, and unknown. Evaluation involves ruling out other conditions through history, exam, ECG and basic tests. If no cause is found, tilt table testing may be used. Treatment focuses on addressing the underlying cause, with beta-blockers and volume expanders sometimes used for vasovagal syncope. Prognosis depends on any cardiac issues found.
Evaluation of syncope in adults
This document discusses the evaluation of syncope in adults. Syncope is defined as a brief, self-limited loss of consciousness due to decreased blood flow to the brain. The causes of syncope can be categorized as neurally-mediated, orthostatic, cardiac, or structural/cardiopulmonary. A thorough history, physical exam, and diagnostic testing are needed to determine the underlying cause and guide treatment. The history provides clues to distinguish syncope from other conditions and identify risk factors, while the physical exam focuses on vital signs and signs of end-organ damage or dysfunction.
Syncope
This document provides guidelines for evaluating and managing patients presenting with syncope. It defines syncope and distinguishes it from other causes of transient loss of consciousness. It covers the etiologies of syncope including neurocardiogenic, cardiovascular, and orthostatic causes. The guidelines recommend an initial evaluation including history, physical exam, ECG and risk stratification to determine if the patient is high or low risk. They provide guidance on cardiac and neurological testing, imaging, and monitoring based on the risk level. The guidelines also cover management strategies for specific causes of syncope.
Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...
Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Syncope
this lecture explains Syncope which is a transient loss of consciousness from many points: the definition, causes, next step, history and physical examination from evidence based resources as the UpToDate and the European society of cardiology guidelines 2018.
Status epilepticus
1. Status epilepticus (SE) is a medical emergency defined as a seizure lasting more than 5 minutes or recurrent seizures without regaining consciousness. SE can be convulsive or non-convulsive.
2. The annual incidence of SE is estimated to be between 9,000-14,000 new cases per year in the UK. Mortality is about 20-30% and is higher in the elderly.
3. SE is initially treated with benzodiazepines like lorazepam or diazepam. If seizures continue, second line drugs like fosphenytoin or phenytoin are used. For refractory SE, anesthetic drugs under ICU care may be required
NEUROPSYCHIATRIC ASPECTS OF EPILEPSY
This document discusses neuropsychiatric aspects of epilepsy. It begins with definitions of key terms like seizure, epilepsy, and convulsion. It then covers the epidemiology, classification, etiology, clinical presentations, pathophysiology, investigations, differential diagnosis, and tools to confirm the diagnosis of epilepsy. The main points are that epilepsy is a clinical condition involving recurrent seizures that can have many causes, presentations involve different seizure types, investigations aim to identify underlying causes or confirm the diagnosis, and tools like EEG and brain imaging are important for diagnosis.
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Syncope
This document provides an outline on syncope (transient loss of consciousness). It defines syncope, describes the mechanisms, classifications, clinical features, diagnosis and treatment. Key points include:
- Syncope is caused by transient global hypoperfusion of the brain due to low cardiac output or systemic vascular resistance.
- Causes are classified as cardiac (e.g. arrhythmias, structural issues), non-cardiac (e.g. neurological, metabolic), or unknown.
- Common causes include vasovagal, orthostatic hypotension, arrhythmias, and carotid sinus hypersensitivity.
- Evaluation involves history, physical exam, ECG and sometimes tilt table testing or cardiac
Syncope 160319195211 (1)
Syncope
Presented by- Dr. Mohammad Rehan
DNB Medicine
SDMH Jaipur
Moderator- Dr. Madhulika Sharma
HOD (General Medicine)
approach to Syncope patient in ED
Syncope, or fainting, is defined as a transient loss of consciousness associated with loss of postural tone that resolves spontaneously. It accounts for 0.8% of ED visits and has a prevalence of 19% in the general population. Common causes include vasovagal, cardiac, orthostatic, and medication-related reactions. A thorough history and physical exam can suggest a diagnosis in 45% of cases and help determine appropriate disposition, whether inpatient for high-risk patients or outpatient follow up for low-risk cases.
