Medicine and Science, that's me! My name is Giusy Davino and I'm just a 22-years-old medical student in University of Salerno (Italy) with internet access!
"Isn't it strange
That princes and kings
And clowns that caper
In sawdust rings
And common people
Like you and me
Are builders for eternity?
Each is given a bag of tools,
A shapeless mass,
A book of rules;
And each must make -
Ere life is flown -
A stumbling block
Or a stepping stone."

 

medicalschool:

The Human Heart
Volume Rendering of a contrast enhanced cardiac CT

medicalschool:

The Human Heart

Volume Rendering of a contrast enhanced cardiac CT

jewsee-medicalstudent:

Tetralogy of Fallot.

Tetralogy of Fallot (TOF) is a congenital heart defect which is classically understood to involve abnormalities of the heart. It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.

As such, by definition, it involves four heart malformations which present together:

  • Pulmonary Infundibular Stenosis: A narrowing of the right ventricular outflow tract. It can occur at the pulmonary valve (valvular stenosis) or just below the pulmonary valve (infundibular stenosis).
  • Overriding aorta: Aorta is situated above the ventricular septal defect and connected to both the right and the left ventricle.
  • Ventricular septal defect (VSD): A hole between the two bottom chambers (ventricles) of the heart.
  • Right ventricular hypertrophy: The right ventricle is more muscular than normal, causing a characteristic boot-shaped (coeur-en-sabot) appearance as seen by chest X-ray. 

Signs and symptomsTetralogy of Fallot results in low oxygenation of blood due to the mixing of oxygenated and deoxygenated blood in the left ventricle via the ventricular septal defect (VSD) and preferential flow of the mixed blood from both ventricles through the aorta because of the obstruction to flow through the pulmonary valve. This is known as a right-to-left shunt. The primary symptom is low blood oxygen saturation with or without cyanosis from birth or developing in the first year of life. Other symptoms include a heart murmur which may range from almost imperceptible to very loud, difficulty in feeding, failure to gain weight, retarded growth and physical development, dyspnea on exertion, clubbing of the fingers and toes, and polycythemia. Digital clubbing or watch-glass nails with cyanotic nail beds is common in adults with tetralogy of Fallot (2nd picture).

Superior vena cava syndrome.
Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava. More than 90% of cases of superior vena cava obstruction are caused by cancer - most commonly bronchogenic carcinoma, typically a tumor outside the vessel compressing the vessel wall - but it can, sometimes, have a benign cause.
Signs and symptoms: Shortness of breath is the most common symptom, followed by face or arm swelling due to excess of fluid (edema). Frequent symptoms are: headache, venous distention in the neck and distended veins in the upper chest and arms, lightheadedness, cough.
Treatment: Several methods of treatment are available, mainly consisting of careful drug therapy and surgery. Glucocorticoids (such as prednisone or methylprednisolone) decrease the inflammatory response to tumor invasion and edema surrounding the tumor. They are most helpful if the tumor is steroid-responsive, such as lymphomas. In addition, diuretics (such as furosemide) are used to reduce venous return to the heart which relieves the increased pressure.
(Picture from The New England Journal of Medicine).

Superior vena cava syndrome.

Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava. More than 90% of cases of superior vena cava obstruction are caused by cancer - most commonly bronchogenic carcinoma, typically a tumor outside the vessel compressing the vessel wall - but it can, sometimes, have a benign cause.

Signs and symptomsShortness of breath is the most common symptom, followed by face or arm swelling due to excess of fluid (edema). Frequent symptoms are: headache, venous distention in the neck and distended veins in the upper chest and arms, lightheadedness, cough.

Treatment: Several methods of treatment are available, mainly consisting of careful drug therapy and surgery. Glucocorticoids (such as prednisone or methylprednisolone) decrease the inflammatory response to tumor invasion and edema surrounding the tumor. They are most helpful if the tumor is steroid-responsive, such as lymphomas. In addition, diuretics (such as furosemide) are used to reduce venous return to the heart which relieves the increased pressure.

