Liver tumours can be benign or malignant. Benign tumours include hepatic hemangiomas and hepatic adenomas. Hepatic hemangiomas are the most common benign liver tumour, often appearing as 4 cm growths, while hepatic adenomas have a risk of bleeding or transforming into cancer. Malignant liver tumours are usually metastases from other cancers but can also include hepatocellular carcinoma, the most common primary liver cancer associated with risk factors like hepatitis, alcoholism and cirrhosis. Symptoms of liver cancer include jaundice and weight loss. Treatment options depend on diagnosis and include surgery, transplantation or other therapies.
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth, nodule, or tumor.
Growths in the liver can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:
Benign tumors:
-- are rarely a threat to life
-- can be removed and usually don't grow back
-- don't invade the tissues around them
-- don't spread to other parts of the body
Malignant growths:
-- may be a threat to life
-- sometimes can be removed but can grow back
-- can invade and damage nearby tissues and organs (such as the stomach or intestine)
-- can spread to other parts of the body
Most primary liver cancers begin in hepatocytes (liver cells). This type of cancer is called hepatocellular carcinoma or malignant hepatoma.
Liver cancer cells can spread by breaking away from the original tumor. They mainly spread by entering blood vessels, but liver cancer cells can also be found in lymph nodes. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
this power point presentation has complete detailed about hepatic carcinoma including statistics data intro definition cause rick factor pathophysiology sig and symptoms managements nursing management surgical chemotherapy radiotherapy and referable. that will be very helpful for BSc as well as MSc students specially oncology students . this content is prepared from American cancer society website. authentic content it is.
Liver cancer is a life-threatening illness and one of the fastest-growing cancer types in the United States. There are two kinds of liver cancer: primary and secondary. Primary cancer starts in your liver. Secondary cancer spreads to your liver from another part of your body. This article is an overview of primary liver cancer.
Like many kinds of cancer, healthcare providers can do more to treat liver cancer during the disease’s early stage. Unlike many kinds of cancer, healthcare providers have a good idea of what increases someone’s risk of developing liver cancer. With that in mind, healthcare providers are intent on identifying who may be at increased risk so they can catch and treat primary liver cancer as early as possible.
Liver cancer is the uncontrolled growth of abnormal cells in the liver. It is also called hepatoma or hepatocellular carcinoma. Hepatocellular carcinoma is the most common primary liver cancer comprising about 90 percent of all primary cancers of the liver. Hepatocellular carcinoma is more common in males as compared to females.
For more information: www.cancertame.com
Sites of the highest risk are the duodenum, for adenocarcinomas, and the ileum, for carcinoids and lymphomas.
In industrialized countries, small bowel cancers are predominantly adenocarcinomas;
In developing countries, lymphomas are much more common.
The incidence of small bowel cancer rises with age and has generally been higher among males than among females.
The risk factors for small bowel cancer include
Dietary factor
Cigarette smoking,
Alcohol intake,
Medical conditions -Crohn's disease, familial adenomatous polyposis, cholecystectomy, peptic ulcer disease, and cystic fibrosis.
The protective factors may include rapid cell turnover, a general absence of bacteria, an alkaline environment, and low levels of activating enzymes of precarcinogens.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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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
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.
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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
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.
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.
2. INTRODUCTION
• Liver tumours or hepatic tumours are tumours or growths on or
in the liver.
• Medical terms pertaining to the liver often start in hepato-
or hepatic from the Greek word for liver, hepar.
3. CLASSIFICATION
• Several distinct types of tumours can develop in the liver because
the liver is made up of various cell types.
THEY ARE CLASSIFIED INTO:
• BENIGN TUMOURS
• MALIGNANT TUMOURS (Most cases are metastases from
other tumours, frequently of the GI tract)
4. BENIGN TUMOURS
• The more common benign tumours of the liver include:
1. Hepatic Haemangioma
2. Hepatic adenoma ( Hepatocellular adenoma/Hepadenoma)
3. Focal nodular hyperplasia
• Other benign tumour which are very rare include fibroma, lipoma,
leiomyoma and cystadenoma.
5. 1- Hepatic Haemangioma
• A liver haemangioma is a tangle of blood vessels in or on the
surface of the liver.
• The most common benign liver tumour in adults and children.
• They are more common in the right lobe of the liver than in the
left lobe
• Liver haemangiomas are noncancerous.
• These growths are usually about 4 cm in size ( In some cases, they
can grow much larger.)
• Typically, there can occur only one liver haemangioma, however in
few cases in which several have been found on liver at once.
6. 1- Hepatic Haemangioma
• Causes & Risk factors-
• Haemangiomas are most likely congenital.
• Most liver haemangiomas are diagnosed in patients between the
ages of 30 and 50.
• Women are more likely than men to develop liver haemangiomas.
• Women who are on hormone therapy to increase their oestrogen
levels are at an increased risk of developing liver haemangiomas.
7. 1- Hepatic Haemangioma
• Symptoms and signs-
• In most cases, liver haemangiomas do not cause symptoms.
Few symptoms include( in larger tumours)
1. Pain in the upper-right side of the abdomen
2. Feeling full after eating a small amount of food
3. Nausea
4. Vomiting
5. Lack of appetite (may cause weight loss).
• However, if they have been aggravated by an injury or fuelled
by a change in oestrogen levels, symptoms can occur.
8. 1- Hepatic Haemangioma
• Diagnosis -
• Usually undiagnosed until accidently found in other circumstances
• Ultrasound, CT scan, MRI scan, or a single photon emission
computerized tomography (SPECT) scan.
