definition of solitary pulmonary nodule and subsolid nodule, various differences to distinguish between benign and malignant nodule, characteristics of subsolid nodule, treatment and followup of solid and subsolid pulmonary nodule.
Solitary pulmonary nodules radiology ppt is very good power point presentation from various source radiology assistant and latest guidelines. this power-point also includes many sign with multiple xray, ct and mri images. this will help alot. Thanks.
The solitary lung nodule. A diagnostic dilemma. hazem youssef
Incidentally discovered pulmonary nodule are a diagnostic challenge. This presentation is focused on the different features of lung nodules and their management.
Solitary pulmonary nodules radiology ppt is very good power point presentation from various source radiology assistant and latest guidelines. this power-point also includes many sign with multiple xray, ct and mri images. this will help alot. Thanks.
The solitary lung nodule. A diagnostic dilemma. hazem youssef
Incidentally discovered pulmonary nodule are a diagnostic challenge. This presentation is focused on the different features of lung nodules and their management.
the lecture approaches the problem of solitary pulmonary nodule in terms of variable imaging findings,differential diagnosis and algorithm of follow up .
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
3 tesla mri, its physics, advantages and disadvantages, its comparison with 1.5 tesla mri scanner, clinical applications of 3 tesla mri, various artifacts related to 3 tesla, physics of silent mri, advantages of silent mri
Focused Assessment with Sonography in Trauma (FAST) in 2017Dr Varun Bansal
FAST , its definition, its modifications, its extensions in various other situations such as pregnancy, in pediatric populations, use in triage of patients. Described extended FAST which include evaulation for pneumothorax, pleural effusion, pericardial effusion. other extensions of FAST such as RUSH, RADIUS.
the lecture approaches the problem of solitary pulmonary nodule in terms of variable imaging findings,differential diagnosis and algorithm of follow up .
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
Describes cross sectional anatomy of the mediastinum , and lobar and segmental anatomy of the lung with teaching points and radiological guidelines and multiple examples of lobar and segmental pathologies and how we localize these pathologies .Also the types of chest CT images and indications of chest CT.
3 tesla mri, its physics, advantages and disadvantages, its comparison with 1.5 tesla mri scanner, clinical applications of 3 tesla mri, various artifacts related to 3 tesla, physics of silent mri, advantages of silent mri
Focused Assessment with Sonography in Trauma (FAST) in 2017Dr Varun Bansal
FAST , its definition, its modifications, its extensions in various other situations such as pregnancy, in pediatric populations, use in triage of patients. Described extended FAST which include evaulation for pneumothorax, pleural effusion, pericardial effusion. other extensions of FAST such as RUSH, RADIUS.
Basic physics of multidetector computed tomography ( CT Scan) - how ct scan works, different generations of ct, how image is generated and displayed and image artifacts related to CT Scan.
Discrete,well marginated opacity that is less than or equal to 3cm in diameter is described as Solitary Pulmonary Nodule.Definitions,incidence,prevalence,etiology,evaluation and management has been described in this powerpoint presentation.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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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.
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.
1. Update in the Evaluation of Solitary
Pulmonary Nodule
Radiographics 2014; 34(Oct):1658–1679
Dr Varun Bansal
Department of Radio-Diagnosis
2. Objectives:
• Identify CT features of subsolid lesions that are
indicative of an increased risk for malignancy.
• List the differential diagnosis of solid and subsolid
solitary pulmonary nodules.
• Discuss the treatment and follow-up of patients
with a solitary pulmonary nodule.
3. Definition
• round opacity
• at least moderately well marginated
• no larger than 3 cm in its maximum diameter
• Small <1 cm
4.
5. Sub-solid Nodule
• contain a component with ground-glass
attenuation (higher than that of normal lung
parenchyma and lower than that of soft tissue)
• may have purely ground-glass attenuation
• partly solid, or
• mixed solid and ground-glass attenuation
6.
7. Benign vs Malignant SPN
• Size
• <4 mm < 1%
• Upto 8mm 10 -20 % overall chances of malignancy – 1 to 12%
• Margins and contour – regular and irregular, lobular
• Spiculations – sunburst or corona radiate sign
• Exceptions- inflammation, lipoid pneumonia, focal atelectasis, tuberculoma and PMF
• Smooth margin – pulmonary mets, upto 20% malignancy
• Halo Sign – poorly defined rim of ground glass attenuation around the
nodule – hemorrhage, tumor infiltration, perinodular inflammation.
• Invasive aspergillosis also seen in adenocarcinoma in situ, Kaposi sarcoma; and lung
metastases from angiosarcoma, choriocarcinoma, and osteosarcoma
• Reverse halo sign (also known as the atoll sign), a central area of ground-
glass attenuation surrounded by a halo or crescent of consolidation
• cryptogenic organizing pneumonia also seen in patients with lung cancer after
radiofrequency ablation
8.
9. • Fat attenuation (-40 to -120 HU) - hamartoma (upto
50% of these)
• Other - pulmonary metastases in liposarcoma or renal
cell cancer and
• lipoid pneumonia .
• Calcification
• attenuation value greater than 200 HU
• benign patterns diffuse, central (a bull’s-eye
appearance), laminated, and popcorn. granulomatous
infections, hamartomas.
• Exceptions: lung metastases from chondrosarcomas or
osteosarcomas.
• 10% of all lung cancers;
• indeterminate patterns include punctate, eccentric, and
amorphous calcifications
10.
