This document discusses cervical lymph nodes and lymphadenitis. It covers causes of cervical lymphadenitis including infectious, neoplastic, and tuberculous etiologies. It describes acute and chronic cervical lymphadenitis. Tuberculous cervical lymphadenitis is discussed in depth, covering pathology, clinical manifestations, diagnosis, and treatment. Levels of cervical lymph nodes and patterns of neck metastasis are also outlined.
a basic and concise description of one of the most common clinical condition we encounter in our daily practice. this info has been gathered from several sources. feel free to point out any mistakes. :)
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Examination of Swelling in a patient is always a task for MBBS students. This PPT provides the students, how to elicit a history & also the easy way to examine a swelling.
a basic and concise description of one of the most common clinical condition we encounter in our daily practice. this info has been gathered from several sources. feel free to point out any mistakes. :)
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
Examination of Swelling in a patient is always a task for MBBS students. This PPT provides the students, how to elicit a history & also the easy way to examine a swelling.
Hints about tuberculosis , Epididymis anatomy and functions, Epididymis infection with TB, Incidence, Clinical picture and complications of it, Hints about the diagnosis and treatment
Presented in the department of Urology, Sohag school of medicine
DETAILED DISCUSSION OF NECROTIZING FASCIITIS.
A SOFT TISSUE INFECTION. USUALLY CALLED AS FLESH EATING BACTERIAL INFECTION. CAUSED BY BACTERIA. AFFECTS THE SOFT SKIN TISSUES
Necrotizing fasciitis has also been referred to as haemolytic streptococcal gangrene, Meleney ulcer, acute dermal gangrene, hospital gangrene, suppurative fasciitis, and synergistic necrotizing cellulitis.
Fournier gangrene is a form of necrotizing fasciitis that is localized to the scrotum and perineal area.
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
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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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
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
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.
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
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3. ACUTE CERVICAL LYMPHADENITIS
• Commonly from tonsillitis or a dental abscess
• Constitutional disturbances like pyrexia, anorexia and
general malaise are +
• Affected nodes are enlarged, warm and tender
• Blood exam. shows leucocytosis with preponderance of
polymorphs
• Treatment is of primary focus
• If, despite antibiotic therapy pain continues, or abscess
formation occurs in the lymph nodes, parapharyngeal or
retropharyngeal space then surgical drainage is required.
4. CHRONIC CERVICAL LYMPHADENITIS
• Non-specific: low-grade pyogenic infection from
caries teeth, ch. tonsillitis,
adenoids, scalp etc., Nodes are
enlarged, not tender and
consistency is firm or soft.
• By far the commonest ch. Cervical
lymphadenitis in India is tuberculous.
5. Tuberculous cervical lymphadenitis
• Commonest form of extra pulmonary tuberculosis esp. in
children and young adults, but may occur at any age.
• Caused by Mycobacterium tuberculosis; both by bovine
and human strains. Now also by atypical mycobacteria
esp. in immuno deficient pts., such as HIV. In most
instances bacilli enter through the tonsil of the
corresponding side. Deep cervical nodes are commonly
affected, but there may be widespread cervical
lymphadenitis.
• Supraclavicular represents upward extension of hilar and
mediastinal lymphadenopathy. Axillary and inguinal
nodes are involved by haematogenous or perhaps by
retrograde lymphatic spread.
6. Tuberculous cervical lymphadenitis
• In 80% tuberculous process is limited to
clinically affected group but primary focus in
the lungs must always be suspected and
investigated. As renal and pulmonary TB
occasionally coexist, urine should be examined
carefully .
Rarely, pt. develops natural resistance and the
nodes may be detected as calcification on x-ray
or after appropriate treatment
7. TB cervical adenitis-Pathology
• Granulomatous inflammation with tubercle
• Undergo caseation, necrosis and destruction
• Spread to adjacent nodes- periadenitis; getting
adherent to each other- “matting”
• Caseous nodes with periadenitis deep to deep
fascia perforates with the escape of caseous
material into subcutaneous space resulting in
“collar-stud abscess”.
• abscess gets adherent to skin and burst in the
surface resulting in abscess or sinus
8. TB cervical adenitis-Pathology
• Stage-1 The glands are enlarged, mobile, firm, and slightly tender.
Histologically, they show non-specific reactive hyperplasia.
• Stage-2 The nodes are large, firm and fixed to surrounding tissues and
to each other. Histologically, they show periadenitis, typical
tuberculous granulomatous tissue with lymphocytes, epithelioid cells,
and caesation.
• Stage-3 The caesation is extensive giving rise to variable consistency
with soft areas of cold abscesses and firm lymph nodes.
• Stage-4 The abscesses burst out of the lymph node mass and extends
into subcutaneous tissue giving rise to a ‘collar-stud’ abscess
• Stage-5 The abscess bursts and gives rise to a persistent, discharging
sinus. The discharge from sinus may infect the surrounding skin and
cause extensive tuberculous ulcer. Ulcers have a typical pale, flabby,
granulation tissue, under-mined edges, and a seropurulent discharge.
