Dreams have been studied since ancient times. They occur during REM sleep and can help process emotions and solve problems. Babies spend more time in REM sleep which may aid development. Daydreams occur between sleep and wakefulness while false awakenings and lucid dreams involve realizing one is dreaming. Nightmares reflect fears and need addressing while facts show everyone dreams and dreams are important for health.
This document provides an overview of sleep, sleep disturbances, and sleep disorders. It discusses the physiology and stages of normal sleep, including non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. It describes factors that affect sleep such as circadian rhythms, lifestyle, environment, and medications. Common sleep disorders are explained, including insomnia, sleep apnea, narcolepsy, and parasomnias. Diagnostic tests and treatments for sleep disturbances are also summarized.
This document discusses various sleep disorders including narcolepsy, sleep apnea, insomnia, and REM behavior disorder. Narcolepsy is caused by a lack of hypocretin in the brain and causes excessive daytime sleepiness. Sleep apnea involves interrupted breathing during sleep that can damage the prefrontal cortex due to sleep fragmentation. Insomnia is difficulty falling or staying asleep and can impair learning. REM behavior disorder allows voluntary muscle movement during dreaming, sometimes causing people to act out violent dreams without waking.
This document discusses various topics related to sleep, including the stages of sleep, reasons for sleep, sleep problems, dreaming, and the impacts of sleep deprivation. It notes that the average person spends about 1/3 of their life sleeping, and that lack of sufficient sleep can cause health issues and accidents. Sleep is regulated by the body's circadian rhythm and passes through stages including slow wave sleep and REM sleep when dreaming occurs. Common sleep problems include insomnia, sleepwalking, sleep apnea, and narcolepsy.
This document discusses the importance of sleep for health. It describes the five stages of sleep, including rapid eye movement (REM) sleep and non-REM sleep. Insufficient sleep can increase risks for various diseases like obesity, diabetes, and heart disease due to changes in hormones like ghrelin and leptin. Getting 7-9 hours of sleep per night is recommended to maintain good health and reduce risks.
Sleep is important for our overall health and well-being. While we sleep, our brains are active and help consolidate memories from the day. There are two main stages of sleep - NREM and REM sleep. NREM sleep has four stages and helps the body repair and grow tissue. REM sleep provides energy to the brain and is when we experience dreams. Not getting enough quality sleep can negatively impact our cognitive functioning, learning, memory and physical skills.
The document summarizes the five stages of sleep in order: stage 1 (light sleep), stage 2 (45-55% of sleep), stage 3 (first stage of deep sleep), stage 4 (second stage of deep sleep), and REM sleep. It then discusses important functions of REM sleep such as its role in learning, memory consolidation, and problem solving. Finally, it briefly outlines common sleep disorders according to the DSM-5 classification and common causes of sleep disorders.
This document discusses various topics related to dreams including what dreams are, theories about why we dream, the sleep cycle and stages of sleep including REM sleep, the importance of dreaming, daydreams and fantasies, nightmares, and epic dreams. Dreams occur during REM sleep and can last a few minutes to 20 minutes, involving imaginary images, sounds, or sensations that may seem real but did not actually occur. Scientists have various theories about why we dream but none have been proven, and dreaming is thought to be important for brain and emotional health.
This document provides an overview of physiology of sleep and sleep disorders. It discusses brain waves during different sleep stages, the cycles of non-REM and REM sleep, theories of what causes sleep, the effects of sleep on physiological functions, comparative aspects of sleep across species, and consequences of sleep deprivation. Key topics covered include the different sleep stages, roles of neurotransmitters like serotonin in regulating sleep, and restoration of brain and body during sleep.
This document is a seminar submission on the physiology of sleep by Ahmad Ali to Dr. S.R. Akarte. It discusses the two types of sleep - slow wave sleep and rapid eye movement sleep. It describes the physiological changes that occur during sleep, including changes to the cardiovascular system, respiratory system, and muscles. It examines sleep and EEG patterns, noting the different wave types. It also discusses the neurotransmitters involved in sleep including acetylcholine, dopamine, glutamate, histamine, serotonin, and norepinephrine. Finally, it provides an overview of the mechanisms of sleep, including the role of sleep inducing centers in the brain.
