This document discusses carcinoma of the bladder. It begins by defining bladder cancer and noting that it forms in bladder tissues and may infiltrate the bladder wall. It then covers the epidemiology, risk factors, pathophysiology, types, clinical manifestations, staging, grading, diagnosis and management of bladder cancer. Management includes surgery such as TURBT and cystectomy, chemotherapy, radiation therapy, and intravesical drug therapy. Nursing management involves assessment, education, managing anxiety and pain, and monitoring the urinary drainage system after any procedures.
This document summarizes bladder cancer, including its definition, epidemiology, risk factors, clinical manifestations, diagnosis, staging, treatment options, complications, nursing diagnoses, and recent research findings. Bladder cancer is the 4th most common cancer in men and 9th in women. Risk factors include smoking, occupational exposures, infections, and prior history of bladder cancer. Symptoms often include hematuria, urinary frequency and urgency. Diagnosis involves tests like cystoscopy, CT scans, and biopsy. Treatment depends on stage but may include surgery, chemotherapy, radiation, and immunotherapy. Complications can be related to alterations after surgery like body image issues or sexual/urinary changes.
This document provides information about prostate cancer, including:
1. It is the most common cancer in men over 65 and risk factors include age, family history, and diet high in red meat and fat.
2. Symptoms include urinary issues and pain, while advanced cancer can spread to bones and lymph nodes.
3. Diagnosis involves exams, blood tests, biopsies and imaging.
4. Treatment depends on stage but includes surgery, radiation, hormone therapy, and watchful waiting. Nursing focuses on education, managing symptoms, and preventing complications.
This document provides information about bladder carcinoma, including:
1. Bladder carcinoma is the most common cancer of the urinary tract, affecting men more than women. It is most common in the elderly, around ages 67-70.
2. Risk factors include family history, chemical exposure, smoking, irradiation, arsenic exposure, and urinary disorders. Preneoplastic abnormalities and carcinoma in situ can develop.
3. Transitional cell carcinoma accounts for 90% of bladder cancers and can range from low to high grade. Staging involves determining if the cancer is superficial, invasive, or metastatic. Treatment depends on the stage and grade.
Bladder cancer is the 7th most common cancer in the US. In 2014, there were 74,690 new cases and 15,580 deaths. Bladder cancer is more common in men than women. Risk factors include smoking, family history, occupational chemical exposure, and bladder infections. Symptoms include blood in the urine, frequent urination, and pain during urination. Diagnosis involves cystoscopy and biopsy. Staging uses CT, MRI, and PET scans to determine if the cancer has invaded the bladder wall or spread. Higher stage and grade cancers have a worse prognosis. Treatment and survival depend on the stage, with 5-year survival rates ranging from 96% for stage 0 to 5.5% for stage IV cancer
1. Bladder cancer is a type of cancer that forms in the bladder. It is more common in older males and risk factors include smoking, exposure to industrial chemicals, chronic bladder infections or irritation, and pelvic radiation.
2. Symptoms include blood in the urine, pain with urination, and low back pain. Diagnosis involves tests to detect cancer cells in urine or tissue samples.
3. Treatment depends on cancer stage and grade and may include surgery, chemotherapy, radiation therapy, immunotherapy, and intravesical therapies directly into the bladder. Ongoing monitoring is important due to the risk of recurrence.
This document provides an overview of bladder cancer, including its subtypes, risk factors, molecular landscape, management approaches, and outcomes. Key points include:
- Bladder cancer is categorized into non-muscle invasive (75%) and muscle invasive (25%) subtypes with different prognoses.
- Risk factors include smoking, chemical exposures, and infections. Molecular subtypes include luminal, basal, and neuroendocrine types.
- Treatment depends on invasiveness and risk level. Non-muscle invasive types often receive transurethral resection and adjuvant BCG therapy. Muscle invasive types may undergo radical cystectomy or trimodality therapy with chemotherapy and radiation.
- Prognosis depends
This document provides information about bladder cancer including its definition, types, risk factors, signs and symptoms, staging, diagnostic tests, and treatment options. It defines bladder cancer as uncontrolled growth of cells in the bladder and lists the main types as urothelial carcinoma, squamous cell carcinoma, and flat carcinoma. Risk factors include smoking, chemicals, and chronic infections. Signs may include blood in urine, urinary changes, bone pain, and weight loss. Staging uses TNM criteria and treatments include surgery, chemotherapy, radiation, immunotherapy, and managing side effects.
This document summarizes bladder cancer, including its definition, epidemiology, risk factors, clinical manifestations, diagnosis, staging, treatment options, complications, nursing diagnoses, and recent research findings. Bladder cancer is the 4th most common cancer in men and 9th in women. Risk factors include smoking, occupational exposures, infections, and prior history of bladder cancer. Symptoms often include hematuria, urinary frequency and urgency. Diagnosis involves tests like cystoscopy, CT scans, and biopsy. Treatment depends on stage but may include surgery, chemotherapy, radiation, and immunotherapy. Complications can be related to alterations after surgery like body image issues or sexual/urinary changes.
This document provides information about prostate cancer, including:
1. It is the most common cancer in men over 65 and risk factors include age, family history, and diet high in red meat and fat.
2. Symptoms include urinary issues and pain, while advanced cancer can spread to bones and lymph nodes.
3. Diagnosis involves exams, blood tests, biopsies and imaging.
4. Treatment depends on stage but includes surgery, radiation, hormone therapy, and watchful waiting. Nursing focuses on education, managing symptoms, and preventing complications.
This document provides information about bladder carcinoma, including:
1. Bladder carcinoma is the most common cancer of the urinary tract, affecting men more than women. It is most common in the elderly, around ages 67-70.
2. Risk factors include family history, chemical exposure, smoking, irradiation, arsenic exposure, and urinary disorders. Preneoplastic abnormalities and carcinoma in situ can develop.
3. Transitional cell carcinoma accounts for 90% of bladder cancers and can range from low to high grade. Staging involves determining if the cancer is superficial, invasive, or metastatic. Treatment depends on the stage and grade.
Bladder cancer is the 7th most common cancer in the US. In 2014, there were 74,690 new cases and 15,580 deaths. Bladder cancer is more common in men than women. Risk factors include smoking, family history, occupational chemical exposure, and bladder infections. Symptoms include blood in the urine, frequent urination, and pain during urination. Diagnosis involves cystoscopy and biopsy. Staging uses CT, MRI, and PET scans to determine if the cancer has invaded the bladder wall or spread. Higher stage and grade cancers have a worse prognosis. Treatment and survival depend on the stage, with 5-year survival rates ranging from 96% for stage 0 to 5.5% for stage IV cancer
1. Bladder cancer is a type of cancer that forms in the bladder. It is more common in older males and risk factors include smoking, exposure to industrial chemicals, chronic bladder infections or irritation, and pelvic radiation.
2. Symptoms include blood in the urine, pain with urination, and low back pain. Diagnosis involves tests to detect cancer cells in urine or tissue samples.
3. Treatment depends on cancer stage and grade and may include surgery, chemotherapy, radiation therapy, immunotherapy, and intravesical therapies directly into the bladder. Ongoing monitoring is important due to the risk of recurrence.
