18 April 2009

Receptor theory



Receptor theory

Presentation covered the following topics.
Nerve/Muscle Endings
Muscle Fiber
Intercellular Signaling
Criteria for hormone-mediated events
Recognition and Transduction
Receptor theory and receptor binding.
Scatchard transformation
Competition binding assays
Dose-response experiments.
Fractional response
Receptor antagonists.
Competitive antagonist.
Non-competitive antagonist
Irreversible antagonists.
Receptor subtypes
Opioid receptor subtypes
Receptor type
Selective antagonists
CTAP
Stopping the GPCR signal
Receptor desensitization
Receptor down-regulation

Receptor theory.ppt

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New Antiepileptic Drugs and Treatments



New Antiepileptic Drugs and Treatments
Presentation by: Josiane LaJoie, MD

Assistant Professor of Neurology and Pediatrics
NYU Comprehensive Epilepsy Center
New AED’s
Gabapentin
Gabapentin Side Effects
FELBAMATE
FBM Dosing
FBM-Common Side Effects
Aplastic Anemia and Hepatotoxicity with Felbamate
Risks of Felbamate
Fatal Hepatotoxicity of VPA
FBM Interactions
LAMOTRIGINE
Lamotrigine Side Effects
Lamictal and SJS
Lamictal Dosing-Children
Lamotrigine and AED’s
Topiramate
Topiramate SE
Topiramate Interactions
TIAGABINE
Tiagabine Dosing
Tiagabine Side Effects
Tiagabine Interactions
Levetiracetam
Zonisamide
New Treatments
Vagus Nerve Stimulator (VNS)
VNS candidates
VNS Implantation
The VNS System
VNS Function
Effects & Side Effects
Deep Brain Stimulation
Cerebellar Stimulation
Brain Stimulation
Functional Radiosurgery
Gamma Knife-Limitations
Neuropace
Melatonin
Melatonin’s Effects
Evidence-Basic Science
Animal study
Evidence-Clinical Studies

New Antiepileptic Drugs and Treatments.ppt

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Menstrual Disorders



Menstrual Disorders
Presentation by: Dr.Anna Mae Smith, MPAS, PA-C
Lock Haven University

Definitions of Amenorrhea
Hypothalamic Disorders
Pituitary Disorders
Ovarian Failure
Hypergonadotropic Amenorrhea
Anatomic Abnormalities
Diagnosis of Amenorrhea
Abnormal Uterine Bleeding
Terminology of Abnormal Bleeding
Pre-puberty Bleeding
Differential Diag of premenarchal bleeding
Bleeding in the Reproductive Years
Organic Pathology Causing Bleeding in Repro Yrs
Physiologic Correlates of Bleeding
Anovulatory Bleeding
Ovulatory DUB
Evaluation of Abnormal Bleeding
Treatment of Abnormal Bleedingy
Postmenopausal Bleeding
Causes of Postmenopausal bleeding
Treatment of Postmenopausal Bldg

Menstrual Disorders.ppt

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INFERTILITY



INFERTILITY
Presentation by:Dr. Anna Mae Smith, MPAS, PA-C
Lock Haven University

Definition: Infertility is one year of unprotected coitus without conception
The term "primary infertility" is applied to the couple who has never achieved a pregnancy
"secondary infertility" implies that at least one previous conception has taken place

Tx Goals
– To identify the cause of the infertility
– To provide a basis for potentially successful treatment options
– To provide a realistic prognosis
– To offer emotional support

Fecundability
Female Infertility Etiologies
Unexplained
Cervical/mucus
Endometrial/uterine
Pelvic/peritoneal
Tubal
Central (CNS)
First visit
Have both come to all visits!!
Get a complete history
Sexual history!!
Educate!!
Manly Questions
Infertility duration
Prior fertility in relationship(s)
Medical & surgical history
Meds (anabolic steroids, cancer chemotherapy, sulfasalazine, nitrofurantoin)
Alcohol, drugs, pot
Occupational exposures
Sexual dysfunction
Tight fitting underwear/pants
Previous testing
Womanly Questions
Infertility duration
Detailed menstrual history
Prior pregnancies
Fertility in other relationships
IUD’s, OCP’s, Depo
Frequency of intercourse / sexual dysfunction

Womanly Questions
Gynecologic history (PID, endometriosis, fibroids, cervical dysplasia)
DES exposure
Medical and surgical history
Medications
Previous tests and therapy


TESTS
Thyroid
Midcycle progesterone level &/or luteal phase progesterone level
FSH/ LH
Cortisol
Hystersalpingogram
Laporoscopy
Postcoital Test

Treatment
Education
BBT’s/menstrual calendar
Clomiphene
Pergonal
Artificial insemination
IVF


Male Infertility
Sperm production… idiopathic or certain known entities such as mumps, endocrine disorders & immunological disorders
Anatomical abnormalities that obstruct the genital tract…varicocele.
Sperm Count
Fresh sample (to lab within 30 mins.) –most sperm in initial ejaculate
Male should be abstinent for 48 to 72 hours
sperm concentration > 20 million per ml
total count > 60 million
ejaculate volume > 1.5 ml
total motile count > 30 million
viable sperm > 50%
normal shapes (morphology) > 60%


Sperm Terms
Normozoospermia
Normal ejaculate
Asthenozoospermia
Teratozoospermia
Azoospermia
Aspermia

Normal ejaculate
Sperm concentration <20 × 106 /ml <50% spermatozoa with forward progression <30% spermatozoa with normal morphology No spermatozoa in the ejaculate No ejaculate Male/Female Infertility Endocrine - gonadotropins, bromocriptine Surgery to repair anatomical conditions Artificial insemination IVF - in vitro fertilization (ET embryo transfer) ZIFT – zygote (embryo) intra-fallopian transfer GIFT - gamete intra fallopian transfer ICSI – Intracytoplasmic sperm injection Microsurgical fertilization Environmental changes Vitamins Baggy shorts Sex not every nite…every other Diet changes Stop smoking

Male/Female Infertility.ppt

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Anatomy & Physiology of the Female Reproductive Tract



Anatomy & Physiology of the Female Reproductive Tract
67 slides presentation by: Dr. Anna Mae Smith, MPAS, PA-C
Lock Haven University

External Genital Organs
Pubococcygeus Muscle
Bartholin’s glands [bulbourethral glands]
Lymph Drainage
Innervation
Pelvic Viscera
Urogenital organs
Broad Ligament
Uterus
uterine tubes
infundibulum
ampulla
isthmus
uterine part
Ovaries
Pelvis
Man vs. Woman
Female Bony Pelvis
Superior Pelvic Aperture
Hypothalamus
Anterior Pituitary
FSH Surge
LH surge
TWO CELL THEORY
Endometrium
Vascular spasm
Thrombosis

Anatomy & Physiology of the Female Reproductive Tract.ppt

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Physiology of Pregnancy & Reproduction Embryology



Physiology of Pregnancy & Reproduction Embryology
Presentation by: Dr.Anna Mae Smith, MPAS, PA-C
Lock Haven University of Pennsylvania

Stage 1

* Fertilization
* 1 Oocyte
* 300 Million Sperm
* 24 Hours
* 0.1 - 0.15 mm
* 1 day post-ovulation

Fertilization

* SPERM + EGG(OOCYTE) = ZYGOTE
* The fertilization process takes about 24 hours.
* Sperm life = 48 hours
o It takes about ten hours to navigate the female productive track, moving up the vaginal canal, through the cervix, and into the fallopian tube where fertilization begins.

