Author Topic: Medical Lecture and Lessons  (Read 18164 times)

C2H4

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Re: Medical Lecture and Lessons
« Reply #40 on: July 12, 2009, 05:13:53 AM »
Now remember, folks, beware of excessive intake of anti-depressants, as dose dependencies can occur. In anycase if any of you are depressants, I highly suggest SSRIs over TCAs or MAOInhibs or SNRIs.

More to come. :)

Dong, the SSRIs are the first-line agents for depression, not because they are more effective than the other drug classes but because they are generally safer, with fewer side effects. Most of the TCAs I see in practice right now are either used as 2nd-line agents for refractory cases, or as sleep aids. One can OD easily with TCAs though, thus the limited use in clinical practice. I almost never see anyone on MAOIs anymore. Out of the hundreds of patients on anti-depressants that I see, probably just one or two are on MAOIs. The SNRIs have pretty much the same safety profile as the SSRIs, with the added benefit of NOT causing as much weight gain as the latter. In fact, many patients lose weight on while on this med class. The last one is Wellbutrin, which acts on NE and Dopamine (and a little bit on serotonin as well), a lot of people prefer this coz it doesn't cause the sexual side effects that's typical with SSRIs. This can be used as an adjuvant also with SSRI therapy, to counteract the weight gain side effect.

Can you discuss fish oil, dong? Very promising pud siya sa depression.

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C2H4

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Re: Medical Lecture and Lessons
« Reply #41 on: July 12, 2009, 05:18:41 AM »
In regards to treating schizo patients, or patients with psychotic disorders, it is best to provide them with any anti-dopaminergic agonists/dopamine antagonists. Lithium salts would do well, but do watch out for extrapyramidal side effects.

I'll provide more about this in a video that will combine anti-psychotics/neuroleptic drug treatment.

Thanks for all the views, and the comments on my page. to those who messaged me on questions, I will provide more vids. I promise. :)

God bless,

The atypical anti-psychotics are considered 1st-line these days because they cause fewer extrapyramidal side effects than the older agents. Monitor carefully lang ta ani kay ga cause ni sila metabolic syndrome and less frequently, agranulocytosis (esp. with Olanzapine).

Personally, ang akong nabantayan nga common side effect with people on anti-psychotics, dong, is tardive dyskinesia. It's barely noticeable on others, but on some people, very pronounced gyud. Mao nang usually, trial and error gyud to treat this. Most people don't do too well on monotherapy anymore.

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C2H4

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Re: Medical Lecture and Lessons
« Reply #42 on: July 12, 2009, 05:20:23 AM »
Keep up the good work, dodong. We are learning a lot from these medical lectures.

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Re: Medical Lecture and Lessons
« Reply #43 on: July 12, 2009, 12:35:52 PM »
The atypical anti-psychotics are considered 1st-line these days because they cause fewer extrapyramidal side effects than the older agents. Monitor carefully lang ta ani kay ga cause ni sila metabolic syndrome and less frequently, agranulocytosis (esp. with Olanzapine).

Personally, ang akong nabantayan nga common side effect with people on anti-psychotics, dong, is tardive dyskinesia. It's barely noticeable on others, but on some people, very pronounced gyud. Mao nang usually, trial and error gyud to treat this. Most people don't do too well on monotherapy anymore.

Hello Darling Ate Ethylene,

I'm glad you found this little niche, hehehe.

Ang primary anti-epileptic strategy namo karon is to address the situation. Initial treatment to suppress or reduce the incidence of seizures is based on the specific types of seizures. Thus tonic-clonic (grand mal) seizures are treated differently than say---absence seizures (petit mal).

The use of monotherapy is initiated w/ a single agent (phenytoin, phenobarbital, ethosuximide, valproate (valproic acid or di-velproic acid), or zonisamide, or BNZ, or GABA-PENTIN. -- we administer monotherapy until seizures are controlled or or the toxic signs occur.

If seizure conditions is refractory to monotherapeutics, a second drug may be added to the therapeutic regimen.

