Portal Vein Thrombosis Case Study

Portal Vein Thrombosis Case Study
This case study examines the development of Portal Vein Thrombosis ("PVT") in two patients,
M.W. and R.C., diagnosed with adenocarcinoma of the pancreas. In both cases the patients had low
volume local disease which responded to treatment over time. Both experienced a longer survival
length than typical pancreatic cancer patients, but ultimately experienced thombosis of the portal
vein and the superior mesenteric vein. Extrinsic compression of the celiac axis by the tumor further
exacerbated the disease. Both patients died as a result of liver failure caused by PVT. New research
in this field gives additional insight into prevention, diagnosis, and recognition of this disease. To
prevent PVT, low–molecular weight heparin administration reduces ... Show more content on
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PVT is a partial or complete thrombosis within the portal vein or its immediate downstream
tributaries. Light symptoms such as fatigue, mild swelling, and abdominal discomfort are the first
signs of PVT and are easily overlooked, or attributed to symptoms of cancer or cancer treatment. It
can also be nearly asymptomatic until the disease has progressed for a long time. Eventually,
symptoms such as ascites, hepatomegaly, and varices present. Varices can rupture and bleed,
resulting in potentially life–threatening complications. Additionally, due to a lack of nutrients being
delivered to the liver, PVT can cause liver failure. If the disease progresses further, death can
result7.
Although the medical community has known about hypercoagulation and its relation to cancer for a
century and a half, patients still die as a result of thromboembolism during cancer treatment. PVT
specifically is a near silent killer and is not well understood. More research is needed to combat
PVT and other forms of venous thromboembolism during
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The Role Of Immunity For The Racial Disparities Of Cancer
Title: Role of Immunity in the Racial Disparities of Cancer
I. Introduction:
A. Racial Disparities in Cancer
During past several decades there has been a significant development in cancer screening, diagnosis,
prevention and treatment [1]. However, cancer health disparities–for instance, higher incidence of
cancer and associated mortality rates, as well as higher rates of occurrence of advanced stage
cancers in certain populations is a domain in which development has not kept pace. These disparities
are frequently seen in people who inhabit in geographically secluded areas, people from low–
socioeconomic society or certain racial/ethnic populations [1]. There has been various documented
cancer health disparities, discussing all of them is well beyond the scope of this article. Hence, in
this review we will discuss one of the principal disparities, which is cancer health disparity between
African Americans (AA) and Caucasian Americans (CA).
In the United States (U.S.), colorectal cancer (CRC) is the second major cause of cancer associated
deaths. During 2008–2012, per year incidence and mortality counts due to CRC were 42.4 and 15.5
per 100,000 men and women [2]. However, during 2008–2012 the incidence rate of CRC in AA
population was 101.2 (16.89% higher) as compared to 84.1 of CA per 100,000 men and women.
Moreover, the number of AA deaths associated with CRC was 47.5 (54.72% higher) in comparison
with 30.7 CA deaths per 100,000 men and women [2]. CRC patients of AA

Pancreatic Cancer: A Short Story
The morning light shone up across Mariah's face which was like a alarm clock for her but a
nice,gentle,quiet alarm clock. Mariah only though it would be a normal morning but she started
getting a queasy feeling in her stomach and started to feel very nausea.She tried to push it off as last
night's dinner but as she thought about it she knew that she was sick.She quickly ran to the bathroom
and everything came up. Mariahs mother Robyn quickly ran to Mariahs bathroom and immediately
called Urgent Care but they did not open yet because of how early in the morning it was. The ER
was their last option; Mariah very much disliked the ER. Although she disliked the ER they knew
they had to go so Mariah was done with using the bathroom they hurried ... Show more content on
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Ms Robyn said "yes". They asked if the could put the dog to sleep so they could implant the "mini–
power cell" into Mariah's system which will then pass through the pancreas making it heal. The idea
didn't seem ideal at first but then they thought Mariah's life would go on and her life is more special
that the dog but we all know the dog will be missed dearly. So on March 1st 2005 Miss Marilyn had
to be put to sleep and Mariah had to be put to sleep too so they could inject the power–cell into her
Pancreas. As soon as she was a sleep they took the miny power cell and injected it into Mariah's

Cholelithiasis Research Paper
Cholelithiasis, are the reaming's of the digestive fluid bile, which form within the gallbladder. They
vary in size and shape from as small as a grain of sand to as large as a golf ball.[1] Cholelithiasis
occur when there is an imbalance in the chemical constituents of bile that result in precipitation of
one or more of the components. Gallstone disease is often thought to be a major affliction in modern
society.[2] However, cholelithiasis must have been known to humans for many years, since they
have been found in the gallbladders of Egyptian mummies dating back to 1000 BC.[3,4] This
disease is however, a worldwide medical problem, even though there are geographical variations in
gallstone prevalence[5,6,7,8,9,10,11] Cholelithiasis are becoming increasingly common. They are
seen in all age groups, but the incidence increases with age.[12] About a quarter of women over 60
years will develop them.[13] In mostbcases they do not ... Show more content on Helpwriting.net ...
In Pakistan and in Western societies more than seventy percent of cholelithiasis are made of
cholesterol, either pure or mixed with pigment, mucoglycoprotein, and calcium carbonate. Pure
cholesterol crystals are soft, and protein gives strength of cholesterol stones. Cholesterol
cholelithiasis form when the cholesterol concentration in bile surpasses the capability of bile to hold
it in

Pancreatic Cancer Awareness
INTRODUCTION
Pancreatic cancer is one of the silent killers. It is the fourth cause of cancer–related death in the
world (Hariharan et al, 2008). According to the American Cancer Society Surveillance Research, the
estimated number of new cases in 2016 is 53,070 and the estimated deaths are about 41,780
(American Cancer Society, 2015).
There is currently no reliable method for the early detection of pancreatic cancer as it has no clear
signs and symptoms. The most predominant sign of pancreatic cancer is jaundice and this occurs
most of the time at a late stage when the tumor size increase and lead to an obstruction of the bile
ducts. Earlier signs and symptoms include mild abdominal pain, loss of appetite, weight loss and
general fatigue. ... Show more content on Helpwriting.net ...
As per the United States Census Bureau , around 73% of the US population are white ,12% are
African–American and 5% are Asian (United States Census Bureau ,2016) , which is close to
pancreatic cancer incidence distribution per race. The assumption that white race is a relevant risk
factor for pancreatic cancer prediction conflicts with previous studies outcome. Yadav, D., &
Lowenfels, A. B. (2013) assumes that pancreatic disorders including pancreatitis and pancreatic
cancer "affect Blacks more than any other race" (Yadav & Lowenfels ,2013).
The distribution of pancreatic cancer incidence within the United States showed higher incidence
rates in the South region. As personal habits like smoking , alcohol drinking and diet habits are
known risk factors for pancreatic cancer , there may be a relation between the geographic location
and such habits . Future studies are recommended to understand the relation between geographic
location and number of pancreatic cancer incidences , and to analyze the impact of weather
variations , common regional traditions and