Mr.SPERM
+
Mrs. EGG
Fertilization

* 300 million sperm enter the the vagina... only 1%, 3 million, enter the uterus
* The next step is the penetration of the zona pellucida, a tough membrane surrounding the oocyte.
* Penetration of the zona pellucida takes about twenty minutes.

Fertilization

* Within 11 hours following fertilization, the oocyte has extruded a polar body with its excess chromosomes. The fusion of the oocyte and sperm nuclei marks the creation of the zygote and the end of fertilization.

Stage 2
Cleavage
* First Cell Division, Blastomeres,
* Mitotic division
* 0.1 - 0.2 mm
* 1.5 - 3 days post-ovulation
* The zygote now begins to cleave, with each division occurring into two cells called blastomeres
* The zygote's first cell division begins a series of divisions, with each division occurring approximately every twenty hours
* When cell division ungenerated about sixteen cells, the zygote becomes a morula (mulberry shaped)
* It leaves the fallopian tube and enters the uterine cavity three to four days after fertilization.

Stage 3
Early Blastocyst
* 0.1 - 0.2 mm
* 4 days post-ovulation
* Blastocyst formation
* Two cell types are forming:
o embryoblast (inner cell mass on the inside of the blastocele)
o trophoblast (the cells on the outside of the blastocele).
Stage 4
Implantation Begins
* HCG Levels Rise
* 0.1 - 0.2 mm
* 5 - 6 days post-ovulation
* The trophoblast cells secretes an enzyme which erodes the epithelial uterine lining and creates an implantation site for the blastocyst.
Implantation Begins

* ovary continues producing progesterone
* trophoblast cells continue releasing human chorionic gonadotropin (hCG)
* Endometrial glands in the uterus enlarge in response to the blastocyst and the implantation site becomes swollen with new capillaries. Circulation begins, a process needed for the continuation of pregnancy.

Stage 5
Implantation Complete
* Placental Circulation System Begins to form
* 0.1 - 0.2 mm
* 7 - 12 days post-ovulation
* Trophoblast cells engulf and destroy cells of the uterine lining creating blood pools, both stimulating new capillaries to grow and foretelling the growth of the placenta.
* The inner cell mass divides, rapidly forming a two-layered disc
* The top layer of cells...
o will become the embryo and amniotic cavity
o the lower cells will become the yolk sac.
* Ectopic pregnancies can occur at this time and sometimes continue for up to 16 weeks of pregnancy before being noticed

Stage 6
Gastrulation, Chorionic Villi Formation
* 0.2 mm
* 13 days post-ovulation
* The formation of blood and blood vessels of the embryo begins
* Yolk sac begins to produce hematopoietic or non-nucleated blood cells.
* Gastrulation three layers of the embryo: ectoderm, mesoderm and endoderm.
Stage 7

* Neurulation and Notochordal Process
* 0.4 mm
* 16 days post-ovulation
* Endoderm forms the lining of lungs, tongue, tonsils, urethra and associated glands, bladder and digestive tract.

Stage 7

* Mesoderm forms the muscles, bones, lymphatic tissue, spleen, blood cells, heart, lungs, and reproductive and excretory systems.
* Ectoderm forms the skin, nails, hair, lens of eye, lining of the internal and external ear, nose, sinuses, mouth, anus, tooth enamel, pituitary gland, mammary glands, and all parts of the nervous system

Stage 8

* Primitive Pit, Notochordal Canal and Neurenteric Canals
* 1.0 - 1.5 mm
* 17-19 days post-ovulation
* Neural plate with a neural groove
* The blood cells of the embryo are already developed and they begin to form channels along the epithelial cells which form consecutively with the blood cells.

Stage 9

* Appearance of Somites(condensations of mesoderm, appear on either side of the neural groove
* 1.5 - 2.5 mm
* 19 - 21 days post-ovulation
* Primitive streak
* Endocardial (muscle) cells begin to fuse and form into the early embryo's two heart tubes.

Stage 10

* Neural Folds Begin to Fuse, Heart Tube fuses
* 1.5 - 3.0 mm
* 21 - 23 days post-ovulation
* Cardiac muscle contraction begins
* Eye & ear cells are present
* Neural tube starts closing

Stage 11

* Thirteen to Twenty Somite Pairs, Rostral Neuropore Closes, Optic Vesicle Appears, Two Pharyngeal Arches Appear
* 2.5 - 3.0 mm
* 23 - 25 days post-ovulation
* A primitive S-shaped tubal heart is beating and peristalsis, the rhythmic flow propelling fluids throughout the body, begins.
* At this stage, the neural tube determines the form of the embryo
Stage 12


* Twenty-one to Twenty-nine Somite Pairs, Caudal Neuropore Closes, Three to Four Pharyngeal Arches Appear, Upper Limb Buds Appear
* 3.0 - 5.0 mm
* 25 - 27 days post-ovulation
* The brain and spinal cord together are the largest and most compact tissue of the embryo.

Stage 12

* Valve & septa appear in the heart
* The digestive epithelium layer begins to differentiate into the future locations of the liver, lung, stomach and pancreas.
* The beginning cells of the liver form before the rest of the digestive system.

Stage 13 (approximately 27-29 postovulatory days)

* Forebrain, midbrain and hindbrain.
* Forebrain senses, memory formation, thinking, reasoning, problem solving.
* Midbrain relay station, coordinating messages to their final destination
* Hindbrain regulates the heart, breathing and muscle movements

This presentation covered upto 40th week stage.
Physiology of Pregnancy & Reproduction Embryology.ppt

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Embryology of the Neck & Neck Masses



Embryology of the Neck & Neck Masses
Presentation by: Steven T. Wright, M.D.
Shawn Newlands, M.D., Ph.D, M.B.A
UTMB Dept of Otolaryngology


Neck Masses
Embryology and Anatomy
Branchial system
Thyroid Gland
Oral Cavity
Midline Neck Masses
Thyroid Nodules
Fine-Needle Aspiration Biopsy
Thyroglossal Duct Cyst
TGDC Carcinoma
Ectopic Thyroid
Lateral Nonmalignant Thyroid Tissue
Cervical Thymic Cysts
Plunging Ranula
Lateral Neck Masses
First Branchial Cleft Cysts
Laryngoceles
Dermoid and Teratoid Cysts
Dermoid Cysts
Teratoid Cysts and Teratomas
Sternomastoid Tumor of Infancy
Conclusions

* Neck masses are very common
* Approach with History and Physical exam will commonly lead to the correct diagnosis
* An understanding of cervical embryology is crucial in treatment of these masses

Embryology of the Neck & Neck Masses.ppt

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17 April 2009

Anatomy - Digestive System: From Mouth to Crapper



Anatomy - Digestive System: From Mouth to Crapper
Video: 9.49 minutes.

