This document summarizes key points about carotid endarterectomy and anesthesia considerations for the procedure. It discusses risks of carotid artery disease and benefits of carotid endarterectomy in reducing stroke risk. It reviews advantages and disadvantages of local, regional, and general anesthesia. It also outlines important perioperative management considerations like maintaining cerebral perfusion and minimizing hemodynamic fluctuations. Monitoring techniques and advances in agents are reviewed to aid neuroprotection during the surgery. Complications are also summarized.
This document discusses the importance of pre-operative liver function assessment prior to liver surgery. It outlines several methods of evaluating liver function, including clinical scoring systems like the Child-Turcotte-Pugh score, dynamic tests that measure hepatic uptake and excretion such as indocyanine green retention and nuclear scintigraphy, and volumetric measurements using CT scans. No single test can fully assess liver function, so a combination is recommended, along with surgical judgment, to determine the severity of any underlying liver disease, tumor extent, predicted post-operative liver remnant, and risk of hepatic failure. This helps select appropriate patients and procedures to optimize surgical outcomes.
Renal transplantation in patients with lupus nephritis - prof. Ayman Refaie MNDU net
?
This document discusses renal transplantation in patients with lupus nephritis. It begins with background on lupus nephritis as a cause of end-stage renal disease. It then covers the pre-transplant workup, including screening for cardiovascular disease, infections, and thrombophilia. The timing of transplantation is discussed, noting most centers recommend 3-6 months of dialysis. Recurrence of lupus nephritis after transplantation is evaluated, finding the rate is low at 2-9%. Outcomes are then reviewed, with graft and patient survival found to be similar to other causes of ESRD. In conclusion, kidney transplantation is a good option for lupus nephritis patients and offers better
Liver transplantation involves complex anesthesia management due to physiological changes from cirrhosis and transplantation. Key aspects include invasive hemodynamic monitoring, management of coagulopathy and fluid shifts, and intensive care of recipients post-operatively due to risks of primary nonfunction, bleeding, infection and renal failure. Outcomes have improved dramatically with advances like cyclosporine in 1979 and living donor transplantation, with 1-year survival rates now over 90% for liver transplantation.
Perioperative management of antithrombotic therapyZaito Hjimae
?
This document discusses the perioperative management of antithrombotic therapy. The goals are to prevent thromboembolic events like strokes while reducing the risk of major hemorrhage during surgery. It assesses thrombotic risk based on the type of anticoagulation and bleeding risk scores. It provides guidance on bridging anticoagulation during surgery and reversing anticoagulants. It also discusses perioperative management of antiplatelet drugs like aspirin and clopidogrel based on surgery type and risk of cardiovascular events.
The document provides a comprehensive overview of liver transplantation, detailing its history, indications, complications, and management strategies. It discusses various physiological and pathological considerations, including preoperative, intraoperative, and postoperative phases for both recipients and living donors. Specific attention is given to complications such as cirrhotic cardiomyopathy, hepatic encephalopathy, and various forms of hypertension related to portal hypertension, along with their diagnostic criteria and treatment options.
Hepatorenal Syndrome (HRS) is a functional kidney failure that occurs in patients with cirrhosis and advanced liver disease. It is characterized by severe abnormalities in renal blood flow regulation and renal function. There are two main types - type 1 is a rapidly progressive form and type 2 is a slower progressive form. The pathogenesis involves splanchnic vasodilation leading to renal vasoconstriction. Diagnosis requires meeting criteria related to kidney function tests and ruling out other causes. Treatment aims to reverse renal failure through use of vasoconstrictors like terlipressin or octreotide to relieve renal vasoconstriction until liver transplantation.
Infection-related Glomerulonephritis (KDIGO 2021 Guidelines) - Dr. GawadNephroTube - Dr.Gawad
?
The document provides a clinical practice guideline for managing infection-related glomerulonephritis, detailing its pathogenesis, pathology, prognosis, and treatment options. It highlights the implications of various infections like streptococcal, viral, and schistosomal on kidney health and emphasizes monitoring for complications. Specific treatment recommendations include avoidance of immunosuppressants in certain viral infections and the need for appropriate antiparasitic medication for schistosomiasis and malaria-related nephropathies.
This document discusses a case presentation of a kidney transplant patient experiencing delayed graft function (DGF). It provides background information on DGF, including definitions, incidence, importance, and risk factors at various stages of the transplant process. These risk factors include characteristics of the donor, recipient, procurement techniques, and the perioperative period. The document then outlines the presenter's thought process and basic workup to consider for DGF cases.
This document discusses relative blood volume (RBV) monitoring and its potential applications in dialysis. It provides an overview of RBV monitoring principles, compartmental fluid shifts, and RBV profiles in relation to intradialytic hypotension. While RBV monitoring shows promise for fluid management and blood pressure control, evidence from studies is mixed. The largest study to date found RBV monitoring increased mortality and hospitalizations. Further research is still needed to fully understand the clinical utility and appropriate applications of RBV monitoring.