(Picture from The New England Journal of Medicine).

Tetralogy of Fallot.

Tetralogy of Fallot (TOF) is a congenital heart defect which is classically understood to involve abnormalities of the heart. It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome.

As such, by definition, it involves four heart malformations which present together:

  • Pulmonary Infundibular Stenosis: A narrowing of the right ventricular outflow tract. It can occur at the pulmonary valve (valvular stenosis) or just below the pulmonary valve (infundibular stenosis).
  • Overriding aorta: Aorta is situated above the ventricular septal defect and connected to both the right and the left ventricle.
  • Ventricular septal defect (VSD): A hole between the two bottom chambers (ventricles) of the heart.
  • Right ventricular hypertrophy: The right ventricle is more muscular than normal, causing a characteristic boot-shaped (coeur-en-sabot) appearance as seen by chest X-ray. 

Signs and symptomsTetralogy of Fallot results in low oxygenation of blood due to the mixing of oxygenated and deoxygenated blood in the left ventricle via the ventricular septal defect (VSD) and preferential flow of the mixed blood from both ventricles through the aorta because of the obstruction to flow through the pulmonary valve. This is known as a right-to-left shunt. The primary symptom is low blood oxygen saturation with or without cyanosis from birth or developing in the first year of life. Other symptoms include a heart murmur which may range from almost imperceptible to very loud, difficulty in feeding, failure to gain weight, retarded growth and physical development, dyspnea on exertion, clubbing of the fingers and toes, and polycythemia. Digital clubbing or watch-glass nails with cyanotic nail beds is common in adults with tetralogy of Fallot (2nd picture).

Hepatitis C, now cure rates of up to 100%.
The European Commission has approved Daclatasvir (Daklinza, Bristol-Myers Squibb) to treat adults with chronic hepatitis C virus (HCV) infection in combination with Sofosbuvir, the company announced today.
Daclatasvir blocks the action of NS5A, a protein essential for HCV replication. It is indicated for adults infected with HCV genotypes 1, 2, 3, and 4. In a news release, the company notes that oral Daclatasvir in combination with oral Sofosbuvir provided cure rates of up to 100% in clinical trials, including in patients with advanced liver disease, genotype 3, and those who have previously failed treatment with protease inhibitors.
Daclatasvir is the first NS5A complex inhibitor approved in the European Union (EU) and provides a “shorter treatment duration (12 or 24 weeks) compared to 48 weeks of treatment with interferon and ribavirin based regimens.
Across clinical studies, Daclatasvir-based regimens have been generally well-tolerated, with low discontinuation rates. The most common adverse effects with daclatasvir when used in combination with other drugs are fatigue, headache, and nausea. The safety of Daclatasvir has been demonstrated in diverse patient populations that include elderly patients, patients with advanced liver disease, post–liver transplant recipients, and patients coinfected with HIV, the company says.
(To read more. To read more about Sofosbuvir).

Hepatitis C, now cure rates of up to 100%.

The European Commission has approved Daclatasvir (Daklinza, Bristol-Myers Squibb) to treat adults with chronic hepatitis C virus (HCV) infection in combination with Sofosbuvir, the company announced today.

Daclatasvir blocks the action of NS5A, a protein essential for HCV replication. It is indicated for adults infected with HCV genotypes 1, 2, 3, and 4. In a news release, the company notes that oral Daclatasvir in combination with oral Sofosbuvir provided cure rates of up to 100% in clinical trials, including in patients with advanced liver disease, genotype 3, and those who have previously failed treatment with protease inhibitors.

Daclatasvir is the first NS5A complex inhibitor approved in the European Union (EU) and provides a “shorter treatment duration (12 or 24 weeks) compared to 48 weeks of treatment with interferon and ribavirin based regimens.

