Preparation for a life devoted to medicine @medify-my-life - Tumblr Blog

Posts

medicalschool

An overview of compliment

medxclusive

medicalschool

Histology of the eye - transverse section of the retina

1. pigment epithelium; 2. photoreceptor layer (cones and rods); 3. outer limiting membrane; 4. outer nuclear layer; 5. outer plexiform layer; 6. inner nuclear layer; 7. inner plexiform layer; 8. ganglion cell layer; 9. nerve fiber layer; 10. inner limiting membrane.

Ebola: basic fluid and nutrition care 'being missed'

Ebola patients can lose five to 10 litres of fluid a day through vomiting and diarrhoea

Ebola patients are missing out on basic care that could improve their chances of survival, according to a report in the Lancet medical journal.

Researchers say organisations are being misled by an "inaccurate view" that there is no proven treatment for Ebola.

They add that patients, who could be treated with fluids and electrolytes, are dying of dehydration.

Charities say there are many challenges to giving the intensive fluid replacement that some patients need.

This requires greater staffing and patient ratios. But it would save more lives”

Dr Catherine Hoolihan Save the Children

Drugs and vaccines

Ebola has killed more than 6,000 people in the worst-affected areas of Sierra Leone, Guinea and Liberia.

The virus causes severe vomiting, diarrhoea and bleeding - all of which can lead to the profound loss of fluids and electrolytes, such as sodium and potassium.

When patients are too sick to drink they can be given fluids intravenously - using a drip through a vein.

But Prof Ian Roberts, of the London School of Hygiene and Tropical Medicine, and Prof Anders Perner, at the University of Copenhagen, say these rehydration therapies are being neglected while people focus on potential drugs and vaccines.

Prof Roberts told the BBC: "When the outbreak started, people thought there was nothing we could do unless we killed the virus.

"But it quickly became apparent when people treated in high-income countries didn't all die that ordinary good-quality medical care makes a huge difference.

"There are some simple things - like replacing fluids and electrolytes - that could improve the fatality rate."

'Greater staffing'

The charity Medecins Sans Frontieres says patients are encouraged to drink but only the sickest patients are given drips, as inserting them can leave staff at risk of getting the disease.

Dr Catherine Hoolihan, of Save the Children, who is currently working at a treatment centre in Sierra Leone, told the BBC: "Some weaker patients absolutely require intravenous fluids in order to support them, but it is a challenging thing to do.

"There are concerns about the safety of having needles inside wards but we are starting to see that when there are training and facilities in place this can work.

"We also have challenges of confused patients who won't let you put in drips. Others will pull them out. And you need people to put up the next bag of fluid.

"This requires greater staffing and patient ratios. But it would save more lives."

Dr Charlie Weller, of the Wellcome Trust, said: "We know intensive fluid therapy can help patients but this requires more staff.

"The UK and global agencies are calling for more people to help. But giving fluids alone will not eradicate Ebola.

"Other therapies and vaccines will also be important right now and for future outbreaks."

Obese lose up to eight years of life

Being severely obese can knock up to eight years off your life and cause decades of ill health, a report says.

The analysis showed being obese at a young age was more damaging to health and life expectancy.

The team, at McGill University in Canada, said heart problems and type 2 diabetes were major sources of disability and death.

Experts said people were frequently "ignorant" of the consequences of obesity.

The health problems caused by obesity are well known.

The report, in the Lancet Diabetes and Endocrinology, used a computer model to take those risks and calculate the impact of weight on life expectancy throughout life.

In comparison with 20 to 39-year-olds with a healthy weight, severely obese men of the same age lost 8.4 years of life and women lost 6.1.

Men also spent 18.8 more years living in poor health while women spent 19.1 in that state.

Moving up an age group to those in the forties and fifties, men lost 3.7 years and women 5.3 years to obesity.

Men and women in their sixties and seventies lost just one year of life to obesity, but still faced seven years in ill health.

'Clear pattern'

Prof Steven Grover said: "Our computer modelling study shows that obesity is associated with an increased risk of developing cardiovascular disease, including heart disease and stroke, and diabetes that will, on average, dramatically reduce an individual's life expectancy.

"The pattern is clear. The more an individual weighs and the younger their age, the greater the effect on their health, as they have many years ahead of them during which the increased health risks associated with obesity can negatively impact their lives."