Anesthesia in patients on anti coagulantsNavin Jain?
?
This document discusses anesthesia considerations for patients on various anticoagulant medications. It reviews the coagulation cascade and indications for anticoagulation therapy. Common anticoagulants are described including antiplatelet drugs, oral anticoagulants like warfarin, heparins, and newer agents. Guidelines are provided for managing patients on these medications in the perioperative period, including recommendations for stopping medications prior to procedures and resuming them postoperatively. Specific guidance is given for neuraxial anesthesia in anticoagulated patients.
This document discusses various intensive care unit (ICU) scoring systems used to evaluate patient severity of illness and predict outcomes. It describes different types of scoring systems including anatomical, therapeutic weighted, organ specific, and physiological assessment scores. Common individual scoring systems are discussed in depth, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score, Simplified Acute Physiology Score (SAPS), Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score (MODS), and Therapeutic Intervention Scoring System (TISS). The ideal features of a scoring system and considerations for which score to use in different situations are also summarized.
This document provides information on ophthalmic anatomy, physiology, and anesthesia. It discusses the layers of the eye, intraocular pressure regulation, types of local anesthesia including peribulbar and retrobulbar blocks, and considerations for general anesthesia. Key factors discussed include maintaining stable intraocular pressure during surgery and preventing complications.
mTOR inhibitors like sirolimus and everolimus are immunosuppressants that provide an alternative to calcineurin inhibitors for renal transplant patients. They have antiproliferative properties, cause less nephrotoxicity than CNIs, and are associated with lower rates of malignancy, viral infections, and improved renal function when used to convert patients from a CNI-based regimen. However, mTOR inhibitors are less effective at preventing acute rejection when used without a CNI in de novo transplants.
The document discusses early graft dysfunction following kidney transplantation, which can occur within the first six months post-transplant. There are several potential causes of early graft dysfunction, including delayed graft function (DGF) from ischemic acute tubular necrosis, acute rejection, vascular complications, drug toxicity from calcineurin inhibitors, and recurrence of the original kidney disease. DGF is the most common cause and presents as slow or no improvement in kidney function within the first week, often requiring dialysis. Long-term outcomes are negatively impacted by early graft dysfunction. Ongoing monitoring for acute rejection and other potential causes is important to identify issues and optimize graft survival in the early post-transplant period.
This document discusses considerations for anesthesia during kidney transplantation. It covers preoperative risk evaluation focusing on systems impacted by renal failure. Important preoperative workup is outlined. Intraoperative concerns include general anesthesia, invasive monitoring, fluid management targeting dynamic indices rather than static pressures, and use of balanced crystalloids over normal saline. Postoperative pain management options emphasizing multimodal analgesia and regional techniques are reviewed. Maintaining normothermia and glycemic control are also noted as important intraoperative concerns. The conclusion emphasizes the challenges of perioperative kidney transplant management and the importance of optimization, pain control, fluid management, and hemodynamics for recovery.
This document discusses anticoagulation reversal. It describes the therapeutic intervals for various anticoagulants including warfarin and heparin. It discusses considerations for reversing anticoagulation including urgency and drug half-life. It provides guidelines for reversing warfarin with vitamin K, FFP, PCC or rFVIIa depending on the urgency and presence of bleeding. It also discusses reversing heparin with protamine and options for reversing newer oral anticoagulants like dabigatran and rivaroxaban.
Pheochromocytoma is a catecholamine-secreting tumor that arises from chromaffin tissue in the adrenal medulla or sympathetic ganglia. It presents with a classic triad of severe headaches, diaphoresis, and palpitations. Biochemical testing of urine or plasma is used to diagnose pheochromocytoma. Patients undergo preoperative pharmacological preparation using alpha-blockers to control hypertension. Intraoperatively, antihypertensives like nicardipine and sodium nitroprusside are used. Postoperatively, patients are monitored for rebound hypotension due to decreased catecholamine levels and hypoglycemia in tumors secreting epinephrine. Long-term follow up is needed
Perioperative Management of Hypothyroid Patients Undergoing Nonthyroidal SurgeryTerry Shaneyfelt
?
The document discusses the perioperative management of hypothyroid patients undergoing non-thyroid surgery, highlighting the assessment of thyroid function and potential complications. It suggests that patients with stable hypothyroidism may not need preoperative TSH measurements, and that those with mild-to-moderate symptoms should postpone surgery until euthyroid. Additionally, it outlines the management strategies for various severity levels of hypothyroidism, including the use of thyroid hormone replacement therapy and stress dose steroids.
This document discusses anaesthetic considerations for transurethral resection of the prostate (TURP). TURP requires large volumes of irrigating fluid which can cause complications if absorbed in large quantities. Regional anaesthesia is preferred to allow for early detection of issues like TURP syndrome. Close monitoring of fluid balance, electrolytes and vital signs is important to manage risks of fluid overload, hyponatremia and other imbalances from irrigating fluid absorption. Prevention involves limiting fluid volume and pressure and prompt treatment of any abnormalities that develop.