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Anatomy - The Heart



Anatomy - The Heart
Video: 4.35 minutes.

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End Stage Heart Disease



End Stage Heart Disease
Video: 8.48 minutes.
Animation by David Aten depicting new treatments for end stage heart disease

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Exposing the Cholesterol Myth



Exposing the Cholesterol Myth
Video: 9.49 minutes

Dr. Ron Rosedale talks about common cholesterol myths.



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ECG Course Part-2



Dr. Dean Keller and Dr. Melissa Stiles continue their discussion on reading an electrocardiogram.
ECG Course Part-2
Video: 15.23 minutes.

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ECG Course Part-1



Dr. Dean Keller and Dr. Melissa Stiles discuss the basics of reading an electrocardiogram.
ECG Course Part-1, Video: 21 minutes.

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Geriatric Grand Rounds - Videos



Geriatric Grand Rounds - Videos
by the University of Arizona College of Medicine at the Arizona Health Sciences Center.

Ethnicity and Aging
Donald E. Gelfand, PhD, Research Associate, Arizona Center on Aging, Professor, Dept. of Sociology, Wayne State University, Coordinator, End-of-Life Interdisciplinary Project, Wayne State University, Detroit Michigan
Mediaplayer Format
Realplayer Format

Anesthesiology and the Older Patient
Steven Barker, MD, PhD, Professor and Department Head, Anesthesiology, College of Medicine, University of Arizona
Mediaplayer Format
Realplayer Format

A Pragmatic and Clinical Approach to the Diagnosis and Treatment of Alzheimer's Dementia
Byron Bair, MD, Associate Professor (Clinical): Department of Psychiatry, University of Utah Health Services Center
Mediaplayer Format
Realplayer Format

Hormone Replacement and Menopause: What Now?
Carla J. Herman, MD, MPH, Chief, Division of Geriatrics, University of New Mexico Center on Aging
Mediaplayer Format
Realplayer Format

The Special Issues of Communicating with Persons Who Have Dementia
Randal Scott, MSW, MBA
Mediaplayer Format
Realplayer Format

General Pharmacologic Principles of Aging: Medical Effects on the Health of the Elderly
Martin Higbee, PharmD, Associate Professor, Department of Pharmacy Practice, The University of Arizona
Mediaplayer Format
Realplayer Format

Nutrition and Aging
Wanda Howell, PhD, University distinguished professor - Nutrit sci-ins.
Mediaplayer Format
Realplayer Format

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Perioperative Care in Geriatrics



Perioperative Care in Geriatrics
Presentation by
Tomas L. Griebling, MD, FACS, FGSA
Department of Urology
The Landon Center on Aging

Surgical Care in Older Adults
ACOVE Surgical Indicators
Preoperative Care
Capacity to Consent
Discussion of Goals of Care
Preoperative Pulmonary Evaluation
Preoperative Cardiovascular Evaluation
Preoperative Diabetes Evaluation
Preoperative Delirium Risk Factor Assessment
Prevention of Surgical Site Infection
Perioperative Beta-blockade
Anticoagulation for Hip Fracture and Replacement
Anticoagulation Prophylaxis in Other Surgical Cases
Diabetes Control
Screen for Postoperative Delirium
Cognition and Function at Discharge
Summary


Perioperative Care in Geriatrics.ppt

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Common Problems in Geriatrics for Orthopedic Surgeons



Common Problems in Geriatrics for Orthopedic Surgeons
Presentation by
Steven Zweig, MD

Family and Community Medicine
MU School of Medicine

Goals

* Recognize the importance of aging physiology in the development and treatment of specific problems
* Prevent and treat delirium
* Recognize the significance of polypharmacy
* Identify patients at risk for elder abuse

Case 1 - 80 year old woman with hip fracture
Delirium
* Physical exam for VS, neuro, skin, infections
* Mental status exam
* Lab and x-ray for infections (lung, urine), fluid and lytes, hypoxia, BS, new trauma, systemic dx

Mental Status Evaluation

Case 2 - 76 year old woman with osteoarthritis
Altered Drug Distribution
Altered Drug Metabolism
Altered Renal Excretion
Common Adverse Drug Reactions
Principles of Geriatric Prescribing


Case 3- 75 year old woman with upper arm pain

X- ray and lab findings
Elder Abuse
Risk factors
Management

Tips for Coordinating Care

* Medicare home care - requires need for skilled nurse or PT
* Admission to SNF requires 3 day hospital stay - contact the NH physician to plan
* PPS means capitated reimbursement to SNFs
* Medicare does not cover costs of drugs
* Get SW involved if any care problems anticipated

Common Problems in Geriatrics for Orthopedic Surgeons.ppt

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Geriatrics in a Nutshell



Geriatrics in a Nutshell
Presentation by: Karen E. Hall, M.D., Ph.D.

Clinical Associate Professor of Internal Medicine
University of Michigan, Ann Arbor VA Health Systems
Research Scientist,
Geriatric Research, Education and Clinical Center

Covers the following topics
Geriatric Syndromes
Common Diseases in Elderly
Documentation/Skills
First rule of history and physical exam
Physical Exam
Diagnosis belongs in the Impression / Plan
Develop a Plan rather than a Diagnosis
Social, Ethical, Cultural

Geriatrics in a Nutshell.ppt

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Scope of Ayurveda in Geriatric Health Care



Scope of Ayurveda in GERIATRIC HEALTH CARE
Dr. B Rajeev MD (Ay), PhD (Psych)
Honorary Consultant- Holistic Medicine
Amrita Institute of Medical Sciences & Research Centre,
AIMS, Kochi, Kerala

Objective of Geriatrics
Gerontology
Problems of Geriatric age group
Common manifestations
Medical care & Management for the old
Preventive Geriatrics
Geriatric rehabilitation
Concept of Geriatrics in Ayurveda
Chikitsa yojana
Chikitsa Padhati
Rasayana – Vajeekarana
Vyadhi Pratyaneeka chikitsa
Glimpses on Diseases where Panchakarma offers better management options
Manasopachara / Achara rasayana

Scope of Ayurveda in Geriatric Health Care.ppt

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Immuno-epidemiology of Malaria



Immuno-epidemiology of malaria
Presentation by Klaus Dietz
Department of Medical Biometry
University of T├╝bingen, Germany
at
DIMACS Worksop 2006

Outline

* What is Immuno-epidemiology?
* What is malaria?
* Why model malaria immunity?
* Malaria immunity models: a brief history
* A within-host malaria model
* Concluding remarks