The document discusses sleep, its regulation in the body, theories of sleep, circadian rhythms, physiological changes during sleep, stages of sleep, classifications of sleep disorders including dyssomnias like insomnia and hypersomnia, and parasomnias. It also covers nursing interventions to promote sleep such as preparing a restful environment, offering relaxation activities, and scheduling care to avoid disturbances.
This document provides information about sleep, including what sleep is, the sleep cycle, types of normal and abnormal sleep, and tips for improving sleep. Key points include:
- Sleep is a condition where the body and mind rest that typically occurs at night for 7-9 hours. It is essential for survival.
- The sleep cycle progresses through NREM and REM sleep stages roughly every 90 minutes over 4-5 cycles per night.
- Normal sleep means falling asleep within 20 minutes, sleeping 7-9 hours continuously, and waking feeling refreshed.
- Tips for better sleep include avoiding screens before bed, using yellow light, sticking to a schedule, and being in a dark, cool room.
The document discusses the sleep cycle and stages of sleep. It describes how sleep is studied using EEG, EOG, EMG and EKG recordings. There are 5 stages of sleep: awake, stages 1 and 2 which are light sleep, stage 3 and 4 which are deep sleep, and REM sleep. The sleep cycle repeats every 90 minutes, alternating between REM and non-REM sleep. REM sleep increases later in the night and is when dreaming occurs. Lack of sleep can negatively impact mood, cognitive performance, and health.
Dreams occur during REM sleep and can reflect our unconscious thoughts and concerns. While the exact purpose of dreaming is unknown, deprivation of REM sleep has been shown to have negative mental and physical effects. Daydreams and fantasies allow us to imagine possibilities when awake. Recurring and nightmares may indicate unresolved issues, while lucid dreaming involves realizing one is dreaming.
Physiology of Sleep and its correlation with EEG wavesABHILASHA MISHRA
Content includes Physiology of sleep and and its correlation with EEG waves along with specific characteristics of different phases of sleep as well as an account of sleep disorders.
Sleep involves distinct stages including non-REM and REM sleep in cycles. The sleep-wake cycle is regulated by two processes - a homeostatic drive (Process S) for sleep that increases with wakefulness and a circadian rhythm (Process C) that promotes wakefulness during the day. Key structures like the suprachiasmatic nucleus and ventrolateral preoptic area help generate and regulate sleep and wake states.
The document summarizes the stages of sleep. It discusses the 5 main stages of sleep: stage 1 (light sleep), stage 2 (true sleep), stage 3 (deep sleep), stage 4 (very deep sleep), and REM sleep. REM sleep is when the eyes move rapidly and dreams occur, but the body is paralyzed. The document states there are between 3 to 5 sleep cycles per night, with each cycle lasting around 90 minutes and consisting of the different stages of sleep. It provides tips on sleep hygiene and explains that sleep is important for the brain to consolidate learning and memories from the day.
This document summarizes key aspects of sleep physiology. It describes the two main types of sleep - slow-wave sleep and REM sleep. Slow-wave sleep is deeper and more restorative while REM sleep is when most dreaming occurs. The brain activity and physiology differs between these sleep stages. Several theories are presented on what causes sleep, including that active inhibitory processes in the brainstem induce sleep rather than fatigue. The role of neurotransmitters like serotonin is also discussed.
This document summarizes key information about sleep and sleep disorders. It discusses how sleep is measured using EEG, EOG and EMG recordings. It describes the different types of brain waves seen on EEGs during sleep stages. The stages of sleep including non-REM sleep stages I-IV and REM sleep are outlined. Factors influencing sleep such as biological rhythms and neuroendocrine regulation are also summarized.
Indian philosophy posits three states of consciousness: waking, dreaming, and deep sleep. These states correspond to the gross, subtle, and causal bodies respectively. Several ancient Upanishads discuss states of consciousness including awake, dream-filled sleep, deep sleep, and beyond deep sleep. There are four types of brain waves - beta, alpha, theta, and delta - which occur during different stages of wakefulness and sleep. Sleep stages progress from light to deep sleep, consisting of NREM stages 1-3 and REM sleep. Neurotransmitters like acetylcholine and hormones like melatonin regulate the sleep-wake cycle which is controlled by the circadian rhythm in the hypothalamus. DNA repair occurs more during sleep, reducing
The document provides an overview of sleep physiology, including:
(1) It describes the differences between sleep and coma, and defines Non-Rapid Eye Movement (NREM) sleep and Rapid Eye Movement (REM) sleep.
