This document summarizes the current state of evidence on prostate cancer screening using PSA tests. Two major randomized trials, ERSPC and PLCO, showed mixed results on the efficacy of PSA screening, with ERSPC finding a small reduction in prostate cancer mortality but PLCO finding no reduction. Several organizations now recommend against routine PSA screening or recommend shared decision making. While screening may reduce prostate cancer deaths by around 1 per 1000 men screened, it also leads to many false positives and overdiagnosis of indolent cancers, with significant harms from treatment. The benefits of screening remain small compared to the harms. Rates of PSA screening in the US have declined since 2012 guidelines, providing a natural experiment
This document summarizes several studies on prostate cancer screening and treatment that will be discussed at an American Urological Association panel. One study found that a single blood test before age 50 could predict long-term risk of prostate cancer death, with 44% of deaths occurring in men with above-average PSA levels. Another study found that while prostate cancer was rare in men with low PSA at age 60-70, continued screening could identify most high-risk cases. A third study found limitations to using PSA velocity but that closely following patients despite initial negative biopsies may be important. The panel will discuss refining PSA use and interpretation to better determine which cancers require treatment.
This document summarizes a study analyzing media coverage of updated prostate cancer screening guidelines from the USPSTF and AUA. The study found that:
1) 92 news articles were analyzed from 2011-2013 covering the preliminary 2011 USPSTF guidelines, final 2012 guidelines, and 2013 AUA guidelines.
2) Articles frequently emphasized potential downsides of screening and inaccurately summarized guidelines/evidence.
3) Coverage of the USPSTF announcements was more extensive than the AUA guidelines.
4) Urologists were commonly interviewed but articles also cited costs and urologists' financial interests in screening.
5) The study provides insight into how media shapes views of
The document summarizes the key findings and implications of the Prostate Cancer Intervention Versus Observation Trial (PIVOT). The trial found that for men with low-risk prostate cancer, radical prostatectomy did not provide a benefit over observation in reducing mortality rates. This suggests that observation may be a reasonable option for some low-risk prostate cancer patients over age 60. However, the trial also implied that radical prostatectomy may provide survival benefits for those with higher-risk disease. The document discusses several limitations of the PIVOT trial and ongoing debates around the management and treatment of localized prostate cancer.
EAU - Guidelines on Prostate Cancer dr. ali mujtabaDr Ali MUJTABA
This document provides an overview and guidelines for the diagnosis and management of prostate cancer from the National Comprehensive Cancer Network. It discusses the classification, staging, diagnostic evaluation through PSA tests, biopsy and imaging. It covers management options including active surveillance, radical prostatectomy and their pre-operative preparation. Post-operative follow up, quality of life outcomes and recurrence are also reviewed based on latest evidence and guidelines.
Evolving recommendations in prostate cancer screeningsummer elmorshidy
Prostate cancer screening recommendations have evolved as more evidence has emerged. Early approaches recommended annual PSA screening for all men over 50, but two large trials had conflicting results. One found no mortality benefit, while the other found a 21% reduction in men aged 55-69. However, significant overdiagnosis and harms were recognized, including false positives in 75% of biopsied men. Current guidelines recommend shared decision making for screening in men 55-69 and against screening for other age groups. Improved tests are still needed to better distinguish indolent from aggressive cancers.
This document summarizes several studies on prostate cancer screening and treatment that will be discussed at an American Urological Association panel. One study found that a single blood test before age 50 could predict long-term risk of prostate cancer death, with 44% of deaths occurring in men with above-average PSA levels. Another study found that while prostate cancer was rare in men with low PSA at age 60-70, continued screening could identify most high-risk cases. A third study found limitations to using PSA velocity but that closely following patients despite initial negative biopsies may be important. The panel will discuss refining PSA use and interpretation to better determine which cancers require treatment.
This document summarizes a study analyzing media coverage of updated prostate cancer screening guidelines from the USPSTF and AUA. The study found that:
1) 92 news articles were analyzed from 2011-2013 covering the preliminary 2011 USPSTF guidelines, final 2012 guidelines, and 2013 AUA guidelines.
2) Articles frequently emphasized potential downsides of screening and inaccurately summarized guidelines/evidence.
3) Coverage of the USPSTF announcements was more extensive than the AUA guidelines.
4) Urologists were commonly interviewed but articles also cited costs and urologists' financial interests in screening.
5) The study provides insight into how media shapes views of
The document summarizes the key findings and implications of the Prostate Cancer Intervention Versus Observation Trial (PIVOT). The trial found that for men with low-risk prostate cancer, radical prostatectomy did not provide a benefit over observation in reducing mortality rates. This suggests that observation may be a reasonable option for some low-risk prostate cancer patients over age 60. However, the trial also implied that radical prostatectomy may provide survival benefits for those with higher-risk disease. The document discusses several limitations of the PIVOT trial and ongoing debates around the management and treatment of localized prostate cancer.
EAU - Guidelines on Prostate Cancer dr. ali mujtabaDr Ali MUJTABA
This document provides an overview and guidelines for the diagnosis and management of prostate cancer from the National Comprehensive Cancer Network. It discusses the classification, staging, diagnostic evaluation through PSA tests, biopsy and imaging. It covers management options including active surveillance, radical prostatectomy and their pre-operative preparation. Post-operative follow up, quality of life outcomes and recurrence are also reviewed based on latest evidence and guidelines.
Evolving recommendations in prostate cancer screeningsummer elmorshidy
Prostate cancer screening recommendations have evolved as more evidence has emerged. Early approaches recommended annual PSA screening for all men over 50, but two large trials had conflicting results. One found no mortality benefit, while the other found a 21% reduction in men aged 55-69. However, significant overdiagnosis and harms were recognized, including false positives in 75% of biopsied men. Current guidelines recommend shared decision making for screening in men 55-69 and against screening for other age groups. Improved tests are still needed to better distinguish indolent from aggressive cancers.
Prostate cancer detection, UroLifts, HaematuriaMarc Laniado
This document discusses innovations in prostate disease management, including focal therapy options for prostate cancer and the UroLift procedure for treating benign prostatic hyperplasia (BPH). It summarizes guidelines for investigating hematuria and evaluating prostate cancer risk. It also compares treatment options for localized prostate cancer and BPH, noting UroLift offers symptom relief while preserving sexual function unlike other BPH treatments. Clinical data shows UroLift improves urinary symptoms and quality of life compared to TURP, with faster recovery and no effect on ejaculation.
The document provides information on developing clinical guidelines for prostate cancer screening using PSA testing. It includes requirements for effective screening programs, characteristics of the PSA test, results from two large randomized controlled trials (PLCO and ERSPC) on PSA screening, and considerations for formulating a screening guideline. A third summary discusses estimates of lead time and overdiagnosis from prostate cancer screening from three mathematical models, with lead times ranging from 5-7 years and overdiagnosis estimated at 23-42% of screen-detected cancers.