Syncope
This document provides an overview of syncope by Dr. Mohammed Lukman Abolaji. It defines syncope and discusses the pathophysiology, including how a loss of cerebral blood flow can cause loss of consciousness. It outlines the most common causes or etiologies of syncope including reflex or neurally mediated syncope, orthostatic hypotension, and cardiac syncope. It emphasizes that obtaining a thorough history and physical examination is important for evaluating syncope and determining its underlying cause in 50-85% of patients.
Approach to Syncope
This document provides an overview of syncope (transient loss of consciousness). It defines syncope and discusses mechanisms and common causes. Cardiac causes include arrhythmias and structural heart issues. Common non-cardiac causes are neurocardiogenic syncope and orthostatic hypotension. The document outlines how to take a history and perform an exam for a syncope patient. It recommends ECG, monitoring, and risk stratification. The summary emphasizes differentiating cardiac from non-cardiac syncope, as cardiac causes have higher mortality and recommends not missing life-threatening conditions.
Syncope in children
This document discusses syncope (fainting), including its definition, causes, pathophysiology, history and examination, investigations, and treatment. Syncope is defined as a sudden, transient loss of consciousness due to cerebral hypoperfusion. It can be caused by neurological, cardiovascular, orthostatic hypotension, or other factors like anemia or hypoglycemia. Evaluation involves taking a history of symptoms and potential triggers, physical exam including orthostatic vital signs, ECG, echocardiogram if needed, and lab tests like glucose and electrolytes. Treatment depends on the identified cause, and may include rehydration, non-pharmacological approaches, or referral to a cardiologist for potential arr
Syncope dr yate
Syncope is defined as a brief, self-limited loss of consciousness due to reduced cerebral blood flow. It is characterized by rapid onset, short duration, and spontaneous recovery. The document discusses the various causes of syncope including neurally-mediated (vasovagal), orthostatic, cardiac, and others. It outlines the evaluation process including history, physical exam, ECG, and cardiac monitoring. Further tests like tilt table testing and electrophysiology studies may be used depending on the suspected cause to determine the etiology and appropriate treatment. The history is critical to differentiate syncope from other mimics and identify high-risk patients who require more extensive cardiac evaluation and monitoring.
Syncope
This document provides an overview of syncope, including its definition, causes, evaluation, and treatment. Syncope is defined as a brief loss of consciousness due to decreased blood flow to the brain. Evaluation involves taking a thorough history and physical exam, with ECG, carotid sinus massage, tilt table testing, and monitoring tests used as indicated. Causes include reflex or neurally-mediated syncope, orthostatic hypotension, cardiac arrhythmias, and structural heart issues. Treatment focuses on managing the underlying cause, lifestyle modifications, and medications depending on the type of syncope. Syncope can be serious if cardiac in origin, so risk stratification helps determine need for further testing and guide management.
Syncope
Vasovagal syncope is a sudden loss of consciousness caused by a drop in heart rate and blood pressure. It can be triggered by pain, stress, or the sight of blood. Symptoms include dizziness, weakness, and vision changes before losing consciousness. After fainting, recovery involves nausea, sweating, and confusion. Prevention focuses on reducing anxiety, ensuring adequate fluid/food intake, and positioning patients supine or semi-reclined during dental procedures.
APPROACH TO SYNCOPE ,DIAGNOSIS AND MANAGEMENT
This document discusses the management of two patients presenting with syncope.
Case 1 is a 42-year-old female with a history of passing out at work. Her workup including physical exam, EKG, labs and tilt table test was normal. She was diagnosed with vasovagal syncope as her tilt table test induced syncope.
Case 2 is an 82-year-old male found unresponsive. His workup in the ER was negative but he was admitted where 2 hours later he developed nonsustained VTach on ECG monitoring. An EP study showed inducible VTach and he received an ICD. He was found to have diffuse coronary artery disease on cardiac cath.
