A 41-year-old woman presented with a 5-year history of right ear blockage and pain was diagnosed with a sympathetic chain schwannoma after imaging showed a mass along the sympathetic chain in the neck. A 43-year-old man with seizures was found to have a dural arteriovenous fistula involving the left sigmoid and transverse sinuses. A 15-year-old boy evaluated for a neck mass was diagnosed with pyriform sinus fistulae after follow-up imaging showed an abnormal tract extending from the pyriform sinus into the neck.
Abstract
Carotid body tumors are rare, slow-growing, hypervascular neuroendocrine tumors. Although these tumors are benign neoplasm, they also have a tendency to malignant transformation. Complete surgical excision is the gold standard therapeutic modality for the treatment of carotid body tumors. Early surgical removal is recommended to prevent the development of larger and more advanced tumors, which are associated with higher morbidity and mortality. In this report, we presented three cases of carotid body tumor which were successfully treated with complete surgical excision, and reviewed the current literature. Furthermore, it was emphasized the necessity of early surgical management regardless of patient age and tumor size.
This topic is very important in day - today practice. Mainly this topic can be kept in clinical cases as well as OSCE's. for Final MBBS - Students. This PPT covers most of them in detail as far as possible.
Abstract
Carotid body tumors are rare, slow-growing, hypervascular neuroendocrine tumors. Although these tumors are benign neoplasm, they also have a tendency to malignant transformation. Complete surgical excision is the gold standard therapeutic modality for the treatment of carotid body tumors. Early surgical removal is recommended to prevent the development of larger and more advanced tumors, which are associated with higher morbidity and mortality. In this report, we presented three cases of carotid body tumor which were successfully treated with complete surgical excision, and reviewed the current literature. Furthermore, it was emphasized the necessity of early surgical management regardless of patient age and tumor size.
This topic is very important in day - today practice. Mainly this topic can be kept in clinical cases as well as OSCE's. for Final MBBS - Students. This PPT covers most of them in detail as far as possible.
Scrotal Masses
98-100% accuracy in distinguishing intra and extra-testicular masses.
*** Most extratesticular masses are benign & most intratesticular masses are malignant
Malignant lesions are msotly hypoechoic.
Malignant neoplasia pts usually presents as
painless , unlateral testicular mass .
Clinically it is important to differentiate between Seminomas and Non Seminomatous germ cell tumors.
General features & management of Common neck lumps are described in this presentation. which are important for Medical students and ENT doctors.
Topics discussed in this presentation are
Cystic hygroma
Hemangioma
Branchial cyst
Thyroglossal cyst
Lipoma
Sebaceous cyst
Cervical lymphadenopathy
Tuberculosis
Carotid body tumor
Preauricular Cyst/Sinus
Lymphoma
While lung cancer remains a very challenging cancer to treat, new treatments that capitalize on advances in our understanding of cancer. It is likely that a more personalized approach to treatment using biological markers and combinations of therapies will provide better results in the future.
A presentation about an interesting case that came to the Radiology Department of Sebha Medical Center.
A 17 years old male, presented with a painful neck swelling, The swelling was first noticed 10 years ago and was small and painless then. In the last two months, the swelling increased in size and became painful and started to cause slight discomfort on swallowing.
The presentation contains 50 slides, and is divided into the following parts :
1 - The case
2 - Thyroglossal cysts
3 - Imaging Thyroglossal cysts
4 - Differential diagnoses
This presentation was prepared by me and I will present it today in sha Allah in the tutorials of the Radiology Department of Sebha Medical Center.
Scrotal Masses
98-100% accuracy in distinguishing intra and extra-testicular masses.
*** Most extratesticular masses are benign & most intratesticular masses are malignant
Malignant lesions are msotly hypoechoic.
Malignant neoplasia pts usually presents as
painless , unlateral testicular mass .
Clinically it is important to differentiate between Seminomas and Non Seminomatous germ cell tumors.
General features & management of Common neck lumps are described in this presentation. which are important for Medical students and ENT doctors.
Topics discussed in this presentation are
Cystic hygroma
Hemangioma
Branchial cyst
Thyroglossal cyst
Lipoma
Sebaceous cyst
Cervical lymphadenopathy
Tuberculosis
Carotid body tumor
Preauricular Cyst/Sinus
Lymphoma
While lung cancer remains a very challenging cancer to treat, new treatments that capitalize on advances in our understanding of cancer. It is likely that a more personalized approach to treatment using biological markers and combinations of therapies will provide better results in the future.
A presentation about an interesting case that came to the Radiology Department of Sebha Medical Center.
A 17 years old male, presented with a painful neck swelling, The swelling was first noticed 10 years ago and was small and painless then. In the last two months, the swelling increased in size and became painful and started to cause slight discomfort on swallowing.
The presentation contains 50 slides, and is divided into the following parts :
1 - The case
2 - Thyroglossal cysts
3 - Imaging Thyroglossal cysts
4 - Differential diagnoses
This presentation was prepared by me and I will present it today in sha Allah in the tutorials of the Radiology Department of Sebha Medical Center.
The anatomy of the ventricular system, the physiology in production of CSF, the pathogenesis, and the different paediatric and adult forms of hydrocephalus.
carotid space is important space for neck.
internal jugular vein is important vein in neck
many nerve tumour are necessary to understand for any mass in neck
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
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.
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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
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.
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.