This document provides an overview of bladder cancer, including its subtypes, risk factors, molecular landscape, management approaches, and outcomes. Key points include:
- Bladder cancer is categorized into non-muscle invasive (75%) and muscle invasive (25%) subtypes with different prognoses.
- Risk factors include smoking, chemical exposures, and infections. Molecular subtypes include luminal, basal, and neuroendocrine types.
- Treatment depends on invasiveness and risk level. Non-muscle invasive types often receive transurethral resection and adjuvant BCG therapy. Muscle invasive types may undergo radical cystectomy or trimodality therapy with chemotherapy and radiation.
- Prognosis depends
This document provides information about bladder cancer including its definition, types, risk factors, signs and symptoms, staging, diagnostic tests, and treatment options. It defines bladder cancer as uncontrolled growth of cells in the bladder and lists the main types as urothelial carcinoma, squamous cell carcinoma, and flat carcinoma. Risk factors include smoking, chemicals, and chronic infections. Signs may include blood in urine, urinary changes, bone pain, and weight loss. Staging uses TNM criteria and treatments include surgery, chemotherapy, radiation, immunotherapy, and managing side effects.
A 73-year-old male presented with hematuria and irritative voiding symptoms. Further testing revealed high-grade urothelial carcinoma of the bladder that had invaded the bladder muscle. The patient received neoadjuvant chemotherapy followed by robotic cystoprostatectomy and urinary diversion surgery. Bladder cancer is usually transitional cell carcinoma and risk factors include smoking, occupational exposures, and prior radiation. Treatment depends on stage and grade but may include surgery, chemotherapy, and radiation.
1) The document discusses pancreatic neoplasms, including classification into exocrine and endocrine tumors.
2) It highlights adenocarcinoma of the pancreas, noting risk factors like smoking, chronic pancreatitis, genetics, and more.
3) Diagnosis involves imaging like CT/MRI, blood tests, and pathology examination of biopsies showing malignant cells and fibrosis.
The document provides an overview of bladder cancer, including types, risk factors, signs and symptoms, diagnostic tests, treatment options such as surgery, chemotherapy, and radiation therapy. It discusses various surgical procedures for bladder cancer like cystectomy, urinary diversions, and postoperative care including management of stomas, catheters, and instructions for patients.
This document provides information about prostate cancer, including:
- It is a cancer that occurs in the prostate gland and is one of the most common cancers in men. While some types grow slowly, others can spread quickly.
- Risk factors include age, family history, and race. Many times it causes no symptoms but can sometimes cause urinary or sexual issues.
- Diagnosis involves exams, blood tests, and biopsies. Treatment depends on stage but can include surgery, radiation, hormone therapy, chemotherapy, and active surveillance. Complications may include incontinence and erectile dysfunction. Prevention focuses on diet, exercise, and weight control.
Pancreatic cancer develops from DNA damage to cells in the pancreas that causes uncontrolled growth. Most cases are ductal adenocarcinoma. Risk factors include smoking, obesity, family history, and chronic pancreatitis. Symptoms include jaundice, abdominal pain, weight loss, and fatigue. Diagnosis involves imaging like CT, MRI, and endoscopic ultrasound. Only 20% of cases are surgically resectable; the remainder receive chemotherapy, radiation, or supportive care. Prognosis is generally poor with a median survival of 4-6 months for metastatic disease.
Management of prostate cancer involves assessing risk levels based on PSA, Gleason score, and percentage of positive biopsy cores. Treatment options include active surveillance for low risk prostate cancer with potential delayed treatment if cancer progresses. Radical prostatectomy is the gold standard for localized prostate cancer and provides the possibility of cure with minimal side effects when performed by an experienced surgeon. While providing excellent cancer control, radical prostatectomy carries risks of erectile dysfunction and urinary incontinence.
This document discusses treatment options for urinary bladder carcinoma. It covers non-muscle invasive bladder cancer (NMIBC), muscle invasive bladder cancer (MIBC), and metastatic disease. For NMIBC, transurethral resection of bladder tumor (TURBT) followed by intravesical immunotherapy like BCG is recommended. For MIBC, radical cystectomy with pelvic lymphadenectomy and urinary diversion is the standard treatment. Neoadjuvant chemotherapy may improve survival for MIBC. Adjuvant chemotherapy is recommended for high-risk MIBC following cystectomy.
This document discusses carcinoma of the rectum. It begins by explaining the anatomy of the rectum and its blood supply, lymphatic drainage and innervation. It then discusses the epidemiology, risk factors, staging systems including Dukes and TNM classification. Signs and symptoms, diagnostic workup including endoscopic, radiological and biopsy evaluation are explained. Principles of surgical treatment including resection margins are outlined. The goal of surgery is eradication of the primary tumor along with adjacent mesorectal tissue.
Colorectal cancer is the third most common cancer in India and develops from the colon or rectum. Risk factors include increasing age, family history of colon cancer, smoking, and a history of gastrectomy. Symptoms can include changes in bowel habits, rectal bleeding, abdominal pain, unintended weight loss, and rectal lesions. Diagnostic tests include abdominal and rectal exams, sigmoidoscopy, and virtual colonoscopy. Treatment may involve radiation therapy, chemotherapy with drugs like 5-flurouracil or capecitabine, and surgery. Prevention strategies aim to reduce risk through lifestyle changes.
The document discusses carcinoma of the pancreas. It covers the anatomy, epidemiology, risk factors, genetics, screening, staging, pathologic conditions, clinical presentation, evaluation, management approaches for resectable, borderline resectable, and unresectable disease, surgical procedures including Whipple procedure and distal pancreatectomy, complications, adjuvant therapy approaches studied in trials such as ESPAC-1, and the role of chemoradiation following gemcitabine chemotherapy.
Renal cell carcinoma arises from the lining of the proximal convoluted tubule in the kidney. It is the most common and lethal type of kidney cancer. RCC can be classified into several subtypes including clear cell and papillary. The incidence is rising and risk factors include smoking, obesity, and family history. Imaging tests such as CT scans and biopsies are used for diagnosis and staging. Surgery is the primary treatment if the cancer is confined to the kidneys, while targeted drug therapies may be options for advanced cases. Prognosis depends on staging, with 5-year survival rates ranging from 90% for small localized tumors to less than 5% if the cancer has metastasized to other organs.
The document discusses the anatomy and diagnostic evaluation of prostate cancer. It describes the prostate as a walnut-sized gland located below the bladder and surrounding the urethra. The primary function is to produce seminal fluid. Diagnostic workup involves PSA levels, digital rectal exam, prostate biopsy and various imaging modalities like CT, MRI, bone scan and PSMA PET/CT to stage disease extent and metastasis. Gleason scoring is used to grade prostate cancer based on architectural patterns seen on biopsy.