Serological surveys as immuno-epidemiological tools
A theoretical framework for immuno-epidemiology
A cartoon of immuno-epidemiological models
Malaria cycle
The challenge of malaria
Why model malaria immunity?
Original Eradication Plans
Points of attack of potential malaria vaccines
Malaria immunity models
Implications of unrealistic assumptions about the strength of immunity
Innate and adaptive immunity
Vaccine efficacy

Immuno-epidemiology of malaria.ppt

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Microbiology Power point presentations and lecture notes



Microbiology Power point presentations and Lecture notes
by Stephen t. abedon
The Ohio State University

Microbiology Part ONE
: life and death of microorganisms

0. Introduction to Micro (lecture 1) (PDF for printing) (PowerPoint for viewing)

1. Humans and the Microbial World (lecture 1) (midterm 1) (PDF for printing) (PowerPoint for viewing)

2. The Molecules of Life (lecture 1) (midterm 1) (PDF for printing) (PowerPoint for viewing)

3a. Microscopy and Cell Structure (lectures 1) (midterm 1) (PDF for printing) (PowerPoint for viewing)

3b. Microscopy and Cell Structure (lectures 2) (midterm 1) (PDF for printing) (PowerPoint for viewing)

4. Dynamics and Prokaryotic Growth (lectures 2 & 3) (midterm 1) (PDF for printing) (PowerPoint for viewing)

5. Control of Microbial Growth (lectures 3 & 4) (midterm 1) (PDF for printing) (PowerPoint for viewing)

6. Metabolism: Fueling Cell Growth (lectures 4 & 5) (midterm 1) (PDF for printing) (PowerPoint for viewing)

7. The Blueprint of Life, from DNA to Protein (lectures 5 & 6) (midterm 1) (PDF for printing) (PowerPoint for viewing)

8. Bacterial Genetics (lecture 6) (midterm 1) (PDF for printing) (PowerPoint for viewing)

9. Biotechnology and Recombinant DNA material will not be covered

Microbiology Part two: the microbial world

10. Identification and Classification of Prokaryotes (lecture 9) (midterm 2) (PDF for printing) (PowerPoint for viewing)

11. The Diversity of Prokaryotic Organisms (lectures 9 & 10) (midterm 2) (PDF for printing) (PowerPoint for viewing)

12. The Eukaryotic Members of the Microbial World (lectures 10 & 11) (midterm 2) (PDF for printing) (PowerPoint for viewing)

13. Viruses of Bacteria (lectures 11 & 12) (midterm 2) (PDF for printing) (PowerPoint for viewing)

14. Viruses, Prions, and Viroids: Infectious Agents of Animals and Plants (lecture 12) (midterm 2) (PDF for printing) (PowerPoint for viewing)

Microbiology Part three: microorganisms and humans

15. The Innate Immune Response (lecture 15) (midterm 3) (PDF for printing) (PowerPoint for viewing)

16. The Adaptive Immune Response (lectures 15 & 16) (midterm 3) (PDF for printing) (PowerPoint for viewing)

17. Applications of Immune Responses (lectures 16 & 17) (midterm 3) (PDF for printing) (PowerPoint for viewing)

18. Immunologic Disorders material will not be covered

19. Host-Microbe Interactions (lectures 17 & 18) (midterm 3) (PDF for printing) (PowerPoint for viewing)

20. Epidemiology (lectures 18 & 19) (midterm 3) (PDF for printing) (PowerPoint for viewing)

21. Antimicrobial Medications (lectures 19 & 20) (midterm 3) (PDF for printing) (PowerPoint for viewing)


Microbiology Unit ONE: THE FUNDAMENTALS

1. Scope and History of Microbiology (click here for lecture notes) week 1

2. Fundamentals of Chemistry (presentation does not exist) (click here for lecture notes)

3. Microscopy and Staining (click here for lecture notes) week 1

4. Characteristics of Prokaryotic and Eukaryotic Cells (mostly the former) (click here for lecture notes) week 2

Microbiology Unit TWO: MICROBIAL METABOLISM, GROWTH, AND GENETICS

5. Essential Concepts of Metabolism (click here for lecture notes) week 2

6. Growth and Culturing of Bacteria (click here for lecture notes) week 3

7. Microbial Genetics (click here for lecture notes) week 4

8. Recombinant DNA and Genetic Engineering (click here for lecture notes) week 4

Microbiology Unit THREE: THE ROSTER OF MICROBES AND MULTICELLULAR PARASITES

9. An Introduction to Taxonomy: The Bacteria (click here for lecture notes) week 5

10. Viruses (click here for lecture notes) week 5

11. Eukaryotic Microorganisms and Parasites (click here for lecture notes) week 6

Microbiology Unit FOUR: CONTROL OF MICROORGANISMS

12. Sterilization and Disinfection (click here for lecture notes) week 7

13. Antimicrobial Therapy (click here for lecture notes) week 7

Microbiology Unit FIVE: HOST-MICROBE INTERACTIONS

14. Host-Microbe Relationships and Disease Processes (click here for lecture notes) week 8

15. Epidemiology and Nosocomial Infections (click here for lecture notes) week 8

16. Nonspecific Host Defenses and Host Systems (click here for lecture notes) week 9

17. Immunology I: Basic Principles of Specific Immunity and Immunization (click here for lecture notes) week 10

18. Immunology II: Immunological Disorders and Tests (click here for lecture notes) week 10

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16 April 2009

Common E.N.T. Problems



Common E.N.T. Problems
Presentation by: B. WAYNE BLOUNT, MD, MPH
Professor, EMORY FAMILY MEDICINE

Acute Otitis Media
AOM Guidelines -Risk Factors
Eustachian tube
Normal Ear Drum
Microbiology
Virology
Tympanometry
Acoustic Reflectometry
Treatment
Follow-Up
Recurrence/Prophylaxis
Some Sticky Business
Chronic MEE
Treatment - OME
Otitis Externa - Treatment
Acute and Chronic Sinusitis
A Practical Guide for Diagnosis and Treatment
Development of Sinuses
Normal Water’s and Towne’ s Views of the Sinuses
Sphenoid Sinus
Classification of Bacterial Sinusitis
Recurrent Acute Bacterial Sinusitis
Differentiating Sinusitis from Rhinitis
X-Ray Image of Sinuses with Maxillary Sinusitis
Acute Bacterial Sinusitis
Physical Findings
Treatment of Acute Sinusitis
Decongestants
Treatment of Acute, Uncomplicated Sinusitis
Bacteria Involved in Acute Bacterial Sinusitis
Antibiotics for Acute Bacterial Sinusitis
Optimal Duration of Antibiotics
Nasal Irrigation
When Medical Therapy for Acute Bacterial Sinusitis Fails…
Assess for chronic causes
Rhinoscope
Recommendations for CT Scans
Evidence-Based Recommendations
PHARYNGITIS
MOST VALIDATED SCORING SYSTEM
TESTS
ENSURE ADEQUATE SWAB
GABHS TREATMENT

and much more in 250 slides presentation.ppt

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Miami University ENT Tutorials



