The document discusses breast cancer risk factors associated with shift work and night shifts. It finds an increased risk of breast cancer for those who do not sleep during typical melatonin secretion hours. Surgical options for breast cancer treatment are also examined, including mastectomy procedures and reconstruction options.
Soft tissue sarcomas, treatment (surgical, radiation, chemotherapy)Joseph A. Di Como MD
A PowerPoint presentation for medical professionals regarding soft tissue sarcomas, likely most helpful to surgical residents and medical students. Gist tumors, liposarcomas, retroperitoneal sarcomas extremity, breast sarcoma and vascular sarcomas
Soft tissue sarcomas, treatment (surgical, radiation, chemotherapy)Joseph A. Di Como MD
A PowerPoint presentation for medical professionals regarding soft tissue sarcomas, likely most helpful to surgical residents and medical students. Gist tumors, liposarcomas, retroperitoneal sarcomas extremity, breast sarcoma and vascular sarcomas
This presentation demonstrates the current paradigm in the treatment of desmoid tumors. As the management is shifting from surgical approach to medical management.
Discusses how to approach a lump found in the breast by triple assessment: clinical assessment (history, breast exam), imaging (mammography, breast ultrasonography), cell/ tissue diagnosis (by fine needle aspiration or core needle biopsy of the mass). Useful for nursing students, midwifery students, nurses, midwives, Medical Students, General Doctors, Gynecologists, Surgeons.
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
It contains details about breast carcinoma-pathology,investigations and diagnosis,NACT,surgery and adjuvant therapy. Hope you will find it helpful.....
Updated Information about inflammatory breast cancer (IBC) - how it is different from other locally advanced breast cancer, pathology, imaging, how it is treated, research directions, resources and contact info for the IBC Network
This presentation demonstrates the current paradigm in the treatment of desmoid tumors. As the management is shifting from surgical approach to medical management.
Discusses how to approach a lump found in the breast by triple assessment: clinical assessment (history, breast exam), imaging (mammography, breast ultrasonography), cell/ tissue diagnosis (by fine needle aspiration or core needle biopsy of the mass). Useful for nursing students, midwifery students, nurses, midwives, Medical Students, General Doctors, Gynecologists, Surgeons.
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
It contains details about breast carcinoma-pathology,investigations and diagnosis,NACT,surgery and adjuvant therapy. Hope you will find it helpful.....
Updated Information about inflammatory breast cancer (IBC) - how it is different from other locally advanced breast cancer, pathology, imaging, how it is treated, research directions, resources and contact info for the IBC Network
breast cancer is a disease which is more common in females. Introduction and definition of breast cancer is explained in slides. Incidence according to american cancer society estimation in united states 2023 is explained here.Types of breast cancer elaborated through images . Stages, pathophysiology, sign and symptoms, essential diagnostic evaluation of breast cancer and TNM classification in detail
described. Medical management includes chemotherapy, neoadjuvant therapy, adjuvant therapy, endocrine therapy, various radiation therapy etc. Pharmacological management described. Surgeries of breast cancer described. Nursing management and post operative management explained .Nursing diagnosis of breast cancer is prioritized.
GB cancer is the 5th most common GIT malignancy(worldwide).200 years later it is still considered to be a highly malignant disease with a poor survival rate
.Here is a brief description regarding
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
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
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
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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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
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.
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
5. Results: Breast cancer risk was increased among subjects who frequently did not
sleep during the period of the night when melatonin levels are typically at their
highest (OR = 1.14 for each night per week; 95% CI = 1.01 to 1.28).
Conclusion:The results of this study provide evidence that indicators of exposure
to light at night may be associated with the risk of developing breast cancer
6. Statistically significant associations were observed between breast cancer and
work durations of ≥5 years with ≥6 consecutive night shifts, with the highest risk
observed for progesterone receptor–positive tumors (odds ratio = 2.4, 95%
confidence interval: 1.3, 4.3; P-trend = 0.01)
13. Inspection of the breast in the upright position with the patient’s arms to the side (A), in the air (B), and hands on hips (C).
(From Bland KI, Copeland EM III.The breast, 3rd ed. Philadelphia:WB Saunders,2004.)
14. Examination of the cervical (A), supraclavicular (B), and axillary nodes (C). (From Bland KI, Copeland EM III.The breast, 3rd
ed. Philadelphia:WB Saunders, 2004.)
20. A, Stellate mass in the breast.
The combination of a density
with spiculated borders and
distortion of surrounding breast
architecture suggests a
malignancy
B, Clustered
microcalcifications. Fine,
pleomorphic,
and linear calcifications that
cluster together suggest the
diagnosis of ductal carcinoma
in situ
C, Ultrasound image of breast cancer.
