A PowerPoint review focusing on hepatic angiosarcomas. Designed for surgical residents but likely useful for any medical profession, student or patient. Specifically, we discuss epidemiology, clinical presentation, pathology, etiology and treatment.
Simple liver cysts are congenital or acquired benign cysts formations and are commonly found incidentally. It has a prevalence of 3-5% in ultrasound studies and 18-24% in CT scans. Frequently asymptomatic, liver cysts may be associated with symptoms in 10-16% of patients. Hemoperitoneum is a far rare complication. Herein, we report a case presented at the emergency room with acute hemorrhagic rupture of a liver cyst.
Renal Tumor with Pancreatic Metastasis: About a Case Report _Crimson PublishersCrimsonpublisherssmoaj
Renal Tumor with Pancreatic Metastasis: About a Case Report by ChakerKays in Surgical Medicine Open Access Journal
Metastatic lesions of the pancreas are rare and account for less than 2% of all pancreatic malignancies. Renal cell carcinoma is most commonly responsible for pancreatic metastasis. Meanwhile, the pancreas is an uncommon site of renal cell carcinoma metastasis. We report the case of a patient presented with renal tumor associated to synchronous pancreatic metastasis at the Urology department in the Rabta Hospital, who underwent a radical nephrectomy followed by immunotherapy.
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more articles in Open access journal of Innovation in Surgical Open Access Journal
Please click on: https://crimsonpublishers.com/smoaj/index.php
A PowerPoint review focusing on hepatic angiosarcomas. Designed for surgical residents but likely useful for any medical profession, student or patient. Specifically, we discuss epidemiology, clinical presentation, pathology, etiology and treatment.
Simple liver cysts are congenital or acquired benign cysts formations and are commonly found incidentally. It has a prevalence of 3-5% in ultrasound studies and 18-24% in CT scans. Frequently asymptomatic, liver cysts may be associated with symptoms in 10-16% of patients. Hemoperitoneum is a far rare complication. Herein, we report a case presented at the emergency room with acute hemorrhagic rupture of a liver cyst.
Renal Tumor with Pancreatic Metastasis: About a Case Report _Crimson PublishersCrimsonpublisherssmoaj
Renal Tumor with Pancreatic Metastasis: About a Case Report by ChakerKays in Surgical Medicine Open Access Journal
Metastatic lesions of the pancreas are rare and account for less than 2% of all pancreatic malignancies. Renal cell carcinoma is most commonly responsible for pancreatic metastasis. Meanwhile, the pancreas is an uncommon site of renal cell carcinoma metastasis. We report the case of a patient presented with renal tumor associated to synchronous pancreatic metastasis at the Urology department in the Rabta Hospital, who underwent a radical nephrectomy followed by immunotherapy.
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more articles in Open access journal of Innovation in Surgical Open Access Journal
Please click on: https://crimsonpublishers.com/smoaj/index.php
Large Cavernous Hemangioma of the Kidney Mimicking a Renal Cancer: A Diagnost...science journals
A 69-year-old man presented with a 9-months intermittent macroscopic painless hematuria. He had a previous left kidney surgery for renal lithiasis 24 years ago. There were no particular physical findings, such as flank pain.
Squamous cell carcinoma in the native kidney of a renal transplant recipient ...Apollo Hospitals
We are reporting a case of squamous cell carcinoma of the native kidney in a renal
transplant recipient. A 54-year-old gentleman, a renal transplant recipient for three years,
presented with flank pain. On evaluation he was found to have a mass in the upper pole of
the left native kidney. Renal angiogram was done which showed a functioning transplanted
kidney with a large mass arising from the upper pole of the left native kidney. He
underwent nephrectomy. The histopathology reported a squamous cell carcinoma. He was
given adjuvant radiotherapy to the tumor bed using image guided radiotherapy thereby
delivering a differential dose to the high risk areas and preserving the surrounding normal
structures. He developed a urethral nodule which was found to be a squamous cell carcinoma.
The lesion was excised with clear margins. We present this case because it is rare
and to discuss adjutant management.
