Vertebral Column Tumors
Primary tumors: These tumors occur in the vertebral column, and grow either from the bone or disc elements of the spine. They typically occur in younger adults. Osteogenic sarcoma (osteosarcoma) is the most common malignant bone tumor. Most primary spinal tumors are quite rare and usually grow slowly.
Metastatic tumors: Most often, spinal tumors metastasize (spread) from cancer in another area of the body , These tumors usually produce pain that does not get better with rest, may be worse at night, and is often accompanied by other signs of serious illness (such as weight loss, fever/chills/shakes, nausea or vomiting).
Spinal Tumors: approach and managementAmit Agrawal
The spinal cord consists of
Central canal surrounded by an H-shaped gray matter region containing neurons
Outer myelinated nerve tracts, termed white matter, surround the central gray matter
Central canal is lined with ependymal cells
Astrocytes support gray matter neurons and white matter axons
Spinal Tumors: approach and managementAmit Agrawal
The spinal cord consists of
Central canal surrounded by an H-shaped gray matter region containing neurons
Outer myelinated nerve tracts, termed white matter, surround the central gray matter
Central canal is lined with ependymal cells
Astrocytes support gray matter neurons and white matter axons
all about brain tumors. clinical presentation of brain tumors also CT scan MRI of different tumors available to interpret the tumors of brain and spinal cord.
you will learn about brain tumor, types of brain tumor, grading of brain tumor, risk factors for brain tumor, diagnosis for brain tumor, treatment for brain tumor, supportive care and rehabilitation for patients with brain tumor.
General Basic knowledge of Brain tumour explained in brief of classification, pathogenesis, clinical features, CT, MRI, management, Radiotherapy. Best for MBBS and PG preparation student.
Conus Medullaris syndrome (CMS) majorly arises from a spectrum of clinico-pathologic entities representing dysfunction of the lowest level of the spinal cord termed the Conus Medullaris, which consists of the sacral segments. There is a subset of spinal cord injuries clinically referred to as spinal cord injury syndromes, to which Conus Medullaris syndrome belongs, that are grouped by their respective symptomatology, encompassing central cord syndrome [2].
all about brain tumors. clinical presentation of brain tumors also CT scan MRI of different tumors available to interpret the tumors of brain and spinal cord.
you will learn about brain tumor, types of brain tumor, grading of brain tumor, risk factors for brain tumor, diagnosis for brain tumor, treatment for brain tumor, supportive care and rehabilitation for patients with brain tumor.
General Basic knowledge of Brain tumour explained in brief of classification, pathogenesis, clinical features, CT, MRI, management, Radiotherapy. Best for MBBS and PG preparation student.
Conus Medullaris syndrome (CMS) majorly arises from a spectrum of clinico-pathologic entities representing dysfunction of the lowest level of the spinal cord termed the Conus Medullaris, which consists of the sacral segments. There is a subset of spinal cord injuries clinically referred to as spinal cord injury syndromes, to which Conus Medullaris syndrome belongs, that are grouped by their respective symptomatology, encompassing central cord syndrome [2].
Cancer has become a global event that requires study, research and development of all that is new. The process of determining the stage of a tumor is considered the most important in treatment, in order to choose the appropriate type of treatment according to the stage. Treatment in the early stages may be limited to surgical intervention, while chemotherapy is added to improve survival. In the advanced stage, chemotherapy, targeted drugs, and immunotherapy are used. Also, the use of the multimodal treatment method is one of the recent therapeutic developments, as is the adjunctive use of chemotherapy and radiation before surgical intervention.
A brief description on cancer.Cancer – a large group of diseases characterized by the uncontrolled growth and spread of abnormal cells,Some topics are genesis of cancer,types of cancer,causes of cancer like Heredity,Immunity,Chemical,Physical,Viral Bacterial,Lifestyle.
,sign&symptom:*Change in bowel habits or bladder function,*Sores that do not heal,*Unusual bleeding or discharge,*Thickening or lump in breast or other parts of the body,Indigestion or trouble swallowing,*Recent change in a wart or mole,Nagging cough or hoarseness,
diagnosis and staging,treatment:Surgery,Radiation,Chemotherapy,Immunotherapy,Hormone therapy, Gene therapy,side effect of cancer treatment,prevention of cancer
Reconstruction of the anterior cruciate ligament (ACL) is a well-established surgical procedure. However, post-operative imaging in the early phase is not routinely performed. The rationale for performing such imaging is to provide a baseline examination for future controls, to provide immediate feedback to surgeons regarding tunnel placement, and to assess placement of fixation devices
Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head. Femoral head ischemia results in the death of marrow and osteocytes and usually results in the collapse of the necrotic segment
A pathologic fracture is a bone fracture caused by disease that led to weakness of the bone structure. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as: cancer, infection (such as osteomyelitis), inherited bone disorders, or a bone cyst. Only a small number of conditions are commonly responsible for pathological fractures, including osteoporosis, osteomalacia, Paget's disease, osteitis, osteogenesis imperfecta, benign bone tumours and cysts, secondary malignant bone tumours and primary malignant bone tumours
Pelvic fractures can be simple or complex and can involve any part of the bony pelvis. Pelvic fractures can be fatal, and an unstable pelvis requires immediate management.
The Ilizarov apparatus is a type of external fixation used in orthopedic surgery to lengthen or reshape limb bones; as a limb-sparing technique to treat complex and/or open bone fractures; and in cases of infected nonunions of bones that are not amenable with other techniques. It is named after the orthopedic surgeon Gavriil Abramovich Ilizarov from the Soviet Union, who pioneered the technique.
Meniscus injury: Injuries to the crescent-shaped cartilage pads between the two joints formed by the femur (the thigh bone) and the tibia (the shin bone). The meniscus acts as a smooth surface for the joint to move on.
The two menisci are easily injured by the force of rotating the knee while bearing weight. A partial or total tear of a meniscus may occur when a person quickly twists or rotates the upper leg while the foot stays still
Tuberculosis was popularly known as consumption for a long time. Scientists know it as an infection caused by M. tuberculosis. In 1882, the microbiologist Robert Koch discovered the tubercle bacillus, at a time when one of every seven deaths in Europe was caused by TB
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Prevalence and
characteristics
■Of all primary benign bone tumors, 8% occur in
the spine or sacrum.
■Benign primary tumors most commonly occur
during first 3 decades of life
■Spine metastasis most often occur in patients
older than 40
■Benign tumors most frequently involve the
posterior elements, but malignant tumors have a
predilection for the vertebral bodies.
3. Prevalence and
characteristics
■ Most common symptom of a spine tumor is pain,
which occurs in 76% of benign and 95% of malignant
tumors.
■ Carcinomas of the breast, prostate, kidney, and
thyroid gland account for 80% of all skeletal
metastasis, with the spine as the most common
site.
■ Malignant tumors occur more frequently in the lower
(lumbar > thoracic > cervical) spinal levels
4. classification of sPinal tumors
Primary: benign & malignant
Metastatic: The most common tumour of the
spine is metastatic
5.
6. Back Pain with following
characteristics :should Be
considered susPicious
1-Prolonged back pain
2-Slow and insidious onset (with or
without trauma)
3-Does not improve with rest
4-Wakes the patient from a sleep
7. evaluation 1
■Presence of a vertebral fracture after a relatively
minor trauma.
■Recent-onset of back pain in a patient with
previous malignancy should be considered a
recurrence or metastasis.
■History of exposure to potential carcinogenic
agent.
8. evaluation 2
■A review of systems is important and should
focus on constitutional symptoms such as
weight loss, mood changes, and chronic fatigue
■Inspection of patient general posture, gait, and
balance, Palpation of the entire spine, and
Percussion of affected areas should be done.
■Assessment of range of motion of the spine.
■Careful neurologic examination of motor
strength, sensation, and tendon reflexes.
9. Diagnostic Work-up
Laboratory studies:
Laboratory testing is among the first step in the
evaluation of a patient with a suspected spine
tumor
F.B.C (Anemia, lymphoma, multiple Myeloma(●
Erythrocyte sedimentation rate (nonspecific(●
Renal function test (BUN, creatinine(●
●Serum Electrolytes
10. Parathyroid hormone●
Alkaline phosphatase (elevated in osteosarcoma(
●
●Urine protein electrophoresis (multiple myeloma,
solitary plasmacytoma(
Thyroid hormones (thyroid malignancy(●
Prostate specific antigen (prostate cancer(●
●Liver function test (gastrointestinal malignancy(
11. imaging stuDies
:Plain radiographs
The first step imaging for a suspected spine tumor is
plain radiographs
■A tumor is detectable on plain radiographs only if
30%to 40% of vertebral body is involved
■Extension of tumor into surrounding soft tissue may
appear as widening of paraspinal soft tissue
■Neoplasms in the vertebrae can present as osteolytic
osteoblastic or mixed
12.
13. The most classic early sign of vertebral
involvement by malignant lesions is Lytic
destruction of pedicles with the (winkingowl
sign ) seen on an anteroposterior view
16. Computed Tomography:
In general, CT is more reliable in demonstrating the
cortical outlines of bone
and calcification in comparison to MRI. It can better
show the extent of the tumor destruction
17. CT scan of the lumbar spine showing destruction of the right
pedicle, occur in aneurysmal bone cysts
18.
19. :Radionuclide Studies
A technetium-99m bone scan is widely used in the
initial diagnosis and follow-up of bone tumors.
Technetium scans are sensitive to any area of
increased osteoid reaction to destructive
processes in bones
They can detect lesions as small as 2 mm, and as
little as a 5–15% alteration in local bone turnover.
They can identify changes in osteolytic or
osteoblastic disease 2–18 months sooner than
radiographs
21. Biopsy
●Diagnosis of a tumor is not considered definitive
until a tissue sample obtained and histologically
evaluated
●Histologic type and grade of tumor can influence
treatment decision making
22. Biopsy methods include percutaneous needle biopsy,
open incisional biopsy, and open excisional biopsy.
CT guided biopsy
25. treatment
Non-operative Treatment
For benign lesions, there are only rare indications for non-
operative treatment, such as hemangioma or Langerhans
cell histiocytosis.
For malignant lesions, non-surgical treatment generally is
an adjunct to surgery and consists of:
pain management: like NSAIDs ,Opioid drugs , epidural
and intrathecal administration of local anesthesia
chemotherapy
Radiotherapy
26. operative Treatment:
the ultimate goal must be a “wide” and preferably an en
bloc resection of the primary tumor in combination with a
spinal reconstruction which allows for early mobilization.
The surgical techniques are classified by the tissue planes
and approach as:
curettage
intralesional resection: is only used for benign tumors or
for debulking of inoperable primary or metastatic lesions.
en bloc resection
27. Curettage and intralesional resection describe a
gradual removal of the tumor.
En bloc resection indicates the attempt to remove
the whole tumor in one piece together with a
layer of normal tissue.
28. En bloc resection pathological specimen is
histologically analyzed, and further classified into:
1-intralesional
2-marginal
3-wide
The term “intralesional” is used when the tumor mass
is violated; marginal is appropriate when the surgeon
dissects along the pseudocapsule,
and “wide” is appropriate if surgical separation has
occurred outside the pseudocapsule,
29. Surgical treatment indicationS
spinal instability due to bony destruction
progressive neurologic deficit
radioresistant tumor that is growing
the need for open biopsy
intractable pain unresponsive to non-surgical treatment