Tele cardiologypresentation
•
0 likes•143 views
This document proposes a rural tele-cardiology program using refurbished iMac computers equipped with medical imaging and monitoring devices. The program would allow cardiologists to remotely review patient data like echocardiograms, EKGs, and impedance cardiography readings from rural areas. The document outlines the key cardiac conditions and data types cardiologists work with and presents a paradigm shift toward detecting asymptomatic arterial wall disease earlier. It also references guidelines for screening asymptomatic populations to stratify cardiac risk levels.
Report
Share
Report
Share
Download to read offline
Recommended
stroke treatment and perspective
This document discusses stroke treatment and prevention. It begins with an introduction to stroke as the second leading cause of death globally. It then outlines various treatment options for stroke including antithrombotic therapies like antiplatelet agents and anticoagulants, neuroprotective drugs, and surgical interventions like carotid endarterectomy and stenting. The document emphasizes lifestyle changes and risk factor modification for stroke prevention in addition to medical therapies.
Medical Imaging In Future Physician
The document discusses trends in medical imaging and its role in modern medicine. It notes that medical imaging is becoming less invasive, more precise, and helps integrate complex clinical information to aid diagnosis and treatment. Molecular imaging allows recognition of molecules involved in diseases and monitoring of treatment response at the molecular level. The document outlines various radiotracers and medical imaging techniques used today as well as areas of emerging research.
Amersham and Hazlemere Health Presentation - Dr Chris Levy - 24 May 2015
The document discusses causes of death in the UK in 2010, statistics about the heart's function, coronary artery disease, diabetes prevalence in the UK, cholesterol and its effects, investigations for cardiovascular disease, treatments, hypertension definitions and background, epidemiology, risk factors, and complications and treatments for hypertension. It provides data on leading causes of death, heart rate and pumping statistics, prevalence of conditions, dietary information on cholesterol and fatty acids, and lifestyle recommendations for reducing cardiovascular risk.
Ekg 운동심전도-추출
This document discusses exercise stress electrocardiography (EKG/ECG). It provides information on:
1) The pathophysiology of exercise-induced changes seen on EKG and how exercise stress testing can detect coronary artery disease.
2) Common treadmill exercise protocols used including Bruce, Naughton, and modified ACIP protocols.
3) Procedure details including monitoring of heart rate, blood pressure and EKG before, during and after exercise.
4) Contraindications and risks of exercise stress testing.
Coronary artery disease (CAD)
The document discusses coronary artery disease (CAD). It begins with an introduction to coronary circulation and the importance of the coronary arteries in delivering blood to the heart muscle. It then discusses atherosclerosis, the primary cause of CAD. CAD is defined as the narrowing of one or more coronary arteries due to atherosclerotic plaque buildup, reducing blood flow to the heart. Risk factors, pathophysiology, clinical manifestations, diagnostic tests, medical and surgical management, and lifestyle changes are summarized. Nursing assessment and management of patients with CAD are also outlined.
Mens health
Men face higher risks of mortality and disease compared to women across many health issues. They are more likely to engage in risky behaviors like unhealthy eating, lack of exercise, excessive alcohol and drug use, and risk-taking behaviors. As a result, men have higher rates of cardiovascular disease, diabetes, suicide, and accidental death. Screening and preventative care can help address these issues. Regular health checks including blood pressure, cholesterol levels, cancer screenings, immunizations, and lifestyle counseling are recommended starting in a man's 20s and 50s to catch problems early and improve health outcomes.
Dr.amsterdam_Low Risk ED Chest Pain Patients_SJMC Cardiovascular Symposium
1) The document discusses evaluation and management of low-risk chest pain patients presenting to the emergency department.
2) It outlines the use of accelerated diagnostic protocols using serial electrocardiograms and cardiac biomarkers to quickly exclude heart attacks.
3) For some low-risk patients, no additional "confirmatory" testing is needed while for others tests like exercise treadmill testing, nuclear imaging or CT coronary angiography may provide high negative predictive value.
4) CT coronary angiography shows promise as a confirmatory test when used selectively in appropriate low-risk patients but has limitations including radiation exposure and inability to exclude in many patients.
Coronary artery calcium scoring IDoR 2018
Oral presentation lecture at the celebration of the Kurdistan association of radiologists on the International Day of Radiology 2018
Recommended
stroke treatment and perspective
This document discusses stroke treatment and prevention. It begins with an introduction to stroke as the second leading cause of death globally. It then outlines various treatment options for stroke including antithrombotic therapies like antiplatelet agents and anticoagulants, neuroprotective drugs, and surgical interventions like carotid endarterectomy and stenting. The document emphasizes lifestyle changes and risk factor modification for stroke prevention in addition to medical therapies.
Medical Imaging In Future Physician
The document discusses trends in medical imaging and its role in modern medicine. It notes that medical imaging is becoming less invasive, more precise, and helps integrate complex clinical information to aid diagnosis and treatment. Molecular imaging allows recognition of molecules involved in diseases and monitoring of treatment response at the molecular level. The document outlines various radiotracers and medical imaging techniques used today as well as areas of emerging research.
Amersham and Hazlemere Health Presentation - Dr Chris Levy - 24 May 2015
The document discusses causes of death in the UK in 2010, statistics about the heart's function, coronary artery disease, diabetes prevalence in the UK, cholesterol and its effects, investigations for cardiovascular disease, treatments, hypertension definitions and background, epidemiology, risk factors, and complications and treatments for hypertension. It provides data on leading causes of death, heart rate and pumping statistics, prevalence of conditions, dietary information on cholesterol and fatty acids, and lifestyle recommendations for reducing cardiovascular risk.
Ekg 운동심전도-추출
This document discusses exercise stress electrocardiography (EKG/ECG). It provides information on:
1) The pathophysiology of exercise-induced changes seen on EKG and how exercise stress testing can detect coronary artery disease.
2) Common treadmill exercise protocols used including Bruce, Naughton, and modified ACIP protocols.
3) Procedure details including monitoring of heart rate, blood pressure and EKG before, during and after exercise.
4) Contraindications and risks of exercise stress testing.
Coronary artery disease (CAD)
The document discusses coronary artery disease (CAD). It begins with an introduction to coronary circulation and the importance of the coronary arteries in delivering blood to the heart muscle. It then discusses atherosclerosis, the primary cause of CAD. CAD is defined as the narrowing of one or more coronary arteries due to atherosclerotic plaque buildup, reducing blood flow to the heart. Risk factors, pathophysiology, clinical manifestations, diagnostic tests, medical and surgical management, and lifestyle changes are summarized. Nursing assessment and management of patients with CAD are also outlined.
Mens health
Men face higher risks of mortality and disease compared to women across many health issues. They are more likely to engage in risky behaviors like unhealthy eating, lack of exercise, excessive alcohol and drug use, and risk-taking behaviors. As a result, men have higher rates of cardiovascular disease, diabetes, suicide, and accidental death. Screening and preventative care can help address these issues. Regular health checks including blood pressure, cholesterol levels, cancer screenings, immunizations, and lifestyle counseling are recommended starting in a man's 20s and 50s to catch problems early and improve health outcomes.