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Prevention of Sudden Cardiac Death in Young Athletes



Prevention of Sudden Cardiac Death in Young Athletes
Topics covered in this presentation

SCD Incidence and Overview
Drezner, Jonathan A., M.D.
Duration: 8:00

Hypertrophic Cardiomyopathy
Towbin, Jeffrey, MD
Duration: 27:42

AVRC and Coronary Artery Anomalies
Corrado, Domenico, MD, PhD
Duration: 20:00

Channelopathies
Campbell, Robert, MD
Duration: 22:34

Commotio Cordis
Link, Mark, MD
Duration: 15:54

ECG Screening: The Italian Experience
Corrado, Domenico, MD, PhD
Duration: 28:49

PPE History & Physical
Campbell, Robert, MD
Duration: 21:26

ECG Screening in the US - Con
Page, Richard L., M.D.
Duration: 19:56

ECG Screening in the US - Pro
Vetter, Victoria, MD
Duration: 33:50

Echocardiography
Lewin, Mark B., M.D.
Duration: 17:35

Athletic Heart Syndrome
Salerno, Jack C., M.D.
Duration: 12:45

Genetic Testing - Is There a Role in Screening?
Towbin, Jeffrey, MD
Duration: 16:40

Natriuretic Peptides
Maisel, Alan, MD
Duration: 24:53

Pediatric & Age Specific ECG Differences
Salerno, Jack C., M.D.
Duration: 12:34

Activity Recommendations in the Young with Conditions that Lead to Sudden Cardiac Arrest
Vetter, Victoria, MD
Duration: 19:43

AED Programs & Emergency Planning in Athletics
Drezner, Jonathan A., M.D.
Duration: 22:05

Prevention of Commotio Cordis
Lewin, Mark B., M.D.
Duration: 11:46

Rapid Cooling After SCA
Kim, Francis, M.D.
Duration: 15:05

View it here

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Top Ranked Peer Reviewed and Proven Radiology Teaching Files



Peer-Reviewed by an Editorial panel. Cases are organized by Organ System, similar to the ACR Learning File.

The MedPix® Teaching File has: 46924 Images from 10724 Cases.
(6503 Approved Disease Topics from 8538 Submitted)


 breast Breast Imaging, Diseases, and Mammography
 brain and skull Skull, Brain, Ventricles, and Cerebrospinal Fluid - || - Start your Differential Diagnosis with Drawings like this!

GBM - glioblastoma');" onmouseout="tip_it(0, '', '')">Brain Lesion Locator

 head and neck Sinus, Orbit, Head and Neck
 spine Spine, Spinal Cord and Vertebra
 musculoskeletal Musculoskeletal, Bones and Soft Tissues
 heart and vessels Heart and Great Vessels of the Thorax
 lung and mediastinum Chest - Lung, Mediastinum, Trachea and Bronchi
 gastrointestinal Gastrointestinal: Esophagus, Stomach, Intestine, Colon, Liver, Gall Bladder, and Pancreas
 genitourinary Genitourinary: Kidney, Ureter, Bladder, Uterus, Testicle, Penis, and Vagina
 vascular and lymphatic Vascular and Lymphatic, Interventional Radiology

The MedPix® COW Educational Activity is ACCME approved for Category 1 CME for Physicians

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Snake Venom Poisoning - A Medical Emergency



Snake Venom Poisoning - A Medical Emergency

Presentation text by Robert Norris, MD, FACEP
Associate Professor, Surgery
Chief, Division of Emergency Medicine
Stanford University

Topics covered.

Objectives
Introduction
Identification of u.s. Snakes
Anatomy
Venom
Signs and symptoms of snake venom poisoning
Factors effecting severity of envenomation
Grading severity of envenomation severity grading
Laboratory analysis management of snake venom poisoning
Method of antivenom administration
Suggested starting doses
Management of the patient with an allergy to antivenom and a severe envenomation
Ddisposition
Mmorbidity and mortality
A note on exotic venomous snakebite in the u.s.
Suggested reading - published journal articles

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26 Rheumatology presentations



USA College of Rheumatology contains 26 presentations
  1. Fibromyalgia- Diagnostic Criteria American College of Rheumatology (1990) Hx of widespread pain; present for at least 3 months; Pain in 11 of 18 tender point sites
  2. Venables PJW. “Mixed Connective Tissue Disease.” Lupus, 2006. 15: 132-137. American College of Rheumatology, classification criteria for SLE.
  3. The American College of Rheumatology proposed clinical criteria for patients enrolled in studies of Wegener's and distinguish other forms of vasculitis (pre-ANCA)
  4. 1987 American College of Rheumatology Revised criteria for the diagnosis of Rheumatoid Arthritis: At least four of the following
  5. American College of Rheumatology –not intended to be used in routine clinical practice and established before ANCA. Presence of 2 or more yield 88% sensitivity and 92 ...
  6. American College of Rheumatology classification criteria . Unexplained weight loss > 4 kg; Livedo reticularis; Testicular pain; Myalgias; Mononeuropathy or polyneuropathy
  7. ASH: American Society of Hematology; ASH: American Society of Hypertension; ACR: American College of Rheumatology; ACR: American College of Radiology
  8. NIMH Working group on Definitional Criteria for HIV-associated Dementia, (AIDS ... Example from Rheumatology
  9. American College of Rheumatology proposed the following five criteria. The presence of three or more had a sensitivity of 71% and a specificity of 84% for the diagnosis
  10. Rheumatology (Oxford) 1999; 38:917. Ramirez-Mata M, Reyes PA, Alarcon-Segovia D et al. Esophageal Motility in systemic lupus erythematosus.
  11. More common in subacute IE . American College of Rheumatology. webrheum.bham.ac.uk/.../ default/pages/3b5.htm . www.meddean.luc.edu/.../ Hand10/Hand10dx.html
  12. There have been several attempts, most notably by the American College of Rheumatology (ACR) in 1990 and the Chapel Hill Consensus Conference of 1994, to create clear ...
  13. This excellent site details the ACR (American College of. Rheumatology) clinical classification criteria. Please take a . look – you won’t believe how detailed it is!
  14. American College of Rheumatology diagnostic criteria; Palpable purpura; Age <20;>
  15. Only about 50% of individuals with a lupus anticoagulant meet the American College of Rheumatology criteria for the classification of lupus (SLE)
  16. RA Classification criteria – 1987 American College of Rheumatology . Morning stiffness in and around the joints lasting at least 1 hour
  17. As revised in 1997 by the American College of Rheumatology) A person is said to have SLE if four of these criteria are present at any time:
  18. Diagnostic Criteria . American College of Rheumatology Diagnostic Criteria (1990) 1; Pain in all 4 quadrants of body and axial skeleton.
  19. The American College of Rheumatology: 5 criteria for the classification of hypersensitivity vasculitis in a patient with vasculitis; Age >16 years
  20. American College of Rheumatology classification criteria; Palpable purpura; Age of onset <= 20 years; Acute abdominal pain; Biopsy showing granulocytes in walls ...
  21. 1990 Criteria of American College of Rheumatology for the Classification of Takayasu’s Arteritis . Definition . Criteria . Development of symptoms or findings related to Takayasu ...
  22. The American College of Rheumatology’s Criteria 1: Widespread musculoskeletal pain for at least 3 months; Axial skeletal pain; Pain in at least 11 out of 18 trigger points
  23. Soft Tissue Rheumatism . Gary Kunkel, M.D. Division of Rheumatology. November, 2005. Objectives . Recognize key features of the most common types of bursitis and ...
  24. Perez JL, et al. Presented at: American College of Rheumatology Annual Meeting; October 21, 2004. Keane J, et al. N Engl J Med. 2001;345:1098-1104.
  25. American College Rheumatology Criteria for SLE Diagnosis (M =5.59 criteria, range of 1 to 10 to make diagnosis) 47% Malar rash; 35% Discoid rash
  26. Arnold LM et al. Arthritis Rheum. 2004;50:2974-2984; Wernicke JF et al. Presented at: 68th Annual Scientific Meeting of the American College of Rheumatology; October 16-21 ...