Liver Fibrosis: Difficulties in Diagnostic and Treatment: A Review-Crimson Pu...CrimsonGastroenterology
Early discovery of liver fibrosis and cirrhosis is becoming more relevant because of enhanced incidence of hepatocellular carcinoma. There a many underlying factors in developing liver fibrosis (i.e. viral hepatitis, steatohepatitis). Diagnosis of liver fibrosis is difficult; chronic liver failure and less distinct fibrosis stages can be underestimated, when laboratory routine parameters and native ultrasound of the liver are unsuspicious. Liver biopsy is a common element of diagnostic workup in hepatic cirrhosis, alongside clinical examination and abdominal ultrasound, and is the accepted diagnostic gold standard. But there is no unitary system of histological classification used to evaluate the degree of fibrosis, and individual systems are often validated only for individual disease entities. On the other hand liver biopsy is of less tolerance for patients. In the last years serological markers for detecting liver fibrosis were developed with different validity. Various imaging modalities have been proposed as methods for assessing liver fibrosis
by liver stiffness measurement. They are sufficient to approve the suspicious of liver fibrosis and/or to uncover unknown chronic liver failure. Studies showed the clinical usefulness of acoustic radiation force impulse shear wave elasticity imaging (ARFI-SWEI) is efficient as a preventive screening method to uncover fibrosis. The ARFI-SWEI system is integrated in an ultrasound device has a good accuracy and high reproducibility. Therapy of liver fibrosis depends on underlying disease and degree of liver failure. When liver failure can be cured liver fibrosis can regress. Direct antifibrotic drugs are
actually not available but in progress.
This is a case study on Viral Pneumonia where a patient came with fever, generalised bodyache and fatigue but was undiagnosed , but when she suddenly, developed respiratory distress, desaturated,then the whole story got changed.so, may this study be of some help to you all!
Large Cavernous Hemangioma of the Kidney Mimicking a Renal Cancer: A Diagnost...science journals
A 69-year-old man presented with a 9-months intermittent macroscopic painless hematuria. He had a previous left kidney surgery for renal lithiasis 24 years ago. There were no particular physical findings, such as flank pain.
Squamous cell carcinoma in the native kidney of a renal transplant recipient ...Apollo Hospitals
We are reporting a case of squamous cell carcinoma of the native kidney in a renal
transplant recipient. A 54-year-old gentleman, a renal transplant recipient for three years,
presented with flank pain. On evaluation he was found to have a mass in the upper pole of
the left native kidney. Renal angiogram was done which showed a functioning transplanted
kidney with a large mass arising from the upper pole of the left native kidney. He
underwent nephrectomy. The histopathology reported a squamous cell carcinoma. He was
given adjuvant radiotherapy to the tumor bed using image guided radiotherapy thereby
delivering a differential dose to the high risk areas and preserving the surrounding normal
structures. He developed a urethral nodule which was found to be a squamous cell carcinoma.
The lesion was excised with clear margins. We present this case because it is rare
and to discuss adjutant management.
Liver Fibrosis: Difficulties in Diagnostic and Treatment: A Review-Crimson Pu...CrimsonGastroenterology
Early discovery of liver fibrosis and cirrhosis is becoming more relevant because of enhanced incidence of hepatocellular carcinoma. There a many underlying factors in developing liver fibrosis (i.e. viral hepatitis, steatohepatitis). Diagnosis of liver fibrosis is difficult; chronic liver failure and less distinct fibrosis stages can be underestimated, when laboratory routine parameters and native ultrasound of the liver are unsuspicious. Liver biopsy is a common element of diagnostic workup in hepatic cirrhosis, alongside clinical examination and abdominal ultrasound, and is the accepted diagnostic gold standard. But there is no unitary system of histological classification used to evaluate the degree of fibrosis, and individual systems are often validated only for individual disease entities. On the other hand liver biopsy is of less tolerance for patients. In the last years serological markers for detecting liver fibrosis were developed with different validity. Various imaging modalities have been proposed as methods for assessing liver fibrosis
by liver stiffness measurement. They are sufficient to approve the suspicious of liver fibrosis and/or to uncover unknown chronic liver failure. Studies showed the clinical usefulness of acoustic radiation force impulse shear wave elasticity imaging (ARFI-SWEI) is efficient as a preventive screening method to uncover fibrosis. The ARFI-SWEI system is integrated in an ultrasound device has a good accuracy and high reproducibility. Therapy of liver fibrosis depends on underlying disease and degree of liver failure. When liver failure can be cured liver fibrosis can regress. Direct antifibrotic drugs are
actually not available but in progress.
