This document summarizes common tumors of the kidney and urinary bladder. It discusses renal cell carcinoma, the most common malignant kidney tumor, which can be of clear cell, papillary, or chromophobe subtypes. Wilms tumor, the most common childhood kidney cancer, is also reviewed. Finally, tumors of the urinary bladder are covered, including papillary urothelial neoplasms and invasive urothelial carcinoma. Classification and clinical features of these tumors are presented.
This Presentation gives summarized overview of Gall Bladder Carcinoma especially the management as per latest National Comprehensive Cancer Network(NCCN) Guidelines version 2.2013
This Presentation gives summarized overview of Gall Bladder Carcinoma especially the management as per latest National Comprehensive Cancer Network(NCCN) Guidelines version 2.2013
Adrenal Gland and its Disorders with surgical management.Manish Shetty
Short and brief description of adrenal gland and its disorder.
it involves the basic anatomy, physiology and metabolism of adrenal hormones.
.Adrenal gland tumor like adrenal cortical tumor phaechromocytoma, incidentalaoma are mentioned in this PPT.
it explains the clinical symptoms, investigation and desired management of adrenal gland disorders.
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
Adrenal Gland and its Disorders with surgical management.Manish Shetty
Short and brief description of adrenal gland and its disorder.
it involves the basic anatomy, physiology and metabolism of adrenal hormones.
.Adrenal gland tumor like adrenal cortical tumor phaechromocytoma, incidentalaoma are mentioned in this PPT.
it explains the clinical symptoms, investigation and desired management of adrenal gland disorders.
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
1. TUMORS OF THE KIDNEY AND
URINARY BLADDER
РИШИК РАНА
ЛА2-204(1)
2. OBJECTIVES
• By the end of this session the student should be able
to:
• List the common benign and malignant tumors of the kidney
• List the types of renal cell carcinoma
• Know the clinical presentation of Wilms tumor
• Understand the basis of the classification of urothelial
carcinoma
4. • A 63-year-old man was found to have microscopic hematuria
on urinalysis done as part of a pre-employment physical
examination. The remainder of the urinalysis was normal, as was
the physical exam. The patient did not complain of any fever,
weight loss, pain, malaise, weakness, or urinary tract symptoms.
5. • Hct: 57%
• Hb: 19 g/dL
• BUN: 12 mg/dL
• Creatinine: 0.7 mg/dL
• WBC: 7,450/mm3 with a normal differential
• Urine cytology: negative
6. • Work-up for the hematuria was begun with noninvasive imaging
studies, which included a renal ultrasound examination and an
intravenous pyelogram. A mass was seen in the left kidney with
both imaging studies. The patient underwent nephrectomy.
12. TUMORS OF THE KIDNEY
• Renal cell carcinoma
• Arise from tubular epithelium
• 85% of primary malignant tumors of the kidney
• 2-3% of cancer in adults
• 6th-7th decade of life, Men 2x> women
• Increased risk in smokers, occupational exposure to cadmium,
in dialysis-associated cysts
13. • Clinical:
• Hematuria 50%
• Pain
• Mass
• Paraneoplastic syndrome:
• Fever, polycythemia 5-10% (erythropoietin)
• Hypercalcemia, hypertension, cushing syndrome
• Metastases to lung, bone
19. RENAL CELL CARCINOMA: TYPES
• 1. Conventional RCC (clear cell RCC)
• 70-80% of RCC
• Familial and sporadic
• Associated with von Hippel-Lindau syndrome
• VHL is autosomal dominant
• Multiple tumors: hemantioblastoma of cerebellum and retina, renal
cysts, renal cell carcinoma
• Germline mutation in VHL gene (3p25)
• Loss of second allele by somatic mutation
• Seen in sporadic RCC as well
20. RENAL CELL CARCINOMA: TYPES
• 2. Papillary RCC
• 10-15% arise from proximal tubular epithelium
• Multifocal, bilateral
• Familial and sporadic
• MET proto oncogene (7q31)
• Trisomy 7, Mutation of chromosome 7
• In sporadic cases: trisomy 7, 16, 17
21.
22.
23.
24.
25. RENAL CELL CARCINOMA: TYPES
• 3. Chromophobe RCC:
• 5% arise from collecting ducts
• Loss of Ch 1,2,6,10,13,17,21
• Hypodiploidy
• Good prognosis
26.
27.
28. • Morphology:
• Clear cell
• Solitary, large, cortical, well defined
• Yellow-orange, gray-white, cysts, hemorrhage, necrosis
• May extend to pelvis, ureters
• May invade renal vein and inferior vena cava
• Papillary
• Bilateral, multiple
• Chromophobe
• Brown-tan
34. • Our patient is a 5 year-old, Caucasian female who presented to
the primary pediatric clinic in early spring with chief complaints of
cough, fever by touch, and decreased activity for six days. Our
patient's illness began with rhinorrhea and progressed to appetite
loss and fever that her parents felt was unresponsive to
acetaminophen.
35. • On physical exam our patient appeared
worrisomely “sick”. She was fatigued. The
outstanding physical findings consisted of a
slightly erythematous throat. On abdominal exam
a mass of 9 cm width by 4 cm length with
regularly shaped margins was palpated with light
depth and verified with percussion in the left
upper quadrant. The mass was smooth, slightly
firm, oval, nonmobile, and did not cross the
midline. The child denied pain during the exam,
but was uncomfortable during palpation.
36.
37. • Our patient was then admitted to the children's hospital after her
fever and upper respiratory symptoms subsided for biopsy.
Biopsy confirmed diagnosis of Wilms' tumor. The tumor was
shrunk with chemotherapy for five months and then removed
from the left kidney via complete nephrectomy and partial right
nephrectomy.
51. • A 73-year-old man presented with painless
hematuria and urinary frequency
52.
53.
54. • Radical prostatocystectomy specimen revealed urothelial
carcinoma with invasion of the muscularis, circumferentially
involving the bladder base. Carcinoma in situ was seen at the
right ureteral margin. There was also invasion of the prostate,
local lymph nodes and vascular structures
72. OBJECTIVES
• By the end of this session the student should be able
to:
• List the common benign and malignant tumors of the kidney
• List the types of renal cell carcinoma
• Know the clinical presentation of Wilms tumor
• Understand the basis of the classification of urothelial
carcinoma