Responding to the findings, Barbara Dinsdale, lifestyle manager for the charity Heart Research UK, said: "How many more wake-up calls do we need?

"This research study yet again supports the clear message that by becoming obese you not only take years off your life, but also life off your years in terms of experiencing more years in poor health rather than enjoying a happy, active and productive life."

"Whatever size you are, small, manageable but sustainable changes are the way forward for a happier, healthier and longer life, and reduced risk of heart disease and type 2 diabetes."

Tam Fry, of the National Obesity Forum, said: "People persist in thinking that fat is just fat and appear ignorant of the many diseases that a high body mass index triggers.

"If they were told that they could lose a leg or go blind from diabetes or develop life-threatening complications from other similar diseases, I am sure they would think hard and twice before piling on the pounds."

girlinwhitecoat-deactivated2017

"Starry-sky pattern"

The tumor cells, which are large with minimal cytoplasm, are closely apposed to each other, forming a dark blue background (the “sky”). These cells have a very high turnover rate, so the macrophages that happen to be hanging around get stuffed with cellular debris (they are at this point called “tingible body macrophages”), and upon fixation, the cytoplasm falls away, leaving round white spaces filled with debris (the “stars”). This pattern can be seen on both bone marrow or lymph node sections, and it is quite specific for Burkitt lymphoma.

drnicoleyva

We performed surgery to this patient due to abdominal pain in the umbilical region, what we found was pretty shocking. A long gauze was left in the abdominal cavity by a surgery performed three years before!! (Not at my hospital) Remember, counting gauzes before and after surgery is very important!!

Sometimos a este paciente a cirugia debido a dolor abdominal en región umbilical, lo que encontramos fue sorprendente! Un compresa fue olvidada dentro de la cavidad por una cirugía realizada tres años atrás (no en mi hospital). Recuerden, es muy importante contar las gasas y compresas antes y después de la cirugía!!

medicowesome

Hemolytic face mnemonic

The mnemonic is, “FACE”

F for forehead prominence.

A for ash white face. (It is due to combination of pallor, hemosiderosis and jaundice.)

C for chew. Which helps me remember that the teeth are widely separated. (Due to maxillary hypertrophy.)

E for eminence. The malar eminence is prominent.

The forehead and malar prominence is due to extramedullary expansion of bone marrow.

That’s all!

I love posting this mini mnemonic points. Even if the mnemonic isn’t useful, the concepts stay with you. Hope you’ll are enjoying reading it.

-IkaN

lifeaccordingtocrohns

Accurate.

allthecanadianpolitics

Whooping cough outbreak declared in central Alberta

Alberta Health Services has declared an outbreak of whooping cough in the central zone of the province.

AHS said in a statement that central Alberta has seen a sustained increase in the number of confirmed cases of pertussis — more commonly known as whooping cough — and of the 107 cases treated this year, seven have required hospitalization..

Whooping cough is caused by bacteria that infects the lungs and airways. The disease causes severe coughing that can last for weeks and can lead to pneumonia, convulsions, brain damage and even death.

Babies under the age of six months are at greatest risk of developing serious complications.

Whooping cough is treatable, especially if caught early, but AHS says immunization can safely prevent the disease.

dance-0f-the-damned

Microscopic video of white blood cells attacking a parasite in an 80 minute battle condensed down to a few seconds.

Gif source: (X)

Text messaging service 'helps people take their pills'

One third of patients do not take their medicine as directed, research suggests

A text messaging service could help people remember to take the medicines they have been prescribed, say researchers.

A test scheme, which involved heart patients, cut the numbers who forgot or just stopped taking their pills.

One in six was helped to continue their treatment, reducing their risk of heart attack and stroke.

It has been estimated that the NHS spends more than £500m on wasted medicines and avoidable illness.

In general, patients really valued the text messages and were disappointed when they stopped”

Prof David WaldQueen Mary University of London

Other research has shown around a third of patients do not take their medicine as directed.

Study leader Prof David Wald said text reminders could be used by GPs, hospital doctors and pharmacists for a range of different conditions, including diabetes, TB and HIV.

Professor David Wald said the service helped identify and help people who stopped taking their medication

In the study, published in Plos ONE, 300 patients who were already on blood pressure medicines or statins were either sent daily texts for two weeks followed by a fortnight of alternate days, then weekly texts for six months, or no texts at all.

Participants had to reply to say whether they had taken their medication, whether the message had reminded them to take it if they had forgotten, or whether they had simply not taken it.