Dr.amsterdam_Low Risk ED Chest Pain Patients_SJMC Cardiovascular Symposium
1) The document discusses evaluation and management of low-risk chest pain patients presenting to the emergency department.
2) It outlines the use of accelerated diagnostic protocols using serial electrocardiograms and cardiac biomarkers to quickly exclude heart attacks.
3) For some low-risk patients, no additional "confirmatory" testing is needed while for others tests like exercise treadmill testing, nuclear imaging or CT coronary angiography may provide high negative predictive value.
4) CT coronary angiography shows promise as a confirmatory test when used selectively in appropriate low-risk patients but has limitations including radiation exposure and inability to exclude in many patients.
Coronary artery calcium scoring IDoR 2018
Oral presentation lecture at the celebration of the Kurdistan association of radiologists on the International Day of Radiology 2018
Carotid intima-media thickness
1) Carotid intima-media thickness (CIMT) measurement is used to assess subclinical atherosclerosis and predict cardiovascular risk. It involves ultrasound imaging of the carotid arteries.
2) Standardized protocols have been developed for measuring CIMT at specific locations in the carotid arteries. Automated methods have good correlation with manual measurements.
3) Higher CIMT is associated with increasing age. Baseline and progression of CIMT over time can predict future cardiovascular events independent of traditional risk factors. However, other emerging risk markers may provide better prediction than CIMT alone.
Thorax cardio coeur heart evaluation asymptomatic smoker p douek
The document discusses cardiovascular risk assessment in asymptomatic patients, specifically evaluating a 50-year-old asymptomatic smoker using coronary artery calcium scoring. Coronary artery calcium scoring can help reclassify patients' risk levels compared to traditional risk models and may lead patients to modify risk factors or receive preventative treatments. However, calcium scoring has limitations and its ability to improve outcomes beyond risk factor modification requires further study.
Cardiac Stress Test vs CT Coronary Angiogram: Which is better?
Cardiac stress tests and CT coronary angiography are effective options for evaluating heart disease, with certain advantages and limitations for each. A cardiac stress test such as a treadmill exercise stress test or stress echocardiogram can detect ischemia by provoking the heart during exercise or pharmacologically, but may have lower sensitivity and specificity than imaging tests. A CT coronary angiogram provides detailed images of the coronary arteries but exposes patients to radiation. The optimal test depends on the individual patient's characteristics, risk factors, and the specific question being answered.
Heart failure api
1) Heart failure is a major and growing public health problem, affecting over 15 million people in Europe with a prevalence of over 2-3% overall and 10-20% in those over 70 years old.
2) It is a primary cause of hospital admissions and readmissions, accounting for 5% of admissions and 40% of patients being readmitted or dying within a year. It represents a significant cost burden on healthcare systems.
3) Diagnosis involves clinical examination, ECG, chest x-ray, echocardiography and natriuretic peptide levels of BNP or NT-proBNP which can help differentiate between possible and likely heart failure.
4) Heart failure is now recognized as a
Role of CT Scan Calcium scoring in Coronary Artery Disease
CT Scan calcium scoring study is a non- invasive way of obtaining information about
presence,
location and
extent of calcified plaque in the coronary arteries.
Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is helpful prognostic tool.
The findings on cardiac CT are expressed as a calcium score.
Chap5 pres jeb
The document discusses three common cardiovascular diagnostic procedures: serum lipoprotein levels tests, echocardiography, and Holter monitor tests. Serum lipoprotein levels tests measure cholesterol and triglyceride levels in blood to determine risk for atherosclerosis. Echocardiography uses ultrasound to visualize the heart's structures and evaluate valves and pumping function. Holter monitors continuously measure heart electrical activity over hours to days to detect arrhythmias.
Approach to Chest Pain
1. A patient presented to the emergency room with chest pain. Initial assessment included ECG, cardiac monitoring, bloodwork, oxygen, aspirin, and morphine if not contraindicated.
2. Further evaluation depended on risk level based on history, exam, ECG findings, and cardiac enzymes. Low risk patients could be evaluated as outpatients, while higher risk patients required inpatient monitoring and treatment for acute coronary syndrome.
3. Ongoing management after discharge focused on lifestyle modifications like smoking cessation, exercise, diet, and medication adherence to control risk factors and prevent future events.
Peer To Peer Coding
The document discusses strategies for improving ICD-9 coding accuracy and completeness, with a focus on common chronic conditions like diabetes, hypertension, heart disease, and kidney disease. It provides diagnostic criteria and recommended ICD-9 codes for documenting complications from these conditions, such as neuropathy, retinopathy, kidney damage, and congestive heart failure. Checklists and electronic medical record tools are presented as ways to systematically capture this clinical information and apply the proper ICD-9 codes.
Dr naghavi's slides
This document outlines guidelines for screening and treating atherosclerosis in asymptomatic individuals. It involves 3 steps: 1) Testing for subclinical atherosclerosis using coronary calcium scoring and carotid intima-media thickness ultrasound. 2) Categorizing individuals based on test results and risk factors as very low to very high risk. 3) Treating risk factors and disease based on risk level, with lifestyle changes and medical treatment aggressiveness increasing with higher risk levels. Treatment is aimed at reducing future risk of heart attack and stroke.
Cardiac ct ccta
Cardiac CT provides a noninvasive way to evaluate the coronary arteries and cardiac structure. It has largely replaced invasive coronary angiography due to improvements in temporal and spatial resolution allowing for clear images of the heart. Cardiac CT is indicated to rule out coronary artery disease in low-moderate risk patients, assess anomalies, evaluate grafts and stents, and aid in surgical planning. It has limitations including irregular heart rates over 80 bpm, high calcium scores, small vessels, and radiation exposure. Proper patient selection and preparation are important to optimize results.
Routine Body Check-up & Good Health Tips For Elder Person
The document discusses the importance of routine health checkups for asymptomatic adults. It provides details on various screening tests that can be done for different organs like eyes, lungs, heart, liver, kidneys etc. These include tests like eye exam, spirometry, ECG, blood tests, mammography and PAP smear. The document also discusses BMI measurement and provides healthy ranges for various biomarkers. It emphasizes the importance of a balanced diet, exercise and lifestyle habits in maintaining overall health and preventing diseases.
Cardiogenic Shock - June_2017
This document summarizes a presentation given by Dr. Michael Dickinson on cardiogenic shock and mechanical circulatory support. It discusses recognizing high-risk heart failure and STEMI patients, engaging close hemodynamic monitoring on those patients, and activating a shock team when they deteriorate to consider mechanical support options like ECMO. It highlights data showing improved outcomes when mechanical support is provided earlier before patients require multiple high-dose inotropes or have prolonged cardiac arrest. The importance of standardized criteria for intervention versus leaving decisions to individual judgment is emphasized.
