ISMRM 2003 Poster: Spatial Resolution Effects on Permeability-Surface Area Estimation
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This project attempts to use the optimal parameters for histopathological determination of tumor type and grade and translate them for use with dynamic contrast enhanced (DCE) MRI. We test the hypothesis that poor spatial resolution used in clinical DCE MRI results in partial volume effects that yield inaccurate physiological parameters, which results in erroneous diagnostic information. Preliminary data shows that correlation between tumor PS and tumor type and grade done at clinical imager resolutions are inaccurate. PS estimated from higher resolution DCE MRI obtained by direct imaging or reduced encoding techniques may provide more diagnostically relevant information.
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![Identifying Tumor Vascular Permeability Heterogeneity Using Reduced Encoding Techniques Michael Aref, Jim Xiuquan Ji, Josh D. Handbury, Keith L. Bailey, Zhi-Pei Liang & Erik C. Wiener University of Illinois at Urbana-Champaign, Urbana, IL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Boreal Research Microscope courtesy of Sciencekit.com ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Figure 1 Figure 2 Figure 3 Eqn 1 Eqn 2 The authors would like to acknowledge Dr. Susanne Aref and PHS Grant Number 1 R01 CA87009-01, awarded by the National Institutes of Health, National Cancer Institute 2500 m Keyhole RIGR 469 m 938 m Figure 4 Figure 6 Figure 7 Figure 8 Figure 5](https://image.slidesharecdn.com/ismrm2003poster-090722002717-phpapp01/85/ISMRM-2003-Poster-Spatial-Resolution-Effects-on-Permeability-Surface-Area-Estimation-1-320.jpg)
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This document describes a low-cost 3D ultrasound system developed to image the brachial plexus for regional anesthesia procedures. The system uses two webcams and custom tracking hardware attached to an ultrasound probe to optically track its movement and reconstruct a 3D image from a series of 2D ultrasound images. Initial results demonstrated a proof of concept for generating a 3D image using freely available software, though processing was slow at 8 hours. Faster processing is expected once the software is compiled. The 3D ultrasound system has the potential to help physicians more accurately locate anatomy like the brachial plexus during regional anesthesia procedures.
Srs and sbrt 2 dr.kiran
This document discusses the history and techniques of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). It begins by outlining the early development of SRS by Lars Leksell in the 1950s. It then defines key terms like SRS, SBRT, and fractionated stereotactic radiosurgery. The document goes on to discuss the rationale and advantages of SRS/SBRT, including its ability to deliver high radiation doses with steep dose gradients using multiple beams and image guidance. It also covers topics like tumor oxygenation, cell kill mechanisms, and recent technological advances in the field like VMAT, flattening filter free beams, and 4D
MRI_CT poster v2
This study developed software tools to analyze geometric distortions in MRI images compared to CT reference images of a fiducial phantom containing 5229 spheres. The software automatically located all fiducial markers in the CT data and most in the MRI data. Analysis found the MRI data exhibited distortions from gradient nonlinearities, visible as an outward radiating effect and bulging near the edges of the field of view compared to the CT data. The positions in the CT data agreed with specifications within 1.73mm root mean squared error, providing a reference for quantifying the geometric distortions in the MRI images.
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An Improved TRICKS Method for Dynamic Contrast-Enhanced Tumor Imaging
3D dynamic contrast-enhanced (DCE) imaging is a widely used technique for tumor diagnosis. A major challenge in this
application is to fast sample the dynamic signal variations while keeping the spatial resolution. TRICKS is a reduced-encoding imaging method
where k-space data are temporally subsampled during data acquisition and then recovered by linear interpolation before image reconstruction.
Significant errors can be introduced by the linear interpolation when underlying signal variations show nonlinear behavior, for example, in DCE
experiments where the signals show a rapid enhancement phase followed by a slow decay phase. This abstract presents a new image reconstruction
scheme to improve the TRICKS method. Using a nonlinear interpolation scheme, the new method can capture dynamic signal variations more accurately. Experimental results from a DCE mice tumor study are presented to demonstrate the effectiveness of the proposed method.
