MRI provides excellent imaging of the kidneys without exposing patients to radiation. It uses strong magnetic fields and radio waves to generate detailed images of the kidney anatomy and any abnormalities. The multiplanar capabilities of MRI allow evaluation of the kidneys and detection of cysts, tumors, infections and other lesions. Dynamic contrast-enhanced MRI with gadolinium is particularly useful for characterizing renal lesions. While MRI is very useful for evaluating the kidneys, there are some risks like nephrogenic systemic fibrosis in patients with kidney disease, so care must be taken with contrast administration.
Magnetic Resonance Imaging is a technique that uses the magnetic field and radio waves to create detail images of the organs and tissues of the human body
Magnetic Resonance Imaging is a technique that uses the magnetic field and radio waves to create detail images of the organs and tissues of the human body
In this presentation we will discuss about the
Anatomy of Prostate
Technique of Transrectal US
Carcinoma Prostate and
Different modes of prostatic biopsy.
Imaging of the prostate with emphasis on evlauation for carcinoma, gains precedence as the curability and disease free survival rates are high. MRI with PIRADS protocol brings uniformity and enables the surgeons and radiologists to converse with great clarity and better stratification of the disease status.
Radiotherapy in the Treatment of Sarcomas in Adolescents and Young AdultsMethodist HealthcareSA
Daniel Indelicato, MD, University of Florida, Jacksonville, FL
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference, Methodist Healthcare-San Antonio
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
In this presentation we will discuss about the
Anatomy of Prostate
Technique of Transrectal US
Carcinoma Prostate and
Different modes of prostatic biopsy.
Imaging of the prostate with emphasis on evlauation for carcinoma, gains precedence as the curability and disease free survival rates are high. MRI with PIRADS protocol brings uniformity and enables the surgeons and radiologists to converse with great clarity and better stratification of the disease status.
Radiotherapy in the Treatment of Sarcomas in Adolescents and Young AdultsMethodist HealthcareSA
Daniel Indelicato, MD, University of Florida, Jacksonville, FL
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference, Methodist Healthcare-San Antonio
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
uses and indication of radiology in surgeryanimesh kunwar
1.Introduction
2.Diagnostic modalities in radiology
3.Role of radiological imaging in emergency surgical situation
4.Role of radiological imaging in elective surgical situation
5.Conclusion
This presentation includes various methods of investigation and management of Renal cell carcinoma according to latest version of NCCN and EUA guidelines
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.
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
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!
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
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
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
1. B Y
M O H A M E D A B O U E L - G H A R
U R O L O G Y & N E P H R O L O G Y C E N T E R
M A N S O U R A U N I V E R S I T Y
MRI of The kidney
2. What is MRI
MRI is a machine creates a magnetic field, sends
radio waves through your body, and then measures
the response with a computer.
This creates an image or picture of the inside of your
body that is much clearer than can be obtained with
most other methods.
3. MRI
The potential advantages of MRI for
evaluating urinary tract abnormalities are:
No ionizing radiation.
Multiplanar capabilities.
Excellent anatomic resolution and
soft tissue contrast.
4. Before MRI
Cardiac pacemaker or
implantable defibrillator.
Catheter that has metal
components.
Metallic prosthesis.
A ferromagnetic metal
vascular clip.
An implanted or external
medication pump.
A cochlear implant.
A neurostimulation system.
5. MRI EXAMINATION TECHNIQUES
• high magnetic field (1.5 – 3 Tesla)
• high performance gradients
• phased-array coil → high SNR & small FOV
12. 3D GRE sequence
HIGH SPATIAL RESOLUTION
HIGH TEMPORAL RESOLUTION
MRI EXAMINATION TECHNIQUES
• Single shot or multishot
• Full coverage of the kidney in one 18-23 s
breathhold
13. 3D GRE T1 SEQUENCE
+
GADOLINIUM
DYNAMIC CONTRAST-ENHANCED MR IMAGING
MRI EXAMINATION TECHNIQUES
18. MRU
MRU is the most important
technique in uroradiology.
It has a good diagnostic value in
virtually all kinds of urinary tract
disorders.
MRU can reduce the need for
radiation exposure and invasive
procedure.
20. T2-W(static –Fluid) MRU
In static- fluid MRU, Heavily T2w Turbo spin
echo (TSE) sequences are used to obtain
water images of the urinary tract.
It is used to image fluid filled cavities such as
hydronephrosis.
21. • slice thickness: 6-10 cm
• inclusion of the entire pelvicaliceal system and the
whole course of the ureters
• coronal plane and sagittal plane
SINGLE SLICE PROJECTION IMAGE
Advantages:
• acquisition time: 3-8 s
• no motion artifacts
• no post-processing
• ureterohydronephrosis and
location of obstruction
Disadvantages:
• no cause of obstruction
• low spatial resolution
• low signal to noise ratio
MRU EXAMINATION TECHNIQUES
22.