(2) It explains that NREM and REM sleep alternate throughout the night in cycles lasting approximately 90 minutes, with NREM occupying around 75-80% of sleep time.
(3) The document discusses current theories about the neural basis of sleep, including the roles of serotonin, melatonin, and cholinergic neurons in regulating sleep-wake cycles and inducing different sleep stages.
- Sleep is divided into two types: slow-wave sleep and REM (rapid eye movement) sleep, which alternate throughout the night. Slow-wave sleep is deep and restful while REM sleep is associated with vivid dreaming.
- Brain waves change patterns between wakefulness, slow-wave sleep, and REM sleep as measured by EEG. Slow-wave sleep involves low frequency delta waves while REM sleep involves high frequency waves similar to wakefulness.
- Disorders like insomnia, narcolepsy, sleepwalking, bedwetting and nightmares can occur if there are issues with slow-wave sleep or REM sleep processes. Understanding normal sleep stages and changes in brain waves provides insight into these disorders.
Sleep is an active, not passive, process where the body recuperates and the day's events are processed. It occurs in stages that progress from light to deep sleep and includes REM sleep characterized by eye movements. While sleep restores energy, its main functions are to maintain cognitive skills and normal functioning. The brain stem contains centers that induce sleep through inhibition of other areas, like the hypothalamus, while neurotransmitters like serotonin are also involved. Sleep cycles between non-REM and REM sleep in a regular pattern governed by activation and fatigue of neuronal centers in the brain.
Isabella thoburn college neural mechanism of sleepMadeeha Zaidi
Sleep is regulated by two main mechanisms - sleep homeostasis and circadian rhythms. Sleep homeostasis refers to the increasing need for sleep driven by a buildup of adenosine in the brain throughout periods of wakefulness. Circadian rhythms refer to the approximately 24 hour cycles in physiology and behavior driven by the brain's biological clock in the hypothalamus, which is synchronized to light/dark cycles. Disruptions to these mechanisms can cause sleep disorders like jet lag. Neural control of sleep involves both sleep-promoting and wake-promoting areas. Key sleep-promoting areas include the basal forebrain, raphe nucleus, and ventrolateral preoptic area. Key wake-promoting areas include the brainstem
The document discusses the neurology of sleep. It describes the two main types of sleep - NREM and REM sleep. NREM sleep involves synchronous cortical EEG, low muscle tone, and minimal dreaming. REM sleep is characterized by rapid eye movements, muscle atonia, and vivid dreaming. The document also discusses circadian rhythms and how the suprachiasmatic nucleus regulates sleep-wake cycles. Disruptions to circadian rhythms can lead to sleep disorders like jet lag.
This document discusses sleep disturbances and patterns. It begins with objectives of gaining knowledge about sleep disturbances, patterns, and their application in patient care. It then covers definitions of sleep, sleep facts, sleep patterns in different age groups, sleep physiology including stages of sleep and sleep regulation. Factors affecting sleep and consequences of sleep deprivation are explained. Common sleep disorders like insomnia are described along with international classification of sleep disorders and their management.
The document discusses biological rhythms and sleep stages, explaining that circadian rhythms operate on a 24-hour cycle and influence sleep and wakefulness, and describing the five distinct sleep stages that occur in a repeating cycle approximately every 90 minutes. It also reviews theories about why we sleep and dream, such as for physiological functions like neural development and information processing, and examines some common sleep disorders like insomnia, narcolepsy, and sleep apnea.
This document discusses sleep and the brain waves associated with it. It defines sleep and describes the two types: slow wave sleep and REM sleep. It explains the neuronal centers and neurotransmitters involved in inducing each type of sleep. The sleep cycle is described as the result of three systems - the arousal system, slow wave sleep center, and REM sleep center - interacting cyclically. The document also outlines the different brain waves seen in EEGs - alpha, beta, theta, and delta waves - and their characteristics and associations with different brain states.