Lung cancer
Lung cancer is the leading cause of cancer death worldwide. Smoking is responsible for about 90% of lung cancer cases. The risk of lung cancer is greatly increased in current or former smokers. Screening with low-dose CT is recommended for those aged 55-80 with a significant smoking history. The main types of lung cancer are small cell lung cancer and non-small cell lung cancer. Symptoms vary depending on the location and size of the tumor but may include cough, hemoptysis, chest pain, and weight loss. Treatment options include surgery, chemotherapy, and radiation therapy. Prognosis depends on the stage of cancer at diagnosis.
Coronary Arteries
Introduction to coronary arteries, tests, and treatments, with brief look at peripheral arterial disease.
CAD.pdf
1. Coronary artery disease (CAD) occurs when there is an imbalance between the oxygen supply and demand of the heart muscle, usually due to atherosclerosis of the coronary arteries.
2. CAD is the leading cause of death worldwide for those over age 20 and prevalence increases with age.
3. Risk factors for CAD include hypertension, diabetes, dyslipidemia, smoking, obesity, and sedentary lifestyle.
4. Treatment involves medication, percutaneous interventions such as stents, and coronary artery bypass grafting depending on the severity and location of blockages.
RIESGO CARDIOMETABOLICO
Los fármacos recomendados para iniciar el tratamiento antihipertensivo en este paciente son:
- Candesartán: por su demostrada capacidad para disminuir la hipertrofia ventricular izquierda y reducir la proteinuria, lo que es importante dado que el paciente presenta diabetes e hipertrofia ventricular.
- Telmisartán: al igual que el candesartán, ha demostrado reducir la proteinuria en pacientes diabéticos. Además, posee efecto antioxidante y antiaterogénico que son beneficiosos en este tipo de pacientes.
- V
Case triple vessel disease
This case presentation describes a 42-year-old man who presented with chest heaviness radiating to his arms and back for the past 6-7 months. His medical history includes surgery for anal fistula. Various tests were performed, including ECG, echocardiogram, treadmill test, and coronary angiogram. The coronary angiogram revealed triple vessel disease. The diagnosis was determined to be coronary artery disease with triple vessel disease, along with atherosclerosis, angina pectoris, silent ischemia, and subclinical hypothyroidism.
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid artery stenosis refers to a 50% or greater blockage of the carotid arteries, which supply blood to the brain. The document discusses the anatomy of the carotid arteries and risk factors for ischemic stroke such as atherosclerosis. For asymptomatic patients, screening with carotid duplex ultrasound may be considered for those with multiple cardiovascular risk factors. Medical management including statins, blood pressure control, and aspirin can significantly reduce stroke risk. For high-risk asymptomatic patients, carotid endarterectomy or stenting may be options. Symptomatic patients with greater than 50% stenosis are generally treated with carotid revascularization, especially if additional risk factors are present.
Anesthesia for elderly
Anesthetic management of elderly patients requires special considerations. The elderly population is growing rapidly. Preoperative testing may not be needed for low or intermediate risk surgery if the patient is followed by their primary care physician and has no concerning findings on history and physical. Anesthetic drugs have longer durations of action in the elderly and some require lower doses for induction to avoid hypotension. Emergence from anesthesia takes longer in the elderly and regional anesthesia may be preferable to general anesthesia when possible. Careful titration of anesthetic drugs is important due to age-related changes in pharmacokinetics and pharmacodynamics.
Heart Failure By Dr. UC Samal
1. Heart failure is a major and growing public health problem, affecting over 15 million people in European societies with a prevalence of over 2-3% overall and 10-20% in those over 70 years of age.
2. It is a primary cause of hospital admissions and is present in about 10% of hospitalized patients, accounting for about 2% of national health expenditures.
3. Natriuretic peptides such as BNP and NT-proBNP can help in the diagnosis of heart failure in patients presenting with symptoms suggestive of heart failure. Elevated levels indicate a higher likelihood of heart failure.
BigDataInMedicine.pptx
This document provides an introductory tutorial on big data in medicine and healthcare. It defines big data as large volumes of structured, semi-structured, and unstructured data that can be mined for information, often referring to sizes in petabytes and exabytes. The key dimensions of big data are described as volume, velocity, variety, and veracity. Hadoop is presented as an open-source framework for distributed storage and processing of large datasets across clusters of commodity servers. Examples of using Hadoop and MapReduce for medical applications like predictive modeling, genomic research, and data integration are also provided.
Eating D/O
This document provides an outline on eating disorders that includes:
- A brief history noting the first descriptions of anorexia nervosa in 1873.
- Definitions of key terms like body mass index and diagnostic criteria for conditions like anorexia, bulimia, and binge eating disorder.
- Statistics on the epidemiology, gender differences, and cultural factors related to eating disorders.
- Discussions of etiology, risk factors, physical and psychological symptoms, common comorbidities, course and burden of illness, treatment approaches, and prevention strategies.
More Related Content
Similar to Tele cardiologypresentation
Carotid intima-media thickness
1) Carotid intima-media thickness (CIMT) measurement is used to assess subclinical atherosclerosis and predict cardiovascular risk. It involves ultrasound imaging of the carotid arteries.
2) Standardized protocols have been developed for measuring CIMT at specific locations in the carotid arteries. Automated methods have good correlation with manual measurements.
3) Higher CIMT is associated with increasing age. Baseline and progression of CIMT over time can predict future cardiovascular events independent of traditional risk factors. However, other emerging risk markers may provide better prediction than CIMT alone.
Thorax cardio coeur heart evaluation asymptomatic smoker p douek
The document discusses cardiovascular risk assessment in asymptomatic patients, specifically evaluating a 50-year-old asymptomatic smoker using coronary artery calcium scoring. Coronary artery calcium scoring can help reclassify patients' risk levels compared to traditional risk models and may lead patients to modify risk factors or receive preventative treatments. However, calcium scoring has limitations and its ability to improve outcomes beyond risk factor modification requires further study.
Cardiac Stress Test vs CT Coronary Angiogram: Which is better?
Cardiac stress tests and CT coronary angiography are effective options for evaluating heart disease, with certain advantages and limitations for each. A cardiac stress test such as a treadmill exercise stress test or stress echocardiogram can detect ischemia by provoking the heart during exercise or pharmacologically, but may have lower sensitivity and specificity than imaging tests. A CT coronary angiogram provides detailed images of the coronary arteries but exposes patients to radiation. The optimal test depends on the individual patient's characteristics, risk factors, and the specific question being answered.
Heart failure api
1) Heart failure is a major and growing public health problem, affecting over 15 million people in Europe with a prevalence of over 2-3% overall and 10-20% in those over 70 years old.
2) It is a primary cause of hospital admissions and readmissions, accounting for 5% of admissions and 40% of patients being readmitted or dying within a year. It represents a significant cost burden on healthcare systems.
