Bladder cancer is a disease of urinary bladder in which cells grow abnormally and have the potential to spread to other parts of the body. This is one of four parts of presentations on Bladder cancer. Please do go through the rest of the presentations too.
What would you recommend as first line therapy for a 68 y/o woman with local pancreatic cancer and no metastatic disease with ECOG-1?
Chemoradiation: Rachna Shroff, MD
Surgical Resection: Yongyut Sirivatanauksorn, MD
urinary bladder malignancy
incidence
risk factors and pathogenesis
staging of the disease
histopathology
transitional and non transitional cell carcinomas
clinical features
laboratory findings
imaging
molecular markers
treatment options
chemotherapy
radiotherapy
surgery
Bladder cancer is a disease of urinary bladder in which cells grow abnormally and have the potential to spread to other parts of the body. This is one of four parts of presentations on Bladder cancer. Please do go through the rest of the presentations too.
What would you recommend as first line therapy for a 68 y/o woman with local pancreatic cancer and no metastatic disease with ECOG-1?
Chemoradiation: Rachna Shroff, MD
Surgical Resection: Yongyut Sirivatanauksorn, MD
urinary bladder malignancy
incidence
risk factors and pathogenesis
staging of the disease
histopathology
transitional and non transitional cell carcinomas
clinical features
laboratory findings
imaging
molecular markers
treatment options
chemotherapy
radiotherapy
surgery
The most common type of cancer arising in the kidney: Renal cell carcinoma(RCC)(also known as Hypernephroma or Grawitz tumor).
Renal cell carcinoma accounts for over 3% of all adult malignancies and has several histological subtypes.
Approximately 85% of kidney tumors are renal cell carcinoma, and approximately 70% of these have a Clear cell histology. Its diagnostic work-up, staging and management.
Chemotherapy induced Nausea and Vomiting
Professional and patient data
ارشادات للقئ والغثيان مع العلاج الكيمائي
Dr Salah Mabrouk Khallaf
د. صلاح مبروك خلاف
استشاري علاج الاورام
Last update of thyroid cancer management from diagnosis till follow up
You can request other lectures by emailing me at salahmab76@yahoo.com or calling me 0020 100 408 1234
Dr Salah Mabrouk Khallaf
الفوائد العظيمة وراء الكشف المبكر لسرطان الثدي
جراحة بسيطة
يمكن الاستغناء عن العلاج الكيمائي في المراحل المبكرة
يمكن ايضا الاستغناء عن العلاج الاشعاعي في المراحل المبكرة
العودة الي الحياة الطبيعية بسرعة
فائدة للفرد والاسرة والمجتمع والدخل القومي
معهد حنوب مصر للاورام
Chemotherapy classes
for more lectures please contact
Dr. Salah Mabrouk Khallaf
MD Medical Oncology & BMT
South Egypt Cancer Institute
Email: salahmab76@yahoo.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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.
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
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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
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
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4. To know indications, you should know staging
Nodal staging
• N0 - none
• N1 - single LN metastasis in the true pelvis (Below common iliac)
• N2 - multiple LN metastases in the true pelvis (Below common iliac)
• N3 - metastases to the common iliac LNs
6. Indications of Cystoscopy
1. Any gross or microscopic hematuria with a normal upper urinary tract
imaging
2. Unexplained or chronic lower urinary tract symptoms
3. Urine cytology that is suspicious for cancer
4. A history of bladder cancer with symptoms suggestive bladder disease
5. Follow up of bladder cancer after successful TURTB
7. Indications of CT Urography
• Diagnostic
1. Any patient with hematuria
2. History of bladder cancer, or positive cytology.
• For staging invasive bladder cancer or upper tract TCC:
1. Abnormally enlarged lymph nodes and visceral metastasis can be observed by CTU.
2. Local invasion into pelvic organs or tumor infiltration into the perivesical fat can also
be observed.
N.B. CT is not reliable for the detection of local invasion.
8. Indications of Urine Cytology
1. Follow-up of patients with a history of bladder cancer
2. Screening symptom-free patients who are exposed to environmental carcinogens
3. Evaluating patients with chronic irritative bladder symptoms before cystoscopy is
done.