This document discusses sleep and the brain waves associated with it. It defines sleep and describes the two types: slow wave sleep and REM sleep. It explains that sleep is an active process involving different neuronal centers and neurohormonal substances that cause different stages of sleep. The brain waves associated with different stages are also described, including alpha, beta, theta, and delta waves. Various sleep disorders are also mentioned.
The document discusses sleep and wakefulness from a neurological perspective. It describes how sleep is a brain process characterized by different stages, including non-REM sleep (NREM) and REM sleep. NREM and REM sleep can be measured using electroencephalography (EEG) brain wave patterns. Factors such as age, circadian rhythms, homeostasis, and the autonomic nervous system regulate sleep-wake cycles.
Dr. Suresh Kumar Murugesan is a professor and researcher in psychology from Madurai, India. He specializes in areas like psychotherapy, positive psychology, education psychology, and cyber psychology. The presentation discusses sleep, explaining that it is essential for survival and important for brain functions. It describes the different stages of sleep - stages 1 to 4 of non-REM sleep and REM sleep. Brain structures like the hypothalamus, brain stem, and pineal gland are involved in regulating sleep cycles. Sleep is controlled by circadian rhythms and homeostasis. Lack of quality sleep can increase health risks like high blood pressure and depression. The document also covers brain waves and the different frequency bands measured during different states of
Classification of sleep disorders and parasomniasEnoch R G
Sleep is made up of two physiological states: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. There are several brain regions and neurotransmitters that regulate the sleep-wake cycle, including serotonin, norepinephrine, acetylcholine, melatonin, and dopamine. Sleep disorders are classified in the DSM-5 and ICSD-2 and include insomnia, sleep-related breathing disorders, hypersomnias, circadian rhythm sleep-wake disorders, parasomnias, and other sleep-related movement disorders.
This document discusses the physiology of sleep and EEG waves. It begins by defining sleep and coma, then outlines the objectives and functions of sleep. The mechanisms of sleep are explored, including theories about what causes sleep onset. The four main EEG wave types - alpha, beta, theta, and delta - are defined. The two types of sleep, NREM and REM, are described along with the sleep cycle and stages. Common sleep disorders and basic sleep hygiene recommendations are also summarized.
1) All animals have endogenous circadian rhythms that regulate sleep-wake cycles on a 24-hour basis, as well as annual rhythms. The suprachiasmatic nucleus controls circadian rhythms.
2) There are different stages of sleep characterized by different brain wave patterns. Slow-wave sleep predominates early in the night while REM sleep increases later in the night.
3) Various brain structures and neurotransmitters regulate arousal and sleep, including the reticular formation, basal forebrain, hypothalamus, and orexin. Disorders can result from imbalances.
- Animals generate circadian and circannual rhythms that regulate sleep/wake cycles, eating/drinking patterns, temperature, hormone secretion and other functions on 24-hour and yearly cycles respectively.
- Humans have a circadian rhythm slightly longer than 24 hours that is reset by light/dark cues. Disruption of circadian rhythms can cause jet lag. The suprachiasmatic nucleus regulates circadian rhythms.
- Sleep stages include NREM (stages 1-4) and REM sleep. REM is characterized by dreaming and paralysis while NREM deepens across stages 1-4. Sleep aids restoration, energy conservation, memory consolidation and more.
Sleep is essential for health and cognitive function. It involves NREM and REM sleep stages measured using polysomnography. Common sleep disorders include insomnia, hypersomnolence, and narcolepsy. Insomnia is difficulty initiating or maintaining sleep and is treated with sleep hygiene, relaxation, and medication. Hypersomnolence involves excessive daytime sleepiness and is treated with stimulants. Narcolepsy involves REM sleep intrusion and is diagnosed by decreased REM latency on polysomnography.
This document discusses the physiology of sleep and sleep disorders. It describes the different stages of non-REM sleep (stages 1-4) and REM sleep, and how they are characterized by changes in brain waves, eye movements, muscle tone, autonomic functions, and more. Sleep is essential for survival but disturbances can occur in psychiatric illnesses. Sleep is studied using electrodes to measure brain waves, eye movements, muscle activity, and other physiological signals.
