This document discusses vascular emergencies and trauma, including acute limb ischemia caused by embolism or thrombosis, vascular trauma to the head and neck, cervical veins, subclavian artery, and blunt aortic injury. It also covers abdominal vascular trauma and extremity vascular injuries. Key points include the importance of history and physical exam findings in diagnosis, the need for immediate anticoagulation or surgery depending on the situation, and computed tomography playing a role in identifying injuries from blunt trauma.
Future of Non Thermal Ablation: Is the Future of Endovenous AblationVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Future of Non Thermal Ablation: Is the Future of Endovenous AblationVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Surgical Management of Lower Limb Occlusive Arterial Diseaserajendra meena
This slide explains briefly touches upon Occlusive Arterial Disease (Peripheral Arterial Disease (PAD)) in the lower limbs along with the types, classification, diagnostic evaluation and various management protocols.
Heart failure is a clinical syndrome that develops when –
The heart can not maintain adequate output
or
Can do so only at the expense of elevated ventricular filling pressure
Surgical Management of Lower Limb Occlusive Arterial Diseaserajendra meena
This slide explains briefly touches upon Occlusive Arterial Disease (Peripheral Arterial Disease (PAD)) in the lower limbs along with the types, classification, diagnostic evaluation and various management protocols.
Heart failure is a clinical syndrome that develops when –
The heart can not maintain adequate output
or
Can do so only at the expense of elevated ventricular filling pressure
Cardiogenicshock by Dr.Afroza Prioty -140123092109-phpapp02Afroza Prioty
A small overview on cardiogenic shock which sometimes becomes a burning issue for the medical personnels and to combat the situation, the measures should be taken immediately and urgently.
CEREBROVASCULAR ACCIDENT/STROKE • Also called “brain attack”, cerebral infarction, cerebral hemorrhage, ischemic stroke or stroke • A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. STEVE HENAO MDSTEVE HENAO MD
ACUTE LIMB ISCHEMIAACUTE LIMB ISCHEMIA
SUDDENSUDDEN DETERIORATION OF THE ARTERIALDETERIORATION OF THE ARTERIAL
SUPPLYSUPPLY
CAUSESCAUSES
TRAUMATRAUMA
IATROGENICIATROGENIC
EMBOLISMEMBOLISM
THROMBOSISTHROMBOSIS
3. STEVE HENAO MDSTEVE HENAO MD
EMBOLISMEMBOLISM
from the Greekfrom the Greek embolosembolos,, or “plug”or “plug”
usually occurs in otherwise normal arteriesusually occurs in otherwise normal arteries
4. STEVE HENAO MDSTEVE HENAO MD
ThrombosisThrombosis
““blood clotting within an artery”blood clotting within an artery”
progressiveprogressive atherosclerotic obstructionatherosclerotic obstruction
hypercoagulabilityhypercoagulability
aortic or arterial dissectionaortic or arterial dissection
5. STEVE HENAO MDSTEVE HENAO MD
Clinical PresentationClinical Presentation
acute ischemia affectsacute ischemia affects sensorysensory nerves firstnerves first
motormotor nervesnerves
skinskin
muscle tissuemuscle tissue
muscle tenderness is one of the end-stagemuscle tenderness is one of the end-stage
signssigns
6. STEVE HENAO MDSTEVE HENAO MD
historyhistory
DURATION OF SYMPTOMSDURATION OF SYMPTOMS IS THE MOSTIS THE MOST
IMPORTANT PART OF THE HXIMPORTANT PART OF THE HX
irreversible muscle necrosis inirreversible muscle necrosis in 6 - 8 hours6 - 8 hours
8. STEVE HENAO MDSTEVE HENAO MD
Initial managementInitial management
immediate anticoagulation withimmediate anticoagulation with heparinheparin
leg stabilizationleg stabilization
prevent deteriorationprevent deterioration
O2O2 by facemaskby facemask
improve skin perfusionimprove skin perfusion
IVFIVF resucitationresucitation
catheter monitoring for urine outputcatheter monitoring for urine output
analgesiaanalgesia
9. STEVE HENAO MDSTEVE HENAO MD
VASCULAR TRAUMAVASCULAR TRAUMA
- head and neck- head and neck
- head and neck- head and neck
Penetrating injuriesPenetrating injuries
