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| style="background:#F5F5F5;" + |Highest risk for VTE | | style="background:#F5F5F5;" + |Highest risk for VTE | ||
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==Images ILD== | |||
<gallery widths=200px> | |||
F2.large.jpg | Cellular Players and Molecules in IPF <br> [http://err.ersjournals.com/content/24/135/102.full<font size="-2">''Adapted from European Respiratory Review''</font>] | |||
</gallery> | |||
<gallery widths=200px> | |||
1-s2.0-S0272523112000044-gr6.jpg | Flow Chart for Lung Fibrosis Evaluation in ILD <br> [http://http://www.sciencedirect.com/science/article/pii/S0272523112000044/ <font size="-2">''Adapted from Clinics in Chest Medicine''</font>] | |||
</gallery> | |||
==Pathophysiology of ILD== | ==Pathophysiology of ILD== | ||
Revision as of 21:11, 7 March 2018
==Classification Gastritis
| Gastritis | Etiology | Gasstritis synonyms | |
|---|---|---|---|
| Non-atrophic |
|
Superficial Diffuse antral gastritis (DAG) Chronic antral gastritis (CAG) Interstitial - follicular Hypersecretory Type B* | |
| Atrophic | Autoimmune |
|
Type A* Diffuse corporal Pernicious anemia-associated |
| Multifocal atrophic | Helicobacter pylori | Type B*, type AB* | |
| Dietary | Environmental | ||
| Environmental factors | Metaplastic | ||
| Special form | Chemical | Chemical irritation | Reactive |
|
| ||
|
| ||
|
| ||
| Radiation | Radiation injury | ||
Risk assessment table
| Scoring criteria for risk assessment* | ||
|---|---|---|
| Scoring system | Score | Risk |
| IMPROVEDD Score[1] | Predicted % VTE risk through 42 days | |
| 0 | 0.4% | |
| 1 | 0.6% | |
| 2 | 0.8% | |
| 3 | 1.2% | |
| 4 | 1.6% | |
| 5-10 | 2.2% | |
| Predicted % VTE risk through 77 days | ||
| 0 | 0.5% | |
| 1 | 0.7% | |
| 2 | 1.0% | |
| 3 | 1.4% | |
| 4 | 1.9% | |
| 5-10 | 2.75 | |
| IMPROVE score[2] | Predicted % VTE risk through 3 months | |
| 0 | 0.5% | |
| 1 | 1.0% | |
| 2 | 1.7% | |
| 3 | 3.1% | |
| 4 | 4% | |
| 5-8 | 11% | |
| Padua Score[3] | < 4 | Low risk for VTE |
| ≥ 4 | High risk for VTE | |
| Caprini score[4] | 0-1 | Low risk of VTE |
| 2 | Moderate of VTE | |
| 3-4 | High risk of VTE | |
| ≥ 5 | Highest risk for VTE | |
Images ILD
-
Cellular Players and Molecules in IPF
Adapted from European Respiratory Review
-
Flow Chart for Lung Fibrosis Evaluation in ILD
Adapted from Clinics in Chest Medicine
Pathophysiology of ILD
Algorithm showing pathophysiology of Interstitial Lung Disease
| Tissue injury in lungs | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Parenchymal injury | Vascular injury | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mast cells in lungs in response to tissue injury | LPA6, LPA2, and LPA4 receptors | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Decreased sFRP-1 (secreted frizzled-related protein 1) in fibroblasts | Secretes tryptase | Transforming growth factor-β (TGF-β) | Insulin-like growth factor (IGF) signalling | Reduced expression of angiogenic factors, vascular endothelial growth factor (VEGF) | Elevation of angiostatic factors, pigment epithelium-derived factor | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Wnt/β-catenin signalling pathway | PAR-2/protein kinase (PK)C-α/Raf-1/p44/42 signaling pathway | Upregulation of Egr-1 (early growth response protein 1) | IGF-binding protein 5 (IGFBP-5) | IGF-binding protein 3 (IGFBP-3) | Loss of endothelial barrier function | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Dysregulation of repair in lung tissue and activation of fibroblasts | Regulates transforming growth factor-β (TGF-β) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Induction of syndecan-2 (SDC2) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Activation,proliferation, and migration of fibroblast to the site of injury | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fibroblasts | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Altered PTEN (phosphatase and tensin homologue)/Akt axis | Acquire contractile stress fibres | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Inactivates Fox (forkhead box) O3a | Protomyofibroblast, composed of cytoplasmic actins | Pleural mesothelial cells (PMCs) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Downregulation of caveolin-1 (cav-1) and Fas expression | De novo expression of α-smooth muscle actin (α-SMA) | TGF-β1-dependent mesothelial–mesenchymal transition | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fibroblast resistant to apoptosis | Myofibroblasts | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Different ranges of contractions mediated by RhoA/Rho-associated kinase | Changes in intracellular calcium concentrations | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Recruitement of fibrocytes in lungs | Lock step mechanism of cyclic and contractile events | T-helper cell type 2 on site of injury | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Upregulation of C-X-C chemokine receptor type 4 (CXCR4) on fibrocytes and its ligand CXCL12 (stromal cell-derived factor 1) | Excess extracellular matrix production | Exerting traction force | Interleukin-13 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Migration of fibrocytes to the site of injury | Tissue remodelling | Alternate pathway activation of macrophages | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Lung Fibrosis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ . doi:10.1055/s-0037-160392910.1055/s-0037-1603929. Missing or empty
|title=(help) - ↑ Spyropoulos AC, Anderson FA, Fitzgerald G, Decousus H, Pini M, Chong BH; et al. (2011). "Predictive and associative models to identify hospitalized medical patients at risk for VTE". Chest. 140 (3): 706–14. doi:10.1378/chest.10-1944. PMID 21436241.
- ↑ Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M; et al. (2010). "A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score". J Thromb Haemost. 8 (11): 2450–7. doi:10.1111/j.1538-7836.2010.04044.x. PMID 20738765.
- ↑ Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F (1991). "Clinical assessment of venous thromboembolic risk in surgical patients". Semin Thromb Hemost. 17 Suppl 3: 304–12. PMID 1754886.