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.
A brief presentation on cystic neoplasms of pancreas.
SOLID PSEUDOPAPILLARY TUMOR NEOPLASM: Relatively rare entity initially described by Frantz in 1959. Represent up to 3% of all pancreatic tumors and 6% to 12% of pancreatic cystic neoplasms. Designated as SPT by the World Health Organization in 1996, several other names, including Frantz tumors, Hamoudi tumors, and papillary cystic neoplasm.
Pancreatic Cysts: A Contemporary ApproachJarrod Lee
Pancreatic cysts are increasingly found during abdominal imaging. Although the majority will not cause any problems, a minority may enlarge or become malignant. We present a contemporary approach to managing pancreatic cysts, utilizing the latest evidence, technologies and endoscopic procedures. We identify which cysts need surveillance or even surgery, and which can be safely ignored.
Pancreatic carcinoma is the most dreaded cancer with very dismal prognosis. It is characterized by obstructive jaundice, high colored urine and clay colored stool.
Gall bladder carcinoma seen in Indian popluation most common in women and presents at a very late stage .Survival is in months hence palliative treatment is being preferred .
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.
A brief presentation on cystic neoplasms of pancreas.
SOLID PSEUDOPAPILLARY TUMOR NEOPLASM: Relatively rare entity initially described by Frantz in 1959. Represent up to 3% of all pancreatic tumors and 6% to 12% of pancreatic cystic neoplasms. Designated as SPT by the World Health Organization in 1996, several other names, including Frantz tumors, Hamoudi tumors, and papillary cystic neoplasm.
Pancreatic Cysts: A Contemporary ApproachJarrod Lee
Pancreatic cysts are increasingly found during abdominal imaging. Although the majority will not cause any problems, a minority may enlarge or become malignant. We present a contemporary approach to managing pancreatic cysts, utilizing the latest evidence, technologies and endoscopic procedures. We identify which cysts need surveillance or even surgery, and which can be safely ignored.
Pancreatic carcinoma is the most dreaded cancer with very dismal prognosis. It is characterized by obstructive jaundice, high colored urine and clay colored stool.
Gall bladder carcinoma seen in Indian popluation most common in women and presents at a very late stage .Survival is in months hence palliative treatment is being preferred .
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
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
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.
- 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
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
3. Introduction
• Second most common cause of pancreatic neoplasm after pancreatic
adenocarcinoma
• Guidelines for the management of cystic neoplasm continues to
evolve
8. Serous cystic neoplasm
• Have predilection for the head of the pancreas and occur in patients with a higher
median age.
• 60-70 years of age (Grandmother lesion) [Grandmother is the head of the family]
• 15-25% of all cystic neoplasms of pancreas
• Are almost always benign
• Presentation
• Vague abdominal pain
• Weight loss
• Obstructive jaundice
Associated with mutation in VHL gene in chromosome 3
9.
10. • On pathological examination
• Gross
• Large, well-circumscribed masses, evenly distributed in pancreas
• Microscopic
• Multiloculated, glycogen-rich small cysts, cuboidal
• Radiological examination
• CT scan
• Central calcification with radiating septa giving the sun-burst appearance
• EUS
• Better delineation of the CT scan features
• Cystic fluid protein expression Helps differentiate IPMN and SCN
• Management
• Pancreatectomy (in uncertain diagnosis and symptomatic serous cystadenomas
• If patients with tumor > 4 cm Resection of the SCN is appropriate
11. Mucinous cystic neoplasm
• MC cystic neoplasm
• Mucin producing cystic neoplastic tumors
• Lack communication with MPD
• Benign to invasive spectrum present
• Women at the 5th decade of life (mother)
• Men are rarely affected
• Found in body and tail of pancreas [Middle]
• Features Incidental discovery, vague abdominal pain
12. • Pathology
• Microscopic
• Presence of mucin rich cells and ovarian-like stroma
surrounding the cyst
• Estrogen and progesterone staining is positive
• Radiological features
• CT scan Solitary cyst with fine septations and a rim of
calcification (eggshell calcification)
• Cystic fluid aspirate
• Mucin rich-aspirate, high CEA levels (>192 ng/mL) and low
amylase
• Management
• Pancreatic resection as MCN has malignant potential
• Adjuvant systemic chemotherapy after surgical resection
when node-positive disease.