This document provides an overview of renal cell carcinoma (RCC). It discusses the epidemiology, clinical presentation, management, and prognosis of RCC. RCC arises from renal tubular epithelium and accounts for 80-85% of kidney cancers. Risk factors include genetic predispositions, smoking, occupational exposures, and obesity. Clinical evaluation involves history, exam, lab tests, and imaging studies. Management depends on staging and may include surgery, targeted therapy, immunotherapy, or palliative care. Prognosis depends on stage, grade, size and histological type of the tumor.
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
This document provides tips for using a PowerPoint presentation (PPT) as an active learning tool. Some key points:
- Blank slides are included between content slides to allow time for student discussion of what they already know about each topic.
- The presenter should first show a blank slide, ask students for their input, then show the next slide with content.
- This process of blank slide + discussion, then content slide, is repeated for each topic and can be done through multiple revisions for deeper learning.
- It can be used for self-study by displaying a blank slide, thinking about what you know, then reading the next content slide.
Urinary diversion involves redirecting the urinary pathway from the bladder due to conditions like muscle invasive bladder cancer. There are various types including continent, incontinent, internal, and external diversions. The ileal conduit is the most common non-continent diversion and involves using a segment of ileum as a urinary conduit connected to an abdominal stoma. Continent diversions like the Indiana pouch create an internal pouch that allows intermittent self-catheterization. Complications of urinary diversion can include metabolic abnormalities, infections, stone formation, and nutritional deficiencies depending on the bowel segment used.
This document provides an overview of bladder cancer presented by Dr. Vikas Kumar. Some key points:
- Bladder cancer is the 9th most common cancer worldwide and the 13th most common cause of death. Risk factors include smoking, occupational exposures, infections, and genetic factors.
- At initial presentation, 80% of bladder cancers are non-muscle invasive. Staging involves evaluating the extent of primary tumor invasion and spread to lymph nodes and distant organs.
- Diagnosis involves cystoscopy, urine cytology, and imaging tests. Random bladder biopsies are also recommended to detect cancers that cannot be seen.
- For non-muscle invasive cancers, the main treatment is transure
Bladder cancer is one of the most common cancers in the United States. It typically begins in the innermost tissue layer of the bladder called the urothelium. The most common type is transitional cell carcinoma, which accounts for around 90% of cases. Risk factors include smoking, exposure to certain chemicals, and bladder infections. Diagnosis involves tests like cystoscopy, CT scans, and urine analysis. Treatment depends on the stage of cancer, and may include surgery to remove part or all of the bladder or chemotherapy and radiation.
The document discusses various innovative teaching methods that can be used to improve upon traditional teaching approaches. It describes limitations of traditional teaching, such as one-way information flow and an overemphasis on theory. Innovative methods discussed include multimedia learning using tools like PowerPoint; brainstorming to promote creative thinking; problem-solving approaches like inductive and deductive reasoning; mind maps to organize information visually; using humor to create a relaxed learning environment; and teaching concepts from applications to definitions using a "Z to A" approach. The goal of innovative methods is to develop lifelong learners and deeper learning through greater interactivity and multisensory lessons.
An 40 year old woman presented with complaints of painful urination, urgency, lower back pain and burning urination. Urine culture showed 105 colony-forming units/ml of bacteria. She was treated with an antibiotic (Trimethoprim–sulfamethoxazole) twice daily for 3 days and pain medication, which reduced her symptoms. Urinary tract infections are common and occur when bacteria or other microbes infect the urethra, bladder, ureters, or kidneys. Symptoms include painful urination and back pain. Diagnosis involves a urine test and culture. Treatment is usually a short course of antibiotics along with pain medication and hydration.
A 73-year-old male presented with hematuria and irritative voiding symptoms. Further testing revealed high-grade urothelial carcinoma of the bladder that had invaded the bladder muscle. The patient received neoadjuvant chemotherapy followed by robotic cystoprostatectomy and urinary diversion surgery. Bladder cancer is usually transitional cell carcinoma and risk factors include smoking, occupational exposures, and prior radiation. Treatment depends on stage and grade but may include surgery, chemotherapy, and radiation.
1) The document discusses pancreatic neoplasms, including classification into exocrine and endocrine tumors.
2) It highlights adenocarcinoma of the pancreas, noting risk factors like smoking, chronic pancreatitis, genetics, and more.
3) Diagnosis involves imaging like CT/MRI, blood tests, and pathology examination of biopsies showing malignant cells and fibrosis.
The document provides an overview of bladder cancer, including types, risk factors, signs and symptoms, diagnostic tests, treatment options such as surgery, chemotherapy, and radiation therapy. It discusses various surgical procedures for bladder cancer like cystectomy, urinary diversions, and postoperative care including management of stomas, catheters, and instructions for patients.
This document provides information about prostate cancer, including:
- It is a cancer that occurs in the prostate gland and is one of the most common cancers in men. While some types grow slowly, others can spread quickly.
- Risk factors include age, family history, and race. Many times it causes no symptoms but can sometimes cause urinary or sexual issues.
- Diagnosis involves exams, blood tests, and biopsies. Treatment depends on stage but can include surgery, radiation, hormone therapy, chemotherapy, and active surveillance. Complications may include incontinence and erectile dysfunction. Prevention focuses on diet, exercise, and weight control.
Pancreatic cancer develops from DNA damage to cells in the pancreas that causes uncontrolled growth. Most cases are ductal adenocarcinoma. Risk factors include smoking, obesity, family history, and chronic pancreatitis. Symptoms include jaundice, abdominal pain, weight loss, and fatigue. Diagnosis involves imaging like CT, MRI, and endoscopic ultrasound. Only 20% of cases are surgically resectable; the remainder receive chemotherapy, radiation, or supportive care. Prognosis is generally poor with a median survival of 4-6 months for metastatic disease.
Management of prostate cancer involves assessing risk levels based on PSA, Gleason score, and percentage of positive biopsy cores. Treatment options include active surveillance for low risk prostate cancer with potential delayed treatment if cancer progresses. Radical prostatectomy is the gold standard for localized prostate cancer and provides the possibility of cure with minimal side effects when performed by an experienced surgeon. While providing excellent cancer control, radical prostatectomy carries risks of erectile dysfunction and urinary incontinence.
This document discusses treatment options for urinary bladder carcinoma. It covers non-muscle invasive bladder cancer (NMIBC), muscle invasive bladder cancer (MIBC), and metastatic disease. For NMIBC, transurethral resection of bladder tumor (TURBT) followed by intravesical immunotherapy like BCG is recommended. For MIBC, radical cystectomy with pelvic lymphadenectomy and urinary diversion is the standard treatment. Neoadjuvant chemotherapy may improve survival for MIBC. Adjuvant chemotherapy is recommended for high-risk MIBC following cystectomy.
This document discusses carcinoma of the rectum. It begins by explaining the anatomy of the rectum and its blood supply, lymphatic drainage and innervation. It then discusses the epidemiology, risk factors, staging systems including Dukes and TNM classification. Signs and symptoms, diagnostic workup including endoscopic, radiological and biopsy evaluation are explained. Principles of surgical treatment including resection margins are outlined. The goal of surgery is eradication of the primary tumor along with adjacent mesorectal tissue.