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Osteoporosis Clinical cases and literature review



Osteoporosis Clinical cases and literature review
Presentation by Catherine Bakewell, MD

Overview
Risk Factors
Screening
Treatment of Osteopenia
EBM
Problems? Flaws?
Study limitations
What doses do you recommend?
Vitamin D
Calcium
Counselling
Bisphosphonates for Osteopenia
Physiologic effects
Guidelines
Conclusions
What about other therapies?
Calcitonin
Estrogen
Selective Estrogen Receptor Modulators
Intermittent PTH
Glucocorticoid induced bone loss
Mechanisms for glucocorticoid induced osteoporosis
General guidelines
Screening
Supplementation
HRT
Bisphosphonates
What would Schousboe say?
Calcitonin
Thiazides
References

Osteoporosis Clinical cases and literature review.ppt

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Rheumatology for Internal Medicine



Rheumatology for Internal Medicine Boards
Presentation by:Victoria K. Shanmugam, MD

Assistant Professor of Medicine
Georgetown University Hospital

What is the diagnosis?
Rheumatoid Arthritis

CRITERIA
EPIDEMIOLOGY
RHEUMATOID FACTOR
CCP
Extra-articular manifestations of RA
Cardiac 3x increased risk of atherosclerosis

Pericarditis
NSAID associated
Pulmonary
Interstitial fibrosis
Anemia of chronic disease
Extra-articular manifestations of RA
DMARDS
DRUG MOA ADMINISTRATION SIDE EFFECTS MONITORING
Bone marrow suppression
DRUG MOA ADMINISTRATION SIDE EFFECTS MONITORING

ANA
ANA Patterns
ACR Criteria For Lupus
Discoid rash
Photosensitivity
Mucocutaneous Ulcers
Lupus Arthritis
Pleuritis
Pericarditis
Nephritis
Neurologic manifestations
Cardiac involvement in Lupus
Cardiovascular risk and Lupus
Disease activity parameters
Symptomatic treatment
PRIMARY AND SECONDARY APS
Myositis
Myositis Antibodies
GOUT vs. PSEUDOGOUT
What is the diagnosis
Disseminated Gonococcal Infection
SYNOVIAL FLUID ANALYSIS
The Antibodies
Scleroderma Renal Crisis
Pathology of renal crisis
Steroids and renal crisis
Management of Renal Crisis
BP Elevated
Risk factors for Renal Crisis
Presentation of Renal Crisis
Raynaud’s Syndrome
DDx Raynaud’s
Wegener’s Granulomatosis
Churg Strauss Syndrome
Giant Cell Arteritis
Polymyalgia Rheumatica

and much more are discussed in this presentation

Rheumatology for Internal Medicine Boards.ppt

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Rheumatology



Rheumatology What you need to know for your ambulatory medicine experience
Presentation by Kevin Latinis, M.D./Ph.D.
Division of Rheumatology
Dept. of Internal Medicine

This Rheumatology presentation covers the following topics.

* Arthritis
-Inflammatory (RA, spondyloarthropathies)
-Mechanical (OA)
* Lupus
* Fibromyalgia
* Low back pain and other peri-articular complaints
* General musculoskeletal exam

Mechanical vs. Inflammatory Arthritis
Osteoarthritis-Background
Osteoarthritis-Distribution
Osteoarthritis-Diagnosis
* Clinical
* Supported by X-rays
* Non-inflammatory lab data, if any

Osteoarthritis-Treatment
Clinical Pearl:
Arthritis of the DIP joint
OA (non-inflammatory)
Psoriatic Arthritis (inflammatory)
Inflammatory Arthritis
Systemic Lupus Erythematosus-Background
Clinical features, classification criteria
Treatment of SLE
Steroids in Lupus
Fibromyalgia-Background -Diagnosis
Fibromyalgia-Treatment
General Musculoskeletal Exam

* Underutilized by primary care providers
* Should be simple and quick
* Goal is to recognize signs of rheumatological diseases and determine if it is appropriate to refer to a rheumatologist or manage independently

Rheumatology.ppt

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Drug Induced Liver Injury



Drug Induced Liver Injury
Presentation by:Robert J. Fontana, MD
University of Michigan Medical Center

Drug Induced Liver Injury
Hepatic Adverse Event Nomenclature
Liver Injury Classification
DILI Population based study
DILI Diagnosis
Clinicopathologic forms of DILI
DILI: A Diagnosis of exclusion
Acute Hepatocellular: Differential Dx
Ultrasound/ CT
DILI: Causality Assessment
RUCAM
RUCAM limitations
Prognosis in DILI with jaundice
Spectrum of DILI
ALT monitoring and DILI
DILI pathogenesis
DILIN: Sphere of Influence
Idiosyncratic Liver Injury Associated with Drugs (ILIAD)
New agent signals
Drug
Human genome
DILIN Genotyping Initiative
Acetaminophen: Friend or foe ?
Glucuronyl transferases sulfotransferases
Acetaminophen
ACM-cysteine adducts
Biomarker for ACM hepatotoxicity
Implications of ACM related ALF
Acetaminophen advice
Acetaminophen toxicity in severe acute HAV/ HBV
Prospective Study Design
DILI Causality Instrument
Prognosis in DILI with jaundice

Drug Induced Liver Injury.ppt

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15 April 2009

Viral Hepatitis Medicine Student Lecture



Viral Hepatitis Medicine Student Lecture
Presentation by:David R Nelson, M.D.

