This document discusses B cell lymphoma and its classification. It notes that lymphomas are malignant disorders derived from lymphoid cells that can be B cell or T cell in origin, with the majority being of B cell origin. B cell lymphomas are divided into Hodgkin's lymphoma and non-Hodgkin's lymphoma. Hodgkin's lymphoma is a distinct malignant disease that is predominantly of B cell origin and has a variable disease course but improved prognosis with modern treatments. Non-Hodgkin's lymphomas are more often clinically disseminated at diagnosis and can be of B cell or T cell origin.
acute leukemia
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acute leukemia
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chronic myeloid leukemia, CML, epidemiology, BCR ABL1 gene, philadelphia chromosome, t(9;22), CML incidence, etiology of CML, pathophysiology of CML, phases of CML, treatment of CML, Allogenic stem cell transplant, TKI therapy for CML, Sokal index for CML,
Dr. Feroze Momin presents Chronic Lymphocytic Leukemia - Review and new Insights.
To read about Dr. Feroze Momin: http://conquercancers.com/ourdoctorso1.html
To read about Cancer Treatment Center in Michigan:
http://conquercancers.com
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
chronic myeloid leukemia, CML, epidemiology, BCR ABL1 gene, philadelphia chromosome, t(9;22), CML incidence, etiology of CML, pathophysiology of CML, phases of CML, treatment of CML, Allogenic stem cell transplant, TKI therapy for CML, Sokal index for CML,
Dr. Feroze Momin presents Chronic Lymphocytic Leukemia - Review and new Insights.
To read about Dr. Feroze Momin: http://conquercancers.com/ourdoctorso1.html
To read about Cancer Treatment Center in Michigan:
http://conquercancers.com
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
Hodgkin’s disease was initially described as an inflammatory
disease (hence the term “disease”), but is clearly
recognized and treated as a malignant lymphoma (hence the
more accurate term Hodgkin’s lymphoma (HL) is used
synonymously with Hodgkin’s disease).
The management of Hodgkin’s lymphoma has evolved from
extended-field radiation alone as the main therapy to a
combined-modality approach with
chemotherapy and radiation, or chemotherapy alone.
Painles lymphadenopathy
Systemic symptoms- unexplained fevers, drenching night sweats, weight loss, generalize pruritus, fatigue, and alcohol-induced pain in tissues involved by HD
Mediastinal mass on a routine chest radiograph
90% of patients present with contiguous sites of involvement or Extension from adjacent lymph nodes
Hematogenous (liver or multiple bony sites) Involvement of the bones may cause blastic changes, especially in the vertebrae (creating the classic “ivory vertebra” on plain radiographs), pelvis, sternum, or ribs
Nearly all patients with hepatic or bone marrow involvement by Hodgkin lymphoma have extensive involvement of the spleen
Rare- Gut-associated lymphoid tissues such as Waldeyer ring and Peyer patches, Upper aerodigestive tract, Central nervous system, and Skin
All u want to knew about epidemiology, pathology, pathogenesis, clinical picture, investigation, differential diagnosis, different treatment modalities.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Lymphoma
Clonal malignant disorders that are derivedClonal malignant disorders that are derived
from lymphoid cells: either precursor orfrom lymphoid cells: either precursor or
mature T-cell or B-cellmature T-cell or B-cell
Majority are of B- cell origin (80%)Majority are of B- cell origin (80%)
T cell Lymphoma (15%)T cell Lymphoma (15%)
3. Classification of B cellClassification of B cell
LymphomaLymphoma
Divided into 2 main types :Divided into 2 main types :
1.1. Hodgkin’s lymphomaHodgkin’s lymphoma
2.2. Non - Hodgkin’s lymphomaNon - Hodgkin’s lymphoma
4. Hodgkin’s Disease
Histologically & clinically a distinctHistologically & clinically a distinct
malignant diseasemalignant disease
Predominantly, B-cell diseasePredominantly, B-cell disease
Course of the disease is variable,Course of the disease is variable,
but the prognosis has improvedbut the prognosis has improved
with modern treatmentwith modern treatment
7. Clinical features
Bimodal age distribution :distribution :
young adultsyoung adults ( 20-30 yrs)( 20-30 yrs) & elderly& elderly (> 50yrs)(> 50yrs)
MMay occur at any ageay occur at any age
M > FM > F
LymphadenopathyLymphadenopathy::
most often cervical regionmost often cervical region
asymmetrical, discreteasymmetrical, discrete
painless, non-tenderpainless, non-tender
elastic character on palpation ( rubbery)elastic character on palpation ( rubbery)
not adherent to skinnot adherent to skin
fluctuate in sizefluctuate in size
8. Contiguous spread via the lymphatic chainContiguous spread via the lymphatic chain
eg.eg.involvement of abdominal & thoracicinvolvement of abdominal & thoracic
LNsLNs
Extra nodal disease - rareExtra nodal disease - rare
HepatospleenomegalyHepatospleenomegaly
9.