3) Diagnosis involves clinical examination, ECG, chest x-ray, echocardiography and natriuretic peptide levels of BNP or NT-proBNP which can help differentiate between possible and likely heart failure.
4) Heart failure is now recognized as a
Role of CT Scan Calcium scoring in Coronary Artery Disease
CT Scan calcium scoring study is a non- invasive way of obtaining information about
presence,
location and
extent of calcified plaque in the coronary arteries.
Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is helpful prognostic tool.
The findings on cardiac CT are expressed as a calcium score.
Chap5 pres jeb
The document discusses three common cardiovascular diagnostic procedures: serum lipoprotein levels tests, echocardiography, and Holter monitor tests. Serum lipoprotein levels tests measure cholesterol and triglyceride levels in blood to determine risk for atherosclerosis. Echocardiography uses ultrasound to visualize the heart's structures and evaluate valves and pumping function. Holter monitors continuously measure heart electrical activity over hours to days to detect arrhythmias.
Approach to Chest Pain
1. A patient presented to the emergency room with chest pain. Initial assessment included ECG, cardiac monitoring, bloodwork, oxygen, aspirin, and morphine if not contraindicated.
2. Further evaluation depended on risk level based on history, exam, ECG findings, and cardiac enzymes. Low risk patients could be evaluated as outpatients, while higher risk patients required inpatient monitoring and treatment for acute coronary syndrome.
3. Ongoing management after discharge focused on lifestyle modifications like smoking cessation, exercise, diet, and medication adherence to control risk factors and prevent future events.
Peer To Peer Coding
The document discusses strategies for improving ICD-9 coding accuracy and completeness, with a focus on common chronic conditions like diabetes, hypertension, heart disease, and kidney disease. It provides diagnostic criteria and recommended ICD-9 codes for documenting complications from these conditions, such as neuropathy, retinopathy, kidney damage, and congestive heart failure. Checklists and electronic medical record tools are presented as ways to systematically capture this clinical information and apply the proper ICD-9 codes.
Dr naghavi's slides
This document outlines guidelines for screening and treating atherosclerosis in asymptomatic individuals. It involves 3 steps: 1) Testing for subclinical atherosclerosis using coronary calcium scoring and carotid intima-media thickness ultrasound. 2) Categorizing individuals based on test results and risk factors as very low to very high risk. 3) Treating risk factors and disease based on risk level, with lifestyle changes and medical treatment aggressiveness increasing with higher risk levels. Treatment is aimed at reducing future risk of heart attack and stroke.
Cardiac ct ccta
Cardiac CT provides a noninvasive way to evaluate the coronary arteries and cardiac structure. It has largely replaced invasive coronary angiography due to improvements in temporal and spatial resolution allowing for clear images of the heart. Cardiac CT is indicated to rule out coronary artery disease in low-moderate risk patients, assess anomalies, evaluate grafts and stents, and aid in surgical planning. It has limitations including irregular heart rates over 80 bpm, high calcium scores, small vessels, and radiation exposure. Proper patient selection and preparation are important to optimize results.
Routine Body Check-up & Good Health Tips For Elder Person
The document discusses the importance of routine health checkups for asymptomatic adults. It provides details on various screening tests that can be done for different organs like eyes, lungs, heart, liver, kidneys etc. These include tests like eye exam, spirometry, ECG, blood tests, mammography and PAP smear. The document also discusses BMI measurement and provides healthy ranges for various biomarkers. It emphasizes the importance of a balanced diet, exercise and lifestyle habits in maintaining overall health and preventing diseases.
Cardiogenic Shock - June_2017
This document summarizes a presentation given by Dr. Michael Dickinson on cardiogenic shock and mechanical circulatory support. It discusses recognizing high-risk heart failure and STEMI patients, engaging close hemodynamic monitoring on those patients, and activating a shock team when they deteriorate to consider mechanical support options like ECMO. It highlights data showing improved outcomes when mechanical support is provided earlier before patients require multiple high-dose inotropes or have prolonged cardiac arrest. The importance of standardized criteria for intervention versus leaving decisions to individual judgment is emphasized.
Lung cancer
Lung cancer is the leading cause of cancer death worldwide. Smoking is responsible for about 90% of lung cancer cases. The risk of lung cancer is greatly increased in current or former smokers. Screening with low-dose CT is recommended for those aged 55-80 with a significant smoking history. The main types of lung cancer are small cell lung cancer and non-small cell lung cancer. Symptoms vary depending on the location and size of the tumor but may include cough, hemoptysis, chest pain, and weight loss. Treatment options include surgery, chemotherapy, and radiation therapy. Prognosis depends on the stage of cancer at diagnosis.
Coronary Arteries
Introduction to coronary arteries, tests, and treatments, with brief look at peripheral arterial disease.
CAD.pdf
1. Coronary artery disease (CAD) occurs when there is an imbalance between the oxygen supply and demand of the heart muscle, usually due to atherosclerosis of the coronary arteries.
2. CAD is the leading cause of death worldwide for those over age 20 and prevalence increases with age.
3. Risk factors for CAD include hypertension, diabetes, dyslipidemia, smoking, obesity, and sedentary lifestyle.
4. Treatment involves medication, percutaneous interventions such as stents, and coronary artery bypass grafting depending on the severity and location of blockages.
RIESGO CARDIOMETABOLICO
Los fármacos recomendados para iniciar el tratamiento antihipertensivo en este paciente son:
- Candesartán: por su demostrada capacidad para disminuir la hipertrofia ventricular izquierda y reducir la proteinuria, lo que es importante dado que el paciente presenta diabetes e hipertrofia ventricular.
- Telmisartán: al igual que el candesartán, ha demostrado reducir la proteinuria en pacientes diabéticos. Además, posee efecto antioxidante y antiaterogénico que son beneficiosos en este tipo de pacientes.
- V
Case triple vessel disease
This case presentation describes a 42-year-old man who presented with chest heaviness radiating to his arms and back for the past 6-7 months. His medical history includes surgery for anal fistula. Various tests were performed, including ECG, echocardiogram, treadmill test, and coronary angiogram. The coronary angiogram revealed triple vessel disease. The diagnosis was determined to be coronary artery disease with triple vessel disease, along with atherosclerosis, angina pectoris, silent ischemia, and subclinical hypothyroidism.
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid artery stenosis refers to a 50% or greater blockage of the carotid arteries, which supply blood to the brain. The document discusses the anatomy of the carotid arteries and risk factors for ischemic stroke such as atherosclerosis. For asymptomatic patients, screening with carotid duplex ultrasound may be considered for those with multiple cardiovascular risk factors. Medical management including statins, blood pressure control, and aspirin can significantly reduce stroke risk. For high-risk asymptomatic patients, carotid endarterectomy or stenting may be options. Symptomatic patients with greater than 50% stenosis are generally treated with carotid revascularization, especially if additional risk factors are present.
