This document provides an overview of normal liver anatomy and imaging characteristics, as well as common liver lesions. It describes that the liver normally enhances homogeneously in all phases. Common benign liver lesions include cysts, hemangiomas and focal nodular hyperplasia. Malignant lesions discussed are hepatocellular carcinoma and cholangiocarcinoma. Cirrhosis causes an atrophic right lobe and hypertrophic left lobe. The gallbladder and bile ducts are also reviewed.
Brief description on the benign tumors of liver that includes hemangioma, focal nodular hyperplasia, regenerative nodular hyperplasia, dysplastic foci, dysplastic nodules and focal fatty change.
Brief description on the benign tumors of liver that includes hemangioma, focal nodular hyperplasia, regenerative nodular hyperplasia, dysplastic foci, dysplastic nodules and focal fatty change.
Biliary tract
Normal IHDs measure less than 3 mm.
Periportal lymphedema can mimic a dilated IHD but shows a low-density area completely surrounding the portal vein.
A common anomaly is an aberrant IHD that drains a circumscribed portion of the liver, such as an anterior or posterior segment right lobe duct that drains into the left rather than the right main hepatic duct.
The wall of the CHD and CBD can normally be demonstrated and measures less than 1.5 mm.
The lecture overviews the different situations where cholecystitis can be fatal,if not accurately diagnosed.Different types of dangerous cholecystitis are illustrated with their imaging findings.
etiology ,classifications of gall stones & causes,risk factors,presentations, clinical examinations ,investigations including radiological (role of ERCP and MRCP ) and serological ,treatment including surgical and non surgical ,post cholecystectomy syndrome and its management ,Iindicatrions for cholecystectomy and cholecystotomy & when to perform ,complications of gall stones ,preventions of gall stone disease
gall stone disease, etiology , pathogenesis , risk factors ,types of gall stones,clinical feature, diagnosis , medical and surgical treatment of gall stones , prevention of gall stones
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.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
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.
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.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
10. • A few characteristics of normal anatomy:
• Portal venous phase: the parenchyma of the
liver/spleen/pancreas is homogeneously enhanced.
• Intra-abdominal fat has the density of fat (HU -50 to -100;
see the X-ray/CT technique course for more information
about Hounsfield units); similar to normal subcutaneous fat.
If not, there may be ascites or fatty infiltration.
11.
12.
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16.
17.
18. •Liver
• A normal liver enhances homogeneously (irrespective of the
scan phase). The liver receives about 80% of its blood through the
portal vein (= nutrient-rich blood from the intestines). The remaining
20% is supplied by the hepatic artery.
y is present, it is important to document its
location. This may be crucial to any surgical options. Using the
Couinaud classification, the liver is subdivided into eight individually
functioning segments. Each segment has its own afferent hepatic
artery and portal vein, and efferent hepatic vein and efferent bile
ducts
19.
20.
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23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34. • Liver cirrhosis is the result of chronic liver
disease, causing irreversible damage to the
liver tissue. The liver is small and
proportions have changed; the left liver
lobe and segment 1 are hypertrophic, and
the right liver lobe is atrophic. The liver
tissue and surface has a nodular aspect (fig.
7). Liver cirrhosis may increase the pressure
in the hepatic vessels, giving rise to ‘portal
hypertension’. Signs of portal hypertension
include collateral formation, splenomegaly
and ascites.
35. Focal abnormalities
As mentioned previously, multiple-phase abdominal CT is performed
when a liver lesion is suspected in order to evaluate the
enhancement pattern of the lesion. Lesion morphology often
presents clues for diagnosis. In order to arrive at a sure diagnosis,
however, additional examination is usually required, mostly in the
form of a liver MRI.
36. •Cyst
• Cysts are very common
abnormalities in the liver. A liver cyst
may vary in size from a few
millimeters up to more than 10 cm.
Cysts are sharply delineated with a
low density (HU < 10). Cysts do not
enhance
37. •Abscess
•Abscesses in the liver are usually a complication of an
intestinal infection. The bacteria migrate to the liver
through the venous system. Patients with a liver
abscess are sick, have a fever and elevated infection
parameters in the blood. The abscess is usually a
cluster of jaggedly delineated hypodensities. The
abscess rim may enhance (note: rim enhancement is
commonly absent).
38. • Hemangiomas are common abnormalities in
the liver. A hemangioma can be up to 10 cm in
size. Hemangiomas are sharply delineated
with a specific enhancement pattern. The
arterial phase reveals peripheral, nodular,
discontinuous enhancement and the portal
venous phase reveals progressive filling.
Characteristic of hemangiomas is that the
enhancement in each phase corresponds with
the ‘blood pool’
39. • Focal nodular hyperplasia (FNH) is
more common in women than
men. FNH arises from liver cells
and bile duct cells, and is sharply
delineated and hypervascular.
Characteristic of FNH is the star-
shaped fibrous core in the middle
of the tumor, the so-called central
scar . In most FNHs, the fibrous
central scar enhances in the
equilibrium/delayed phase.