This document provides information on estimating oil and gas reserves. It defines various classifications of reserves from proven to unproven, and how reserves are estimated using volumetric, material balance, and production performance methods. The key classifications discussed are proven and probable reserves, with proven reserves having a 90% certainty of recovery and probable having 50% certainty. Volumetric estimation calculates initial hydrocarbon volumes using parameters like rock volume, porosity, fluid properties, and recovery factors.
This document discusses the innervation and control of the vesicourethral unit and the effects of spinal cord injury on lower urinary tract function. It notes that spinal cord injury above T12 can cause detrusor hyperreflexia and sphincter dyssynergia due to disruption of pontine control of micturition. Autonomic hyperreflexia, a dangerous hypertensive episode triggered by stimuli below the level of injury, is also discussed and management involves identifying and removing the trigger as well as using antihypertensive drugs. The classification and effects of varying levels of spinal cord injury on the lower urinary tract are summarized.
Av fistula examination dr tarek alerakyFarragBahbah
?
- Physical examination of arteriovenous fistulas is recommended weekly to monitor for problems. Inspection looks for abnormalities on the skin, cannulation sites, aneurysms, and diameter and length of the fistula. The arm elevation test checks for collapse which could indicate stenosis. A pulse may indicate downstream obstruction while a thrill normally indicates flow but could indicate turbulence from stenosis. Accessory veins can divert blood flow, slowing fistula maturation.
Anaesthesia for joint replacement surgeriesaratimohan
?
This document provides an overview of the anaesthetic management considerations for joint replacement surgeries. It discusses the common joints replaced, patient characteristics, comorbidities to assess, and techniques for hip and knee replacements. For hip replacements, it covers surgical approaches, positioning risks, blood loss management using controlled hypotension, and cement implantation syndrome risks. For knee replacements, it discusses nerve blocks, tourniquet use risks like nerve injury, and managing tourniquet pain. Thromboprophylaxis guidelines are also reviewed.
This document discusses guidelines and considerations for clinical trials in hypertension. It provides information on:
1. The increasing global prevalence and costs of hypertension, with an estimated 1.6 billion hypertensive patients by 2025.
2. Guidelines for classifying and treating hypertension from organizations like JNC, WHO, and ESC/ESH. The JNC 8 guideline is evidence-based and recommends treatment thresholds, goals, and medications based on randomized controlled trials.
3. Methodological considerations for designing and conducting clinical trials to evaluate antihypertensive drugs and combinations, including study populations, measures of efficacy like blood pressure and target organ damage, safety aspects, and trial durations. Long-term safety data is important
This document discusses anaesthetic considerations for morbidly obese patients. Key points include:
- Morbid obesity is defined as a body weight more than twice the ideal body weight or 100kg heavier.
- It is associated with increased risks of cardiovascular, respiratory, endocrine and other medical conditions.
- Anaesthetic challenges include difficulties with airway management, ventilation, increased drug volumes of distribution and altered pharmacokinetics.
- Thorough pre-operative evaluation of co-morbidities and risks is important for planning anaesthesia.
This study evaluated whether sodium bicarbonate infusion improved outcomes in critically ill patients with severe metabolic acidemia. The study randomized 389 ICU patients to receive either sodium bicarbonate infusion aimed at achieving an arterial pH of ¡Ý7.30, or no bicarbonate (control group). The primary outcome of all-cause mortality at day 28 and presence of organ failure at day 7 was not improved with bicarbonate in the overall population. However, in the subgroup of patients with acute kidney injury, the primary outcome occurred less frequently with bicarbonate. Additionally, more days alive without renal replacement therapy were seen with bicarbonate both overall and in acute kidney injury patients.
2020 NSTE-ACS slide-set for web updated 5.5.2021.pptxtoanc2tb
?
This document provides guidelines from the European Society of Cardiology (ESC) for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. It includes recommendations on the diagnosis and risk stratification of these patients as well as their antithrombotic, invasive, and pharmacological treatment. New recommendations include the use of high-sensitivity cardiac troponin assays, assessment of bleeding risk to guide antithrombotic treatment duration, and consideration of complete revascularization in patients with multivessel coronary artery disease. The guidelines also introduce new sections on microvascular obstruction and spontaneous coronary artery dissection.
This document discusses a case presentation of a kidney transplant patient experiencing delayed graft function (DGF). It provides background information on DGF, including definitions, incidence, importance, and risk factors at various stages of the transplant process. These risk factors include characteristics of the donor, recipient, procurement techniques, and the perioperative period. The document then outlines the presenter's thought process and basic workup to consider for DGF cases.
This document discusses relative blood volume (RBV) monitoring and its potential applications in dialysis. It provides an overview of RBV monitoring principles, compartmental fluid shifts, and RBV profiles in relation to intradialytic hypotension. While RBV monitoring shows promise for fluid management and blood pressure control, evidence from studies is mixed. The largest study to date found RBV monitoring increased mortality and hospitalizations. Further research is still needed to fully understand the clinical utility and appropriate applications of RBV monitoring.