Anti diabetic medications
Patients who are intolerant of metformin are unlikely to be successful with a third trial of that agent. Empagliflozin, an SGLT2 inhibitor, is considered a second-line choice for patients who are intolerant of metformin. Both sitagliptin, a DPP-4 inhibitor, and liraglutide, a GLP-1 receptor agonist, should be avoided or used with caution in patients with a history of pancreatitis
-Linagliptin is not cleared by the kidney second choice if GFR<35(Stop Metformin)
only liraglutide has been shown to lower the risk of recurrent cardiovascular events and has received FDA approval for this indication
Empagliflozin, an SGLT2 inhibitor, has also been associated with secondary prevention of cardiovascular disease.
Fasting C-peptide levels are markedly elevated in patients with T2DM, but in people with T1DM, C-peptide levels should be low
. TZDs tend to cause fluid retention and should not be used in patients with congestive heart failure
References
ADA
Step up to medicine
Toronto notes
UpToDate
ABFM
This document discusses tubulointerstitial disorders, which are diseases affecting the renal tubules and interstitium. Tubulointerstitial disorders are distinguished from glomerular diseases by the absence of nephritic or nephrotic syndrome and the presence of tubular dysfunction manifesting as defects in concentration ability, polyuria, nocturia, and metabolic acidosis. Common tubulointerstitial disorders discussed include acute tubular necrosis, tubulointerstitial nephritis, pyelonephritis, drug-induced tubulointerstitial nephritis, analgesic nephropathy, and diseases causing hypercalcemia and nephrocalcinosis.
The key features in this case are:
- Age of 4 years old
- Abdominal mass
- Hematuria
- Hypertension
This combination of findings is classic for Wilms tumor (nephroblastoma), which is the most common renal tumor in children.
The diagnosis is Wilms tumor (D).
Membranous GN
MOST COMMON cause is idiopathic (85%); peak age 30-50; male:female, 2:1
May be secondary to:
Drugs-captopril, penicillamine, gold, mercury, trimethadione, NSAIDS
Infections-malaria (P. malariae), leprosy, schistosomiasis, syphilis, hepatitis B and C, filariasis, hydatid disease and enterococcal endocarditis
Diseases-malignancy (Carcinoma of breast, lung, colon, stomach, and esophagus) melanoma, renal cell CA, SLE, sarcoidosis, diabetes, thyroiditis, sickle cell anemia, Crohn’s disease
1. Women aged 21-24 with ASC-US or LSIL should have repeat cytology in 1 year; if negative twice, return to routine screening, but AGC, HSIL or ASC-H requires colposcopy.
2. Women over 30 should have co-testing every 5 years; if HPV negative the risk is low, but a positive HPV requires repeat co-testing in 1 year or colposcopy if cytology is ASC-US or greater.
3. ASC-H in women over 25 requires colposcopy regardless of HPV results due to possibility of significant abnormality.
Normal Heart
Fist size muscular pump
Pumps 6000 lit of blood daily
Perfuses
tissues with nutrients and
Facilitates
removal of waste products.
Heart diseases
Have severe physiologic consequences
Are leading cause of morbidity and mortality in developed nations
750,000 deaths/ year (In US
This document describes various congenital heart diseases (CHD) including their embryology, classification, pathophysiology and clinical presentations. It discusses abnormalities causing left-to-right shunts such as ventricular septal defects, atrial septal defects and patent ductus arteriosus which can cause volume overload. It also describes right-to-left shunting defects like tetralogy of Fallot and transposition of the great arteries which result in cyanosis. Obstructive lesions including coarctation of the aorta are also summarized. Fetal circulation is compared to changes at birth.
Infective Endocarditis(IE)
Is due to bacterial or fungal infection of the heart valves (endocardium).
Characterized by:
Formation of bulky, friable,easily detached and infected vegetations.
Damage to heart Valves and Chorda tendinae
perforation, ulceration, destruction (causes valve dysfunction)
Ischemic Heart Disease
IHD is caused by myocardial ischemia due to
Imbalance between the myocardial oxygen demand and supply from the coronary arteries.
Majority of cases due to
Reduction in coronary artery blood flow caused by
Obstructive atherosclerotic disease.