Across clinical studies, Daclatasvir-based regimens have been generally well-tolerated, with low discontinuation rates. The most common adverse effects with daclatasvir when used in combination with other drugs are fatigue, headache, and nausea. The safety of Daclatasvir has been demonstrated in diverse patient populations that include elderly patients, patients with advanced liver disease, post–liver transplant recipients, and patients coinfected with HIV, the company says.

(To read more. To read more about Sofosbuvir).


The illustration shows the front surface of a heart, including the coronary arteries and major blood vessels 

The illustration shows the front surface of a heart, including the coronary arteries and major blood vessels 

iheartguts:

A few details from the Periodic Table of Your Period by I Heart Guts, learn all you wanted to know about your woman times.

Violinist plays during brain surgery.
Musician Roger Frisch underwent deep brain stimulation to fix tremors in his hands and played the violin throughout the process. Deep brain stimulation is a technique used to aid people with Parkinson’s disease, dystonia (neurological movement disorder) and essential tremors, as well as people suffering from OCD, major depression or chronic pain.
During the procedure, surgeons place electrodes inside the deepest parts of the brain and use electric pulses to modify neurological responses. Surgeons implanted electrodes into Roger’s thalamus while he was still awake in an attempt to rectify his tremors.
There are no pain receptors in the brain so patients are always conscious during brain surgery so that the doctors can monitor their condition. In Roger’s case, the surgeons were concerned that the tremors were so small that they risked placing the electrodes in the wrong position and failing to fix the shaking. 
(To read more).

Violinist plays during brain surgery.

Musician Roger Frisch underwent deep brain stimulation to fix tremors in his hands and played the violin throughout the process. Deep brain stimulation is a technique used to aid people with Parkinson’s disease, dystonia (neurological movement disorder) and essential tremors, as well as people suffering from OCD, major depression or chronic pain.

During the procedure, surgeons place electrodes inside the deepest parts of the brain and use electric pulses to modify neurological responses. Surgeons implanted electrodes into Roger’s thalamus while he was still awake in an attempt to rectify his tremors.

There are no pain receptors in the brain so patients are always conscious during brain surgery so that the doctors can monitor their condition. In Roger’s case, the surgeons were concerned that the tremors were so small that they risked placing the electrodes in the wrong position and failing to fix the shaking. 

(To read more).

ozzies-world:

A map of referred pain, something nice to keep in mind when taking patient assessments.

ozzies-world:

A map of referred pain, something nice to keep in mind when taking patient assessments.

Human kidney proximal tubule.
This is a SEM picture of a human proximal tubule, showing the tubular structure and projections extending over the tissue surface. The proximal tubule is the portion of the duct system of the nephron of the kidney which leads from Bowman’s capsule to the loop of Henle.
The kidney participates in whole-body homeostasis, regulating acid-base balance, electrolyte concentrations, extracellular fluid volume, and blood pressure. It accomplishes these homeostatic functions both independently and in concert with other organs, particularly those of the endocrine system. Various endocrine hormones coordinate these endocrine functions
Many of the kidney’s functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in the nephron. Filtration, which takes place at the renal corpuscle, is the process by which cells and large proteins are filtered from the blood to make an ultrafiltrate that eventually becomes urine. Reabsorption, which takes place at the proximal tube, is the transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.
(Picture by The Cell: An Image Library).

Human kidney proximal tubule.

This is a SEM picture of a human proximal tubule, showing the tubular structure and projections extending over the tissue surface. The proximal tubule is the portion of the duct system of the nephron of the kidney which leads from Bowman’s capsule to the loop of Henle.

The kidney participates in whole-body homeostasis, regulating acid-base balance, electrolyte concentrations, extracellular fluid volume, and blood pressure. It accomplishes these homeostatic functions both independently and in concert with other organs, particularly those of the endocrine system. Various endocrine hormones coordinate these endocrine functions

Many of the kidney’s functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in the nephron. Filtration, which takes place at the renal corpuscle, is the process by which cells and large proteins are filtered from the blood to make an ultrafiltrate that eventually becomes urine. Reabsorption, which takes place at the proximal tube, is the transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.