40. •Adenoma
• Adenomas are particularly common in
women aged 20-50 years, but may also
occur in men. Oral contraceptive use
constitutes a risk factor for developing an
adenoma. Large adenomas may bleed or
become malignant. Sizes vary markedly:
from 1 cm up to more than 20 cm.
Adenomas are hypervascular, usually
clearly delineated, encapsulated and may
contain fat. The bleedings and presence
of fat may give the adenoma a
heterogeneous aspect (table 2). The
enhancement pattern varies. About 20%
have enhancement of the
(pseudo)capsule in the
equilibrium/delayed phase.
41.
42. •Metastasis
•Logically, metastases develop in people with a
malignancy, but the primary malignancy may not be
known yet. Metastases are vaguely delineated. There
are both hypovascular and hypervascular liver
metastases (table 6). It is important to realize that
hypervascular metastases may be very difficult or
impossible to see on a scan in the portal venous phase
(fig. 9).
43.
44. • Hypervascular liver metastasis in a patient with a history of
renal cell carcinoma. Note it is difficult to see the metastasis
in the portal venous phase.
• It is therefore important to know beforehand whether a
patient is known (or suspected) to have a tumor giving rise
to hypervascular metastases. It can then be decided to scan
in the arterial phase also. Table 3 summarizes tumors that
may give rise to hypervascular metastases.
45.
46. • Hepatocellular cell carcinoma
• Hepatocellular cell carcinoma (HCC) is a malignant tumor
arising from hepatocytes. HCC is strongly associated with
chronic liver diseases such as hepatitis B and C and liver
cirrhosis. HCC is more prevalent in non-Western countries
than Western countries. HCC is an infiltrative tumor that may
proliferate into the veins. Characteristic of HCC is the marked
arterial enhancement and the rapid washout of contrast
agent in the portal venous and equilibrium/delayed phases
47.
48. • Liver cirrhosis with ascites. Two
hypervascular enhancing liver lesions in
the arterial phase. Both lesions reveal
washout in the portal venous &
equilibrium/delayed phases (=
hypodense as compared to other liver
parenchyma), consistent with HCC.
49. •Cholangiocarcinoma
•Cholangiocarcinoma is a bile duct malignancy. The
development of cholangiocarcinoma is associated
with bile duct cysts and primary sclerosing cholangitis
(PSC). The tumor may arise from both the intrahepatic
and extrahepatic bile ducts. Characteristic of
cholangiocarcinoma is the fibrous nature with
capsular retraction and persisting enhancement in the
equilibrium/delayed phase and dilation of the
proximal bile ducts ,
50.
51.
52. • Gallbladder and bile ducts
• Normal undilated intrahepatic bile ducts are
invisible on an abdominal CT.
• The left and right hepatic duct join to form the
common hepatic duct. These in turn join the
cystic duct to form the choledochous duct. The
choledochous duct eventually joins the
pancreatic duct at the level of Vater's papilla,
where the bile and pancreatic juice is released
into the duodenum (fig. 11).
• The choledochous duct is frequently
identifiable on CT scans; it should be < 6 mm.
53. • Bile stones
• Bile stones may develop in the gallbladder
(cholecystolithiasis) and may migrate to the
bile ducts (choledocholithiasis). Bile stones
are generally invisible on CT scans.
Ultrasound is most suited to identify bile
stones. However, the consequences of an
obstructive bile stone can be seen on CT. The
obstruction prevents the bile from passing.
With an obstructive stone in the gallbladder,
the gallbladder becomes enlarged
(hydropic). With an obstructive stone in the
bile ducts, the bile ducts are dilated; the
intrahepatic bile ducts are dilated when
their diameter exceeds 2 mm, the
choledochous duct is dilated when its
diameter exceeds 6 mm
54. • Cholecystitis
• A complication of bile stones is an infected
gallbladder or cholecystitis. Cholecystitis
rarely occurs in the absence of bile stones.
Ultrasound is also best suited to diagnose
cholecystitis. Ultrasound improves the
visibility of the bile stones, and gallbladder
compressibility can be evaluated (dynamic
examination). Absent compressibility
constitutes a key characteristic of
cholecystitis (see abdominal ultrasound
class). Other characteristics of cholecystitis
on CT include gallbladder wall thickening
and infiltration of the fat surrounding the
gallbladder. A common complication of
cholecystitis is gallbladder perforation,
where bile leaks into the abdominal cavity
(biloma).
55.
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57.
58.
59.
60.
61.
62. • The pancreatic drainage system is
variable. Many people have one
pancreatic duct which drains into
Vater's papilla. Some people have an
accessory pancreatic duct, also known
as Santorini’s duct (anatomic
variation). The accessory pancreatic
duct drains into the minor papilla (fig.
15). Other anatomic variations, such
as the pancreatic divisum, will not be
discussed in this course.
63. Thanks for watching
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