You are right tho, 'te, monotherapy is rare nowadays due refractory effects.


hehehe, such a sharp and intelligent lady~~~


Always,
Bran

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #44 on: July 12, 2009, 12:42:28 PM »
Dong, the SSRIs are the first-line agents for depression, not because they are more effective than the other drug classes but because they are generally safer, with fewer side effects. Most of the TCAs I see in practice right now are either used as 2nd-line agents for refractory cases, or as sleep aids. One can OD easily with TCAs though, thus the limited use in clinical practice. I almost never see anyone on MAOIs anymore. Out of the hundreds of patients on anti-depressants that I see, probably just one or two are on MAOIs. The SNRIs have pretty much the same safety profile as the SSRIs, with the added benefit of NOT causing as much weight gain as the latter. In fact, many patients lose weight on while on this med class. The last one is Wellbutrin, which acts on NE and Dopamine (and a little bit on serotonin as well), a lot of people prefer this coz it doesn't cause the sexual side effects that's typical with SSRIs. This can be used as an adjuvant also with SSRI therapy, to counteract the weight gain side effect.

Can you discuss fish oil, dong? Very promising pud siya sa depression.

Hahaha yes yes yes! Sharp and correct jud ka oi!
Agree ko sa imung observation 110%.

;)

I will honor your request, darling Ate.
Fish oil is also good for hyperlipidemic states. It has been medical established that increased intake of fishoil has lead to the increase of HDL (high density lipoproteins), which is good for the heart (cardiothoracic health). And increase in HDL will result in a reduction of LDL (low density lipoprotein; and ldl is correlated to atherosclerotic growth --> which leads to prothrombotic states---> which can dislodge and cause systemic embolus---> can cause visceral infarct ---> if untreated via thrombolytics and anti-platelets/anticoagulants, will lead to Death.

Since HDL outcompetes LDL for the ldl receptors in the liver, this will lead to the metabolism of ldl and prevention of its development in to cholesterol states; thereby increasing the health of the patient.

HDL = very good for pt
LDL = contraindicated for pt.

Dear Ate,
I will honor your request.
Give me a few days. lang.


Love,
Always,
Bran

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #45 on: July 14, 2009, 07:30:32 AM »
Neuropharmacology: Fish Oil and Depression: An Analysis (Part 1)

Presented by: A. Lorenzo Lucino Jr.

http://www.youtube.com/watch?v=9SVzx1sPckE

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #46 on: July 14, 2009, 07:33:39 AM »
[Neuropharmacology: Fish Oil and Depression (Part 2)]

Presented by: A. Lorenzo


http://www.youtube.com/watch?v=OolWJ-HrpqM


For you, Ethylene.
;)





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Re: Medical Lecture and Lessons
« Reply #47 on: July 14, 2009, 08:22:42 AM »
In some instances, Ethyl, the patient responds well with monotherapy of EPA (from Fish Oil) and has positive results for depressive patients. But a dual therapy with atypical types such as: Bupropion, or mirtazapine and also: EPA(fish oil) is proven effective.

hehehe cool stuff actually, i learned alot in this mini-research.

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Re: Medical Lecture and Lessons
« Reply #48 on: July 14, 2009, 08:45:14 AM »
Ethy. I do have a question for you, I was talking to my pharmacology and Behav. Psychiatry instructors regarding this earlier today and one thing that i was observing was that some typical anti-depressant drugs have inductive capability of P-450 enzymes and also some have inhibitory effects of the P-450. So in the case of depressive patients that were taking warfarin or heparin to treat their CHD conditions or any CVD conditions as well as depressive states, this would impede the effect of the drug warfarin since it would be subject to hepatometabolism, or the antithesis in the case of inhibitors of the P-450 isoenzymes. I bet you see alot of prescriptions for patients with depressive states as well as HTN/coagability states with changes in dosage for the hemotastatic drugs.

When we treat patients with drugs of the SNRI class (ventafaxine, venlafaxine), these drugs have critical A/E such as:  GIT disturbance (n/v/d: nausea-vomitting-diarrhea) as well as CNS sequelae, and instances of insomnia and sexual dysfunction.

We are taught to treat depressive patients with: Atypical drug therapy and then typical drug therapy. However, my only concern is the fact that atypical drug therapy has substantial S/E that include: tremors, seizures.