10. Constitutional symptoms (B symptoms)Constitutional symptoms (B symptoms)
Night sweats,Night sweats,
sustained fever > 38 degree celsius,sustained fever > 38 degree celsius,
loss of weight >10% of body weight in 6 moloss of weight >10% of body weight in 6 mo
Fever sometimes cyclicalFever sometimes cyclical (‘Pel-Ebstein fever’)
Pain at the site of disease after drinkingPain at the site of disease after drinking
alcoholalcohol
PallorPallor
PruritisPruritis
Symptoms of Bulky (>10 cm) diseaseSymptoms of Bulky (>10 cm) disease
12. LN FNAC / biopsyLN FNAC / biopsy ::
MalignantMalignant REED-STERNBERG ( RS) Cell: Bi-: Bi-
nucleate cell with a prominent nucleolus. Derivednucleate cell with a prominent nucleolus. Derived
from B cell, at an early stage of differentiationfrom B cell, at an early stage of differentiation
Reactive background of eosinophils,Reactive background of eosinophils,
lymphocytes, plasma cellslymphocytes, plasma cells
Fibrous tissueFibrous tissue
20. Staging
Stage I : Involvement of single LN region (I) or extra: Involvement of single LN region (I) or extra
lymphatic site (IAlymphatic site (IAEE ))
Stage II : Two or more LN regions involved (II) or anTwo or more LN regions involved (II) or an
extra lymphatic site and lymph node regions on theextra lymphatic site and lymph node regions on the
same side of diaphragmsame side of diaphragm
Stage III : Involvement of lymph node regions on bothInvolvement of lymph node regions on both
sides of diaphragm, with (IIIsides of diaphragm, with (IIIEE) or without (III) localized) or without (III) localized
extra lymphatic involvement or involvement of theextra lymphatic involvement or involvement of the
spleen (IIspleen (IISS) or both (IIS) or both (IISEE))
Stage IV : Involvement outside LN areas (Liver, boneInvolvement outside LN areas (Liver, bone
marrow)marrow)
AA : Absence of ‘B’ symptoms: Absence of ‘B’ symptoms
BB : B symptoms present: B symptoms present
23. Treatment - Guidelines
Indications for RT:
Stage I diseaseStage I disease
Stage II disease with 3 or lesser areas involvedStage II disease with 3 or lesser areas involved
For Bulky diseaseFor Bulky disease
For pressure problemsFor pressure problems
Indications for CT
All with B symptomsAll with B symptoms
Stage II disease with >3 areas involvedStage II disease with >3 areas involved
Stage III and IV diseaseStage III and IV disease
24. Treatment
Stage IA , Stage IIA with 3 or < 3 areas involved::
RadiotherapyRadiotherapy
Stage IB, Stage II A with > 3 areas , Stage IIB::
ChemotherapyChemotherapy every 3-4 weeks, 6-8 cycles;every 3-4 weeks, 6-8 cycles;
either alone, or in combination witheither alone, or in combination with radiotherapyradiotherapy
Stage III & IV :
ChemotherapyChemotherapy ++ RadiotherapyRadiotherapy ( for bulky( for bulky
disease or palliation of symptoms)disease or palliation of symptoms)
25. Prognosis
Overall 10 yr survival – 80%Overall 10 yr survival – 80%
In long term survivors there is a risk ofIn long term survivors there is a risk of
secondary malignancy: (secondary malignancy: (leukemia , NHL), Solid), Solid
tumors- Lung, breast
InfectionsInfections
Cardiac, pulmonary, endocrinal abnormalitiesCardiac, pulmonary, endocrinal abnormalities
26. International Prognostic Index (IPI)
AgeAge
Advanced stage diseaseAdvanced stage disease
Performance statusPerformance status
Elevated LDHElevated LDH
Presence of Extra nodal diseasePresence of Extra nodal disease
27. Non Hodgkin’s lymphoma
Incidence is increasingIncidence is increasing
NHL>HDNHL>HD
Median age of presentation isMedian age of presentation is 65-70 yrs65-70 yrs
M>FM>F
More often clinically disseminated atMore often clinically disseminated at
diagnosisdiagnosis
B-cell-70% ; T-cell-30%B-cell-70% ; T-cell-30%
28.