Assessment of Incidence and Prevalence of Prostate Cancer in Middle Aged Male...BRNSS Publication Hub
This study was conducted to evaluate the incidence of prostate cancer (PCa) in male patients with increased prostate-specific antigen (PSA), and normal or abnormal digital rectal examination (DRE) that underwent a prostate biopsy. From March 2018 to November 2018, a total of 98 consecutive males suspected of having PCa due to increased PSA levels underwent transrectal ultrasonography (TRUS)-guided sextant biopsy of the prostate. The total PSA (tPSA), demographic data, the incidence of PCa, benign prostate hyperplasia (BPH), and prostatitis were assessed. The patients were divided into two groups according to their PSA values (Group A serum tPSA level, 4–10 ng/mL; and Group B serum tPSA level, 10.1–20.0 ng/mL). Of the 98 biopsied cases, 56% had PCa, 23% had BPH, and 21% had prostatitis. The mean PSA and the age of the carcinoma group were significantly higher than those of the benign group (P < 0.01). The biopsy results were grouped as PCa, BPH, and prostatitis. The incidence of PCa for Group A and Group B cases was 51% and 65%, respectively. In the case of PCa, BPH, and prostatitis, the mean PSAs were 10.02 ng/mL, 8.76 ng/mL, and 8.41 ng/mL, respectively (P < 0.40). In conclusion, TRUS-guided prostate biopsy and interpretation by a skilled team are highly recommended for early detection of PCa or its ruling-out. Due to the very high incidence of PCa in the patients with PSA >10 ng/mL, TRUS-guided biopsy is indicated, whatever the findings on DRE and/or LUTS, since the PCa detection rate is high.
1) Prostate cancer screening is controversial because while screening can reduce prostate cancer mortality, it also leads to overdiagnosis and overtreatment of indolent cancers.
2) The PSA test is an imperfect screening test that does not perfectly predict who needs a biopsy or aggressive treatment. Newer tests may help better identify high-risk cancers.
3) Most prostate cancers grow slowly and will not cause harm. Screening identifies many localized or regional cancers with nearly 100% 5-year survival rates.
Prostate cancer - Vincent Batista LemaireNiela Valdez
The document summarizes the PI-RADS (Prostate Imaging Reporting and Data System) guidelines for prostate imaging and reporting. It describes the goal of PI-RADS to standardize acquisition, interpretation, and reporting of prostate imaging globally. It also reviews techniques for prostate cancer screening and diagnosis including digital rectal exam, prostate-specific antigen testing, transrectal ultrasound biopsy, and multiparametric magnetic resonance imaging, and discusses the Gleason grading system for evaluating prostate cancer specimens.
This document discusses active surveillance for prostate cancer. It defines active surveillance as monitoring low-risk prostate cancer through regular testing and biopsies, and only providing invasive treatment if signs of cancer growth appear. Active surveillance is indicated for younger men with low-risk cancer defined by grade, tumor extent and other clinical criteria. Studies show active surveillance can effectively manage low-risk cancer with low rates of cancer-specific mortality and metastasis over long-term follow-up while avoiding overtreatment. Improving patient selection, monitoring methods, and confidence in active surveillance can help optimize its use in managing prostate cancer in Europe.
Multidisciplinarity and the Prostate Cancer UnitEuropa Uomo EPAD
This document discusses the benefits and structure of a Prostate Cancer Unit (PCU). Key points include:
- A PCU is a multidisciplinary team approach that can improve outcomes for prostate cancer patients through coordinated care.
- The core team of a PCU includes urologists, radiation oncologists, medical oncologists, pathologists, nurses, and data managers who work together.
- A successful PCU sees over 100 new prostate cancer cases per year, follows evidence-based guidelines, and facilitates access to rehabilitation and palliative care programs.
Prostate MDT workshop 16 nov 17 queriesMarc Laniado
1) The document discusses challenges with multi-disciplinary team meetings for prostate cancer including not having enough time to discuss each patient and missing key information.
2) It provides examples of cases to illustrate how MRI and targeted biopsies can provide more accurate risk stratification compared to standard biopsies alone. This includes finding higher grade cancers.
3) Treatment options for prostate cancer are varied and patient preferences should help guide decision making, as the long term outcomes of different approaches are unclear. Biomarkers may also provide additional information beyond pathology results.
This document discusses the use of the Prolaris test in decision making for prostate cancer treatment. It describes several case studies where Prolaris provided more precise risk stratification compared to standard tests like Gleason score and CAPRA. Prolaris separated patients into more meaningful low and high risk groups, changing treatment decisions in about 2/3 of cases. The document argues Prolaris adds value by improving risk prediction compared to existing tools. It suggests Prolaris could be incorporated into optimal prostate cancer care pathways to better guide active surveillance versus immediate treatment.
1) The accuracy of the PSA test for detecting prostate cancer depends on the age of the patient and the prevalence of prostate cancer, which increases significantly with age.
2) For patients under 70 years old, the PSA test has very low accuracy, ranging from near 0% to 22% accuracy, which could lead to many unnecessary invasive biopsies.
3) The U.S. Preventive Services Task Force recommends against PSA-based prostate cancer screening for men 75 and older, and makes no recommendation for men under 75 due to inadequate evidence that screening improves health outcomes.
This document discusses prostate specific antigen (PSA) and its clinical uses. It provides information on:
- What PSA is and how it is produced by the prostate
- How PSA levels are measured and can be affected by various factors
- How PSA is used for screening, diagnosis, staging of prostate cancer
- How PSA levels after treatment can provide prognostic information and indicate recurrence
- The limitations and controversies around PSA screening
Pros and cons of prostate cancer screening by mungai ngugiKesho Conference
1) Prostate cancer screening can have both benefits and harms. The benefits include reducing mortality from prostate cancer by detecting it at an early stage, but screening also commonly results in false positives.
2) Common harms of screening include overdiagnosis where cancers are detected that would never have caused harm, false positives which can lead to invasive biopsies, and potential complications from treatment of screen-detected cancers including incontinence and erectile dysfunction.
3) Guidelines from organizations disagree on screening recommendations for men of different ages, but shared decision making is encouraged to weigh the benefits and harms based on individual risk factors and preferences.
Prostate cancer is commonly diagnosed in men over 50. If detected early, physicians may recommend active surveillance which involves close monitoring of cancer progression through regular PSA blood tests, ultrasounds, and rectal exams. This allows patients to delay more aggressive treatments like surgery and radiation therapy unless the cancer becomes more advanced or aggressive over time.
The PSA test measures levels of prostate-specific antigen in the blood to screen for prostate cancer. High PSA levels could indicate prostate cancer but can also be caused by other prostate conditions. There is conflicting advice about PSA testing and whether a man should get tested depends on discussing risks and benefits with their doctor. In addition to a PSA test, doctors may perform a digital rectal exam to check the prostate for abnormalities. The US Preventive Services Task Force currently recommends against PSA screening because many men are harmed by overtreatment while few benefit, as better tests and treatments are still needed.
