Cancer Epigenetics: Concepts, Challenges and PromisesMrinmoy Pal
The presentation highlights how recent investigations have shown extensive reprogramming of almost every component of the epigenetic machinery in cancer leading to the emergence of the promising field of epigenetic therapy.
The epigenetic regulation of DNA-templated processes has been intensely studied over the last 15
years. DNA methylation, histone modification, nucleosome remodeling, and RNA-mediated targeting regulate many biological processes that are fundamental to the genesis of cancer. Here, we
present the basic principles behind these epigenetic pathways and highlight the evidence suggesting that their misregulation can culminate in cancer. This information, along with the promising clinical and preclinical results seen with epigenetic drugs against chromatin regulators, signifies that it
is time to embrace the central role of epigenetics in cancer.
It describes the prevalence of Breast Cancer among BRCA 1/2 mutations with special consideration to biological background, detection and screening, actions taken upon discovering mutation carriers and whether we have a different therapeutic algorithm than sporadic cases. Special emphasis on the role of PARP inhibitors in the management of metastatic disease.
Cancer Epigenetics: Concepts, Challenges and PromisesMrinmoy Pal
The presentation highlights how recent investigations have shown extensive reprogramming of almost every component of the epigenetic machinery in cancer leading to the emergence of the promising field of epigenetic therapy.
The epigenetic regulation of DNA-templated processes has been intensely studied over the last 15
years. DNA methylation, histone modification, nucleosome remodeling, and RNA-mediated targeting regulate many biological processes that are fundamental to the genesis of cancer. Here, we
present the basic principles behind these epigenetic pathways and highlight the evidence suggesting that their misregulation can culminate in cancer. This information, along with the promising clinical and preclinical results seen with epigenetic drugs against chromatin regulators, signifies that it
is time to embrace the central role of epigenetics in cancer.
It describes the prevalence of Breast Cancer among BRCA 1/2 mutations with special consideration to biological background, detection and screening, actions taken upon discovering mutation carriers and whether we have a different therapeutic algorithm than sporadic cases. Special emphasis on the role of PARP inhibitors in the management of metastatic disease.
Audio and slides for this presentation are also available on YouTube: http://youtu.be/ukXhuy5cXrE
Huma Q. Rana, MD, a cancer geneticist with Dana-Farber Cancer Institute, explains the cancer risk associated with BRCA1 and BRCA2 gene mutations. This presentation was originally given on July 23, 2013 as part of the "What Every Woman Should Know" event put on by Dana-Farber's Susan F. Smith Center for Women's Cancers.
Audio and slides for this presentation are available on YouTube: http://youtu.be/e_KVYJX2GTs
Have you ever wondered about your genetic predisposition to cancer? How cancer evolves in families? Or how cancer cells differ from normal cells in your body? Join Judy Garber, MD, MPH, director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, as she explores the basics of cancer genetics, DNA mutations, genetic screening, management, and more.
Presentation by Scott Woodman, MD, PhD. Presented at the 2018 Eyes on a Cure: Patient & Caregiver Symposium, hosted by the Melanoma Research Foundation's CURE OM initiative.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
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When to Consider Multi-Gene Testing in Early-Stage and Metastatic Breast Cancerbkling
You can’t change your genes, but knowing and acting on your family health history is essential for you and your medical team in developing your treatment plan. The National Comprehensive Cancer Network (NCCN) recommends genetic testing NCCN recommends genetic testing, including the BRCA1/2 genes, for all metastatic breast cancer patients because it could change treatment decisions. Additionally, individuals with early-stage breast cancer may meet testing criteria based on their type of breast cancer or family history.
Our guest speaker Christina (Chrissy) Spears, the Assistant Professor at Ohio State University and helps run the High-Risk Breast Cancer Clinic as a genetic counselor, will discuss not only the common BRCA1/2 tests but the multiple other high-risk gene mutations called expanded panel testing or multi-gene testing to consider. It may also help your family members better understand their risk of breast cancer and other cancers, such as ovarian cancer, prostate cancer or pancreatic cancer.