My question to you, regarding this, is : Do you see much prescription of drugs such as Mirtazapine and Bupropion to treat anti-depressive states or more so of drugs such as: duloxetine and venlafaxine, Risperidone, Sertindole, Clozapine?



Thanks a bunch, darling.



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C2H4

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Re: Medical Lecture and Lessons
« Reply #49 on: July 16, 2009, 07:04:57 AM »
Thanks for the post on fish oil, dong. I am getting ready for fish burps. LOL

I was intrigued by your question so I looked into our files and I was surprised actually with what I found out. We have a lot of patients on warfarin but only two were on antidepressants concomittantly. One is on prozac, the other on zoloft. Warfarin is metabolized thru CYP2C9, and prozac inhibits CYP2C9, so I was a little surprised about that. The doctor started with a really low dose though, and the warfarin dose was adjusted as well. Still, it's worrisome coz prozac has a really long half-life. Sertraline on the other hand works better w/ warfarin coz the former mostly inhibits CYP2D6 and it doesn't make that drastic of a change in PT and INR.
We don't have a lot of patients on Mirtazapine. It is not a commonly prescribed drug. That goes for nefazodone as well. Venlafaxine and Buproprion on the other hand are fast-moving drugs. Trazodone is a common prescription too, but not for depression. It's mostly used as a sleep aid. Duloxetine is popular too, for depression as well as for neuropathic pain and fibromyalgia. The SSRIs are still the most prescribed antidepressants. I believe a major factor is the price. They're really cheap, most are only $4 for a month's supply. I also think a big factor on doctor's choice of a med for a patient is what that patient's insurance would pay for. Insurance companies have a tier copay system where SSRIs have the lowest copay, then Buproprion is middle ground, Venlafaxine usually has the highest copays. A lot of companies won't pay for nefazodone or mirtazapine at all. Clozapine is very rarely dispensed, at least, in the retail setting. It is highly regulated, doctors, patients and pharmacies have to enroll and register with a national clozapine program, requiring lots of steps and paperwork, not to mention all the monitoring with bloodwork and everything. So clozapine is reserved for the really refractive cases.
As far as warfarin and antidepressants, they don't pose really severe interactions, thus they are not absolute contraindications. The doctor can prescribe any antidepressant he wants, as long as INR levels as closely monitored. But then, it also depends on what the patient is willing to pay for or what the insurance company would cover.
Hehehe, naglabad akong ulo kay nagamit nko akong utok ug gamay. I will hibernate for a while to recharge. My next post might not be for a while. Always take care, ok? Take it easy with the caffeine. mwah!

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Re: Medical Lecture and Lessons
« Reply #50 on: July 16, 2009, 02:53:42 PM »
Thank you for the in-depth pharmacokinetic-pharmacodynamic explanation, Ate Ethyl.
Noted, noted.  ;)




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Re: Medical Lecture and Lessons
« Reply #51 on: July 18, 2009, 01:22:26 PM »
Ate Ethyl, very true jud imung gi ingoon about SSRI's being preferred due to the cost. Thanks for bringing this to all of us to learn and to undersand.

This is why i love Pharmacists. ;)

Muah 8)

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Re: Medical Lecture and Lessons
« Reply #52 on: July 20, 2009, 01:16:07 PM »
Let us proceed further to the discussion of Virology, a subset of Microbiology.

One topic that I want to share here is the concept of Pox Viridae (Pox Viruses), this is the 2nd largest viralgroup, next only to herpes viruses. It contains DNA and RNA. It is brick-shaped ; it is a double stranded DNA , which is enveloped. And there are over 10,000 viruses particles produced from each affected cell and one big particle.

So let me share some Epidemiology of Small Pox:

Pox Viridae do not cause chickenpox; chicken pox is caused by the herpes viridae varicella zoster (VZV). Do note that Pox Viridae Used to cause Small Pox.

Why do we say 'Used' to cause small pox? Answer: That last case of small pox was in 1977. Small Pox is the only major viral agent that has been eradicated from the face of the Earth.