IHD is also known as Coronary artery disease
The document discusses several disorders of the pleura and lungs, including pleural effusions, pneumothorax, and mesothelioma. Pleural effusions can be transudative or exudative depending on disturbances to Starling forces or increased vessel permeability. Pneumothorax can be spontaneous due to bleb rupture or tension pneumothorax from a flap-like pleural tear. Mesothelioma is a malignant tumor of the pleura associated with asbestos exposure that encases the lung.
Restrictive lung diseases (interstitial lung diseases)
Histological Structure of Alveoli
The wall of the alveoli is formed by a thin sheet of tissue separating two neighbouring alveoli.
This sheet is formed by epithelial cells and intervening connective tissue.
Collagenous , reticular and elastic fibres are present.
Between the connective tissue fibres we find a dense, anastomosing network of pulmonary capillaries. The wall of the capillaries are in direct contact with the epithelial lining of the alveoli.
Neighbouring alveoli may be connected to each other by small alveolar pores (pores of Kohn).
The epithelium of the alveoli is formed by two cell types:
Alveolar type I cells (small alveolar cells or type I pneumocytes) are extremely flattened and form the bulk (95%) of the surface of the alveolar walls.
Alveolar type II cells (large alveolar cells or type II pneumocytes) are irregularly (sometimes cuboidal) shaped.
They form small bulges on the alveolar walls.
Type II alveolar cells contain are large number of granules called cytosomes (or multilamellar bodies), which consist of precursors to pulmonary surfactant (the mixture of phospholipids which keep surface tension in the alveoli low) .
Cilia are absent from the alveolar epithelium and cannot help to remove particulate matter which continuously enters the alveoli with the inspired air. Alveolar macrophages take care of this job. They migrate freely over the alveolar epithelium and ingest particulate matter.
FUNCTIONS OF PULMONARY CELLS
Type I pneumocytes
Permeable to Oxygen and CO2, do not divide
Type II pneumocytes
Reserve cells
secrete pulmonary surfactant
Serve as repair cells
Alveolar macrophages
Phagocytosis
Pores of Kohn (allow passage of Macrophages)
Asthma
A chronic relapsing inflammatory disorder characterized by:
Hyper-reactivity of the respiratory tree to various stimuli leading to
Reversible airway obstruction
Obstruction produced by combination of :
Constriction of bronchial musculature (bronchospasm)
Mucosal inflammation (edema)
Excessive secretion of mucus.
Clinically Manifested by :
Difficulty in breathing (Dyspnea)
Wheeze (a soft whistling sound during expiration)
Difficulty in expiration.
Asthma is:
Episodic and reversible airway disease
Primarily targets the bronchi and terminal bronchioles
MC chronic respiratory disease in children
Two types:
Extrinsic asthma (allergic, atopic)
Intrinsic asthma (non-allergic asthma or idiosyncratic asthma)
Obstructive diseases : Chr.by
Obstruction to airflow out of the lungs
Due to partial or complete obstruction in airway.
Increase in lung compliance and
Decrease in lung elasticity.
Restrictive diseases : Chr by
reduced expansion of lung parenchyma with problems in getting air in the lungs.
Lung compliance is decreased
Elasticity is increased: once air is in the lungs it comes out rapidly on expiration.
Tumors of lung
Malignant tumors of lung
Primary
Metastatic
Metastatic lung cancer
More common* than primary lung cancer.
Breast cancer (MCC)
Renal Cell carcinoma
Choriocarcinomas
Colorectal carcinomas
Appear as: "Cannon Balls” On X rays
This document discusses several types of pneumonia including nosocomial, aspiration, and lung abscess pneumonia. It provides details on causative organisms, pathophysiology, clinical features, diagnosis and treatment. Key points include:
- Nosocomial pneumonia is associated with immunosuppression, antibiotics, and respirators. Common organisms are E. coli, Pseudomonas aeruginosa, and S. aureus.
- Aspiration pneumonia results from gastric content aspiration and is characterized by necrotizing inflammation. Causative organisms include a mixture of oral aerobes and anaerobes like Bacteroides and S. pneumoniae.
- Lung abscesses develop most commonly from aspiration or
1. Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by diffuse alveolar capillary damage and severe pulmonary edema, resulting in hypoxemia that is refractory to oxygen therapy.