Anesthesia for elderly
Anesthetic management of elderly patients requires special considerations. The elderly population is growing rapidly. Preoperative testing may not be needed for low or intermediate risk surgery if the patient is followed by their primary care physician and has no concerning findings on history and physical. Anesthetic drugs have longer durations of action in the elderly and some require lower doses for induction to avoid hypotension. Emergence from anesthesia takes longer in the elderly and regional anesthesia may be preferable to general anesthesia when possible. Careful titration of anesthetic drugs is important due to age-related changes in pharmacokinetics and pharmacodynamics.
Heart Failure By Dr. UC Samal
1. Heart failure is a major and growing public health problem, affecting over 15 million people in European societies with a prevalence of over 2-3% overall and 10-20% in those over 70 years of age.
2. It is a primary cause of hospital admissions and is present in about 10% of hospitalized patients, accounting for about 2% of national health expenditures.
3. Natriuretic peptides such as BNP and NT-proBNP can help in the diagnosis of heart failure in patients presenting with symptoms suggestive of heart failure. Elevated levels indicate a higher likelihood of heart failure.
Similar to Tele cardiologypresentation (20)
Thorax cardio coeur heart evaluation asymptomatic smoker p douek
Thorax cardio coeur heart evaluation asymptomatic smoker p douek
Cardiac Stress Test vs CT Coronary Angiogram: Which is better?
Cardiac Stress Test vs CT Coronary Angiogram: Which is better?
Role of CT Scan Calcium scoring in Coronary Artery Disease
Role of CT Scan Calcium scoring in Coronary Artery Disease
Routine Body Check-up & Good Health Tips For Elder Person
Routine Body Check-up & Good Health Tips For Elder Person
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
Carotid Artery Stenosis Dr Pankaj Rathi DM Traine Shri Aurobindo Medical Coll...
More from Frank Meissner
BigDataInMedicine.pptx
This document provides an introductory tutorial on big data in medicine and healthcare. It defines big data as large volumes of structured, semi-structured, and unstructured data that can be mined for information, often referring to sizes in petabytes and exabytes. The key dimensions of big data are described as volume, velocity, variety, and veracity. Hadoop is presented as an open-source framework for distributed storage and processing of large datasets across clusters of commodity servers. Examples of using Hadoop and MapReduce for medical applications like predictive modeling, genomic research, and data integration are also provided.
Eating D/O
This document provides an outline on eating disorders that includes:
- A brief history noting the first descriptions of anorexia nervosa in 1873.
- Definitions of key terms like body mass index and diagnostic criteria for conditions like anorexia, bulimia, and binge eating disorder.
- Statistics on the epidemiology, gender differences, and cultural factors related to eating disorders.
- Discussions of etiology, risk factors, physical and psychological symptoms, common comorbidities, course and burden of illness, treatment approaches, and prevention strategies.
Bipolar D/O
This document provides information on bipolar disorder, including its subtypes, diagnostic criteria, epidemiology, clinical presentation, etiology and risk factors, comorbidity, and treatment. It discusses bipolar disorder types I and II, as well as cyclothymic disorder. It outlines the DSM-5 diagnostic criteria for mania, hypomania, and depression. It notes the prevalence of bipolar disorder in adults and youth, gender and age of onset differences, burden of illness, and course of the disorder. It covers etiology, risk factors, and high rates of comorbidity with other psychiatric disorders. It also discusses clinical presentations, differential diagnosis, assessment, and treatment approaches including pharmacotherapy, sleep hygiene, psychosocial
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
This document discusses several electrocardiogram patterns that can indicate risk of sudden cardiac death. It presents six case studies and the corresponding ECG patterns:
1) Wolf-Parkinson-White syndrome seen in a 34-year-old with palpitations, shown by a short PR interval and delta wave.
2) Brugada syndrome in a 36-year-old with chest pain, shown by ST elevation in right precordial leads.
3) Arrhythmogenic right ventricular dysplasia in a 28-year-old with dizziness, shown by epsilon waves and T wave inversion.
4) Long QT syndrome in a 44-year-old with dizziness and
PE case
1. This case presentation discusses a 27-year-old Hispanic female who presented with syncope and anemia and was ultimately diagnosed with pulmonary embolism.
2. An echocardiogram revealed signs consistent with pulmonary embolism including right ventricular dysfunction, severe tricuspid regurgitation, and elevated pressures in the inferior vena cava.
3. A CT scan showed saddle emboli in the main pulmonary artery and clots throughout both lungs. Interventional procedures discussed for treating massive pulmonary embolism when thrombolysis fails include catheter-directed techniques like embolectomy and balloon angioplasty.
Pediatric delirium
This document provides an overview of pediatric delirium, including its epidemiology, clinical characteristics, diagnosis, treatment, and potential sequelae. Some key points:
- Pediatric delirium occurs in 20-30% of critically ill children and is underrecognized. It can be hyperactive, hypoactive, or mixed in presentation.
- Diagnosis involves assessing for disturbances in attention, cognition, and awareness that fluctuate and are caused by medical conditions or treatments. Scales are used to aid diagnosis.
- Treatment of hyperactive delirium involves starting low doses of haloperidol or risperidone and monitoring for side effects, while hypoactive delirium has no established treatments.
- D
Taktosubo cardiomyopathy verona june2018
1. The document discusses two case studies of patients who experienced Takotsubo cardiomyopathy, which is a type of temporary heart muscle weakening or dysfunction brought on by severe emotional or physical stress.
2. The authors propose that abnormal adult attachment, as manifested through transitional objects like a cherished vehicle, is a risk factor for later developing Takotsubo cardiomyopathy if that transitional object is lost.
3. They present models showing how unresolved or complicated grief over past losses can lead to Takotsubo cardiomyopathy months or years later if a symbolic replacement for the loss is then damaged or taken away.
Drug induced brugadda apa
1. A 48-year-old female taking amitriptyline and fluoxetine for over 5 years presented with dizziness and was found to have Type 1 Brugada syndrome on her EKG.
2. Brugada syndrome is a rare cardiac condition caused by a genetic mutation that can increase the risk of sudden cardiac death, and certain drugs including amitriptyline are known to potentially induce Brugada syndrome.
3. While baseline EKGs are often normal in Brugada syndrome, serial monitoring is recommended for patients taking drugs known to induce it, as this case highlights the potential for late onset of changes when exposed long term to triggering medications.
Curanderos presentation
This document discusses the importance of cultural competence in psychiatric care for children on the Texas-Mexico border. It describes two cases of young Hispanic females who experienced hallucinations and were treated by both local curanderos (faith healers) and psychiatrists. The treatment team took time to understand the families' cultural beliefs and integrate them into the treatment plans. It emphasizes that cultural competence is essential for physicians due to increasing diversity and the role of culture in shaping illness perceptions and treatments.