• Treatment- Most liver haemangiomas do not require treatment.
However, if the haemangioma is large or causes symptoms, it can
be removed surgically, hepatic artery ligation, arterial
embolization.
• In Extremely rare cases, a liver transplant surgery or radiation
treatments may be required
9. 2- Hepatic adenoma
• Uncommon benign liver tumour.
• Also called as Hepatocellular adenoma/ Hepadenoma
• Large hepatic adenomas have a tendency to rupture and bleed
massively inside the abdomen.
10. 2- Hepatic adenoma
• Causes & Risk factors-
• 90% hepatic adenomas arise in women aged 20–40.
• Patients taking higher potency hormones, patients of advanced
age, or patients with prolonged duration of use have a
significantly increased risk of developing hepatocellular
adenomas.
• When hepatic adenomas grow to a size of more than 6–8 cm, they
are considered cancerous and thus become a risk of hepatocellular
carcinoma.
• Hepatic adenomas transform into the more dangerous
hepatocellular carcinoma in anabolic steroid users.
11. 2- Hepatic adenoma
• Symptoms and signs-
• Usually asymptomatic, and may be discovered incidentally on
imaging ordered for some unrelated reason.
• Less frequent signs and symptoms include:
1. Pain in the right upper quadrant or epigastric region(25-50%).
2. In Large hepatic adenomas (8–15 cm), palpable mass is noted.
3. If not treated, there is a 30% risk of bleeding. Bleeding may lead
to hypotension, tachycardia, and sweating (diaphoresis).
4. Large hepatic adenomas have a tendency to rupture and bleed
massively inside the abdomen.
12. 2- Hepatic adenoma
• Diagnosis-
• It is important to distinguish hepatic adenoma from other benign
liver tumours, such as haemangiomas and focal nodular
hyperplasia, because hepatic adenomas have risk of progressing
into a malignancy.
• MRI is the most useful investigation in the diagnosis and work-up.
• A poly-phasic CT scan is another useful test for diagnosing hepatic
adenoma
13. 2- Hepatic adenoma
• Treatment :
• All hepatocellular adenoma should be resected, because of the
risk of rupture causing bleeding and because they may contain
malignant foci.
• Patients with adenomas should avoid oral contraceptives or
hormonal replacement therapy.
• Pregnancy could cause the adenoma to grow faster, so patients
with hepatic adenomas should avoid pregnancy.
14. 3- Focal nodular hyperplasia
• Its the second most prevalent tumour of the liver.
• Non- malignant
• This tumour is the result of a congenital arteriovenous
malformation hepatocyte response.
• This process is one in which all normal constituents of the liver are
present, but the pattern by which they are presented is abnormal.
Even though those conditions exist the liver still seems to perform
in the normal range.
15. MALIGNANT TUMOURS
• The most frequent, malignant, primary liver cancer
is hepatocellular carcinoma
• Most cases are metastases from other tumours, frequently of
the GI tract.
• More rare primary forms of liver cancer includes
• Cholangiocarcinoma,
• Mixed tumours,
• Sarcoma and
• Hepatoblastoma(a rare malignant tumour in children).
16. Hepatocellular carcinoma
• Also called malignant hepatoma ( also named hepatoma, which is
a misnomer because adenomas are usually benign).
• Most common type of liver cancer.
17. Risk factors
• Alcoholism
• Hepatitis B & Hepatitis C (25% of causes globally)
• Aflatoxin
• Cirrhosis of the liver
• Non-alcoholic steatohepatitis (if progression to cirrhosis has
occurred)
• Hemochromatosis
• Wilson's disease
• Type 2 diabetes (probably aided by obesity)
• Haemophilia
18. Risk factors
• The risk factors which are most important varies widely from
country to country.
• In countries where Hepatitis B is endemic, such as China,
Hepatitis B will be the predominant cause of Hepatocellular
Carcinoma.
• Whereas in countries, such as the United States, where Hepatitis
B is rare because of high vaccination rates, the major cause of
HCC is Cirrhosis (often due to alcohol abuse).
• The risk of hepatocellular carcinoma in type 2 diabetics is greater
(from 2.5 to 7.1 times the non diabetic risk) depending on the
duration of diabetes and treatment protocol.
19. Signs and symptoms
• Yellow skin ( Icterus )
• Ascities
• Easy bruising from blood clotting abnormalities
• Loss of appetite
• Unintentional weight loss
• Abdominal pain especially in the right upper
quadrant, nausea, vomiting or feeling tired.
20. Diagnosis
• Rule out past
- H/O of HEPATITIS-B/C,
- H/O OF ALCOHOLIC ABUSE,
• ULTRASONOGRAPHY
• ALPHA- FETOPROTEIN & DES-GAMMA CARBOXYPROTHROMBIN
LEVELS
• CT-SCAN
21. Prognosis
• The usual outcome is poor, because only 10–20% of hepatocellular
carcinomas can be removed completely using surgery.
• If the cancer cannot be completely removed, the disease is usually
deadly within 3 to 6 months.
• However, survival can vary, and occasionally people will survive
much longer than 6 months.
22. Prevention
• Since hepatitis B or C is one of the main causes of hepatocellular
carcinoma, prevention of this infection is key to then prevent
hepatocellular carcinoma.
• Thus, childhood vaccination against hepatitis B may reduce the
risk of liver cancer in the future.
• In the case of patients with cirrhosis, alcohol consumption is to be
avoided. Also, screening for hemochromatosis may be beneficial
for some patients.
• It is unclear if screening those with chronic liver disease for
hepatocellular carcinoma improves outcomes.