Telephone support

Anyone who had not taken their medicine was flagged up by a computer and received a telephone call to offer advice.

Of those who did not receive texts, 25% stopped taking their medicine completely, or took less than 80% of it.

In the text group, that figure was 9% - 14 out of 150 patients.

There were only three patients who did not start taking the medicine again after receiving advice.

Prof Wald, consultant cardiologist at Queen Mary University of London, said there was a range of reasons why people stopped taking their medicine, including uncertainty over the need for treatment and concerns over potential side-effects, often prompted by negative reports of statins they had read in the media.

"In general, patients really valued the text messages and were disappointed when they stopped."

David Taylor, emeritus professor of pharmaceutical and public health policy at University College London, said text messaging could be coupled with each relevant prescription and prevent several thousand heart attacks and strokes in the UK annually.

It could also be used for other diseases, he said.

Maureen Talbot, senior cardiac nurse at the British Heart Foundation, added that the study was small but encouraging.

"It's crucial that heart patients take prescribed treatments to control their blood pressure and cholesterol as it helps reduce their risk of having a heart attack or stroke.

"Carrying out a larger study over a longer period would help establish the full extent of the benefits of sending this type of reminders to patients."

Ebola virus: Genes 'play significant role in survival'

Genetic factors could play an important role in whether people survive the Ebola virus, say US scientists.

A study of mice infected with the virus found they showed a number of different symptoms, with 19% remaining unaffected by the disease.

This could explain why some people recover from the illness while others die in pain, the scientists said.

Their study is published in the journal Science.

Scientists from the universities of Washington and North Carolina, and the National Institute of Health in Montana, examined mice they had infected with the same species of Ebola virus causing the current outbreak in West Africa.

It may not be necessary to completely eliminate Ebola virus from the body during infection to ensure that there is no disease”

Prof Andrew EastonUniversity of Warwick

Although all the mice lost weight in the first few days after infection, nearly one in five regained that weight within two weeks and showed no evidence of the disease.

But 70% of the mice became very ill, some showing signs of liver inflammation and a larger group having blood that took too long to clot.

These mice also had internal bleeding, swollen spleens and changes in liver colour.

They also had a greater than 50% chance of dying from the disease.

Host's genes

Angela Rasmussen, from the Katze Laboratory at the University of Washington, said the different ways in which the mice were affected mirrored the variety of symptoms seen in humans in the 2014 outbreak.

Recent Ebola survivors could have had immunity to this virus or a related virus which may have saved them, for example.

This would have meant the disease reacting in a particular way to a host's genes, which is seen with many other viruses.

Andrew Easton, professor of virology at the University of Warwick, said the study provided valuable information, but the data could not be directly applied to humans because they have a much larger variety of genetic combinations than mice.

He added: "The paper also does not assess the role of environmental factors that undoubtedly also play a role in the disease process such as the underlying health status of the at-risk population."

However, Prof Easton said the data suggested that "it may not be necessary to completely eliminate Ebola virus from the body during infection to ensure that there is no disease, and that reduction of virus growth in the body may offer alleviation from some aspects of the disease".

It will be important to see if a similar phenomenon is happening in humans”

Prof Jonathan BallUniversity of Nottingham

This suggests new treatments may not have to be as thorough as initially expected, he said.

'Intriguing'

Prof Jonathan Ball, professor of molecular virology at the University of Nottingham, said some of the study's discoveries regarding blood clotting were interesting.

"In this mouse model study, the finding that levels of expression of a gene involved in coagulation differs between mice showing different severity of disease symptoms is really intriguing.

"Of course, this is merely an association and needs to be explored more to know definitively how expression is controlled and how it might influence disease.

Prof Ball added: "It will also be important to see if a similar phenomenon is happening in humans."

Another study published in Science, on how best to stop the transmission of the Ebola virus, concluded that funerals were "super-spreader events".

Researchers from Yale University, Oregon State University and Liberia, said funeral practices - which often involve washing, touching and kissing of the bodies - had to end in order to bring the disease under control.

They also said aggressive steps should also be taken "to isolate cases and and better protect healthcare workers".

Alcohol calorie content: Labels needed, say doctors

Alcohol should have a calorie content label in order to reduce obesity, according to public health doctors.

The doctors warn a large glass of wine can contain around 200 calories - the same as a doughnut.