A Study On The Epidemiology Of Chronic Dacryocystitis
A STUDY ON THE EPIDEMIOLOGY OF CHRONIC DACRYOCYSTITIS IN AN
ECONOMICALLY–DEPRIVED POPULATION IN SOUTH INDIA
ABSTRACT:
Dacryocystitis is infection of the lacrimal sac, resulting from blockage of the nasolacrimal duct. This
study was done to determine etiopathogenesis of chronic dacryocystitis in an economically deprived
population in South India. A total of 50 samples were obtained from the contents of the lacrimal sac
in 50 patients with chronic dacryocystitis. These samples were cultured for aerobic and anaerobic
bacteriae, and fungi with a routine microbiological technique. A total of 13 samples were obtained
from 13 patients who underwent dacryocystectomy. The average age in the study was 52.5 years.
Females predominated in the study (68%).Of the cultures from the nasolacrimal sac, 84% were
positive for bacteria. The majority of microorganisms in our study were gram positive bacteria with
a predominance of pneumococcus (40%). Histopathological results of all 13 specimens showed
non–granulomatous inflammation of the sac. Thus, every case of dacryocystitis has to be
investigated to detect the predisposing and precipitating factor.
KEY WORDS: dacryocystitis, lacrimal, dacryocystectomy, bacteria
INTRODUCTION:
Dacryocystitis is one of the most common diseases of the eye that is encountered in daily routine
ophthalmic practice. Dacryocystitis has a higher incidence among the people living in tropical
countries with poor hygienic conditions. It occurs both in infants and

Pancreatic Cancer Research Paper
There are two kinds of pancreatic cancer. There is the endocrine tumors and the exocrine tumors.
Endocrine tumors are less common and they affect the islet cells of the pancreas. They tend to be
benign and not often become malignant. However the exocrine tumors are much more common and
this is what Gene is diagnosed with. Exocrine tumors are often called adenocarcinomas and that
means cancer affect the gland cells such as the ducts of the glands (American Cancer Society).
Pancreatic adenocarcinomas keep the glands from secreting normal The signs and symptoms of
pancreatic adenocarcinoma is darkening of the urine, irritated skin, jaundice, pain in the upper
abdomen and back, unexplained weight loss, stomach bloating, weakness, and nausea.
Some

Humane Essay : Patient Assisted Suicide Is Humane
Patient Assisted Suicide Is Humane Every year, thousands of people are diagnosed with pancreatic
cancer. The further along their disease progresses, the more they suffer both physically and mentally.
The humane thing to do is to allow these people to choose whether or not to end their lives before
this painful and inevitable conclusion is reached.
Over 30,000 people are diagnosed with pancreatic cancer each year (Pancreatic Cancer 1). The
pancreas is a small gland located near the stomach. Treatments for this type of cancer is very limited
because it is often only discovered after it has progressed past the point of no return. Once the
cancer has metastasized, or spread, the only option is to hope that chemotherapy and radiation can ...
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To be truly considered physician–assisted suicide, the injection, while taken in the presence of a
medical professional, must be delivered by the patient. This injection is typically given a few weeks
to months before natural death would occur, allowing the patient to not have to suffer the worst
stages of their disease (Dixon). Currently in America, physician–assisted suicide is only legal in the
states of Oregon, Montana, Washington, Vermont, California, Colorado and Washington D.C. While
pain to the body is extreme during the later stages of pancreatic cancer, pain to the mind is even
greater. As the disease progresses and the body breaks down, the quality of life a person has is
nowhere near what they once had. They need help doing the simplest things, such as going to the
bathroom or getting dressed. For a person who just a few months earlier was completely healthy,
this change can be unbearable. These patients shouldn't be forced to live trapped inside a decaying
body. There are some things worse than death (Beauchamp 3) It is not only the patient who is helped
by physician–assisted suicide; the families of the sufferers are also spared. It is a sad truth that
ninety–five percent of pancreatic cancer patients are killed by the disease (Pancreatic Cancer 2).
With death being a near certainty, family members of pancreatic cancer patients

Cholelithiasis is the medical term for gallstones. The gallbladder is a small, pear–shaped organ
situated in the upper part of the right abdomen below the liver. Gallstones are solid particles that
build up in the gallbladder. The size of gallstones can range in size from that of sand grain to that of
a golf ball. There may be a single large stone or several small and large stones of different sizes in
the gallbladder. Approximately 10–15% of the adult population in the west is known to develop gall
stones annually. Stones in the gallbladder form due to an imbalance in the chemical constituents of
bile. Due to this, one or more components of bile get precipitated. The exact reason for this
imbalance is not known. Patients suffering from this disease may experience a sudden pain ( called
gall bladder attack, also called biliary colic)in the upper right abdomen. This pain occurs when the
biliary ducts are blocked by the gallstones. Gallstones have been observed in people of all age
groups. However, the risk increases with age. Obesity increases the risk of formation of gallstones.
In females, oestrogen leads to secretion of more cholesterol, excess of which leads to formation of
stones. Thus, the risk is higher in females. Genetic reasons also contribute to cholelithiasis. Other
factors that increase risk of gallstones include ... Show more content on Helpwriting.net ...
After the gallbladder is surgically removed, bile pours out of the liver directly into duodenum.
Surgical removal is carried out in two different ways. Accordingly these two methods are called
laparoscopic cholecystectomy and open cholecystectomy. In the former, minor incisions are made in
the abdomen of the patient and a laparoscope is inserted. A laparoscope is a tube which has a video
camera attached to it. The doctor can see a magnified image of the internal organs on video monitor
and accordingly use the tools to remove the gall

Informative Speech On Pancreatic Cancer
No one can catch cancer from another person. While it can seldom be explained why one person
gets any type of cancer and another doesn't, it is very clear that the disease is not contagious.
Although research scientists do not know the exact causes of cancer of the pancreas, they are always
learning some things that can increase a person's chance of getting this disease. Smoking of any kind
is a major risk factor and research shows that cigarette smokers tend to develop cancer of the
pancreas two to three times more often than nonsmokers. So by quitting smoking, you will reduce
the risk of pancreatic cancer, lung cancer, as well as a number of other diseases.
What are the specific symptoms of pancreatic cancer?
Pancreatic cancer has been referred ... Show more content on Helpwriting.net ...
In the biopsy, the doctor will remove a piece of tissue from the pancreas. A pathologist then
examines the tissue sample under a microscope to check for cancer cells.
Tissue samples that are obtained with one kind of biopsy may not give a clear diagnosis, and the
biopsy may need to be repeated using a different method.
One of the ways to obtain tissue is by using a long needle that is passed through the skin and into the
pancreas, hence the name needle biopsy. Doctors will use either x–rays or ultrasound to properly
guide the placement of the needle to obtain the sample.
A brush biopsy is performed during the ERCP. The doctor will insert a very small brush through the
endoscope into the bile duct and rub off cells to examine under a microscope. Sometimes, when a
biopsy does not provide an accurate indication, a surgeon will perform an operation called a
laparotomy. During this operation, the doctor will look at the organs in the abdomen and can remove
tissue samples, if needed from any organ. This surgical procedure helps the doctor determine the
stage or extent of the disease. This will help the doctor plan the best approach for

Neoplasm Essay
The neoplasm is assumed to have a nonaggressive nature; however, data regarding the course in
HIV immunocompromised persons is scant. A case of orolabial bowenoid papulosis caused by
HPV–32is noted.[63]
Histopathology: reveals features of an intraepithelial carcinoma. Secondary amyloid deposition has
been reported histologically in one case of BP.[64]
Differential diagnosis Lichen planus, common warts, seborrhoeic warts, naevi and condylomata lata.
A biopsy is indicated in instances where the clinical diagnosis is uncertain.
Treatment and follow up Treatment depends on many factors. Circumcision removes a major risk
factor for cancer and provides extensive tissue for histology. Topical 5–fluorouracil as a 5% cream is
a well established conventional option for the treatment of BP,[65–67] but there have not been any
clinical trials. Other treatments include cryosurgery, curettage and electrocautery, excisional surgery,
glans resurfacing, Mohs micrographic surgery, laser and photodynamic therapy.[ 65–69]
Radiotherapy should be avoided. Topical imiquimod may help some patients.[70–72] Patients
presenting with these conditions should be counselled and screened for HPV and other sexually
transmitted diseases, including HIV infection. They should stop smoking. Sexual ... Show more
content on Helpwriting.net ...
Only 25% are extraocular and the majority of these appear on the head and neck. One–half of
periocular tumors arise from Meibomian glands. The neoplasm appears as a firm, skin–colored, or
yellowish papule that slowly grows into a nodule. Metastasis occurs in 14 to 25% of patients.
Several cases reported in HIV–infected patients achieved unusually large sizes and were not present
on the