This is a case study on Viral Pneumonia where a patient came with fever, generalised bodyache and fatigue but was undiagnosed , but when she suddenly, developed respiratory distress, desaturated,then the whole story got changed.so, may this study be of some help to you all!
Ectodermal Dysplasia: a case report and overview Waikhom Singh
A rare case of Hypohydrotic Ectodermal Dysplasia afflicting a 14 year old male is described.The characteristic features related to teeth and hair is also highlighted .
Diagnostic records /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Diabetes Mellitus: Presentation and CLinical ExaminationPranab Chatterjee
The presentation which won the Best Paper award at the Students' Paper Presentation in Rhapsody 2010. This paper was presented by Dr. Rimesh Pal Medical College Kolkata, 3rd Professional MBBS Student.
Abstract
Hepatic angiosarcoma is a rare tumour that is often difficult to diagnose. Historically, most cases of hepatic angiosarcoma were seen in the setting of industrial epidemics caused by exposure of workers to toxins such as vinyl chloride. Cases associated with recognised exposure to carcinogens have fortunately been extremely rare for the last three or more decades. However, the tumour has by no means disappeared in the Australian community. In this case series, we describe three cases of hepatic angiosarcoma that were seen at our institution since 2002. The first case presented with cholestatic liver function tests and was found to have angiosarcoma on liver biopsy. In the second case, the patient was admitted for decompensated liver disease on a background of presumed hepatitis B cirrhosis. The diagnosis of hepatic angiosarcoma was made only at autopsy after the patient died from multi-organ failure. The third case presented with ascites and the diagnosis of disseminated angiosarcoma was again made at autopsy following a negative ante-mortem liver biopsy.
Portosystemic Shunt for Treatment of Symptomatic Varices in Polycythemia Vera...georgemarini
Myeloproliferative disorders are commonly associated with portal vein thrombosis, which can lead to extensive and symptomatic variceal disease due to the development of noncirrhotic portal hy- pertension. In severe cases, a decline in liver synthetic function may indicate the need for liver transplantation
Liver Transplantation for Hepatic Trauma: Case Report and Literature Reviewsemualkaira
Liver transplantation can be offered to selected
patients following sever liver trauma as a possible life-saving procedure after all other treatment modalities have been exhausted.
Authors present a case of severe liver trauma followed by liver
transplantation due to total liver necrosis as a result of initial damage-control surgery and embolisation with literature review
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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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.
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.
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
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.
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
1. John Martinelli
IM Geriatric Case #2: Prostate CA/Septic Shock SBMC 2/24/14
History of Presenting Illness:
Mr. C.E. is a 79-year-old gentleman who arrived by ambulance to the SBMC ED on the
morning of February 17, 2014 after being found unresponsive in his home. In the ED, it
was determined he was in septic shock for which he received aggressive IV fluid
resuscitation and immediate broad spectrum IV antibiotic infusion. Upon admission to
the ICU, vasopressors were started with progressive improvement of his hemodynamic
status; however, he remained obtunded with altered mental status. He was anuric with
labs revealing probable acute kidney injury and uremia. His past medical history is
significant for metastatic prostate cancer for which he underwent radical prostatectomy,
cystectomy, and bilateral renal ureter ileal conduit placement. He has also been treated
for COPD (emphysema), hyperlipidemia, and peripheral vascular disease.