Prostate cancer molecular bio markers seminarHarshaR35
This document discusses various molecular biomarkers for prostate cancer that have been approved by regulatory agencies or are under investigation. It begins by providing background on prostate cancer statistics and the rationale for biomarkers. It then discusses currently approved blood-based biomarkers like PSA, PHI, and 4Kscore. Circulating tumor cells and cell-free DNA are also mentioned. Finally, it briefly summarizes urine-based biomarkers like PCA3 and potential new serum protein panels. In general, the document reviews both established and emerging liquid and tissue-based biomarkers that could improve prostate cancer screening, diagnosis, and monitoring.
Localized prostate cancer is the most common cancer in men in Western countries. For patients with high risk localized prostate cancer, the current recommended treatment is androgen deprivation therapy combined with radiotherapy. Several large randomized controlled trials have shown this combination prolongs progression-free and overall survival compared to androgen deprivation alone. Additional treatment options for high risk localized prostate cancer currently being investigated include radical prostatectomy and chemotherapy with docetaxel. Erectile dysfunction is a common side effect of treatment that can be addressed with oral phosphodiesterase inhibitors or intracavernosal injections.
Screening for Prostate cancer has had many different opinions and much research has been conducted in the last 20 years. In this presentation we will discuss the current guidelines for proper screening and gain more insight into men’s health.
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
Este documento describe la fisiología de la visión. Explica que la visión ocurre en tres etapas: 1) la luz entra en el ojo y es enfocada en la retina por el cristalino, 2) los fotorreceptores de la retina traducen la energía luminosa en señales eléctricas, y 3) las señales eléctricas son procesadas por las vías neurales. También describe la anatomía y fisiología del ojo, incluyendo los músculos oculares, la acomodación, los defectos
Prostate cancer detection, UroLifts, HaematuriaMarc Laniado
This document discusses innovations in prostate disease management, including focal therapy options for prostate cancer and the UroLift procedure for treating benign prostatic hyperplasia (BPH). It summarizes guidelines for investigating hematuria and evaluating prostate cancer risk. It also compares treatment options for localized prostate cancer and BPH, noting UroLift offers symptom relief while preserving sexual function unlike other BPH treatments. Clinical data shows UroLift improves urinary symptoms and quality of life compared to TURP, with faster recovery and no effect on ejaculation.
The document provides information on developing clinical guidelines for prostate cancer screening using PSA testing. It includes requirements for effective screening programs, characteristics of the PSA test, results from two large randomized controlled trials (PLCO and ERSPC) on PSA screening, and considerations for formulating a screening guideline. A third summary discusses estimates of lead time and overdiagnosis from prostate cancer screening from three mathematical models, with lead times ranging from 5-7 years and overdiagnosis estimated at 23-42% of screen-detected cancers.
Assessment of Incidence and Prevalence of Prostate Cancer in Middle Aged Male...BRNSS Publication Hub
This study was conducted to evaluate the incidence of prostate cancer (PCa) in male patients with increased prostate-specific antigen (PSA), and normal or abnormal digital rectal examination (DRE) that underwent a prostate biopsy. From March 2018 to November 2018, a total of 98 consecutive males suspected of having PCa due to increased PSA levels underwent transrectal ultrasonography (TRUS)-guided sextant biopsy of the prostate. The total PSA (tPSA), demographic data, the incidence of PCa, benign prostate hyperplasia (BPH), and prostatitis were assessed. The patients were divided into two groups according to their PSA values (Group A serum tPSA level, 4–10 ng/mL; and Group B serum tPSA level, 10.1–20.0 ng/mL). Of the 98 biopsied cases, 56% had PCa, 23% had BPH, and 21% had prostatitis. The mean PSA and the age of the carcinoma group were significantly higher than those of the benign group (P < 0.01). The biopsy results were grouped as PCa, BPH, and prostatitis. The incidence of PCa for Group A and Group B cases was 51% and 65%, respectively. In the case of PCa, BPH, and prostatitis, the mean PSAs were 10.02 ng/mL, 8.76 ng/mL, and 8.41 ng/mL, respectively (P < 0.40). In conclusion, TRUS-guided prostate biopsy and interpretation by a skilled team are highly recommended for early detection of PCa or its ruling-out. Due to the very high incidence of PCa in the patients with PSA >10 ng/mL, TRUS-guided biopsy is indicated, whatever the findings on DRE and/or LUTS, since the PCa detection rate is high.
1) Prostate cancer screening is controversial because while screening can reduce prostate cancer mortality, it also leads to overdiagnosis and overtreatment of indolent cancers.
2) The PSA test is an imperfect screening test that does not perfectly predict who needs a biopsy or aggressive treatment. Newer tests may help better identify high-risk cancers.
3) Most prostate cancers grow slowly and will not cause harm. Screening identifies many localized or regional cancers with nearly 100% 5-year survival rates.
Prostate cancer - Vincent Batista LemaireNiela Valdez
The document summarizes the PI-RADS (Prostate Imaging Reporting and Data System) guidelines for prostate imaging and reporting. It describes the goal of PI-RADS to standardize acquisition, interpretation, and reporting of prostate imaging globally. It also reviews techniques for prostate cancer screening and diagnosis including digital rectal exam, prostate-specific antigen testing, transrectal ultrasound biopsy, and multiparametric magnetic resonance imaging, and discusses the Gleason grading system for evaluating prostate cancer specimens.
This document discusses active surveillance for prostate cancer. It defines active surveillance as monitoring low-risk prostate cancer through regular testing and biopsies, and only providing invasive treatment if signs of cancer growth appear. Active surveillance is indicated for younger men with low-risk cancer defined by grade, tumor extent and other clinical criteria. Studies show active surveillance can effectively manage low-risk cancer with low rates of cancer-specific mortality and metastasis over long-term follow-up while avoiding overtreatment. Improving patient selection, monitoring methods, and confidence in active surveillance can help optimize its use in managing prostate cancer in Europe.
Multidisciplinarity and the Prostate Cancer UnitEuropa Uomo EPAD
This document discusses the benefits and structure of a Prostate Cancer Unit (PCU). Key points include:
- A PCU is a multidisciplinary team approach that can improve outcomes for prostate cancer patients through coordinated care.
- The core team of a PCU includes urologists, radiation oncologists, medical oncologists, pathologists, nurses, and data managers who work together.
- A successful PCU sees over 100 new prostate cancer cases per year, follows evidence-based guidelines, and facilitates access to rehabilitation and palliative care programs.
Prostate MDT workshop 16 nov 17 queriesMarc Laniado
1) The document discusses challenges with multi-disciplinary team meetings for prostate cancer including not having enough time to discuss each patient and missing key information.
2) It provides examples of cases to illustrate how MRI and targeted biopsies can provide more accurate risk stratification compared to standard biopsies alone. This includes finding higher grade cancers.