Causes And Treatment Of Pancreatic Cancer
Pancreatic Cancer What exactly is the pancreas it is an organ that makes insulin and enzymes for
digestion. The pancreas is located behind the lower part of the stomach and is about the size of a
hand (National Institute of Health, n.d.). Pancreatic cancer is a disease that targets the Pancreas. Can
start out as pancreatitis, which can be acute inflammation of the pancreas or the hereditary and even
the deadliest chronic pancreatitis. The chronic form can devastate and debilitate the patient this form
is at higher risk of pancreatic cancer. The mode of transmission is abnormal cells start to multiply
and reproduce and collect creating a tumor or a mast. The detection and treatment of these tumors
can be difficult as medical imaging such as x–rays, sonograms and MRI's don't always give an
adequate depiction of the cancer the best way to see the pancreas is through surgery.
There are over 100 kinds of Cancer, the term cancer is used to described a disease in which
abnormal cells divide without control and can invade other tissues (Center for Disease Control and
Prevention(CDC), 2016). Cancer cells do not die out naturally, once the cells start to grow; they
metastasize forming new abnormal cells. In many cancer cases the abnormal cells collect and form
tumors. They have also been known to grow in other tissues and spread all over the body which is
referred to as seeding. Normal cells do not do this. When the DNA is damaged it can cause cancer
cells to rapidly reproduce and

Not much is known to help prevent this cancer from attacking your cells not only that but what
makes the Pancreatic Cancer so deadly is that not only can this cancer start to develop quickly but
can multiply and attack your cells without being detected.The Pancreatic Cancer can only be
detected once the cancerous cells are too advance meaning it's later symptoms start to form such as
not only a lost of an appetite but also an unusual decrease in weight due to the cancerous cells that
not only affect the pancreas itself but other organs as well it can create tumors. This cancer is rarely
found in teenagers they are mostly found in adults from ages around 45 and so on. The pancreas is
an organ and or a gland that can be found in the near back of the stomach. The pancreas role to our
body is to help create specific hormones that help manage blood sugars and even digestive juice.
There are many forms and also many times of pancreatic cancers that were found. Due to unable to
detect this cancer there's high ... Show more content on Helpwriting.net ...
On which can help the patient who has this cancer be able to live for a more longer time than back
then where you aren't able to stop the cancer cells to affect the rest of your body. Some test perform
to help with the research to help scientist and also doctors to help detect and be able to stop the
source it's by looking at ultrasounds. As well as not only that but also CT Scanning, MRI, and even
ERCP. Thanks to this technology doctors are able to treat these cancer by doing series of surgeries to
extract tumors created and remove the organs or parts where it's most affected by the cancer.
Another possible cure for this cancer is chemotherapy which is basically usage of certain chemicals
and even specific

What Makes You Have Cancer?
"You have Cancer." A single sentence that is among the most devastating words one could hear from
a doctor today. They immediately cause one to go into shock then fear then shock, swinging back
and forth like a pendulum in an old clock. Suddenly, time becomes the most valuable resource
known to man and one will sacrifice everything else to get more. Cancer, has followed me through
life almost like my own shadow, never truly touching me but gripping those I love. Who knew that
three years ago sitting at the kitchen table my life would be flipped upside down, and I would lose
all the time I thought I had. Humming, I turned the steering wheel to the right directing the car onto
a two lane road with farm pastures on either side. All around me ... Show more content on
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I followed through the front door locking the car as I was followed unknowingly by a shadow. My
father and mother were home from the doctor. I stared at my father's still yellow tinged skin. I
curiously asked, "What did the doctor say?" My dad looked at me, and said, "We want to wait to tell
all of you boys at the table. Call your brothers, and tell them we are meeting at the table." I did as I
was told. My thoughts turned fearful, as the song that played in my head turned dark. The shadow
was at my shoulder, a malignant presence
I was humming a song the whole way. Trying not to worry. I knew something was wrong. The air
seemed to sing a mournful dirge. My Mother seemed to be standing on the edge of a complete
breakdown. My Father even seemed to be off. His normal joking manner was gone. I couldn't see
past the wall he had built around him. The shadow stood behind his eyes. The light bulbs over the
table seemed to go and in out. Sitting down, I looked at my mother as she began to speak, "The
doctor said that believes he can fix your father's yellow skin. Yet, we have to a do a few more tests."
The doctor believes that it is..." My Mother was holding back the tears. Pain filled her eyes. She
said, "Dad is going to tell you the rest." My Father began slowly all while looking us in the eyes,
"The reason that I am Jaundice is that a tumor has formed out of my Pancreas causing my liver to
not be able to function. Pancreatic Cancer is

Dealing with My Mom's Pancreatic Cancer
My mom was diagnosed with pancreatic cancer stage IV last July. "I could believe what was
happening to me, at the age of 44 I considered myself a healthy person, I was never sick, I never
smoked, I was highly active and had a healthy diet. I couldn't find a possible explanation that
justified this illness." she said. It was really though for my family, we couldn't even say the word
"cancer" for a few months. We became angry because we thought that my mom didn't deserved that.
The doctors were confident, even though stage IV of pancreatic cancer has 1% of survival rate in the
US. In addition to that, my mom's tumor couldn't be removed because the cancer spread to distant
organs. " I tried to find out everything I could about my cancer. When I first browsed pancreatic
cancer on the internet, I got worried. The results, news and statistics are scary, I tried to keep a
positive mind and told myself that I had to succeed and be healthy again" she said. My mom talked
to people who successfully remitted, and that gave her a positive mind.
My mom started chemotherapy in october 2013. She needed six cycles of two chemos every two
weeks. Although she felt weak, sick and her nervous system got affected, she successfully
completed twelve chemos and she still has one more to go. By the middle of her treatment she got a
PET scan (Positron Emission Tomography) and the results were unexpected. Her cancer reduced
70% its size, the metastatic rate was very low and the cancer in her

Causes Of Pancreatic Cancer
Pancreatic cancer occurs when malignant (cancerous) cells develop within the tissues of the
pancreas. The pancreas produces digestive juices and hormones that regulate blood sugar. Cells
called exocrine pancreas cells produce the digestive juices, while cells called endocrine pancreas
cells produce the hormones. The majority of pancreatic cancers start in the exocrine cells. (WebMD,
2015) Pancreatic cancer is the cause of the 4th most cancer deaths in the United States of American
with a median of six or less months and a 5–year survival rate of 4.6%. The lethal nature of
pancreatic cancer stems from its propensity to rapidly disseminate to the lymphatic system and
distant organs. (Sarkar, 2007) The most common form of pancreatic cancer is ... Show more content
on Helpwriting.net ...
Two of the main pancreatic hormones are insulin, which acts to lower blood sugar, and glucagon,
which acts to raise blood sugar. Maintaining proper blood sugar levels is crucial to the functioning
of key organs including the brain, liver, and kidneys. (Columbia, 2015)
In pancreatic cancer, cancer cells in the pancreas grow and multiply quickly, which can cause a
tumor to grow. In stage 4 pancreatic cancer, a cancerous tumor has begun in the pancreas and has
spread beyond the pancreas into parts of the body far from the pancreas. It may also have spread to
the lymph nodes and the organs and tissues found near the pancreas. The effect of this tumor on the
body depends on where the tumor is, how it has spread, and how large it is. If the tumor blocks the
flow of bile, which is produced in the