Sanjay
GIS has several advantages over traditional maps and CAD systems:
1. GIS can handle large amounts of spatial and non-spatial data from various sources and formats and integrate them into a single database.
2. GIS allows for analysis of the integrated data through tools to generate maps, reports and other digital outputs.
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Whitcher Ismrm 2009
Statistical Analysis of Imaging Trials: Multivariate Methods and Prediction, Probing Cancer with MR II: From Animal Models to Clinical Assessment, 17th Annual Conference of the International Society for Magnetic Resonance in Medicine, Honolulu, Hawai\'i, April 19-24
Magnetom flash Special Edition USA
This study compared two T2-weighted FLAIR sequences for imaging the posterior fossa in pediatric patients - a conventional sequence with rectilinear k-space coverage and a BLADE sequence with rotating blade-like k-space trajectories. Ratings of 26 patients found significantly fewer motion and pulsation artifacts with BLADE, allowing better differentiation of lesions from artifacts. BLADE improved delineation of small lesions and increased interobserver agreement.
A Taxonomy of Clustering, or, No Container is an Island
Covers the evolution from static deployments using individual Docker containers, to dynamic deployments in Kubernetes and Mesos, with a taxonomy of clustering, i.e., what's important about cluster managers.
Talk given at the Software Development & Evolution Conference in Winnipeg, Manitoba, Canada on November 2nd, 2015.
Remote sensing
Remote sensing is the collection of information about Earth's surface without direct contact. It uses sensors on satellites and aircraft to detect and measure electromagnetic radiation reflected or emitted from objects. There are two types of remote sensing - active uses sensors that emit energy like radar, while passive detects natural energy like sunlight. Applications include monitoring agriculture, forestry, geology, oceans, and the environment. NASA operates many satellites that use different parts of the electromagnetic spectrum to analyze features and changes on Earth.
Interaction of EMR with atmosphere and earth surface
The document discusses how electromagnetic radiation interacts with the atmosphere and earth's surface. It notes that radiation is scattered or absorbed by particles in the atmosphere through mechanisms like Rayleigh scattering, Mie scattering, and absorption by gases. When radiation reaches the surface, it can be absorbed, transmitted, or reflected depending on the material. The type of reflection - specular or diffuse - depends on the smoothness of the surface. Different materials like vegetation, water, and soil have distinct spectral responses when measured over various wavelengths.
The Future Of Mri Safety W Kainz 13 Jul2009
The document discusses MRI safety challenges from a regulatory perspective at the FDA. It provides an overview of the FDA and its role in regulating medical devices like MRI. It then discusses defining and achieving MRI safety, including limiting SAR and temperature increases. It notes trends toward higher field MRI systems and the need for virtual patient models to evaluate safety for different populations. The goal is safe scanning for all while improving imaging capabilities.
Cardiac MRI
Myocardial viability testing is important in patients with coronary disease and severely reduced left ventricular systolic function to determine whether revascularization may improve outcomes by identifying dysfunctional but still viable myocardium. Revascularization of viable myocardium can help recover function and symptoms, whereas predominantly scarred myocardium will not benefit from revascularization.
Ct & mri of central nervous system
This document summarizes CT and MRI findings for various central nervous system conditions. It describes normal anatomy and imaging appearances of common intracranial tumors, vascular diseases, and traumatic injuries. Key points covered include characteristics of tumors like meningioma, astrocytoma and metastases. It also outlines imaging features of hemorrhage, infarction, aneurysms and skull fractures.
Lec_6_Intro to geo-referencing
This document discusses geo-referencing raster data. It defines geo-referencing as aligning raster data to real-world coordinates so it can be viewed and analyzed with other geographic data. There are two main types of geo-referencing: absolute, which aligns raster to maps or coordinates, and relative, which aligns raster to other geo-referenced raster. The document outlines the geo-referencing process, including selecting ground control points, performing transformations, and interpreting error metrics to evaluate accuracy.
