coagulation.ppt
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This document discusses the relationship between blood clotting factors and lymph node metastasis in gastric cancer. It notes that lymph node metastasis is a key factor in the poor prognosis of gastric cancer. Several studies have found correlations between preoperative levels of coagulation-related factors like platelets, fibrinogen, and D-dimer, and the presence of lymph node involvement in gastric cancer patients. These factors may promote tumor invasion and migration through various mechanisms like enhancing cancer cell behavior, serving as a bridge between cells, and promoting proliferation. Antiplatelet drugs may help prevent cancer progression and metastasis by reducing these effects.
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- The document summarizes a seminar presentation on the molecular pathophysiology of colorectal cancer.
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This document discusses hemorrhoids, including their epidemiology, anatomy, pathogenesis, grading system, diagnosis, and management approaches. Hemorrhoids affect 4.4% of people in the US and are cushions in the anal canal that can become enlarged and symptomatic. Risk factors include lack of fiber, straining, and pregnancy. Grades I and II hemorrhoids can often be managed conservatively while grades III and IV may require procedures like rubber band ligation, injections, or surgery.
carcinoid syndrome.ppt
This document discusses carcinoid syndrome, which occurs after metastasis of carcinoid tumors to the lungs or liver. It causes symptoms like flushing, diarrhea, increased heart rate, low blood pressure, wheezing, and skin changes. Serotonin is overproduced by the tumors and causes these symptoms when released systemically. Diagnosis involves urine tests for serotonin breakdown products or serum chromogranin A levels. Treatment options aim to reduce serotonin levels through medications or procedures to block its effects or production.
Thrombo embolic prophylaxis.ppt
The document discusses thromboprophylaxis in surgery. It notes that venous thromboembolism (VTE) is a common cause of mortality worldwide. Risk factors for VTE include surgery, trauma, immobility, cancer, pregnancy, and genetic factors. The primary goals of pharmacologic VTE prophylaxis are to prevent fatal pulmonary embolism and reduce mortality in surgical and ICU patients. Effective prophylaxis includes early ambulation, mechanical methods like compression stockings, and anticoagulant medications, which reduce VTE risk by 50-80% with a modest bleeding risk increase. Prophylaxis aims to identify high-risk groups like hip surgery patients.
teratogenic drugs.ppt
This document discusses teratogenic drugs and categorizes them based on potential risk during pregnancy. Category A drugs like folic acid and senna have shown no risk in human studies. Category B drugs like metformin and hydrochlorothiazide have not shown risks in animal studies, but adequate human studies are lacking. Category C drugs like gabapentin and amlodipine have shown animal risks but potential benefits may outweigh risks. Category D drugs like losartan have human risk evidence but benefits may still outweigh risks. Category X drugs like isotretinoin and methotrexate have shown clear fetal abnormalities and risks outweigh potential benefits. Specific drugs are provided as examples for each category.
Triad of death, damage controle surgery.ppt
The document discusses the "lethal triad of death" that can occur with penetrating trauma: acidosis, coagulopathy, and hypothermia. It describes how damage control surgery can be used to reverse these effects in three phases - an initial laparotomy to control bleeding and contamination, intensive care to resuscitate the patient, and definitive reconstruction once the patient is stabilized. The goal of damage control surgery is to rapidly correct physiological abnormalities through temporary measures to allow time for full reconstruction later.
systemic manifestations of IBD.ppt
This document discusses extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD). Some key points:
- EIMs occur in 25-40% of IBD patients and can involve many organ systems, including the musculoskeletal, dermatological, hepatopancreatobiliary, ocular, renal and pulmonary systems.
- Common EIMs include arthritis, erythema nodosum, pyoderma gangrenosum, ankylosing spondylitis, episcleritis and uveitis.
- EIMs can occur before or after an IBD diagnosis. Having one EIM increases the risk of developing another.