Bladder Cancer Essay
Bladder Cancer
Medicine #1
GEMCITABINE
1. MECHANISM OF ACTION – Gemcitabine is an anti–cancer chemotherapy drug. Gemcitabine is
classified as an antimetabolite. It is given by infusion intravenously. It works by killing cancer cells
and preventing cancer cells from growing and multiplying in the body.
2. INDICATIONS – Gemcitabine is used in the treatment of patients with lung cancer, cancer of the
pancreas, bladder cancer, breast cancer, and ovarian cancer. It is indicated for the first–line treatment
of locally advanced or metastatic transitional–cell bladder cancer, metastatic biliary tract cancer, and
treatment of advanced ovarian cancer that has relapsed.
It is used for the first–line treatment of metastatic pancreatic cancer and metastatic breast cancer as a
single agent Gemcitabine is used in combination with ... Show more content on Helpwriting.net ...
ADVERSE EFFECTS – Myelosuppression, nausea, vomiting, elevated increased alkaline
phosphatase, proteinuria, fever, haematuria, rash, dyspnoea, edema, flu–like symptoms, infection,
alopecia, neurotoxicity, renal or liver failure, haemolytic uremic syndrome, capillary leak syndrome,
and posterior reversible encephalopathy syndrome.
Medicine #2
CARBOPLATIN
1. MECHANISM OF ACTION – Carboplatin is a chemotherapy drug that interferes with the growth
of cancer cells and slows their growth and spread in the body. Carboplatin is used together with
other cancer medications to treat cancer. It works by disrupting the cell growth of cancer cells,
which helps to fight cancer. Carboplatin is usually given by infusion intravenously. Carboplatin can
also be given directly into the peritoneal cavity in the abdomen.
2. INDICATIONS – Carboplatin is used in the treatment of patients with lung cancer, head and neck
cancers, breast cancer, ovarian cancer, oesophageal cancer, bladder cancer, cervical cancer, testicular
cancer, brain cancer; central nervous system or germ cell tumours; osteogenic sarcoma; and as
preparation for a stem cell or bone marrow

Megan Gogel
Mrs. Pund
English 9
March 27, 2017
Word Count:
Pancreatic Cancer:
A Complex Disease In 2000, there were 28,300 new cases of pancreatic cancer and 28,000 deaths,
making the mortality rate for pancreatic cancer at a high of ninety nine percent. Over the years,
researchers have found more about the pancreatic tumor to have to mortality rate to go down.
Between 2000 and 2009, the mortality went down by sixteen percent. (Panno) Pancreatic cancer can
be rare, hard to treat, and get diagnosed before too late; the low chances of survival make pancreatic
cancer the deadliest of all of the cancers. For cancer deaths, pancreatic cancer is ranked at the fourth
highest cause of deaths. In 2009, the mortality rate for pancreatic cancer decreased ... Show more
The doctor may also take a blood test to determine if the jaundice is due to pancreatic cancer or liver
disease. (Panno) Once the patient is diagnosed with pancreatic cancer, they can choose from
different treatment plans. When determining the person's treatment plan, they take consider their age
and expected lifespan, other serious health conditions, the stage of the cancer, if surgery can remove
cancer, likelihood of curing the cancer, and how the person feels about side effects. For many
patients, the part that most important is the controlling of pain. Some treatments for the cancer
include surgery, radiation therapy, chemotherapy and other drugs. (Treating) Treating pancreatic
cancer is very difficult due to the dense outer shell around the pancreatic tumor and nearly
impossible to penetrate with cancer–killing drugs. "Wall is so tough that clinical trials with
medications that are experimental designed to breach barrier had to be abandoned mainstream, drug
so harsh they sicken already ailing patients," said Doctor Abram Handly–Santana, a researcher who
specializes in pancreatic cancer. (Ricks) Even though treating pancreatic cancer is difficult, some
doctor decide to perform surgery to determine if the tumor is removeable and to determine the
staging of the cancer to prescribe the best treatment. (Panno) The best

Endoscopic Imaging Study
Abstract Intraductal Mucinous Neoplasms and Mucinous Cyst Neoplasms are two distinct entities
used in categorizing non–inflammatory cystic lesions of the pancreas. Utilization of the
International Consensus Guidelines for the diagnosis and treatment of IPMN and MCN assist
physicians in the management of these cystic lesions while proving the highest quality of care.
Introduction Intraductal Papillary Mucinous Neoplasms (IPMN) are tumors that grow within the
pancreatic duct that produce thick fluid. This tumor can be classified as main duct IPMN or branch
duct IPMN. The classification between main duct IPMN and branch duct IPMN are based on
imaging studies as well as histology. In imaging studies some cysts at times display involvement
within ... Show more content on Helpwriting.net ...
CT or MRI is recommended for cysts larger than 1 cm in order to be categorized for high risk
stigmata. An MRI is typically more detailed than CT and will illustrate the cystic nature of the
pancreatic lesion as well as the internal structure of the cyst. Follow up MRI images will reveal any
changes in the cystic lesion as well as any abnormalities. The patient charts and radiologic images
will advise the physician in the status of the cyst in addition to changes in symptoms being
experienced by the patient. Pancreatic cysts that present high risk stigmata should be considered for
resection if patient is medically fit for surgery. The surgical pathology specifies their diagnosis post
operation. While monitoring patients in the Cyst Surveillance Program, the EUS specifies cyst
diameter and findings. Depending on the condition of the cyst and if they show any worrisome
features, 6 months or yearly follow ups are necessary.

Symptoms And Treatment Of Pancreatic Cancer
Introduction:
Intraductal papillary mucinous duct neoplasms of the pancreas (IPMN–p) are one of the subtypes of
cystic neoplasms of the pancreas. They are neoplasms that arise in the pancreatic ducts and can be
visualized as they are usually greater than 0.5 inch in length. They are comprised of tall mucin–
producing columnar cells, that have the capability of transforming into pancreatic cancer if left
untreated. Their ability to develop into pancreatic cancer is one of the main reasons behind their
significance. IPMNs commonly exhibit cell atypia, papillary propagation, and cyst production. Their
main feature is the ability to produce copious amounts of fluid.
In general pancreatic cysts are not an uncommon finding on abdominal computerized tomography
(CT) scans. A study done at University College Dublin in 2008, in which, 2,832 abdominal CT scans
were evaluated for presence of pancreatic cysts, showed that 2.6% of people have pancreatic cysts.
These patients had no history of pancreatic disease, and had no pancreatic symptoms at the time of
the scan i.e the abdominal scan was done for other reasons. Pancreatic cysts increased with age, with
zero cysts found in patients below 40 and up to 8.7% of scans of those above 80 years of age had
cysts present. (12)
IPMNs of the pancreas can occur in either the main pancreatic duct or in one of its branches. The
smaller the branch size in which the neoplasm arose, the higher the likelihood of a less aggressive
neoplasm. Tumors