Anesthesia in patients on anti coagulantsNavin Jain?
?
This document discusses anesthesia considerations for patients on various anticoagulant medications. It reviews the coagulation cascade and indications for anticoagulation therapy. Common anticoagulants are described including antiplatelet drugs, oral anticoagulants like warfarin, heparins, and newer agents. Guidelines are provided for managing patients on these medications in the perioperative period, including recommendations for stopping medications prior to procedures and resuming them postoperatively. Specific guidance is given for neuraxial anesthesia in anticoagulated patients.
This document discusses various intensive care unit (ICU) scoring systems used to evaluate patient severity of illness and predict outcomes. It describes different types of scoring systems including anatomical, therapeutic weighted, organ specific, and physiological assessment scores. Common individual scoring systems are discussed in depth, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score, Simplified Acute Physiology Score (SAPS), Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score (MODS), and Therapeutic Intervention Scoring System (TISS). The ideal features of a scoring system and considerations for which score to use in different situations are also summarized.
This document provides information on ophthalmic anatomy, physiology, and anesthesia. It discusses the layers of the eye, intraocular pressure regulation, types of local anesthesia including peribulbar and retrobulbar blocks, and considerations for general anesthesia. Key factors discussed include maintaining stable intraocular pressure during surgery and preventing complications.
mTOR inhibitors like sirolimus and everolimus are immunosuppressants that provide an alternative to calcineurin inhibitors for renal transplant patients. They have antiproliferative properties, cause less nephrotoxicity than CNIs, and are associated with lower rates of malignancy, viral infections, and improved renal function when used to convert patients from a CNI-based regimen. However, mTOR inhibitors are less effective at preventing acute rejection when used without a CNI in de novo transplants.
The document discusses early graft dysfunction following kidney transplantation, which can occur within the first six months post-transplant. There are several potential causes of early graft dysfunction, including delayed graft function (DGF) from ischemic acute tubular necrosis, acute rejection, vascular complications, drug toxicity from calcineurin inhibitors, and recurrence of the original kidney disease. DGF is the most common cause and presents as slow or no improvement in kidney function within the first week, often requiring dialysis. Long-term outcomes are negatively impacted by early graft dysfunction. Ongoing monitoring for acute rejection and other potential causes is important to identify issues and optimize graft survival in the early post-transplant period.
This document discusses considerations for anesthesia during kidney transplantation. It covers preoperative risk evaluation focusing on systems impacted by renal failure. Important preoperative workup is outlined. Intraoperative concerns include general anesthesia, invasive monitoring, fluid management targeting dynamic indices rather than static pressures, and use of balanced crystalloids over normal saline. Postoperative pain management options emphasizing multimodal analgesia and regional techniques are reviewed. Maintaining normothermia and glycemic control are also noted as important intraoperative concerns. The conclusion emphasizes the challenges of perioperative kidney transplant management and the importance of optimization, pain control, fluid management, and hemodynamics for recovery.
This document discusses anticoagulation reversal. It describes the therapeutic intervals for various anticoagulants including warfarin and heparin. It discusses considerations for reversing anticoagulation including urgency and drug half-life. It provides guidelines for reversing warfarin with vitamin K, FFP, PCC or rFVIIa depending on the urgency and presence of bleeding. It also discusses reversing heparin with protamine and options for reversing newer oral anticoagulants like dabigatran and rivaroxaban.
Pheochromocytoma is a catecholamine-secreting tumor that arises from chromaffin tissue in the adrenal medulla or sympathetic ganglia. It presents with a classic triad of severe headaches, diaphoresis, and palpitations. Biochemical testing of urine or plasma is used to diagnose pheochromocytoma. Patients undergo preoperative pharmacological preparation using alpha-blockers to control hypertension. Intraoperatively, antihypertensives like nicardipine and sodium nitroprusside are used. Postoperatively, patients are monitored for rebound hypotension due to decreased catecholamine levels and hypoglycemia in tumors secreting epinephrine. Long-term follow up is needed
Perioperative Management of Hypothyroid Patients Undergoing Nonthyroidal SurgeryTerry Shaneyfelt
?
The document discusses the perioperative management of hypothyroid patients undergoing non-thyroid surgery, highlighting the assessment of thyroid function and potential complications. It suggests that patients with stable hypothyroidism may not need preoperative TSH measurements, and that those with mild-to-moderate symptoms should postpone surgery until euthyroid. Additionally, it outlines the management strategies for various severity levels of hypothyroidism, including the use of thyroid hormone replacement therapy and stress dose steroids.
This document discusses anaesthetic considerations for transurethral resection of the prostate (TURP). TURP requires large volumes of irrigating fluid which can cause complications if absorbed in large quantities. Regional anaesthesia is preferred to allow for early detection of issues like TURP syndrome. Close monitoring of fluid balance, electrolytes and vital signs is important to manage risks of fluid overload, hyponatremia and other imbalances from irrigating fluid absorption. Prevention involves limiting fluid volume and pressure and prompt treatment of any abnormalities that develop.