- The pathogenesis of E
surgical drains.ppt
Dr. Hiwa Omer Ahmed gives a presentation on inserting surgical drains. The document discusses the aims of inserting drains such as drainage or monitoring outputs. It describes how to insert a drain by placing it deep in the cavity and securing it with sutures. The document outlines types of drains including open versus closed and active versus passive drains. Finally, it briefly mentions complications and post-removal care.
Stump stone after cholecystectomy.ppt
Stump stones after cholecystectomy can occur when a cystic duct remnant is left behind after surgery. This summary will discuss cystic duct remnant stones.
Cystic duct remnant stones are a rare cause of post-cholecystectomy syndrome, occurring in less than 2.5% of cases. They are more common after laparoscopic versus open cholecystectomy since the cystic duct is often cut closer to the gallbladder laparoscopically. Diagnosis is difficult but can be made using ERCP or MRCP. Treatment options include ERCP with basket extraction, ESWL with fragmentation and basketting, endoscopic biliary lithotripsy, or repeat lapar
steralization.ppt
The document discusses various sterilization methods for medical devices and instruments. It describes that steam sterilization is the most common sterilization method for heat-resistant devices due to its reliability and effectiveness. For heat-sensitive devices, low-temperature sterilization methods are required, such as ethylene oxide, hydrogen peroxide gas plasma, and peracetic acid. The document provides details on different low-temperature sterilization technologies including their mechanisms and applications.
scar.ppt
Dr. Hiwa Omer Ahmed is a professor of general and bariatric surgery at the University of Sulaimani College of Medicine. The document discusses scar formation and healing, outlining the three phases of inflammation, proliferation, and remodeling. It also examines factors that affect scarring such as wound characteristics, patient health, surgical technique, and postoperative care. The types of scars like hypertrophic, keloid, and mature scars are also defined.
pus.ppt
This document discusses types of pus and its formation. Pus is a thick, yellow or green fluid that accumulates at the site of an infection. It contains dead tissue, white blood cells, and bacteria. The color and smell of pus depends on the infecting organism. Pus is formed when the body sends white blood cells to fight infection, and some cells and surrounding tissue die off. Common bacteria that cause pus include Staphylococcus aureus and Streptococcus pyogenes, which release toxins damaging tissue. Risk factors for postoperative pus include diabetes, smoking, obesity, long surgeries, and weakened immunity. Any pus must be drained and treated with antibiotics based on gram stain and culture
postsplenectomy precautions.ppt
This document discusses recommendations for patients who have undergone splenectomy. It recommends that post-splenectomy patients receive vaccinations for pneumonia, meningitis, and influenza. It also recommends lifelong antibiotic prophylaxis and carrying stand-by antibiotics to prevent overwhelming infection. Additional recommendations include patient education, medical alert cards, and seeking early treatment for animal bites while traveling.
oral manifestation of systemic diseases.ppt
This document discusses the various oral manifestations of systemic diseases. It describes how autoimmune diseases, hematological illnesses, endocrine diseases, and neoplastic processes can present in the oral cavity. Specific conditions mentioned include systemic lupus erythematosus, Sjogren's syndrome, diabetes, leukemia, and metastatic cancers. Infectious diseases and eating disorders are also noted as systemic processes that can involve the mouth. A wide range of oral signs and symptoms are associated with systemic illness, including ulcers, bleeding, swelling of the tongue and lips, and dental abnormalities.
Nails in systemic diseases.ppt
This document discusses various nail abnormalities and their potential systemic disease associations. Clubbing, koilonychia, Muehrcke's lines, blue lunulae, Beau's lines, splinter hemorrhages, trachyonychia, nail separation, pale nails, white nails, yellow nails, bluish nails, rippled/pitted nails, cracked/split nails, puffy nail folds, dark lines beneath nails, gnawed nails, Terry's nails, and brown nails are each described along with one or more conditions they may indicate such as iron deficiency, liver disease, glomerulonephritis, diabetes, zinc toxicity, or chemotherapy side effects.