Gallstones Research Paper
Gallstones are described as digestive fluid that has hardened which can be very painful. They form
in the gallbladder which is a pear shaped organ that is located on the right side of of the abdomen
right underneath the liver. Gallstones can be many sizes which varies how much the pain is. They
can be as small as a crumb to a size of a golf ball! Ouch! Also, some people have more than one,
while other people may just have one. More than likely, you will have symptoms if you have
gallstones and if you do have symptoms, most people have to get gallstone removal surgery. These
symptoms may include, sudden pain in your upper right side of the abdomen or under the breast,
back pain between shoulder blades, right shoulder pain, nausea, or vomiting. ... Show more content
on Helpwriting.net ...
You need to seek immediate care when you are experiencing so much pain you can't sit comfortable,
skin is turning yellow, whitening of eyes, high fever, and chills. There are different types of
gallstones and these types consist of cholesterol gallstones and pigment gallstones. Cholesterol
gallstones are the most common type of gallstones. These gallstones contain mostly undissolved
cholesterol and are yellow in color. Pigment gallstones are when your bile contain too much
bilirubin and are either black or brown in color. The cause of gallstones are not yet completely found
but doctors figure they are caused by either your bile containing to much cholesterol, bile containing
to much bilirubin, or by your gallbladder not emptying correctly. Doctors can diagnose gallstones in
many ways. Either through blood test, MRCP, HIDA scan, endoscopic ultrasound, and ERCP.
Treatment for gallstones vary. It depends on how bad they are, and size. Most people get surgery to
remove their gallstones because of the pain. There are two diffrent types of surgerys to remove
gallstones and they are called Laparoscopic cholecystectomy and open

Case Study On Acute Pancreatitis
Background: Acute pancreatitis is an inflammatory disease of the pancreas, develops over a short
period of time. Aim: To evaluates the clinical presentation in different age group, gender, aetiology,
mortality, morbidity and outcome of management of patients with acute pancreatitis in surgical unit
of MNR teaching hospital. Material and Methods: A prospective study was conducted in MNR
Medical College Hospital over a period of 3 years. Patient details, clinical examinations, laboratory
reports, treatment options, complications and mortality rate were recorded during study period.
Results: Among 46 patients, 29 (63.04%) were males and 17 (36.95%) were female. Most common
age group with acute pancreatitis was 21–30 years (45.65%). All patients ... Show more content on
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Major age group with acute pancreatitis was 21–30 years (45.65%). There were significant
differences in age group of patients (at P< 0.05) [Table2]. In our study all patients had pancreatic
oedema. 12 patients (26.08%) had gallstones, 7 patients (15.21%) had pseudo cyst, 8 (17.4%) had
ascities and 7 patients (15.21%) had hepatosplenomegaly [Table3]. There was increase in serum
amylase level in all patients. Hypocalcaemia was found in 7 patients (15.2%). In 11 cases (23.95)
bilirubin level was raised. Prothrombin time was increased in 3 patients (6.5%). In all patients
haemoglobin level was normal. We followed Ranson's criteria to assess the severity and prognosis of
the disease. Cholecystectomy was applied for 19 (41.30%) patients. Other operative procedures such
as, cholecystogastrostomy and necrosectomy was done for 3 (6.52%) and 2 (4.34%) respectively.
There was no need to use any operative procedures for 22 (47.82%) patients [Table4]. 3 patients
(6.5%) were died out of 46

Approximately 3% of cancer patients are diagnosed with pancreatic cancer. Though multiple options
exist, sometimes surgery is the best method of treatment. For patients whose cancer has not yet
spread, there are a surprising number of pancreatic cancer treatment options that attack the disease
before it becomes unmanageable. Because surgery is so often paired with other treatments, it is
important to know the full extent of your possible treatment pairings.
An Overview of Pancreatic Cancer
This disease occurs when abnormal cells develop in the pancreas, and the body has an extremely
difficult time regulating growth. Without any limitations, these cells spread to other organs, shut
down their functions, and ultimately lead to death. Adenocarcinoma ... Show more content on
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Distal Pancreatectomy – This procedure is used when tumors lay within the pancreas, and grows in
the tail end of the pancreas. Because the thin end of the pancreas is harder to remove, the tumor, the
tail, and pancreas body are removed. The head, near the bile ducts, are left alone. Because the spleen
is near the tail, this organ will also be removed. This is considerably less invasive than both a
Whipple procedure and total Pancreatectomy. Because it is an easier surgery, it is also a faster
procedure.
If the spleen needs to be removed during any of these pancreatic cancer treatments, the patient will
need to take antibiotics for the duration of their life, due to the increased chance of infection.
If you have pancreatic cancer and need a surgeon, only the very best will do. Dr. Fraiman built his
career performing surgery on pancreatic and liver cancers, and he is considered the very best in his
field. He comes armed with a top–notch medical team, including oncologists and radiation
specialists to assist patients through every stage of the treatment process. Contact Dr. Fraiman today
to put yourself in the very best pancreatic cancer care on the East

Pancreas Carcinoma Research Paper
Pancreatic cancer is the fourth leading cause of cancer death in men in the United States and the
fifth leading cause of cancer death in women. It is very rare before the age of 45 years, and the
majority of patients present in or beyond the sixth decade of life (Feldman et al.2010). Carcinoma
arises anywhere in the pancreas. The most common frequent focus is in the head (60%), followed by
the body (10%), and the tail (5%). Carcinomas of the head of the pancreas may cause biliary
obstruction and jaundice by compressing the ampulla of Vater and common bile duct. They thus
tend to be smaller at diagnosis than those of the body and tail and show more limited spread to
regional lymph nodes and distant sites. On gross examination, pancreas carcinoma ... Show more
Intraoperative ultrasonography has been used to determine whether there is metastatic disease to
other organs. Laboratory test will exhibit elevated WBC and AST. A complete blood count (CBC) is
a common laboratory test used to measure blood counts (or the number of blood cells circulating in
the bloodstream). A CBC measures the level of red blood cells (which carry oxygen throughout the
body), white blood cells (which fight infection), and platelets (which help with blood clotting) in a
blood sample. A CBC also measures hemoglobin (a protein in red blood cells that carries oxygen)
and hematocrit (the ratio of red blood cells to

Biological Understanding Of The Disease And Clinical...
Despite current advances in both biological understanding of the disease and clinical management
through systemic chemotherapy, improvements in survival rates continue to remain scarce, with
only 3% of patients surviving over 5 years (Singh et al., 2015). At the point of diagnosis, only 20%
of patients display localised disease and hence susceptibility to surgical resection and successful
chemotherapeutic intervention (Indolfi et al., 2016). Therefore, for the majority of PDAC patients,
tumours remain asymptomatic until an advanced–disease stage upon metastasis to the liver and
other organs (Singh et al., 2015). The delayed manifestation of overt clinical symptoms, such as
jaundice, pain and weight loss severely constrict treatment ... Show more content on Helpwriting.net
...
Due to the low prevalence of disease, it is not deemed feasible to carry out population–based
screening for PDAC (Brand et al., 2011). However, the successful implementation of screening
strategies to enrich for individuals who remain high–risk candidates for development of PDAC, such
as patients of new–onset diabetes mellitus and chronic pancreatitis, provides distinct opportunities
for early disease detection (Kang et al., 2016; Hwang et al., 2015; Zhang et al., 2014). This may in
turn improve the number of asymptomatic PDAC cases detected at a stage where curative therapy
remains viable (Kang et al., 2016).
Serum Biomarkers
The potential role of serum biomarkers in the early detection of PDAC provides promise for the
screening of high–risk groups and presents an increasingly stratified approach to disease treatment
(Costello et al., 2012). However, detection of PDAC at its curable stage remains highly difficult as
early–warning signs are often non–specific (Radon et al., 2015; Tonack et al., 2013). PDAC must
also be differentiated from other benign and inflammatory conditions of the pancreas, that often
yield similarity in clinical presentation (Zhang et al., 2014; Tonack et al., 2013). Such conditions
include chronic pancreatitis and benign biliary obstruction. Furthermore, around 75% of PDAC
patients have tumours

