This document discusses multiple myeloma (MM), a plasma cell malignancy characterized by proliferation of monoclonal plasma cells in the bone marrow. Key points include: MM commonly precedes other premalignant conditions like MGUS; genetic defects contribute to disease heterogeneity and drug resistance; MM causes skeletal destruction and can involve other organ systems; diagnosis involves tests like serum and urine protein assays, bone marrow biopsy, and imaging; and treatment involves chemotherapy while considering prognostic factors like tumor mass, hypercalcemia, and renal impairment.
chronic myeloid leukemia, CML, epidemiology, BCR ABL1 gene, philadelphia chromosome, t(9;22), CML incidence, etiology of CML, pathophysiology of CML, phases of CML, treatment of CML, Allogenic stem cell transplant, TKI therapy for CML, Sokal index for CML,
chronic myeloid leukemia, CML, epidemiology, BCR ABL1 gene, philadelphia chromosome, t(9;22), CML incidence, etiology of CML, pathophysiology of CML, phases of CML, treatment of CML, Allogenic stem cell transplant, TKI therapy for CML, Sokal index for CML,
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
What is Lymphoma?
Malignant lymphoma is a term given to tumors of the lymphoid system and specifically of lymphocytes and their precursor cells
i.e.
Cancer of the lymphatic system.
Many lymphomas are known to be due to specific genetic mutations.
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
What is Lymphoma?
Malignant lymphoma is a term given to tumors of the lymphoid system and specifically of lymphocytes and their precursor cells
i.e.
Cancer of the lymphatic system.
Many lymphomas are known to be due to specific genetic mutations.
multiple myloma
By: Nader Amir Al-assadi
Supervised by : Dr/ Ghazi Alariqe
taiz university
Multiple myeloma (MM) is a plasma cell malignancy in which monoclonal plasma cells proliferate in bone marrow, resulting in an over abundance of monoclonal para protein (M protein), destruction of bone, and displacement of other hematopoietic cell lines.
The precise etiology of MM has not yet been established.
Roles have been suggested for a variety of factors, including genetic causes, environmental or occupational causes,radiation, chronic inflammation, and infection .
It is a neoplasm of B-cell lineage; proliferation of the cells forms a monoclonal population of plasma cells and produces a single type of Ig/Ig fragment.
Plasma cell disorders is a difficult topic where most residents and students confuse with regarding to differentiating between various types of para-proteinemias or plasma cell dyscrasias. This simple presentation will highlight the key points in differentiating, diagnosing these orders. Initial management principles are discussed as well.
For medical students, especially for early clinical exposure , it will help preclinical medical students. It gives details of about seven case reports in carbohydrate metabolism. MBBS students can use the information for theory exam also.
For medical students , it will help. Especially for preclinical students, as early clinical exposure, it will be very useful. Even for theory exam, it will help.
Extra cellular matrix is recently being explored in connection with cancer , metastases and autoimmune disorders. It is prepared for the benefit of both UG and PG medical and dental students.
Various neurotransmitters, mechanism of action and their physiological functions are explained and is useful for ug and pg students of medicine, neurology, psychiatry branches.
Porphyrias are difficult to diagnose . Here it is comprehensively explained to aid making diagnosis of porphyrias easier for the benefit of medical students and practitioners.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Liver function tests and interpretation is a very important topic for students of medical and allied fields. It is essential for efficient practice of clinical and laboratory medicine.
Students of medical and allied subjects must be exposed to the concept of monoclonal antibodies for the efficient practice of clinical and laboratory medicine.
Concepts of acid base balance and its disorders are very important for practice of medicine.It is for the benefit of medical and students of allied fields.
Coronary heart disease due to atherosclerotic process is the major cause of death.Lipids have been implicated for enhanced atherosclerosis. The major lipids involved are triacy glycerol and cholesterol which are transported in the plasma by lipoproteins. So a better understanding of lipid transport and its abnormalities is essential for medical and health professional students.
Water and electrolyte balance is clinically very important topic . It will be very useful for both UG and PG medical students. Efforts are made to explain basic concepts clearly.
It gives basic things regarding urinalysis and will be very useful for medical students, house surgeons, laboratory technicians and postgraduates in medicine.
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
- 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
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
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
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. Multiple myeloma (MM)
It is a plasma cell malignancy in which monoclonal
plasma cells proliferate in bone marrow, resulting in
an overabundance of monoclonal paraprotein (M
protein)
There is destruction of bone, and displacement of
other hematopoietic cell lines.
3.
4.
5. Etiology
The precise etiology of MM has not yet been
established.
Genetic causes
Environmental or occupational causes
MGUS
Radiation
Chronic inflammation
Infection-Human herpesvirus 8 (HH8) infection of
bone marrow dendritic cells
6. Genetic defects - MM
About 50% are hyperdiploid, with extra copies of the
odd-numbered chromosomes.
A primary translocation involving the Ig heavy-chain
gene at 14q32.
Gysregulation of the cyclin D/retinoblastoma (cyclin
D/RB) pathway.
This genetic heterogeneity contributes to the rapid
emergence of drug resistance in MM.
7. Pre MM conditions
MM is commonly preceded by monoclonal gammopathy of
undetermined significance (MGUS), a premalignant
condition
In MGUS, these clonal plasma cells take up less than 10% of
bone marrow.
The serum protein value is less than 3 g/dL and myeloma-
related end-organ damage is absent.
