This document summarizes colonic neoplastic polyps. It defines polyps and classifies them based on their appearance, size, and whether they have stalks. Adenomas are the most common type of polyp and can be tubular, tubulovillous, or villous based on histology. Dysplasia is also classified from mild to severe. Risk of malignancy increases with polyp size over 1cm, villous histology, higher dysplasia grade, or presence of advanced pathology. Dietary and lifestyle factors can influence polyp risk. Initial treatment is full colonoscopy and polyp removal. Follow-up depends on features of the polyp.
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
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.
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
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
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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.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Definition
A GI polyp is a discrete mass of tissue that protrudes into the
lumen of the bowel.
characterized by its gross
appearance and overall size,
whether or not it has a stalk,
whether it is 1 of multiple similar masses occurring elsewhere in
the GI tract.
6. World Health Organization,
adenomas are classified
Tubular- if at least 80% of the glands are of the
branching tubule type
Villous -if at least 80% of the glands are villiform.
Of all adenomatous polyps,
tubular adenomas account for 80% to 86%,tubulovillous
for 8% to 16%, and villous adenomas for 3% to16%.
13. Malignant Potential of Polyp
Larger adenoma size >1cm
Villous Adenoma on histology
Higher degrees of dysplasia
Adenoma with advanced pathology(AAP)
14. Flat Polyps
Macroscopically, a flat adenoma is either
completely flat or slightly raised, and can
contain a central depression.
Diameter of this polyp is more than twice its
thickness.
Typically less than 1 cm in diameter, these
lesions can be easily missed at endoscopy.
15.
16. Relation of Adenoma, Histology, and Degree of
Dysplasia to the Incidence of Invasive
Carcinoma by Adenoma Size
17. Pathogenesis
Adenomatous polyps are thought to arise from
a failure in a step, or steps, of the normal
process of cell proliferation and cell death
(apoptosis).
23. Risk Factors for Susceptibility to
Adenomas
Inherited Susceptibility
Dietary and lifestyle risk factors
Conditions Associated With
Adenomatous Polyps
24. Inherited Susceptibility
Hereditary Polyposis Syndrome
Lynch Syndrome
Probands with first degree relatives
with colon cancer or adenoma
Adenomas in pts with family history
of colon cancer have faster growth
rates
10-30% are familial
28. Conditions Associated with
Adenomatous Polyps
Ureterosigmoidostomy -29%,20-26yrs later
Acromegaly – Increased IGF,5-25% CRC,14-35%
adenoma
Streptococcus bovis and JC virus
Cholecystectomy-increased bile in colon,
increases proliferation
29. Clinical Features
Usually no symptoms
Occult or Overt bleeding
Constipation,diarrhea and flatulance.
• Intermittant intususception
Cramping abdominal Pain
• Villous,3-4cm,sigmoid or rectal
Secretary Diarrhea
Obstruction
30. Detection
Fecal occult blood testing –
<40% pts adenoma have Positive testing
Asymptomatic >40yrs-1-3% positive
50% will have adenoma colonoscopy
3:1Adenoma Vs CRC
PPV-Adenoma(30-35%),CRC(8-12%)
31. Sigmoidoscopy
Rigid sigmoidoscopy would detect polyps
(of all histologic types) in about 7% of
asymptomatic persons older than 40 years,
flexible sigmoidoscope would find polyps in
10% to 15%,principally because a greater
length of bowel could be examined.
Screening sigmoidoscopy now show
reductions in CRC mortality from 21% to
38%.
32. Colonoscopy
Preferred colon cancer screening
test
Gold standard
• 10% failure caecal intubation
• higher cost, can miss CRC
• Miss rate-0-6%(1cm),
• 12-13%(6to9mm),15-27%(<6mm)
Limitations -
• Adequacy of preparation,caecal intubation rate,withdrawl time and
adenoma detection rate
Miss Rate
34. CT Colonography (virtual
colonoscopy)
2 and 3dimensional CT
Bowel preparation,colon
distended with CO2
Images taken in supine and
prone position
Sensitivity-
86%(5to9mm),92%(>10mm)
Low sensitivity for <5mm
polpyps
Radiation exposure(0.14%)
Incidental findings 70%,11%
Surveilliance interval
Concerns
36. Newer methods
Altered human DNA in stool analysis
3-4 times more sensitive for adenoma
detection
37. Treatment
Untreated adenoma-5-10yrs for CRC
cumulative risk of cancer at the polyp site is 2.5% at 5 years,
8% at 10 years, and 24% at 20 years after diagnosis.
Diminutive polyp <5mm size reaches 1cm at 3yrs
Age distributions-mean age of people with a single adenoma
is about 4 to 5 years younger than those with a colon cancer.
A similar analysis in FAP patients has shown that patients with
adenomas are about 12 years younger than colon cancer.
38. Multiple Adenomas-2 or more
Synchronus adenoma– same time
(30%),50-85% 2 cancers
Metachronus lesion-6 months later
40. A few general
recommendations
contain carcinoma in situ, pedunculated
adenomas that harbour well differentiated or
moderately differentiated invasive carcinoma,
and polypoid carcinomas.
Endoscopic polypectomy alone is adequate
therapy for adenomas that
41. malignant polyps in which the invasive carcinoma is
poorly differentiated,
involves endothelium-lined channels
(lymphatics,blood vessels),
extends to or within 2 mm of the polypectomy
margin,
or involves the submucosa of the colonic wall
(includes all sessile adenomas).
Resection surgery is indicated for
45. Serrated Polyps
Most common nonadenomatous polyps.
CpG island methylation pathway (CIMP) results in decreased
expression of genes,including DNA mismatch repair genes,
which can lead to microsatellite instability (MSI).
SSP/As are much less common than HPs, accounting for less
than 1% of all polyps and between1% and 11% of adenomas
SSP/As are typically flat, located in the right colon, and
covered with a mucus cap.
47. Treatment
It is recommended that all serrated polyps
be removed when detected.
This is because it may not be possible to
distinguish SSP/A or TSA from an HP, and
SSP/As and TSAs have a significant risk
of progression to invasive carcinoma.