Pills & Thrills
- A 24-year-old male college student overdosed on Coricidin cough and cold medicine ("Triple C's") to get high, resulting in grand mal seizures. He was intubated and treated with magnesium and bicarbonate for severe lactic acidosis and prolonged QTc interval.
- "Triple C's" or dextromethorphan (DXM) is a cough suppressant that is abused for its euphoric and dissociative effects but can cause seizures, cardiac issues like prolonged QTc, and death in high doses.
- The patient required intensive care for 7 days but survived after aggressive treatment of his lactic acidosis, seizures, and prolonged QTc
Verona sleep hx presentation
This document discusses the importance of obtaining a detailed sleep history in evaluating and managing post-traumatic stress disorder (PTSD). It presents two case studies to illustrate this point. The first case involves a veteran experiencing night terrors related to combat trauma memories as well as significant dissociative experiences during the day. The second case describes a veteran with delayed onset PTSD who is experiencing REM sleep behavior disorder and progressive memory problems, suggesting an underlying neurodegenerative process. The document argues that a thorough examination of a patient's sleep phenomena, rather than just noting the presence of nightmares, can provide crucial insights into their psychological presentation and lead to improved treatment.
Burns zagreb presentation
This document provides guidance on the initial assessment and management of a patient with burns. It details the patient's history of a 39-year-old man who suffered scalding burns after losing cold water in the shower. The physical exam found burns covering 9%, 18%, 18%, 18%, 9%, and 1% of the patient's body surface area. Key priorities for burn treatment include airway, breathing, circulation, exposing the skin, and wound care. Initial labs and assessments should evaluate for potential complications like inhalation injuries. Fluid resuscitation is critical and guidelines are provided for calculating fluid volumes based on the patient's weight, burn percentage, and urine output goals. Airway management may require intubation depending on signs
Hemmorhagic fever zagreb
This document discusses a 27-year-old male patient presenting with fever, renal failure, and hemorrhagic symptoms who is diagnosed with Korean hemorrhagic fever (KHF). KHF is caused by hantaviruses carried by rodents. It presents initially as fever and progresses through hypotensive, oliguric, and diuretic stages. While severe cases have high mortality, intravenous ribavirin treatment was shown to reduce mortality and complications in a Chinese clinical trial. KHF and related illnesses like nephropathia epidemica are occupational hazards for those exposed to infected rodents.
Tropical cardiology
This document presents a case of a 41-year-old Kenyan male presenting with wheezing, cough, and orthopnea. On exam, he has elevated blood pressure, wheezing, increased jugular venous pressure, and an abnormal EKG. The document then reviews various tropical cardiac diseases including protein-calorie malnutrition, beriberi heart disease, idiopathic cardiomyopathy, tropical endomyocardial fibrosis, pericardial diseases, rheumatic fever, and various infectious myocardiopathic diseases that can present in tropical regions.
Schistomasis
This document discusses a case of Schistosomiasis haematobium in a 25-year-old male from Kenya. Laboratory tests found eggs of S. haematobium in the patient's urine. The document then provides details on the life cycle, epidemiology, clinical manifestations, diagnosis, and treatment of schistosomiasis. Schistosomiasis remains a major public health problem worldwide, with certain areas of Africa and the Philippines having high infection rates. Praziquantel is the treatment of choice.
Onchocerciasis
The patient is a native of Kenya who recently spent 9 months in Croatia and presents with progressively decreased vision in the left eye over 3 weeks. Exam finds eczematoid dermatitis and hypopigmentation of the legs with sclerosing keratitis of the left cornea. Labs show 90% eosinophilia. The document discusses onchocerciasis, caused by the filarial nematode Onchocerca volvulus transmitted by blackflies in equatorial Africa and other regions. Clinical manifestations include skin lesions, subcutaneous nodules, and eye involvement that can lead to blindness. Diagnosis involves skin snip biopsy and treatment is diethylcarbamazine or ivermectin
Malaria
- 34 year old male from Pakistan presents with fever, rigors, and sweats for 3 days after travel to Croatia 14 days prior. Physical exam is notable for fever of 102.7F but otherwise unremarkable.
- Malaria is endemic in parts of Pakistan, transmitted by several mosquito species. P. falciparum is increasing and causes the most severe disease.
- The patient likely has malaria acquired in Pakistan or Croatia, with P. falciparum or P. vivax being the most common causes. He will be treated with intravenous quinidine followed by oral therapy if parasites decrease sufficiently.
Visceral leishmanasis
Visceral leishmaniasis is caused by the L. donovani parasite and transmitted through sandfly bites. It is endemic in parts of Asia, Africa, South America, and around the Mediterranean. The patient is a 45-year-old male from Pakistan presenting with fever, weight loss, and wasting for 4-5 weeks. Laboratory findings show anemia, thrombocytopenia, and leukopenia. Sodium stibogluconate is the first-line treatment, though amphotericin B or pentamidine may be used if initial treatment fails.
Chest pain perals
This document discusses the evaluation and diagnosis of chest pain. It notes that the chest x-ray is an important initial test that can provide clues to life-threatening causes of chest pain other than coronary artery disease. A thorough history is also essential in evaluating stable patients with chest pain. The document then lists and describes various life-threatening and non-life-threatening potential causes of chest pain, as well as abnormalities that may be seen on electrocardiogram, chest x-ray, and lab tests in different conditions.
Cardiomyopathy
This document discusses various types of cardiomyopathies including dilated, restrictive, hypertrophic, and infectious cardiomyopathy. It provides details on specific cases including symptoms, diagnostic studies, treatment, and prognosis. Causes of cardiomyopathy discussed include viruses, bacteria, fungi, parasites, drugs, toxins, malnutrition, and genetic factors. Infectious etiologies like Coxsackie virus are among the most common causes. Diagnosis involves echocardiogram, biopsy, and identifying an infectious agent. Treatment focuses on the underlying cause and managing heart failure symptoms.
More from Frank Meissner (20)
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
Recently uploaded
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdf
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
Bath patient Fundamental of Nursing.pptx
This is presentation about how to bath a patient.
It is a fundamental of nursing.