Syncope
Syncope is defined as a transient loss of consciousness due to decreased cerebral blood flow. It is commonly caused by neurally-mediated reflexes, orthostatic hypotension, or cardiac arrhythmias. Evaluation involves determining the cause through history, physical exam, ECG and tests like tilt table testing, echocardiogram, and cardiac monitoring. Treatment depends on the underlying cause and may include lifestyle changes, medications, pacemakers, or defibrillators.
Syncope
Syncope is defined as a transient loss of consciousness and postural tone caused by a fall in cerebral blood flow. The document outlines the various causes of syncope including neurally-mediated, orthostatic, cardiac, metabolic, neurological/psychiatric disorders, and unexplained causes. It emphasizes obtaining a detailed history of the syncopal episode including circumstances, symptoms, age of onset, drugs, and pregnancy to help determine the underlying cause, which guides further testing and management.
Syncope
This document provides an overview of syncope (fainting), including definitions, causes, diagnostic approaches, and management. The main points are:
1. Syncope is defined as a brief loss of consciousness due to reduced blood flow to the brain. It has many potential causes including cardiac arrhythmias, orthostatic hypotension, and vasovagal responses.
2. The diagnostic approach involves taking a medical history and conducting tests like an ECG, tilt table test, or Holter monitor depending on the situation.
3. Syncope has both cardiac and reflex causes. Cardiac causes are more serious and require prompt treatment, while reflex syncope often has identifiable triggers and presentations.
Syncope: Etiology & Pathophysiology
Transient loss of consciousness can be caused by reduced cerebral blood flow (syncope). There are three main etiologies of syncope: cardiogenic, neurocardiogenic, and metabolic. Cardiogenic syncope is caused by structural heart issues or arrhythmias like bradycardia or tachycardia. Neurocardiogenic, or vasovagal, syncope is the most common type and caused by pain, fear, or anxiety triggering a vagal response and hypotension. Metabolic syncope is rare and caused by issues like hypoxia or hypoglycemia. Neurocardiogenic syncope may serve as a protective mechanism for the heart during times of central hypovolemia.
Aproach to syncope
Syncope, or fainting, is caused by insufficient blood flow to the brain. It is usually brief and self-limited. Evaluation of syncope involves obtaining a detailed history, physical exam, ECG, and testing based on risk factors. Causes are categorized as benign if due to things like vasovagal response, or dangerous if due to cardiac arrhythmias. High-risk patients warrant further cardiac workup and monitoring, while low-risk patients can often be evaluated as outpatients.
Syncope
Syncope is a common medical problem that causes a brief loss of consciousness. It affects 15-39% of the general population annually. The main causes are vasovagal, orthostatic hypotension, cardiac issues, and unknown. Evaluation involves ruling out other conditions through history, exam, ECG and basic tests. If no cause is found, tilt table testing may be used. Treatment focuses on addressing the underlying cause, with beta-blockers and volume expanders sometimes used for vasovagal syncope. Prognosis depends on any cardiac issues found.
Evaluation of syncope in adults
This document discusses the evaluation of syncope in adults. Syncope is defined as a brief, self-limited loss of consciousness due to decreased blood flow to the brain. The causes of syncope can be categorized as neurally-mediated, orthostatic, cardiac, or structural/cardiopulmonary. A thorough history, physical exam, and diagnostic testing are needed to determine the underlying cause and guide treatment. The history provides clues to distinguish syncope from other conditions and identify risk factors, while the physical exam focuses on vital signs and signs of end-organ damage or dysfunction.
Syncope
This document provides guidelines for evaluating and managing patients presenting with syncope. It defines syncope and distinguishes it from other causes of transient loss of consciousness. It covers the etiologies of syncope including neurocardiogenic, cardiovascular, and orthostatic causes. The guidelines recommend an initial evaluation including history, physical exam, ECG and risk stratification to determine if the patient is high or low risk. They provide guidance on cardiac and neurological testing, imaging, and monitoring based on the risk level. The guidelines also cover management strategies for specific causes of syncope.
Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...
Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Syncope
this lecture explains Syncope which is a transient loss of consciousness from many points: the definition, causes, next step, history and physical examination from evidence based resources as the UpToDate and the European society of cardiology guidelines 2018.
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Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...
Syncope (nx power lite) /certified fixed orthodontic courses by Indian dental...
Similar to Syncope
Status epilepticus
1. Status epilepticus (SE) is a medical emergency defined as a seizure lasting more than 5 minutes or recurrent seizures without regaining consciousness. SE can be convulsive or non-convulsive.
2. The annual incidence of SE is estimated to be between 9,000-14,000 new cases per year in the UK. Mortality is about 20-30% and is higher in the elderly.
3. SE is initially treated with benzodiazepines like lorazepam or diazepam. If seizures continue, second line drugs like fosphenytoin or phenytoin are used. For refractory SE, anesthetic drugs under ICU care may be required
NEUROPSYCHIATRIC ASPECTS OF EPILEPSY
This document discusses neuropsychiatric aspects of epilepsy. It begins with definitions of key terms like seizure, epilepsy, and convulsion. It then covers the epidemiology, classification, etiology, clinical presentations, pathophysiology, investigations, differential diagnosis, and tools to confirm the diagnosis of epilepsy. The main points are that epilepsy is a clinical condition involving recurrent seizures that can have many causes, presentations involve different seizure types, investigations aim to identify underlying causes or confirm the diagnosis, and tools like EEG and brain imaging are important for diagnosis.
NEUROPSYCHIATRIC ASPECTS OF EPILEPSY
The document discusses neuropsychiatric aspects of epilepsy. It begins with definitions of key terms like seizure, epilepsy, and convulsion. It then provides epidemiological data on epilepsy prevalence and incidence globally. It describes different types of seizures including primary generalized seizures, partial seizures, and epilepsy syndromes. Causes of epilepsy including genetic, acquired, congenital, and withdrawal factors are outlined. Risk factors for developing epilepsy and common seizure triggers are mentioned. The pathophysiology involving glutamate and GABA neurotransmitters is explained. Finally, clinical presentations of different seizure types and differential diagnosis considerations are covered.
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EPILEPTIC ENCEPHALOPATHY
Epileptic encephalopathies are a group of epileptic disorders that cause cognitive and behavioral impairments beyond what would be expected from seizures alone. They typically begin early in life and are characterized by frequent seizures and abnormal EEG patterns. Common types include early myoclonic encephalopathy, Ohtahara syndrome, West syndrome, Dravet syndrome, and Lennox-Gastaut syndrome. These disorders can cause developmental delays, neurological deficits, and sometimes early death if not properly treated. Management involves seizure control through medications and other therapies like the ketogenic diet.
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Hie ppt
Hypoxic Ischemic Encephalopathy (HIE) occurs when a term infant experiences intrapartum asphyxia and lack of oxygen. It can cause death or disabilities like cerebral palsy. Diagnosis involves assessing the infant at birth using the APGAR score and neurological staging. Imaging tools like MRI are useful to detect brain injury patterns. HIE management aims to prevent further brain damage through temperature control, seizure treatment, and potentially neuroprotective drugs. The condition remains a major cause of newborn mortality and morbidity.
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ATAXIA IN CHILDREN -CAUSES, MANAGEMENT, INVESTIGATIONS, TYPES, COMMONEST ATAXIA IN CHILDREN IN DETAIL, HOW WILL YOU FIND OUT THE CAUSE FOR ATAXIA IN CHILDREN FLOWCHART, DEFINITION, TREATMENT
epilepsy.ppt
This document provides an overview of epilepsy, including its definition, pathogenesis, epidemiology, classification, investigation, treatment, and surgical treatment options. Epilepsy is defined as a chronic neurological disorder characterized by recurrent seizures resulting from uncontrolled neuronal discharges in the brain. It can be caused by various factors and presents across all age groups. Treatment primarily involves anticonvulsant drugs, while surgery may be an option for intractable cases.
