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13
285

Vagus nerve

An edited version of my Friday Evening Discouse given to the Royal Institution on 11 April 2008. Abstract: The vagus nerves (cranial nerve X) connects our brainstem to the body, facilitating monitoring and control of many automatic functions; the vagus electrically links our gut, lungs and heart to the base of the brain in an evolutionarily-ancient circuit, similar between mammals and also seen in birds, reptiles, and amphibians. The vagus comprises a major part of the parasympathetic autonomic nervous system, contributing to the motor control of important physiological functions such as heart rate and gut motility. The vagus is also sensory, relaying protective visceral information leading to reflexes like cough and indication of lung volume. The vagus has been described as a neural component of the immune reflex. By monitoring changes in the level of control exerted by the vagus, apparent as beat by beat changes of heart rate, it is possible to indirectly view the effect of pharmaceuticals and disease on brainstem function and neural processes underlying consciousness. The paired vagus nerves of humans have different functions, and stimulation of the left vagus has been shown to be a therapeutic treatment for epilepsy, and may modulate the perception of pain.  
Chris Pomfrett
about 10 years ago
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12
833

Pleural effusion x-ray (left-sided)

This PA Chest X-Ray demonstrates a left sided pleural effusion. In this condition fluid collects between the parietal and visceral pleura and appears as a shadowy fluid level on the X-Ray with obliteration of the costophrenic angles. If you were to examine this patient they might be in respiratory distress from reduced oxygen uptake (so have low sats, high resp rate, possible cyanosis and accessory muscle useage) - they may have reduced chest expansion on the affected side and it would be stony dull to percussion. Fluid transmits sound poorly so breath sounds would be decreased as would vocal resonance/fremitus. Someone with consolidation may have very similar clinical findings but the underlying area of lung is almost solid due to pus from the infective process - as sounds travel well through solids they would have increased vocal fremitus which is how you can clinically differentiate between the two conditions. Clinical examination and understanding of conditions is paramount to practice effective medicine. Before you recieved this X-Ray you should be able to diagnose the condition and use the X-Ray to confirm your suspicions.  
Rhys Clement
about 9 years ago
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9
338

CXR - left sided pneumothorax and surgical emphysema

In this Chest X-Ray we can identify a left sided pneumothorax - there is absence of lung markings in the periphery and we can also see a shadow which outlines the edge of the lung. A pneumothorax is caused when air enters the potential space between the viceral and parietal pleura and causes the lung to collapse down under the pressure of it's elsatic recoil. In this case it is likely that the pneumothorax has been caused by trauma as we can see air in the soft tissues on the left side (surgical emphysema - clinically feels like bubble wrap). A pneumothorax can be a life threatening condition. The patient presents in respiratory distress with decreased expansion on the affected side. There will be hyperresonance to percussion on that side but absent breath sounds. The emergency treatment is decompression with a large bore cannula in the 2nd intercostal space mid-clavicular line followed by insertion a chest drain in the 5th intercostal space mid-axilllary line  
Rhys Clement
about 9 years ago
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7
342

DVT and pulmonary embolisms

This 3D medical animation shows a blood clot forming in a lower leg vein, creating a deep vein thrombosis, or DVT. When the thrombus breaks free of the valve, it is called an embolus, and travels toward the heart and lungs. The animation ends by showing the embolus lodging in the lung tissue forming a life-threatening pulmonary embolism (PE).  
Liz Walker
over 8 years ago
2
1
17

Peak Inspiratory Pressure: Physiological Determinants

Peak inspiratory pressure (PIP) the center of a great deal of discussion of ventilator management.&nbsp;&nbsp; Knowing the factors that increase or decrease PIP are important to those managing critically ill patient.&nbsp; This podcast is steeped in physiology and perhaps more difficult than my typical podcasts.&nbsp; PIP=&nbsp; [Tv/ (Compliance Lung &amp; Thorax)] + (Resistance of airway + flow )<br/>  
Jeffrey S. Guy, MD, FACS
over 8 years ago
1
1
12

Expert Round Table with Drs. Hensing and Jackman on Molecular Markers and Sequencing of Therapy for Advanced NSCLC, Case 2 (video)

<p>Case discussion with Drs. Tom Hensing of in Chicago &amp; David Jackman in Boston, discussing practical issues around molecular marker testing &amp; recommended treatments for first line &amp; maintenance therapy for an ex-smoker with a lung adenocarcinoma.</p>  
Howard (Jack) West, MD
over 8 years ago
2
1
12

Expert Round Table with Drs. Hensing and Jackman on Molecular Markers and Sequencing of Therapy for Advanced NSCLC, Case 2 (audio)

<p>Case discussion with Drs. Tom Hensing of in Chicago &amp; David Jackman in Boston, discussing practical issues around molecular marker testing &amp; recommended treatments for first line &amp; maintenance therapy for an ex-smoker with a lung adenocarcinoma.</p>  
Howard (Jack) West, MD
over 8 years ago
11
1
37

IInterview with Dr. Matthew Horton, Pathologist Part 3: Defining Lung Cancer with Molecular Markers (audio)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses new approaches in molecular profiling of lung cancers.</span></p>  
Howard (Jack) West, MD
over 8 years ago
12
1
15

Interview with Dr. Matthew Horton, Pathologist Part 3: Defining Lung Cancer with Molecular Markers (video)

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses new approaches in molecular profiling of lung cancers.</span></p>  
Howard (Jack) West, MD
over 8 years ago
1
1
33