This document provides information on estimating oil and gas reserves. It defines various classifications of reserves from proven to unproven, and how reserves are estimated using volumetric, material balance, and production performance methods. The key classifications discussed are proven and probable reserves, with proven reserves having a 90% certainty of recovery and probable having 50% certainty. Volumetric estimation calculates initial hydrocarbon volumes using parameters like rock volume, porosity, fluid properties, and recovery factors.
This document discusses the innervation and control of the vesicourethral unit and the effects of spinal cord injury on lower urinary tract function. It notes that spinal cord injury above T12 can cause detrusor hyperreflexia and sphincter dyssynergia due to disruption of pontine control of micturition. Autonomic hyperreflexia, a dangerous hypertensive episode triggered by stimuli below the level of injury, is also discussed and management involves identifying and removing the trigger as well as using antihypertensive drugs. The classification and effects of varying levels of spinal cord injury on the lower urinary tract are summarized.
Av fistula examination dr tarek alerakyFarragBahbah
?
- Physical examination of arteriovenous fistulas is recommended weekly to monitor for problems. Inspection looks for abnormalities on the skin, cannulation sites, aneurysms, and diameter and length of the fistula. The arm elevation test checks for collapse which could indicate stenosis. A pulse may indicate downstream obstruction while a thrill normally indicates flow but could indicate turbulence from stenosis. Accessory veins can divert blood flow, slowing fistula maturation.
Anaesthesia for joint replacement surgeriesaratimohan
?
This document provides an overview of the anaesthetic management considerations for joint replacement surgeries. It discusses the common joints replaced, patient characteristics, comorbidities to assess, and techniques for hip and knee replacements. For hip replacements, it covers surgical approaches, positioning risks, blood loss management using controlled hypotension, and cement implantation syndrome risks. For knee replacements, it discusses nerve blocks, tourniquet use risks like nerve injury, and managing tourniquet pain. Thromboprophylaxis guidelines are also reviewed.
This document discusses guidelines and considerations for clinical trials in hypertension. It provides information on:
1. The increasing global prevalence and costs of hypertension, with an estimated 1.6 billion hypertensive patients by 2025.
2. Guidelines for classifying and treating hypertension from organizations like JNC, WHO, and ESC/ESH. The JNC 8 guideline is evidence-based and recommends treatment thresholds, goals, and medications based on randomized controlled trials.
3. Methodological considerations for designing and conducting clinical trials to evaluate antihypertensive drugs and combinations, including study populations, measures of efficacy like blood pressure and target organ damage, safety aspects, and trial durations. Long-term safety data is important
This document discusses anaesthetic considerations for morbidly obese patients. Key points include:
- Morbid obesity is defined as a body weight more than twice the ideal body weight or 100kg heavier.
- It is associated with increased risks of cardiovascular, respiratory, endocrine and other medical conditions.
- Anaesthetic challenges include difficulties with airway management, ventilation, increased drug volumes of distribution and altered pharmacokinetics.
- Thorough pre-operative evaluation of co-morbidities and risks is important for planning anaesthesia.
This study evaluated whether sodium bicarbonate infusion improved outcomes in critically ill patients with severe metabolic acidemia. The study randomized 389 ICU patients to receive either sodium bicarbonate infusion aimed at achieving an arterial pH of ¡Ý7.30, or no bicarbonate (control group). The primary outcome of all-cause mortality at day 28 and presence of organ failure at day 7 was not improved with bicarbonate in the overall population. However, in the subgroup of patients with acute kidney injury, the primary outcome occurred less frequently with bicarbonate. Additionally, more days alive without renal replacement therapy were seen with bicarbonate both overall and in acute kidney injury patients.
2020 NSTE-ACS slide-set for web updated 5.5.2021.pptxtoanc2tb
?
This document provides guidelines from the European Society of Cardiology (ESC) for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. It includes recommendations on the diagnosis and risk stratification of these patients as well as their antithrombotic, invasive, and pharmacological treatment. New recommendations include the use of high-sensitivity cardiac troponin assays, assessment of bleeding risk to guide antithrombotic treatment duration, and consideration of complete revascularization in patients with multivessel coronary artery disease. The guidelines also introduce new sections on microvascular obstruction and spontaneous coronary artery dissection.
Fr?lsning och relationen mellan judarna och folken i Efesierbrevet 2Lars Gunther
?
Efesierbrevet 2 har s?v?l Bibelns mest k?rnfulla f?rklaring av vad fr?lsningen inneb?r som dess tydligaste utl?ggning av relationen mellan folken (hedningarna) och det judiska folket. Detta studium h?lls p? SPF i Hestra 2022-10-26.
The Epistle of Ignatius to the Philadelphians is an epistle attributed to Ignatius of Antioch, a second-century bishop of Antioch, and addressed to the church in Philadelphia of Asia Minor. It was written during Ignatius' transport from Antioch to his execution in Rome.