13. Intraductal papillary Mucinous Neoplasm
• Mucinous epithelial neoplasms Arise from the main pancreatic ducts or
branch ducts or both.
• Typically manifest at 6th-7th decade of life
• IPMN encompass wide spectrum of epithelial changes
• Histopathologic grading includes low, moderate or high grade dysplasia and
presence/ absence of invasive malignancy
• Subtypes of IPMN
• Divided by the pattern of duct involvement
• Branch Duct-IPMN only small side branches affected
• Main Duct-IPMN MD-IPMN
• BD-IPMN that extend into the main duct often leading to upstream dilation Mixed-type IPMN
15. What to do when IPMN is encountered?
• There are worrisome and high risk factors that are used to stratify the
lesion when encountered
• Stratify the patient as per risk
• Genetic mutations to evaluate
• KRAS
• P53
• MUC
16.
17.
18.
19. BD-IPMN
• BD-IPMN involves dilation of the pancreatic duct side branches that
communicate with MPD but doesn’t involve the MPD
• Types
• Unifocal
• Multifocal [ Multiplicity of the cysts favor diagnosis if BD-IPMN]
• All cysts with worrisome features on CT/MRI should undergo EUS and all
cysts with high-risk features MUST be resected
20. What to do with BD-IPMN?
• Asymptomatic patients/ no worrisome features
• Depends upon multiple factors Age, Comorbidities AND size of the cyst
• If cyst > 3cm and asymptomatic Surgery
• If cyst 2-3 cm consider for resection/ observation depending on age and physical
condition
• If cyst < 2cm Surveillance
• Symptomatic patients/ High-risk features
• Surgical resection [See in later slides]
21. MD-IPMN
• MD-IPMN is characterized by abnormal cystic dilation of MPD with columnar
metaplasia and thick mucinous secretions
• Types
• Focal
• Diffuse
• MD-IPMN have 30-50% risk of harboring invasive pancreatic cancer. Hence,
surgical resection is the cornerstone in the management of MD-IPMN.
22.
23. • Clinical features
• 50% abdominal pain
• 25% Acute pancreatitis
• Note the following
• Jaundice
• Raised Alkaline phosphatase
• Presence of Mural nodule
• Diabetes
• Dilated MPD of > 7mm or larger
• All of these indicate as predictors of malignancy in patients with MD-IPMN
24. • Radiographic features in IPMN
• CT scan shows
• Dilated MPD
• Cysts (various sizes)
• Mural nodules
• MRCP and EUS
• Evaluation of patients with suspected IPMN
• MRCP allows localization of mural nodules, pretreatment
classification of suspected side branch OR main duct IPMN
• EUS allows assessing pancreatic duct fluid assessment as well as
assessment of solid components of neoplasm.
• Cytology assessment
• Mucin rich fluids with variable cellularity
• Columnar mucinous cells with variable atypia
• CEA > 192ng/mL [ indicates presence of mucinous
metaplasia]
25. Mixed type IPMN
• Mixed IPMN includes side branch IPMN that has extended to involve
main pancreatic duct to varying degree
• Concern for mixed type IPMN should be raised in individuals with side
branch cysts who exhibit upstream dilation of the pancreatic duct
• Similar in behavior to MD-IPMN
• 30-50% have risk of malignancy
• Surgery is the main treatment method
28. Is there a high-risk
Is there a
Worrisome
risk
@I-TMC
29. Treatment
• Partial pancreatectomy [primary treatment for high risk lesions]; extent of
resection is unknown
• For BD-IPMN Resection should target the lesion of concern; Surgical decision is
therefore straight forward.
• For MD-IPMN Not always possible to determine the extent of microscopic
abnormality
• In absence of diffuse polyps or enhancing nodules, right sided pancreatectomy is preferred.
• Intraoperative frozen section of the pancreas neck margin is obtained total pancreatectomy
is done in patients with high-grade dysplasia or invasive carcinoma
30. Survival outcomes
• Survival is dependent upon the invasive component of the IPMN lesion.
• Following resection, surveillance of the remaining pancreas is advocated due
to high risk of recurrence of IPMN or invasive malignancy
• Decision to terminate surveillance will depend on the age, condition of the
patient
• Re-operation should be considered for patients with recurrence or
progression of disease in the pancreas remnant
Editor's Notes
@ Benign VC-IS-MAD
Border MIS
Malignant Blastic-MINDS