9. TB cervical adenitis-
Types of clinical manifestations
• Acute type : Seen in infants and children
< 5yrs. The glandular enlargement is painful, tender, and
evolves within few days. The overlying skin is red and
oedematous. The child has moderate fever. The clinical
picture resembles acute septic lymphadenitis.
• Caseating Type: Most common type seen in young
adults: Glands are multiple, moderately enlarged and
matted together. The caseation leads to softening, cold
abscess and sinuses. The patient is anemic and
moderately nourished. Constitutional features like fever
anorexia and weight loss may be present.
10. TB cervical adenitis-
Types of clinical manifestations
• Hyperplastic type in patients with good general
resistance, lymph nodes show a marked degree of
reactive, reticular and lymphoid hyperplasia. TB
garanulomatous tissue is more productive with least
caseation and periadinitis. The glands are notably
enlarged and appear fleshy, elastic and freely mobile
resembling those of Hodgekin’s disease.
• Atrophic type: Seen in elderly individual in whom
lymphoid tissue undergoes natural process of involution,
glands are comparatively small and soon burst with the
onset of caesation.
11. TB cervical adenitis-
Diagnosis
Clinical diagnosis is not difficult in classical case, where chronic
iymphadenopathy in young individual is associated with matting
and soft areas of caesation.
• A negative tuberculin test excludes.
A positive test has no diagnostic value.
ESR raised. Serum albumin falls and gamma globulins increase.
• An X-ray chest is mandatory for coexisting pulmonary lesion.
• Positive FNAC and biopsy are essential for confirming diagnosis.
Typical tuberculous granuloma with epithelioid cells, giant cells
and lymphocytes surrounding the area of caseation are
characteristics.
• Besides M.tuberlcosis ,atypical bacteria such as M.scrofulaceum
and M. intercellulare have been recovered from cases.
12. TB cervical adenitis-
Treatment
• Multi drug regime
• Initial phase for 4 drugs for 2 – 3 months.
Cap Rifampicin - 450-600 mg. daily.
Tab Isoniazid - 300 mg daily.
Tab Ethambutol – 1000 mg daily.
Tab Pyrazinamide – 1500 mg daily.
• Subsequently 2 drugs for 4-6 months.
Cap Rifampicin and Tab Isoniazid.
With full course of anti tuberculosis drug therapy, the glands subside
within 3 – 4 months and response is even quicker in children.
13. TB cervical adenitis-
Treatment
• Cold absess: repeated non dependent
aspiration; streptomycin may be instilled locally.
• Surgical excision is indicated
(a) When the glands continue to persist after
adequate chemotherapy and localised to one
single group.
(b) for persistent sinuses- secondary infection,
necrotic and calcified material replacing the
lymph nodes, and fibrosis are responsible for
persistence of sinus even after the active
disease has subsided.
14. SEC. CERVICAL LYMPH NODES
Prognostic factors
• Presence or absence of cl. palpable nodes,
• size, number, location
• Involvement below crico-thyroid - Lower (Level IV) &
posterior (Level V) is ominous
• extra nodal spread to soft tissue
• perivascular and perineural infiltration
• tumour emboli in regional lymphatics
15. Levels of cervical nodes
• Level I
Submental Gr. within the triangle bounded by
ant. bellies of digastric and hyoid bone
Submandibular gr. bounded by post. Belly of
digastric and body of mandible
16. Levels of cervical nodes
• Level II (upper jugular)
around upper 1/3 of IJV and adjacent
spinal accessory nerve
extending from carotid bifurcation to skull
base
17. Levels of cervical nodes
• Level III (middle jugular)
around middle 1/3 of IJV from carotid
bifurcation superiorly to cricothyroid
membrane inferiorly
18. Levels of cervical nodes
• Level IV (lower jugular)
around lower 1/3 of IJV from cricothyroid
membrane to the clavicle inferorly
19. Levels of cervical nodes
• Level V (posterior triangle)
along the lower ½ of spinal accessory N.
and tr. Cervical artery. Supraclavicular
nodes are included in this group
Posterior border is anterior border of
trapezius and anterior boundary is
posterior border of sternomastoid
20. Levels of cervical nodes
• Level VI (anterior compartment group)
from hyoid bone superiorly to
suprasternal notch inferiorly . Lateral
boundary in each side is medial border of
sternomastoid. Consists of pretracheal,
paratracheal, prelaryngeal and precricord
nodes.
21. OCCULT PRIMARY
• Male : Female - 4 : 1
• Age Peak incidence 65yrs for men 55 for women
• 1/3 to1/2 Sq. cell ca., 1/4 anaplastic ca.
1/4 adeno ca. if supraclavicular is involved followed
by miscellaneous tumours such as melanoma and
thyroid gland tumours
• Primary sites in order of frequency
Head and neck sites
nasopharynx, tonsil, base of tongue, thyroid,
supraglotic larynx, floor of mouth, palate and
pyriform fossa
Non head and neck sites
bronchus, oesophagus, breast and stomach
22. Relative sites of Pr. sites
Thyroid 20%
Lungs 20%
Oropharynx 15%
Nasopharynx 15%
Hypopharynx 10%
GI tract 10%
Miscellaneous 10%