Management of epilepsy in children
The document discusses the management of epilepsy in children. It covers the etiology, classification, clinical features and treatment of different types of childhood epilepsy including neonatal seizures, infantile spasms, Lennox-Gastaut syndrome, benign epilepsy of childhood, and febrile seizures. It also discusses diagnostic evaluation, choice of antiepileptic drugs, prognosis, and management of refractory seizures.
epilepsy
This document discusses neuropsychiatric aspects of epilepsy. It defines seizures and epilepsy, discusses classification, epidemiology, etiology, investigations and treatment. Some key points:
- Epilepsy is a clinical condition characterized by recurrent seizures due to an underlying chronic process in the brain. Seizures are transient symptoms of abnormal excessive neuronal activity in the brain.
- Epilepsy can begin at any age and prevalence is higher in developing countries and among those with medical conditions like cerebral palsy or stroke.
- Seizures are classified based on origin in the brain as generalized or partial. Common types include tonic-clonic, absence and complex partial seizures.
- Causes of
Seizure disorders in pediatric
This document defines seizure disorders and classifies different types of seizures. It discusses focal seizures, generalized seizures, infantile spasms, and several epilepsy syndromes that typically present in the neonatal period or childhood such as West syndrome, Ohtahara syndrome, and benign childhood epilepsy with centrotemporal spikes. Causes, clinical presentations, diagnostic workups, and treatment options are provided for many of the conditions.
Pediatrics 5th year, 11th lecture (Dr. Adnan)
This document defines different types of seizures and epilepsy, discusses their causes and classifications. It describes several specific epilepsy syndromes like benign focal epilepsy of childhood and complex partial seizures. Treatment options are provided for different seizure types as well as status epilepticus. Prognosis depends on factors like age of onset, frequency of seizures, and presence of underlying conditions.
pediatrics.Seizures and epilepsy.(dr.adnan)
This document defines and classifies different types of seizures and epilepsy. It discusses various etiologies and syndromes of epilepsy, including idiopathic, symptomatic, partial and generalized seizures. It also covers the diagnosis, treatment and prognosis of conditions like complex partial seizures, absence seizures, tonic-clonic seizures, infantile spasms, febrile seizures, and status epilepticus.
Approach to stupor and coma
1) Stupor and coma are states of decreased or absent responsiveness that require evaluation to identify potentially reversible causes and provide emergency treatment.
2) The initial approach involves stabilizing vital functions, treating potentially reversible causes, obtaining history, and performing a full neurological examination.
3) Emergency treatment may include supplemental oxygen, IV thiamine, glucose, and antibiotics depending on suspected causes identified from history and examination.
Status Epilepticus
This document discusses status epilepticus, which is defined as prolonged or repeated seizures without recovery between seizures. It classifies status epilepticus, explores its pathophysiology and etiology, and outlines its presentation, differential diagnosis, workup, and management. Status epilepticus results from either failed seizure termination mechanisms or initiation of mechanisms leading to prolonged seizures. It can cause neuronal death or injury if not promptly treated. Management involves initial treatment with benzodiazepines followed by anti-seizure medications like fosphenytoin or anesthetic doses if seizures persist over 40 minutes.
Epileptic encephalopathies
The document discusses epileptic encephalopathy syndromes that occur in neonates, infants, and children. It describes the key features of early myoclonic encephalopathy, West syndrome, Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and continuous spike-wave during sleep. The syndromes are characterized by seizures, developmental regression or impairment, and specific electrographic findings on EEG. Prognosis varies between syndromes but is often poor, with cognitive and neurological deficits. Treatment involves antiepileptic drugs, corticosteroids, ketogenic diet, or surgery in refractory cases.
Epilepsy and seizure disorders
EPILEPSY AND SEIZURE DISORDERS
The document discusses epilepsy and seizure disorders. It defines seizures as paroxysmal events due to abnormal neuronal activity in the brain. It classifies seizures as either focal or generalized based on their origin. Focal seizures originate in one hemisphere while generalized seizures rapidly engage both hemispheres. Common types of seizures include absence seizures, tonic-clonic seizures, atonic seizures, and myoclonic seizures. The document also discusses the etiology, diagnosis, treatment and management of epilepsy through use of anti-epileptic drugs, surgery, or other methods.