1. Tredje trosartikeln:
Den Helige Andes
verksamhet
¡±Jag tror p? en helig,
allm?nnelig kyrka, de heligas
samfund¡±
Wednesday, October 20, 2010
2. Ordens betydelse
? F?rsamling, gr. Ekklesia, ¡±kallad
ut¡±. F?rsamlingen ?r kallad ut ur
v?rlden, utanf?r l?gret, till ett
liv med Kristus.
? Kyrka, gr. kyriakhe, ¡±Tillh?r
Herren¡±. Ordet kyrka anv?nds som
synonym till ordet f?rsamling
(ekklesia). Skriver man Kyrkan med
stort K s? avser man den
v?rldsvida f?rsamlingen.
? Kyrka. Byggnad som ?r helgad ?t
Herren. Byggnadens historiska
urprung kommer fr?n hemmen vid
medelhavet.
? Guds rike. Ett vidare begrepp ?n
den v?rldsvida kyrkan. Den
inbegriper hela Guds rike i himlen
och p? jorden. Vi ber att det skall
komma till v?rt liv i Fader V?r
b?nen.
Wittenbergs stadskyrkas
altartavla, Lukas Cranach.
Wednesday, October 20, 2010
3. F?rsamlingen ?r
Kristi Kropp (1. Kor. 12:27)
? Kristi v?rldsvida f?rsamling
eller Kyrkan ?r ¡±en, helig,
allm?nnelig och
apostolisk¡± (Niceanska ? En, eftersom
trosbek?nnelsen) Kristus ?r en.
? Helig, eftersom
Kristus ?r helig
? Allm?nnelig,
eftersom den
tillh?r alla
troende.
? Apostolisk,
eftersom den h?ller
sig till den
apostoliska l?ran.
¡±.. alla ?r ni ett i
Kristus¡±. Gal. 3:28
Wednesday, October 20, 2010
4. Kristi
f?rsamlingskropp
?verskrider gr?nser av
tid och rum
? Medlemmarna i
f?rsamlings-kroppen ?r av
tv? slag
a) den triumferande kyrkan
(ecclesia triumphans, de
heliga som kommit fram,
Hebr. 12:1)
b) den k?mpande kyrkan
(ecclesia militans, den
kyrka som i tiden k?mpar
mot synden, v?rlden och
dj?vulen.)
Wednesday, October 20, 2010
5. Corpus permixtum
¡±en blandad kyrka¡±
? I f?rsamlingen h?r i tiden ?r de
(Augustinus)
sant heliga och skrymtarna
blandade (¡±?kerns ogr?s¡± Matt.
13:24-30). Endast Gud kan
slutligen avg?ra r?tt.
? Med v?ra ler?gon f?r vi inte skilja
eller undanskuffa ur
f?rsamlingen de som har en r?tt
bek?nnelse och som k?mpar p?
omv?ndelsens v?g.
? ¡±Med k?rlekens ?gon¡± skall vi
betrakta alla d?pta och
bek?nnande som kristna, ¡±med
trons ?gon¡± betraktar vi endast de
som kristna som Gud har f?rklarat
r?ttf?rdiga inf?r himmelsens
domstol. I denna tid kan vi endast
se med k?rlekens ?gon. (Enligt
Luther)
? Vi ?r skyldiga att fullt ut ?lska
alla kristna eftersom Gud har
?lskat oss utan villkor.
Wednesday, October 20, 2010
6. Kyrkan eller f?rsamlingen
?r fr?lsningens gemenskap
Guds kyrkas fasta
grundval, dess sk?ld
och v?rn i strid
?r Herren Jesus
Kristus, Guds Son
fr?n evig tid.
(Sionsharpan 68)
"Jag har f?tt all makt i himlen och p? jorden. G? d?rf?r ut och
g?r alla folk till l?rjungar! D?p dem i Faderns och Sonens och
den helige Andes namn och l?r dem att h?lla allt vad jag har
befallt er. Och se, jag ?r med er alla dagar intill tidens slut¡±
¡±...Men kyrkan ?r de heligas samfund, i vilket evangelium rent
f?rkunnas och sakramenten r?tt f?rvaltas... En tro, ett dop, en
Gud som ?r allas Fader etc. (Ef. 4:5--6).
Augsburgska bek?nnelsen (CA 7):
Wednesday, October 20, 2010
7. Att f?renas med
f?rsamlingen ?r att
f?renas med fr?lsningen
? Dopet ?r Kristus-d?rren till
f?rsamlingens gemenskap. Genom tron
tar vi emot dopets g?va varje dag. I
Fornkyrkan var dopsk?len placerad vid
kyrkans d?rr och man gick via den in i
fr?lsningens gemenskap.
? Ocks? med m?nga andra ord vittnade han
och uppmanade dem: "L?t er fr?lsas fr?n
detta bortv?nda sl?kte." De som d? tog
emot hans ord d?ptes, och s? ?kade
antalet l?rjungar den dagen med
omkring tre tusen.¡± (Apg. 2:40-41).