80% of deaths are80% of deaths are strokestroke relatedrelated
10. STEVE HENAO MDSTEVE HENAO MD
Clinical presentationClinical presentation
Neck classically divided intoNeck classically divided into
“zones”“zones”
IIIIII: above the angle of the: above the angle of the
mandiblemandible
IIII: between cricoid and: between cricoid and
mandiblemandible
most common (47%)most common (47%)
II: below cricoid: below cricoid
11. STEVE HENAO MDSTEVE HENAO MD
evaluationevaluation
Hard signsHard signs:: 97% have a vascular injury97% have a vascular injury
shock, refractory hypotension, pulsatileshock, refractory hypotension, pulsatile
bleeding, bruit, enlarging hematoma, lossbleeding, bruit, enlarging hematoma, loss
of pulse with stable or evolving neurologicof pulse with stable or evolving neurologic
deficitdeficit
Soft signs:Soft signs: only 3% have a vascular injuryonly 3% have a vascular injury
hx of bleeding at scene, stablehx of bleeding at scene, stable
hematoma, nerve injury, proximity of thehematoma, nerve injury, proximity of the
injury track, unequal arm BPsinjury track, unequal arm BPs
13. STEVE HENAO MDSTEVE HENAO MD
BCVIBCVI
““blunt cerebrovascular injury”blunt cerebrovascular injury”
less than 1% of all admissions for blunt traumaless than 1% of all admissions for blunt trauma
stroke rates range from 25 to 58%stroke rates range from 25 to 58%
mortality rates 31 to 59%mortality rates 31 to 59%
many patients initially asymptomaticmany patients initially asymptomatic
can develop symptoms from 1 hr to many weekscan develop symptoms from 1 hr to many weeks
screeningscreening
15. STEVE HENAO MDSTEVE HENAO MD
BCVIBCVI
•
16 slice16 slice CTACTA has been validated as the primaryhas been validated as the primary
screening modality for BCVIscreening modality for BCVI
16. STEVE HENAO MDSTEVE HENAO MD
BCVIBCVI
•
The mainstay of treatment for BCVI isThe mainstay of treatment for BCVI is
antithrombotic therapyantithrombotic therapy
•
If the patient has no contraindications toIf the patient has no contraindications to
anticoagulation, a prudent protocol would beanticoagulation, a prudent protocol would be
heparin therapy (goal, activated partialheparin therapy (goal, activated partial
thromboplastin time of 50 to 60 seconds) andthromboplastin time of 50 to 60 seconds) and
transition to warfarin (goal, internationaltransition to warfarin (goal, international
normalized ratio of 2.0) for 3 months.normalized ratio of 2.0) for 3 months.
•
Antiplatelet therapy should be used for theAntiplatelet therapy should be used for the
same period.same period.
17. STEVE HENAO MDSTEVE HENAO MD
Subclavian InjurySubclavian Injury
•
Injuries to the thoracic outlet are often lethal.Injuries to the thoracic outlet are often lethal.
Prehospital mortality is 50% to 80%, and ofPrehospital mortality is 50% to 80%, and of
those patients who survive transport, 15% diethose patients who survive transport, 15% die
during treatment.during treatment.
•
long-term morbidity may be secondary tolong-term morbidity may be secondary to
brachial plexus injuries.brachial plexus injuries.
•
Endovascular treatmentEndovascular treatment in this area can obviatein this area can obviate
the need for extensive dissection at the base ofthe need for extensive dissection at the base of
the neck.the neck.
19. STEVE HENAO MDSTEVE HENAO MD
Cervical Venous InjuriesCervical Venous Injuries
•
If the patient has hard signs of a vascular injuryIf the patient has hard signs of a vascular injury
and is in extremis,and is in extremis, the neck and subclavianthe neck and subclavian
veins can be ligated with limited morbidityveins can be ligated with limited morbidity..
•
If the internal jugular vein is ligated, the patientIf the internal jugular vein is ligated, the patient
should be monitored forshould be monitored for cerebral edemacerebral edema;;
however, this is a rare occurrence, even withhowever, this is a rare occurrence, even with
bilateral internal jugular vein ligation.bilateral internal jugular vein ligation.