Audio and slides for this presentation are also available on YouTube: http://youtu.be/ukXhuy5cXrE
Huma Q. Rana, MD, a cancer geneticist with Dana-Farber Cancer Institute, explains the cancer risk associated with BRCA1 and BRCA2 gene mutations. This presentation was originally given on July 23, 2013 as part of the "What Every Woman Should Know" event put on by Dana-Farber's Susan F. Smith Center for Women's Cancers.
Audio and slides for this presentation are available on YouTube: http://youtu.be/e_KVYJX2GTs
Have you ever wondered about your genetic predisposition to cancer? How cancer evolves in families? Or how cancer cells differ from normal cells in your body? Join Judy Garber, MD, MPH, director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, as she explores the basics of cancer genetics, DNA mutations, genetic screening, management, and more.
Presentation by Scott Woodman, MD, PhD. Presented at the 2018 Eyes on a Cure: Patient & Caregiver Symposium, hosted by the Melanoma Research Foundation's CURE OM initiative.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
When to Consider Multi-Gene Testing in Early-Stage and Metastatic Breast Cancerbkling
You can’t change your genes, but knowing and acting on your family health history is essential for you and your medical team in developing your treatment plan. The National Comprehensive Cancer Network (NCCN) recommends genetic testing NCCN recommends genetic testing, including the BRCA1/2 genes, for all metastatic breast cancer patients because it could change treatment decisions. Additionally, individuals with early-stage breast cancer may meet testing criteria based on their type of breast cancer or family history.
Our guest speaker Christina (Chrissy) Spears, the Assistant Professor at Ohio State University and helps run the High-Risk Breast Cancer Clinic as a genetic counselor, will discuss not only the common BRCA1/2 tests but the multiple other high-risk gene mutations called expanded panel testing or multi-gene testing to consider. It may also help your family members better understand their risk of breast cancer and other cancers, such as ovarian cancer, prostate cancer or pancreatic cancer.
NEED OF GENETIC SEQUENCING
- Understanding the particular DNA sequence can shed light on a genetic condition and offer hope for the eventual development of treatment.
- An alteration in a DNA sequence can lead to an altered or non functional protein and hence to a harmful effect in a plant or animal.
- Simple point mutations can cause altered protein shape and function.
DNA SEQUENCING METHODS AND STRATEGIES FOR GENOME SEQUENCINGPuneet Kulyana
This presentation will give you a brief idea about the various DNA sequencing methods and various strategies used for genome sequencing and much more vital information related to gene expression and analysis
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
Breast surgery plus systemic treatment may improve local PFS when compared to systemic treatment alone (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; I2 = 43%; low quality evidence)
The group receiving breast surgery plus systemic treatment probably had a shorter time
to distant PFS compared to the group receiving systemic treatment alone (HR 1.42, 95%CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence)
Advantages of Cervicofial flaps :
Operative time is short.
It causes minimum deviations in relations to important structures around cheek.
reduce surgical risk in high risk patients like old age, diabetic patients, un-controlled hypertension
It can provide excellent skin colour and texture match.
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Oncoplastic Breast surgery is simultaneous application of lumpectomy and reconstructive techniques. The word ‘oncoplastic’ is derived from the Greek words ‘onco’ (tumour) and ‘plastic’ (to mould).
Approximately 10% to 30% of patients submitted to BCS alone are not satisfied with the aesthetic outcomes like “swan beak/ parrot beak deformities. The main reasons are related this is the tumour resection which can produce asymmetry, retraction, and volume changes in the breast.
Recently, increasing attention has been focused on oncoplastic procedures since the immediate application of plastic breast surgery techniques provide a wider local excision while still achieving the goals of a better breast shape and symmetry to obtain oncologically sound and aesthetically pleasing results. Thus, by means of customized techniques the surgeon ensures that oncologic principles are not jeopardized while meeting the needs of the patient from an aesthetic point of view.
Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC):
Evaluation of POSSUM scoring system in patients with perforation peritonitis ...Kundan Singh
Background: Continuous audit of clinical practice is an essential part of making improvements in medicine and
enhancing patient care. Recently, physiological and operative severity score for the enumeration of mortality and
morbidity (POSSUM) scores has been developed, which would help to identify those patients who are at increased
risk of developing complications and deaths. This scoring system is based on 12 physiological characteristics of
patient and 6 characteristics of the surgery performed.
