The document discusses diseases of the pancreas, including congenital anomalies, endocrine and exocrine pancreatic diseases, acute and chronic pancreatitis, and pancreatic tumors. It provides details on the causes, pathophysiology, clinical presentation, diagnosis, and treatment of each condition. Key points include the role of gallstones and alcohol as common causes of acute pancreatitis, the use of CT and lab tests to diagnose and determine severity, and supportive care along with surgical or endoscopic interventions for severe cases.
This is a powerpoint slideshow discussing some of the commonest disorders of colon; namely Hirschsprung's disease, Diverticular diseases of colon, ulcerative colitis, pseudomembranous colitis and ischemic colitis.
Presentation describes the pathophysiology of Acute pancreatitis & its management in detail. Information is useful in practice although acute pancreatitis is quite rare
This is a powerpoint slideshow discussing some of the commonest disorders of colon; namely Hirschsprung's disease, Diverticular diseases of colon, ulcerative colitis, pseudomembranous colitis and ischemic colitis.
Presentation describes the pathophysiology of Acute pancreatitis & its management in detail. Information is useful in practice although acute pancreatitis is quite rare
Thyroid and its pathology (Hypothyroidism).Vikas Reddy
GREEK :- THYREOS – SHIELD ; EIDOS – FORM
1.LOCATION:- Anterior to trachea in between the cricoid cartilage and the suprasternal notch.
2.SHAPE:- It has 2 lobes connected with an isthmus, each lobe in turn has two poles.
3.Weighs around 10-20 gm, highly vascular and soft in consistency.
4. 4 Parathyroid glands which secrete PTH are located posterior to each pole of thyroid
The RLN traverse the lateral border of thyroid gland and must be identified during thyroid surgery to avoid injury and vocal cord paralysis.
Develops from the floor of primitive pharynx during the 3rd week of gestation.
Fetal cells in which developmental transcription factors TTF-1,TTF-2 & PAX-8 are expressed selectively form the thyroid gland ,secondly they result in induction of thyroid specific genes
Tg,TPO,NIS,TSH-R.
Mutations-THYROID AGENESIS & DYSHORMONOGENESIS(CONG. HYPOTHYROIDISM).
The developing gland migrates along the thyroglossal duct to reach its final location in the neck.
LINGUAL THYROID AND THYROGLOSSAL DUCT CYST.
Thyroid hormone synthesis begins at about 11 weeks of gestation.
Until 11 week of gestation and even later, it is the maternal thyroid hormones which cross the placenta to reach the fetus and aid its development.
Therefore a child born to a hypothyroid mother would suffer from features of congenital hypothyroidism.
Secondly if the mother has TSH-R blocking antibodies or has received anti thyroid therapy during pregnancy, might lead to transient congenital hypothyroidism.
Hyperthyroidism, Reference: Hyperthyroid, Harrison's Principles of Internal Medicine, Soheil Elahi, Islamic Azad University of Medicine- International Branch (IAUM-int)
15 cm in length, 60-140 gm, consists of head, body & tail; pancreatic duct empty into duodenum or common bile duct
Histologically, consists of 2 components:
1) Exocrine: 80-85%, consists of numerous glands (acini) lined by columnar basophilic cells containing zymogen granules, which form lobules; ductal system
Trypsin, chemotrypsin, aminopeptidase, amylase, lipase
2) Endocrine: islets of Langerhans, which are invaded by capillaries. Islets consist of:
4 main cell types: B (insulin), A (glucagon), D (somatostatin), PP cells (pancreatic polypeptide)
2 minor cell types: D1 (VIP) & enterochromaffin cells (serotonin
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
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
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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.