? ¡±Den som tror och blir d?pt skall bli
fr?lst, men den som inte tror skall bli
f?rd?md.¡± (Mark. 16:16) Dopet ?r Kristus-d?rren
till fr?lsningen och
? Gud har f?renat dopet med sitt l?fte. nattvardsgemenskapen.
Bild: Muonio kyrkas altare
Guds Ord ger dopet dess kraft. ¡±N?r
Ordet kommer till ?mnet blir det ett
sakrament.¡± (Augustinus).
Wednesday, October 20, 2010
8. Kyrkans makt
(ius ecclesia)
? Kyrklig makt (nycklamakten)
betyder att f?rsamlingen har
r?tt att predika Ordet och
f?rvalta sakramenten samt kalla
och ins?tta herdar f?r
f?rsamlingen.
? Makten har getts f?r att
evangeliet skall utspridas (dop-
och missionsbefallningen) och
villol?ror bek?mpas.
? Denna makt har varje f?rsamling.
Dessutom har varje kristen f?tt
fullmakt att predika evangeliet i
sin n?romgivning.
? Enskilda kristna kan inte Evangeliets l?senyckel
anv?nda bindenyckeln. ?ven befriar fr?n synd.
apostlarna anv?nde dem Bindenyckeln inneb?r att man
tillsammans med f?rsamlingen. binds i synden och f?r inte
Anv?ndningen av bindenyckeln komma till nattvarden.
tillh?r pastorn och Bindenyckeln ?r en allvarlig
f?rsamlingen (1 Kor. 5:3-4; Matt. varning och kallelese till
omv?ndelse fr?n den v?g som
18:17). leder till f?rd?rv.
Wednesday, October 20, 2010
9. Kyrkan ?r en
bek?nnande gemenskap
L?rans grund:
? Bibeln
L?ran:
? De gammalkyrkliga
trosbek?nnelserna
Nicenska-, apostoliska-
och Athanasianska
trosbek?nnelsen
? De lutherska
bek?nnelseskrifterna
Wednesday, October 20, 2010
10. Kyrkotr?det
Kyrkan bevarades i stort sett
enig fram till ?r 1054, n?r den
delades i v?st och ?st. ?ven
efter splittringen erk?nde
kyrkorna varandra men ?rade
inte l?ngre gemensam nattvard.
Efter detta har delningarna
fortsatt. Alla grenar i detta
¡±tr?d¡± kan vi inte erk?nna som
delaktiga i Kristi kyrka. De ?r
d?da grenar eftersom de har
avfallit fr?n den apostoliska
l?ran och tron.
En r?tt kyrkas k?nnetecken ?r
den apostoliska trosbek?nnel-
sen och ett r?tt evangelium
samt sakramentsf?rvaltning
enligt Kristi instiftelse
(Augsb. Bek., CA 7).
Wednesday, October 20, 2010
11. V?rldsvid Kyrka
? ¡±Kristenheten¡± =
alla troende i olika
trossamfund
? ¡±Levande stenar¡±
samlade till en
byggnad.
? Den v?stliga kyrkan:
Protestantismen
(luterska,
anglikanska och
reformerta kyrkor)
och
romerskkatolska
kyrkan
? Den ?stliga kyrkan:
olika ortodoxa
kyrkor
Wednesday, October 20, 2010
12. Kyrkorna i Finland
? I Finland verkar alla
historiska kyrkor och n?gra
nya kyrkor.
? Kyrkorna godk?nner varandras
dop f?rutom de baptistiska
riktningarna som f?rr?ttar
omdop.
? De olika lutherska kyrkorna
(folkkyrkan och
bek?nnelsekyrkor), har samma
l?rogrund och samma
bek?nnelseskrifter.
? Andra samfund har inte samma
l?rogrund.
? I vilken m?n samfunden f?ljer
sin of?ciella l?rogrund
varierar.
Wednesday, October 20, 2010
13. Splittring, sekter och
schismer
De?nition av termer Enligt Bibelns helhetsbild ?r Kristi
f?rsamlingskropp den som har samlats ihop
Gr. ¦Ä¦É¦Ö¦Ï¦Ò¦Ó¦Á¦Ò¦É¦Á¦É, ¦Á¦É¦Ñ¦Å¦Ò¦Å¦É?, ¦Ò¦Ö¦É¦Ò¦Ì¦Á, dikastasia,
genom det apostloliska evangeliet. Den kan
heresia, skisma inte ramla s?nder i delar men fr?n den kan
sekter utg? som f?ljer falska l?ror.
Splittring, oenighet, dikastasia. ¡±St?
skild¡±, ¡±tudelning¡±, ¡±splittring¡±. (Dika = Guds Ord ¡±kallar och samlar¡± av alla folk
itu; stasis = st?, station). (Gal. 5:20)). till den enda Kristi kropp som ?nns. Ordet
Sekt, parti, heresia. NT anv?nder detta bygger nya gemenskaper p? evangeliets
ord om sekt, parti och skolbildningar. (Apg. grund.