MRI physics
MRI physics involves magnetic resonance imaging using protons' spin and magnetic properties. Protons precess at their Larmor frequency when placed in an external magnetic field. Radiofrequency pulses excite protons which absorb and emit energy, inducing a signal. Magnetic field gradients encode spatial information to generate images showing proton density and relaxation times, providing tissue contrast. Contrast depends on extrinsic parameters like pulse timing and intrinsic properties like T1 and T2 relaxation times.
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The document discusses the anatomy of the knee and basics of MRI examination for knee imaging. It covers MR anatomy of the knee, including signal characteristics of different tissues on T1-weighted, T2-weighted, proton density, and fat-suppressed sequences. Examples given are viewing the cruciate ligaments on T2-weighted sagittal images and collateral ligaments on proton density fat-suppressed coronal images.
MRI brain; Basics and Radiological Anatomy
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1. MRI uses strong magnetic fields and radio waves to produce detailed images of the brain and detect abnormalities. It has largely replaced CT for evaluating many conditions due to its superior soft tissue contrast.
2. Different MRI sequences such as T1-weighted, T2-weighted, FLAIR and DWI highlight various tissues and pathologies based on their relaxation properties. T1 highlights anatomy while T2 highlights abnormalities like tumors and inflammation.
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Investigation of spatial resolution and temporal performance of SAPHIRE (scin...
We have previously proposed SAPHIRE (scintillator avalanche photoconductor with high resolution emitter readout), a novel detector concept with potentially superior spatial resolution and low-dose performance compared with existing flat-panel imagers. The detector comprises a scintillator that is optically coupled to an amorphous selenium photoconductor operated with avalanche gain, known as high-gain avalanche rushing photoconductor (HARP). High resolution electron beam readout is achieved using a field emitter array (FEA). This combination of avalanche gain, allowing for very low-dose imaging, and electron emitter readout, providing high spatial resolution, offers potentially superior image quality compared with existing flat-panel imagers, with specific applications to fluoroscopy and breast imaging. Through the present collaboration, a prototype HARP sensor with integrated electrostatic focusing and nano- Spindt FEA readout technology has been fabricated. The integrated electron-optic focusing approach is more suitable for fabricating large-area detectors. We investigate the dependence of spatial resolution on sensor structure and operating conditions, and compare the performance of electrostatic focusing with previous technologies. Our results show a clear dependence of spatial resolution on electrostatic focusing potential, with performance approaching that of the previous design with external mesh-electrode. Further, temporal performance (lag) of the detector is evaluated and the results show that the integrated electrostatic focusing design exhibits comparable or better performance compared with the mesh-electrode design. This study represents the first technical evaluation and characterization of the SAPHIRE concept with integrated electrostatic focusing.
Statement Of Faith[1]
This document outlines the statement of faith of Moms In Touch International. It believes:
1) The Bible is the infallible word of God. 2) There is one God consisting of three persons: Father, Son, and Holy Spirit. 3) Jesus Christ is the Son of God who was born of a virgin, lived a sinless life, died as an atonement for sins, was resurrected, and will return.
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Similar to ISMRM 2003 Poster: Spatial Resolution Effects on Permeability-Surface Area Estimation
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1. The document proposes a formalism to utilize clinically available MRI imaging data for early detection of resistance to targeted cancer therapies.
2. By extracting tumor growth parameters from serial MRI scans, mathematical models can be used to predict future tumor growth and identify signs of resistance earlier than current methods.
3. Simulated data is used to determine the number and frequency of scans needed to reliably extract parameters and detect resistance under different levels of initial resistance and sampling intervals.
On Dose Reduction and View Number
This document summarizes a research paper on computed tomography (CT) dose reduction and view number optimization. It discusses how CT uses X-rays to create images but that radiation exposure is a concern, especially for pediatric patients. The paper explores how iterative reconstruction techniques and compressed sensing theories have aimed to reduce views and dose while maintaining image quality. It presents the goal of investigating the relationship between image quality, view number, and radiation dose level. Numerical tests were performed to determine the optimal view number for a given dose level that achieves the best reconstruction quality.