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
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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8. The Pancreas
• Endocrine pancreas:
– Diabetes Mellitus (DM)
– Islet Cell Tumors
• Exocrine pancreas:
– Acute pancreatitis
– Chronic pancreatitis
– Carcinoma of the pancreas
9. Endocrine Pancreas
• 1 million microscopic units – the islets of
Langerhans
• 4 most important cell types of the islets are:
– Β (beta): constitute 70% of the cells and contain
insulin
– A (alpha): 20% of the cells and elaborate glucagon
– D (delta): secrets somatostatin which suppresses
the insulin and glucagon secretion
– PP (pancreatic polypeptide): unknown physiologic
function
17. Acute pancreatitis
• Clinical finding
• Abdominal pain
• Abdominal distention
• Nausea and vomiting
• Respiratory failure, confusion, or coma.
• Low-grade to moderate fever
• Tachycardia and hypotension
• Mild jaundice,
• Pleural effusion.
• Shock
18. Acute pancreatitis
• Peritoneal irritation sign ( Abdominal
tenderness , rebound tenderness and
rigidity )
• Shifting dullness
• Decreased bowel sounds
• Cullen’ sign: discoloration of periumbilical
area
• Grey Turner’ sign:discoloration of flanks
19.
20. Acute pancreatitis
• Laboratory finding
• Amylase and lipase (elevations of amylase are
more sensitive but less specific than lipase in the
diagnosis of acute pancreatitis )
• 500
• 400 Urine amylase
• 300
• 200 Blood amylase
• 100
• 0
• 0 1H 24H 48H 5DAY
21. Acute pancreatitis
• Serum calcium
• Serum glucose
• Blood gas analysis
• CRP(C-reactive protein)
• Imunolipase, trypsinogen ,and immuno
elastase.
• ALT and AST (gallstone pancreatitis )
22. Acute pancreatitis
• Imaging finding
• X-ray
• Dilated loop of small bowel (sentinel loop)
• Abrupt cessation of gas in the distal transverse colon
(colon cutoff sign)
• Radioopaque densities (biliary calculi)
• Left-sided pleural effusion
• B-US: pancreatic edema, ascites----
• CT: Important
23. •CT is the best
diagnostic test for
the diagnosis of
acute pancreatitis.
•Contrast-enhanced
CT is excellent for
diagnosis of
pancreatic necrosis
24. Acute pancreatitis
• Assessment of severity of acute pancreatitis
Ranson's criteria
On Admission Within 48 Hours
Age > 55 years Hematocrit decrease by >10%
WBC > 16,000 mm³ Urea nitrogen increase > 5 mg/dl
LDH > 350 IU/L Serum calcium < 8 mg/dl
Glucose > 200 mg/dl Arterial PO² < 60 mm Hg
AST > 250 IU/L Base deficit > 4 mEq/L
Estimated fluid sequestration > 6 L
28. Acute pancreatitis
• Treatment
• Acute edematous pancreatitis—internal
medicine (Emergency surgery is not indicated
in mild acute pancreatitis)
• Acute hemorrhagic necrotizing pancreatitis
• Supportive care
• Replacement of fluid and electrolytes
• Correction of metabolic abnormalities
• Nutritional support
• Other measures :nasogastric suction and
antibiotics
29. • Agents to inhibit pancreatic secretion
• Have not been found to be useful in altering
the course in acute pancreatitis
• Somatostatin(sandostatin stilamin)
• Glucagon.
• Protease inhibitors (trasylol)
• Surgical therapy
• Inefficiency by internal medicine
• Complication (pancreatic or/and peripancreatic
Infection and abscess)
• Combined wit biliary diseases(Gallstone ASP)
• Diagnosis unclear
30. Surgical approach
Rresection of necrotic tissue and peritoneal lavage
severe, progressive necrotizing pancreatitis or
pancreatic abscess.
Cholecystectomy
recurrent acute pancreatitis and microlithiasis.
Surgical sphincteroplasty of the pancreatic
sphincter
pancreatic sphincter dysfunction
outcome is the same as for the endoscopic pancreatic
sphincterotomy
more invasive
requiring laparotomy and duodenotomy
31. Acute pancreatitis
• Endoscopic therapy
• 1) acute gallstone pancreatitis
• 2) recurrent pancreatitis due to
pancreatic sphincter dysfunction,
• 3) recurrent pancreatitis due to pancreas
divisum.
