This study aimed to compare the overall and disease specific survivals of patients who underwent laparoscopic and open resection of colorectal cancer in a high volume tertiary center.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
This study aimed to compare the overall and disease specific survivals of patients who underwent laparoscopic and open resection of colorectal cancer in a high volume tertiary center.
Impact of Multidisciplinary Discussion on Treatment Outcome For Gynecologic C...Emad Shash
Tumor conferences are multidisciplinary meetings at which the
management of cancer patients is discussed. They have been
an integral part of oncology services and are regarded
as an essential component of quality control and continuing
medical education. There are data to suggest that the tumor conference enhances patient care. Many studies of effectiveness have been conducted. Reported benefits include improved patient management and treatment. In this presentation, I'll try to assess the role of the multidisciplinary tumor conference in patient management in gynecologic oncology services.
A thoughtful presentation on participation in clinical trials from the Thomas Jefferson University team at the 2017 CURE OM Patient & Caregiver Symposium.
Information about Management of Appendicular Lump by Dr Dhaval Mangukiya.
Details of Appendicular Lump, Basic to Above the Basics, Incidence, Safe Approach Interval Laparoscopy, Early Surgery etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Overview about evolution of the term Oligometastases,the paradigm and various states of oligometastases,treat options ,clinical trials and relevance in current clinical practice
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
Breast surgery plus systemic treatment may improve local PFS when compared to systemic treatment alone (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; I2 = 43%; low quality evidence)
The group receiving breast surgery plus systemic treatment probably had a shorter time
to distant PFS compared to the group receiving systemic treatment alone (HR 1.42, 95%CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence)
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Envisia Genomic Classifier is the first commercially available genomic test to improve the diagnosis of idiopathic pulmonary fibrosis (IPF). The test harnesses the power of RNA sequencing and machine learning to improve physicians’ ability to differentiate IPF from other interstitial lung diseases (ILD) without the need for invasive, risky and costly surgery.
A thoughtful presentation on participation in clinical trials from the Thomas Jefferson University team at the 2017 CURE OM Patient & Caregiver Symposium.
Information about Management of Appendicular Lump by Dr Dhaval Mangukiya.
Details of Appendicular Lump, Basic to Above the Basics, Incidence, Safe Approach Interval Laparoscopy, Early Surgery etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Overview about evolution of the term Oligometastases,the paradigm and various states of oligometastases,treat options ,clinical trials and relevance in current clinical practice
Study of the distribution and determinants of
health-related states or events in specified populations and the application of this study to control health problems.
John M. Last, Dictionary of Epidemiology
Breast surgery for Metastatic Breast Cancer : Cochrane Analysis Kundan Singh
Breast surgery plus systemic treatment may improve local PFS when compared to systemic treatment alone (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; I2 = 43%; low quality evidence)
The group receiving breast surgery plus systemic treatment probably had a shorter time
to distant PFS compared to the group receiving systemic treatment alone (HR 1.42, 95%CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence)
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Envisia Genomic Classifier is the first commercially available genomic test to improve the diagnosis of idiopathic pulmonary fibrosis (IPF). The test harnesses the power of RNA sequencing and machine learning to improve physicians’ ability to differentiate IPF from other interstitial lung diseases (ILD) without the need for invasive, risky and costly surgery.
Development and Validation of a Nomogram for Predicting Response to Neoadjuva...semualkaira
Retrospective analysis of clinical data on female patients with breast cancer was performed. Model 1 was developed by entering variables from the univariate analysis (P < 0.1) into a multivariate logistic regression analysis. Model 2 was developed via the stepwise forward-backward variable selection technique in partial least squares regression. For model 3, the least absolute shrinkage and selection operator (LASSO) method was used to choose suitable variables, followed by the multivariate logistic regression analysis.