The mass is solid, contains internal
echoes, and displays an irregular border.
Most malignant lesions are taller than
they are wide
21. D, Ultrasound image of a simple cyst.
By ultrasound, the cyst is round with smooth borders,
there is a paucity of internal sound echoes, and there is
increased through-transmission of sound, with enhanced
posterior echoes
E, Breast MRI showing gadolinium enhancement of
a breast cancer.
Rapid and intense gadolinium enhancement
reflects increased tumor vascularity. Lesion contour
and size may also be assessed by MRI .
22.
23. PrimaryTumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
Tis (DCIS ) Ductal carcinoma in situ
Tis (LCIS ) Lobular carcinoma in situ
Tis (Paget’s) Paget’s disease of the nipple not associated with invasive carcinoma or carcinoma in situ (DCIS and/or LCIS ) in the
underlying breast parenchyma.
T1 Tumor ≤20 mm in greatest dimension
T1mi Tumor ≤1 mm in greatest dimension
T1a Tumor >1 mm but ≤5 mm in greatest dimension
T1b Tumor >5 mm but ≤10 mm in greatest dimension
T1c Tumor >10 mm but ≤20 mm in greatest dimension
T2 Tumor >20 mm but ≤50 mm in greatest dimension
T3 Tumor >50 mm in greatest dimension
T4 Tumor of any size with direct extension to the chest wall and/or to the skin
T4a Extension to the chest wall, not including only pectoralis muscle adherence or invasion
T4b Ulceration and/or ipsilateral satellite nodules and/or edema of the skin
T4c BothT4a andT4b
T4d Inflammatory carcinoma
24. Regional Lymph Nodes (N)
pNX Regional lymph nodes cannot be assessed
pN0 No regional lymph node metastasis
pN0(i−) No regional lymph node metastasis histologically, negative IH C
pN0(i+) Malignant cells in regional lymph node(s) no greater than 0.2 mm
pN0(mol−) No regional lymph node metastasis histologically, negative molecular findings (IHC)
pN0(mol+) Positive molecular findings (RT -PCR), but no metastasis detected by histology or IHC
pN1 Micrometastases; or metastases in one to three axillary nodes; and/or in internal mammary nodes with metastases detected by sentinel
lymph node biopsy but not clinically detected
pN1mi Micrometastases (>0.2 mm and/or >200 cells but none >2.0 mm)
pN1a Metastases in one to three axillary nodes; at least one metastasis >2.0 mm
pN1b Metastases in internal mammary nodes with micrometastasis or macrometastases detected by sentinel lymph node biopsy (not
clinically detected)
pN1c Metastases in one to three axillary nodes and in internal mammary nodes with micrometastases or macrometastases detected by
sentinel lymph node biopsy but not clinically detected
pN2 Metastases in four to nine axillary nodes; or in clinically detected internal mammary lymph nodes in the absence of axillary lymph node
metastases
pN2a Metastases in four to nine axillary nodes (at least one tumor deposit >2.0 mm)
pN2b Metastases in clinically detected internal mammary lymph nodes in the absence of axillary lymph node metastases
pN3 Metastases in ten or more axillary nodes; or in infraclavicular (level III axillary nodes); or in clinically detected ipsilateral internal
mammary lymph nodes in the presence of one or more positive level I, II axillary nodes; or in more than three axillary lymph nodes and
internal mammary lymph nodes, with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically
detected; or in ipsilateral supraclavicular lymph nodes
25. Distant Metastases (M)
M0 No clinical or radiographic evidence of distant metastases
cM0(i+) No clinical or radiographic evidence of distant metastases, but deposits of molecularly or
microscopically detected tumor cells in circulating blood, bone marrow, or other nonregional nodal
tissue that are no larger than 0.2 mm in a patient without symptoms or signs of metastases
M1 Distant detectable metastases as determined by classic clinical and radiographic means and/or
histologically proven larger than 0.2 mm
26. ANATOMIC STA GE PROGNOSTICGROUP
0 Tis N0 M0
IA T1 N0 M0
IB T0
T1
N1mi
N1mi
M0
M0
IIA T0
T1
T2
N1
N1
N0
M0
M0
M0
IIB T2
T3
N1
N0
M0
M0
IIIA T0
T1
T2
T3
T3
N2
N2
N2
N1
N2
M0
M0
M0
M0
M0
IIIB T4
T4
T4
N0
N1
N2
M0
M0
M0
IIIC AnyT N3 M0
IV AnyT Any N M1
27.
28.
29. The Halsted radical mastectomy involved removing the breast with the overlying skin, the pectoralis major and minor
muscles, and the level I, II, and III axillary lymph nodes. (From Bland KI, Copeland EM III.The Breast, 3rd ed. Philadelphia:
WB Saunders, 2004.)