Colorectal cancer is the third most common cancer in India and develops from the colon or rectum. Risk factors include increasing age, family history of colon cancer, smoking, and a history of gastrectomy. Symptoms can include changes in bowel habits, rectal bleeding, abdominal pain, unintended weight loss, and rectal lesions. Diagnostic tests include abdominal and rectal exams, sigmoidoscopy, and virtual colonoscopy. Treatment may involve radiation therapy, chemotherapy with drugs like 5-flurouracil or capecitabine, and surgery. Prevention strategies aim to reduce risk through lifestyle changes.
The document discusses carcinoma of the pancreas. It covers the anatomy, epidemiology, risk factors, genetics, screening, staging, pathologic conditions, clinical presentation, evaluation, management approaches for resectable, borderline resectable, and unresectable disease, surgical procedures including Whipple procedure and distal pancreatectomy, complications, adjuvant therapy approaches studied in trials such as ESPAC-1, and the role of chemoradiation following gemcitabine chemotherapy.
Renal cell carcinoma arises from the lining of the proximal convoluted tubule in the kidney. It is the most common and lethal type of kidney cancer. RCC can be classified into several subtypes including clear cell and papillary. The incidence is rising and risk factors include smoking, obesity, and family history. Imaging tests such as CT scans and biopsies are used for diagnosis and staging. Surgery is the primary treatment if the cancer is confined to the kidneys, while targeted drug therapies may be options for advanced cases. Prognosis depends on staging, with 5-year survival rates ranging from 90% for small localized tumors to less than 5% if the cancer has metastasized to other organs.
The document discusses the anatomy and diagnostic evaluation of prostate cancer. It describes the prostate as a walnut-sized gland located below the bladder and surrounding the urethra. The primary function is to produce seminal fluid. Diagnostic workup involves PSA levels, digital rectal exam, prostate biopsy and various imaging modalities like CT, MRI, bone scan and PSMA PET/CT to stage disease extent and metastasis. Gleason scoring is used to grade prostate cancer based on architectural patterns seen on biopsy.
This document provides an overview of renal cell carcinoma (RCC). It discusses the epidemiology, clinical presentation, management, and prognosis of RCC. RCC arises from renal tubular epithelium and accounts for 80-85% of kidney cancers. Risk factors include genetic predispositions, smoking, occupational exposures, and obesity. Clinical evaluation involves history, exam, lab tests, and imaging studies. Management depends on staging and may include surgery, targeted therapy, immunotherapy, or palliative care. Prognosis depends on stage, grade, size and histological type of the tumor.
This document provides an overview of the history and techniques for orthotopic neobladder urinary diversion. Some key points:
- Orthotopic diversion was pioneered in the 1950s as an alternative to ureterosigmoidostomy and ileal conduit diversion due to complications of those procedures.
- Patient selection considers oncologic factors like risk of urethral recurrence and tumor stage, as well as patient factors like age, renal function, manual dexterity, and prior treatments.
- Surgical techniques aim to optimize continence by preserving the rhabdosphincter and its innervation during cystectomy. For males the urethra is detached in a retrograde
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
This document provides tips for using a PowerPoint presentation (PPT) as an active learning tool. Some key points:
- Blank slides are included between content slides to allow time for student discussion of what they already know about each topic.
- The presenter should first show a blank slide, ask students for their input, then show the next slide with content.
- This process of blank slide + discussion, then content slide, is repeated for each topic and can be done through multiple revisions for deeper learning.
- It can be used for self-study by displaying a blank slide, thinking about what you know, then reading the next content slide.
Urinary diversion involves redirecting the urinary pathway from the bladder due to conditions like muscle invasive bladder cancer. There are various types including continent, incontinent, internal, and external diversions. The ileal conduit is the most common non-continent diversion and involves using a segment of ileum as a urinary conduit connected to an abdominal stoma. Continent diversions like the Indiana pouch create an internal pouch that allows intermittent self-catheterization. Complications of urinary diversion can include metabolic abnormalities, infections, stone formation, and nutritional deficiencies depending on the bowel segment used.
This document provides an overview of bladder cancer presented by Dr. Vikas Kumar. Some key points:
- Bladder cancer is the 9th most common cancer worldwide and the 13th most common cause of death. Risk factors include smoking, occupational exposures, infections, and genetic factors.
- At initial presentation, 80% of bladder cancers are non-muscle invasive. Staging involves evaluating the extent of primary tumor invasion and spread to lymph nodes and distant organs.
- Diagnosis involves cystoscopy, urine cytology, and imaging tests. Random bladder biopsies are also recommended to detect cancers that cannot be seen.
- For non-muscle invasive cancers, the main treatment is transure
Bladder cancer is one of the most common cancers in the United States. It typically begins in the innermost tissue layer of the bladder called the urothelium. The most common type is transitional cell carcinoma, which accounts for around 90% of cases. Risk factors include smoking, exposure to certain chemicals, and bladder infections. Diagnosis involves tests like cystoscopy, CT scans, and urine analysis. Treatment depends on the stage of cancer, and may include surgery to remove part or all of the bladder or chemotherapy and radiation.
The document discusses various innovative teaching methods that can be used to improve upon traditional teaching approaches. It describes limitations of traditional teaching, such as one-way information flow and an overemphasis on theory. Innovative methods discussed include multimedia learning using tools like PowerPoint; brainstorming to promote creative thinking; problem-solving approaches like inductive and deductive reasoning; mind maps to organize information visually; using humor to create a relaxed learning environment; and teaching concepts from applications to definitions using a "Z to A" approach. The goal of innovative methods is to develop lifelong learners and deeper learning through greater interactivity and multisensory lessons.
An 40 year old woman presented with complaints of painful urination, urgency, lower back pain and burning urination. Urine culture showed 105 colony-forming units/ml of bacteria. She was treated with an antibiotic (Trimethoprim–sulfamethoxazole) twice daily for 3 days and pain medication, which reduced her symptoms. Urinary tract infections are common and occur when bacteria or other microbes infect the urethra, bladder, ureters, or kidneys. Symptoms include painful urination and back pain. Diagnosis involves a urine test and culture. Treatment is usually a short course of antibiotics along with pain medication and hydration.
Este documento resume conceptos clave sobre la percepción desde la perspectiva de la psicología de la Gestalt. Explica que la percepción implica la selección y organización de la información sensorial según la experiencia previa de una persona. También describe que la percepción depende del contexto y puede variar entre individuos. Finalmente, resume que la teoría de la Gestalt estudia las estructuras psicológicas como totalidades organizadas y significativas, dando importancia a cómo se forman las percepciones.
Managers control hospital costs through various budgeting processes including fixed, flexible, operating, and strategic budgets. Fixed budgets do not change with volume while flexible budgets change based on actual activity levels. Operating budgets project annual expenses and strategic budgets focus on long-term trends. Organizations deal with changes in the short, intermediate, and long-run through measures like adjusting staffing levels. Hospital costs vary due to differences in services, cost-shifting, patient illness, and production efficiency. Regulatory approaches to controlling costs include certificate of need laws, utilization review, professional standards review organizations, and administered pricing systems like DRGs and PPS.
