External beam radiotherapy can be delivered via linear accelerators (LINACs) or cobalt-60 teletherapy machines. LINACs use electromagnetic waves to accelerate electrons and produce high energy x-ray beams, allowing for more advanced treatment techniques like intensity modulated radiation therapy. However, LINACs are more expensive and complex. Cobalt-60 machines provide a less costly option that is less dependent on stable power, making it suitable for areas with unreliable electricity, but they produce continuous radiation and are an older technology with safety issues like potential leakage. Both methods have advantages and disadvantages depending on the clinical situation and resource availability.
This seminar is presented as a part of weekly journal club and seminar regularly conducted at Apollo hospital,Kolkata Department of Radiation oncology.
its all about x ray physics and advancement, in these slides a reader can easily understand how x-ray are produce. phenomenon,x ray room equipment,x ray positioning and contrast studies by using x-ray like fluoroscopy. A reader will easily understand the wording .it also helps a students for making ppt,assignments.
Various types of Energy Sources used in Surgery are discussed In this presentation,like Radio frequency ablation,Ultrasound Energy, Argon beam Coagulation etc
Dr H V Shivaram, HOD-Surgery & Allied Specialties, Aster CMI Hospital, Bangalore
Similar to Discussion about machines of Radiotherapy: Linac cobalt 60 (20)
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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.
- 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
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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.
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
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
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
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. Overview of Radiotherapy
• Use of ionizing radiation to kill cells
• 3 historical types
– External beam radiotherapy or teletherapy
– Brachytherapy/sealed source radiotherapy
– Systemic radiotherapy/unsealed source radiotherapy
3. Some historical land marks
• German scientist Wilhelm Röntgen discovered
it on November 8, 1895. triggering immediate
interest and experimentation in its therapeutic
use
4. Continued…
• first attempted x-ray treatment by french
physician Victor Despeignes, on a patient with
stomach cancer, In 1896
• He published a paper: a week-long treatment
was followed by a diminution of pain and
reduction in the size of the tumor, though
ultimately fatal
• results were inconclusive, as the patient was
concurrently being given other treatments
5. Continued…
• First demonstration of side effect
– In Leopold Freund's first experiment same year he
applied x-rays to a naevus
– Caused a deep ulcer resulted, which resisted
further treatment by radiation.
6. Continued…
• discovery of radium in 1898 by Pierre
and Marie Curie
• physiological effect of radium was first
observed in 1900 by Otto Walkhoff, and later
confirmed by "Becquerel burn“
– In 1901 Henri Becquerel placed a tube of radium
in waistcoat pocket where it remained for several
hours; a week or two after which there was severe
inflammation of his skin underneath
7. Continued…
• Evolution of isotope machine for EBRT
– By 1930s radium was used in some machines, but
ver expensive and impractical size of source
– After world war II through Manhattan project
process for synthesizing new isotope discovered,
enabling cobalt 60 and caesium 137 machines
– 1949 Dr. Harold E. Johns designed prototype Co60
machine
8. Continued…
• Evolution of isotope machine for EBRT
– First patient to be treated with cobalt-60 radiation
was treated on October 27, 1951
– 1966 Walt Disney treated for Lung Cancer with
Co60 machine
– By 1960s it was expected it would replace all Xray
generating machines
9. Continued…
• Evolution of LINAC for EBRT
– Principles proposed by Gustav Ising in 1924
– First working machine constructed by Rolf
Wideroe in 1928
– First dedicated Medical LINAC established in
Hammersmith Hospital, UK in 1952 by
Metropolitan-Vickers, treating first patient in 1953
10. Linear Accelerator
• A device that uses high frequency
(¬3000cycle/s) electromagnetic wave to
