Radiotherapy is an important treatment for lymphomas and is often used in combination with chemotherapy. It is very effective for lymphomas due to their radiosensitivity. For Hodgkin lymphoma, 30 Gy is recommended for early-stage unfavorable disease after chemotherapy, while 20 Gy can be used for early-stage favorable disease. For non-Hodgkin lymphomas, 24 Gy is recommended for indolent types and 30 Gy for other aggressive types. Modern radiotherapy planning involves defining target volumes using CT imaging to minimize doses to normal tissues while adequately treating tumor volumes.
Audio and slides for this presentation are available on YouTube: http://youtu.be/pkB_mfPtjrA
Andrea K. Ng, MD, of Dana-Farber/Brigham and Women's Cancer Center Department of Radiation Oncology, gives an overview of the different types of radiation therapy, the side effects, and how it is used in the treatment of lymphoma. This presentation was given at the 2013 Lymphoma Research Foundation North American Forum on Sept. 29, 2013. http://www.dana-farber.org | http://www.lymphoma.org
Audio and slides for this presentation are available on YouTube: http://youtu.be/pkB_mfPtjrA
Andrea K. Ng, MD, of Dana-Farber/Brigham and Women's Cancer Center Department of Radiation Oncology, gives an overview of the different types of radiation therapy, the side effects, and how it is used in the treatment of lymphoma. This presentation was given at the 2013 Lymphoma Research Foundation North American Forum on Sept. 29, 2013. http://www.dana-farber.org | http://www.lymphoma.org
The combined use of radiation therapy and chemotherapy in cancer treatment is a logical and reasonable approach that has already proven beneficial for several malignancies.
Hypofractionation in early breast cancer is no more a research scholars topic. Multiple studies with robust data have proven its utility. It may hold an important role in many countries with constrained resources. This is a short presentation incorporating important completed and ongoing trials. Feel free to use this.
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
Contouring Guidelines for Gynecological MalignancyJyotirup Goswami
A brief overview of gynecological malignancy contouring guidelines (teletherapy & brachytherapy), including a discussion of problems and inadequacies of the present guidelines
The combined use of radiation therapy and chemotherapy in cancer treatment is a logical and reasonable approach that has already proven beneficial for several malignancies.
Hypofractionation in early breast cancer is no more a research scholars topic. Multiple studies with robust data have proven its utility. It may hold an important role in many countries with constrained resources. This is a short presentation incorporating important completed and ongoing trials. Feel free to use this.
EBCTCG METAANALYSIS
INDICATION OF POST OP RADIOTHERAPY
Immobilization devices
Conventional planning
Alignment of the Tangential Beam with the Chest Wall Contour
Doses To Heart & Lung By Tangential Fields
This presentation is intended to refer while doing planning of SBRT Prostate for all practical aspects from Simulation - contouring - planning - treatment. I am sure it will be very useful presentation for any radiation oncologist who are willing to start workflow of SBRT Prostate in the department of radiation oncology
Contouring Guidelines for Gynecological MalignancyJyotirup Goswami
A brief overview of gynecological malignancy contouring guidelines (teletherapy & brachytherapy), including a discussion of problems and inadequacies of the present guidelines
Hitechled integrated solar led street light vs other street lightsJames Chen
Hitechled engaged in providing green renewable energy solutions. Our new generation all in one integrated smart solar led street light, which integrates high lumen LED lamp, latest LiFePO4 lithium battery(about 2000circles,more than 5 years. Much better than normal Li-Ion battery which only about 500circles),high efficient Sunpower monocrystal solar panel (22% transfer ratio,whiles others normal mono solar only about 17% transfer ratio) and the smart controller with PIR motion sensor(optional) together. It is 100% clean,green, renewable light,can be frequently used new rural construction lighting, residential lighting,parking lot lighting, pathway lighting , ramp lighting,perimeter security lighting, farm & ranch lighting, wildlife area lighting,dock& pier lighting ,garden lighting , campus lighting ,county yards lighting, desert lighting, seaside resort lighting, military base lighting, any exterior area wherever there is sufficient sunlight, especially for those places where wiring is not economic and/or achievable.
Web Observatorio Esclerosis Múltiple presentada en la Jornada de ccyc - Comunicación, visibildad y relaciones a través de la red. Un reto para las organizaciones de salud – 14 mayo de 2015.
Web Observatori Esclerosi Múltiple presentada a la Jornada de ccyc - Comunicació, visibilitat i relacions a través de la xarxa. Un repte per a les organitzacions de salut – 14 de maig de 2015.