For more than 3 thousand years this highly contagious virus spread via the respiratory tract; causing pox skin lesions and death. A concerted vaccination and surveillance program conducted by the World Health Organization brought this tyranny to an End.

Small pox was the agent that was responsible for the ERADICATION of the Native Americans in North America and Central-South America.

The Small Pox Virus has been eradicated by Medical Science.
Completely.

:)

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #53 on: August 14, 2009, 01:07:03 PM »
The following will be covered in later lectures:

1) Anti-Viral Drugs

2) Anti-Cancer Drugs

3) Basis of Vaccination & Lab Testing

4) Psychological Behavioral Problems: Schizophrenia, Manic Depression, Depression (General): and Treatment Modes.


Cheers.

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AsPo

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Re: Medical Lecture and Lessons
« Reply #54 on: August 17, 2009, 12:35:09 PM »
dONG LORENZ,,,unsa ning LUPUS desease.is it fatal.nagsearch ko naa may mga sub.is this can tranmit to anay one?thanks dong.heres my E mail,[email protected]

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Re: Medical Lecture and Lessons
« Reply #55 on: August 17, 2009, 01:59:01 PM »
Catalina,

I will answer your question here.
Lupus or otherwise known as SLE (systemic lupus ereythematosus) isn't a viral or bacterial disease that can be transmitted via aerosol.

It is an immunological defecit. Its a hypersensitivity disease; Type III Hypersensitivity. It is a result of your body being unable to recognize self antigens; as a result, the body's human immune system (innate and adaptive) will target and attack the self antigens; it can lead to systemic damage.

There is no cure to this; as it is a genetic disease; a result of the antigen presenting cell's inability to recognize the 'self' antigen.

What we can do; is suppress the immune system to hinder the damage and prevent further systemic prolapse.

The adverse effect, of course, is bacterial and viral infection as a result of drug-induced immuno suppression.


If you have further questions, you can reach me vis-a-vis:
[email protected]




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Re: Medical Lecture and Lessons
« Reply #56 on: August 17, 2009, 05:08:24 PM »
dong thanks so much for the explanation,

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Re: Medical Lecture and Lessons
« Reply #57 on: August 20, 2009, 11:39:08 AM »
The pleasure is mine, Catalina.

Hope all is well.

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Re: Medical Lecture and Lessons
« Reply #58 on: August 20, 2009, 11:50:31 AM »
Hi Guys,

I recently presented a Medical Case Review on: Schizophrenia and Psychotic Disorders , the mode of treatment, diagnosis, and relations recently this month.

As a member of the AMSA (American Medical Students' Association), we, medical student members, are required and opted to present a case that has our interest.

In ever so much interest in the mode of psychotic diseases and treatment of psychotic diseases, which has been fueled by this year's Medical Pharmacology and Psychiatric Behavioral Science classes, I have grown quite interested into the diseases that have plagued human mental health and psychological disturbances.

In understanding the chemical and hormonal imbalances, the pathway deviations, and the methodology that is implemented to correct the neuropathology.

So, I presented on Schizophrenia, a disastrous and severe psychotic disorder, a result of excessive dopaminergic activity and inhibition of inhibitory pathways.

I will post some clips of my presentation; as I was recorded and filmed during my presentation. :)

I thank my friends and medical staff for the recording, as it has been quite rewarding watching it again.

I hope and trust all of you will enjoy it as well.

A learning experience pood.


All the best,
Bran Lorenzo
M.D & Ph.D Candidate
SJUSOM' 2012

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #59 on: September 01, 2009, 06:11:14 AM »
A brief overview of the H1N1 Viral Strain, popularly known by the news media as 'Swine Flu'.

http://www.youtube.com/watch?v=DcbH_x3nChA

Enjoy and if you have any questions, feel free to ask.

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Re: Medical Lecture and Lessons
« Reply #60 on: September 20, 2009, 11:11:33 AM »
This following semester, I will be making more videos on the following subjects:

1. Systemic Pathology
2. Clinical Medicine
3. Epidemiology
4. Surgical Anatomy


Thanks, and for those who PMed me for video requests, rest assured that I will honor your request in due time.


Cheers!
Thanks for Watching!

