Cell growth and differentiation are normally controlled processes that maintain tissue structure. Disorders can occur when these processes are deregulated. Key disorders include hypertrophy (enlarged cells), hyperplasia (increased cell number), atrophy (decreased cell size and number), metaplasia (one cell type replaces another), dysplasia (abnormal cell growth), and neoplasia (uncontrolled cell growth, i.e. cancer). These disorders are caused by various stimuli and involve molecular pathways regulating cell growth and protein synthesis. Disorders can progress from early changes like metaplasia and dysplasia to late stage cancers if deregulation persists over time.
Cellular Adaptation
as cells encounter stresses they undergo functional or structural adaptations to maintain viability / homeostasis.
Injury - altered homeostasis
if limits of the adaptive response are exceeded or if adaptation not possible, a sequence of events called cell injury occurs.
Reversible Cell Injury
removal of stress results in complete restoration of structural & functional integrity.
b) Irreversible Cell Injury / Cell Death
if stimulus persists or is severe enough from the start, the cell suffers irreversible cell injury and death.
2 main morphologic patterns: necrosis & apoptosis.
Adaptations are reversible changes in the size, number, phenotype, metabolic activity, or functions of cells in response to changes in their environment.
Physiologic adaptations are responses of cells to normal stimulation by hormones or endogenous chemical mediators
Pathologic adaptations are responses to stress that allow cells to modulate their structure and function and thus escape injury.
Hypertrophy refers to an increase in the size of cells, that results in an increase in the size of the affected organ
The hypertrophied organ has no new cells, just larger cells.
Types:
a) physiologic b) pathologic
Causes:
a) increased functional demand b) hormonal stimulation
Neoplasia: Is the abnormal growth and proliferation of abnormal cells or abnormal amounts of cells due to a benign or malignant process. There can be benign tumors, or neoplasms, and malignant ones.
Cellular Adaptation
as cells encounter stresses they undergo functional or structural adaptations to maintain viability / homeostasis.
Injury - altered homeostasis
if limits of the adaptive response are exceeded or if adaptation not possible, a sequence of events called cell injury occurs.
Reversible Cell Injury
removal of stress results in complete restoration of structural & functional integrity.
b) Irreversible Cell Injury / Cell Death
if stimulus persists or is severe enough from the start, the cell suffers irreversible cell injury and death.
2 main morphologic patterns: necrosis & apoptosis.
Adaptations are reversible changes in the size, number, phenotype, metabolic activity, or functions of cells in response to changes in their environment.
Physiologic adaptations are responses of cells to normal stimulation by hormones or endogenous chemical mediators
Pathologic adaptations are responses to stress that allow cells to modulate their structure and function and thus escape injury.
Hypertrophy refers to an increase in the size of cells, that results in an increase in the size of the affected organ
The hypertrophied organ has no new cells, just larger cells.
Types:
a) physiologic b) pathologic
Causes:
a) increased functional demand b) hormonal stimulation
Neoplasia: Is the abnormal growth and proliferation of abnormal cells or abnormal amounts of cells due to a benign or malignant process. There can be benign tumors, or neoplasms, and malignant ones.
How is a cell formed?
What is growth?
What is differentiation?
What is morphogenesis?
Growth disorders-
What is growth disorder?
Difference between growth and development.
Classification – hypertropy, hyperplasia
hypoplasia, atrophy
agenesis
metaplasia
dysplasia
neoplasia
Growth hormone – hypopituitarism
hyperpituitarism
Developmental disorder of orofacial structures – clefts
lip disorders
tongue
jaws
teeth
Public health significance
Information about how cell get injured from different stimuli. Mechanism of cellular injury. Different types of cellular injury. Different examples of cellular injury with images which makes it easy to understand.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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!
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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
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.
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.
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.
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.
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
3. Introduction
•
• The cells of the body continue to grow, divide
and differentiate throughout life. Normally,
growth and differentiation are controlled in
such a way as to maintain the normal
structure of a particular tissue.This is seen in
tissues e.g (skin, intestinal mucosa, blood)
characterized by labile stem cells which
continuously undergo mitosis to replace lost
cells.
4. Introduction (contd)
• The processes of cell growth and
differentiation are the means by which a
single cell develops into a large complex
multicellular organism.Many cells undergo
growth in response to normal (physiological)
or abnormal (pathological) stimuli.