Yet the Royal Society for Public Health says the vast majority of people are blissfully unaware.

Public Health Minister Jane Ellison said "great strides" had been made with labelling food, and that the government will look at the issue.

The drinks industry said it was open to the idea of calorie labels, but that labelling drinks with units of alcohol was more important.

The UK is one of the most obese nations in the world with about a quarter of adults classed as obese.

'Startling'

Food already comes with calorie information, but alcohol is exempt from EU food labelling laws.

And the European Commission is considering whether drinks should also carry such information.

Research by the Royal Society for Public Health suggested the measure would be popular with British drinkers.

The RSPH's chief executive, Shirley Cramer, told the BBC: "Quite startling really - 80% of adults have no idea what the calorie count is in anything they're drinking and if they do think they have an idea they totally underestimate it anyway.

"It could help the nation's waistlines as well as probably reduce alcohol consumption."

In a small pub experiment conducted by the society, people who were told the calories content of their drink consumed 400 fewer calories in a session.

How many calories

Estimates suggest 10% of an adult's calorie intake comes from alcohol.

Gram for gram it is the second most calorie-dense source of energy, just behind fat.

'Open to discussion'

The Portman Group, which represents drinks manufacturers, said it took the health consequences of drinking "very seriously" and provided calorie information on the Drinkaware website.

In a statement it said: "Drinks producers can play a key role in informing and educating consumers and are open to further discussions about calorie information.

"However, it is essential that alcohol content, not calorie content, should primarily inform consumer decision-making."

Brendan O'Donnell says cutting down on alcohol helped him lose more than 11 stone

Tam Fry, from the National Obesity Forum, said the government had been dragging its feet on the issue.

"A calorie-count on wine and beer bottles can't come soon enough.

"Just one premium lager contains by itself contains enough calories for a small meal and, added to the meal itself, eats up a chunk of anyone's maximum allowance."

Ms Ellison said: "It is very positive to see that people want more information to help them lead a healthier life.

"We have made great strides in food labelling and customers can see at a glance the calories they are consuming on many products.

"While it is already possible for alcohol producers and retailers to display calorie content on their labels, we will continue to look at what else can be done to help people make healthier lifestyle choices."

Jackie Ballard, the chief executive of Alcohol Concern, said: "Much more needs to be done to raise awareness of both the contents and the harms which can be caused by alcohol.

"You walk into any shop and the calorie, fat content, sugar and more are on the back of food packets and we don't see why alcohol should be any different."

Ebola outbreak: Cases pass 10,000, WHO reports

Liberia remains the worst affected country, with 4,665 cases

The number of cases in the Ebola outbreak has exceeded 10,000, with 4,922 deaths, the World Health Organization says in its latest report.

Only 27 of the cases have occurred outside the three worst-hit countries, Sierra Leone, Liberia and Guinea.

Those three countries account for all but 10 of the fatalities.

Mali became the latest nation to record a death, a two-year-old girl. More than 40 people known to have come into contact with her have been quarantined.

The latest WHO situation report says that Liberia remains the worst affected country, with 2,705 deaths. Sierra Leone has had 1,281 fatalities and there have been 926 in Guinea.

Nigeria has recorded eight deaths and there has been one in Mali and one in the United States.

Obama: "Patients can beat this disease, and we can beat this disease"

The WHO said the number of cases was now 10,141 but that the figure could be much higher, as many families were keeping relatives at home rather than taking them to treatment centres. It said many of the centres were overcrowded.

And the latest report also shows no change in the number of cases and deaths in Liberia from the WHO's previous report, three days ago.

Eight countries have registered cases in the outbreak. In West Africa, Senegal and Nigeria have now been declared virus-free by the WHO.

'Facts, not fear'

In the US, the governors of the states of New York, New Jersey and Illinois have ordered a mandatory 21-day quarantine period for all doctors and other travellers who have had contact with Ebola victims in West Africa.

Anyone arriving from affected West African countries without having had confirmed contact with Ebola victims will be subject to monitoring by public health officials.

Health workers arrive to pick up the body of a young victim in Freetown, Sierra Leone

The move follows the diagnosis in New York of Dr Craig Spencer, who had been working in Guinea.

The first person to be quarantined under the rules was a female health worker who arrived at Newark Liberty International Airport on Friday.

She had no symptoms then but later developed a fever. A preliminary test came back negative for Ebola, the New Jersey health department said on Saturday, but the woman remains in isolation.