一比一原版(USF毕业证)旧金山大学毕业证如何办理
USF毕业证offer【微信95270640】《旧金山大学毕业证购买》《如何办理USF毕业证旧金山大学文凭学历》Q微信95270640实体公司，专业可靠，办理毕业证办美国成绩单,做加拿大文凭学历认证,办新西兰学位证，学位证书是什么?《制作旧金山大学毕业证多少钱》《USF学历证书丢了怎么办理》办澳洲文凭认证，办留信网认证（网上可查，实体公司，专业可靠）
专业为留学生办理旧金山大学旧金山大学硕士学位证成绩单【100%存档可查】留学全套申请材料办理。本公司承诺所有毕业证成绩单成品全部按照学校原版工艺对照一比一制作和学校一样的羊皮纸张保证您证书的质量！
如果你回国在学历认证方面有以下难题请联系我们我们将竭诚为你解决认证瓶颈
1所有材料真实但资料不全无法提供完全齐整的原件。【如：成绩单丶毕业证丶回国证明等材料中有遗失的。】
2获得真实的国外最终学历学位但国外本科学历就读经历存在问题或缺陷。【如：国外本科是教育部不承认的或者是联合办学项目教育部没有备案的或者外本科没有正常毕业的。】
3学分转移联合办学等情况复杂不知道怎么整理材料的。时间紧迫自己不清楚递交流程的。
如果你是以上情况之一请联系我们我们将在第一时间内给你免费咨询相关信息。我们将帮助你整理认证所需的各种材料.帮你解决国外学历认证难题。
国外旧金山大学旧金山大学硕士学位证成绩单办理方法：
1客户提供办理信息：姓名生日专业学位毕业时间等（如信息不确定可以咨询顾问：我们有专业老师帮你查询旧金山大学旧金山大学硕士学位证成绩单）；
2开始安排制作旧金山大学毕业证成绩单电子图；
3旧金山大学毕业证成绩单电子版做好以后发送给您确认；
4旧金山大学毕业证成绩单电子版您确认信息无误之后安排制作成品；
5旧金山大学成品做好拍照或者视频给您确认；
6快递给客户（国内顺丰国外DHLUPS等快读邮寄）。头贼脑的倒也逗人喜爱日上三竿时山娃总爱窜进自家瓜棚里跟小伙伴们坐着聊天聊着聊着便忍不住往瓜田里逡巡一番抱起一只硕大的西瓜用石刀劈开抑或用拳头砸开每人抱起一大块就啃啃得满嘴满脸猴屁股般的红艳大家一个劲地指着对方吃吃地笑瓜裂得古怪奇形怪状却丝毫不影响瓜味甜丝丝的满嘴生津遍地都是瓜横七竖八的活像掷满了一地的大石块摘走二三只爷爷是断然发现不了的即便发现爷爷也不恼反而教山娃辨认孰熟孰嫩孰甜孰淡名义上是护瓜吃
Hypotension and role of physiotherapy in it
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
2024 HIPAA Compliance Training Guide to the Compliance Officers
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
practical guide of obesityfinal hyper1د حاتم البيطار القمة اكاديمي 0120238902...
https://www.facebook.com/drhatemnutritiondiploma01005684344/
https://www.facebook.com/hospitaldrhatem/
📞 01202389028
📞 01005684344
#دحاتم_البيطار
https://64a832848a05c.site123.me/
https://64a9fcd1e98aa.site123.me/
#دكتور_حاتم_البيطار
#دحاتم_البيطار
#timodentist
#drhatem_elbitar
#محاضر_طبي
#مكافحة_العدوي
#الزمالة_المصرية
#دكتور_اسنان
#الهرم_الغذائي
#ادارة_المستشفيات
#أقوي_اعتماد_في_مصر
#الغذاء_الصحي
#دبلومة_التغذية
#الغذاء
#دحاتم_البيطار
#الغذاء_والتغذية
📞01005684344
💬 واتس 01202389028
#دكتور_حاتم_البيطار
#دحاتم_البيطار
#timodentist
hatem elbitar
مكافحة العدوي
ادارة المستشفيات
الزمالة المصرية
دكتور اسنان
الهرم الغذائي
ادارة المستشفيات
الغذاء الصحي
دبلومة التغذية
الغذاء
البيطار استشاري
slides
الغذاء والتغذية
📞01005684344
💬 واتس 01202389028
Dr Hatem ElBitar
د حاتم البيطار
أستشاري وجراح أسنان
زميل الزمالة المصرية
محاضر ادارة المستشفيات ومكافحة العدوى
01005684344
#دحاتم_البيطار
http://bit.ly/2xzMIlo
https://64a832848a05c.site123.me/
https://64a9fcd1e98aa.site123.me/
https://daalacademy.com/instructor/drhatemelbitar/
MYASTHENIA GRAVIS POWER POINT PRESENTATION
Myasthenia gravis is a neurological disease. It affects the grave muscles in our body. Myasthenia gravis affects how the nerves communicate with the muscles. Drooping eyelids and/or double vision are often the first noticeable sign. It is involving the muscles controlling the eyes movement, facial expression, chewing and swallowing. It also effects the muscles neck and lip movement and respiration.
It is a neuromuscular disease characterized by abnormal weakness of voluntary muscles that improved with rest and the administration of anti-cholinesterase drugs.
The person may find difficult to stand, lift objects and speak or swallow. Medications and surgery can help the patient to relieve the symptoms of this lifelong illness.
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
EUR毕业证offer【微信95270640】《鹿特丹伊拉斯姆斯大学毕业证书原版制作EUR成绩单》【Q微信95270640】《仿制EUR毕业证成绩单鹿特丹伊拉斯姆斯大学学位证书pdf电子图》，A.为什么留学生需要操作留信认证?
留信认证全称全国留学生信息服务网认证,隶属于北京中科院。①留信认证门槛条件更低,费用更美丽,并且包过,完单周期短,效率高②留信认证虽然不能去国企,但是一般的公司都没有问题,因为国内很多公司连基本的留学生学历认证都不了解。这对于留学生来说,这就比自己光拿一个证书更有说服力,因为留学学历可以在留信网站上进行查询!
B.为什么我们提供的毕业证成绩单具有使用价值？
查询留服认证是国内鉴别留学生海外学历的唯一途径，但认证只是个体行为，不是所有留学生都操作，所以没有办理认证的留学生的学历在国内也是查询不到的，他们也仅仅只有一张文凭。所以这时候我们提供的和学校颁发的一模一样的毕业证成绩单，就有了使用价值。
实体公司，专业可靠，办理加拿大毕业证|办美国成绩单|做德国文凭学历认证|办新西兰学位证，办澳洲文凭认证，办留信网认证（网上可查，实体公司，专业可靠）铸就十年品质！信誉！实体公司！
办理国外鹿特丹伊拉斯姆斯大学毕业证书 #成绩单改成绩 #教育部学历学位认证 #毕业证认证 #留服认证 #使馆认证（留学回国人员证明） #（证）等
真实教育部认证教育部存档中国教育部留学服务中心认证（即教育部留服认证）网站100%可查.
真实使馆认证（即留学人员回国证明）使馆存档可通过大使馆查询确认.
留信网认证国家专业人才认证中心颁发入库证书留信网永久存档可查.
鹿特丹伊拉斯姆斯大学鹿特丹伊拉斯姆斯大学毕业证假文凭毕业证 #成绩单等全套材料从防伪到印刷从水印到钢印烫金跟学校原版100%相同.