5. ---------What is Cell growth---------
Cell Growth is the process of increase in
size and mass of a cell resulting from the
synthesis of specific cell components.
--------------What is Cell Differentiation-------
Cell Differentiation is the process
whereby a cell develops an overt
/observable specialised morphology or
function which distinguishes it from its
parent cell.
7. HYPERTROPHY
• Hypertrophy refers to an increase in the size of
cells,that results in an increase in the size of the
affected organ.
• Increased cell size is due to the synthesis and assembly
of additional intracellular structural components.
• The hypertrophied organ has no new cells(due to lack
of cell division) but larger cells.
• Hypertrophy can be:
-Physiologic
-Pathologic
8. HYPERTROPHY(CONTD)
Physiological hypertrophy is caused by:
(A) Increased functional demand which can be found in
the heart &skeletal muscle .The common stimulus for
hypertrophy of muscle is increased work load.E.g is
seen in the bulging muscles of body builders.
(B) Stimulation by hormone & growth factors as seen in
growth of the uterus during pregnancy due to the
estrogen hormone acting on estrogen receptors.
The pathologic R/L ventricular hypertrophy of the
heart is usually caused by chronic hemodynamic
overload resulting from either hypertension or faulty
valves.
10. HYPERPLASIA
• Hyperplasia is defined as an increase in the number of cells in an
organ or tissue in response to a stimulus.
• It can only take place if the tissue contain cells that are capable of
dividing.
• It can be physiologic or pathologic.
Physiologic hyperplasia occurs in (2) types:
• (a)Hormonal hyperplasia:It increases the functional capacity of a
hormone-sensitive organ e.g, proliferation of the glandular
epithelium of female breasts at puberty and pregnancy, which is
usually accompanied by hypertrophy of glandular epithelial cells.
• (b)Compensatory hyperplasia:This is seen in the regeneration of the
liver after a partial hepatectomy.The remaining cells proliferate so
that organ soon grows back to the original size.
• Another example of physiologic hyperplasia is the production of
RBC’S from the bone marrow in response to its deficiency.
11. HYPERPLASIA(CONTD)
Pathologic hyperplasia are caused by excessive or
inappropriate actions of hormones or growth factors acting
on cells.
Examples include:
• -Endometrial hyperplasia due to increased amount of
estrogen.
• -Benign prostatic hyperplasia in responses to hormonal
stimulation by androgens.
• Responses to viral infections like HPV causing warts.
It can constitute a fertile soil in which cancerous
proliferations can arise when growth control mechanisms
becomes deregulated or ineffective because of genetic
abberations.
12. MECHANISM OF HYPERPLASIA
• Hyperplasia is the result of growth-factor
driven proliferation of mature cells and, in
some cases, by increased output of new cells
from tissue stem cells.
13. ATROPHY
• Atrophy is defined as a reduction in the size of an organ or
tissue due to a decrease in cell size and number-resulting in
the decreased functional ability of the cell.
• It can be physiologic or pathologic.
(1)Physiologic atrophy
• This is common during normal development.They include:
• Atrophy of notochord & thyroglossal ducts during fetal
development.
• Atrophy of uterus after parturition.
• Atrophy of ductus arteriosus in infants .
• Atrophy of thymus.
14. ATROPHY(CONTD)
(2)Pathologic atrophy.
This may be localized or generalized.
LOCALIZED:-
*Disuse:When a fractured bone is immobilized in a plaster cast/when
a patient is restricted to complete bed rest,muscle rapidly ensues.
*Denervation:Damage of nerves leads to atrophy of muscles.
*Ischemia: In late adult,the brain undergoes atrophy progressively as
atherosclerosis narrows blood vessels.
*Loss of endocrine stimulation: E.g-The loss of estrogen stimulation
after menopause results in physiologic atrophy of the
endometrium,vaginal epithelium, and breast.
*Pressure:Tissue compression for any length of time can cause atrophy
.An enlarged benign tumor can cause atrophy in surrounding
compressed tissue,probably due to ischemic changes.
