1) The document discusses management of breast cancer, including diagnosis, staging, treatment options, and controversial issues.
2) It provides statistics on breast cancer incidence worldwide and in Egypt, noting it is one of the most common cancers in Egyptian females.
3) Projections estimate the number of breast cancer cases in Egypt could double from 2025 to 2050 as the population grows, posing greater challenges for cancer control efforts.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
Modified Sweat gland
Lies in the deep pectoral
fascia
Boundaries:
clavicle superiorly,
the lateral border of the latissimus muscle laterally,
the sternum medially
inframammary fold inferiorly
Report Back from SGO 2023: What’s New in Cervical Cancer?bkling
Curious about what’s new in cervical cancer research? Join Dr. Evelyn Cantillo, gynecologic oncologist at Weill Cornell Medicine, as she shares the latest updates from the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer. Dr. Cantillo will also highlight what the research presented at the conference means for you and answer your questions about the new developments.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
Modified Sweat gland
Lies in the deep pectoral
fascia
Boundaries:
clavicle superiorly,
the lateral border of the latissimus muscle laterally,
the sternum medially
inframammary fold inferiorly
Report Back from SGO 2023: What’s New in Cervical Cancer?bkling
Curious about what’s new in cervical cancer research? Join Dr. Evelyn Cantillo, gynecologic oncologist at Weill Cornell Medicine, as she shares the latest updates from the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer. Dr. Cantillo will also highlight what the research presented at the conference means for you and answer your questions about the new developments.
2012 Project design of an Integrated Well Woman Clinic combining a Women's Health assessment with Screening and Early Diagnosis of Breast and Gynecological Cancers
Womans Cancer Foundation, Well Woman ClinicMaheshShettyMD
A suggested model for a Well Woman Examination combined with Screening and Early diagnosis methods for Breast and Gynecological Cancers in developing countries proposed by Woman's Cancer Foundation, USA. www.womanscancerfoundation.org
Cancer screening may discover many dormant, regressing, or slowly progressing tumors that would not have affected the screened individuals. Such findings with there therapies are obviously harmful. This lecture is highly based on the book "over diagnosed" by H. Gilbert Welch and was presented in 2013 to KFSH-Dammam physicians
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
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.
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
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.
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
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.
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
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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2. 2
BREAST CANCER
Worldwide incidence in females*
*Incidence per 100,000 population.
Parkin DM, et al. CA Cancer J Clin. 1999;49:33-64.
67.4
36.0
28.6
71.7
21.2
25.0
31.5
25.5
86.3
Eastern
Europe
Japan
Australia/
New Zealand
South Central
Asia
Northern
Africa
Southern
Africa
Central
America
Western
Europe
North
America
4. 4
BREAST CANCER
Signs and symptoms at presentation
Mass or pain
in the axilla
Palpable mass
Thickening
Pain
Nipple discharge
Nipple retraction
Edema or erythema
of the skin
6. 6
BREAST CANCER
Diagnosis path
Evaluation
for
biopsy
Cyst
aspiration
Biopsy
•Excisional biopsy
•Core-cutting needle biopsy
•Fine-needle aspiration
Palpable
mass
Ductal
carcinoma
in situ
Invasive
cancer
Lobular
carcinoma
in situ
Benign
Insufficient
evaluation,
rebiopsy
If persistent,
short-term
follow-up
with surgeon
Continued
appropriate
screening
Cyst Normal
Nonpalpable
mass
Treatment Path
Needle
localization
12. 12
NSABP B-06:
Effect of Lumpectomy v. Mastectomy on Survival
DISTANTDISEASE-FREESURVIVAL(%)
Cohort A Cohort B Cohort C
Total Mastectomy: 692/265 569/233 494/192
Lumpectomy: 699/302 634/282 520/236
No. of patients / No. of recurrences
YEAR
Lumpectomy + XRT: 714/278 628/253 515/204
26. 26
What elements drive therapy
decision making ?
Prognosis
Treatment
efficacy
Treatment
toxicity
Co morbidity
27. 27
ER +
ER -
ER +
ER -
T1a (0-5 mm) T1b (6-10 mm) T1c (11-20 mm)
NCI
NCCN*)
St. Gallen
GUIDELINE RECOMMENDATION
FOR CHEMOTHERAPY FOR
STAGE I BREAST CANCER
Not Recommended Optional Recommended
*) NCCN = National Comprehensive Cancer Network
29. 29
The Breast Health Global Initiative (BHGI)
Guideline Publication 2003
CONSENSUS
STATEMENTS
Early Detection Panel
Diagnosis Panel
Treatment Panel
30. 30
BHGI GLOBAL SUMMIT 2005:
Guideline Stratification
Breast J 2006;12 Suppl 1:S117-120
31. 31
History
Physical examination
Clinical breast examination
Surgical biopsy
Fine-needle aspiration biopsy
Diagnostic breast ultrasound +/-
diagnostic mammography
Plain chest radiography
Liver ultrasound
Blood chemistry profile / complete
blood count (CBC)
Maximal
Stereotactic biopsy HER-2/neu status
CT scanning, PET scan, MIBI scan,
breast MRI
Sentinel node biopsy
IHC staining of sentinel nodes
for cytokeratin to detect
micrometastases
Enhanced
Diagnostic mammography
Bone scan
On-site cytopathologist
Preoperative needle localization
under mammographic or ultrasound
guidance
Basic
Interpretation of biopsies
Cytology and/or pathology
report describing tumor size,
lymph node status, histologic
type, tumor grade
Limited
Determination and reporting of
ER and PR status
Determination and reporting of
margin status
Core needle biopsy
Image guided sampling
(ultrasounographic +/-
mammographic)
Level of
resources
Clinical Pathology Imaging and lab tests
Diagnosis
32. 32
Controversial Issues :
FNAC or Frozen Sections
5 or 10 years of HT
T and AI
Type of CT
Herceptin and others
Pre or post op CT
Ov ablation
Cases who do not need systemic treatment
43. 43
Magnitude of Breast Cancer in Egypt: 2025
Population size: 51 million females
Crude incidence rate: 55.1./100,000 females
Incidence: 14,000 28,000 breast cancer cases
Prevalence: 42,000 84,000 breast cancer cases
Magnitude of Breast Cancer in Egypt: 2050
Population size: 64 million females
Crude incidence rate: 68.8./100,000 females
Incidence: 14,000 44,000 breast cancer cases
Prevalence: 42,000 132,000 breast cancer cases
Projection of Magnitude of Breast Cancer
in Egypt: 2025, 2050
44. 44
Breast cancer T stage 1984 - 2006, Port Said, Egypt
0
10
20
30
40
50
60
70
80
84-1985 86-1988 94-1999 2004 2005 2006
T1 T2 T3 T4
SOURCE: Prof. Dr. Ahmed Elzawawy
47. 47
Clinico–Pathological Correlation
in Breast Cancer Cases
(2002)
Revision of the slides of 212 patients.
Only 16 patients had both clinical and pathological features
of IBC (8%)
Age distribution
4 patients 35 yrs or less
8 patients 45 yrs or less
8 patients More than 45 yrs
The youngest 25 yrs
The oldest 76 yrs
48. 48
More than 90% of IBC showed positive axillary nodes.
IBC’s are characterized by:
High histologic grade tumors with high
Nuclear grade, necrosis and high PCNA and MIB-
1(Ki-67) labeling indices.
ER & PgR are frequently negative.
p53 > 70% positivity.
HER-2/Neu > 60%.
Biologic profile
“ Immunphenotypic signature”
49. 49
Tumor emboli and LYVE-1 and RhoC expression in IBC tumors from
Egypt and the United States