Hepatitis C Treatment (Dutch)

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Achtergrond

-Hepatitis C virus in 1989 ontdenkt als verwekker non-A non-B hepatitis

-Replicatiesnelheid zeer hoog: 1012 deeltjes/dag

-Zes belangrijke genotypen

West-europa: 1, 2, 3 en 4

Genotype 1: m.n. bloed Tx

Genotype 3: m.n. drugsverslaafden

-HCV overdracht vooral via bloed; sexuele en verticale transmissie veel zeldzamer

-Prevalentie 3%

-Jaarlijks 3-4 miljoen nieuwe patiënten

-Prevalentie NL <0.5% (600.000 mensen)

-Cirrose en HCC t.g.v. HCV = belangrijkste indicatie voor lever Tx

Meckels

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INTRODUCTION

=Meckel diverticulum is the most common congenital abnormality of the small intestine

=It is caused by an incomplete obliteration of the vitelline duct (ie, omphalomesenteric duct).

=Originally described by Fabricius Hildanus in 1598

=Johann Friedrich Meckel established its embryonic origin in 1809 and it is now known by his name

Pathophysiology

=Midgut elongates faster than trunk: herniates into umbilical cord in 6th week

=Midgut loop connected to yolk sac via a yolk stalk

=Cranial limb of loop: jejunum and most of ileum

Diabetic foot

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Diabetic Foot

-Any foot pathology that results directly from diabetes or its long term complications – ( Boulton 2002)

-The foot of a diabetic patient that has the potential risk of pathologic consequences including infection, ulceration and or destruction of deep tissues associated with neurologic abnormalities, various degrees of peripheral vascular disease and/or metabolic complications of diabetes in the lower limb

–Diabetic foot ulcer

—Diabetic foot infections

–Charcot Joints

Dub medical management

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NORMAL MENSTRUATION

=MEAN INTERVAL OF 28 DAYS

(+ 7DAYS)

=DURATION OF 4 – 7 DAYS

=LOSS OF 35 ml ( 31 – 44 ml )

ANOVULATORY BLEEDING

-UNOPPOSED ESTROGEN

-ENDOMETRIAL HYPERPLASIA

-LACK OF PROGESTERONE STABILISATION OF ENDOMETRIUM

-NO CYCLICAL WITHDRAWAL

Educational philosophy

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Philosophy of education

philosophy of education is the philosophical 

study of the purpose, process, nature and 

ideals of education. 

For example, it might

=Study what constitutes upbringing and

education,

=The limits and legitimization of education as

an academic discipline

Educational objectives

-Individual development

-Social transformation

-Modernization

-Productivity

-Communication participation

-Social and national development

-Acquisition of values