Epilepsy in children by Dr.Shanti
Epilepsy is a chronic neurological condition characterized by recurrent seizures. The majority of childhood epilepsy is idiopathic or genetic in origin. Seizures can be generalized, arising from both hemispheres, or focal, arising from one hemisphere. Common generalized seizures include tonic-clonic, absence, and myoclonic seizures. Diagnosis involves a clinical history and may include EEG and imaging. Treatment primarily involves antiepileptic drug therapy to control seizures.
Seizure final.ppt
This document defines pediatric seizures and epilepsy, describes the different types of seizures including partial, generalized, absence, myoclonic, atonic, and tonic-clonic seizures. It discusses the epidemiology, pathophysiology, classification, and etiologies of seizures in children. Seizures are common in children, especially those under 3 years old, and have different characteristics compared to seizures in adults due to the immature nervous system in children. Febrile seizures occur in 3% of children. Genetic factors account for 20% of childhood epilepsy cases.
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APPROACH TO JAUNDICE IN EMERGENCY MEDICINE New.pptx GEETHA.pptx
Based on the information provided:
A. Gamma-glutamyl transpeptidase is indicated to further evaluate liver function.
B. Hepatitis A serologies are indicated to evaluate for possible acute viral hepatitis.
D. Hepatitis B and C serologies are indicated to evaluate for possible viral hepatitis.
E. Prothrombin time is indicated to check for possible coagulopathy due to liver dysfunction.
Tests C (anti-mitochondrial antibodies) would not be indicated based on the information provided.
So the correct answers are: A, B, D, E.
METHANOL POISONING
Methanol poisoning occurs from ingesting methanol, a colorless alcohol found in windshield wiper fluid and antifreeze. Methanol is metabolized to formic acid, which causes metabolic acidosis, visual disturbances, and can lead to blindness or death. Diagnosis involves detecting a high anion gap metabolic acidosis and elevated blood methanol levels. Treatment aims to correct acidosis, inhibit methanol metabolism with fomepizole or ethanol, and remove methanol through hemodialysis if needed. Prognosis depends on the degree of acidosis and time to initiating proper treatment.
OXYGENATION DEVICES
Dr. Rose Mary Joseph is a senior resident in the Department of Emergency Medicine at GMCK hospital. She has over 5 years of experience working in emergency rooms and treating a wide variety of medical issues. Dr. Joseph is highly skilled at quickly diagnosing patients and providing appropriate care for both minor injuries and life-threatening conditions.
diaghramatic hernia
A patient presented with left sided chest pain, vomiting, and decreased bowel movements. Examination found decreased breath sounds and crepitations bilaterally. Tests showed mixed acidosis and abnormalities on ECG and chest x-ray. A barium study revealed gastric volvulus secondary to diaphragmatic hernia. The patient underwent surgery for diaphragmatic hernia repair and gastric resection but expired postoperatively due to complications.
splenic infarct
Dr. ASHMAL KT presents a case report of a 56-year-old male who presented with abdominal pain and vomiting for 1 day. Initial assessments revealed abnormal ECG and lab results. Further imaging with CECT abdomen and echo found left renal infarct, splenic infarct, severe mitral stenosis and mitral regurgitation, and a left atrial appendage clot. The final diagnosis was rheumatic heart disease with severe mitral stenosis and regurgitation, atrial fibrillation with a left atrial appendage clot, and acute splenic and left kidney infarcts likely due to embolism. The patient was treated with IV anticoagulants and advised for valve replacement
Occular emergencies
This document summarizes various ocular emergencies commonly seen in emergency departments. It discusses trauma-related emergencies like penetrating injuries, blunt injuries, burns, as well as non-trauma emergencies such as infections, glaucoma, retinal vessel occlusions, retinal detachment, and ruptured globes. It also provides details on management of specific conditions like chemical injuries, acute angle closure glaucoma, foreign bodies, orbital fractures, and ocular infections.