21. Sympathetic chain
• Travels up the neck in the carotid sheath
• Continues up through the carotid canal
• Forms plexus on ICA
22. Schwannomas in the head and neck
• Most common
– Vagus >> sympathetic chain
• Vagus – dysphagia, hoarseness
Sympathetic chain – Horner’s
• In most cases, patients present with a palpable mass or
have no symptoms
23. • Vagus
- Lateral to ICA
• Sympathetic chain,
cervical sympathetic
ganglion
- Posteromedial to
ICA
24. Treatment
• Observation
• Surgery
– Post-operative Horner’s
– First bite syndrome
• First bite syndrome
– Pain in the parotid area on the first bite of food
– Intense ear pain increased with strong sialogogues
– Due to loss of sympathetic input to parotid after severing the
chain
– Denervation hypersensitivity
63. Multichannel dural AVF of left sigmoid-transverse sinus
Venous infarction with vasogenic edema
64. Dural AVF
• Abnormal connection between dural arteries or
pachymeningeal branches of cerebral arteries and dural
veins
• Arteries can be recruited from branches of both the ECA
and ICA
• Venous drainage can occur through large dural venous
sinuses, and retrogradely through cortical cerebral veins
• If cortical cerebral veins are involved, there is a higher
risk of rupture and hemorrhage from the dAVF
• Frequently located in the transverse and sigmoid sinuses
65. Dural AVF
• Believed to result from thrombosis of a dural venous
sinus, with subsequent collateral revascularization
• Leads to venous hypertension, an initiating factor
opening up microscopic vascular connections within the
dura
• Results in abnormal fistulous connection between
arteries and veins in the walls of a dural sinus or
involving an adjacent cortical vein
66. Dural AVF
• Venous hypertension may be related to thrombosed
dural venous sinus or arterialized veins
– Pulse synchronous bruit
– Pulsatile tinnitus
– Headache
– Visual impairment
– Papilledema
– Venous infarct
– Cerebral hemorrhage (SAH, SDH, parenchymal)
67. Dural AVF
• Borden classification system
– Type I: antegrade drainage through a dural venous sinus or
meningeal vein (usually benign clinical behavior)
– Type II: antegrade drainage into dural venous sinus and
retrograde flow into cortical veins (may present with
hemorrhage)
– Type III: direct retrograde flow into cortical veins (causes venous
hypertension with risk of hemorrhage)
68. Dural AVF
• Cognard system
– Type I: normal antegrade flow into a dural venous sinus
– Type IIa: drainage into a sinus with retrograde flow within the
sinus
– Type IIb: drainage into a sinus with retrograde flow into cortical
vein(s)
– Type II a+b: drainage into a sinus with retrograde flow within the
sinus and cortical vein(s)
– Type III: direct drainage into a cortical vein without venous
ectasia
– Type IV: direct drainage into a cortical vein with ectasia > 5 mm
and 3x larger than the diameter of the draining vein
– Type V: direct drainage into spinal perimedullary veins
69. Dural AVF
• Treatment is indicated in aggressive cases, typically
those showing cortical venous reflux on angiography
• Treatment options include surgical and endovascular
approaches, or occasionally radiation
81. • Acute suppurative thyroiditis and thyroid abscess are
extremely rare.
• Acute suppurative neck infections are frequently
recurrent when associated with branchial fistulas (3rd or
4th)
• When an inflammatory infiltration or abscess is present
between the pyriform fossa and the thyroid bed in the
lower neck, esp on L, an infected 3rd or 4th branchial fistula
must be suspected
83. Pyriform sinus fistula
• The 3rd & 4th branchial pouches form the pyriform sinus
• Persistent ducts from either of these pouch sinuses may
drain into the pyriform sinus
• There are authors suggesting that there is wide
discrepancy between clinical/radiologic presentations
and the theoretical course of the 3rd and 4th branchial arch
anomalies
• They propose that persistence of the thymopharyngeal
duct of the 3rd pouch, frequently passing through or
adjacent to the thyroid gland, most often on the L side, is
the more suitable explanation embryologically
84. Pyriform sinus fistula
• >80% of cases are left-sided
• >60% of cases occurred after acute URI
• High rate of recurrence
• Children or young adults
• Pathway: pyriform sinus apex, anteroinferiorly through
the strap muscle layer, beside or through the thyroid
gland, into perithyroidal space
85. Pyriform sinus fistula
• CT is preferred imaging modality – can show air in sinus
or fistulous tract, thyroid gland involvement by loss of
normal high density, subtle infiltration or stranding
• Barium esophagram during active infection often do not
show the sinus or fistulous tract, perhaps because of
closure of the tract due to regional inflammation and
edema
• Perform barium swallow after infection has cleared
91. Endolymphatic Sac Tumor
• Papillary epithelial neoplasm involving the
endolymphatic sac or duct
• Also been termed CPA ceruminoma,
adenocarcinoma, papillary adenomatous
tumor, etc
• Most occur sporadically; association with
von Hippel Lindau
• Papillary adenomatous architecture,
areas of hemorrhage, hemosiderin,
cholesterol clefts, giant cell reactions
• Slow-growing, may recur locally
• Involves posterior edge of petrous bone,
frequently involve dura
92. Endolymphatic Sac Tumor
• Hypervascular, locally-invasive, bone-
destroying; can have reactive new bone
formation
• CT: geographic, moth-eaten, intratumoral
bone reticular or spiculated, thin rim of
calcification
• MR: heterogeneous signal, areas of high
signal on T1-weighted sequence
• Late presentation: unilateral hearing loss,
vestibular dysfunction; facial nerve palsy
when tumor becomes large
• Duration of hearing loss 6 months to 18
years