Cómo encontrar el elemento en la educación renovadoIvonne Rodriguez
Este documento discute cómo mejorar la educación en México alejándose del enfoque actual. Argumenta que no todos los estudiantes se desempeñan bien bajo los estándares actuales y que las habilidades de cada persona deben valorarse. También sugiere que la educación básica es más importante que la superior y que los maestros deben ser guías para los estudiantes en lugar de simplemente enseñar el plan de estudios.
3V0-622 objective-3.1-logical-physical with Joe Clarke @elgwhoppoJoe Clarke
The document provides an overview of the objectives for transitioning from a logical design to a physical design for a vSphere 6.x environment. It begins with an introduction by Joe Clarke and then outlines the following key points:
1. It reviews the conceptual, logical, and physical design phases to refresh understanding of the differences between each.
2. For objective 3.1, it discusses analyzing design decisions and options from the logical design to determine their impact on various factors like availability, performance, security, and cost in the physical design.
3. For objective 3.1, it also covers determining the impact of applying VMware best practices to identified risks, constraints, and assumptions in a given design.
El documento describe los beneficios de los huertos escolares agroecológicos para la sostenibilidad y soberanía alimentaria. Propone educar a los niños sobre la producción de alimentos, el reciclaje y el respeto por la naturaleza para formar ciudadanos saludables y autosuficientes. También aboga por la soberanía alimentaria, el derecho a producir y decidir qué se consume, y promueve la agricultura ecológica y los huertos comunitarios como modelos educativos.
Este documento resume la evidencia a favor del uso de la polipíldora en la prevención secundaria de enfermedades cardiovasculares. La polipíldora combina múltiples fármacos en una sola pastilla para mejorar la adherencia al tratamiento. Estudios muestran que la polipíldora incrementa la adherencia y reduce eventos cardiovasculares. Actualmente, la polipíldora Trinomia es la única aprobada en Europa para prevención secundaria cardiovascular.
Que es un accidente de trabajo?
Cuál es la diferencia entre causas básicas y causas inmediatas?
Cuáles son los factores de riesgo o peligros laborales generadores de accidentes de trabajo?
Cuál es la diferencia entre acto inseguro y condición insegura?
Cuál es la diferencia entre factor personal y factor del trabajo?
Los árabes comparten una identidad étnica definida por su lengua, el árabe, más que por su religión. Actualmente la mayoría son musulmanes pero existen minorías cristianas y judías. Dentro del islam árabe existen varias ramas como los suníes y chiíes. Los árabes cristianos suelen seguir iglesias orientales como la coptas o maronitas.
This presentation discusses the key differences between marketing and selling. Marketing is defined as a process of transferring a product or service to a buyer at a competitive price in order to satisfy their needs. It focuses on understanding customer needs and converting them into products. Selling, on the other hand, is a process of transferring a product regardless of customer needs and focuses on earning profits. The main differences are that marketing starts with understanding customers while selling starts with the product, marketing aims for customer satisfaction and selling aims for sales, and marketing involves additional activities like research while selling is just one part of marketing.
Opening credits at the beginning of films list the director, producers, editor, soundtrack composer, and main actors and actresses involved in making the film. While there is no single main reason for opening credits, they serve to recognize the status of those involved by displaying their names, and get their names recognized as most viewers have stopped paying attention by the end of the closing credits.
Este documento contiene 20 preguntas de matemáticas para una prueba SIMCE de 8o año básico. Las preguntas cubren una variedad de temas matemáticos como porcentajes, proporciones, álgebra, geometría y más. Algunas preguntas requieren que los estudiantes calculen valores numéricos, mientras que otras piden explicaciones o fundamentaciones de las respuestas.
The document discusses various techniques for implementing subprograms in programming languages. It covers:
1) The general semantics of calls and returns between subprograms and the actions involved.
2) Implementing simple subprograms with static local variables and activation records.
3) Implementing subprograms with stack-dynamic local variables using run-time stacks and activation records.
4) Techniques for implementing nested subprograms using static linking chains to access nonlocal variables.
El documento habla sobre los accesos vasculares para hemodiálisis. Explica que existen dos tipos principales: las fistulas arteriovenosas y los catéteres venosos centrales. Las fistulas arteriovenosas son el acceso ideal porque permiten un flujo suficiente para la hemodiálisis y tienen pocas complicaciones. Sin embargo, a veces se requieren catéteres venosos centrales temporales o permanentes. Tanto los accesos como los catéteres pueden presentar complicaciones como trombosis, infección, síndrome del
This document summarizes the key topics covered in an entrepreneurship training program. Session 3 focuses on turning passions into business opportunities. It provides examples of how Mark Zuckerberg turned his passion for connecting people into Facebook. It then lists 7 tips for transforming a passion into a business reality, such as defining the sellable element and understanding customers. The presentation emphasizes creating a business plan that addresses problems, proposed solutions, business models, marketing strategies, competition, team members, and financial projections.
The document discusses the impact of digital platforms on the sharing economy, using Airbnb as a case study. It makes three key points:
1) Airbnb has grown rapidly due to technological innovations that allow individuals to share unused resources through an online platform. This platform model reduces transaction costs and builds trust between strangers.
2) As a digital platform, Airbnb utilizes a modular system that facilitates product innovation and achieves economies of scale. It also executes control over hosts and customers through mechanisms like reviews, commissions, and branding.
3) The emergence of sharing platforms like Airbnb is driven by consumers' desire for new economic and experiential options beyond traditional hotels. This competition has led
Wk3 classical vs_developmental_theories_of_play: Spot the DifferenceSimone Crighton
Hall's Recapitulation theory of play suggests that play allows children to engage in instinctive activities no longer necessary for survival, while Smilansky's 4 Stages theory says play evolves with children's cognitive development. Hall's theory sees play as unstructured, while Smilansky's identifies 4 stages from sensory exploration to rule-based games. The theories provide different rationales for why children play and how play changes as they grow.
This document provides information about esophageal cancer, including its symptoms, risk factors, diagnosis process, staging, and treatment options. It discusses that esophageal cancer occurs when cancer cells develop in the esophagus and there are two main types: squamous cell carcinoma and adenocarcinoma. Risk factors include smoking, heavy alcohol use, and gastroesophageal reflux disease. Diagnosis involves various imaging tests and biopsies. Treatment depends on cancer type and stage, and may include surgery, chemotherapy, radiation, or targeted drug therapies. Complications are also discussed.
The document provides an overview of cancer nursing. It defines cancer and describes the signs and symptoms of common cancer types like lung, colon, breast, uterine, prostate, and bladder cancer. It also discusses the causes of cancer, diagnostic tests, treatment goals and modalities like surgery, radiation therapy, and chemotherapy. Treatment modalities aim to cure, control, or palliate cancer while minimizing risks to patients.
Cervical cancer develops slowly over time and is usually caused by HPV infection. It begins in the cervix and can spread to other nearby tissues and organs. Early stage cancers are often asymptomatic while later stages may cause abnormal bleeding or discharge. Diagnosis involves pap smears, biopsies, and imaging tests. Treatment depends on the stage but may include surgery, radiation, chemotherapy, or a combination. Adopting safe sex practices, getting the HPV vaccine, and undergoing regular pap smears can help prevent cervical cancer.