29. Clinical features
Widely disseminated at presentationWidely disseminated at presentation
Nodal involvementNodal involvement::
Painless lymphadenopathyPainless lymphadenopathy, often cervical, often cervical
region is the most common presentationregion is the most common presentation
HepatospleenomegalyHepatospleenomegaly
ExtranodalExtranodal ::
Intestinal lymphoma ( abdominal pain, anemia,( abdominal pain, anemia,
dysphagia);dysphagia);
CNSCNS ( headache, cranial nerve palsies,( headache, cranial nerve palsies,
spinal cord compression) ;spinal cord compression) ;
Skin, Testis; Thyroid; Lung
Bone marrow (low grade):(low grade):
PancytopeniaPancytopenia
33. Diagnosis and staging
Similar to HDSimilar to HD plus,
Bone marrow aspirate & trephineBone marrow aspirate & trephine
Immunophenotyping : Monoclonal antibodiesImmunophenotyping : Monoclonal antibodies
directed against specific lymphocytedirected against specific lymphocyte
associated antigensassociated antigens
B cell antigens ( CD 19, 20, 22);B cell antigens ( CD 19, 20, 22);
T cell antigens ( CD 2, 3, 5T cell antigens ( CD 2, 3, 5
& 7)& 7)
Immunoglobulin determination: Ig G / IgMImmunoglobulin determination: Ig G / IgM
praprotein markerpraprotein marker
HIVHIV
35. Classification
Low grade
Proliferation: LowProliferation: Low
Course:Course: IndolentIndolent
Symptoms: -veSymptoms: -ve
Treatment: Not curableTreatment: Not curable
High grade
HighHigh
Rapid, fatal(un-Rx)Rapid, fatal(un-Rx)
+ve+ve
Potentially CurablePotentially Curable
Staging
Similar to HD
36. Etiology
Cannot be attributed a single causeCannot be attributed a single cause
Chromosomal translocationsChromosomal translocations: t: t
(14, 18)(14, 18)
Infection:Infection:
Virus:Virus:EBV, HTLV,HHV-8, HIVEBV, HTLV,HHV-8, HIV
Bacteria: H.Pylori - Gastric lymphomaBacteria: H.Pylori - Gastric lymphoma
Immunology:Immunology:
Congenital immunodeficiency,Congenital immunodeficiency,
Immunocompromised patients -Immunocompromised patients - HIV, organHIV, organ
transplantationtransplantation
37. Management
Low grade:
Asymptomatic : No treatment ;Asymptomatic : No treatment ;
RadiotherapyRadiotherapy for localised disease (Stage 1);for localised disease (Stage 1);
Chemotheraphy: mainstay isChemotheraphy: mainstay is
ChlorambucilChlorambucil; Initial response good , but; Initial response good , but
repeated relapses, median survival 6-10 yrs;repeated relapses, median survival 6-10 yrs;
Newer: Fludarabine, 2-CdA (Chlorodeoxyadenosine)Newer: Fludarabine, 2-CdA (Chlorodeoxyadenosine)
Monoclonal antibody: RituximabMonoclonal antibody: Rituximab
SCT/BMT
38. Aggressive ( high / intermediate grade):
ChemotherapyChemotherapy: mainstay: mainstay
CHOP
-every 3 weeks, at least-every 3 weeks, at least
6 cycles6 cycles
Cyclophosphamide,yclophosphamide,
Doxorubicinoxorubicin HHydrochloride,ydrochloride,
Vincristine,incristine,
Prednisolononerednisolonone
39. High risk cases with poor prognosticHigh risk cases with poor prognostic
factors or relapse :factors or relapse :
High dose chemotherapyHigh dose chemotherapy
combined with autologous BMT / SCTcombined with autologous BMT / SCT
Monoclonal antibodyMonoclonal antibody
With CNS involvement / leukemic relapse :With CNS involvement / leukemic relapse :
Similar to ALLSimilar to ALL
All cells have protein markers on their surface, known as antigens. Monoclonal antibodies are designed in the laboratory to specifically recognise particular protein markers on the surface of some cancer cells. The monoclonal antibody then &apos;locks&apos; onto this protein. This either triggers the cell to destroy itself or signals to the body&apos;s immune system to attack and kill the cancer cell.
For example, rituximab, the monoclonal antibody that is used in the treatment of non-Hodgkin&apos;s lymphoma, recognises a protein marker known as CD20. CD20 is found on the surface of the abnormal B cells that are found in some of the most common types of non-Hodgkin&apos;s lymphoma.
When rituximab locks onto CD20 on the surface of a B cell, the cell may be destroyed directly, but also the body&apos;s natural defences are alerted. Rituximab effectively targets the lymphoma cells for destruction by the body&apos;s immune system, which can now kill the cancer cells.
CD20 is also found on the surface of normal B cells, one of the types of white blood cells that circulate in the body. This means that these normal B cells, too, may be destroyed when rituximab is used. However, the stem cells in the bone marrow that develop into B cells do not have CD20 on their surface.
Stem cells are therefore not destroyed by rituximab and can go on to replenish the body with healthy B cells. Although the number of mature, normal B cells is temporarily reduced by the treatment, they return to previous levels after the treatment.