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Re: Medical Lecture and Lessons
« Reply #61 on: September 20, 2009, 08:26:55 PM »
Doy, unsa may maayong pag-kaon para akong mother in-law (85)may sakit nga Parkinson?
ps
my sakit sa kasing kasing ug  highpertension pa jud.

Manay

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Re: Medical Lecture and Lessons
« Reply #62 on: September 25, 2009, 12:28:57 AM »
Blessings and Peace of Our Lord Jesus Christ be with you and your family, Manay.

Thanks for the question, manay it is very hard to care for parkinson's patients, there is great emphasis on physical exertion and emotional/mental ability, God Bless you for your love and caring of your mother in law.

If it is difficult, I would recommend you purchase a nasal feeding tube, to increase nutritional input for your mother-in-law. A decrease in appetite and refusal to eat is a hallmark of parkinsons patients. If you can, Manay, it would be beneficial if you could hire a part-time nurse to help you care for your mom-in-law.

Remember to feed your mom enough soft foods: proteins, starch, and multivitamins.
--If you can, purchase ensure for her, it is a chocolate brand of drink (comes in different flavors; it is a rich source of multi-vitamins, and high in protein and anti-oxidants).
This is what we give to my Lolo, who is himself 82 years old, and is good source of calcium, especially good for elderly patients with developing osteoarthritis and osteoperosis, and increased osteoclastic conditions (bone loss).

here is the link to ENSURE.
Im sure it is found there in Germany, its quite common in Europe.
http://abbottnutrition.com/products/products.aspx?pid=14


---

For your mama's hypertension, ask your doctor to put her on Anti-Hypertensive medication:
recommed the following:
1. ACE INHIBITORS (angiotension converting enzyme inhibitors)
 --> If your mom develops coughs when taking ACEINHIBS, then i recommend she takes: ARDS (LOSARTAN)
2. Beta Blockers
3. Calcium Channel Blockers
    ---> this works well for elderly patients over 55yo.

Thanks for asking Manay, and I do earnestly hope and pray your mama stays in good health.
An extra prayer here and there helps any medical treatment. he he he

EXTRA CARE AND EXTRA LOVE from OUR LORD JESUS CHRIST! :)

Medicine can only do so much. The power of Prayer can compliment any treatment.


Blessings and Peace,
Bran

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hofelina

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Re: Medical Lecture and Lessons
« Reply #63 on: September 25, 2009, 05:34:23 AM »
Nigamay akong ugangan Doy, I think she shrinks. She has alert mind that´s why I buy her newspapers everyday. She can eat, and she loves rice and pancit. I always cook for her, so she gets warm meals. Ako jud ning gi-agwantahan kay she is a very loving lola, ( pero dili mi-vibes). Mao ni nga tig-simba ko kada adlaw, kay nangaliyopo ako sa Kahitas-an ang iyang pag-tabok linaw, kon itugot Niya.
Nag hubag iyang mga tiil, kay wala na nag function pag-ayo iyang kidney. Her medications includes tablets for her hypertension, kidney, heart disease, blood thinner and something for her Parkinson.
We will not bring her to a home for the aged, we will try our best that she is comfortable as much as possible.
I want to thank you from the bottom of my heart for your advices, Gob Bless.

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Re: Medical Lecture and Lessons
« Reply #64 on: September 25, 2009, 11:50:27 PM »
Manay, am happy to hear that she has medications and is up to date with that.
Right now, the best thing for her is just being around family, appropriate foods, and a good quiet environment for her to be at peace in.

I admire your refusal to put her in a nursing home, Manay. Very honorable jud ka.
Am praying for you and your mama in law, that you have the continued strength to go on to care for her.

You are welcome, Manay, am always here to help in whatever way I can, though it be limited in scope.

God Bless You!

-Lorenzo

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Re: Medical Lecture and Lessons
« Reply #65 on: November 07, 2009, 06:37:38 AM »
Dear Friends,
My apologies for not being able to post recent videos, I shall have a video on Systemic pathology relating wbc (white blood cells) and associated disorders ready this week. Thanks for all the requests, they shall be honored in time.