3) Treatment options for prostate cancer are varied and patient preferences should help guide decision making, as the long term outcomes of different approaches are unclear. Biomarkers may also provide additional information beyond pathology results.
This document discusses the use of the Prolaris test in decision making for prostate cancer treatment. It describes several case studies where Prolaris provided more precise risk stratification compared to standard tests like Gleason score and CAPRA. Prolaris separated patients into more meaningful low and high risk groups, changing treatment decisions in about 2/3 of cases. The document argues Prolaris adds value by improving risk prediction compared to existing tools. It suggests Prolaris could be incorporated into optimal prostate cancer care pathways to better guide active surveillance versus immediate treatment.
1) The accuracy of the PSA test for detecting prostate cancer depends on the age of the patient and the prevalence of prostate cancer, which increases significantly with age.
2) For patients under 70 years old, the PSA test has very low accuracy, ranging from near 0% to 22% accuracy, which could lead to many unnecessary invasive biopsies.
3) The U.S. Preventive Services Task Force recommends against PSA-based prostate cancer screening for men 75 and older, and makes no recommendation for men under 75 due to inadequate evidence that screening improves health outcomes.
This document discusses prostate specific antigen (PSA) and its clinical uses. It provides information on:
- What PSA is and how it is produced by the prostate
- How PSA levels are measured and can be affected by various factors
- How PSA is used for screening, diagnosis, staging of prostate cancer
- How PSA levels after treatment can provide prognostic information and indicate recurrence
- The limitations and controversies around PSA screening
Pros and cons of prostate cancer screening by mungai ngugiKesho Conference
1) Prostate cancer screening can have both benefits and harms. The benefits include reducing mortality from prostate cancer by detecting it at an early stage, but screening also commonly results in false positives.
2) Common harms of screening include overdiagnosis where cancers are detected that would never have caused harm, false positives which can lead to invasive biopsies, and potential complications from treatment of screen-detected cancers including incontinence and erectile dysfunction.
3) Guidelines from organizations disagree on screening recommendations for men of different ages, but shared decision making is encouraged to weigh the benefits and harms based on individual risk factors and preferences.
Prostate cancer is commonly diagnosed in men over 50. If detected early, physicians may recommend active surveillance which involves close monitoring of cancer progression through regular PSA blood tests, ultrasounds, and rectal exams. This allows patients to delay more aggressive treatments like surgery and radiation therapy unless the cancer becomes more advanced or aggressive over time.
The PSA test measures levels of prostate-specific antigen in the blood to screen for prostate cancer. High PSA levels could indicate prostate cancer but can also be caused by other prostate conditions. There is conflicting advice about PSA testing and whether a man should get tested depends on discussing risks and benefits with their doctor. In addition to a PSA test, doctors may perform a digital rectal exam to check the prostate for abnormalities. The US Preventive Services Task Force currently recommends against PSA screening because many men are harmed by overtreatment while few benefit, as better tests and treatments are still needed.
Prostate cancer molecular bio markers seminarHarshaR35
This document discusses various molecular biomarkers for prostate cancer that have been approved by regulatory agencies or are under investigation. It begins by providing background on prostate cancer statistics and the rationale for biomarkers. It then discusses currently approved blood-based biomarkers like PSA, PHI, and 4Kscore. Circulating tumor cells and cell-free DNA are also mentioned. Finally, it briefly summarizes urine-based biomarkers like PCA3 and potential new serum protein panels. In general, the document reviews both established and emerging liquid and tissue-based biomarkers that could improve prostate cancer screening, diagnosis, and monitoring.
Localized prostate cancer is the most common cancer in men in Western countries. For patients with high risk localized prostate cancer, the current recommended treatment is androgen deprivation therapy combined with radiotherapy. Several large randomized controlled trials have shown this combination prolongs progression-free and overall survival compared to androgen deprivation alone. Additional treatment options for high risk localized prostate cancer currently being investigated include radical prostatectomy and chemotherapy with docetaxel. Erectile dysfunction is a common side effect of treatment that can be addressed with oral phosphodiesterase inhibitors or intracavernosal injections.
Screening for Prostate cancer has had many different opinions and much research has been conducted in the last 20 years. In this presentation we will discuss the current guidelines for proper screening and gain more insight into men’s health.
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
Este documento describe la fisiología de la visión. Explica que la visión ocurre en tres etapas: 1) la luz entra en el ojo y es enfocada en la retina por el cristalino, 2) los fotorreceptores de la retina traducen la energía luminosa en señales eléctricas, y 3) las señales eléctricas son procesadas por las vías neurales. También describe la anatomía y fisiología del ojo, incluyendo los músculos oculares, la acomodación, los defectos
Este documento resume las principales obligaciones y medidas de protección de datos personales que deben aplicarse en un centro educativo de acuerdo con la legislación española. Explica que los centros deben declarar ficheros de datos sobre alumnos, personal y página web, y tomar medidas de seguridad adecuadas al nivel de sensibilidad de la información. También cubre aspectos como la privacidad en la web del centro, el uso de cámaras de seguridad y los impresos para la recogida de datos personales.
Este documento describe diferentes tipos de funciones, incluyendo funciones polinómicas, exponenciales, logarítmicas y trigonométricas. Explica que las funciones polinómicas están definidas por polinomios y tienen características como dominio en los números reales y cortar el eje x un máximo de veces igual al grado del polinomio. Las funciones exponenciales tienen la variable en el exponente y siempre cortan el eje y en (0,1). Las funciones logarítmicas son inversas de las funciones exponencial
Este documento trata sobre diferentes tipos de identidad y estereotipos. Define la identidad personal como los rasgos y patrones de comportamiento que identifican a una persona. La identidad nacional se refiere a la nacionalidad y sentido de pertenencia a un territorio. Explica que los estereotipos de género son modelos de conducta que definen cómo deben ser y actuar hombres y mujeres. Por último, señala que los estereotipos sociales son ideas aceptadas pasivamente que a menudo son erróneas y extendidas por quienes tienen poder
Este documento presenta los términos de referencia para el diseño de un módulo de residuos sólidos que incluye una planta de tratamiento, aprovechamiento y relleno sanitario. Se describen los objetivos, alcances, localización, costos estimados, cronograma, caracterización del área, diseños requeridos para cada componente e informes y especificaciones técnicas necesarios. El diseño comprende plantas para compostaje, lombricultura, materiales inorgánicos y tratamiento térmico, así como el
El documento resume las funciones superiores del sistema nervioso, incluyendo el sueño, las emociones, el habla, la memoria y el aprendizaje. Explica que estas funciones emergen de las áreas corticales y subcorticales del cerebro, especialmente el sistema límbico e hipocampo. También describe los principales métodos para estudiar estas funciones, como imágenes cerebrales, estimulación cerebral y estudios con primates.
