This document provides an overview of pheochromocytoma, which are rare catecholamine-producing tumors. Key points include:
- Pheochromocytomas arise from sympathetic nervous system and can be sporadic or inherited. Approximately 25% of cases are associated with genetic syndromes.
- Presentation involves classic triad of headaches, palpitations, and sweating along with hypertension. Diagnosis is confirmed through urine and plasma tests and imaging studies.
- Complete surgical removal is the primary treatment, with pre-operative medication to control blood pressure. About 10% of cases are malignant with distant metastases. Some pheochromocytomas are associated with genetic syndromes like VHL, MEN2, and
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
Overview and Pharmacotherapy of Prostate Cancer (based on NCCN 2012 guideline...hyunik116
This presentation was the prostate cancer lecture for the oncology therapeutics course (31:725:560) that was presented to the class of 2014 PharmD students at the Ernest Mario School of Pharmacy.
I really enjoyed researching and preparing this lecture for the students, and hope you also will find at least something useful in this presentation.
Neuroblastoma diagnosis, treatment, complications, and further management. The main contents of this review have been accessed from MedScape. Please do not reprint or copy this material without permission from the copyright owner.
A presentation about Adrenal gland tumors. This presentation contains 43 slides, and is divided into 3 parts :
1 - Adrenal gland tumors (Introduction).
2 - Imaging Adrenal gland tumors.
3 - Cases.
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
it is a young boy ,suddenly became unconscious, found high blood pressure on clinical exam,. on USG bilateral adrenal mass confirmed on contrast CT scan. Radiological diagnosis was made phaeochromocytoma
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.
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.
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
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.
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.
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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
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!
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
- 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
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.
2. INTRODUCTION
• Phaeochromocytomas and paragangliomas are
catecholamine producing tumors derived from
sympathetic or parasymapathetic nervous
system.
• Can be sporadic or inherited.
3. EPIDEMIOLOGY
• Seen in 2-8 out of 1 million persons per year.
• 0.1% of hypertensive patients harbor a
phaeochromocytoma.
• Rule of ten : 10% bilateral
• 10% extra adrenal
• 10% malignant
• 10% not associated with hypertension
• 10% in children
4. ETIOLOGY AND PATHOGENESIS
• Both are well vascularized tumors that arise from
sympathetic(eg: Adrenal medulla) or
parasympathetic(eg: Carotid Body, Glomus Vagale)
paraganglia.
• Phaeochromocytoma – catecholamine producing
tumors including those in extra adrenal
retroperitoneal, pelvic and thoracic sites.
• Paraganglioma – catecholamine producing tumors in
the head and neck as well as tumors arising from
parasympathetic system, which may secrete little or
no catecholamine.
5. • Etiology of sporadic cases unknown.
• 25% of patients have inherited condition
including germ line mutations in
RET, VHL, NF1, SDHB, SDHC, SDHD genes.
8. CLINICAL FEATURES
• The ‘Great Masquerader’.
• Episodes of headache, palpitation and profuse
sweating constitute a classic triad.
• Presence of all 3 symptoms along with
hypertension makes phaeochromocytoma a likely
diagnosis.
• Dominant sign is hypertension which is classically
episodic.
9. • Catecholamine crises can lead to heart
failure, pulmonary edema, arrythmias and
intracranial hemorrhage.
• During episode of hormone release patients are
pale anxious and experience tachycardia and
palpitations. These episodes usually last for an hour
and can be precipitated by surgery, positional
changes, exercise, pregnancy, urination, and various
medications.
• Phaeochromocytomas can also be asymptomatic for
many years.
10. • Headaches
• Sweating attacks
• Palpitation and tachycardia
• Hypertension, sustained or
paroxysmal
• Anxiety and panic attacks
• Pallor
• Nausea
• Abdominal Pain
• Weakness
• Weight loss
• Paradoxical response to
antihypertensive drugs
• Polyuria and Polydipsia
• Constipation
• Orthostatic hypotension
• Dilated cardiomyopathy
• Erythrocytosis
• Elevated Blood Sugar
• Hypercalcemia
12. TREATMENT
• Complete tumor removal is the ultimate therapeutic
goal.
• Pre-operative preparation using alpha blockers
should be initiated. – Phenoxybenzamine
• Adequate alpha blockade requires 10 – 14 days
• Oral prazosin or IV phentolamine can be used to
manage paroxysms.
• Beta blockers can be added if tachycardia persists.
13. • Blood pressure can be labile during
surgery, particularly at onset of intubation and
when manipulating tumor.
• Nitroprusside infusion is useful for intraoperative
hypertensive crises.
14. MALIGNANT
PHAEOCHROMOCYTOMA
• Around 10% are malignant.
• Diagnosis is difficult.
• Refers to tumors with distant metastases to
lung, bone, liver suggesting vascular spread.
• More common in hereditary cases.
• Treatment:
Chemotherapy: Dacarabazine + cyclophosphamide
+vincristin
Radiotherapy
Prognosis : 5 year survival rate of 30 – 60%
15. PHAEOCHORMOCYTOMA IN
PREGNANCY
• Phaeochromocytomas are occasionally diagnosed
in pregnancy.
• Endoscopic removal preferably in fourth to sixth
month of gestation is possible and can be
followed by uneventful childbirth.
16. PHAEOCHROMOCYTOMA
ASSOCIATED SYNDROMES
• 25 – 33% of patients with phaeochromocytoma
have an inherited syndrome.
• Neurofibromatosis type 1 – changes in NF1 gene
Phaeochromocytoma occurs in 1% of these
patients.
• Classical features include multiple
neurofibromas, café au lait spots, axillary
freckling of skin and Lisch nodules of the iris.
17. • Multiple Endocrine Neoplasia type 2A and 2B
• Autosomal dominant disorder
• Both types caused by mutations in RET gene.
• MEN 2A : Medullary thyroid
carcinoma, phaeochromocytoma and
hyperparathyroidism.
• MEN 2B : Medullary thyroid
carcinoma, phaeochromocytoma and multiple
mucosal neuromas
• Phaeochromocytoma seen in 50% of patients of
MEN2.
18. • Von Hippel-Lindau syndrome
• Autosomal dominant disorder that predisposes to
retinal and cerebellar hemangioblastomas. Also
predisposes to renal clear carcinoma, pancreatic
islet cell tumours, endolympatic sac tumors of the
inner ear etc,.
• Associated with mutations of VHL gene.
• 20 – 30% of patients with VHL syndrome have
pheochromocytoma.