This document provides an overview of vasculitis including:
1. It classifies vasculitis based on the size of blood vessels involved - large, medium, or small vessel vasculitis.
2. It describes several specific types of vasculitis like Takayasu's arteritis, Kawasaki disease, granulomatosis with polyangiitis, and IgA vasculitis.
3. Clinical manifestations, diagnosis, and treatment options for vasculitis are discussed with an emphasis on using steroids and cytotoxic drugs to treat vasculitis.
This presentation is about pulmonary manifestations of systemic vasculitis,in it m discussing about WEGNER,S GRANULOMATOSIS, churg-strauss syndrome and MPA
This presentation is about pulmonary manifestations of systemic vasculitis,in it m discussing about WEGNER,S GRANULOMATOSIS, churg-strauss syndrome and MPA
ASCO 2014 Highlights: Breast Cancer, Prostate Cancer; AI diagnosingdianecleverley
American Society of Clinical Oncology, 2014.
ALTTO: all groups did well.
IOM reports: Out-of-pocket costs, termed financial toxicity, are a side effect of this disease.
Obese women with ER+ breast cancer are at a greater risk.
WATSON-like Artificial Intelligence computer program useful in as daignosis aid
New immune system of information security from CHINA by WooYun - CODE BLUE 2015CODE BLUE
This talk is about the introduction of Wooyun.
WooYun is a platform where security researchers report vulnerabilities and vendors give feedbacks. While WooYun follows vulnerabilities, it also provides researchers a platform for public interests, study, communication, and research.I will introduce how WooYun works and why we start this project in my presentation, also what WooYun changes in the security circle in China, and why, when, where it built, how it developed and the difficulties when developing.
Neurocysticercosis and its management in pediatric age group.difference between neurocysticrcosis and tubercuolma based on imaging.Life cycle of Neurocysticercosis.
NECROTISING FASCIITIS- the flesh eating infection
#surgicaleducator #necrotisingfasciitis #surgicaltutor #babysurgeon #usmle
· Dear Viewers
· Greetings from “Surgical Educator”
· Today in this episode I have discussed about Necrotising Fasciitis- the flesh eating infection
· It is common in immunocompromised patients even after trivial trauma.
· I have discussed about the overview,etiology,types,clinical features,complications and treatment of Necrotising Fasciitis
· I hope this video is interesting and also useful to all of you
· You can watch the video in the following links:
· surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
Thank you for watching the video
- 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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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!
6. Pathogenesis
• Direct attack by an agent.
• A process directed specifically at
components in vascular tissue (e.g.
ANCA, anti-basement membrane
disease).
• Secondary to an inflammatory process
(e.g. immune complex disease).
7. Antineutrophil cytoplasmic
antibodies, ANCA
Cause of ANCA-associated vasculitis (AAV)
C-antineutrophil cytoplasmic antibodies (CANCA) against proteinase 3 (PR3)
– Associated with GPA and MPA
– Disease activity is parallel to C-ANCA titer.
P-ANCA against myeloperoxidase (MPO) is
non-specific marker for vascultiis syndrome
and other autoimmune diseases
15. MONONEURITIS MULTIPLEX
Peripheral neuropathy of more than one
nerve roots.
Pathogenesis: nerve infarction resulting
from widespread destruction of
epineural arterioles.
Causes: vasculitis (esp PAN), diabetes
or other autoimmune conditions (eg.
SLE, RA).
16. Vasculitis syndrome (Vasculitides)
1.
2.
3.
Diagnostic triad:
Palpable purpura
Glomerulonephritis
More than three organs involved
–
–
–
–
–
–
Fever, fatigue, weight loss, granuloma
Nerve
Airway (ENT, Lung)
Allergy
GI
Musculoskeletal
18. Giant Cell Arteritis
(Temporal arteritis)
• Occurring primarily over the age of 50
years.
• Frequent features include fatigue,
temporal headaches, jaw claudication,
loss of vision, scalp tenderness,
polymyalgia rheumatica and aortic arch
syndrome.
• Rarely involves the skin, kidneys and
lungs.
• The ESR is usually highly elevated
21. Polymyalgia Rheumatica
Myalgia, low-grade fever, fatigue, weight loss and
an elevated ESR.
May combined with temporal arteritis
Morning stiffness is usually the predominant
feature
Muscular pain is often diffuse and is accentuated
by movement; pain at night is common.
Muscle strength is unimpaired although the pain
makes interpretation of muscle testing difficult.
Rx: Corticosteroid treatment is for at least 2
years.
22. TAKAYASU’S ARTERITIS
Affecting aorta and its major branches.
most commonly in females under 40 years of
age.
Clinical features
• Systemic phase: malaise, fever, night
sweats and fatigue.
• Occlusive phase: upper limb claudication,
headaches, postural dizziness and visual
disturbances.
• Reduced or absent upper limb pulses.