The signs and symptoms of pancreatic cancer are always a good thing to detect early so the cancer
can be stopped in time and the person does not have to suffer. There are two different types of
pancreatic cancer with different symptoms for each. Exocrine pancreatic cancer is one of the most
common type of pancreatic cancers that exist today. Although some people might have symptoms of
this cancer does not mean that they are diagnosed with this until they are seen by a Doctor and are
medically diagnosed. Jaundice is one common symptom of pancreatic cancer and it is distinguished
by the yellowing of eyes and skin in a person. Jaundice is caused by the buildup of bilirubin which
is a dark yellow–brown substance made in the liver. The liver makes ... Show more content on
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When the common bile duct becomes blocked, bile can't reach the intestines, and the level of
bilirubin in the body builds up. Belly or back pain and weight loss are another symptom that are
easy to spot and usually start early in the buildup of pancreatic cancer. Some cancers that start with
pain in the body or tail of the pancreas can grow really fast and spread nearly into other organs
which cause lots and lots of pain. When the cancer spreads to the stomach it can cause Nausea and
vomiting which is another symptom which will make it harder for the processing of food or making
a person have no appetite which leads to weight loss. Most of the times the first clue of pancreatic
cancer is a blood clot of a large vein, often in the leg which is called deep vein thrombosis(DVT).
The symptoms for this is pain, swelling, redness, and warmth in the affected leg. Fatty tissue and
diabetes is one of the biggest symptoms for the pancreatic cancer and are usually the last things in
the cancer that has been fully developed. Uneven texture underneath the skin is caused by the
release of the pancreatic enzymes that digest fat causing this to become excessive fatty

Different Treatment Options For Cancer
The different treatment options available for cancer vary depending on which cancer has been
diagnosed. Pancreatic cancer which affects the pancreas and surrounding lymph nodes and tissue, is
the 4th leading cause of cancer–related deaths in the United States (pancreatic.org) and when
compared to the other leading cancers in mortality rates, 94% of pancreatic cancer patients will die
within five years of diagnoses and only 7% will survive more than five years. According to the
Hirschberg Foundation for Pancreatic Cancer Research, 74% of patients will die within the first year
of diagnoses of pancreatic cancer and the chances of recovering depend on which stage a patient has
been diagnosed with (cancer.gov).
If a patient is diagnosed with ... Show more content on Helpwriting.net ...
The surgery is hard to perform because the pancreas is a soft tissue and filled with blood and liquid
etc. therefore making it hard to cut and remove. Chemotherapy is offered after the surgery, if it is
performed to try and prevent the cancer returning. If the pancreatic cancer is metastatic,
chemotherapy is offered to help with quality of life and trying to extend the patient's life.
The most common type of pancreatic cancer is Pancreatic adenocarcinoma, which 'starts in the
glands', and about '95% of cancers of the exocrine pancreas are adenocarcinomas. These cancers
usually begin in the ducts of the pancreas' (cancer.org). Endocrine tumors of the 'pancreas are less
common, making up less than 4% of all pancreatic cancers' (cancer.org).
Pancreatic cancer 'may cause only vague symptoms that could indicate many different conditions
within the abdomen or gastrointestinal tract' (pancreatic.org) such as back pain, jaundice, nausea,
weight loss etc. you could be at risk of developing this form of cancer if the disease runs in your
family, if you smoke, your age also affects your outcome, diabetes can also aid in causing this
disease. The national cancer institute 'There are three ways that cancer spreads in the body. Cancer
can spread through tissue, the lymph system, and the blood'. If the cancer spreads from where it
originally started and goes into nearby areas. Another way for the cancer to spread is via the lymph

Essay On Pancreatic Cancer
Surgery:
Localized Disease
Approximately 20% of pancreatic cancer is found to be operable or resectable. The complete
resection of the primary lesion is best treatment for patients with localized pancreatic cancer.
However the risk of both local and distal recurrence is high in following resection. In early stage
pancreatic cancer the complete resection are associated with considerable morbidity in 40–60% of
patients and mortality in less than 3% of patients (Sohn et al., 2000; Winter et al., 2006). Moreover,
it takes 2–3 months for complete recovery to a normal quality of life. Although the 5–year survival
rate of resected pancreatic cancer is approximately 20% and the median overall survival time is 17–
27 months (Winter et al., 2006). ... Show more content on Helpwriting.net ...
The total pancreatectomy is used for removes the whole pancreas and the spleen. It is possible to
live without a pancreas but these people had increased diabetes, which can be complicate to control.
People who complete this surgery moreover need to take pancreatic enzyme pills for digesting of
certain foods.
Radiotherapy:
Usually, radiation therapy is treated by neoadjuvant, adjuvant or definitive treatment with systemic
therapy. Around 20% to 80 % of the patients with cancer received radiation therapy through the way
of their treatment (de Gonzalez et al., 2011). In this treatment the radiation is usually given along
with chemotherapy, which is recognized as chemoradiation or chemoradiotherapy. The Duke
University conducts investigational study of neoadjuvant radiation therapy in 96 resectable patients.
Everyday patients who received 50.4 Gy dose of radiotherapy are combined with 5–FU–based
chemotherapy. After this patients were then surgically findout if there was no evidence of metastatic
disease and less mortality. Overall survival (OS) and median survival was (28%:23 months)
respectively (Spitz et al., 1997; White and Tyler, 2004). In 1980's The Gastro–intestinal Tumor
Study Group (GITSG) conducted randomized study in purpose of adjuvant chemoradiotherapy in
resected pancreatic cancer. After R0 resection 49 patients were treated with chemorediotherapy for
evaluation of adjuvant

A Study On Conventional Imaging
Conventional Imaging Upon presenting symptoms of abdominal pain or back pain, a common
symptom of pancreatic adenocarcinoma, an abdominal x–ray or lumbar x–ray to may be performed.
This exam would be performed as a preliminary image to rule out what is causing the pain; but it is
not a preferred modality for diagnostic purposes. The radiographic appearance of the pancreas may
show calcifications, which can be a symptom of chronic pancreatitis but not necessarily
adenocarcinoma (T. Williams, personal communication, October 14, 2015).
Transabdominal Ultrasound
Initially when a patient presents with jaundice or abdominal pain, an ultrasound is frequently
considered the first–line diagnostic tool. The ultrasound provides a non–ionizing imaging of the
pancreas and can typically show if dilation of the pancreatic duct and/or dilation of the common bile
duct is present, also known as the double duct sign (E. Lee & J. Lee, 2014). The two most common
causes of a radiographic appearance of the double duct sign is carcinoma of the head of the pancreas
and carcinoma of the ampulla of Vater (Goel, 2015). The ability to visualize this sign provides
answers as to why the jaundice and abdominal pain is present and calls for further investigation to
potentially diagnose the patient with pancreatic adenocarcinoma (E. Lee & J. Lee, 2014). US may
also show a hypoechoic mass with irregular margins that can be typically appreciated as pancreatic
adenocarcinoma (E. Lee & J. Lee, 2014; Pietryga &