Physical Examination:
Post-resuscitation efforts, vitals were T 99.2, BP 79/63, HR 101, RR 17, O2sat 97% on
2L NC. Mr. C.E. exhibited severe lethargy but did become minimally responsive to
verbal and tactile stimuli by opening his eyes, however, he did not follow verbal
commands. He occasionally mumbled unrecognizable words. A GCS score of 6 was
recorded. Cardiovascular examination revealed tachycardia with S1, S2, and no evidence
of murmurs, gallops, or rubs. Peripheral pulses were palpated. There was no peripheral
edema with adequate perfusion. Lung sounds were equal bilaterally and clear to
auscultation. Abdomen was soft, non-distended, with active bowel sounds. Bilateral IV
access was patent at each forearm. A foley catheter was present. The ileal conduit stoma
appeared clean and dry.
Laboratory Investigations:
Blood cultures were positive for both gram(+) cocci in clusters suggesting
staphylococcus and gram(-) rods confirmed as e. coli by PCR analysis. ABG showed pH
7.33, pCO2 19, pO2 93. Lactic acid 2.9. CBC indicated Hgb 13.6, Hct 40.3, WBC 18.5,
Platelets 136. BMP showed Na 141, K 4.3, Cl 109, HCO3 9, BUN 157, Cr 9.82. Noncontrast abdominal CT revealed right-sided ureteral obstruction, dilatation, and
associated renal pelvic fluid collections. There was no urine output present in the foley.
There was no evidence of gastrointestinal obstruction, perforation, or air-fluid levels.
Discussion/Assessment/Plan:
Mr. C.E.’s ICU assessment and laboratory evidence was consistent with the diagnosis of
septicemia, septic shock, renal failure, and uremia status-post radical prostatectomy,
cystectomy, and ileal conduit placement. Considering blood cultures growing both
gram(+) and gram(-) organisms, the source of infection is likely multifactorial. Gram(+)
2. staphylococcus entry via the external abdominal stoma surface and classic gram(-) fecaloral transmission. Additionally, persistent ureteral obstruction leading to chronic
pyelonephritis is a significant factor with respect to septic source.
Mr. C.E. experienced fever, neutrophilia, hypotension, acidosis, thrombocytopenia, and
tachycardia, which are septic shock hallmarks. The neutrophilia is representative of an
infectious process, however, it is also responsible for producing inflammatory
vasodilation leading to systemic hypotension, distributive shock, and tachycardia. An
anion gap metabolic acidosis was evident along with appropriate respiratory
compensation. In the setting of hypotension, hypoperfusion and tissue ischemia, lactic
acidosis is expected and was indeed elevated contributing to the gap. Uremia was an
additional contributor with a BUN/Cr ratio indicating renal hypoperfusion leading to prerenal azotemia and uremic acidemia. In addition, serum creatinine was also very elevated
which corresponds to acute or acute-on-chronic renal failure likely from pre-renal
hypoperfusion, possible ischemic acute tubular necrosis (ATN), septic ATN, combined
with post-renal obstruction and pyelonephritis. This degree of renal injury/failure also
contributes to elevated blood urea levels and uremic acidosis. Regarding the acidosis,
platelet function will be altered leading to the thrombocytopenia observed.
Considering the level of acidosis, exemplified by an ABG pH @ 7.33, eventually multisystem organ failure, immunosuppression, opportunistic infection, hemorrhage, as well as
CNS/neurologic dysfunction can ensue. Recall the acidosis is present in the background
of other septic pathophysiologic processes, all which require aggressive treatment before
death ensues.
With regards to Mr. C.E.’s septic state, volume status, hemodynamic stability, renal
function, and metabolic acidosis, continued treatment was to be maintained in ICU.
Immediate dialysis/CRRT with central line access was planned, vancomycin and
meropenem was to be continued, IV fluids were to be continued with tapering of pressers,
and nephrology was consulted regarding future revision of ileal conduit/ureteral
obstruction. After meeting with the family and reviewing Mr. C.E.’s Living Will, it was
found that he requested no artificial life-saving interventions including dialysis and was
therefore made DNR/DNI. All treatment was suspended other than comfort care
measures with IV morphine. Several hours after this decision, Mr. C.E. passed away
comfortably with his family at his side.