Ovarian cancer arises from the epithelial tissue lining the ovaries. There are several classifications of ovarian cancer including surface epithelial tumors, germ cell tumors, and sex cord stromal tumors. Risk factors include nulliparity and family history. Symptoms are often vague but include abdominal pain or bloating. Staging involves examining if the cancer is localized to the ovaries or has spread within the pelvis or further. Treatment depends on the stage but commonly involves surgery to remove the ovaries and chemotherapy. Prognosis is best for early stage disease and worse for late stage disease.
This document provides an overview of cancer and its treatment from a nursing perspective. It begins by defining cancer and describing the characteristics of benign and malignant tumors. It then discusses cancer causes, types, diagnosis, staging, and treatments including surgery, radiation therapy, and chemotherapy. Nursing management focuses on educating patients, minimizing side effects, and providing psychological support. The document provides a comprehensive yet concise introduction to oncology nursing.
The document discusses several uterine disorders including endometrial polyps, uterine fibroids, endometriosis, and adenomyosis. It provides details on their characteristics, risk factors, clinical presentation, investigations, and treatment options. The document also discusses malignant disorders of the uterus including endometrial cancer and cervical cancer. It covers their etiology, staging, signs and symptoms, diagnostic workup, and management approaches.
Esophageal cancer is a malignant tumor that arises from the esophagus. It has several histological forms but squamous cell carcinoma is most common. Risk factors include smoking, drinking alcohol, and gastroesophageal reflux disease. Symptoms include difficulty swallowing and weight loss. Treatment depends on the cancer stage but may involve surgery to remove the esophagus, chemotherapy, and radiation therapy. Preventive measures include not smoking, limiting alcohol, and treating gastroesophageal reflux disease.
Gastric carcinoma is the second most common cancer-related death worldwide. It typically spreads through direct extension, lymphatics, or hematogenously to distant sites like the liver. Staging involves endoscopy, imaging, and biopsy to determine the depth of invasion and lymph node involvement. Surgery aims to perform a curative resection with negative margins and lymph node dissection, but outcomes remain poor with high rates of recurrence.
Breast cancer is a disease that primarily affects women and can develop in the lobules or ducts of the breast. The presentation discussed types of breast cancer, including ductal carcinoma in situ and invasive lobular carcinoma, as well as risk factors like family history, menstrual history, radiation exposure, and lifestyle. Diagnostic tests for breast cancer include mammography, ultrasound, and biopsy. Treatment involves surgery to remove cancerous tissue, which may be lumpectomy or mastectomy, as well as chemotherapy, radiation therapy, and hormonal therapy. Nursing care focuses on pre-operative teaching, postoperative wound care, managing side effects and providing psychosocial support.
Colorectal cancer begins in the colon or rectum. It is the third most common cancer globally and incidence increases with age. Risk factors include family history, diet high in red meat, and certain medical conditions. Symptoms include changes in bowel habits, blood in stool, and abdominal discomfort. Diagnosis involves tests like colonoscopy, biopsy, and blood tests. Treatment depends on stage and location of cancer and may include surgery, chemotherapy, and radiation. Nursing care focuses on managing pain, nutrition, and educating patients. Prevention includes exercise, limiting red meat, and screening to detect and remove precancerous polyps.
This document discusses gastric carcinoma. It begins by defining gastric carcinoma as a malignant lesion of the stomach. It then discusses the epidemiology and risk factors, noting that incidence is highest in Japan and declining worldwide. Common clinical presentations include dyspepsia, epigastric pain, weight loss, and vomiting. Diagnostic tests include endoscopy with biopsy, which has high accuracy. Staging involves evaluating depth of invasion and lymph node involvement. Treatment options are surgery, chemotherapy, and radiotherapy. Prognosis depends on stage, with early-stage carcinoma having high 5-year survival rates.
Esophageal cancer develops in the esophagus, the tube connecting the throat to the stomach. There are two main types: squamous cell carcinoma and adenocarcinoma. Risk factors include smoking, heavy alcohol use, gastroesophageal reflux disease, and Barrett's esophagus. Diagnosis involves endoscopy, biopsy, and imaging tests. Treatment depends on cancer stage and health but may include surgery, radiation, chemotherapy, targeted therapy, or palliative care. Prognosis ranges from 47% 5-year survival for localized cancer to 5% for distant stage cancer.
This document provides an overview of breast carcinoma, including its anatomy, etiology, epidemiology, clinical presentation, classification, staging, diagnosis, and management. Some key points include:
- Breast carcinoma is the most common cancer in women worldwide and a leading cause of cancer death. Risk factors include genetics, hormones, lifestyle.
- The breast is composed of lobules that drain into ducts and is supported by ligaments. Lymph nodes in the axilla are the primary drainage site.
- Clinical presentation varies from asymptomatic to palpable lumps, skin changes, nipple abnormalities. Mammography and biopsy are used for diagnosis.
- Treatment involves surgery (mastectomy or lumpectomy), radiation,
The document provides information on various topics related to oncology and cancer treatment. It defines oncology as the branch of medical science dealing with tumors, and cancer as uncontrolled growth of abnormal cells that can spread. The stages of cancer are described using the TNM system which evaluates the size of the primary tumor (T), spread to lymph nodes (N), and metastasis (M). Common cancer treatment modalities are discussed, including chemotherapy, radiation therapy, immunotherapy, hormone therapy, and surgery. Side effects of treatments are also summarized.
A brief description on cancer.Cancer – a large group of diseases characterized by the uncontrolled growth and spread of abnormal cells,Some topics are genesis of cancer,types of cancer,causes of cancer like Heredity,Immunity,Chemical,Physical,Viral Bacterial,Lifestyle.
,sign&symptom:*Change in bowel habits or bladder function,*Sores that do not heal,*Unusual bleeding or discharge,*Thickening or lump in breast or other parts of the body,Indigestion or trouble swallowing,*Recent change in a wart or mole,Nagging cough or hoarseness,
diagnosis and staging,treatment:Surgery,Radiation,Chemotherapy,Immunotherapy,Hormone therapy, Gene therapy,side effect of cancer treatment,prevention of cancer
This document discusses endometrial carcinoma (cancer of the uterus). It provides information on:
- Risk factors including prolonged estrogen exposure, nulliparity, obesity, and tamoxifen use.
- Types include endometrioid adenocarcinoma (most common), adenocarcinoma with squamous differentiation, clear cell carcinoma, and uterine papillary serous carcinoma.
- Staging from Stage I (limited to uterus) to Stage IV (distant metastases). Prognosis is generally good due to late invasion and spread but worsens with higher stage, grade, and certain histological types.
- Investigations include ultrasound, endometrial biopsy/sampling, and MRI or
Breast cancer is the most common cancer in women. It develops from breast cells, usually in the milk ducts or lobules. Risk factors include age, family history, lifestyle. Symptoms may include a breast lump or nipple changes. Diagnosis involves mammogram, biopsy. Treatment depends on cancer type and stage but may include surgery, radiation, chemotherapy, hormone therapy. New targeted therapies are improving survival rates.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
2. At the end of the class….
Understand what is cancer bladder
Epidemiology
Risk factors
Pathophysiology
Types and clinical manifestations
Staging and grading
Management
3. Carcinoma Bladder
Cancer that forms in tissues of the bladder and that
may infiltrate the bladder wall.