国际留学归国服务中心：实体公司注册经营行业标杆精益求精！
国外毕业证学位证成绩单办理流程：
1客户提供办理鹿特丹伊拉斯姆斯大学鹿特丹伊拉斯姆斯大学毕业证假文凭信息：姓名生日专业学位毕业时间等（如信息不确定可以咨询顾问：我们有专业老师帮你查询）；
2开始安排制作鹿特丹伊拉斯姆斯大学毕业证成绩单电子图；
3鹿特丹伊拉斯姆斯大学毕业证成绩单电子版做好以后发送给您确认；
4鹿特丹伊拉斯姆斯大学毕业证成绩单电子版您确认信息无误之后安排制作成品；
5鹿特丹伊拉斯姆斯大学成品做好拍照或者视频给您确认；
6快递给客户（国内顺丰国外DHLUPS等快递邮寄鹿特丹伊拉斯姆斯大学鹿特丹伊拉斯姆斯大学毕业证假文凭）。地跟着父亲昼夜兼程第二天凌晨就辗转到了父亲的城哇父亲的城真的好大好美哟走出广州火车东站的那一刻山娃感受到了一种从未有过的激动和震撼太美了可爱的广州父亲的城山娃惊喜得几乎叫出声来山娃觉得父亲太伟大了居然能单匹马地跑到这么远这么大这么美的地方赚大钱高楼大厦鳞次栉比大街小巷人潮涌动山娃一路张望一路惊叹他发现城里的桥居然层层叠叠扭来扭去桥下没水却有着水一般的车水马龙山娃惊诧于城里的公交车那么大那么美不的
Letter to MREC - application to conduct study
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.Gemma Wean- Nutritional solution for Artemia
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
CANSA support - Caring for Cancer Patients' Caregivers
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
MBC Support Group for Black Women – Insights in Genetic Testing.pdf
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
DRAFT Ventilator Rapid Reference version 2.4.pdf
Ventilator rapid reference for the Zoll Z cvent. Presented for educational purposes only.
Recently uploaded (20)
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdf
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdf
2024 HIPAA Compliance Training Guide to the Compliance Officers
2024 HIPAA Compliance Training Guide to the Compliance Officers
practical guide of obesityfinal hyper1د حاتم البيطار القمة اكاديمي 0120238902...
practical guide of obesityfinal hyper1د حاتم البيطار القمة اكاديمي 0120238902...
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
chatgptfornlp-230314021506-2f03f614.pdf. 21506-2f03f614.pdf
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
NEEDLE STICK INJURY - JOURNAL CLUB PRESENTATION - DR SHAMIN EABENSON
CANSA support - Caring for Cancer Patients' Caregivers
CANSA support - Caring for Cancer Patients' Caregivers
MBC Support Group for Black Women – Insights in Genetic Testing.pdf
MBC Support Group for Black Women – Insights in Genetic Testing.pdf
Tele cardiologypresentation
- 1. Rural Tele-Cardiology: A Proposal Frank W Meissner MD FACP FACC FCCP FASNC CPHIMS
- 2. Cardiology Intellectual Work Products Principle Skill is Analysis of Cardiovascular Specific Signals and Images Cardiologist is just a Radiologist Who See’s Patient’s and Works at Night. Principal Signals - Sound & EKG Data Principal Images - US, Ionizing Radiation, RF
- 3. Adult Cardiology Knowledge Domain Detection & Treatment of Epicardial Coronary Artery Disease (CAC + MDCT Angiography) Detection & Treatment of Acquired Valvular Heart Disease (Echocardiography & Phonocardiography) Detection & Treatment of Cardiomyopathy (Echocardiography & Impedance Cardiography) Detection & Treatment of Heart Rhythm Disorders (EKG Systems & Arrhythmia Monitoring) Applied Lipid-ology & Health Promotion (TelePresence)
- 4. Sound Data - Heart/ Lung
- 5. Sound Data - Heart/ Lung
- 6. EKG Signals
- 7. EKG Signals
- 10. Echocardiography
- 11. 4-747’s # Deaths/D! Deaths (thousands) Coronary Heart Dz Cancer Accidents HIV/AIDS 959.2 544.7 93.8 32.7 American Heart Association. Heart and Stroke Statistical Update 2007.
- 12. Paradigm Shift- ! CAD Detection ! Symptomatic ! Luminal Obstruction ! Asymptomatic ! Arterial Wall Atherosclerosis!
- 13. Paradigm Shift in! CAD Detection ! Symptomatic ! Luminal Obstruction ! Asymptomatic ! Arterial Wall Atherosclerosis!
- 15. 0 (n=11,044) 1-10 (n=3,567) 11-100 (n=5,032) 101-299 (n=2,616) 300-399 (n=561) 400-699 (n=955) 700-999 (n=514) 1,000+ (n=964) !2=1363, p<0.0001 for variable overall and for each category subset. Cumulative Survival 0.0 2.0 4.0 6.0 8.0 10.0 12.0 0.70 0.75 0.80 0.85 0.90 0.95 1.00 All Cause Mortality and CAC Scores: Long Term Prognosis in 25, 253 patients Budoff, et al. JACC 2007; 49: 1860-70
- 16. Calcium Scoring Equipment 64 Slice CT scanner + 30 minutes of technician Training - Push Data Via Internet
- 17. Atherosclerosis Test Very Low Risk3 Negative Test • CCS =0 • CIMT<50th percentile Lower Risk Moderate Risk Positive Test • CCS !1 • CIMT !50th percentile or Carotid Plaque Moderately High Risk High Risk Very High Risk No Risk Factors5 + Risk Factors • CCS <100 & <75th% • CIMT <1mm & <75th% & No Carotid Plaque • Coronary Calcium Score (CCS) or • Carotid IMT (CIMT) & Carotid Plaque4 • CCS 100-399 or >75th% • CIMT !1mm or >75th% or <50% Stenotic Plaque • CCS >100 & >90th% or CCS !400 • !50% Stenotic Plaque6 Individualized Individualized Individualized 5-10 years 5-10 years Re-test Interval <70 mg/dl <100 mg/dl <70 Optional <130 mg/dl <100 Optional <130 mg/dl <160 mg/dl LDL Target All >75y receive unconditional treatment2 Apparently Healthy Population Men>45y Women>55y1 Exit Exit Myocardial IschemiaTest No Angiography Follow Existing Guidelines Yes The 1st S.H.A.P.E. Guideline Towards the National Screening for Heart Attack Prevention and Education (SHAPE) Program Step 1 Step 2 Step 3 Optional CRP>4mg ABI<0.9 Imaging Based Risk Screening
- 21. Mac-Based Tele-Cardiology Suite Built in Wireless & Ethernet Unparalleled Quality of Durability of Systems Higher Intrinsic Security with UNIX systems Built in iChat Video Teleconferencing System Add on VMWare Fusion or Parallels Desktop for Windows Emulation for EKG and Cardiac Impedance Systems Improved Ease of Use of ThinkLabs Stethoscope
- 22. Mac-Based Tele-Cardiology Suite OsirisX Ease of Remote Network Maintance via LogMeIn.Com
- 23. Store & Forward Work Process Model Upload Data to Google Docs Download to Local Storage
- 24. Refurbished iMac