Respiratory rate
The respiratory rate is controlled by the respiratory center located in the medulla oblongata and pons of the brain. The respiratory center receives input from chemoreceptors and mechanoreceptors to regulate breathing rate and depth. It is made up of groups of neurons that control inspiration and expiration. The normal respiratory rate varies by age but is typically 12-20 breaths per minute for adults. Deviations from the normal respiratory rate can indicate respiratory dysfunction and impact illness severity assessments.
Adrenal insufficeincy/ADRENAL CRISIS
Adrenal insufficiency can occur when the adrenal glands or pituitary gland fail to produce adequate hormones. Symptoms include weakness, fatigue, loss of appetite, and low blood pressure. Laboratory findings may include hyponatremia and hyperkalemia. Treatment involves lifelong hormone replacement therapy with glucocorticoids and mineralocorticoids. Unexplained hypotension resistant to fluids and pressors should raise suspicion for adrenal crisis, which requires stress-dose glucocorticoid treatment in the ICU.
BRADYDYSARRYTHMIAS
Bradydysrhythmias are heart rhythms with a ventricular rate slower than 60 beats per minute in adults. They are commonly caused by problems with impulse formation or conduction in the heart's conduction system. Bradydysrhythmias can be classified as sinus bradycardia, AV blocks, junctional rhythms, or idioventricular rhythms. Treatment may include atropine or cardiac pacing depending on the specific rhythm abnormality and its symptoms.
Rapid sequence intubation in ED
Rapid sequence intubation (RSI) involves the simultaneous administration of an induction agent and neuromuscular blocking drug to facilitate endotracheal intubation. It allows for increased success rates, decreased intubation times, and reduced risks of aspiration, hypoxia, and trauma. The key steps of RSI are preparation, preoxygenation, pretreatment, paralysis with induction, positioning, placement with proof of tube position, and post-intubation management. Confirmation of tube placement involves clinical assessment and mechanical methods like end-tidal CO2 monitoring and ultrasound. Complications can be minimized by adhering to the standardized RSI protocol.
APPROACH TO TRAUMATIC SHOCK
The document discusses the approach to traumatic shock. It details the pathophysiology of hemorrhagic shock, which leads to impaired oxygen delivery and hypoperfusion. The clinical features and diagnosis are variable depending on the cause, rate, and duration of blood loss. Treatment priorities include restoring intravascular volume, maintaining oxygen-carrying capacity, limiting ongoing blood loss, preventing coagulopathy and hypothermia. Massive transfusion protocols aim to replace lost blood with balanced ratios of packed red blood cells, plasma, and platelets to improve outcomes.
Median nerve and ulnar nerve in ed
The document discusses examination of the median nerve and ulnar nerve in the emergency department. It focuses on branches of the ulnar nerve, examining their function and assessing any deficits that could indicate nerve damage. In a few brief sentences, it outlines key areas to evaluate sensation and motor function related to these major nerves in the arm.
Nihss
This document provides information about the National Institutes of Health Stroke Scale (NIHSS), including how to administer and score it. The NIHSS is an 11-item neurological examination used to evaluate stroke severity. It assesses different functional domains, with higher scores indicating more severe strokes. An increase of 2 points or more on serial NIHSS exams indicates stroke progression. NIHSS scores can help predict outcomes and guide treatment decisions. The presenter reviews the components and administration of the full NIHSS exam.
Shoulder dislocation
This document discusses shoulder dislocations, including the types, risk factors, clinical signs and symptoms, diagnosis, and treatment methods. It notes that anterior dislocation is the most common type at over 95% of cases. Reduction techniques discussed include traction counter-traction, Kocher's technique, Simpson method, and Milch technique. Complications can include nerve or blood vessel injury, recurrence, or fracture. Surgery may be needed for inferior, posterior, or recurrent dislocations, or those with associated fractures.
Acid base disorders
1. The document discusses acid-base disorders and provides normal values and equations for pH, bicarbonate, PCO2, and other parameters.