Arntzen de Besche sine advokater tok på sitt frokostseminar 11. november 2016 et tilbakeblikk på anskaffelsesåret. Nyheter som nytt regelverk og de viktigste avgjørelsene fra norske domstoler, EU-domstolen og KOFA ble gjennomgått. I 2016 kom det flere prinsipielle avgjørelser som har betydning for leverandørenes rettigheter, blant annet knyttet til avvisning, erstatning, vesentlig feil m.v. og vi vil gjennomgå betydningen av disse for oppdragsgiver og leverandør.
AccuThermo AW 820V Vacuum Rapid Thermal Anneal EquipmentPeter Chen
The AccuThermo AW820V is a stand alone Vacuum RTP (Rapid Thermal Processing) system, which uses high intensity visible radiation to heat single wafer for short process periods of time at precisely controlled temperatures. The process periods are typically 1 900 seconds in duration, although periods of up to 9999 seconds can be selected. These capabilities, combined with the heating chamber's cold-wall design and superior heating uniformity, provide significant advantages over conventional furnace processing.
BrandMe os presenta su trabajo final para la asignatura de Imagen Corporativa. Os hablaremos de redes sociales, Internet, gestión de imagen corporativa, etc... Todo ello, englobado dentro del Social Branding 2.0 - 3.0, que es lo que se lleva ahora.
Atypische Beschäftigung drängt normale Arbeitsverhältnisse nicht zurück
Studie der Bertelsmann Stiftung: Teilzeit, Leiharbeit und Mini-Jobs schaffen zusätzliche Beschäftigung / Zugleich wächst Anteil der unbefristeten Vollzeitstellen
Der Zuwachs an Beschäftigung während der vergangenen zehn Jahre in Deutschland ist wesentlich der Zunahme an flexiblen Arbeitsverhältnissen zu verdanken. 2003 arbeitete nicht einmal jeder fünfte Erwerbsfähige (19 Prozent) in einem so genannten atypischen Beschäftigungsverhältnis – also in Teilzeit, befristet, als Leiharbeiter oder in einem Mini-Job. Inzwischen haben 24 Prozent aller Erwerbsfähigen einen solchen Job. Diese Entwicklung ging allerdings laut einer Studie des "Instituts zur Zukunft der Arbeit IZA" im Auftrag der Bertelsmann Stiftung nicht zu Lasten der stabilen Arbeitsverhältnisse, im Gegenteil: Im selben Zeitraum stieg der Anteil der Erwerbsfähigen, die in eine klassische unbefristete Vollzeitstelle bekleiden, von 39 auf 41 Prozent.
Mehr dazu unter: http://www.bertelsmann-stiftung.de/cps/rde/xchg/bst/hs.xsl/nachrichten_119681.htm
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
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
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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.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
4. Current issues in lymphoma
radiotherapy
• Who to treat
• What volume to irradiate
• What dose to use
5. Overview
• Why use radiotherapy to treat lymphomas
• Practicalities of radiotherapy delivery
- Why fractionate
- Treatment planning and delivery
• Indications for external beam radiotherapy
in:
-Hodgkin lymphoma
-Non Hodgkin lymphoma
6. Why use radiotherapy to treat
lymphomas?
• Lymphoma is very radiosensitive
• Relatively small doses of radiotherapy are
required
• Local relapse within an irradiated area is
rare
• Radiotherapy fields are now smaller,
reducing late toxicities
16. Radiotherapy Planning (1)
• Identify the treatment volume
-Essential to have pre-chemotherapy imaging
- Need up to date diagnostic imaging
- Radiotherapy planning scan
• Treatment volumes
- The visible tumor (GTV)
- Sites of possible microscopic disease (CTV)
- The area to be treated with a margin to allow
for movement and set up accuracy (PTV)
17. Radiotherapy Planning (2)
Considering the best way to deliver the
radiotherapy
• Ensure that PTV receives the intended
treatment dose
• Minimise the dose to normal surrounding
tissues
- Conform fields to treatment volume
- Field arrangements
18. Use of PET to identify the GTV
Terezakis SA, Yahalom J. 2011
19. what is the role for RT as part of
combined-modality treatment in
aggressive lymphoma?
30. IFRT remains the treatment of choice of for localized
stage IA and selective stage IIA patients and delivers
long-term disease-free survival and potential cure for
some patients.
31. The conventional dose of curative RT used in
the early studies was considerably larger at
30–40 Gy. However, a British randomized study
demonstrated equivalence of 24 Gy with 40 Gy.
32. Localized LDRT appears to induce apoptosis and this
follicular lymphoma cell death may then elicit a host
immune response mediated by macrophages and
dendritic cells.