Development and Validation of a Nomogram for Predicting Response to Neoadjuva...semualkaira
Retrospective analysis of clinical data on female
patients with breast cancer was performed. Model 1 was developed by entering variables from the univariate analysis (P < 0.1)
into a multivariate logistic regression analysis. Model 2 was developed via the stepwise forward-backward variable selection technique in partial least squares regression. For model 3, the least
absolute shrinkage and selection operator (LASSO) method was
used to choose suitable variables, followed by the multivariate
logistic regression analysis. Harrell’s C-index, calibration curves,
and decision curve analyses (DCA) were used to compare the
performance of the models. In the validation cohort, these results
were validated
ISSN 2347-2251
It appears that you're describing the scope of a scientific journal. This journal covers a wide range of topics related to both Pharmaceutical Sciences and Biological Sciences of the scopus database journal.
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
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
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Quality Assurance in Breast Pathology
Lessons Learned From a Review of Amended Reports
Archives of Pathology & Laboratory Medicine
Vol 141
February 2017
Harrison, B.T., Dillon, D.A., Richardson, A.L., Brock, J.E., Guidi, A.J. and Lester, S.C., 2016. Quality
Assurance in Breast Pathology: Lessons Learned From a Review of Amended Reports. Archives of
pathology & laboratory medicine, 141(2), pp.260-266..
8. All amended pathology reports for breast surgical specimens
for a 5-year period at a large academic medical center were
retrospectively identified and classified based on an
established taxonomy.
10. Revised pathology reports
A change in the information of a
pathology report after the report
has been finalized and released
and requires unsigning the original
report.
All changes that do more than add
information
Represents additional information
added to an unchanged original
report.
Only changes that just add
information
allows editing of the report text,
including diagnostic fields, and
requires adequate documentation
of all changes and notifications to
referring clinicians.
serves as a record of errors in
specimen collection, processing,
interpretation, and reporting.
Amendments Addendum
11. Review of amended surgical pathology reports
• Identifies defects in the surgical pathology process and to
promote quality assurance and improvement.
• A ‘‘taxonomy of defects’’ was developed and validated by
Meier and colleagues to approach the review of amended
reports.
• Classified into 4 categories—
• misidentifications
• specimen defects
• misinterpretations
• report defects
13. Review of amended surgical pathology reports
• Breast was the second most common organ site for
misinterpretations (16.2%) and misidentifications
(12.6%).
• Breast was the most common organ site for
specimen defects (41.6%).
15. • All amended pathology reports for breast surgical specimens
in the Department of Pathology at Brigham and Women’s
Hospital (Boston, Massachusetts) from January 1, 2009, to
December 31 2013, were retrospectively identified from the
departmental database of cases.
• Study specimens included core needle biopsies, excisions,
re-excisions, mastectomies and excluded consultation cases.
• Addendum reports, presumed to include added information
only, were not reviewed.
16. • The classification of amended reports was modeled after
the taxonomy of defects.
• The 4 categories included :-
1. report defects
2. specimen defects
3. misidentifications
4. Misinterpretations
• An amendment was classified as a report defect (ie, a
typographical error) only after review of the case
suggested that it would not be better classified as 1 of
the other 3 types of defects.
17. • Misinterpretations were classified into
• major diagnostic changes (potential to alter patient
care)
oupgraded
odowngraded
ochanged diagnoses.
• minor diagnostic changes
• additional diagnostic information.
19. • Of 12,228 breast pathology
reports, 122 amended
reports were identified.
• Most (88 cases; 72%)
amendments were due to
noninterpretative errors,
including 58 report defects,
12 misidentifications & 3
specimen defects.
• A few (34 cases; 27.9%) were
classified as
misinterpretations, including
14 major diagnostic changes
(11.5% of all amendments).
Amendments to Breast Pathology Cases
During a 5-Year Period
20. Major Diagnostic Changes During a 5-Year Period
Among major diagnostic changes, there were cases of
•missed microinvasion or small foci of invasion
•missed micrometastasis,
•atypical ductal hyperplasia overcalled as ductal carcinoma in situ,
•ductal carcinoma in situ involving sclerosing adenosis mistaken for invasive carcinoma,
•lymphoma mistaken for invasive carcinoma
•amyloidosis misdiagnosed as fat necrosis.
21. Major Diagnostic Changes During a 5-Year Period
•9 major changes were detected at interpretation of receptor studies and were not associated
with clinical consequences.