IGRT APP.pdf
This document summarizes 4 abstracts from the AROICON 2018 conference:
1. The first abstract describes a protocol for using cone beam CT with an extended longitudinal field of view to localize and adaptively verify treatment along the craniospinal axis for radiotherapy. It found the extended CBCT method provided accurate localization and dosimetric verification.
2. The second abstract involves developing a Python script to evaluate treatment plan robustness using both physical and radiobiological parameters for proton pencil beam scanning. The script allowed quick evaluation of perturbed dose distributions.
3. The third abstract reports on clinical implementation of deep inspiration breath hold amplitude gating for stereotactic body radiotherapy of lung and liver oligome
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One approach to computerized histopathology image analysis is to leverage the multi-scale texture information resulting from single nuclei appearance to entire cell populations. In this talk, we will introduce a novel framework for learning highly adaptive texture-based local models of biomedical tissue. I will discuss our initial experience with the differentiation of brain tumor types in digital histopathology.Session 6 image quality ct and session 8 dose ct
1) The document summarizes two quality control practices performed on a CT scanner to evaluate image quality and radiation dose.
2) In the first practice, various image quality parameters were measured using a Catphan phantom, including CT number linearity, spatial resolution, low contrast resolution, and spatial uniformity.
3) In the second practice, the CT dose index (CTDI) was measured using head and body phantoms to evaluate radiation dose from the CT scanner. The results of both practices were within acceptable limits.
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Cedric De Bazelaire new advance in multiparametric breast mri jfim ifupi mila...JFIM - Journées Francophones d'Imagerie Médicale
This document summarizes new advances in quantitative multiparametric breast MRI. It discusses using diffusion, perfusion, and radiomics parameters to characterize breast lesions and predict response to neoadjuvant chemotherapy. Diffusion metrics like ADC, perfusion metrics like Ktrans and Ve, and radiomics features can differentiate benign from malignant lesions, predict molecular subtypes, and determine response to therapy with moderate accuracy. Baseline radiomics features achieved an AUC of 0.91 for predicting response to neoadjuvant chemotherapy in one study. Quantitative MRI is providing new insights into breast cancer characterization and treatment monitoring.The Use Of High Energy Protons
The document discusses the use of high-energy protons in cancer therapy. It provides a history of proton beam therapy beginning in 1946 when Robert Wilson first suggested its use. It describes the first proton treatment centers and worldwide growth of proton therapy facilities. Key advantages of protons over photons discussed include lower entrance dose and maximum dose at tumor depth. Challenges and uncertainties in proton therapy planning and delivery are also summarized.
Stereotactic Radio-Surgery/Therapy (SRS/SRT)
Stereotactic radiotherapy uses a rigid coordinate system attached to the patient to precisely target tumors for radiation treatment. Imaging such as CT and MRI are used to delineate the tumor target and nearby organs at risk. Treatment planning software then designs radiation beams that converge on the target from multiple angles, creating a steep dose gradient to spare surrounding tissue. This allows high-dose radiation to be focused within millimeters to eradicate the tumor while avoiding side effects in normal tissue.
Iran Journal
This document summarizes a study that modeled the dose distribution of a radioactive 32P-coated coronary stent using Monte Carlo simulations. The researchers calculated dosimetry parameters like the geometry function, anisotropy function, and radial dose function according to AAPM TG-60 protocols. The Monte Carlo calculated dose rates were found to be within acceptable agreement of measured values from previous studies, with differences of less than 5% near the stent surface decreasing to around 30% at farther distances, which can be explained by measurement uncertainties. The high dose region was confined to near the stent surface, decreasing rapidly with depth in tissue.
Topic -Analysis of Patients specific Quality Assurance of IMRT/VMAT
Analysis and How to process of doing Pre-treatment Quality assurance of VMAT Plans. Here I described only Point Dose.
Improved non-calcified plaque delineation on coronary CT angiography by sonog...
Purpose: To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP).