GST T1-1
Study Information (Type of study, Location, Purpose, Study Design, Subjects, Subject Selection)
This was a cross–sectional study done to determine the relationship of 1,2–Dichloropropane (1,2–
DCP) and cholangiocarcinoma in Japanese men working in a printing company. The researchers
took men who had developed the disease already, compared their liver and bile duct samples to
those of healthy individuals, and found some noticeable differences in those who were more
exposed to 1,2–DCP. They had a test group of 8 men with cholangiocarcinoma and a control group
of 13 human livers from autopsy files in order to do an immunohistochemical analysis to determine
the effects of 1,2–DCP on the genes and proteins. They chose the sample that they did because ...
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The extent of the GST T1–1 expressions differ from person to person. Hardly any normal human
samples had the expression for CYP2E1. Comparing the diseased human livers to those of the
control group, the test group had similar expressions of GST T1–1. None of the test group samples
showed an expression for the gene CYP2E1. For the test group, there was the dominant presence of
a marker of DNA double–strand break, γ–H2AX. For the control group, less than half of the liver
samples displayed this marker. It was clear that those who were exposed to 1,2–DCP had more of an
expression of this DNA marker in their non–neoplastic biliary epithelial cells of the large bile duct
than those in the control group with no exposure to 1,2–DCP. Those livers which had been exposed
to 1,2–DCP had signs of a tumor protein in their cells and bile ducts called p53. This study is
extremely difficult to read if it is something you are not used to. The researchers are assuming that
you know all of the concepts which made this especially difficult to comprehend. Also, there may
not have been enough liver and bile duct samples to make a definitive claim of the relationship
between 1,2–DCP and cholangiocarcinoma. The researchers were extremely thorough and did not
have to spend too much time searching for the affected men or the healthy livers which saved time
and money for this

David Reimann Research Paper
Rev. David Reimann was 51 years old when he passed away on January 15, 2008. He was a faithful
pastor at St. John Lutheran Church in Dublin, Ohio for 17 years. He was born on August 1, 1957 in
Michigan. He grew up there and moved to Dublin in 1990. He graduated from Ludington High
School, Michigan, and got his Bachelor's degree from Concordia University, Ann Arbor. He then
went to The University of Michigan School of Music to receive his master's degree and then went to
Concordia Seminary in St. Louis. He was married for 28 years to his loving wife Mary Jo and had
four children; Kim, Tara, Tim, and Malia. Pastor Dave, or PD, as I knew him, was a loving, funny,
honest man. He always put everyone before himself. Every time I needed a little pick me up, he
always knew how to make me laugh and put a smile on my face. SHOW HOW HE DID THIS There
were many activities he loved including the outdoors and softball. Every Sunday, during the spring
and summer, he would be out on the ball field after church ready to win another softball game. He
loved to be out there with many other men from the church including his own son. He loved being
outdoors no matter if it was blazing hot or freezing cold. I remember going to his house in the
middle of winter when it was snowing and ... Show more content on Helpwriting.net ...
When our church installed its new pipe organ, he was the first person to play it and when he played,
it sounded like angels coming down from heaven. He loved playing the organ, singing in the choir,
playing handbells and playing the piano anytime he got the chance. I remember every Christmas
Eve, before the service started, he would be upstairs in the sanctuary playing the organ, making the
most beautiful sounds that filled the church with joy. His love of music passed down to his son who
is now a music minister in St. Louis. He always fulfilled his love for music in all he did in

Pancreatic Carcinoma Research Paper
Introduction
Pancreatic carcinoma (P.C) is a malignant disease of the pancreas and one of the top ten leading
causes of cancer deaths in the UK. This type of cancer is one of the few which has shown a small
improvement in the survival rate. On average, the age at which patients are diagnosed with such
disease is at 71 years of age and with a minimum of 40 years old in rare accounts. Whilst the risk of
developing such disease is greater in developed than developing countries, various factors either
lifestyle factors or hereditary can metamorphose into risk factors and become cancer causing. The
pathophysiology of this type of cancer is complex and involves modification of the DNA by various
ways such as point mutation, indels, gene rearrangement and more. Early diagnosis of pancreatic
cancer is difficult as it is an organ found quite deep in the body so any anomalies co go unnoticed
during routine examinations. The incidence aswell as the mortality of ... Show more content on
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P.C can be classified into two main groups: exocrine and endocrine cancers. Exocrine cancers
accounts for the majority of most P.C cases which involves a cancer originating in the pancreatic
juice secreting ducts. There are two major groups of these including intraepithelial neoplasia and
intraductal papillary mucinous neoplasia. In contrast, pancreatic neuroendocrine cancers (PanNET)
cases are minor, these involve cancer arising in hormone secreting regions. The majority of
pancreatic tumours are adenocarcinoma which is the most common type of exocrine P.C. Pancreatic
ductal adenocarcinoma matures from non–invasive precursor lesions otherwise termed as pancreatic
intraepithelial neoplasia. The mutated genes in P.C are characterized by the sequence of exomes of
24 pancreatic ductal adenocarcinomas (Jones S, Zhang X, Parsons DW, et al,

Casey Anthony Trial Essay
The Casey Anthony Trial
One of the most controversial and polemic trials of all times since the OJ Simpson trial was the case
of Casey Anthony and the murder of her two year old daughter. All the evidences and witness
revealed that she was the main suspect in the murder of her daughter; however in 2011 she was
found not guilty of this murder due to several different aspects. This paper will inform and provide
the reader with detailed information about this case. In addition the reader will find out what was the
outcome of this case and will provide the evidence and will summarize the criminal procedures that
occurred from arrest through appeal. The elements of the crime and the evidence which prove that
she was guilty will be ... Show more content on Helpwriting.net ...
Also the whole nanny situation was a lie, after detectives went to the apartment complex where
supposable Zenaida Fernandez lived records showed that no one by that name had ever been a
resident there. The next lie discovered was Casey's employment, she was actually unemployed and
not working at Universal studios like she stated. Records show that she worked there years back but
was fired. Detectives saw no ambition in Casey trying to find her daughter, Casey was a liar and
never did she show any type of emotions of suffering while talking to the detectives. The biggest
concern to police was "Why Caylee was reported missing until a month after she was last seen?"
Weeks before the call, the vehicle Casey had been driving was found abandoned. The tow truck
driver who found the vehicle told officers that the vehicle had a smell as if something had been
decomposing. The tow truck driver compared the smell to a similar situation where he found an
abandoned truck with a dead man's body laying inside. Along with the horrible smell inside the
vehicle; hair and a black plastic bag were found in the trunk of the car. Also found was what it
seemed to be blood. On July 16 Casey Anthony was charged with first–degree murder, child neglect,
aggravated child abuse and four counts of lying to detectives. On December 11, 2008 Caylee's body
was found wrapped inside a plastic bag, her body was decomposed and her skull only

Symptoms Management Issues And Skills Assessment Essay
Symptom Management Issues and Skills Assessment
The Cancer Research UK note the symptoms of insulinoma is hypoglycemia such as tiredness,
confusion, weak, and light–headedness (Insulinoma | Cancer Research, 2014). Also, Ghosn notes the
common symptoms of pancreatic cancer include weight loss, jaundice, pain, nausea and depression.
Of the best practices noted by Ghosn, surgery is not an option per the doctor; pharmacological pain
medications are not one per Charlie's choice; diet is the main practice he implemented to manage his
hypoglycemia (2012). Recognizing symptoms of insulinoma/pancreatic cancer in daily life and
finding ways that work for the patient takes a significant amount of work since they are generalized
and the patient may not notice them initially.
The most important symptom to manage first is the hypoglycemia. While looking for information
and alternative ways to help Charlie, his wife Dixie found a diet called The Alkaline Diet in the
book The Acid Alkaline Balance Diet, Second Edition: An Innovative Program that Detoxifies Your
Body 's Acidic Waste to Prevent Disease and Restore Overall Health: Edition 2 by Felicia Kliment.
The diet is based on the belief that cancer cells are acidic and thrive in an acidic environment; so by
making the internal environment more alkaline one hinders the growth of cancer cells (Kliment,
2010). Their diet now includes even more raw or steamed veggies, fresh fruit, nuts, and fish than
before and have completely eliminated red

Introduction
Cholelithiasis (also called gallstones) is a form of gallbladder disease in which gallstones form in
the gallbladder. The gallbladder is an organ that stores bile. Bile is made in the liver, and it helps
digest fats. Gallstones begin as small crystals and slowly grow into stones. Gallstone pain occurs
when the gallbladder contracts and a gallstone is blocking the duct. Pain can also occur when a stone
passes out of the duct.
What are the causes?
This condition [is / may be] caused by:
What increases the risk?
The following factors may make you more likely to develop this condition:
Being female.
Having multiple pregnancies. Health care providers sometimes advise removing diseased
gallbladders before future pregnancies.
Eating a diet ... Show more content on Helpwriting.net ...
Tenderness to the touch.
In some cases, when gallstones do not move into the bile duct, people have no pain or symptoms.
These are called "silent" gallstones.
How is this diagnosed?
This condition [is / may be] diagnosed [by / based on / with / during] ____.
How is this treated?
Treatment for gallstones depends on the severity of the condition. Silent gallstones do not need
treatment. In severe cases, emergency surgery may be required. Options for treatment include:
Medicines. These do not always work and may take 6–12 months or more for them to work.
Shock wave treatment (extracorporeal biliary lithotripsy). In this treatment, an ultrasound machine
sends shock waves to the gallbladder to break gallstones into smaller pieces that can then be passed
into the intestines, or be dissolved by medicine.
Surgery to remove the gallbladder. This is the most common treatment. Attacks almost always come
back and surgery is usually required for permanent treatment.
Follow these instructions at home:
Take over–the–counter and prescription medicines only as told by your health care provider.
Follow a low–fat diet until you are seen again by your health care provider. Fat causes the
gallbladder to contract, which can result in

Causes Of Pancreatic Cancer
Pancreatic cancer has been studied many times. Pancreatic Ductal Adenocarcinoma(PDAC) is a
pancreatic cancer and it is the third most leading cause of death by cancer in the world. Many
studies and experiments have been done to improve the poor long–time survival rate of this disease.
These studies show that a mutation in KRAS show up in many cases of pancreatic cancer. KRAS is
what regulates proliferation, differentiation, metabolism, and survival. Being that KRAS has been
confirmed in studies of animals that it is an initiation in cancer cells, it is a great therapeutic target.
But these attempts to create something to affect the initiation of pancreatic cancer have been
hindered in many ways. Scientists have been looking into how greatly

Pancreatic Cancer: A Case Study
Clinically, pancreatic cancer is diagnosed using a combination of the following approaches. A
person suspected of having pancreatic cancer will first undergo a physical examination that will be
focused on identifying fluid buildup in areas of the abdomen that surround the pancreas (SITE).
Also, a physician can reference a patient's medical history for risk factors, which may include
familial and previously mentioned risk factors (Esposito et al., 2014). Once that has been completed,
other physical exams such as examining the patient's skin, eyes, and lymph nodes for jaundice–like
symptoms and inflammation is performed, respectively (SITE).
If the physician suspects pancreatic cancer, various tests may be recommended. Computed
tomography (CT) ... Show more content on Helpwriting.net ...
In researching which animal models are used for studying pancreatic cancer, it was found that mice,
dogs, and hamsters are useful organisms (Murtaugh, 2013). Considering the closeness of these
models to man, dogs would have been the best to use. However, studies have shown that pancreatic
cancer is quite rare in dogs naturally (SITE). To further discount using a dog model is that older
female dogs are more susceptible, implying that the cost in procuring and caring for these dogs will
be relatively higher (SITE). As the gestational period is 63 days on the average compared with 20
days in mice, we decided to utilize a mouse model (SITE). Additionally, hamsters could be used to
study PDAC, but since their genome is not as easily manipulated compared to mice this model was
not pursued (Murtaugh,

Pancreatic Magnetic Resonance Imaging Analysis
Introduction
Pancreatic ductal adenocarcinoma is the most common malignant tumor of the pancreas, accounting
for about 85–90% of all pancreatic tumors and is the fourth most common cause of cancer death
worldwide [1]. The remaining 10–15% of pancreatic tumors are a heterogeneous group of pancreatic
neoplasms that includes cystic pancreatic neoplasms, endocrine tumors and other uncommon
pancreatic tumors. Magnetic resonance imaging (MRI) is reliable for the characterization of solid
and cystic pancreatic lesions. Due to the excellent soft tissue contrast, MRI is able to readily
separate cystic from noncystic tumors. Cystic tumors are frequently easier to diagnose since they
often possess typical imaging findings that permit an accurate and reliable ... Show more content on
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This is particularly important in patients at higher risk of radiation injury (e.g. younger patients)
especially those requiring repeated imaging follow–up.
Some gadolinium based contrast (GBC) agents are associated with nephrogenic systemic fibrosis
(NSF); Patients with advanced acute or chronic kidney disease. Avoidance of GBC exposure is the
best approach for high–risk patients[14].
Also, had been reported that the incidence of immediate hypersensitivity reactions to MR contrast
media was 0.079%, and the recurrence rate of hypersensitivity reactions was 30% in patients with
previous reactions. It is a very low percentage if we compare it to iodinate contrast media but
however it should be considered.
New motion–robust MRI techniques provide adequate images even in patients that are not able to
cooperate with breath–hold instructions [16]. Preliminary studies demonstrated that in patients who
unable to suspend respiration, new imaging techniques for MRI, such as radial 3D–GRE acquired in
a free breathing fashion, may be useful for pancreatic MR imaging and aid the radiologist in the
detection and characterization of pancreatic focal

Evaluation Of A Old End Stage Cancer Patient
As I was about to round off my shift 7am to 3:15pm, on 7/31/2015, I received a call from the
admission office that I should prepare for a 75year old end stage cancer patient As I was preparing
for the admission the patient was brought in on a stretcher with her family. The patient was admitted
for back pain and loss of weight. It was diagnosed that "Miriam" had been diagnosed with
pancreatic cancer and was given three months to live. She has two siblings who live far apart, one in
New York and the other in Georgia. She used to live with her daughter in Georgia until she began
complaining of back pain and losing weight. Upon admission to the facility her daughter was
convinced that Miriam had less than ninety days to live. The primary ... Show more content on
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People with certain risk factors may be more likely than others to develop cancer of the pancreas.
Some risk factors that may increase the chance of getting cancer of the pancreas include smoking
tobacco, the most important risk factor for pancreatic cancer. People with diabetes, family history
with pancreatic cancer increases the risk of developing the disease, inflammation of the pancreas
and having pancreatitis for a long time. Overweight or obese people may likely than other people to
develop pancreatic cancer. Possible risk factors being studied include, diet high in animal fat and
heavy drinking of alcoholic beverages. "Another area of active research is whether certain genes
increase the risk of disease. Many people who get pancreatic cancer have none of these risk factors,
and many people who have known risk factors don't develop the disease".(pg. 7). Signs and
Symptoms from early to late stages include; Dark urine, pale stools, and yellow skin and eyes from
jaundice, Nausea and vomiting, frequent bowel movement, Pain in the upper part of your belly and
pain in the middle part of your back, relieved by a shift in position, Others may include weakness or
feeling very tired with loss of appetite or feelings of fullness and weight loss. Pancreatic cancer can
be diagnosis by having a blood tests, CT scan, an x–ray, ultrasound and endoscopy. Physical exam
may examine abdominal changes in areas near the pancreas, liver,

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