23. MULTISLICE TECHNIQUE
• overlapping slices
• section thickness: less than 5 mm
• post-processing: MIP images
Advantages
• reduced partial volume
averaging
• small pathological details
Disadvantages
• more time consuming
• superimposing extraurinary
fluid
MRU EXAMINATION TECHNIQUES
26. T1-w excretory MR Urography
Excretory MRU imitates the conventional
IVU.
Gd-Enhanced urine is imaged with use of fast
T1-w GRE sequences.
Low –molecular –weight Gd have
demonstrated a good safety profile at
standard clinical dose.
27.
28. Diffusion-weighted imaging (DWI)
• MR diffusion-weighted imaging (DWI) provides information on the
velocity and direction of movement of the water molecules in tissue
under influence of a diffusion gradient
• The velocity and direction of the diffusion movement of the water
molecules can be quantified by means of the apparent diffusion
coefficient (ADC)
Koh DM et al, AJR (2007)
MRI EXAMINATION TECHNIQUES
36. All In Approach
Preoperative assessment of potential live
kidney donor.
Basal study of transplanted kidney.
Pelviureteral junction obstruction.
Nephron sparing surgery.
37.
38.
39.
40.
41.
42. MR Urography
Obstructed or non-obstructed?
Urothelial lesions.
Cause of obstruction.
Congenital Anomalies.
47. Ectopic kidney
-Simple renal ectopy refers to a kidney that remains in the
ipsilateral retroperitoneal space.
-The most common position is in the pelvis or sacral
region below the aortic bifurcation.
-Crossed renal ectopia with fusion occurs in 85%, without
fusion in less than 10%.
ANOMALIES OF POSITION
50. In infancy the
appearance is variable,
from normal to few
isolated cysts, rarely a
kidney packed with
cysts.
There is preservation
of the renal shape,
echogenicity and
cortico -medullary
differentiation.
ADPCKD
51. ARPCKD
Kidneys: the dilated
tubules are responsible for
the appearance.
- Kidneys enlargment.
-Diffuse increase
echogenicity and
hyperechoic foci on US.
-Low attenuation with
striate pattern on CT.
-Diffuse increase signal
intensity in T2 w Images
on MRI.
-Macro cyst in varying
patterns can be present.
Liver: dilatation of the bile
ducts.
68. NSF
Nephrogenic systemic fibrosis (NSF) is a relatively
uncommon condition in which fibrous plaques
develop in the dermis and, often, in deeper
connective tissues.
Reported cases have occurred almost exclusively in
patients with severe renal disease, and almost all
have been associated with prior use of gadolinium-
containing MRI contrast agents.
The disease is often disabling, no proven treatments
exist.
69. Clinical features of NSF
Onset: From the day of exposure for up to 2–3 months
Initially
– Pain
– Pruritus
– Swelling
– Erythema
– Usually starts in the legs
Later
– Thickened skin and subcutaneous tissues — ‘woody’ texture and brawny
plaques
– Fibrosis of internal organs, e.g. muscle, diaphragm, heart, liver, lungs
Result
– Contractures
– Cachexia
– Death, in a proportion of patients
70. Who is at RISK
Whilst cases have occurred in patients with either
acute or chronic renal failure.
Most have been in patients with chronic and severe
kidney disease (CKD Stage 4 & 5, glomerular
filtration rate (GFR) < 30 ml/ min/1.73 m2); most
have been on dialysis.
At lower risk Patients with CKD 3 (GFR 30-
59ml/min)
Not at risk of NSF Patients with stable GFR > 60
ml/min
71. Take care
Children under one year of age, have a
physiologically low GFR yet no case of NSF has been
reported in a patient under the age of 6 years.
In lactating patients, the proportion entering the
breast milk is very small (1% of the injected dose),
and very little of this is actually absorbed. Hence the
risk to the child would appear negligible.
Lactating women: Stop breastfeeding for 24 hours
and discard the milk.
Pregnant women: Can be used to give essential
diagnostic information.
72. High Risk Patients
The minimum adequate dose of gadolinium is used.
Restrict dose to 0.1 mmol/kg and avoid repeat scans.
Consider immediate post-scan hemodialysis.
A single conventional hemodialysis session will
remove 75% of the free Gadolinium – a 2nd
treatment 93% and a 3rd treatment 98% of a dose.
If the patient has severe renal failure, but is not
receiving hemodialysis, the possibility of
commencing hemodialysis will need individual
consideration.
73. ESUR Guidelines, 8.1 Contrast Media
Guidelines
Never deny a patient a clinically well- indicated
enhanced MRI examination.
In all patients use the smallest amount of contrast
medium necessary for a diagnostic result.