Este plano de aula visa discutir a situação atual dos povos indígenas do Peru e México. Será realizado um jogo chamado "Quebra-cabeças Humano: Peru versus México" para promover a interação entre os alunos e ensinar sobre as culturas indígenas desses países de forma lúdica.
O documento discute a evolução para uma sociedade da informação baseada no conhecimento, caracterizada pela centralidade da informação, ciência e tecnologia. A terceira revolução industrial teria sido baseada na informação, diferentemente das primeiras que usaram vapor e eletricidade. Há dúvidas se essa sociedade seria mais democrática e igualitária ou se a informação se tornou privatizada e controlada por corporações.
El resumen del documento es:
1) Explica los conceptos de utilidad y garantía en relación al valor de un servicio según ITIL. La utilidad se refiere a los beneficios para el cliente y la garantía asegura la disponibilidad, capacidad, continuidad y seguridad del servicio.
2) Describe cómo un caso hipotético de verificación de antecedentes penales ilustra estos conceptos. El servicio brinda utilidad al cliente al agilizar el proceso y reducir costos, y garantía a través de la disponibilidad y calidad
This document discusses RIPE Atlas, a global network measurement platform. It notes that RIPE Atlas has over 9,300 probes connected across over 200 anchors that collect over 35,000 user-defined measurements per week. The presentation describes how RIPE Atlas can be used by ISPs to monitor network performance from multiple vantage points, troubleshoot problems, and validate peering strategies. It also provides examples of how RIPE Atlas has been used to monitor game services, measure cloud connectivity, and debug network issues.
Este documento presenta varios conceptos clave de la teoría de la identidad social. Explica que la identidad personal se basa en la memoria y nos define como individuos, mientras que la identidad nacional se refiere a la pertenencia a una colectividad cultural. También describe los componentes de la identidad social como las actitudes, valores, prejuicios, liderazgo, motivaciones sociales, estereotipos de género y movimientos de masa.
El documento habla sobre diferentes opciones de marketing digital como Twitter, Google Display y Facebook. Twitter permite llegar a más seguidores pero el contenido se pierde rápido, mientras que Google Display es de costo medio y permite anuncios de imagen o video. Facebook ofrece contenido orgánico de fuerza pero solo al 1% de la comunidad, aunque permite campañas con múltiples objetivos de manera amigable.
El documento resume el contenido del capítulo 1 de la primera carta de Pedro. Explica que Pedro escribió la carta a creyentes de varias provincias en Asia Menor. Resalta que en los versículos 1-2, Pedro describe la elección de los creyentes y el papel de Dios, Jesús y el Espíritu Santo en la salvación. Luego, los versículos 3-12 describen temas como la herencia celestial y el sufrimiento de los creyentes. Finalmente, los versículos 13-25 exhortan a vivir santamente y amarse
Este documento presenta un proyecto de investigación sobre la situación política y económica actual en Venezuela. Explica las raíces de los problemas económicos actuales que se remontan a las reformas de Chávez en 2001. También analiza cómo la caída del precio del petróleo, los intentos de desestabilización de la oposición y el control de cambios han contribuido a la hiperinflación, escasez y crisis actual. El documento concluye explicando los esfuerzos actuales del gobierno para abordar la crisis a través de program
Libert Youssa-tientcheu has over 10 years of experience in laboratory settings including roles at Astrazeneca, Smithers AVANZA PHARMACEUTICALS, Thermofisher, and the NIH. He has a Bachelor of Science in Chemistry from the University of the District of Columbia and is proficient in cGMP documentation, batch record completion, sample management, and storage of biological materials. Libert seeks to utilize his laboratory skills and training in standard operating procedures.
Un accidente laboral es un evento inesperado que causa lesiones, discapacidad o muerte a un trabajador mientras cumple sus funciones o se transporta al trabajo. Las causas incluyen el manejo inadecuado de equipos de protección, maquinaria peligrosa y posturas de trabajo inseguras. Las causas básicas son factores subyacentes como falta de capacitación, mientras que las causas inmediatas son condiciones de trabajo o acciones que llevan directamente al accidente. Los factores de riesgo que pueden causar accidentes incluy
La arquitectura barroca en Italia se caracterizó por su grandiosidad, dinamismo y contrastes. Se desarrolló principalmente en Roma, donde los papas patrocinaron grandes obras como San Pedro en el Vaticano. Las iglesias barrocas buscaban impresionar a los fieles con su riqueza decorativa y efectos ilusorios de luz y movimiento. Los palacios reales también se hicieron más dinámicos y abiertos, reflejando el poder de la monarquía.
New study confirms psa screening saves livesRebecca Sage
A new study confirms that PSA screening saves lives by showing a 21% overall survival advantage for prostate cancer and a 38% advantage for those screened for more than 10 years. However, the USPSTF recently recommended against routine PSA screening based on flawed studies. The updated data from the ERSPC highlights problems with the USPSTF process, which lacks transparency and oversight. Ultimately, the decision about prostate cancer screening and treatment should remain between patients and their doctors.
This document summarizes several studies on prostate cancer screening and treatment that will be discussed at an American Urological Association panel. One study found that a single blood test before age 50 could predict long-term risk of prostate cancer death, with 44% of deaths occurring in men with above-average PSA levels. Another study found that while prostate cancer was rare in men with low PSA at age 60-70, continued screening could identify most high-risk cases. A third study found limitations to using PSA velocity but that closely following patients despite initial negative biopsies may be important. The panel will discuss refining PSA use and interpretation to better determine which cancers require treatment.
The article discusses findings from the prostate cancer intervention verses observation trial (PIVOT) which randomized 731 men with prostate cancer to radical prostatectomy or watchful waiting. The study found a small reduction in mortality at 12 years for those who underwent surgery (2.9%), but the confidence interval was wide. Subgroup analysis found that for men at low risk of death from prostate cancer (<3% risk at 12 years), watchful waiting resulted in marginally better outcomes. The findings suggest there is little benefit from radical prostatectomy for men with low risk disease.
This document provides an overview and updates on prostate cancer pharmacotherapies. It discusses the anatomy and physiology of the prostate, risk factors for prostate cancer like diet and genetics, screening methods including PSA tests and digital rectal exams, diagnostic workup involving imaging and biopsies, tumor staging using Gleason scores and TNM classification, and treatment strategies at different stages including radiation, surgery, and hormone therapies. Controversies around PSA screening and increasing legal risks for failure to diagnose are also reviewed.
This document summarizes preliminary results from an observational study on using [-2]proPSA (p2PSA) to predict early biochemical recurrence after radical prostatectomy.