Associate Professor of Medicine
Director, Hepatology and Liver Transplantation
University of Florida

Causes of Acute Hepatitis

Acute Hepatitis
Viral Hepatitis
A, B/D, C, E
EBV
CMV & HSV
Drugs
Ethanol
Tylenol
Halothane
Toxins
Jamaica Bush Tea
Mushrooms
Vascular
Hypotension
Budd-Chiari
Autoimmune
Hepatitis
Metabolic
Wilson's Disease
A1AT

Causes of Chronic Hepatitis
Chronic Hepatitis
Viral Hepatitis
Drugs
MTX
INH
Amiodarone
Alcohol
NAFLD
Autoimmune
AIH
PBC
PSC
Metabolic
A1AT
HHC

Hepatitis A Virus
Nucleic Acid: 7.5 kb ssRNA
HAV Prevalence
Global Prevalence of Hepatitis A Infection
Hepatitis A Prevention - Immune Globulin

ACIP Recommendations MMWR 1999; 48(RR12):1
Hepatitis A: Pre-exposure Vaccination
Persons at increased risk or danger of infection
Hepatitis E

Clinical Characteristics
Hepatitis B Virus
HBsAg
HBV DNA
HBcAg
HBV Sources of Infection
Signs and Symptoms of Acute Hepatitis B

Hepatitis B - Clinical Features
Progression to Chronic Hepatitis B Virus Infection
Typical Serologic Course
Recovery from acute hepatitis B
Chronic HBeAg + disease
Chronic HBeAG – disease
Successful Vaccination
Resistance to antiviral agents
Hepatitis B: Disease Progression
Acute Infection
Chronic HBV is the 6th leading cause of liver transplantation in the US
Higher in HIV, immune suppressed
Targeted Surveillance for HCC
Hepatitis B Carriers
Non-hepatitis B Cirrhosis
Prevention of Transmission of Hepatitis B

and much more are discussed in this presentation.
Viral Hepatitis Medicine Student Lecture.ppt

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Treatment for Chronic Hepatitis B



Treatment for Chronic Hepatitis B
Screening for Hepatocellular Carcinoma
Presentation by: Mindie H. Nguyen, MD, MAS

Assistant Professor of Medicine
Division of Gastroenterology & Hepatology
Liver Transplant Program
Stanford University Medical Center

Chronic Hepatitis B
HBV Disease Burden in Asian-Americans
Hepatitis B Prevalence
Etiology of HCC in Asians
Impact of HBV DNA and ALT Levels on Disease Outcomes
HBV DNA Levels,
Disease Progression and HCC Risk
Impact of Viral Load
HBV DNA Associated with Increased Risk of HCC
HBV DNA levels and Risk of Cirrhosis and HCC REVEAL-HBV Study
HBV DNA Levels Predict Risk of Developing Cirrhosis
HBV DNA Levels Predict Risk of Developing HCC
Dose-Response Relationship:
HBV DNA and HCC
REVEAL-HBV Study: HCC Analysis Conclusions
Impact of Treatment on Disease Progression
Primary Goal of Treatment
Rapid and sustained suppression of HBV to the lowest possible level1,2
Rapid and Profound HBV Suppression: an Important Therapeutic Goal
Lamivudine and Disease Progression and HCC incidence in Advanced HBV (stage III/IV)
HBV DNA Suppression Reduces HCC Incidence Rate
Screening for Hepatocellular Carcinoma
HCC: Screening Tests
HCC: Screening Strategies and Frequency
WHO Principles of Screening
Screening improves survival
HCC Screening: clinical studies
RCT for HCC Screening

Treatment for Chronic Hepatitis B

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Hepatitis C



Hepatitis C
Presentation by
Bruce Luxon, MD, PhD
James A. Clifton Chair in Gastroenterology
Professor of Internal Medicine
Director, Division of Gastroenterology and Hepatology
University of Iowa


The Silent Epidemic
DIAGNOSTIC APPROACH TO CHRONIC HEPATITIS
RISK FACTORS FOR HCV OR ELEVATED ALT LEVELS
ANTI-HCV (EIA) TESTING
REFER TO SPECIALIST FOR EVALUATION AND TREATMENT
NEGATIVE
POSITIVE
EIA=enzyme immunoassay.
Check HCV RNA (viral load) and HCV genotype

* Basic facts on diagnosing hepatitis C
o Who is at risk?
o How do I screen?
o Why should I screen?
* Basic facts on treating hepatitis C
o What are treatment options?
o What are the success rates?
* Mention new trials and treatment options
o What should I do if initial treatment fails?

Cure
Consensus Interferon (CIFN)
DIRECT Trial
Maintenance Therapy?
HALT-C Trial
Summary
What to Take Away from Today

Hepatitis C.ppt

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Natural Supplements in Gastroenterology



Natural Supplements in Gastroenterology—An overview
Presentation by: Victor S. Sierpina, MD

W.D. and Laura Nell Nicholson Professor of Integrative Medicine
Family Medicine Department
University of Texas Medical Branch

Learning Objectives

* Describe common categories and examples of natural products for gastroenterology
* Describe indications and rationale for use of probiotics in clinical care
* Outline integrative approaches to irritable bowel syndrome, inflammatory bowel syndrome, chronic hepatitis
* List reliable references for evidence in the use of natural supplements in gastroenterology

Categories of GI herbals with examples
Some popular Hispanic herbs for GI complaints

* Basil/Albahaca
* Chamomile/Manzanilla
* Cumin/Comino
* Rue/Ruda
* Sage/Chia
* Spearmint/Yerba buena



Probiotics/Prebiotics
* Lactobacillus GG
* Lactobacillus casei
* Lactobacillus acidophilus
* Lactobacillus planatarum
* Lactobacillus reuteri
* Bifidobacterium bifidum/longum
* Saccharomyces boulardii
* Streptococcus therpophlus

Mechanisms of Action of Probiotics
* Colonization resistance
* Production of antibacterial substances
* Competition for nutrients
* Competitive inhibition at bacterial adhesion sites
* Enhancement of the immune defense system

Roles and indications of probiotics

* Dysbiosis
* Diarrhea (anitbx, e.g. H. Pylori tx, viral, traveler’s, infantile, AIDS related)
* Lactose intolerance
* Immunomodulatory effects
* Altered gut permeability (leaky gut)
* Inflammatory disorders
* Colon cancer prevention
* Atopy/food allergy

How to prescribe probiotics

* Occur naturally in many foods: yogurt, milk, miso, tempeh, kefir, sauerkraut, some cheeses
* Even non-viable organisms may have benefit (block bacterial adherence)
* Take on an empty stomach
* Space 3-4 hrs after antibx (2 weeks post tx)
* At least 1 billion organisms per dose
* Length of intake uncertain for many conditions


Peppermint
Herbal approach to IBS--carminatives

* Enteric coated peppermint (Mentha piperita):1-2 capsules (0.2ml) tid between meals
* Ginger (Zingiber officinale): 0.25-1 g tid
* Fennel (Foeniculum vulgare): ½-1 tsp seeds pp, 0.03-0.2 ml oil qd, alcoholic extract 0.5-2 ml/d
* Chamomile (Matricaria recutita): tea/infusion with 2-3 g of flowers; 1-4 ml tincture (1:5) tid
* Caraway:1-2 tsp seeds in tea/infusion, or alcoholic extract

Fennel
Herbal approach to IBS—stool agents

Other options
Inflammatory bowel disease

Hepatitis

Anti-viral, anti-inflammatory, anti-fibrotic
Selected References—Hispanic Herbs


Natural Supplements in Gastroenterology

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Academic Enhancement Presentations



Academic Enhancement Presentations from The University of Texas Health Science Center at San Antonio.