• The rationale for endoscopic therapy in
each area is the relief of obstruction to
flow of pancreatic juice
52. Tumors of Pancreas
• Treatment of pancreatic carcinoma
• Radical operation
• Pancreatoduodenectomy ---- tumor in pancreatic
head
• Resection of pancreatic body and tail---tumor in
pancreatic body or tail
• Palliative operation: to relieve jaundice
• Biotherapy
53. Tumors of Pancreas
• Pancreatic endocrine neoplasm(PEN)
• Insulinoma
• Arise from B cell
• Symptoms: whipple’s triad
• Spontaneous hypoglycemia accompanied by central
nervous system, psychiatric,or vasomotor symptoms
• Repeated blood sugar levels below 2.8mmol/L(50mg%)
• Relief of symptoms by oral or intravenous
administration of glucose
• Diagnosis: symptom and IRI/G>0.3,B-us,CT,MRI,
Endo-US,Angiography,PTPC,ASVS
• Treatment:operation(resection)
54. Carcinoma of periampulla
• Arise from:
• Papilla of duodenum
• Vater ampulla
• Distal CBD
• Symptom: obstructive
jaundice
• Diagnosis
• Treatment :similar to
pancreatic carcinoma
55. Carcinoma of the Pancreas
• Carcinoma of the pancreas refers to
carcinoma of the exocrine pancreas, almost
always arising from ductal epithelial cells
(adenocarcinoma).
• It is the fourth most common cause of death
in the US and accounts for 5% of all cancer
death.
• Survival rates are 18% at 1 year and only 2%
at 5 years.
• Incidence rates are higher in smokers (2-3 x)
than in nonsmokers; alcohol consumption
imposes a modestly increased risk.
• 65-80 y/o, M>F, B>W.
56.
57. Morphology
• Distribution:
– Head 60%
– Body 15%
– Tail 5%
– Diffuse or widely spread 20%
• small and ill defined or large (8-10 cm), with
extensive local invasion and regional metastases.
• Microscopically, more or less differentiated glandular
patterns (adenocarcinoma) arise from ductal
epithelium, mucous or non-mucous secreting.
58.
59.
60.
61. Clinical features
• fatigue, anorexia, weight loss, and painless jaundice. Pain
may develop later in the course.
• local extension or metastases at the time of diagnosis.
• With tumors in the head of the pancreas, the ampullary
region is invaded, obstructing the outflow of the bile;
patients usually die of obstructive jaundice and
hepatobilliary dysfunction while the tumor is still relatively
small and not widely disseminated.
• In marked contrast, carcinoma of the body and tail of the
pancreas remain silent for some time and may be quite
large and widely disseminated by the time they are
discovered.
• Migratory thrombophlebitis (Trousseau sign) may occur,
particularly with carcinoma of the body and tail.
62. Diagnosis of pancreatic
adenocarcinoma
• Tumor markers, including carcinoembryonic antigen
(CEA), CA 19-9, and CA 125, are associated with
pancreatic cancer but are not accurate enough to rule
in or rule out a clinical diagnosis.
• CT is the principal diagnostic test, although MRI,
endoscopic ultrasonography, and ERCP each have a
role.
• Cytologic and histologic specimens can be obtained
by ERCP. The aim is to determine if curative
resection (pancreaticoduodenectomy – Whipple
procedure) is possible.
64. • About half of the patients who are deemed to have
operable disease by imaging studies are found to
have unresectable tumors at laparatomy.
• In most instances, therapy is palliative, with the aim
of relieving jaundice, pain, and duodenal obstruction.
ERCP with billiary stent placement relieves jaundice
in most patients with unresectable tumors.
• Survival is related to functional status and is usually
6-12 months.
Editor's Notes
Fig. 15.30 C, Mucus-hypersecreting intraductal carcinoma. There is marked dilatation of a major pancreatic duct accompanied by fibrosis and atrophy of the surrounding parenchyma. This duct contained large amounts of mucin in its lumen. ( A and C courtesy of Dr. David S. Klimstra, Memorial Sloan-Kettering Cancer Center)