9. Indications of NMP22 Antigen
• Nuclear matrix proteins (NMP): Instead of urine cytology if available as:
• Nuclear matrix proteins (NMP) make up the structural framework of the nucleus and
are important in gene expression
• Malignant urothelial cells contain up to 80 times higher concentration of NMP22
antigen than normal urothelial cells and release it upon cell death
• FDA approved for monitoring and diagnosis.
• Sensitivity for Detecting TCC (Grossman et al. JAMA 293:810-816, 2005)
• NMP22 Test = 57% versus Cytology = 16% (P < 0.001)
11. Indications of cystectomy in noninvasive TCC
• Tis
• Multifocal CIS (Tis) cannot be removed by TURT
• T1
• After failure of repeated TURT
12. Indications of Segmental resection (partial cystectomy) in noninvasive
TCC
1. Solitary tumor
2. Localized tumor to the bladder dome
3. Not associated with areas of CIS sought by multiple biopsies of urothelial mucosa
4. Able to be removed with a 2-cm margin of healthy tissue: far enough away from the
ureteral orifices and bladder neck
5. Bladder reconstruction is feasible as sufficient margin around the ureteral orifices and
bladder neck is preserved
13. Indications of Adj intravesical CTR or immunotherapy for noninvasive
TCC after TURT
• Immunotherapy
• Ta
• High-grade tumors: G3 (Immuno preferred to CTR)
• T1
• Any grade, after complete or incomplete TURT
• Chemotherapy
• Ta
• Low-grade G1-2
• High-grade tumors: G3
• T1
• Any grade, after complete or incomplete TURT
14. Indications of RT for noninvasive TCC
• Definitive RT is an alternative to surgery for patients refuse or unfit for radical
surgery
• Preoperative RT is seldom used. RT does not appear to improve expected
survival beyond that achieved by radical surgery alone, although local
recurrence is reduced.
• Postoperative radiation has no proved role
19. Indications of Definite CCRT (bladder sparing)
Only for patients without hydronephrosis (NCCN, category 2B) followed by 2-3
cycles of adjuvant chemotherapy
• T2
• T3
• T4
20. Indications of radical cystectomy in fit patients
• Initial option
• T2
• T3
• T4a
• After definite CCRT
• Residual tumor
• After neoadjuvant CCRT or CTR
• T2
• T3
• T4a
• T4b (became resectable)
21. Indications of chemotherapy in invasive node –ve TCC
• Neoadjuvant for T2-4
• Adjuvant
• 2-3 Cycles after Definite CCRT (Bladder sparing)
• 6 cycles after radical cystectomy
• Palliative for unfit or inoperable T4b TCC
22. Indications of CTR, RT, Surgery in invasive node +ve TCC
• As shown from this plan of treatment
• CCRT OR 2-3 cycles of Chemotherapy THEN assessment of response:
• If complete response
• Observation OR
• Cystectomy OR
• Boost with RT.
• If residual tumor
• Cystectomy if resectable OR
• Chemo-RT if not received if unresectable or unfit patient OR
• Palliative TURBT OR
• Salvage CT if unresectable or unfit patient
25. CTR for metastatic TCC
• MVAC was the standard
• GC (Gemcitabine and Cisplatin) became the standard
• Carboplatin instead of cisplatin
• Neuropathy grade 3-4
• Poor renal function
• Gemcitabine/ paclitaxel is comparable to Gemcitabine and Cisplatin
26. Indications of Atezolizumab (Tecentriq)
• The Food and Drug Administration (FDA) on May 18 2016, approved for
• Locally advanced or metastatic urothelial carcinoma in patients who are
• Not eligible for cisplatin-containing chemotherapy, or
• Have disease progression during or following platinum-containing chemotherapy, or
• Disease progression within 12 months of neoadjuvant or adjuvant chemotherapy
27. Indications of Pembrolizumab (Keytruda)
• The Food and Drug Administration (FDA) on May 10 2017, approved for
• Locally advanced or metastatic urothelial carcinoma in patients who are
• Not eligible for cisplatin-containing chemotherapy, or
• Have disease progression during or following platinum-containing chemotherapy, or
• Disease progression within 12 months of neoadjuvant or adjuvant chemotherapy
28. Sq CC of bladder (rare)
• Surgery is only curative
• Radioresistent
• No adjuvnt RT or CTR
• Palliative CTR
• Epirubicine based CTR
• Cisplatin based CTR
• Taxines