Patient ventilator interactions during mechanical ventilationDr.Mahmoud Abbas
Patient Ventilator Interaction during Mechanical Ventilation lecture presented by Dr.Lluis Blanch at Pulmonary Critical Care Egypt Meeting and Exhibition, January 2014. www.pccmegypt.com
Basic information on the Graphics displayed on the Ventilators. Prepared to educate about the graphics to train the professionals who work with Ventilators.
Patient ventilator interactions during mechanical ventilationDr.Mahmoud Abbas
Patient Ventilator Interaction during Mechanical Ventilation lecture presented by Dr.Lluis Blanch at Pulmonary Critical Care Egypt Meeting and Exhibition, January 2014. www.pccmegypt.com
Basic information on the Graphics displayed on the Ventilators. Prepared to educate about the graphics to train the professionals who work with Ventilators.
An excellent tool to treat refractory hypoxia. Target audience are ICU junior physicians and Respiratory Therapists. It will take away the fear of "What is APRV?" from your hearts and you will feel ready to give it a try.
This slide include information regarding ventilators, modes of ventilators , its parts, weaning process, nursing care of patient in mechanical ventilation.
An excellent tool to treat refractory hypoxia. Target audience are ICU junior physicians and Respiratory Therapists. It will take away the fear of "What is APRV?" from your hearts and you will feel ready to give it a try.
This slide include information regarding ventilators, modes of ventilators , its parts, weaning process, nursing care of patient in mechanical ventilation.
Demonstration on Mechanical Ventilator.pptxShashi Prakash
Consist of
Definition of mechanical ventilator
Purpose of mechanical ventilator
Indications of mechanical ventilations
Normal cycle of Respiration
Lung volumes
Modes of ventilator Types of mechanical ventilators
Describe the alarms of mechanical ventilator
Contraindications of mechanical ventilation
Complication of mechanical ventilator
Role of nurses during weaning and care of patient with VAP
How to ventilate COPD and ARDS in Intensive care unit. safe lung ventilation. PEEP, Tidal volume, mode of ventilation. limits of ventilation. ventilator alarms
A – Assess, Prevent and Manage Pain
B – Both SATs and SBTs
C – Choice of Sedation
D – Delirium: Assess, Prevent and Manage
E – Early Mobility and Exercise
F – Family Engagement and Empowerment
*www.iculiberation.org
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!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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
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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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
2. Background
• Main purpose of ventilator is to decrease the work of breathing
• What is work of breathing
3. Work of Breathing
• respiratory muscles account for 1% to 3% of total oxygen
consumption
• In patients with acute hypoxemic respiratory failure and shock who
are undergoing cardiopulmonary resuscitation, the respiratory
muscles account for approximately 20% of total oxygen consumption
• This is result of increased work of breathing
10. Campbell diagram as used to calculate work of breathing (WOB).
Dean R Hess Respir Care 2014;59:1773-1794
(c) 2012 by Daedalus Enterprises, Inc.
11. Trigger-Related Dyssynchrony
• Trigger-Related Dyssynchrony
• Trigger threshold is too high
• Muscle weakness
• Outside extra flow in VAC ventilation
• Auto PEEP
• Expiratory flow limitation
• Extra Triggering
18. Cycle-Related Dyssynchrony
• The duration of inspiratory muscle contraction leading to inspiration
is known as the patient’sneural inspiratory time (neural TI).
Asthma, chronic obstructive pulmonary disease (COPD),
pneumonia, cardiogenic pulmonary edema, and acute respiratory
distress syndrome (ARDS) are just a few of the many
conditions that cause an increase in work of breathing and,
with it, increased energy expenditure by the respiratory
muscles.