The study enrolled 64 patients over 15 months to compare p2PSA to total PSA (tPSA) in detecting recurrence. After 12 months, p2PSA detected recurrence in 16 patients (48.5%) compared to only 2 (6.1%) by tPSA. All patients with tPSA recurrence also had elevated p2PSA. p2PSA detected recurrence earlier with a mean of 9 months compared to 12.4 months for tPSA. The findings suggest p2PSA may be more sensitive than
New research studies presented at the 2011 Annual Meeting of the American Urological Association examine promising biomarkers and genetic tests for bladder and prostate cancers. Certain genetic variants on chromosomes 8q24 and 19q13 were found to be associated with higher rates of prostate cancer aggressiveness. Combining measurements of the PCA3 and TMPRSS2:ERG tests improved the sensitivity and accuracy of prostate cancer diagnosis compared to the PCA3 test alone. Additionally, a urine assay measuring TMPRSS2:ERG gene fusion levels correlated with higher pathologic stage, Gleason score, and Gleason upgrading in prostate cancer patients. The studies suggest newer diagnostic tests may help distinguish between indolent and aggressive forms of prostate and bladder cancers.
New research studies presented at the 2011 Annual Meeting of the American Urological Association examine promising biomarkers and genetic tests for bladder and prostate cancers. Certain genetic variants on chromosomes 8q24 and 19q13 were found to be associated with higher rates of prostate cancer aggressiveness. Combining measurements of the PCA3 and TMPRSS2:ERG tests improved the sensitivity and accuracy of prostate cancer diagnosis compared to the PCA3 test alone. Additionally, a urine assay measuring TMPRSS2:ERG gene fusion levels correlated with higher pathologic stage, Gleason score, and Gleason upgrading in prostate cancer patients. The studies suggest newer diagnostic tests may help distinguish between indolent and aggressive forms of prostate and bladder cancers.
Mon 8-00 Prostate Cancer Screening in the Post-USPSTF Era_0.pptxRonitEnterprises
This document discusses prostate cancer screening and recommendations. It begins with a case presentation of a 54-year-old man before discussing the US Preventive Services Task Force recommendations against PSA screening. It then reviews the goals of cancer screening, basics of PSA testing and prostate cancer, impact of the Task Force, and ways to improve screening through risk stratification using newer biomarkers, imaging, and genetic profiling to avoid overdiagnosis while identifying high-risk cancers.
This seminar discussed screening for carcinoma of the prostate. It was chaired by Prof. C. S. Ratkal and co-chaired by Dr. M. Shivalingaiah. Dr. Prakash H. S. presented on various screening modalities including digital rectal examination (DRE), prostate-specific antigen (PSA) testing, prostate biopsy, and imaging. PSA testing combined with DRE is the most useful first-line screening approach. While screening can detect early-stage cancers, it also risks overdiagnosis and overtreatment of indolent tumors. The benefits and limitations of prostate cancer screening continue to be debated.
Prostate cancer screening and early detection is an ongoing area of research and debate. While screening can detect prostate cancer earlier when it may be more treatable, it also leads to overdiagnosis and overtreatment. Several large clinical trials have had conflicting results on the benefits of prostate cancer screening. Guidelines from organizations also vary in their recommendations for screening. New biomarkers and imaging techniques are being studied to improve screening specificity and reduce unnecessary biopsies and treatment. Overall, the effectiveness of prostate cancer screening remains uncertain, and any decision to be screened requires informed discussion of risks and benefits.
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes MellitusBhargav Kiran
This document summarizes the results of the ASCEND trial, which investigated the effects of low-dose aspirin (100 mg daily) for primary prevention of cardiovascular events in 15,480 adults with diabetes but no history of cardiovascular disease. Over a mean follow-up of 7.4 years:
- Serious vascular events were lower in the aspirin group (8.5%) compared to placebo (9.6%), but major bleeding events were higher with aspirin (4.1% vs 3.2%).
- There was no significant difference in gastrointestinal cancer rates between groups.
- Aspirin prevented some vascular events but increased bleeding, largely offsetting the benefits. The absolute risks and benefits were closely balanced
This document discusses management strategies for localized prostate cancer, including active surveillance and radical prostatectomy. It notes that active surveillance involves delayed treatment if cancer progresses, allowing patients to avoid or delay unnecessary treatment. However, criteria for patient selection and treatment triggers require further definition and validation. Radical prostatectomy remains the gold standard for treating localized prostate cancer as it offers the possibility of cure while minimizing damage to surrounding tissues when performed skillfully. Innovations have led to improved preservation of urinary continence and erectile function with this procedure.
This analysis suggests that delaying biopsy to allow additional PSA testing can provide useful information about PSA trends. The study found that the potential reduction in unnecessary biopsies by observing subsequent PSA trends was 72-80%. PSA trends that showed substantial deceleration or decreases were less likely to require biopsy. The fastest growth in PSA per year, over 100% increase, was the most likely to see decreases and had the potential for a 93% reduction in biopsies. Higher annual exponential growth rates in cancer PSA were significantly associated with increased all-cause and cancer-specific mortality in a large cohort, indicating faster growing cancers were more deadly. Observing PSA trends may help distinguish potentially deadly cancers warranting early
This document provides guidelines and recommendations for breast cancer screening. It discusses that breast cancer is the most commonly diagnosed cancer in women and the second leading cause of cancer death in women. Screening through mammography can effectively reduce breast cancer mortality. Current guidelines recommend annual mammography screening beginning at age 40, as well as regular clinical breast exams. Newer screening technologies such as digital mammography and MRI for high-risk women are discussed. The importance of breast self-awareness over formal breast self-exam is also highlighted.
This document summarizes a study that found a combination of pomegranate, green tea, turmeric, and broccoli concentrated into a pill significantly slowed markers of prostate cancer growth in men. The study of 203 men with prostate cancer found that those taking the pill saw their PSA levels rise by only 14.7% over six months, compared to a 78.5% rise in the placebo group, a statistically significant 63.8% difference. The pill also supported deferring aggressive treatment for more men being monitored with watchful waiting.
Journal of the Formosan Medical Association (2011) 110, 695e70.docxcroysierkathey
Journal of the Formosan Medical Association (2011) 110, 695e700
Available online at www.sciencedirect.com
journal homepage: www.jfma-online.com
ORIGINAL ARTICLE
A multivariable logistic regression equation to
evaluate prostate cancer
Jhih-Cheng Wang a, Steven K. Huan a, Jinn-Rung Kuo b, Chin-Li Lu c,
Hung Lin a, Kun-Hung Shen a,*
a Division of Urology, Departments of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
b Division of Neurosurgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
c Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
Received 29 January 2010; received in revised form 14 May 2010; accepted 9 August 2010
KEYWORDS
Logistic regression;
men’s health;
probability;
prostate cancer;
risk factor;
score
* Corresponding author. Division of U
Taiwan 710.
E-mail address: [email protected]
0929-6646/$ - see front matter Copyr
doi:10.1016/j.jfma.2011.09.005
Background/Purpose: A possible means of decreasing prostate cancer mortality is through
improved early detection. We attempted to create an equation to predict the likelihood of
having prostate cancer.