11. • Cavitation - infectious and inflammatory
conditions, such as abscesses, infectious
granulomas, vasculitides, and pulmonary
infarctions, malignancies - primary and metastatic
tumors, (squamous cell)
• smooth, thin walls - benign lesions,
• thick, irregular walls - malignant lesions.
• 95% - wall thickness greater than 15 mm are malignant,
and
• 92% of cavitary nodules with a wall thickness less than 5
mm are benign. For cavities that were
• 5–15 mm in their thickest part, 51% were benign, and
49% were malignant.
12.
13. Subsolid Nodules
• Infection, Inflammation, Hemorrhage, or Neoplasm
• may also be benign (eg, focal interstitial fibrosis and
organizing pneumonia)
• Persistent - more likely to be malignant(primary
lung adenocarcinoma),
14. CT Findings and Morphologic Characteristics
• After an SSN is initially detected, reassessing with
CT at 3 months is important ( inflammatory and
infectious lesions may regress )
15. Association with Adenocarcinoma
• Adenocarcinoma - 50% of all lung cancers, is more
likely to manifest as a solitary subsolid nodule (SSN)
than other subtypes NSCLC
• The IASLC, ATS, and ERS have proposed new
terminology to describe the degree of growth along
the alveolar surface (ie, lepidic growth), and it uses
invasive components to define
• preinvasive - AAH,AIS
• invasive lesions- MIA,LPA
16. Persistent SSNs
• In terms of the IASLC, ERS, and ATS classification,
adenocarcinomas have both mucinous and
nonmucinous forms.
• Term Invasive Mucinous Adenocarcinoma has
replaced the term mucinous BAC.
17. adenocarcinoma
• Fig 7
Arch Pathol Lab Med 2013;137(5):685–705
IASLC, ATS, and ERS
classification of lung
adenocarcinoma
18. Degree of invasion of subsolid
adenocarcinomas.
• attenuation - significantly higher in the group with
invasion
• mean nodule attenuation number could be used to
differentiate among
• AAH (-609 HU),
• AIS (-450 HU), and
• proportion of the solid component to the ground-
glass component
19. • Honda et al reported that a
• ratio of the largest tumor dimension on images
obtained with
• soft-tissue window settings versus lung window
settings
• 50% or less “air-containing type,”
• more than 50% “solid type” lesion
• 114 of 142 air-containing lesions were AIS,
whereas none were invasive adenocarcinomas
• 30 of the 158 solid-type lesions were AIS, 24
were MIA, and 104 were invasive
adenocarcinomas
20. Other Morphologic Features in
Subsolid Nodule
• there are no imaging features that may be used to
reliably differentiate inflammatory and malignant
entities.
• For subsolid nodules, size is of limited use in
determining malignancy.
21. • round shape - more common in malignant subsolid
nodules (65%) than benign modules (17%).
• AAH rather than adenocarcinoma.
• notches in the nodule margin and pleural tags -
more frequent in invasive adenocarcinoma
compared with MIA and AIS
• lobulation, spiculation, a well-defined but coarse
interface, and pseudocavitation (a bubbly
appearance) - more frequently in malignant
subsolid lesions
22. • In patients who are immunocompetent, nodules
that exhibit both pseudocavitation and the halo
sign are reported to have a high likelihood of being
adenocarcinoma.
23. Assessment of Malignant Potential
• NODULE GROWTH
• growth is important to differentiate benign and malignant lesions.
• assessed - volume doubling time;
• spherical volume 4r3.
• A doubling in volume manifests as a 26% increase in diameter.
• Malignant solid SPNs less than 100 days, (20–400 days)
• less than 20 days infectious or inflammatory cause
• more than 400 days benign
• stable size over a 2-year period (d t > 730 days) is a reliable
determinant of benignity
• This growth characteristic does not apply to subsolid
adenocarcinomas, which may take up to 1346 days to double in
volume
24. For subsolid nodules
• limitations
• typically small and poorly defined
• growth that may be indolent and difficult to perceive
• In contrast to growth in solid nodules, which is based solely
on size, in subsolid nodules, growth may manifest as an
• increase in size, an
• increase in attenuation,
• development of a solid component,
• increase in size of a solid component.
• three-dimensional volumetric assessment, rather than
diameter, is a more accurate and reproducible method for
determining the size and growth of solid and subsolid SPNs
30. Nodule Enhancement
• degree of nodule enhancement degree of
vascularity, which increases in malignant lesions
• malignant nodules enhance more than 20 HU,
• benign nodules enhance less than 15 HU
• Nodules that enhance less than 15 HU are almost
certainly benign (negative predictive value, 96%;
sensitivity, 98%; specificity, 58%; accuracy, 77%)
• limitation of this technique prudent to use this
enhancement technique for nodules with a
• diameter of 2 cm or less, because smaller nodules have
a higher likelihood of benignity and are less likely to
have substantial necrosis
31.
32. Nodule Metabolism
• (PET) is a more widely used alternative to measuring
nodule enhancement in the evaluation of solid SPNs.
• The most common semiquantitative method for
evaluating pulmonary lesions at PET is the FDG
standardized uptake value (SUV).
• Typically, metabolism of glucose is increased in
malignancies, and, historically, an SUV cutoff of 2.5
visual analysis is just as accurate
• sensitivity and specificity of approximately 90% for
detecting malignant nodules with a diameter of 10 mm
or larger.
33. • In a study comparing PET/CT and helical dynamic
CT (MDCT) for the evaluation of SPNs, PET/ CT was
more sensitive (96% vs 81%) and more accurate
(93% vs 85%) than MDCT.