Interview with Dr. Matthew Horton, Pathologist Part 2: Neuroendocrine Lung Tumors and Bronchioloalveolar Carcinoma (audio)

<p><font face="'Lucida Grande', Arial, Helvetica, sans-serif" size="3"><span style="font-size: 11px; white-space: pre-wrap;"><span style="font-family: Times; font-size: medium; white-space: normal;" <div style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; background-image: initial; background-repeat: initial; background-attachment: initial; background-color: #ffffff; background-position: initial initial; margin: 8px;" <p><font face="'Lucida Grande', Arial, Helvetica, sans-serif" size="3"><span style="font-size: 11px; white-space: pre-wrap;"><span style="font-family: arial, sans, sans-serif; font-size: 13px;">Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses the neuroendocrine spectrum of lung tumors and the evolving views on bronchioloalveolar carcinoma (BAC).</span></span></font></p </div </span></span></font></p>  
Howard (Jack) West, MD
over 8 years ago
2
1
37

Interview with Dr. Matthew Horton, Pathologist Part 2: Neuroendocrine Lung Tumors and Bronchioloalveolar Carcinoma (video)

<p><font face="'Lucida Grande', Arial, Helvetica, sans-serif" size="3"><span style="font-size: 11px; white-space: pre-wrap;"><span style="font-family: arial, sans, sans-serif; font-size: 13px;">Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses the neuroendocrine spectrum of lung tumors and the evolving views on bronchioloalveolar carcinoma (BAC).</span></span></font></p>  
Howard (Jack) West, MD
over 8 years ago
3
0
60

Interview with Dr. Matthew Horton, Pathologist Part 1: Basics of Non-Small Cell Lung Cancer Subtypes (audio)

Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses the basic subtypes of non-small cell lung cancer (NSCLC), methods of interpreting NSCLC histology, and the changing importance of pathology in NSCLC management.  
Howard (Jack) West, MD
over 8 years ago
4
1
52

Interview with Dr. Matthew Horton, Pathologist Part 1: Basics of Non-Small Cell Lung Cancer Subtypes (video)

Dr. Matthew Horton, specialist in lung pathology at CellNetix in Seattle, WA, discusses the basic subtypes of non-small cell lung cancer (NSCLC), methods of interpreting NSCLC histology, and the changing importance of pathology in NSCLC management.  
Howard (Jack) West, MD
over 8 years ago
3
1
10

The ABC's of BAC (Bronchioloalveolar Carcinoma) (Audio)

This slide presentation by medical oncologist and lung cancer expert Dr. Jack West describes the unique clinical, imaging, and treatment response features of advanced bronchioloalveolar carcinoma (BAC), a distinct sybtype of lung adenocarcinoma.  
Howard (Jack) West, MD
over 8 years ago
4
1
8

The ABC's of BAC (Bronchioloalveolar Carcinoma) (Video)

This slide presentation by medical oncologist and lung cancer expert Dr. Jack West describes the unique clinical, imaging, and treatment response features of advanced bronchioloalveolar carcinoma (BAC), a distinct sybtype of lung adenocarcinoma.  
Howard (Jack) West, MD
over 8 years ago
0
1
22

How important is Aspergillus in cystic fibrosis? by Rick Moss

Cystic fibrosis (CF) occurs in 1 in 4,000 births, and there are approximately 70,000 people worldwide who have CF. Aspergillus lung infection is often found in people with CF, is more common in adults and becomes increasingly common as lung function declines.  
Aspergillus Website
over 8 years ago
13
1
9

BCU Journal Club 2009 | Case 5

ResearchToPractice.com/BCU/JournalClub – 48yo treated w/FEC doce for 3-cm, Grade II, trip-neg, node-pos IDC; developed biopsy-confirmed lung/liver mets +1yr. Moderated by Neil Love, MD. Produced by Research To Practice.  
Dr Neil Love
over 8 years ago
1
1
6

BCU Journal Club 2009 | Case 7 bonus audio

ResearchToPractice.com/BCU/JournalClub – 32yo, 2 cancerous lymph nodes, susp lung/liver lesions 6y after adj chemo/trast & tam for 1.5-cm, ER+/PR+/HER2+ br tumor w/1 pos node. Moderated by Neil Love, MD. Produced by Research To Practice.  
Dr Neil Love
over 8 years ago
3
1
9

SABCS 2008 | Case02

ResearchToPractice.com/SABCS_2008 – Second Opinion: Proceedings and Interviews from a 2-Part CME Satellite Symposia Held at the 31st Annual San Antonio Breast Cancer Symposium. Case: 49-year-old woman with biopsy-confirmed liver and lung metastases three years after adjuvant AC for a triple-negative IDC. Interviews conducted by Neil Love, MD. Produced by Research To Practice.  
Dr Neil Love
over 8 years ago
5
1
10

SABCS 2008 | Case04

ResearchToPractice.com/SABCS_2008 – Second Opinion: Proceedings and Interviews from a 2-Part CME Satellite Symposia Held at the 31st Annual San Antonio Breast Cancer Symposium. Case: 65-year-old woman with rapidly progressive, symptomatic bone and lung metastases after recurrence during her fifth year of an adjuvant aromatase inhibitor for ER/PR-positive, HER2-negative BC. Interviews conducted by Neil Love, MD. Produced by Research To Practice.  
Dr Neil Love
over 8 years ago