accelerate charged particles such as electrons to
high velocities or energies through linear tube
16. Linear Accelerator…Cont…
• Power supply
– DC current
– Rectification of AC current
• Modulator
– Sends flat top DC pulses of microsecond duration
to magnetron or klystron and electron gun
simultaneously
– 3 important parts Primary power distribution,
auxillary power distribution (emergency off
switch), Fan control (cooling),
21. Linear Accelerator…Cont…
• Electron gun
– Has a tungsten filament
– Vacuum inside
– Inject electron by thermioninc process in pulses
directed by modulator synchronized with
electromagnetic wave
23. Linear Accelerator…Cont…
• Waveguide
– Horizontal long tube
– Travelling and standing wave guide system
– Accelerate electron to high velocity
– Electrons repulse each other but beam is kept
precise by steering coil
24. Linear Accelerator…Cont…
• Treatment Head
– Bending magnet (pair)
• Makes the beam further precise (1mm)
– Shielding material (lead tungsten alloy)
– Tungsten target- transmission type
– Primary collimator- only allow forward beam
– Flattening filter
– Scattering foil- scatter pencil electron beam
– Beam monitoring device- ionization chamber
– Secondary collimator- 2 set of jaw, basic shape to field
– Multileaf collimator- irregular shape
– Field Light
28. Telecobalt Machine
• Source
– solid cylinder, disks, or pallets contained inside a stainless-
steel capsule and sealed by welding
– 1-2cm
– All sources monitored by IAEA
29. Telecobalt Machine…Cont…
• Source housing/Source head
– Still shell filled with Lead (Z-82) for shielding purpose
– ‘’On’’ position ‘’off’’ position of source
• ‘’Off’’ position has extra shielding by heavy metal blocks
– ‘’on’’ by
• source mounted on a heavy metal drawer with ability to
slide horizontally through a hole running through the
sourcehead in ‘’on’’ position.
• the source faces the aperture for the treatment beam and in
the off position the source moves to its shielded location
• A light source mounted on the same drawer occupies the on
position of the source
30. Telecobalt Machine…Cont…
• Other methods of ‘’on-off’’ by
– source mounted on a rotating wheel inside sourcehead
that carry the source from ‘’off’’ position to ‘’on’’ position;
– Liquid mercury (z-80) is allowed to flow into the space
immediately below the source to ‘’off’’ the beam
– source is fixed in front of the aperture & the beam can be
turned ‘’on’’ and ‘’off’’ by a shutter consisting of heavy
metal jaws.
• All of the above mechanisms incorporate a safety
feature in which the source is returned automatically
to the off position in case of a power failure
31. Telecobalt Machine…Cont…
• Beam shaping
– Collimator system consist of pairs of heavy metal
blocks called jaws that can produce only
rectangular field (5cm x 5cm to 35cm x 35cm at
80cm SSD)
– No multileaf collimator discovered for use in this
machine
– wedges
• Penumbra reduction
– Extendable penumbra trimmer
36. Summary
• Advantage of LINAC
– Latest technology and will improve further
– Accuracy more than Co-60
– Safer
• To this date no major catastrophic accident
• No leakage radiation
– Multiple energy beam possible in same machine
• Higher energy so spares skin and bone
– Electron therapy possible
– Conformational and modulated beam treatment possible
– Sharp beam no least penumbra
– No Source disposal
37. Summary
• Disadvantage of LINAC
– Costly
– Complexity
– Expert personnel needed
– Reliable high power demand
– prone to failure as more parts
– Not suitable for periphery
38. Summary
• Advantage of telecobalt machine
– Cheaper
– Less expertise needed
– May treat day and night continuous
– Not very much dependent on high and reliable
power supply so can be used in periphery where
power supply is less reliable
– Simple and soo less prone to failure
39. Summary
• Disadvantage of Telecobalt unit
– Older technology, developed countries don’t use anymore
– Safety issue
• To this date 4 major catastrophic accidents with isotope machine
• Leakage radiation
• No process of turning off, so continuous radiation production day and night
– Variable dose rate
– Source change needed
– IAEA monitoring
– Only single beam energy
– Shaped or modulated beam not possible to the extent of LINAC
– Can’t treat very deep tissue effectively
– Can’t spare organ at risk all the time