Also in the US, two nurses infected while caring for dying Dallas patient Thomas Eric Duncan have been declared free of the virus.

One, Nina Pham, 26, met President Barack Obama at the White House, hours after being discharged.

The BBC's Gabriel Gatehouse travels with an ambulance worker in Liberia

In his weekly radio and online address, Mr Obama repeated that people cannot contract Ebola unless they have come into direct contact with an infected patient's bodily fluids.

He said the disease had to be stopped at source in Africa.

Mr Obama added: "Patients can beat this disease, and we can beat this disease. But we have to stay vigilant... And we have to be guided by the science, we have to be guided by the facts - not fear."

'High-risk exposure'

In Mali, authorities continue to try to trace anyone who may have had contact with the victim there.

The child had travelled more than 1,000 km (600 miles) from Guinea through the capital, Bamako, to Kayes.

"The child's symptomatic state during the bus journey is especially concerning, as it presented multiple opportunities for exposures, including high-risk exposures, involving many people," the WHO said.

The girl's mother died in Guinea a few weeks ago and the child was then brought by relatives to Mali.

Malian President Ibrahim Boubacar Keita told French radio on Saturday: "We are doing everything to prevent panic and psychosis.

"Since the start of this epidemic, we in Mali took all measures to be safe, but we never hermetically sealed ourselves from this."

He said the border with Guinea would remain open.

However, officials in neighbouring Mauritania said it had closed its borders with Mali in response to the case.

Public mental health spending in England too low, says Mind

Local authorities in England spend an "unacceptably low" amount of money on public mental health, according to the charity Mind.

A report by the charity says on average just 1.4% of public health budgets is spent on mental health.

Public Health England welcomed the report and said there should be more investment at the local level.

The Local Government Association said councils did many positive things that the report had not recognised.

Local authorities need much clearer guidance and support”

Paul FarmerChief executive, Mind

Public mental health includes interventions to prevent mental health problems, promote good mental health and ensure good physical health for people with mental health issues.

National strategy

During NHS reforms in April 2013, the responsibility for this moved from primary care trusts to local government.

Of the 152 local authorities in England, 86 replied to Mind's freedom of information requests about public mental health budgets.

According to the charity, local authorities plan to spend £76m on increasing physical activity, £160m on anti-smoking initiatives and £671m on sexual health services in 2014/15. This compares with just £40m on public mental health.

Louise Rubin, a spokesperson for Mind, says spending is "unacceptably low"

Mind said spending on preventing mental health problems was just as important as physical health - particularly for vulnerable groups.

Mind chief executive Paul Farmer said: "Mind's findings show that while local authorities are happy to spend on preventing physical health problems, their equivalent spending on mental health is unacceptably low.

"Local authorities need much clearer guidance and support on how best to tackle mental health problems.

"We want the next government to introduce a national strategy to ensure local authorities know what to do and use their budgets to prevent mental health problems developing."

'Too narrow'

Councillor Izzi Seccombe of the Local Government Association said: "While we welcome a discussion about public mental health, we think the focus of this report is too narrow.

"There are many things that councils do that impact positively on mental health but might not come with a mental health 'badge'.

"We would support the development of a national strategy that gives greater attention and focus to promoting mental health but would caution against any approach which dictates to local authorities and public health teams how to use their health promotion budgets."

There are many things that councils do that impact positively on mental health but might not come with a mental health 'badge'”

Izzi SeccombeLocal Government Association

Gregory Henderson of Public Health England said: "PHE welcomes this important report as it clearly underlines the need for more local investment in improving the public's mental health.

"The old adage 'prevention is better than cure' is also very much true for mental health and more needs to be done to help individuals, families and communities maintain and gain good mental health.

"There is good evidence on what local areas should be investing in and PHE is working in partnership to develop a national approach."

In 2015 Mind plans to train hairdressers, pub landlords, beauty therapists and restaurant staff to spot the signs of people struggling with mental health issues and to offer advice on local support services.

The project will run in Tameside, Oldham and Glossop and is based on a similar scheme that began in Norfolk in 2015. The Norfolk team trained more than 200 people in mental health first aid skills, providing guidance on listening techniques and how to identify the signs and symptoms of common mental health problems.

nicolecoffee

Trending Blogs

Recently Viewed Blogs

Preparation for a life devoted to medicine