20. STEVE HENAO MDSTEVE HENAO MD
VASCULAR TRAUMA:VASCULAR TRAUMA:
thoracicthoracic
thoracicthoracic
BLUNT AORTIC INJURYBLUNT AORTIC INJURY
80% caused by MVC80% caused by MVC
head-on collisions - most commonhead-on collisions - most common
pts young - mean age: 39pts young - mean age: 39
9% survival at scene/9% survival at scene/ 98% overall mortality98% overall mortality
substance abuse is a factor in 40%substance abuse is a factor in 40%
seat belt use decreases risk by a factor of 4seat belt use decreases risk by a factor of 4
ejection from vehicle doubles the riskejection from vehicle doubles the risk
21. STEVE HENAO MDSTEVE HENAO MD
BAIBAI
CXRCXR
subxiphoid ultrasoundsubxiphoid ultrasound
multi - slice CTAmulti - slice CTA
ONCE DIAGNOSIS IS MADE = IMMEDIATEONCE DIAGNOSIS IS MADE = IMMEDIATE
SURGERYSURGERY
22. STEVE HENAO MDSTEVE HENAO MD
VASCULAR TRAUMA:VASCULAR TRAUMA:
abdominalabdominal
abdominalabdominal
penetrating trauma responsible for 90% ofpenetrating trauma responsible for 90% of
abdominal vascular injuriesabdominal vascular injuries
LOW VELOCITY: DIRECT INJURY TO VESSELLOW VELOCITY: DIRECT INJURY TO VESSEL
HIGH VELOCITY: SHOCK WAVE/TRANSIENTHIGH VELOCITY: SHOCK WAVE/TRANSIENT
CAVITATIONCAVITATION
23. STEVE HENAO MDSTEVE HENAO MD
blunt abdominal traumablunt abdominal trauma
rapid deceleration (MVC, falls)rapid deceleration (MVC, falls)
direct AP crushing (seat belt, direct blows)direct AP crushing (seat belt, direct blows)
direct laceration by bone fragment (severedirect laceration by bone fragment (severe
pelvic fx)pelvic fx)
26. STEVE HENAO MDSTEVE HENAO MD
Prehospital treatmentPrehospital treatment
Rapid transportation to Trauma CenterRapid transportation to Trauma Center
““SCOOP AND RUN”SCOOP AND RUN”
‘‘CONTROLLED HYPOTENSIONCONTROLLED HYPOTENSION’’
trying to balance exanguination againsttrying to balance exanguination against
cardiac arrestcardiac arrest
Immediate surgical control of the bleedingImmediate surgical control of the bleeding
27. STEVE HENAO MDSTEVE HENAO MD
•
Computed tomography (CT) has little or no roleComputed tomography (CT) has little or no role
in suspected vascular injuries resulting fromin suspected vascular injuries resulting from
penetrating traumapenetrating trauma during the acute stage.during the acute stage.
However, it may play a useful role in bluntHowever, it may play a useful role in blunt
trauma by identifying large hematomas, falsetrauma by identifying large hematomas, false
aneurysms, or vessel occlusionsaneurysms, or vessel occlusions
31. STEVE HENAO MDSTEVE HENAO MD
VASCULAR TRAUMA:VASCULAR TRAUMA:
extremityextremity
extremityextremity
90% of all peripheral arterial injuries occur in an90% of all peripheral arterial injuries occur in an
extremityextremity
civilian: upper extremitiescivilian: upper extremities
military: lower extremitiesmilitary: lower extremities
32. STEVE HENAO MDSTEVE HENAO MD
evaluationevaluation
Hard signsHard signs: (IMMEDIATE SURGICAL: (IMMEDIATE SURGICAL
EXPLORATION)EXPLORATION)
observed pulsatile bleeding, arterial thrill,observed pulsatile bleeding, arterial thrill,
bruit, absent distal pulse, visiblebruit, absent distal pulse, visible
expanding hematomaexpanding hematoma
Soft signs:Soft signs:
hemorrhage by history, neurologichemorrhage by history, neurologic
abnormality, diminished pulse, proximityabnormality, diminished pulse, proximity
to bone injury or penetrating woundto bone injury or penetrating wound
33. STEVE HENAO MDSTEVE HENAO MD
intra-arterial drugintra-arterial drug
injectioninjection
often neglected,often neglected, frequently misdiagnosed and mistreated arterial injuryfrequently misdiagnosed and mistreated arterial injury
BRACHIAL ARTERY : most commonBRACHIAL ARTERY : most common
street drugs w/ insoluble additivesstreet drugs w/ insoluble additives
SITE OF INJECTION SHOULD BE LOCATED AND NOTEDSITE OF INJECTION SHOULD BE LOCATED AND NOTED
injection followed by severe, unremitting paininjection followed by severe, unremitting pain
accompanied by edema, numbness, discoloration, cyanosis,accompanied by edema, numbness, discoloration, cyanosis,
mottlingmottling
34. STEVE HENAO MDSTEVE HENAO MD
QUESTIONS?QUESTIONS?
INTERESTING STORIES?INTERESTING STORIES?