5:17, 1 Kor. 11:19). Fr?n ordet haireo,
¡±er?vra, r?da ?ver¡±, ¡±antagen ?sikt, L?rom?ssiga grupper som uppstiger mot
uppfattning¡± (speciellt avvikande ?sikt), ¡±Kristi l?ra¡± inom f?rsamlingen ?r k?ttets
¡±?loso?sk skola¡±. Ursprungligen ett verk och d?rmed synd. P? samma s?tt ?r det
sv?rmiskt fenomen och n?got man g?r f?r
att tj?na sig sj?lv. Heresier har synd att av illvilja h?lla sig ?tskilld om man
undantryckt den h?lsosamma l?ran. har samma l?ra. (Gal. 5:19-20).
Schism, skisma. ¡±..F?rst och fr?mst h?r jag Det fanns olika ?sikter och man kunde ta
att det f?rekommer stridigheter (skismata)
bland er, n?r ni m?ts i f?rsamlingen, och miste redan p? apostlarnas tid. Allt detta var
delvis tror jag att det ?r s?. Partier inte synd. Den apostoliska ¡±v?gen¡± och
(heireseis) m?ste ?nnas bland er, f?r att det ¡±vandringen¡± var ?nd? norm enligt vilken Gud
skall visa sig vilka det ?r som h?ller provet. ledde dem som var av annan ?sikt. (Fil. 3:15-18).
(1 Kor. 11:18).
En l?ra som avviker fr?n Bibelns l?ra
Dj?vulen, satan, gr. Diabolos. Hebr. splittrar alltid en f?rsamling. Det
¡±?klagare (i domstol), den som hindrar och ¡±?tskiljer¡± (diabolos) fr?n Guds Ords
bedrar p? ett l?mskt s?tt. Gr. ¡±den som h?lsosamma l?ra.
kastar ?tskillt¡±, ¡±motst?ndare¡±,
¡±konspirat?r¡± (to plot against).
Wednesday, October 20, 2010
14. Bliv kvar i broderlig
k?rlek ? Var innerligt tillgivna varandra i
broderlig k?rlek. ?vertr?ffa varandra
i ?msesidig hedersbevisning¡± (Rom.
12:10)
? ¡±Lev i endr?kt med varandra. T?nk inte
p? det som ?r h?gt utan h?ll er till det
som ?r ringa. Var inte sj?lvkloka. .¡±
Rom. 12:16
? ¡±Br?der, bli kvar i
brodersk?rleken.¡± (Hebr. 13:1)
? ¡±G?r d?rf?r allt ni kan f?r att i er tro
visa dygd,.. i gudsfruktan broderlig
k?rlek och i k?rleken till br?derna
k?rlek till alla m?nniskor. ¡± (2. Petr.
1:6-7)
? ¡±Ty liksom kroppen ?r en och har m?nga
lemmar, men kroppens alla lemmar - och
de ?r m?nga - utg?r en kropp, s? ?r det
ocks? med Kristus. I en Ande har vi alla
blivit d?pta f?r att h?ra till en kropp,
vare sig vi ?r judar eller greker,
slavar eller fria, och alla har vi f?tt
en och samme Ande utgjuten ?ver oss.
Kroppen best?r ju inte av en enda lem
utan av m?nga.¡± (1. Kor. 12:12-14).
Wednesday, October 20, 2010
15. Sin enda
grund har
kyrkan
4. N?r l?gn och v?ld f?rmeras var ?r d? jordens
salt? Vem hj?lper och vem helar vid v?rldens
s?nderfall? M? kyrkan bli som fordom ett hj?rta
och en sj?l, en fristad mitt i oron, f?r sanningen
ett v?rn
5.Guds kyrka ?r gemenskap med Fadern och hans
Son, det sk?dar hon och erfar i Andens kraft och
n?d. Guds helgon och martyrer betygar det med
blod. Omkring dem sjunger rymden d?r segerns
1. Sin enda grund har kyrkan i Kristus, Fr?lsaren. kyrka bor.
Hon ?r hans egen byggnad, den nya skapelsen.
I v?rlden som han l?ste fr?n m?rkret med sitt
blod, blev hon den brud han kr?nte med evangelii
ord. (Psalmboken 167,
Samuel John Stone
2. Fast spridd i m?nga l?nder ?r kyrkan endast 1866. Svensk
en och har en enda Herre och en bek?nnelse. ?vers?ttning Olov
Av vatten f?dd och Ande till ett och samma Hartman 1981, en
hopp, hon g?r till l?fteslandet med samma annan ?vers?ttning
resekost. ?nns av Anna
?lander i
3. Med undran och med l?je ser v?rlden hur Sionsharpan 68)
hon slits av tusen tvister s?nder och nekar
sig Guds frid. Hur s?llsamt klingar orden i
kyrkor utan fred om Herrens frid p?
jorden, om Guds barmh?rtighet.
Wednesday, October 20, 2010