Atherosclerosis - Definition - Risk Factors - Lesser and Non Quantitated risk factors - Arterial wall - The development of Atherosclerosis - Many Features of the injury Hypothesis - The process of Atherogenesis - Pathogenesis in short - Morphology of Atheroma - Components of Atheromatous Plaque (MP) - Complications and clinical significance - Cardiovascular risk and its assessment.
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!
Atherosclerosis - Definition - Risk Factors - Lesser and Non Quantitated risk factors - Arterial wall - The development of Atherosclerosis - Many Features of the injury Hypothesis - The process of Atherogenesis - Pathogenesis in short - Morphology of Atheroma - Components of Atheromatous Plaque (MP) - Complications and clinical significance - Cardiovascular risk and its assessment.
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!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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
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.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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
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
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
1. Vessel Wall Biology &
Atherosclerosis
Dr. Muhammad Nasir
Postgraduate Resident Vascular Surgery
2. Normal Vessel Wall
Arteries and veins have three main layers of the vessel wall.
Intima, Media and Adventitia.
In the arteries there are well developed layers that separate these three
compartments; internal elastic lamina (IEL) and the external elastic
lamina (EEL).
In veins these layers are disorganized, less prominent and are difficult
to define
Lymphatics also have these layers but they are less well defined.
4. Artery
Intima:
Innermost layer, extends from lumen to internal elastic lamina
Very thin, lined by endothelium
Consists of few scattered leukocytes, smooth muscle cells and
connective tissue of elastic and collagen fiber.
Endothelium:
Cell thickness varies from 0.1 um to 100 um
Regulator of vasomotor tone, hemostatic balance, permeability,
immunity
Simple squamous epithelium
Continuous layer of flat polygonal / elongated endothelial cells.
5. A Tight junctions ( zona occluden)
Barrier to the transport between ECs.
- Rigid tight junction
- Help to maintain polarity
B Adhrens junctions (zona adherens)
- Permits inter ECs communications
– movements of ions, metabolites,
6. Internal Elastic Lamina
Separates subendothelial layer from the media
Composed of elastic fibers 70-100 nm in diameter
In large arteries IEL and elastic lamellae may function as
barrier to macromolecular accumulation
Defective IEL result in abnormal attachment with ECs causing
gap – entry of macromolecules, lipids, leukocyte into intima.
Advanced plaque – fragmentation of the IEL and disruption of
medial layers.
Structural defects within IEL are directly implicated in the
onset of intimal thickening
7. MEDIA
Extends from IEL to adventitia
Is porous heterogenous medium consisting of ECM phase with
embedded SMCs.
Consist of SMCs, elastin and collagen fibres arranged in highly
oraganised fashion.
At low and physiologic pressure, media is chief determinant of arterial
properties.
8. ADVENTITIA
From EIL to ill defined boundary
continuous with the perivascular
connective tissue.
Cells are more sparse and consist
mainly of fibroblast.
Contains vasa vasorum and nerves.
9. Classification of Arteries
Classified according to cellular and fibrous components of media
1 Elastic arteries
Well defined elastic lamellae and collagen fibres are prominent in media - Connective
tissue fibres are less frequent
E.g arteries close to heart - aorta, brachiocephalic trunk, iliac arteries.
Lamellar from heart units decrease to periphery.
2 Muscular arteries
Primarily SMCs with fewer connective tissue.
Nonparallel branching elastin strands increases capacity to change in diameter under
neuro humoral stimulation.
e.g - femoral, popliteal, radial, ext carotid artery, etc
10. Veins
Venous system is adaptable with unique mechanism for accommodating hemodynamic stress
INTIMA
One layer ECs sitting on incomplete elastic basement membrane
MEDIA
Less developed than that of arterial system thus causing varicosities
SMCs of this layer held in quiescent state
Heparin like molecule neutralize FGF to downregulate cell proliferation.
When vein exposed to arterial flow - increase cell proliferation
ADVENTITIA
Thickest layer
abundant collagen fibers
Vasa vasorum is much more extensive compared with arteries
11. Venules
Smallest of venous vessel, formed from confluence of several cappilaries
10-50 um in diameter and 50 -650 um in length
During inflammation - Main site for blood cell diapedesis and tissue exudate from circulation
to interstitial tissue
VENOUS VALVES
Characteristic of small and medium sized vein- > 2mm dia.
Local intimal semilunar infolding
Reverse velocity of 30 cm/s – for valve closure
Chronic venous insufficiency causing reduction in number
14. Lymphatics
Initial lymphatics - single layer of ECs with large gap between cells and incomplete
basal lamina.