• Arterial bruits over the carotid, abdominal
and subclavian vessels.
28. Kawasaki disease
An acute febrile disease occuring most
commonly in infants and children under 5
years of age.
Sore red eyes , red lips tongue or mouth.
Redness or swelling of the hands and feet.
Rash all over the body.
Vasculitis, especially of the coronary arteries,
is the most serious and life-threatening
complication of the disease.
30. Granulomatosis with polyangiitis, GPA
2011-4 前舊名 WEGENER'S GRANULOMATOSIS
韋格納氏肉芽腫 (WG)
Young and middle age adults
Small and occasionally medium-sized
vessel vasculitis
Midline granuloma
– Necrosis, granuloma formation and vasculitis of
the upper and lower respiratory tracts.
Glomerulonephritis in 75% of patients.
Fever, malaise, weight loss, arthralgia, ,
sinusitis, nasal or oral ulceration, purpura
C-ANCA related.
31. Eosinophilic granulomatous angiitis
(CHURG–STRAUSS SYNDROME)
Small sized artery granulomatous
inflammation.
Clinical features
• History of atopy.
• Constitutional symptoms – fever, anorexia,
weight loss.
• Asthma.
• Peripheral neuropathy.
• Skin involvement – nodular lesions over
pressure areas.
• Peripheral eosinophilia.
33. Microscopic polyangiitis, MPA
Pathogenesis is presumed to be due to
circulating immune complexes.
Cutaneous involvement – palpable purpura or
urticaria-like lesions are most common, less
common are livedo reticularis, ulcerations or
necrosis.
Systemic involvement – arthritis,
glomerulonephritis, gastrointestinal
hemorrhage or colic are most common.
Skin biopsy: leukocytoclastic vasculitis
Kidney biopsy: pauci-immune segmental
necrotizing glomerulonephritis
36. IgA Vasculitis
(Henoch–Schönlein purpura)
A specific vasculitic
syndrome which is due to
IgA immune complexes
and IgA deposition within
the vessels and the kidney.
mainly in children and
young adults
The full spectrum includes
palpable purpura, nephritis,
arthritis and gastrointestinal
involvement.
39. Antiphospholipid Antibodies Syndrome (APS)
1 clinical + 1 lab criteria
Clinical criteria
1. Vascular thrombosis
» arterial, venous, or small-vessel thrombosis
1. Pregnancy morbidity
» One or more late-term (>10 weeks’ gestation) spontaneous
abortions
» One or more premature births at or before 34 weeks’
gestation
» Three or more spontaneous abortions before 10 weeks’
gestation
Laboratory criteria: on at least 2 occasions at least 12 weeks apart
(1) anticardiolipin (aCL),
(2) anti–b2 glycoprotein I (anti-b2 GPI),
(3) Lupus anti-coagulant
41. Recurrent oral
ulceration
Minor or major aphthous, or herpetiform ulceration
observed by physician or patient that recurred at least 3
times in one 12-month period
Plus 2 of the following criteria:
Recurrent
genital
ulceration
Eye lesions
Aphthous ulceration or scarring observed by physician or
patient
Skin lesions
Positive
pathergy test
Anterior uveitis, posterior uveitis, or cells in vitreous on
slit lamp exam.; or retinal vasculitis observed by
ophthalmologist
Erythema nodosum observed by physician or patient,
pseudofolliculitis or papulo- pustular lesions; or acneiform
nodules observed by physician in postadolescent patients
not receiving corticosteroid Tx
Read by physician at 24-48 hr
International Study Group for Behcet's Disease: Criteria for the diagnosis of
Behcet's disease. Lancet 335:1078-1080, 1990.
45. Steroid Therapy
Glucocorticoids
initially: 1 mg/kg/day prednisone
tapering of the dosis: 5-10 mg every week,
from 15 mg/day only 1 mg every several
week, treatment at least for 2 years
pulsus steroid: 1 g/day for 3 days
0.5 mg/kg/day after megadose pulse therapy
47. Indication for addition of
cytotoxic drug to prednisone
on initial evaluation, rapidly
progressive vasculitis with significant
visceral involvement
prednisone in high daily divided dosis
is not controlling the activity and
progression of vasculitis
prednisone dose cannot be tapered
to tolerable level and still controll the
disease
48. Other Treatment of Vasculitis
1.
2.
3.
4.
5.
Aspirin
Anticoagulants
Plasmapheresis
Intravenous immunoglobulin, IVIG
Biological agents
1. Anti-TNFα: (−)
2. Anti-CD20, Rituximab for ANCA-associated
vasculitis
49. Conclusion
Vasculitis is a syndrome and disease
spectrum
Classification depends on vascular size
and clinical manifestations
ANCA, anti-cardiolipin antibody are key
autoantibodies
Treated by steroid and cytotoxic drugs
Editor's Notes
sensitivity of 91 percent and specificity of 96 percent.