The energy expenditure of the respiratory muscles can
be quantified in terms of pressure-time product 2 —the time
integral of the difference between the esophageal pressure
tracing and the estimated recoil pressure of the chest wall 3 , 4
( Fig. 4-1 ). The pressure-time product of patients in acute
respiratory failure is about four times 5 – 7 the normal value
(100 cm H 2 O・s/min), and it can be increased sixfold in
individual patients. 5 , 6 The inspiratory pressure-time product
can be partitioned into resistive, elastic, and intrinsic
positive end-expiratory pressure (PEEP) components
( Fig. 4-1 ). 6 Patients in respiratory distress typically have a
30% to 50% greater inspiratory resistance, 6 100% greater
dynamic elastance, 6 and 100% to 200% greater intrinsic
PEEP 5 , 6 than do similar patients who are not in acute respiratory
failure. Inspiratory effort is almost equally divided
in offsetting intrinsic PEEP, elastic recoil, and inspiratory
resistance. 6 The increase in respiratory effort means that
the respiratory muscles account for a much larger fraction
of the body’s oxygen consumption. In healthy subjects, this
fraction is only 1% to 3% of total oxygen consumption. In
patients with acute hypoxemic respiratory failure and shock
who are undergoing cardiopulmonary resuscitation, the
respiratory muscles account for approximately 20% of total
oxygen consumption. 8
Respiratory effort during unassisted respiration. Recordings of flow ( inspiration upward ), esophageal ( Pes ), gastric ( Pga ), and transdiaphragmatic
( Pdi ) pressures and electrical activity of the diaphragm ( Edi ) in a stable patient with COPD ( left ) and in a patient with respiratory failure
( right ). The green vertical lines indicate the onset of inspiratory flow and the red vertical lines indicate the onset of expiratory flow. The excursions in
Pes and Edi in the patient in respiratory failure are three times greater than in the stable patient, signifying heightened respiratory motor output. The
increase in Pga during exhalation in the patient with respiratory failure signifies expiratory muscle recruitment.
Recordings of flow ( inspiration upward ), rib cage ( RC ), and abdominal ( Ab ) cross-sectional areas in two patients in respiratory distress.
The green vertical lines indicate the onset of inspiratory flow and the red vertical lines indicate the onset of expiratory flow. On the left , expansion of the
rib cage is occurring faster than expansion of the abdomen (asynchrony). On the right , while the rib cage expands during inspiration, the abdominal
cross-sectional area is getting smaller (paradox).
Campbell diagram as used to calculate work of breathing (WOB). The green area represents elastic WOB, and the blue area represents resistive WOB. The total shaded area represents total WOB.
Pressure-volume curve of a normal subject (dashed curve) and of a patient with ARDS (solid curve). The pressure-volume curve is shifted downwards on the volume axis and has a reduced total lung capacity (TLC). The sigmoid shape of the curve is much more evident in ARDS. Note the small amount of pressure at the start of the ARDS pressure-volume curve, indicating a small amount of intrinsic PEEP (PEEPi) at end-expiratory lung volume (EELV). Some investigators divide the curve into linear segments: Cstart, Cinf or Clin, and Cend (explained below). Using these segments, the upper and lower Pflex (the pressure at the intersection of 2 lines: a low compliance region at low lung volumes [Cstart] and a higher compliance region at higher lung volumes [Cinf]) were defined by the intersection of these lines. The lower (LIP) and upper (UIP) inflection points are defined by where the curve first begins to deviate from the line Clin. Mathematically, these are not inflection points; the true inflection point (where concavity changes direction) is marked by the arrow. FRC = functional residual capacity. From Reference 47.
Figure 7.1 Respiratory circuit demonstrating the flow trigger mechanism.
(a) A continuous amount of gas flows from the inspiratory limb to
the expiratory limb of the ventilator. (b) A patient’s inspiratory effort
will cause some of the gas flow to enter the patient instead of returning
to the ventilator. If the reduction in flow returning to the ventilator is
above the flow trigger threshold, the inspiratory effort would trigger the
ventilator. (c) The use of continuous-flow nebulizer treatments adds
additional flow into the inspiratory limb of the respiratory circuit. In
order for the patient to successfully trigger the ventilator, the patient
must inspire all of the flow delivered by the nebulizer, in addition to the
threshold amount of continuous flow from the inspiratory limb of the
ventilator that is destined for the expiratory limb.
Flow and pressure waveforms of a flow-targeted mode
demonstrating the response to a sustained patient inspiratory effort.
A patient inspiratory effort, which decreases alveolar pressure, will
not affect the flow waveform because the flow waveform is set in
flow-targeted mode. Instead, there will be a decrease in proximal
airway pressure during the inspiratory effort, as represented by a
divot in the pressure waveform.