Image Processing in Measurement guided Radiotherapy and Geometric accuracy
This document discusses image processing in measurement guided radiotherapy and geometric accuracy. It provides an outline on the history of x-rays and medical imaging, types of radiotherapy including 2D, 3DCRT, IMRT, IGRT and SRS. It describes the key steps involved in radiotherapy including patient positioning, imaging, treatment planning, dosimetry and treatment delivery. It emphasizes the importance of quality assurance for imaging and treatment machines to ensure geometric accuracy and highlights periodic training as important for all staff involved.
Stereotactic Radiosurgery/ Radiotherapy
This document discusses stereotactic radiotherapy and radiosurgery. It begins by explaining that stereotactic radiotherapy precisely delivers radiation doses to defined tumor volumes, sparing surrounding normal tissues, using an external coordinate system attached to the patient. Stereotactic radiotherapy involves fractionated doses while radiosurgery delivers a high single dose. Imaging is used to delineate the target and organs at risk. Treatment planning software is then used to plan radiation techniques delivering a steep dose gradient. Quality assurance protocols ensure precise dose delivery. Indications, advantages, and limitations of stereotactic radiotherapy and radiosurgery are provided. The document concludes by discussing advances and other modalities like proton radiosurgery.
Mutli vendor mrsi_2020
Multi-Vendor Implementation and Comparison of Density Weighted Concentric Ring
Trajectory Magnetic Resonance Spectroscopic Imaging
Patient data acquisition and treatment verification.pptx
1) Patient data acquisition involves obtaining 3D models from CT, MRI, or ultrasound scans to represent patient anatomy and tumours for treatment planning. CT numbers provide information on tissue density.
2) Treatment verification is important to ensure accurate radiation dose delivery and can involve portal films, electronic portal imaging, or cone-beam CT to check patient positioning.
3) Cone-beam CT acquires multidirectional x-ray images using on-board imaging systems to reconstruct 3D volumetric images for treatment guidance and avoiding critical structures.
G If Mi2010 No Animations
This document discusses using quantitative MRI (qMRI) to assure safety in radiation treatments for cancer. It notes that about half of cancer cases in Flanders are treated with radiation therapy using various techniques like IMRT. However, routine surveys show about 1/3 of radiation therapy centers fail target criteria. qMRI allows 3D dosimetry that mimics patient treatments, with gel phantoms undergoing the same planning and irradiation steps. This yields dose maps with R2 relaxation rate measurements correlated to absorbed dose. Current projects aim to improve gel dosimeters, accuracy, and clinical validation through multicenter studies to safely verify radiation therapy plans with qMRI.
A Hybrid Data Analysis And Mesh Refinement Paradigm For Conformal Voxel
This document proposes and implements an algorithm to optimize the placement of spatial saturation planes in magnetic resonance spectroscopy to minimize contamination from healthy tissue. It involves:
1) Segmenting tumor tissue from MR images
2) Defining an initial excitation region using principal component analysis on the tumor shape
3) Reconstructing the tumor as a 3D mesh and progressively refining it to obtain a set of conformal saturation planes
The algorithm was tested on 6 tumor datasets and achieved an average ratio of 0.87 for tumor volume to the optimized polyhedral volume, demonstrating improved conformity over traditional methods.
Total Variation-Based Reduction of Streak Artifacts, Ring Artifacts and Noise...
Optical projection tomography (OPT) is a computed tomography technique used to image samples between 0.5-15mm in size. It involves taking 2D projections of a sample rotated over 360 degrees and computationally reconstructing the 3D structure. Standard reconstruction uses filtered backprojection which can produce streak and ring artifacts. Total variation minimization has been shown to improve reconstruction quality by smoothing small fluctuations while preserving edges. The document reviews various techniques for reducing artifacts in OPT reconstruction through additional projections, model-based iterative methods, and total variation minimization.
Begoña Caballero-'La visión computacional se encuentra con la medicina'
El 14 de noviembre de 2016, la Fundación Ramón Areces organizó un Simposio Internacional sobre tecnología aplicada al mundo de la medicina de la mano del Instituto Tecnológico de Massachusetts (MIT) y de la Fundación mVision. Este encuentro llevó por título 'La visión computacional se encuentra con la medicina'. Durante esta jornada, se analizó el impacto que están teniendo las nuevas técnicas de imagen en alta resolución para el diagnóstico de todo tipo de enfermedades.