(Picture by The Cell: An Image Library).

Edema.
This picture shows a 49-years-old woman with Elephantiasis nostras verrucosa (ENV), a rare form of chronic lymphedema that causes progressive cutaneous hypertrophy.
The edema is an abnormal accumulation of fluid in the interstitial tissue: beneath the skin or in one or more cavities of the body and it is clinically shown as swelling. 
Six factors can contribute to the formation of edema:
Increased hydrostatic pressure in the capillaries;
Reduced oncotic pressure within blood vessels; 
Increased tissue oncotic pressure; 
Increased blood vessel wall permeability (for example in anaphylaxis or in inflammation);
Obstruction of fluid clearance in the lymphatic system (lymphedema);
Changes in the water retaining properties of the tissues themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidney.
Edema can be generalized (Anasarca, usually caused by liver failure, renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency) or organ-specific, through tissue specific mechanisms:
Lymphedema, where abnormal accumulation of interstitial fluid is caused by failure of the lymphatic system. This may be due to obstruction, destruction of lymph vessels by radiotherapy, or infiltration of the lymphatics by infection (such as elephantiasis).
Myxedema, a cutaneous edema, which is caused by increased deposition of mucopolysaccharides, that hold water in the skin.
Cerebral edema, where there is an extracellular fluid accumulation in the brain. It causes drowsiness or loss of consciousness.
Pulmonary edema occurs when the pressure in blood vessels in the lung is raised because of obstruction to the removal of blood via the pulmonary veins. This is usually due to failure of the left ventricle of the heart. It can also occur in altitude sickness or on inhalation of toxic chemicals. Pulmonary edema produces shortness of breath. Pleural effusions may occur when fluid also accumulates in the pleural cavity.
Periorbital edema is the edema surrounding the eyes. The periorbital tissues are most noticeably swollen immediately after waking, perhaps as a result of the gravitational redistribution of fluid in the horizontal position.
(Picture by The New England Journal of Medicine).

Edema.

This picture shows a 49-years-old woman with Elephantiasis nostras verrucosa (ENV), a rare form of chronic lymphedema that causes progressive cutaneous hypertrophy.

The edema is an abnormal accumulation of fluid in the interstitial tissue: beneath the skin or in one or more cavities of the body and it is clinically shown as swelling

Six factors can contribute to the formation of edema:

  • Increased hydrostatic pressure in the capillaries;
  • Reduced oncotic pressure within blood vessels;
  • Increased tissue oncotic pressure;
  • Increased blood vessel wall permeability (for example in anaphylaxis or in inflammation);
  • Obstruction of fluid clearance in the lymphatic system (lymphedema);
  • Changes in the water retaining properties of the tissues themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidney.

Edema can be generalized (Anasarca, usually caused by liver failure, renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency) or organ-specific, through tissue specific mechanisms:

  • Lymphedema, where abnormal accumulation of interstitial fluid is caused by failure of the lymphatic system. This may be due to obstruction, destruction of lymph vessels by radiotherapy, or infiltration of the lymphatics by infection (such as elephantiasis).
  • Myxedema, a cutaneous edema, which is caused by increased deposition of mucopolysaccharides, that hold water in the skin.
  • Cerebral edema, where there is an extracellular fluid accumulation in the brain. It causes drowsiness or loss of consciousness.
  • Pulmonary edema occurs when the pressure in blood vessels in the lung is raised because of obstruction to the removal of blood via the pulmonary veins. This is usually due to failure of the left ventricle of the heart. It can also occur in altitude sickness or on inhalation of toxic chemicals. Pulmonary edema produces shortness of breath. Pleural effusions may occur when fluid also accumulates in the pleural cavity.
  • Periorbital edema is the edema surrounding the eyes. The periorbital tissues are most noticeably swollen immediately after waking, perhaps as a result of the gravitational redistribution of fluid in the horizontal position.

(Picture by The New England Journal of Medicine).