Methods: This study was done in Department of surgery at Patna medical college, Patna, Bihar, India from April
2014 to October 2015 on 100 patients. Physiological variables were collected prior to induction of anesthesia and
operative variable collected during operation chi-square test was used for expected and actual mortality differences.
Results: In present study 100 patients of peritonitis due to different cause of intestinal perforation were studied.
Comparison of observed and POSSUM predicted mortality and morbidity rates were done. Observed to expect
mortality and morbidity ratio was 1.005 and 1.001 respectively and there was no statistically significant difference
between the predicted and observed values.
Conclusions: This study confirms and validates the findings of previous work that POSSUM is an accurate and
reliable tool for estimating in-hospital mortality.
multilobed spleen : A case report
The spleen plays multiple supporting roles in the body. It is a vital organ for the functioning
of immune system. It acts as a filter for blood as part of the immune system. Old red blood
cells are recycled in the spleen, and platelets and white blood cells are stored there. It can
have a wide range of congenital anomalies including its shape, location, number, and size.
Although most of these anomalies are congenital, there are also acquired types. Multilobed
spleen is one of such condition. It is most commonly detected during abdominal surgeries.
Since they are bigger in size than the normal spleen, they are more pre disposed to trauma. In
this case report we have presented such a case of multi lobed spleen, which was detected
incidentally during exploratory laprotomy for blunt trauma abdomen with hemoperitoneum
A retrospective study of outcome of intraoperative gallbladder perforation du...Kundan Singh
Abstract:
Background: During laparoscopic cholecystectomy, gallbladder perforation with leakage of bile and/or gallstones into the abdominal cavity occurs frequently while gallbladder is being dissected from liver bed or while extracting it through the port site. In this retrospective study we have studied the case files of the patients who underwent laproscopic cholecystectomy and had intraoperative gallbladder perforation and had studied its effect on outcome of the surgery.
Material & method: This is a retrospective done at patna medical college and hospital in January 2016 in which the patients records of 310 patients of laproscopic cholecystectomy from January 2015 to December 2015 were studied. The incidence of perforation, duration of operation and the post-operative complications were noted and the data obtained was analysed
A Prospective Study on Role of Water Soluble Contrast in Management of Small ...Kundan Singh
There is no definite protocol in management of small bowel obstruction in relation to duration and need of surgery. The aim is to study the role of gastrografin in management of small bowel obstruction.In this study patients who were diagnosed with intestinal obstruction were administered gastrografin. The patients were followed serially using x-ray at 4hrs interval for 24hrs; decision to operate was taken on non-progression of dye in two consecutive x-ray. Among 20 patients of this study 9 patients were operated on basis of gastrografin study. 11 were treated conservatively. 8 patients were of adhesive bowel obstruction. Out of which 1 was operated, 7 were treated conservatively. The sensitivity, specificity, positive and negative predictive value of gastrografin administration in this study was 100%, 89%, 92%, 100% respectively.Gas¬trografin helps in strengthening the clinical decision about the management of intestinal obstruction; it helps in early decision making regarding continuing the conservative or operative management and allows the introduction of oral intake earlier and earlier discharge from the hospital as well as reduction in operative rate.
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.
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
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.
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- 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
2. 1. Histologic- to a genetic-based level.
2. Somatic genetic alterations are legitimate targets for therapy.
3. Tumor genotyping is helping clinicians individualize treatments
by matching patients with the best treatment for their
tumors.
4. Tumor-specific DNA alterations represent highly sensitive biomarkers for
disease detection and monitoring.
5. Finally, the ongoing analyses of multiple cancer genomes will
identify additional targets, whose pharmacologic exploitation
will undoubtedly result in new therapeutic approaches.
3.
4.