As tumor progresses it may extend in to the
retroperitoneal structures.
5. Epidemiology
In India 4th
common cancer in men &
8th
common cancer in females.
2-3 times common in men
Male to female ratio= 2.4:1
Commonly occurs in people over 55yrs or above
6. Risk factors
Smoking-active and passive
Exposure to carcinogen (aniline, asbestos,
aromatic amines, arsenic)
Occupational risk (hair dressers,
painters, truck drivers, rubber,
textile, metal workers)
Chronic bladder irritation (UTI’s)
7. Risk factors…
Chemotherapy and Pelvic
radiation
Bladder birth defects
Diet high in saturated fat
Personal/family Hx of bladder
Cancer
Excessive Consumption of
coffee, artificial sweetners, low
fluid diet.
8. Pathophysiology
Exposure of the bladder wall to a carcinogen
Bladder wall irritation
Pre malignant changes start from the transitional layer
These changes are called as cell dysplasia
Formation of warts like growths in the wall
9. Pathophysiology
Formation of locally invasive carcinoma in situ
Penetrates the submucosal and mucosal layer of the
bladder forming deep invasive cancers
Progress to adjacent structures {retroperitoneal
structures}
Distant metastasis to liver,bone,lungs through LNs,Bld
12. Staging
TX: Main tumor cannot be
assessed due to lack of
information
T0: No evidence of a primary tumor
Ta: Non-invasive papillary carcinoma
Tis: Non-invasive flat carcinoma (flat carcinoma in
situ, or CIS)
13. T1: The tumor has grown from the layer of cells
lining the bladder into the connective tissue below. It
has not grown into the muscle layer of the bladder.
T2: The tumor has grown into the muscle layer.
T2a: The tumor has grown only into the inner half of
the muscle layer.
T2b: The tumor has grown into the outer half of the
muscle layer.
14. T3: The tumor has grown through the muscle layer
of the bladder and into the fatty tissue surrounding it
T3a: The spread to fatty tissue can only be seen by
using a microscope.
T3b: The spread to fatty tissue is large enough to be
seen on imaging tests or to be seen or felt by the
surgeon
15. T4: The tumor has spread beyond the fatty tissue and
into nearby organs or structures. It may be growing into
any of the following: the stroma (main tissue) of the
prostate, the seminal vesicles, uterus, vagina, pelvic wall,
or abdominal wall.
T4a: The tumor has spread to the stroma of the prostate
(in men), or to the uterus and/or vagina (in women).
T4b: The tumor has spread to the pelvic wall or the
abdominal wall
16.
17. NX: Regional lymph nodes cannot be assessed due
to lack of information.
N0: There is no regional lymph node spread.
N1: The cancer has spread to a single lymph node in
the true pelvis.
N2: The cancer has spread to 2 or more lymph nodes
in the true pelvis.
N3: The cancer has spread to lymph nodes along the
common iliac artery
18. M0: There are no signs of distant spread.
M1: The cancer has spread to distant parts of the
body. (The most common sites are distant
lymph nodes, the bones, the lungs, and the liver).
19. Staging of Ca Bladder
Stage 0:Stage 0: Cancer cells are found only on the inner
lining of the bladder
Stage IStage I: Cancer cells have proliferated to the layer
beyond the inner lining of the urinary bladder but
not to the muscles of the urinary bladder.
Stage II:Stage II: Cancer cells have proliferated to the
muscles in the bladder wall but not to the fatty tissue
that surrounds the urinary bladder.
20. Stage IIIStage III:: Cancer cells have proliferated to the fatty
tissue surrounding the urinary bladder and to the
prostate gland, vagina, or uterus, but not to the lymph
nodes or other organs.
Stage IVStage IV: Cancer cells have proliferated to the lymph
nodes, pelvic or abdominal wall, and/or other organs.
RecurrentRecurrent: Cancer has recurred in the urinary bladder
or in another nearby organ after having been treated
21.
22. Grading bladder cancer
Grading describes how aggressive the cancer cells
are:
• Low grade – The cancer cells look fairly normal
and behave similarly to healthy cells. The cells tend
to grow slowly. Most bladder tumours are low grade.
• High grade – The cancer cells look very abnormal
and grow in a disorderly way. These cells tend to
grow very quickly.
Bladder cancer can also be graded on a scale of 1–3.
Grade 1 cancers are the slowest growing and grade 3
cancers are the most aggressive
23. Diagnosis
Complete medical Hx
Cystoscopy and biopsy
CT, USG, Excretory urography
Bimanual examination
Cytologic examination of fresh urine and saline bladder
washing.
Bladder tumour antigens, nuclear matrix proteins, growth
factors, cytoskeletal proteins etc.
40. Nursing assessment
Take careful health, medical and Sx history.
Assess for changes in urine or urination patterns.
Assess risk from carcinogen exposure.
Assess for any drug, chemical or food allergy.
41. Nursing assessment
Assessment of the client for anxiety, coping,
disease related knowledge.
Assist in Routine investigations
Written informed consent.
monitoring pre-op vital signs
Complete self-care & functional assessment.
42. Pre-op Nursing Management
1. Deficient knowledge R/T Ca bladder diagnosis,
diagnostic testing, surgical intervention
Provide teaching
Encourage discussion
Explain purpose of various tubings like catheters,
NG tube etc.
Explanation abt various tubes ,catheters
Discuss abt bowel preparation
Pre –op teaching abt stoma care, catheterisation of
stoma.
43. Pre-op Nursing Management
2.Risk for disturbed body image R/t Sx, possible post op stoma,
sexual dysfunction, change in urinary elimination
Explanation for surgical procedure
Suggest a visit to a client with similar diagnosis and
procedure.
Choosing the appropriate site for stoma construction
Discuss lifestyle changes because of stoma or urinary
diversion
Counselling for risk for sexual dysfunction
Community support groups
Family counselling
44. 3.Anxiety related to crisis situations (cancer), health change,
socio-economics, the role and functions, form interaction,
preparation of death, separation of the family.
Determine the patient's experience prior to the illness.
Provide accurate information about prognosis
Give the client an opportunity to express anger, fear,
confrontation. Give the information with reasonable emotion
and expression of the corresponding
Explain the treatment, the purpose and side effects. Helps
patients prepare for treatment
Note the ineffective coping such as lack of social interaction,
impotence etc.
Encourage to develop interaction with the support system
Provide a quiet environment and comfortable
Maintain contact with patients, talk and touch with them.
45. Post –op Nursing Management
AssessmentAssessment
Routine post op evaluation
Stoma site monitoring
Maintaining NPO status untill bowel sounds returns
Assessment of nasogastric contents and stools
Minimal handling of the tubings
Monitor Hrly urine output, pH.