metabolic syndrome.ppt
The document discusses metabolic syndrome, including its prevalence, risk factors, and diagnostic criteria. It notes that the prevalence of metabolic syndrome is higher in men than women and varies by race and ethnicity. The presence of metabolic syndrome increases the relative risk of cardiovascular disease by 1.5 to 3 times. The diagnostic criteria for metabolic syndrome include abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, high fasting glucose or diabetes, and a prothrombotic and pro-inflammatory state.
colonic diverticulosis.ppt
This document discusses diverticulosis and diverticulitis. It defines diverticulosis as the presence of small pouches or sacs that form in the lining of the digestive system, usually in the colon. Diverticulitis occurs when these pouches become inflamed or infected, causing abdominal pain, fever, nausea and changes in bowel habits. Risk factors include aging, obesity, smoking, lack of exercise and a low fiber diet. Treatment depends on severity, with mild cases treated conservatively and more severe cases or complications requiring surgery.
gastrointestinal tract endoscopic biopsies.ppt
This document discusses endoscopic biopsy procedures for diagnosing gastrointestinal cancers. It notes that 6-8 biopsies are currently recommended for suspected malignant lesions, though additional biopsies increase risks like bleeding while providing diminishing returns for diagnosis. Positive diagnosis rates for gastric and colon cancers reached around 95% after just 3 specimens. For accurate diagnosis, biopsies should be taken from lesion rims rather than bases, by experienced endoscopists who can differentiate malignant from benign lesions macroscopically.
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coagulation.ppt
- 1. Monday, January 23, 2023 1 Thromboses and nodal invasion in gastric cancer PROFESSOR DR. HIWA OMER AHMED GENERAL AND BARIATRIC SURGERY University of Sulaimani-College of Medicine Kurdistan-Iraq
- 2. Monday, January 23, 2023 2 Gastric cancer is a major global health problem. Worldwide, gastric cancer is the fifth most prevalent cancer, and presents with the fourth highest mortality rate Lymph node metastasis is one of the most important influencing factors for poor prognosis in gastric cancer
- 3. Monday, January 23, 2023 3 Indicators of LN involvement Tumor length Tumor short diameter Tumor area Histopathologic grade The ratio of preoperative platelets/lymphocytes The ratio of neutrophils/lymphocytes Various inflammatory indicators Studies reported that coagulation factors may mediate invasion and migration in gastric cancer
- 4. Monday, January 23, 2023 4 Pathophysiology The coagulation process mainly comprises Platelet activation Adhesion Aggregation Deposition of the fibrin network Maturation of the fibrin network Activation of the coagulation system, including platelet activation, can also induce the production of tumor growth factors and can lead to tumor metastasis
- 5. Monday, January 23, 2023 5 Components of the coagulation system may be involved in mediating the invasion and migration of malignant tumors. Moreover there is correlations between coagulation-related factors and gastric cancer tumor stage. Lymph node metastasis in patients of gastric cancer correlated with multiple preoperative coagulation-related factors. 1. platelet level is higher with LN metastasis. platelet levels in patients at a low N stage are lower than those of patients with a higher N stage. platelets can enhance the malignant behavior of gastric cancer cells, including invasion and migration, through direct contact with gastric cancer cells 2. Fibrinogen level is higher in LN involvement.
- 6. Monday, January 23, 2023 6 Antiplatelet drugs Antiplatelet drugs may play an important role in preventing 1. Gastric cancer progression 2. Proliferation 3. Migration 4. Reducing tumor cell metastasis 5. Reducing microvascular density
- 7. Monday, January 23, 2023 7 Fibrinogen Fibrinogen may promote the metastasis of circulating tumor cells through several possible mechanisms. 1. Fibrinogen may serve as an important molecular bridge between tumor cells, platelets, and endothelial cells, 2. Fibrinogen-like protein 1 may promote the proliferation, invasion, and migration of gastric cancer cells by participating in the epithelial mesenchymal transition (EMT) of cells
- 8. D-dimer D-dimer is a stable end product of the degradation of cross-linked fibrin as a result of enhanced fibrin formation and fibrinolysis, indicates hyperfinrogenemia Monday, January 23, 2023 8