  1. [PPT]

    SuccessTypes And Effective Learning

    File Format: Microsoft Powerpoint - View as HTML
    1. SuccessTypes And Effective Learning. John W. Pelley, PhD. john.pelley@ttuhsc.edu. www.ttuhsc.edu/SOM/success/. 2. Getting In Touch With Your Thalamus ...
    som.uthscsa.edu/AcademicEnhancement/documents/SuccesstypesandeffectivelearningUMiss2008.ppt - Similar pages
  2. [PPT]

    Patient 1

    File Format: Microsoft Powerpoint - View as HTML
    Patient 1. CC: 5YOWFpresents with fever, marked weakness, pallor, bone pain, and bleeding from her nose; HPI: progressively increasing fatigability and ...
    som.uthscsa.edu/AcademicEnhancement/documents/USMLEcasepresentations.ppt -Similar pages
  3. [PPT]

    CV and Personal Statement

    File Format: Microsoft Powerpoint - View as HTML
    Agenda. Introductions; Time Lines; Curriculum Vitae (CV); Personal Statement; Evaluation. Background to Presentation. Dr. Nan Clare – Dean’s Office ...
    som.uthscsa.edu/AcademicEnhancement/documents/82207presentation.ppt - Similar pages
  4. [PPT]

    Biomedical Research: Opportunities and Benefits for Medical Students

    File Format: Microsoft Powerpoint - View as HTML
    Biomedical Research: Opportunities and Benefits for Medical Students. Robin L. Brey, MD. Associate Dean for Research. UTHSCSA. School of Medicine ...
    som.uthscsa.edu/AcademicEnhancement/documents/MedStudent1SummerandDistinction.ppt - Similar pages
  5. [PPT]

    Concept Mapping – Why, How, and When?

    File Format: Microsoft Powerpoint - View as HTML
    Concept Mapping – Why, How, and When? John W. Pelley, PhD. Texas Tech University School Of Medicine Lubbock, TX. www.ttuhsc.edu/SOM/success/ ...
    som.uthscsa.edu/AcademicEnhancement/documents/ConceptMappingwhenandhowUMiss2008.ppt - Similar pages
  6. [PPT]

    Learning in Groups

    File Format: Microsoft Powerpoint - View as HTML
    1. Learning in Groups. John W. Pelley, PhD. Texas Tech University School Of Medicine Lubbock, TX. www.ttuhsc.edu/SOM/success/ ...
    som.uthscsa.edu/AcademicEnhancement/documents/LearningingroupsUMiss2008.ppt -Similar pages
  7. [PPT]

    Week 2

    File Format: Microsoft Powerpoint - View as HTML
    Steven Katz, MSIV. Genetics Terms. Basic Terms (Review). Gene: A hereditary unit consisting of a sequence of DNA that occupies a specific location on a ...
    som.uthscsa.edu/AcademicEnhancement/documents/Step1Week2.ppt - Similar pages
  8. [PPT]

    USMLE STEP 1 Review: Week 3, Biochemistry

    File Format: Microsoft Powerpoint - View as HTML
    Chase Findley, MSIV. Vitamins, Fat Soluble, 94. Vitamins A, D, E, K. Absorption dependent on ileum and pancreas; Accumulate in body fat, more potential for ...
    som.uthscsa.edu/AcademicEnhancement/documents/week3.ppt - Similar pages
  9. [PPT]

    Board Review Week 1 Test

    File Format: Microsoft Powerpoint - View as HTML
    Board Review Week 1 Test. Good luck!! Question 1 of 40. (E) Opioids. (D) Barbiturates. (C) Amphetamines. (B) Cocaine. (A) Alcohol ...
    som.uthscsa.edu/AcademicEnhancement/documents/week1USMLEquestions.ppt -Similar pages
  10. [PPT]

    Slide 1

    File Format: Microsoft Powerpoint - View as HTML
    Board Review Week 3 Test. Good luck!! (E) Neocortex. (D) Cerebral motor cortex. (C) Cerebral frontal lobes. (B) Amygdaloid nuclei and lumbar system ...
    som.uthscsa.edu/AcademicEnhancement/documents/week3USMLEquestions.ppt -Similar pages
  11. [PPT]

    Rapid review: first aid

    File Format: Microsoft Powerpoint - View as HTML
    Rapid review: first aid. Often precedes squamous cell carcinoma. Actinic keratosis. Primary adrenocortical deficiency. Addison’s disease ...
    som.uthscsa.edu/AcademicEnhancement/documents/Rapidreviewboards.ppt - Similar pages
  12. [PPT]

    Week 7 USMLE Step 1 Review: Biostatistics and Nutrition

    File Format: Microsoft Powerpoint - View as HTML
    Steven Katz MSIV. PART 1: BIOSTATISTICS. Terms: Independent variable: values that are controlled or selected by the person experimenting to determine its ...
    som.uthscsa.edu/AcademicEnhancement/documents/week7ppt.ppt - Similar pages
  13. [PPT]

    USMLE STEP I Review Week 6: Renal and Hematology Physiology

    File Format: Microsoft Powerpoint - View as HTML
    Steven Katz, MSIV. Part 1: Hematology and Oncology (p.326-347). Blood Cell Differentiation. Heme Terms (p. 327). Erythrocyte: anucleate, biconcave cell with ...
    som.uthscsa.edu/AcademicEnhancement/documents/week6ppt.ppt - Similar pages
  14. [PPT]

    som.uthscsa.edu/ClinicalSkillCenter/documents/Clin...

    File Format: Microsoft Powerpoint - View as HTML
    CLINICAL SKILLS CENTER.
    Similar pages
  15. [PPT]

    Slide 1

    File Format: Microsoft Powerpoint - View as HTML
    Board Review Week 2 Test. Good luck!! Question 1 of 40. (E) the seminiferous tubules. (D) the urethral opening. (C) the cervix. (B) the ovary ...
    som.uthscsa.edu/AcademicEnhancement/documents/week2USMLEquestions.ppt -Similar pages

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All links posted here are collected from various websites. No video or powerpoint files are uploaded on this blog. If you are the original author and do not wish to display your content on this blog please Email me anandkumarreddy at gmail dot com I will remove it. The contents of this blog are meant for educational purpose and not for commercial use. If you use any content give due credit to the original author.

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