Multisite UTE 31P Rosette MRSI(PETALUTE)
While Phosphorous (31P) MRS (I) has been promising in experimental and clinical settings since the early 70s, it has been beset by prohibitively lower sensitivity, limited spectral-spatial resolution, and prolonged acquisition. This manuscript and proceedings of the annual scientific meeting of ISMRM in 2022 (REF1) and 2023 (REF2) demonstrate that our novel acquisition strategy, the novel Rosette Trajectory for fast and flexible MR(S)I contrast (Shen et al. 2023 (REF3), later we renamed it as PETALUTE after the translation to the preclinical scanners of 7T and 9.4T), enables operator-independent (1) rapid acquisition (~7 minutes), (2) reconstruction, and (3) processing pipeline, resulting in phosphorous metabolite ratio maps (10 x 10 x 10 mm3) of the whole brain.
In response to the “Repeat it with Me” challenge organized by the Reproducible Research study group of ISMRM, we demonstrated the power of this technique in 5 healthy volunteers at three different institutions with different experimental setups (2nd Place: UTE 31P 3D Rosette MRSI Reproducibility Team, REF4). Since the proposed acquisition/reconstruction/processing pipeline was operator/scanner/coil-independent, the Reproducer sub-teams successfully replicated the findings of the original proceeding in 2022 (REF1). As part of this challenge, we provided some MATLAB scripts and k-space data to reproduce some of the results described in this manuscript. The software and data can be downloaded from https://purr.purdue.edu/projects/ismrm31pmrsi.
These results will likely be of broad interest across clinical settings since the proposed acquisition strategy is not specific to any region, nuclei, or magnetic field and is operator-independent. This study's resolution and signal-to-noise ratios permit the metabolite maps in an experimentally and clinically feasible timeframe at 3 Tesla and 7T.
REF1 Bozymski B, Shen X, Ozen AC, Ibey S, Chiew M, Thomas A, Dydak U, Emir UE. Ultra-Short Echo Time 31P 3D MRSI at 3T with Novel Rosette k-space Trajectory. Proceedings 30th Scientific Meeting, International Society for Magnetic Resonance in Medicine, 2022.
REF2 Farley N, Bozymski B, Dydak U, Emir UE*. Fast 3D 31P MRSI Using Novel Rosette Petal Trajectory at 3T with x4 Accelerated Compressed Sensing. Proceedings 31st Scientific Meeting, International Society for Magnetic Resonance in Medicine, 2023.
REF3 Shen X, Özen AC, Sunjar A, Ilbey S, Sawiak S, Shi R, Chiew M, Emir UE. Ultrashort T2 components imaging of the whole brain using 3D dual-echo UTE MRI with rosette k-space pattern. Magnetic Resonance in Medicine. 2023;89(2):508–521.
REF4 https://challenge.ismrm.org/2023-24-reproducibility-challenge/results-22-23/
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Topic -Analysis of Patients specific Quality Assurance of IMRT/VMAT
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Improved non-calcified plaque delineation on coronary CT angiography by sonog...
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Image Processing in Measurement guided Radiotherapy and Geometric accuracy
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Patient data acquisition and treatment verification.pptx
Patient data acquisition and treatment verification.pptx
A Hybrid Data Analysis And Mesh Refinement Paradigm For Conformal Voxel
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Total Variation-Based Reduction of Streak Artifacts, Ring Artifacts and Noise...
Total Variation-Based Reduction of Streak Artifacts, Ring Artifacts and Noise...
Begoña Caballero-'La visión computacional se encuentra con la medicina'
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This document discusses care conferences and goals-of-care discussions. It provides guidance on organizing and conducting care conferences, including introducing participants, explaining what is happening with the patient's condition, empathizing with family members, highlighting the patient's voice, and planning next steps. The document emphasizes listening to understand different perspectives, acknowledging emotions, and having follow-up conversations to improve outcomes for the patient.