•3 cases were associated with clinical consequences, and of note, the same pathologist
interpreted the corresponding receptor studies.
23. DCIS involving sclerosing adenosis misinterpreted as invasive
ductal carcinoma on core biopsy and surgical excision
Apocrine ductal carcinoma in situ
involving sclerosing adenosis displayed
a highly complex, pseudoinfiltrative
architecture and marked cytologic
atypia on both core biopsy and excision
(A)
Immunohistochemical workup
(p63/cytokeratin and myosin/cytokeratin)
revealed a myoepithelial layer through
the lesion (B)
(Report amended after 2 months)
24. Diffuse, large B-Cell lymphoma misinterpreted as
triple-negative breast carcinoma on core biopsy
Diffuse, large B-cell lymphoma mimicked
poorly differentiated carcinoma on core
biopsy (C) triple negative profile on
immunohistochemical studies for estrogen
receptor, progesterone receptor, and
HER2.
On excision, the tumor consisted of sheets
of dyshesive, polygonal cells with large
vesicular nuclei and prominent nucleoli (D)
worrisome for a lymphoma.
(Report amended after 3 weeks)
25. Amyloidosis misinterpreted as fat necrosis on core biopsy
Amyloidosis of the breast manifested as deposition of eosinophilic material between adipocytes
and surrounding ducts, and as scattered calcifications, which was difficult to distinguish from fat
necrosis and fibroadenomatoid change (E).
An amorphous quality to areas initially appearing hyalinized, raising concern for amyloidosis
Further workup with Congo red (F) and sulfated Alcian blue special stains confirmed the
diagnosis.
.
27. • First study to investigate amended pathology reports specific to
breast specimens at a single institution.
• The study provided further insight into specimen
misidentifications and misinterpretations.
• Laterality reporting errors were most often discovered by the
radiology team soon after release of the final pathology report.
• Major interpretive errors were detected by pathologists, most
commonly at interpretation of immunohistochemical studies for
ER, PR and HER2.
• Major interpretative errors were associated with clinical
consequences in 3 cases.
28. • The study established standardized methodology for data
collection and benchmarks for quality measures.
• The study showed misinterpretations and specimen defects
were most often discovered by pathologists, whereas
misidentifications were most often discovered by clinicians.
• Review of ancillary studies after sign out was one of the more
common mechanisms of error detection.
• A second review at the time of predictive factor reporting
could be another valuable strategy for retrospective review of
all new breast cancer.
• The study contributed to an understanding of diagnostically
challenging cases in breast pathology.
30. • A review of amended pathology reports provides
valuable insights into surgical pathology processes.
• A review of amended pathology reports suggests
strategies for error detection and reduction.
• A second review at the time of ancillary studies is a
potentially valuable approach to the detection of
interpretive errors in a timely fashion and prevention
of associated clinical consequences.
Editor's Notes
The most common organ sites with report defects were skin (18.2%), followed by breast (17.7%), lower gastrointestinal tract (10.5%), female genital tract (10.4%), and upper gastrointestinal tract (7.6%). Cases with report defects most commonly involved neoplastic disease, as original diagnoses of benign and malignant neoplasms accounted for 61.6% of defect cases.
Misinterpretations and specimen defects were more often discovered by pathologists (73.5% and 82.7%, respectively). Misidentifications were most often discovered by clinicians (44.6%). These differences were statistically significant (P , .001, v2 test) (Table 5). In Table 6 the defect fractions for the 5 most common organ sites are reported: breast, female genital tract, upper gastrointestinal tract, lower gastrointestinal tract, and skin, with all other organs grouped as ‘‘other.’’ The most common source of misinterpretation was ‘‘other’’ (38.5%), followed by skin (20%) and breast (16%). The most common source of misidentifications was skin (42.6%), the most common site for specimen defects was breast (41.6%), and the most common site for the residual category of other nondiagnostic information defects was ‘‘other’’ (40.3%). These differences also were statistically significant (P , .001, v2 test). It should be noted that participants did not collect information about the relative number of each organ type evaluated during the study period. Thus, the relative proportions of defects by specimen type may be biased by the proportion of those specimens reported in this data collection.