Samter's Triad (also known as Aspirin-Exacerbated Respiratory Disease / AERD)
The clinical triad shown in the diagram consists of:
Asthma
Aspirin Sensitivity (or intolerance to non-steroidal anti-inflammatory drugs / NSAIDs)
Nasal Polyps (often associated with chronic rhinosinusitis)
Pathophysiology:
It is caused by an abnormality in arachidonic acid metabolism.
Non-selective NSAIDs/Aspirin inhibit the cyclooxygenase-1 (COX-1) enzyme.
This shunts arachidonic acid breakdown down the 5-lipoxygenase (5-LOX) pathway, leading to an overproduction of pro-inflammatory cysteinyl leukotrienes (\text{LTC}_4, \text{LTD}_4, \text{LTE}_4).
The excess leukotrienes trigger severe bronchospasm (asthma exacerbation) and persistent chronic nasosinusal inflammation with polyp formation.
A quick 30-second look at the key steps of hip hemiarthroplasty: from incision to implant placement and closure.
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I’ve long said, “successful bypass surgery is 1,000 perfect moves.” But perfection isn’t always attainable, which means we must know how to correct our mistakes. The mark of great surgeons isn’t perfection, but knowing those key moves that salvage a tough situation & get to success. Here, the “through stitch”….
الطب قاعد يفسر ليه diarrhea يعمل acidosis قال علشان بنفقد HCO3
و ال vomiting بيعمل alkalosis علشان بنفقد HCL
أنا في عالم موازي
Diarrhea من تحت ⬇️⬇️
يبقي PH ينزل لتحت ⬇️⬇️ يبقي acidosis
العكس بقا vomiting لفوق ⬆️⬆️
يبقي pH لفوق ⬆️⬆️ يبقي alkalosis
سهلة و مش مستهلة