15. ATROPHY (CONTD)
GENERALIZED:-
*Inadequate nutrition:Profound protein-calorie
malnutrition(marasmus) is associated with the
utilization of skeletal muscle proteins as a source
of energy after other reserves such as adipose
stores have been depleted.This results in marked
muscle wasting(cachexia).
(3)Senile atrophy as seen in ageing.
It is associated with cell loss,typically seen in the
brain and the heart.
16. Fig 1-5: atrophy A. normal brain of a young adult. B. Atrophy of the brain
in an 82-year-old male with atherosclerotic cerebrovascular disease,
resulting in reduced blood supply. Note that loss of brain substance
narrows the gyri and widens the sulci. The meninges have been striped
from the right half of each specimen to reveal the surface of the brain.
17. MECHANISM OF ATROPHY
• Atrophy results from:
(1)Decreased protein synthesis due to reduced metabolic
activities in the cells.
(2)Increased protein degradation in cells:-This occurs
mainly by the ubiquitin-proteasome pathway.Nutrient
deficiency and disuse activate the ubiquitin ligases
which attach the small ubiquitin molcules to cellular
proteins and target these tagged proteins for
degradation in proteasomes.This pathway is also
thought to be responsible for the accelerated
proteolysis seen in cachexia.
19. MECHANISM(CONTD)
• Atrophy,in many situations,is also accompanied
by increased autophagy(‘’self-eating’’),marked by
the appearance of increased numbers of
autophagic vacuoles.
• Some of the cell debris within the autophagic
vacuoles may resist digestion and persist in the
cytoplasm as membrane-bound residual bodies
called lipofuscin granules-which if present in
sufficient amounts,they impart a brown
discoloration to the tissue (BROWN ATROPHY).
20. METAPLASIA
Metaplasia is an acquired form of altered
differentiation.
Metaplasia is the reversible transformation and
replacement of one type of terminally
differentiated (epithelial or mesenchymal) cell
into another fully differentiated cell type.
Metaplasia often represents an adaptive
response of a tissue to environmental stress.The
metaplastic tissue is better able to withstand the
adverse environmental changes.
21. EXAMPLES OF METAPLASIA
The most common metaplasia is columnar to squamous as occurs
in the respiratory tract in response to chronic irritation as seen in an
habitual cigarette smokers.
A deficiency of vit.A also induces squamous metaplasia in the
respiratory epithelium.
Metaplasia from squamous to columnar can occur in Barrette
oesophagus under the influence of refluxed gastric acid.
Stones in the excretory duct of salivary glands,pancreas or bile duct
which are normally lined by secretory columnar epithelium may be
replaced by stratified squamous epithelia.
Connective tissue metaplasia is the formation of cartilage,bone&
adipose tissues in the tissues that do not originally contain
them...E.g myositis ossificans after intramuscular
haemorrhage(bone fracture).
22.
23. Metaplasia (contd)
• Metaplasia does not itself necessarily progress
to malignancy, although the environmental
changes which initially caused the metaplasia
may also induce dysplasia and, if persistent,
progression to tumour formation.
24. DYSPLASIA
• This is literally known as ‘’disordered growth’’.
• It is an abnormality where a tissue partially loses
the morphological characteristics of mature cells.
• It is mostly encountered in the epithelia.
• It involves 4 major changes:
(1)Anisocytosis(cells of unequal sizes)
(2)Poikilocytosis(abnormally shaped cells)
(3)Hyperchromatism(Excessive pigmentation)
(4)Presence of mitotic figures(unusual no of
continually dividing cells)
25. Dysplasia (contd)
• These changes result in the loss of uniformity and
architectural orientation of the cells.
• Dysplasia=Earliest form of a precancerous lesion.
• It is also an indication of premature neoplastic
progression.
• Dysplasia may occur in tissue which has
metaplasia (i.e., dysplasia developing in
metaplastic squamous epithelium from the
bronchus of smokers). Dysplasia may also
develop without coexisting metaplasia, for
example in squamous epithelium of the uterine
cervix, glandular epithelium of the stomach, or
the liver.
26. ANAPLASIA
• ANAPLASIA (LACK OF DIFFERENTIATION)IS A
MORE ADVANCED STAGE THAN DYSPLASIA.
• IT IS THE HALLMARK OF MALIGNANT
NEOPLASMS.
• ‘’Detailed explanation of the above underlined
terms will be made in the next presentation’’.