Methods: Between January 2005 and May 2008, patients who received prostate biopsies were
retrospective evaluated. The relationship between the possibility of prostate cancer and the
following variables were evaluated: age; serum prostate specific antigen (PSA) level, prostate
volume, numbers of prostatic biopsies, digital rectal examination (DRE) findings, and the pres-
ence of hypoechoic nodule under transrectal ultrasonography.
Results: A multivariate regression model was created to predict the possibility of having pros-
tate cancer, and a receiver-operating characteristic (ROC) curve was drawn based on the
predictive scoring equation. Using a predictive equation, P Z 1/(1 � e�x), where X Z
�4.88, þ 1.11 (if DRE positive), þ 0.75 (if hypoechoic nodule of prostate present), þ 1.27
(when 7 < PSA � 10), þ 2.02 (when 10 < PSA � 24), þ 2.28 (when 24 < PSA � 50), þ 3.93 (when
50 < PSA), þ 1.23 (when 65 < age � 75), þ 1.66 (when 75 < age), followed by ROC curve
analysis, we showed that the sensitivity was 88.5% and specificity was 79.1% in predicting
the possibility of prostate cancer.
Conclusion: Clinicians can tailor each patient’s follow-up according to the nomogram based on
this equation to increase the efficacy of evaluating for prostate cancer.
Copyright ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
rology, Department of Surgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan,
il.com (K.-H. Shen).
ight ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
mailto:[email protected]
http://dx.doi.org/10.1016/j.jfma.2011.09.005
www.sciencedirect.com/science/journal/09296646
http://www.jfma-online.com
http://dx.doi.org/10.1016/j.jfma.2011.09.005
http://dx.doi.org/10.1016/j.jfma.2011.09.005
696 J.-C. Wang et al.
Prostate cancer is the most common solid malignancy ...
An Investigation of the Knowledge and Opinions of British Men Regarding Pros...Jedrik Martinez
The document is a dissertation that investigates the knowledge and opinions of British men regarding prostate cancer. It includes the following key points:
- The study surveyed 25 British men and found that most (76%) lacked knowledge about the causes of prostate cancer, though some knew family history and age were factors.
- Regarding screening and treatment, only 12% knew there is no screening program in the UK, while 68% did not know the treatment options.
- However, the men showed positive attitudes, as 80% were willing to undergo screening, 96% felt comfortable talking about prostate cancer, and most said they would not treat someone with prostate cancer differently.
This document summarizes evidence on screening for prostate cancer with the prostate-specific antigen (PSA) test. It finds that PSA screening can result in a small reduction in prostate cancer mortality but no reduction in all-cause mortality. The harms of screening include false-positive results in 11.3-19.8% of men screened, and complications from unnecessary biopsies and treatments in those with slow-growing cancers that would not have caused symptoms. While one large trial found a benefit, the evidence is uncertain due to variations between study sites and high rates of screening in the control groups of trials.
Number of Pages 4 (Double Spaced)Number of sources 8Writi.docxcherishwinsland
Number of Pages: 4 (Double Spaced)
Number of sources: 8
Writing Style: APA
Type of document: Coursework
Category: Healthcare
Order Instructions:
Comprehensive Article Review
Caverly, T.J., Fagerlin, A, & Wiener, R.S. (2018, January 22). Comparison of observed harms and expected mortality benefit for persons in the Veterans Health Affairs Lung Cancer Screening Demonstration Project. JAMA Internal Medicine.
1. What research questions are addressed in this study and what is their purpose (5 points)?
2. What type of research design was used (experimental, quasi-experimental, correlational) in this study and what led you to your decision (5 points)?
3. Are the instruments in this study valid and reliable, why or why not (10 points)?
4. Discuss the specific results of each of the ANCOVAs (analysis of covariance) done in this study. What was the purpose of"each" of the ANCOVAs? What was the covariate in each and why did they do an ANCOVA in each case (5 points)?
5. In the Tables, results are presented, Please explain the tables and summarize the results (15 points).
6. Explain, in simple language, any significant results of this study (25 points)?
7. Identify and discuss any threats to internal and/or external validity in this study (10 points).
8. If you could redesign this study correcting anything you have found wrong with the research, what would you correct and how would you do it (20 points)?
Opinion
EDITORIAL
Reducing Harms in Lung Cancer Screening
Bach to the Future
Michael ln cze, MD, MSEd: Rita F. Redberg, MD, MSc
TbeUS PreventativeServices Task Force cmrcntly recom mends si:;ree ning (grade Brecommendation)for lung canc er witha nnuallow-dose computed tomo graph}' for high-risk in dividuals ages55 to 80 years, defined as those having greate r
gLblefor LCS using the Bach risk tool,11 a vaJidatcd risk model usingsex,age, smokingduration, durationof abstinence from smoking and number of cigarettes smoked per day as inpu ts.
The asto undingly high ratesof false-pos itiveresults in the low
=Related attid e
than a 30 pack-year cumula tivesmoking historyand h av• ing quit with in the past 15 years.1 The evide nce to sup
est risk quintiles (eg, 2221false-positive resul ts per lung ca n cer death averted and a NNS of nearly 5600 in quintile1), as well as extremelylow ratesoflungcancerincidencein the low est-risk groups, confirm trends illustrated in previous stud
port thisrecommendation overwhelminglycomes rrom the Na
tional Lung CancerScreenfngTrial(NL ST). While3 other large randomized clinical trials failed to show any mortality ben efit tolung cancer screening (LCS), the NLST demonstrateda 20% reduction in lungcan ce r mortality,a lo ng with a 6.7% re duction in .ill-ca use mortality, when compared with an an nual chest radiograph, witb a number needed toscreen (NNS} of256to prevent I lung-cancerassociated death over3years.-2 5 Real-worldapplication ofLCS has been particularly .
Similar to Screening cáncer próstata, nejm, marzo 2017 (20)
This document discusses recent advances and ongoing challenges in treating metastatic prostate cancer. Key points include:
1) Androgen deprivation therapy combined with docetaxel or abiraterone plus prednisone is now standard of care for patients initially diagnosed with metastatic disease based on improved survival seen in clinical trials.
2) New, more sensitive imaging techniques are enabling earlier detection of metastases but implications for treatment are still unclear.
3) Longer survival with metastatic disease has prompted questions about optimal treatment of the primary tumor site.
4) Understanding mechanisms of castration resistance, such as altered androgen receptor signaling, may help address ongoing challenges in treating advanced disease.
The document summarizes the American Society of Clinical Oncology's (ASCO's) endorsement of the Society for Integrative Oncology's (SIO's) 2017 clinical practice guideline on the use of integrative therapies during and after breast cancer treatment. ASCO endorsed the SIO guideline after conducting a methodological and content review. The SIO guideline addresses integrative therapies for managing symptoms/side effects and makes recommendations for therapies to reduce anxiety, nausea/vomiting, depression, fatigue, lymphedema, and improve quality of life. Therapies recommended include meditation, music therapy, yoga, and acupuncture.