An intermediate disease stage between MGUS and MM,
termed smoldering MM, is characterized by an M protein
level of 3 g/dL or more and over 10% clonal plasma cells in
bone marrow
But no symptoms of myeloma-related end-organ damage.
9. MM and cytokines
Interleukin (IL)-6 is also an important factor
promoting the in vitro growth of myeloma
cells.
Other cytokines are tumor necrosis factor
and IL-1b.
MM involves the skeletal, hematologic,
renal, and nervous systems
10. Skeletal manifestations
Plasma-cell proliferation causes extensive skeletal
destruction with osteolytic lesions, anemia,
and hypercalcemia through production of the
osteoclast-activating factor.
Destruction of bone and its replacement by tumor may
lead to pain, spinal cord compression, and pathologic
fracture.
Compression fracture of a vertebral body destroyed by
multiple myeloma
Bony involvement is typically lytic in nature.
11. Hematologic processes
Bone marrow infiltration by plasma
cells results in neutropenia, anemia,
and thrombocytopenia.
M components may interact with
clotting factors, leading to defective
aggregation.
12. Renal processes
Direct tubular injury, amyloidosis, or
involvement by plasmacytoma.
Hypercalcemic nephropathy, hyperurcemia
Due to renal infiltration of plasma cells
resulting in myeloma, light-chain
nephropathy
Amyloidosis
Glomerulosclerosis.
13. Hyperviscosity syndrome.
Due to overproduction of IgG1, IgG3, or
IgA. Sludging in the capillaries
It results in purpura, retinal hemorrhage,
papilledema, coronary ischemia, or central
nervous system (CNS) symptoms (eg,
confusion, vertigo, seizure).
Cryoglobulinemia causes Raynaud
phenomenon, thrombosis, and gangrene in
the extremities.
14. Complications
Renal failure
Nephrocalcinosis due to hypercalcemia
Anemia, neutropenia, or thrombocytopenia
is due to bone marrow infiltration of plasma
cells.
Thrombosis and Raynaud phenomenon due
to cryoglobulinemia may be present.
15. Clinical features
Severe bone pain, pathologic fracture due to
lytic lesions
Increased bone resorption leading to
hypercalcemia
Spinal cord compression: Symptoms
typically include back pain, weakness or
paralysis in the legs, numbness, or
dysesthesias in the lower extremities.
16. Clinical features
Radiculopathy and/or cord compression may occur
because of skeletal destruction and nerve
compression.
Bacterial infection may develop
Purpura, retinal hemorrhage, papilledema,
coronary ischemia, seizures, and confusion may
occur as a result of hyperviscosity syndrome.
Hypercalcemia may cause polyuria and polydipsia,
muscle cramps, constipation
A change in the patient’s mental status.
21. Exudative macular detachment, retinal
hemorrhage, or cotton-wool spots
Dermatologic evaluation
Pallor from anemia
Ecchymoses or purpura from thrombocytopenia
Extramedullary plasmacytomas
Bony tenderness or pain without tenderness
Sensory level change, neuropathy, myopathy,
positive Tinel sign, or positive Phalen sign
Abdominal examination: Hepatosplenomegaly
Cardiovascular evaluation: Cardiomegaly
22.
23. Myeloma-defining events
Serum calcium level >0.25 mmol/L (>1 mg/dL) higher than
the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
Renal insufficiency (creatinine >2 mg/dL [>177 μmol/L] or
creatinine clearance < 40 mL/min)
Anemia (hemoglobin < 10 g/dL or hemoglobin >2 g/dL
below the lower limit of normal)
One or more osteolytic bone lesions on skeletal
radiography, CT, or PET-CT
Clonal bone marrow plasma cells ≥60%
Abnormal serum free light chain (FLC) ratio ≥100 (involved
kappa) or < 0.01 (involved lambda)
One or more focal >5 mm lesions on MRI scans
24. Differential Diagnoses
Primary (Malignant) Lymphoma of
Bone
Metastatic Bone Disease
Monoclonal Gammopathies of
Undetermine Significance (MGUS)
Waldenstrom Macroglobulinemia
25.
26. Lab tests
Serum and urine assessment for monoclonal
protein (densitometer tracing and
nephelometric quantitation;
immunofixation for confirmation)
Serum-free light chain assay
Bone marrow aspiration and/or biopsy
Serum beta-2 microglobulin
Albumin,
LDH
28. Lab tests
Total protein, albumin, and globulin
Blood urea nitrogen (BUN) and creatinine
Uric acid
Quantitative Immunoglobulin Levels (IgG, IgA, IgM)
C-reactive protein (CRP) is a surrogate marker of
interleukin (IL)-6 activity.
IL-6 is often referred to as the plasma cell growth
factor.
beta-2 microglobulin is useful for prognostic marker
29. Urine Collection
24-hour urine for quantification of the
Bence Jones protein (ie, lambda light
chains), protein, and creatinine clearance.
> 1 g of protein in 24 h is a major criterion
for MM
For monitoring the response to therapy
Creatinine clearance - renal impairment.
30. Serum Viscosity
Check the serum viscosity in patients
with central nervous system (CNS)
symptoms, nosebleeds, or very high M
protein levels.
These findings may
indicate hyperviscosity syndrome.
37. Prognosis
C-reactive protein (CRP) and beta-2
microglobulin:
If levels of both proteins are less than 6
mg/L, the median survival is 54 months.
If the level of only one component is less
than 6 mg/L, the median survival is 27
months.
If levels of both protein values are greater
than 6 mg/L, the median survival is 6
months.