Large lymph vessels – 3 concentric tunicae
Valves in greater numbers
Unidirectional flow network originating in the interstitial space Draining fluid from
ECM
15. Hemodynamics of Blood Vessels
Sheer Stress
Endothelial Cells align in the direction of stress
Greater the stress – more elongated cells.
Redistribution of intracellular fiber quantity
Higher stress – ECs express higher amount of stress fibers including actin, myocin and
other contractile proteins
Acute changes
Release of vasoactive agents and alternation in vessel diameter
Chronic changes
Enhance L- anginine / NO pathway
Marked increase in NO synthase mRNA and cGMP
NO and SOD anions help to activate MMP
MMP induces remodeling IMP
16. Circumferential Stress
Induce cell proliferation, In Endothelial cells
Endothelin is released
IncreasedTotal protein content and Gene expression
SMCs hypertrophy
Shear Stress and circumferential stretch likely play a critical role in
determining loss and gain of vessel identity to adapt to each
environment.
18. Introduction
1. Disease of large and medium-sized muscular arteries
2. Characterized by – endothelial dysfunction, vascular inflammation, and the buildup of
lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall.
3. Intimal lesions called atheromas (also called Atheromatous or atherosclerotic
plaques), that protrude into vascular lumina.
19. Atheromatous Plaque
A raised lesion with a soft, yellow, grumous core of lipid (mainly cholesterol and
cholesterol esters) covered by a firm, white fibrous cap.
Plaques weaken the underlying media and can themselves rupture, causing acute
thrombosis.
Primarily affects elastic, large and medium-sized muscular arteries
In small arteries, atheromas can gradually occlude lumina, compromising blood flow and
cause ischemic injury.
Causes acutely or chronically diminished arterial perfusion, such as mesenteric occlusion,
sudden cardiac death ,PAD etc
20. Theories of Pathogensis
1 Lipid Hypothesis:
Hypercholestrolemia is associated with defective binding of LDL to cells
Suppression of HMG CoA Reducatse fails as it depends upon the amount of
bound LDL
2 Monoclonal Hypothesis:
Each atherosclerotic plaque is derived from single smooth muscle cell.
This single cell acts as a precursor for clonal exoansion.
21. 3 Response to Injury Hypothesis:
Endothelial Injury triggers Atheroma formation
Injury maybe cause by mechanical disruption, exposure to toxic or infectious
agents, or endogenous inflammatory signals.
Injury allows adhesion of platelets and an influx of LDL and other serum factors
into the subendothelial space.
Platelets release their alpha granules and stimulate migration of SMC into the
intima, where they proliferate and form a thickened neointima responsible for
narrowing of the arterial lumen.
Restoration of a healthy endothelial cell layer abates the process.
22. Other investigators have countered that retention of
inflammatory lipids in the subendothelial space that
renders a particular area susceptible to atherosclerosis.
This hypothesis is still under consideration.
24. Atherosclerosis as Chronic
Inflammatory Disease
LDL Retention
Early attachment of Monocytes by oxidized LDL
Members of the immunoglobulin superfamily (vascular cell adhesion molecule-1
[VCAM-1] and intercellular adhesion molecule-1 [ICAM]) cause more permanent
fixation
Monocytes undergo a series of phenotypic modulations and become resident tissue
macrophages that take up oxidized LDL via the scavenger receptor A (SR-A) and
CD36.
25. Proinflammatory mediators stimulate the migration of SMC from the tunica media
into the intima.
Bone morphogenetic protein-2 (BMP-2) and inorganic phosphate induce the
osteochondrogenic phenotype in SMC leading to calcification.
26. Progression/Regression of Plaques
Plaque formation is a dynamic process
Periods of intermittent growth spurts are followed by relative
quiescence.
Local non occlusive plaques induce healing process with cytokines and
growth factor production
Acute plaque rupture with nonocclusive thrombosis may signal a
cascade of events leading to a fibrous atheroma and constrictive
remodeling.
28. Complications
Vascular Stenosis
Physical Disruption of Plaque
Coronary/Carotid thrombosis
Exposure of blood to eroded site of previous plaque accelerates thrombosis
Most thrombotic complications lead to stenosis rather than complete
occlusion
29. Identification of Lesion
Through impaired endothelial vasodilator function
Molecular Imaging
Contrast Enhance CT
Contrast Enhanced Ultrasonography