The document discusses physician burnout and argues that organizing toward collective action can help address burnout caused by feelings of powerlessness when treating patients facing socioeconomic hardships. It notes that while burnout is usually attributed to work overload and bureaucracy, its origins may also lie in caring for marginalized patients whose health issues stem from deep-rooted social problems beyond a physician's control. Organizing with others around such issues can combat isolation and empower physicians to enact meaningful change, providing a strategic and therapeutic approach to fighting burnout.
This document provides an updated clinical practice guideline from the American Society of Clinical Oncology (ASCO) and Infectious Diseases Society of America (IDSA) on outpatient management of fever and neutropenia in adults treated for malignancy. The guideline addresses which patients may be appropriate for outpatient treatment, recommended assessments and interventions for outpatients, and antimicrobial treatment options. A systematic review was conducted and the guideline recommendations are based on the available evidence. Key recommendations include using validated tools or clinical judgment to determine which low-risk patients are candidates for outpatient management, administering initial antibiotic doses within 1 hour and monitoring patients for at least 4 hours before discharge, and considering oral fluoroquinolone plus amo
The document discusses the need for improved leadership development in medicine. It argues that health systems currently lack sufficient physician leaders to manage increasing complexity, and that traditional medical training does not emphasize the skills needed for leadership roles. These include communication, collaboration, and decision-making. The article recommends that health systems focus on identifying and developing emerging physician leaders through structured programs, rigorous selection processes, onboarding support, and ongoing feedback and mentoring to close the leadership gap in healthcare.
This document summarizes a randomized controlled trial that compared the effectiveness of talc pleurodesis administered through an indwelling pleural catheter versus placebo among patients with malignant pleural effusions. The trial recruited 154 patients across 18 UK centers who underwent catheter insertion and were randomly assigned to receive either talc or placebo through the catheter. The primary outcome was successful pleurodesis at day 35, defined as less than 50ml of fluid drained on 3 consecutive occasions and less than 25% chest radiograph opacification. At day 35, successful pleurodesis was achieved in 43% of the talc group versus 23% of the placebo group, demonstrating talc administered through a catheter was more effective at inducing pleuro
This document summarizes HIV-associated cancers. It discusses how the introduction of antiretroviral therapy in the 1990s led to a decrease in AIDS-defining cancers like Kaposi's sarcoma and aggressive B-cell lymphomas, but also an increase in non-AIDS defining cancers as the population of people living with HIV aged. It focuses on Kaposi's sarcoma, describing its epidemiology and pathogenesis associated with Kaposi's sarcoma-associated herpesvirus, clinical manifestations, staging, and treatments including the importance of antiretroviral therapy and systemic therapies for advanced disease.
1) Pleural effusions develop in over 1.5 million patients in the US each year, mainly from heart failure, pneumonia, and cancer. Pneumothorax affects around 20,000 patients annually as well.
2) The pleura helps maintain lung shape and prevents atelectasis by keeping pleural pressure slightly negative. While the physiological role of the pleura is unclear, humans can survive without one as pleurodesis alleviates symptoms.
3) Evaluating pleural effusions quickly is important as delays in diagnosing conditions like empyema increase morbidity and mortality. Ultrasound helps guide safe and accurate fluid sampling.
- Larotrectinib, a TRK inhibitor, showed marked antitumor activity in 55 patients with TRK fusion-positive cancers of various types who were enrolled in three clinical studies.
- The overall response rate was 75% according to independent review and 80% according to investigators. At one year, 71% of responses were ongoing and 55% of patients remained progression-free.
- Adverse events were predominantly grade 1. No grade 3-4 adverse events related to larotrectinib occurred in more than 5% of patients, and no patients discontinued treatment due to drug-related adverse events.
The document reviews literature on teaching undergraduate medical students about oncology. It finds that involving patients in teaching through methods like portfolio learning is effective. Using simulated models or standardized patients to teach skills like breast examination improves students' clinical assessment abilities. Computer-based learning has a role but is not necessarily superior to other approaches. Teaching about cancer screening and prevention increases students' knowledge and skills and changes their behaviors. The conclusion recommends oncology educators consider evidence-based teaching approaches covered in the review and that more research is needed in this field.
El documento describe la experiencia de un hospital con 5 casos de cáncer de cuello uterino diagnosticado durante el embarazo. Resume los datos clínicos y de tratamiento de cada paciente. Concluye que debido a la baja casuística, no se puede afirmar que la asociación con el embarazo implique menor supervivencia y que el tratamiento debe decidirse de forma individualizada.
Este documento presenta los resultados de la técnica de biopsia de ganglio centinela combinada utilizada en 252 pacientes con cáncer de mama en etapas tempranas en un hospital en Argentina. La tasa de detección del ganglio centinela fue del 100% y no se observaron recurrencias después de un seguimiento promedio de 12 meses. Los autores concluyen que los resultados son similares a los reportados en la literatura y que la biopsia de ganglio centinela continúa siendo una herramienta útil en la evaluación del cáncer
Este documento proporciona información sobre el cáncer de mama, incluida su anatomía, factores de riesgo, métodos de detección y tipos de tratamiento. Explica que el cáncer de mama se debe al crecimiento anormal de células en el tejido mamario y puede ser benigno o maligno. Detalla los principales métodos para detectarlo como el examen clínico, la mamografía y la biopsia. Además, resume los enfoques de tratamiento como la cirugía, radioterapia, quimioterapia y
Este documento presenta el caso de un paciente de 26 años con un tumor germinal testicular asociado a VIH y patologías oportunistas. El paciente fue diagnosticado con un tumor testicular mixto con metástasis hepáticas y pulmonares. Recibió quimioterapia y tratamiento para VIH y tuberculosis pleural. La estrategia para pacientes con tumores germinales y VIH es administrar quimioterapia estándar y antirretrovirales específicos para reducir las interacciones entre los tratamientos.
El informe describe los resultados del Registro Institucional de Tumores del Hospital Escuela Agudos Dr. Ramón Madariaga en Posadas, Misiones, Argentina desde enero de 2015 hasta mayo de 2017. Se registraron 1105 pacientes con 1109 casos de cáncer, predominando los tumores ginecológicos como el cáncer de cuello uterino y de mama. El objetivo fue conocer las variables epidemiológicas y de estadificación tumoral para mejorar la detección y seguimiento de pacientes oncológicos.
Este documento presenta los resultados de 3 pacientes con cáncer de cuello uterino en estadios tempranos que fueron sometidas a histerectomía radical robot-asistida (HRR). La estadía hospitalaria promedio fue de 3.66 días y no hubo complicaciones postoperatorias. El tiempo quirúrgico promedio fue de 287 minutos. Una paciente fue dada de alta sin seguimiento. Las otras dos pacientes continúan sin evidencia de enfermedad a los 18 meses posteriores a la cirugía. Los autores concluyen que la HRR puede
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis