This PowerPoint presentation provides a concise yet thorough exploration of Acromegaly, a rare hormonal disorder caused by excessive production of growth hormone (GH). The presentation covers key aspects of the condition, including its definition, underlying causes, symptoms, and potential complications. It delves into the diagnostic methods, highlighting the importance of early detection. Furthermore, the presentation offers insights into the available treatment options, ranging from medical interventions to surgical procedures. With clear visuals and easily understandable language, the audience will gain a better understanding of Acromegaly's impact on the body and the various management approaches to improve the quality of life for those affected by this condition.
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Graves’ disease is a type of autoimmune problem that causes the thyroid gland to produce too much thyroid hormone, which is called hyperthyroidism. Graves’ disease is often the underlying cause of hyperthyroidism.
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Graves’ disease is a type of autoimmune problem that causes the thyroid gland to produce too much thyroid hormone, which is called hyperthyroidism. Graves’ disease is often the underlying cause of hyperthyroidism.
Acromegaly nursing care plan & managementNursing Path
Acromegaly is a rare, chronic, and disabling disorder of body growth and endocrine dysfunction in adults (after closure of the epiphyses) that is caused by excessive levels of growth hormone (GH).
This clinical topic presentation which was done by me, on topic gynecomastia, a common problem medicine and endocrine specialists face on their day to day practice. It gives a brief idea about definition, clinical presentation, pathophysiology and management and prognosis of gynecomastia.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. Acro' comes from the Greek word
ákros, meaning topmost or
highest and refers to the extremities
of the body (such as the hands and
feet), 'Megaly' comes from the Greek
word for great, meaning enlarged. So
acromegaly literally means 'large
extremities'.
Acromegaly is a hormonal disorder
that develops when the pituitary
gland produces too much growth
hormone during adulthood.
Acromegaly is usually diagnosed in
adults aged between 30 to 50, but it
can affect people of any age. When it
develops before the end of puberty,
it's known as “Gigantism".
WHAT IS ACROMEGALY ?
5. CAUSES
Pituitary adenoma
Carcinoid tumor
Pancreatic islet cell tumor
Genetic conditions(ex. McCune-Albright syndrome,
MEN-1, neurobromatosis)
In more than 9 out of 10 cases, acromegaly is
caused by a tumor in the pituitary gland. More
rarely, the cause may be a tumor in another part of
the body.
6. PATHOGENESIS
Acromegaly develops when
the pituitary gland releases
too much GH into the body
over a long period of time.
When GH enters the blood,
this signals the liver to
produce another hormone,
called insulin-like growth
factor I (IGF-I). IGF-I is the
hormone that actually
causes bones and body
tissue to grow.
7. DIAGNOSIS
We will ask about their medical history and conduct
a physical exam. Then conduct the following steps:
IGF-1 measurement. After they've fasted overnight,
we will take a blood sample to measure the IGF-1
level in their blood. An elevated IGF-1 level
suggests acromegaly.
Growth hormone suppression test. This is the
best method for confirming an acromegaly
diagnosis. During this test, their GH blood level is
measured both before and after they drink a
preparation of sugar (glucose). In people who don't
have acromegaly, the glucose drink typically causes
the GH level to fall. But if they have acromegaly,
their GH level will tend to stay high.
Imaging. We will conduct an imaging test, such as
X-ray,CT scan,magnetic resonance imaging (MRI),
to help pinpoint the location and size of a tumor on
pituitary gland. If no pituitary tumors are seen, we
may order other imaging tests to look for
nonpituitary tumors.
8. TREATMENT
The goals of treatment are to control tumor size,
return GH and IGF-I levels back to normal, improve
symptoms, and manage related health problems.
Treatment options include:
Surgery
Medicines
Radiation therapy
9. SURGERY
Surgeons most often use a type of surgery called
transsphenoidal surgery, which involves going through the
patient’s nose and sphenoid sinus, a hollow space in the
skull behind the nasal passages and below the brain, to
perform surgery.
The goal of surgery is to remove all of a tumor that is causing
excess growth hormone production.
If surgeon removes enough of the tumor, may not need
further treatment .
If surgeon can remove only a part of a tumor, may need
medication or radiation therapy to manage symptoms and
reduce the production of growth hormone.
10. MEDICINES
Currently, three types of medicines are used to treat
acromegaly, but they are not a cure. The medicines may
be used alone or in combination with each other.
1. Somatostatin Analogs
2. Dopamine Agonists
3. Growth hormone-receptor antagonists.
11. 1) Somatostatin analogs
Most often used
These drugs curb the release of GH and may also reduce the
size of the pituitary tumor.
Safe and effective for long-term treatment.
octreotide,(sandostatin),lanreotide(somatuline depot)
2) Dopamine agonists
Inhibit GH production and tumor growth, but not as well as
SSAs do.
Likely to work in people who have mild GH excess and those
who have both acromegaly and hyperprolactinemia (too much
of the hormone prolactin).
Cabergoline & bromocriptine
3) Growth hormone-receptor antagonists
they block GH from signaling the body to make more IGF-I.
Pegvisoment(somavert)
12. RADIATION THERAPY
Uses high-energy x-rays or particle waves to kill tumor
cells.
Recommended if surgery isn’t possible or fails to
remove all tumor tissue, and medicines are not an
option or working for the patient.
13. CASE DISCUSSION
REFERENCE:HTTPS://WWW.IJMRHS.COM/MEDICAL-RESEARCH/ACROMEGALY-A-CASE-REPORT.PDF
Case Report
A 35 year old female patient came to OPD with chief
complaints of weight gain, excessive sweating , widening
of both hands and feet since 4 to 5 years. She also
reported complaints of change in voice and headache
intermittently.
Past Medical History
No history of convulsions or altered sensorium or she
doesn't have any visual complaints or any weakness.
For amenorrhorea she underwent total abdominal
hysterectomy 9 years back.
14. PHYSICAL EXAMINATION
Vitals are normal
There was no pallor, cyanosis,
clubbing, lymphadenopathy.
But patient’s general appearance
didn't look normal. Careful
examination from head to toe
showed prominent supraorbital
ridges, prognathism, widening of
teeth spaces , macroglossia with
thick lips, large ears and fleshy nose
, patient also had spade like hands
and feet and also had deep, husky
voice which was not before.
Systemic examination was normal.
Seen all these features, we
suspected the provisional diagnosis
of 'acromegaly'.
15.
16. MRI brain shows: 3.1*2.4*1.6 cm sized, well defined lesion, with
moderate enhancement on post contrast study in sellar and supra sellar
region with extension and mass effect over adjacent structures s/o sellar
or supra sellar SOL like pituitary macroadenoma.
17. TREATMENT
Treatment was started with oral hypoglycemic drugs
i.e. metformin 500mg for impaired fasting blood
glucose level before surgery and ‘Transsphenoidal
surgical resection (TSS)' was done.
Patient is now stable and her postoperative GH level
is 7.94ng/ml. And patient is discharged on tab
prednisolone 5mg half tab daily, and patient is called
for follow up after 3 months.
18. There were noticeable changes were seen in patient
after surgery.
She lost 7kg weight in 2 months.
19. CONCLUSION
Acromegaly is a rare disease but not incurable. it is
caused due to excessive secretion of growth
hormone and insulin like growth factor type 1
mostly due to pituitary adenoma.
Early recognition and treatment of disease helped
in prognosis of disease and arrested the
complications like hypertension, cardiomyopathy,
diabetes mellitus, visual disturbances etc. Hence
early recognition and management is a key to
success in better prognosis and improved quality of
life.
20. REFERENCES
[1] Lavrentaki A, Paluzzi A, Wass JA, Karavitaki N. Epidemiology of acromegaly:
review of population studies. Pituitary. 2017;20(1):4–9.
[2] Chanson P, Salenave S, Kamenicky P. Acromegaly. In: Fliers E, Korbonits M,
Romijn JA, eds. Handbook of clinical neurology. Vol 124. 1st ed. Waltham, MA:
Elsevier B.V.; 2014:197–219.
[3] Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an endocrine society
clinical practice guideline. Journal of Clinical Endocrinology and Metabolism.
2014;99(11):3933–3951.
[4] Paragliola RM, Salvatori R. Novel somatostatin receptor ligands therapies for
acromegaly. Frontiers in Endocrinology. 2018;9:78.