2. Metabolic and respiratory acidosis and alkalosis are examined, along with causes such as ketoacidosis, lactic acidosis, respiratory failure, and vomiting.
3. Treatment approaches are outlined for different acid-base imbalances, including correcting underlying causes and using sodium bicarbonate or respiratory support as needed.
Stridor and drooling in infants and children
This document discusses various causes of stridor in children under 6 months and over 6 months of age. In infants under 6 months, common causes of stridor include laryngomalacia, vocal cord paralysis, subglottic stenosis, vascular rings, and hemangiomas. For older children over 6 months, common causes are croup, epiglottitis, bacterial tracheitis, foreign body aspiration, and retropharyngeal abscess. Each condition is described in terms of symptoms, diagnostic approach, and treatment options. Croup is highlighted as the most common cause of stridor outside the neonatal period.
EMPHYSEMATOUS PYELONEPHRITIS
This case discusses a 44-year-old male patient who presented with fever, abdominal pain, and constipation. Initial examination and tests revealed sepsis, uncontrolled diabetes, metabolic acidosis, and acute kidney injury. Imaging showed emphysematous pyelonephritis of the right kidney. The patient received IV antibiotics, fluids, insulin, percutaneous drainage of the right kidney, and hemodialysis. His condition improved with treatment but he may require future nephrectomy if his condition worsens. Emphysematous pyelonephritis is a rare, gas-forming kidney infection seen in diabetics that requires aggressive management with antibiotics, drainage, and potentially nephrectomy.
sudden cardiac death
Coronary artery disease is the major cause of sudden cardiac death in adults, accounting for 80% of cases. Cardiomyopathy accounts for 10-15% of cases, with hypertrophic cardiomyopathy being the most common cause of sudden cardiac death in young athletes. Other less common causes include hereditary channelopathies, valvular disease, and congenital anomalies, which together account for 5-10% of remaining cases. Prevention strategies for sudden cardiac death include avoiding proarrhythmic drugs, taking beta blockers, and receiving implantable cardiac defibrillators.
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Breast cancer: Post menopausal endocrine therapy
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.
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Syncope
- 1. ASHMAL
- 2. SYNCOPE Syncope, or fainting, is the abrupt loss of consciousness and postural tone resulting from transient global cerebral hypoperfusion, followed by complete spontaneous recovery. EPIDEMIOLOGY -Syncope is a presenting symptom in 1% to 3% of pediatric emergency -80% of pediatric fainting is neurocardiogenic. Neurologic disorders, mostly seizures, account for about 10% of episodes 2% to 3% are due to cardiac pathology
- 4. HISTORY History focused on hydration status, last meal, environmentalconditions, activity preceding the syncopal event, and the use of drugs and medications. Position and activity of child warmth, nausea, lightheadedness,and a visual gray- out or tunneling of vision is indicative of benign neurocardiogenic syncope. Loss of consciousness occurs with the onset of movements in seizures, but loss of consciousness precedes movements in most cases of true syncope Past and family history
- 5. LABORATORY EVALUATION ECG CXRAY TFT CBC
- 6. SUDDEN DEATH 7.5 cases per 100,000 children
- 7. ORTHOSTATIC SYNCOPE A drop of>20 mm Hg in blood pressure with an increase in heart rate of >20 beats/min when the child changes from a supine position to a standing position is often considered diagnostic of orthostatic hypotension. anemia,dehydration, and use of certain medications, especially calcium channel blockers and angiotensin- converting enzyme inhibitors. SITUATIONAL SYNCOPE Urination, defecation, coughing, and swallowing Stretching,neck extension, external neck pressure, and hair grooming also havebeen described as causing syncope, presumably due to carotid sinushypersensitivity or abnormal Valsalva responses.
- 8. HYPERTROPHIC CARDIOMYOPATHY Exertional syncope, congestive heart failure and cyanosis loud crescendo-decrescendo murmur may be heard at the left sternal border Ecg-left ventricular hypertrophy.