This exquisite radiation-induced apoptosis and
subsequent immune response may underlie the
durability of responses seen with both LDRT and
radioimmunotherapy (RIT).
33.
34.
35.
36. What is the role for RT in the modern
management of HL?
37.
38. Identify the risks
GHSG EORTC Stanford
Risk Factors a- Bulky mediastinum a-Bulky mediastinum a-Bulky mediastinum
b-Extranodal disease b- Age >=50 b-Age>=40
ESR>=50 with no
c-ESR>=50 with out B symptoms c-B symptoms c- ESR >=50
Or >=30 with B symptoms Or >=30 with B symptoms
d->=3 nodal sites d->=4 nodal sites D->=3 nodal sites
GHSG EORTC Stanford
Favorable CS I-II CS I-II CS I-II
No risk factors No risk factors No risk factors
Unfavorable CS I- IIA with >=1 CS I- IIA with >=1 CS I- IIA with >=1
risk factor risk factor risk factor
CS IIB with c or d
not a+b (otherwise
advanced)
39. The use of RT also allows a shorter and
safer course of chemotherapy.
40. The combination of reduced chemotherapy
followed by mini-RT has produced disease
control and even overall results that are
significantly superior to those achieved with
chemotherapy alone.
42. The analysis included five randomized controlled
trials involving 1245 patients. Although the complete
remission rate was similar in the two groups, both
tumour control and OS were significantly better in
patients receiving combined-modality therapy.
43. The authors’ conclusions were that adding RT to
chemotherapy improves tumour control and OS in
patients with early-stage HL.
44. The conclusion from these studies was that after four
cycles of ABVD, 30 Gy is recommended for early-stage
unfavourable Hodgkin lymphoma,whereas 20 Gy is
adequate for early-stage favourable Hodgkin lymphoma
after two cycles ABVD.
48. The principal distinction between involved-node
radiotherapy and involved-site radiotherapy is
that no additional margin around the node
volume is added in involved-node radiotherapy.
Typical margins are as follows:
(a) Head and neck: 0.5-1 cm, depending on local set-up.
(b) Mediastinum: 1 cm transversely and 1.5 cm craniocaudally
(c) All other sites: 1 cm.
49. This is based on defining the site of gross
disease before chemotherapy, the GTV and
using a CT-based volume with an
expansion to form a CTV in the cranio-
caudal direction. The post-chemotherapy
involved nodal chain and residual disease
form the CTV in all other directions.
59. Role of RT in Advanced Hodgkin Disease
Offering RT after effective chemotherapy is not standard
practice and is still undergoing investigation.
60. Although a meta-analysis and studies by the GELA
and EORTC groups showed no benefit of
consolidation RT after effective chemotherapy with
suggestions of worsened outcome when RT was
added, more recent data have emerged from 2 large
randomized control trials (RCT) in support of
consolidation RT.
64. Indications for radiotherapy in
DLBC NHL
• In early stage disease with short course
chemotherapy
• In advanced disease
- Bulky disease at the outset (MINT Study,
Pfreundschuh 2008))
• Risk of relapse increases with size of mass
• Should irradiate masses >10cm at diagnosis
- PET positive at the end of treatment (Sehn et al,
2010)
• Dose 30 Gy in 15 # (Hoskin et al, 2011)
65.
66. Current evidence-based recommendations for radiation doses in
lymphoma are shown below:
Hodgkin lymphoma
1.Early-stage favourable Hodgkin
lymphoma, after two cycles of ABVD,
may be treated with 20 Gy.
2.Early-stage unfavourable, or for
residual or refractory disease in
advanced Hodgkin lymphoma, should
receive 30 Gy.
3.If early-stage unfavourable disease is
treated using BEACOPP rather than
ABVD, the dose may be reduced to
20 Gy.
67. Non-Hodgkin lymphoma
1.Indolent lymphomas (follicular,
marginal zone, small lymphocytic or
chronic lymphocytic lymphoma (CLL)
should be given 24 Gy in 12 fractions.
2.In the palliative setting, follicular
lymphoma patients will respond to 4 Gy
in two fractions.
3.Natural killer cell lymphoma should
receive at least 50 Gy in 25 fractions.
4.All other non-Hodgkin lymphomas
should receive 30 Gy in 15 fractions
68. The planning of radical radiotherapy for lymphoma
patients, both Hodgkin and non-Hodgkin lymphoma,
should be based upon contrast-enhanced 3 mm
contiguous CT imaging with three-dimensional
definition of volumes using the convention of GTV, CTV
and PTV.
69. All patients should be treated with involved-site
radiotherapy unless no pre-chemotherapy
imaging is available,when involved-field
radiotherapy is used.