46. Post –op Nursing Management
AssessmentAssessment
Adequate fluid support
patency & cont. drainage monitoring
Catheterise the client if stoma is present
Observe for hematuria, stenosis, incontinence,
difficult catheterazation
Prevent electrolyte imbalances
47. Post –op Nursing Management
Acute pain r/t surgical incision
Administration of analgesic medication
Deep breathing exercises
Patient controlled analgesia
Pain intensity scale is used to evaluate the adequacy
of the medication and the approach to pain
management
48. Post –op Nursing Management
Risk for injury R/t occlusion of urinary
drainage
Monitor vitals, incision lines, s/s of bleeding
Maintain continuous drainage of urine
Frequent catheter irrigation with N/S
Catheterise stoma until it heals
Label & seperately monitor each tubes
Inspect the abdomen for distention
49. Post –op Nursing Management
Risk for impaired skin integrity r/t problems
in managing the urine collection appliance
Keep the drainage system intact
Proper skin care
Skin care techniques are teached to the family
members to prevent ulceration around the stoma
Adequate nutrition
Long –term management of the stoma is teached
50. Post-op care after urinary diversion
Altered urinary elimination related to urinary diversion
Maintain a transparent urostomy pouch over the stoma
post operatively for easy assessment
Inspect the stoma for colour and size
Report any bleeding , necrosis, sloughing, suture
separation
Check patency of ureteral stents
Keep the pouch on at all times and observe normal urine
drainage
51. Post-op care after urinary diversion
2. Stoma care:
Inspect the stoma every hr for first 24 hrs post-op,
and atleast 8 hrs thereafter.
Note size, shape & colour of stoma
Assess for any leakage, bleeding
Aeration of skin
Keep the area dry & clean
Nystatin powder or cream application to avoid
yeast infection
Check pH of urine
Change appliances when necessary
Assess for s/s of peritonitis
52. Post-op care after urinary diversion
3. Diet
Fluids are very important.
Eat several small meals rather than fewer large meals
Take a multivitamin with iron daily after surgery
Keep bowel movements soft with stool softener of
choice
Avoid diet that gives urine a strong odor( high fat
diet)
take ascorbic acid tablets daily to maintain urine
acidity.
53. Post-op care after urinary diversion
4. Activity
Avoid lifting heavy wts for 6 weeks after surgery
Walk every day. Short frequent walks are better that
1 long walk
It is normal to be fatigued after surgery
Patients recover at different rates.
54. Post –op Nursing Management
Risk for sexual dysfunction r/t structural &
physiologic alterations
Counseling the partners
Encourage open discussions
Sexual rehabilitation
Encourage partners to seek sexual councelling and
alternate ways of expressing sexuality
A visit from another ‘ostomate’ who is functioning
fully in society and family life
55. Post –op Nursing Management
Risk for complications r/t the condition
To reduce the risk take following interventions:
Adequate fluid intake
Regular stoma care
Acidification of urine
Prevent leakage of urine
Regular catheterisation
Prevent urinary stasis
Peritonitis
56. Post –op Nursing Management
Client education:
Teaching pt self-care for stoma
Managing the ostomy appliances
Changing the appliance
Controlling odour
Cleaning and deodorizing the appliance
Clean with soap & water, use white vinegar solution.
Teaching skin care: apply skin barrier
Teaching pt self-care for urine reservoir
catheterization of the reservoir
Irrigation
Encourage follow –up
57. Assist in intravesical drug administrations
Instruct the pt to retain fluid for atleast 2 hrs
Instruct to change position frequently
After voiding, instruct to drink fluids to flush the
bladder
Clean the toilet with bleach after voiding.
Assess for complications like bleeding, fever,
bladder irritation etc.
Nursing Management of pt
undergoing chemotherapy
58. Conclusion
Carcinoma bladder is one of the common urological
cancer . Patients with Cancer bladder requires
special care and attention during the treatment and
afterwards also.
60. References:
Brunner & Suddarth’s, Textbook of Medical
Surgical Nursing.10th ed. Lippincott.
Black M. Joyce, Hawks Hokanson Jane, Medical
Surgical nursing.7th ed.2005, Saunders
Harrison's Principles of internal medicine,
Seventeenth Edition, 2008, The McGraw-Hill
Companies.
www.cancer.gov
Editor's Notes
Infection with schistosoma haematobium: leads to UTI
Bladder birth defects : extropy bladder esp. leads to adenocarcinoma
Dysplasia: abnormality in maturation of cells within a tissue
Symptoms of bladder irritation,dysuria,frequency,urgency.
Obstructive symptoms hesitancy, intermittency, straining to begin urination, retention.
Sterile pyuria is the presence of elevated numbers of white cells (>10/cubic mm) in a urine which appears sterile using standard culture techniques.
stages are used to classify the location, size, and spread of the cancer, according to the TNM (tumor, lymph node, and metastasis) staging system:
Bta= bladder tumor antigen test
NMP22: nuclear matrix protein
TRAP= telomeric repeat amplification protocol test
Carcinoembryonic antigen (CEA) is a glycoprotein involved in cell adhesion. It is normally produced during fetal development, but the production of CEA stops before birth. CEA measurement is mainly used as a tumor marker to identify recurrences after surgical resection. Elevated CEA levels should return to normal after surgical resection, as elevation of CEA during follow up is an indicator of recurrence of tumour.
Partial cystectomy: if pt is unable to tolerate radical cystectomy
Non-continent urinary diversion: typically consists of a piece of bowel which acts as a conduit taking urine from the ureters through bowel to the skin in a continuous flow pattern. This requires an appliance (stoma bag) on the skin to collect the urine
continent urinary diversion attempts to mimic the action of the normal bladder by storing urine for a period of time at low pressure. Drainage of urine is performed by either normal voiding through the urethra or catheterization of either the urethra or a reservoir of bowel. This type of diversion does not require a skin appliance (bag).
Percutaneous nephrostmy, ureterostomy: for palliative sx
Systemic CT-used to treat inoperable tumors/distant metastasis
s/e : hemorrhagic cystitis
bladder irritation, f ever, malaise, nausea,chills,arthralgia, pruritus
Intravesical therapies are used in two general contexts: as an adjuvant to a complete endoscopic resection to prevent recurrence or, less commonly, to eliminate disease that cannot be controlled by endoscopic resection alone
Mitomycin C which disrupts the normal DNA function in cancer cells. The mitomycins are a family of aziridine-containing natural products isolated fromStreptomyces caespitosus or Streptomyces lavendulae.[1] One of these compounds,mitomycin C, finds use as a chemotherapeutic agent by virtue of its antitumour antibiotic activity. It is given intravenously to treat upper gastro-intestinal (e.g. esophageal carcinoma) and breast cancers, as well as by bladder instillation for superficial bladder tumours.
hold the medication in bladder for up to 2 hours, then urinate. If BCG is used, pour bleach into toilet after urinate.
About 50-75% of patients with superficial bladder cancer have a very good response to intravesical therapy
1. After surgery while your pouch is healing, a tube called a Foley catheter drains the urine from your pouch to a leg bag or bedside bag. A second catheter (called a suprapubic tube)