2. ARDS is caused by direct or indirect injury to the lungs from sources such as sepsis, gastric aspiration, trauma, or smoke inhalation. This causes damage to the alveolar capillary endothelium and epithelium.
3. The damage leads to increased capillary permeability, leakage of fluid into the alveoli, and formation of hyaline membranes. This results in impaired gas exchange and respiratory failure.
Mainstreaming #CleanLanguage in healthcare.pptxJudy Rees
In healthcare, every day, millions of conversations fail. They fail to cover what’s really important, fail to resolve key issues, miss the point and lead to misunderstandings and disagreements.
Clean Language is one approach that can improve things. It’s a set of precise questions – and a way of asking them – which help us all get clear on what matters, what we’d like to have happen, and what’s needed.
Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared.
This project, which emerged from work done by the NHS England South-West End-Of-Life Network, with help from the Q Community and especially Hesham Abdalla, aims to fix that.
Descoperă Bucuria Vieții Sănătoase cu Jurnalul Fericirii Life Care - Iulie 2024!
Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată.
Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi:
Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate.
Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase.
Trucuri pentru un stil de viață activ:
Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii.
Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi.
Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi.
Sfaturi pentru o stare de bine mentală:
Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință.
Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea.
Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale.
Bonus:
Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă.
Concursuri și premii: Participă la concursuri distractive și câștigă premii valoroase.
Jurnalul Fericirii Life Care - Iulie 2024 este mai mult decât o simplă revistă. Este un ghid complet și personalizat pentru a te ajuta să obții o viață mai sănătoasă, mai fericită și mai plină de satisfacții.
Nu rata această șansă de a te bucura de vară la maximum! Descoperă Jurnalul Fericirii Life Care - Iulie 2024 astăzi!
Comandă-ți exemplarul acum și fă un pas important către o viață mai bună!
#JurnalulFericirii #LifeCare #Iulie2024 #ViataSanatoasa #Bunastare #Fericire #Oferte #Concursuri #Premii
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
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Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
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- Video recording of this lecture in English language: https://youtu.be/pCU7Plqbo-E
- Video recording of this lecture in Arabic language: https://youtu.be/kbDs1uaeyyo
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Tod...rightmanforbloodline
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
TEST BANK For Katzung's Basic and Clinical Pharmacology, 16th Edition By {Todd W. Vanderah, 2024,} Verified Chapter
2. :Objectives
a)Describe the normal sleep pattern. Sleep-wake cycles and factors that control
them.
b)Describe the mechanism of sleep generation
3. a)Describe the normal sleep pattern. Sleep-wake cycles and factors that control them
•
Sleep is defined as unconsciousness from which the person can be aroused by sensory or other
stimuli.
distinguished from coma, which is unconsciousness from which the person cannot be
aroused. There are multiple stages of sleep, from very light sleep to very deep sleep; sleep
researchers also divide sleep into two entirely different types of sleep that have different
qualities,
4. Sleep-wake cycle refers to our 24 hour daily sleep pattern which consists of
approximately 16 hours of daytime wakefulness and 8 hours of night-time sleep.
The complex process of the sleep-wake cycle is controlled by the body’s circadian
rhythm and sleep homeostasis (the amount of accumulated sleep need that builds
during time spent awake).
•
5. Two Types of Sleep-Slow-Wave Sleep and Rapid Eye Movement (REM) Sleep:
During each night, a person goes through stages of two types of sleep that alternate with each other.
They are called (1) slow-wave sleep, and (2) rapid eye movement sleep (REM sleep)
6. • Slow-Wave Sleep:
• restful and is associated with decreases in both peripheral vascular tone and many other
vegetative functions of the body.
30 percent decreases in blood pressure, respiratory rate, and basal metabolic rate.
Although slow-wave sleep is frequently called "dreamless sleep," dreams
7. • Stage 1 is a time of drowsiness or transition from being awake to falling asleep. Brain waves and
muscle activity begin to slow down during this stage.
People in stage 1 sleep may experience sudden muscle jerks.
. • Stage 2 is a period of light sleep during which eye movements stop. Brain waves become slower,
coupled with spontaneous periods of muscle tone mixed with periods of muscle relaxation.