Best,
Lorenzo

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #66 on: January 21, 2010, 06:48:31 AM »
Human Physiology Lecture (Multiple Part Series)


Let's talk about Physiology. Human Physiology, to be exact.

If one asks, "What is human physiology?"

A: The very fact that we remain alive is almost beyond our control.
The human being is actually an automaton, and the fact that we are sensing, feeling, and knowledgeable beings is part of this automatic sequence of life.

First, know that the body is composed of cells; the cell is the compository makeup of tissues, organ systems. Estimated, there are over 25 trillion Erythrocytes (red blood cells) in the human body. Overall, there are over 100 Trillion cells in the human body.



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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #67 on: March 31, 2010, 01:49:26 PM »
The Arterial Blood Supply to the Heart


Heart Arterial Supply


Enjoy!

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Re: Medical Lecture and Lessons
« Reply #68 on: March 31, 2010, 01:57:47 PM »
Cellular Injury Processes: Necrosis VS Apoptosis

Apoptosis and Necrosis





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Re: Medical Lecture and Lessons
« Reply #69 on: March 31, 2010, 02:04:35 PM »
Components of Hemostasis: Role in Thrombosis and Hemodynamics


Medical Pathology Lecture by: A. Lorenzo


Pathology: Hemostasis Lecture


Enjoy

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hofelina

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Re: Medical Lecture and Lessons
« Reply #70 on: April 05, 2010, 03:55:25 AM »
Thanks Ondoy, mora man pod ta ug nagtoon.

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Re: Medical Lecture and Lessons
« Reply #71 on: April 12, 2010, 09:52:11 AM »
Glad you found it useful, Manang.

I shall post more uploaded videos when available. To learn is to be enlightened.


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hofelina

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Re: Medical Lecture and Lessons
« Reply #72 on: April 12, 2010, 06:01:42 PM »
Kamusta naman ka Doy? I miss thread, please post more!

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Re: Medical Lecture and Lessons
« Reply #73 on: April 17, 2010, 12:02:11 PM »
I will go over Hemostasis yet again. This is important information for all who are interested about infarcts (myocardial or cerebral)


Enjoy.


Pathology: Hemostasis Lecture

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Re: Medical Lecture and Lessons
« Reply #74 on: April 17, 2010, 12:03:31 PM »
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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #75 on: April 27, 2010, 07:34:31 AM »
To the members that have sent me emails on health topics, I will refrain from answer your pms personally, but rather, answer your questions via this thread. I will produce more videos that involves your medical questions as i have received over 20 pms regarding health questions. I thank you for your concern and thoughts in this, and to better serve everyone, it will be answered in this thread. I have sent all of you pms that have the link to this thread. So for those who are active 'readers' but not active 'posters', this thread is for you guys.



So, let us begin.



Bran

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Re: Medical Lecture and Lessons
« Reply #76 on: April 27, 2010, 08:08:51 AM »
To the members that have sent me emails on health topics, I will refrain from answer your pms personally, but rather, answer your questions via this thread. I will produce more videos that involves your medical questions as i have received over 20 pms regarding health questions. I thank you for your concern and thoughts in this, and to better serve everyone, it will be answered in this thread. I have sent all of you pms that have the link to this thread. So for those who are active 'readers' but not active 'posters', this thread is for you guys.



So, let us begin.



Bran


is that really your voice, enz? i like it. sounds innocent yet dangerous. hehehe, peace.

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Lorenzo

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Re: Medical Lecture and Lessons
« Reply #77 on: April 27, 2010, 08:14:25 AM »
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glacier_71

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Re: Medical Lecture and Lessons
« Reply #78 on: April 27, 2010, 08:18:09 AM »
That is my voice, Glacier.



nice to hear that it's you.

thanks for your lecture series, enz.

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Re: Medical Lecture and Lessons
« Reply #79 on: April 27, 2010, 08:22:31 AM »
I love to teach, Glacier, and more, I love to help people.

Its good to give back to those who ask questions on a certain medical problem; this way they are better informed when they visit their physicians next time, or inquire about certain drugs that their physician did not tell them about.

Medical Students are called to inform the public. Knowledge is to be shared, not hoarded.
That is my view on this.


Lorenzo.

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