POLST
The document discusses POLST (Physician Orders for Life-Sustaining Treatment), which is used to document patients' end-of-life treatment preferences. It outlines a series of questions asked of patients to determine their goals of care, including whether they would want CPR if their heart stopped or life-sustaining treatment if their lungs and heart could no longer provide oxygen to their organs. Answers to these questions determine the appropriate treatment options selected on the POLST form. The POLST is then signed by the patient and healthcare provider to document the patient's wishes.
Ethics of Prognostication
The document discusses the ethics of prognostication in medicine. It begins with an introduction to palliative and curative models of medicine. It then reviews key ethical principles of autonomy, beneficence, non-maleficence, justice and veracity as they relate to prognosis. Finally, it discusses Downing's 10 steps to better prognosis, focusing on using tools and judgment to foresee a patient's situation, while centering the discussion on a patient's goals and framing prognosis in a way that respects ethical values.
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Presentation of my MBE capstone in which I discuss the issues with using technology to engage in the informed consent process.
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The nuances of managing dysphagia and bring this diagnosis back into the mainstream of internal medicine practice.
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Palliative care aims to relieve suffering and improve quality of life for patients with serious illnesses and their families. It can be provided alongside curative treatment. The presentation discusses primary palliative care provided in primary care settings and specialty palliative care provided by palliative care specialists. It provides criteria for referring patients to specialty palliative care, such as advanced cancers, organ failures, neurological diseases, and frequent hospitalizations. Early referral to palliative care can improve quality of life and mood and extend survival. While many could benefit from palliative care, there are not enough specialists to meet the need.
Ethics in Pandemics - Basic Principles and Advanced Planning.pptx
The document discusses ethics considerations during pandemics and public health emergencies. It begins with a brief history of pandemics and infectious diseases. It then covers various bioethical frameworks and methods of analysis that can be applied to challenges that arise, including principlism, narrative ethics, and casuistry. The document also discusses the differences between clinical ethics and public health ethics. It uses several case examples to demonstrate how different bioethical approaches could be applied to issues like visitor restrictions, goals of care conversations, changing PPE recommendations, and resource allocation. Throughout, it emphasizes the importance of transparency, inclusion, reasonableness and revisiting decisions as more information becomes available.
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Presentation on the work in progress by our high-quality dysphagia management committee for the Carle Bioethics Seminar Series
Carle Palliative Care Journal Club 1/15/2020
A journal club review and criticism of J Natl Cancer Inst. 2019 Dec 17. pii: djz233. doi: 10.1093/jnci/djz233 Emergency Department Visits for Opioid Overdoses Among Patients with Cancer by Jairam V, Yang DX, Yu JB, Park HS.
Palliative Care Boot Camp II
Basics of palliative care including symptom management: pain, dyspnea, nausea and constipation; family meetings, goals-of-care, end-of-life care, and artificial nutrition.
Critical Palliative Care: End-of-Life Care
Palliative care is about providing well-being and the highest quality of life to patients with serious, progressive, chronic life-limiting illness, including during the dying process.
Carle Palliative Care Journal Club for 7/3/18
Journal club review of "Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial" by D. Hui et. al. in JAMA. 2017 Sep 19;318(11):1047-1056.
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Presentation to the Carle Brain Injury Symposium regarding palliative care in traumatic brain injury patients.
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Carle General Surgery Grand Rounds presentation on palliative care symptom management, specifically pain, nausea, constipation, and malignant bowel obstruction.
Palliative Care
Palliative care aims to improve quality of life and relieve suffering for patients with serious illnesses. It can be provided along with curative treatment or on its own for comfort care. Total dyspnea involves physical, psychological, social and spiritual factors causing breathing distress. Signs that a patient is actively dying include profound weakness, disorientation, changes in breathing, and vocalizations like grunting.
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Ethical Issues of Applying Technological Solutions to the Informed Consent Pr...
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Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
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June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
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NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
Pharmacology of 5-hydroxytryptamine and Antagonist
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Acute Gout Care & Urate Lowering Therapy .pdf
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
DECLARATION OF HELSINKI - History and principles
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Artificial Intelligence Symposium (THAIS)
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Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
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Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.Recently uploaded (20)
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