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
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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.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
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
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Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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4. FFA: This is based on the principle of studying the
vasculature of retina with the help of injecting dye
and then studying the contrast report after
photographing it.
The dye used is the fluorescein solution.
5. Fundus angiography---fluorescence--luminiscence
When light energy is absorbed into a luminescent
material, free electrons are elevated into higher energy
states. This energy is then re-emitted by spontaneous decay of
the electrons into their lower energy states. When this decay
occurs in the visible spectrum, it is called luminescence.
Fluorescence is luminescence that is
maintained only by continuous
excitation
6. INTRODUCTION:An orange-red crystalline hydrocarbon,has a low
molecular weight & readily diffuses through most of the body fluids
and through the choriocapillaris.
AVALABILITY:
500 mg fluorescein are available in vials
of 10 mL of 5% fluorescein or 5 mL of 10% fluorescein.
Also 3 mL of 25% fluorescein solution (750 mg)
ELIMINATION:This is eliminated through liver & kidneys
7. Fundus camera and auxiliary equipment
Matched fluorescein filters (barrier and exciter)
23-gauge scalp vein needle
5 mL syringe
5 mL of l0% fluorescein solution
2 -inch needle to draw the dye
Armrest for fluorescein injection
Tourniquet
Alcohol swabs
Bandage
Standard emergency equipment
8. Exposed to light to a particular wavelength---fluorescent substance absorbs
energy & electrons are raised to a higher energy—now this substance
emits light of longer wavelength.
When excited by blue light(465-490nm)
It emits yellow green light (520—530nm).
9. Pupils: dilated
Film: white& black on which retnal & choroidal
vasculature is recorded.
Camera:electronic flash of a xenon light source.
Excitor filter: permits transfer of only blue light into the
eye
Barrier filter: it filters & eliminates the unwanted blue
light
17. Anatomy & physiology of eye.
The retinal circulation
The choroidal circulation
The blood retinal barrier
Passage of the dye.
18. Retinal circulation: Choroidal circulation:
Blood vessels– from CRA—
The main vessels are found in the
nerve fibre layer.
Fine capillaries are found in inner
nuclear layer & outer plexiform
layer.
There are no capillaries in about
400-500 microns in diameter
around the fovea.
Endothelial cells in these capilaries
have tight junctions which prevent
its passage .
30% of eyes there is a cilioretinal
artery.
Highly vascular tissue.
Chorocapillaries consists of large
,thin walled capillaries with
fenestrations which allow the
passage which allows some
plasma proteins.
choroid is supplied by
segmentally supplied by both the
large & small capillaries.
19. Outer blood barrier
Retina—RPE---choroid.
Hexagonal cells are arranged in a
monolayer –zona occludentes
which do not allow the diffusion
of smaller molecules
Transport of water & waste occurs
in the other direction.
20. The endothelial cells lines the capillaries
of the retina & thus forms the inner
retinal blood barrier
All fluid & metabolic transport takes
place by active process through the
endothelial cells.
Inner blood barrier
21. Dye passes through the choroidal circulation first &
then through the retinal circulation.
It does not crosses through the bruch’s membrane
22. Time it appears:-10-15 secs after injection.
Factors influences it-speed of injection
tight clothing around the arm
cardiovascular status.
Sequential photography: Dye appearance in choroidal
then followed by retina after
1-2 secs only.
33. Autofluorescence: It occurs in absence of fluorescein.
ex: exposed optic nerve drusen which is inherently
fluorescent.
34. It is due to reflected light from the eye
passing through the camera filters.
Scar tissue
Foreign body
Myelinated
nerve fibre
35. LEAKAGE: This is a misuse word & it implies
permeability of “BRB” which can be focal & diffuse.
36.
37.
38. Pooling: Dye collection in anatomical spaces leads to
characteristics pattern.
Ex: cystoid macular oedema
central serous retinopathy
39.
40.
41. Staining: often confused with the leakage.
It means that the stain is taken up by the
tissues even after the stain has left the ocular circulation.
55. Extravasation: for this local ice pack should be given at the area of
extravasation.
If the extravasation occurs earlier it’s the physician who decides
whether to continue the procedure or not.
Prevention: to use a scalp vein needle which is flexible & not the large
needle which is directly attached to the syringe.
NAUSEA: It starts within 20-30 seconds & last for 2-3 minutes & then
disappears slowly.
VOMITING:It starts within 40-50 seconds post injection.
HIVES & ITCHING: It starts after 2-15 mins of injection.
56. No contraindication to cardiac disease, pace
makers,cardiac arrhythmias.
No teratogenicity (but avoided in 1st trimester of
pregnancy).
57. An oxygen cylinder
A sphygmomanometer
A stethoscope
An airway support system.