Ak plaza training run May 4
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A fun run will take place on May 4th at Camp Humphreys Pedestrian Gate, starting at an unspecified time. The 5.3 mile route will go through back roads, rice paddy roads, and a river-side trail, with a water stop along the way. Participants should bring Korean won for snacks and bus fare.
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Proton Pump Inhibitors (PPIs) Omeprazole, Pantoprazole Irreversibly inhibit H+/K+ ATPase pump
H2-Receptor Antagonists Ranitidine, Famotidine Block histamine-mediated gastric acid secretion
2. Mucosal Protective Agents
Class Examples Mechanism
Prostaglandin Analogues Misoprostol Increases mucus & bicarbonate; decreases acid; protects mucosa
Mucosal Coating Agents Sucralfate Forms protective barrier over ulcer site
Bismuth Compounds Bismuth subsalicylate Antimicrobial, mucosal protective, and anti-inflammatory
3. Eradication Therapy (for H. pylori)
Combination of:
PPI + Two Antibiotics (e.g., amoxicillin + clarithromycin OR metronidazole + tetracycline)
Duration: 714 days depending on local guidelines
See BNF regimens above for detailed protocols
4. Cytoprotective/Adjunctive Agents
Class Examples Role in PUD
Somatostatin Analogues Octreotide Used in bleeding ulcers; reduces splanchnic blood flow and gastric secretions
Antacids Magnesium hydroxide, Aluminium hydroxide Neutralize gastric acid; provide symptomatic relief
Non-Pharmacologic Measures
Avoid NSAIDs, smoking, alcohol, and spicy foods
Small, frequent meals in symptomatic patients
Stress reduction
Endoscopic therapy in case of bleeding or perforation
Surgical Indications (rarely needed)
Perforated ulcer
Gastric outlet obstruction
Refractory ulcers not responding to medical therapy
Severe bleeding unresponsive to endoscopic management
Summary
Peptic ulcer disease is primarily driven by H. pylori infection and NSAID use, with duodenal ulcers more common than gastric. Treatment is tailored based on etiology and includes acid suppression, H. pylori eradication, and mucosal protection. Advanced cases may require somatostatin analogues for hemorrhage control or surgery for complications. Prostaglandin analogues like misoprostol are especially valuable in preventing NSAID-induced ulcers.ADA Releases 2025 Standards of Care for Diabetes
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Anatomy of the Larynx
Larynx is a cartilaginous structure located in the **anterior neck** at the level of **C3C6 vertebrae**.
* Also called the **voice box**responsible for **phonation**, **airway protection**, and **breathing regulation**.
**Cartilages of the Larynx**
**Unpaired Cartilages:**
1. **Thyroid cartilage**:
* Largest cartilage; forms the **Adams apple (laryngeal prominence)**.
* Composed of two laminae that fuse anteriorly.
2. **Cricoid cartilage**:
* Ring-shaped; **only complete ring** around the airway.
* Located below thyroid cartilage; articulates with thyroid & arytenoid cartilages.
3. **Epiglottis**:
* Leaf-shaped elastic cartilage.
* Covers the laryngeal inlet during swallowing.
**Paired Cartilages:**
1. **Arytenoid**:
* Pyramid-shaped; sit on top of cricoid.
* Attach vocal cords and muscles.
2. **Corniculate**:
* Small cartilages sitting atop the arytenoids.
3. **Cuneiform**:
* Embedded in the aryepiglottic folds; provide structural support.
**Intrinsic Muscles of the Larynx**
> Responsible for controlling **vocal cord movement**.
| Muscle | Action | Nerve Supply |
| **Cricothyroid** | Tenses vocal cords | External laryngeal nerve |
| **Thyroarytenoid** | Relaxes vocal cords | Recurrent laryngeal nerve |
| **Posterior cricoarytenoid** | Abducts vocal cords (opens glottis) | Recurrent laryngeal nerve |
| **Lateral cricoarytenoid** | Adducts vocal cords | Recurrent laryngeal nerve |
| **Transverse & oblique arytenoids** | Closes the posterior glottis | Recurrent laryngeal nerve |
| **Vocalis** | Fine-tunes pitch | Recurrent laryngeal nerve | **Nerve Supply*
* **Motor**:
* All intrinsic muscles (except cricothyroid): **Recurrent laryngeal nerve** (branch of vagus nerve).
* Cricothyroid: **External branch of superior laryngeal nerve**.
* **Sensory**:
* Above vocal cords: **Internal branch of superior laryngeal nerve**.
* Below vocal cords: **Recurrent laryngeal nerve**.
**Blood Supply**
* **Superior laryngeal artery** (branch of superior thyroid artery).
* **Inferior laryngeal artery** (branch of inferior thyroid artery).
**Laryngeal Cavity & Folds**
Divided into 3 regions:
1. **Vestibule** from inlet to vestibular folds (false cords).
2. **Ventricle** between vestibular and vocal folds.
3. **Infraglottic cavity** below vocal cords to trachea.
**Vocal folds (true cords)** involved in sound production.An interesting case of facial Swelling in an autoimmune rheumatic disease Ahm...
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Ak plaza training run May 4
- 1. Fun Run to AK Plaza May 4 Where: Camp Humphreys Pedestrian Gate When: Call Health Promotion for details! Distance: 5.3 miles What to Bring: Korean for snacks and return bus fare This is NOT A RACE! We are only doing a fun easy training run on a route that includes back roads, rice paddy roads, and river-side trail. No pre-registration. river KTX Water stop Rice paddys Ace dirt Town For details contact Dave Elger at Health Promotion 753-3253