The heart rate slows and body temperature decreases, theta activity is observed
Stages 3 and 4 (called slow wave sleep), the presence of slow brain waves called delta waves
interspersed with smaller, faster waves. , body becoming immobile. Sleep is deeper, with no eye
movement and decreased muscle activity, though muscles retain their ability to function
The amount of stage 4 slow-wave sleep declines with age and in many people is nearly absent by age
70.
8. REM Sleep (Paradoxical Sleep, Desynchronized Sleep)
REM sleep is an active period of sleep marked by intense brain activity. Brain waves are fast and desynchronized,
similar to those in the waking state.
Breathing becomes more rapid, irregular, and shallow; eyes move rapidly in various directions and limb muscles
become temporarily paralyzed.
REM sleep lasting 5 to 30 minutes usually appear on the average every 90 minutes. When the person is
extremely sleepy.
Each bout of REM sleep is short and may even be absent.
important for obtaining restful, restorative sleep and for promoting processes such as learning,
memory, mood, and ability to concentrate.
9. •
REM sleep has several important characteristics:
1. It is an active form of sleep usually associated with dreaming and active bodily muscle
movements.
2. The person is even more difficult to arouse by sensory stimuli than during deep slow-wave sleep,
3. Muscle tone throughout the body is exceedingly depressed, indicating strong inhibition of the
spinal muscle control areas.
4. Heart rate and respiratory rate usually become irregular, which is characteristic of the dream
state.
5. Despite the extreme inhibition of the peripheral muscles, irregular muscle movements do occur.
These are in addition to the rapid movements of the eyes.
6. The brain is highly active in REM sleep, and overall brain metabolism may be increased as much
as 20 percent.
11. :The electroencephalogram (EEG)
• shows a pattern of brain waves similar to those that occur during wakefulness.
This type of sleep is also called paradoxical sleep because it is a paradox that a person can still be asleep despite
marked activity in the brain.
, REM sleep is a type of sleep in which the brain is quite active
12. •
• Alpha waves are rhythmical waves that
occur at frequencies between 8 and 13
cycles per second.
• Beta waves occur at frequencies greater
than 14 cycles per second and as high as
80 cycles per second.
• Theta waves have frequencies between 4
and 7 cycles per second.
• Delta waves have frequencies less than
3.5 cycles per second, and they often
have voltages two to four times greater
than most other types of brain waves
14. • The complex process of the sleep-wake cycle :
• is controlled by the body’s circadian rhythm and sleep homeostasis .
• Circadian rhythms are regulated by the body’s internal master clock which is located in the brain.
• This master clock controls many biological functions over a 24 hour period, such as the release of
hormones, body temperature changes, and sleep-wake cycles
•the biological clock consists of a group of neurons in the hypothalamus of the brain called the
suprachiasmatic nucleus (SCN).
•Homeostasis is the process by which the body maintains a “steady state” of internal conditions such
as blood pressure, body temperature, and acid-base balance
15. b)Describe the mechanism of sleep generation
• 1- most conspicuous stimulation area for causing almost natural sleep is the raphe nuclei in
the lower half of the pons and in the medulla..
Many nerve endings of fibers from these raphe neurons secrete serotonin. When a drug that
blocks the formation of serotonin is administered to an animal, the animal often cannot sleep
for the next several days. Therefore, it has been assumed that serotonin is a transmitter
substance associated with production of sleep.
Stimulation of several specific areas of the brain can produce sleep with characteristics near those of natural
sleep. Some of these areas are the following::
16. 2- Stimulation of some areas in the nucleus of the tractus solitarius can also cause sleep.
This nucleus is the termination in the medulla and pons for visceral sensory signals entering by way of
the vagus and glossopharyngeal nerves
3- Sleep can be promoted by stimulation of several regions in the diencephalon, including (1) the
rostral part of the hypothalamus, mainly in the suprachiasmal area, and (2) an occasional area in the diffuse nuclei
of the thalamus.
17. Summary
•
Sleep is defined as unconsciousness from which the person can be aroused by sensory or other
stimuli.
coma, is unconsciousness from which the person cannot be
aroused.
Stimulation of several specific areas of the brain can
produce sleep:
•the raphe nuclei in the lower half of the pons and in
the medulla..
•the nucleus of the tractus solitarius
•The rostral part of the hypothalamus