30. The classic Stewart elliptical
mastectomy incision.
The medial aspect is at the
lateral edge of the sternum
and the lateral aspect overlies
the latissimus dorsi muscle.
(From Bland KI, Copeland EM
III.The breast, 3rd ed.
Philadelphia:WB Saunders,
2004.)
31. The classic Orr oblique elliptical
mastectomy incision. (From Bland KI,
Copeland EM III.The breast, 3rd ed.
Philadelphia: WB Saunders, 2004.)
32.
33.
34.
35.
36. Total mastectomy with and without axillary dissection.
A, Skin incisions are generally transverse and surround the central breast and nipple-areolar complex.
B, Skin flaps are raised sharply to separate the gland from the overlying skin and then the gland from the underlying
muscle. Simple mastectomy divides the breast from the axillary contents and stops at the clavipectoral fascia.
C, In modified radical mastectomy, dissection continues into the axilla and generally extends up to the axillary vein, with
removal of level I and II nodes. Division of a branch of the axillary vein is shown, with separation of the node-bearing
axillary fat from the axillary vein at the superior aspect of the dissection.
37.
38.
39. Breast-conserving surgery.
A, Incisions to remove malignant tumors are placed directly over the tumor, without tunneling. A transverse incision in the low
axillary region is used for sentinel node biopsy or axillary dissection.The axillary dissection is identical to the
procedure for a modified radical mastectomy.The boundaries of the operation are the axillary vein superiorly, the latissimus
dorsi muscle laterally, and the chest wall medially.The inferior dissection enters the tail of Spence (the axillary tail of the
breast). Inset, Excision cavity of the lumpectomy.
B, In sentinel node biopsy, a similar transverse incision is made, which may be located by percutaneous mapping with the
gamma probe if radiolabeled colloid is used. It is extended through the clavipectoral fascia and the true axilla is entered.The
sentinel node is located by its staining with dye, radioactivity, or both, and dissected free as a single specimen
50. Type Advantages Disadvantages
Implant One stage procedure, minimal
prolongation, hospitalization, or
recovery.
Low cost.
Poor symmetry if skin removed or in
large ptotic breasts.
Capsular contracture, leakage,
rupture possible.
Tissue expander Short operative time.
Hospitalization, recovery not
prolonged.
Low cost.
Multiple physician visits postop. Poor
symmetry large or ptotic breasts.
Capsular contracture, leakage
rupture possible.
Latissimus dorsi flap Very low risk of flap loss.
Natural contour with autogenous
tissue.
Donor site scar.
Usually requires an implant.
Moderate prolongation
hospitalization and recovery.
51. Type Advantages Disadvantages
Transverse rectus abdominous
myocutaneous (TRAM) flap
Natural contour. Good match for
large or ptotic breasts.
Abdominoplasty.
Donor site scar.
Fat necrosis, flap loss possible.
Abdominal wall weakness plus
hernia.
Significant prolongation
hospitalization plus recovery.
Deep inferior epigastric perforator
(DIEP) flap
Natural contour.
Muscle sparing.
Abdominoplasty.
Donor site scar.
Need for microsurgeon.
Flap loss possible.
Moderate prolongation
hospitalization plus recovery.
Superior gluteal artery perforator
flap
Natural contour.
Alternative donor site.
Donor site scar.
Need for microsurgeon.
Flap loss possible.
Moderate prolongation
hospitalization plus recovery.
52.
53.
54.
55.
56.
57. Patients are marked preoperatively in the standing position for anatomic landmarks as well as the proposed
DIEP flap procedure. Slight adjustments to the suprapubic marking can be made during surgery to assure a
tension-free closure of the abdomen
58. Isolation of the DIEP flap on the selected perforators proceeds
under loupe magnification, and begins by opening the anterior
rectus sheath around each perforator. A very small cuff of the
fascia can be harvested along with each perforator, as shown
here, but routinely, no fascia is harvested.
The rectus abdominis muscle is split along the direction
of its fibers during DIEP flap harvest. All small side
branches originating from the selected perforators or
the deep inferior epigastric vessels are carefully ligated
and divided as the dissection proceeds.
59. End-to-end microanastomoses are fashioned between the deep inferior epigastric vessels and either the
thoracodorsal or internal mammary recipient vessels. Once perfusion is re-established, the DIEP flap is
debulked, contoured, and inset. Areas of the skin island underlying the native mastectomy flaps are
deepithelialized in situ.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69. Atlas of Breast Surgery
DeVita, Hellman, and Rosenberg’s
Cancer: Principles & Practice of Oncology
Greenfield’s Surgery: Scientific Principles & Practice
Mastery of Surgery
Netter’s Surgical Anatomy and Approaches
SabistonTextbook of
Surgery