5. Sustaining Proliferative Signaling
• Normal tissue control production and release of growth promoting signal
• Cancer cell deregulate these signal
6. Point mutation at 12th /61st
codon
Mutation due to
methylation
Substitution
10. Inducing angiogenesis
• VEGF A- ( three receptors R1-R3)
upregulated by Hypoxia and Oncogenes
• Thrombospondin 1 ( Tsp-1)
• Fibroblast growth factor (FGF)
• It also contribute to microscopic premalignant
phase of neoplastic progression
• Intensity of angiogeneisis is variable
21. • Driver Mutation : - functional role in
malignant transformation
• Passenger Mutation : - Neutral / No functional
role
- incorporate the signature of previous
exposure
27. • Cancer genes are broadly grouped into
oncogenes and tumor suppressor genes.
• Mutations in oncogenes typically occur at specific
hotspots, often affecting the same codon or
clustered at neighboring codons in different
tumors.
• mutations in oncogenes are almost always
missense,
• Affect only one allele, making them
heterozygous.
28. • tumor suppressor genes are usually mutated
throughout the gene; a large number of the
mutations may truncate the encoded protein
and
• generally affect both alleles, causing loss of
heterozygosity (LOH).
32. DNA Sequencing
• DNA sequencing is the process of determining
the precise order of nucleotides within a DNA
molecule.
33. First Gen Sequence
• Maxam-Gilbert sequencing
.
• Chain-termination methods
The chain-termination method developed by Frederick
Sanger and coworkers in 1977
.
• The Sanger method, in mass production form, is the
technology which produced the first human genome in
2001, ushering in the age of genomics. However, later
in the decade, radically different approaches reached
the market, bringing the cost per genome down from
$100 million in 2001 to $10,000 in 2011
34.
35. Ingredients for Sanger sequencing
• Sanger sequencing involves making many copies of a target
DNA region.
Its ingredients are similar to those needed for DNA replication
in an organism, or for polymerase chain reaction (PCR),
which copies DNA in vitro. They include:
• A DNA polymerase enzyme
• A primer, which is a short piece of single-stranded DNA
that binds to the template DNA and acts as a "starter" for
the polymerase
• The four DNA nucleotides (dATP, dTTP, dCTP, dGTP)
• The template DNA to be sequenced
36.
37. Human Genome Project
• The sequencing of the human genome was
completed in 2003, after 13 years of
international collaboration and investment of
USD 3 billion.
• The Human Genome Project used Sanger
sequencing
• Haplotype Map of human Genome
38. • A single-nucleotide polymorphism (SNP,
pronounced snip) is a DNA sequence variation
occurring when a single nucleotide adenine
(A), thymine (T), cytosine (C), or guanine (G])
in the genome (or other shared sequence)
differs between members of a species or
paired chromosomes in an individual.
39. • A SNP in which both forms lead to the same
polypeptide sequence is
termed synonymous (sometimes called a
silent mutation) — if a different polypeptide
sequence is produced they
are nonsynonymous. A nonsynonymous
change may either be missense or nonsense,
40. NGS
Next generation methods of DNA sequencing
have three general steps:
• Library preparation: libraries are created
using random fragmentation of DNA, followed
by ligation with custom linkers
• Amplification: the library is amplified using
clonal amplification methods and PCR
• Sequencing: DNA is sequenced using one of
several different approaches
41.
42. DNA is fragmented either enzymatically or by sonication (excitation using ultrasound)
to create smaller strands.
Adaptors (short, double-stranded pieces of synthetic DNA) are then ligated to these
fragments with the help of DNA ligase, an enzyme that joins DNA strands.
The adaptors enable the sequence to become bound to a complementary
counterpart.
47. Third generation sequencing
single molecule sequencing and single real time sequencing,
removing the need for clonal amplification.
reduces errors caused by PCR,
simplifies library preparation and,
gives a much higher read length using higher throughput platforms.
SMRT (single molecule real time)
sequencing
48.
49. The Cancer Genome Atlas (TCGA)
TCGA is a joint effort of the National Cancer
Institute (NCI) and the National Human
Genome Research Institute (NHGRI), which
are both part of the National Institutes of
Health, U.S. Department of Health and Human
Services.
Started in 2006
• brain (glioblastoma), lung, and ovarian.
50. international cancer genome
consortium
• To obtain a comprehensive description of
genomic, transcriptomic and epigenomic
changes in 50 different tumor types and/or
subtypes which are of clinical and societal
importance across the globe.
• Multinational Constorium
• More than 90 types of cancers