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Identifying ductal carcinoma in situ, or DCIS, during screenings can be frightening, but there are ways to identify whether or not your DCIS is likely to become aggressive. Here, Rick Baehner, MD and Senior Director of Pathology at Genomic Health, Inc. explains how DCIS scores can help determine risk of recurrence.
Genomic Health is committed to improving the quality of cancer treatment decisions through the research, development and commercialization of genomic-based clinical laboratory services. The company's lead product, the Oncotype DX breast cancer test, has been shown to predict the likelihood of chemotherapy benefit as well as recurrence in invasive breast cancer and has been shown to predict the likelihood of recurrence in ductal carcinoma in situ (DCIS).
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Dr Kevin Soh describes how to minimise injury to the facial nerve during parotid gland surgery (parotidectomy) using a nerve integrity monitor or nerve stimulator.
3 Mount Elizabeth, #07-02, Mount Elizabeth Medical Centre, Singapore 228510
https://www.google.com.sg/maps..../place/Dr+Kevin+Soh,
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If you prefer to read, rather than watch the video, here’s the transcript.
0:16 – Case Presentation: A 39 year old man presents with a right neck swelling for one year. It is 3 cm in size. Fine needle aspiration cytology (FNAC) was performed. Cytology showed adenocarcinoma. Fine needle cytology has an accuracy rate of 90%.
0:34 – CT scan of the Parotid Gland. The normal parotid gland is radiolucent on CT scan. The tumor lies in the posterior part of the superficial lobe of the right parotid gland.
0:49 – MRI scans: A 3 cm right parotid mass is detected. Notice that the tumor enhances intensely with gadolinium administration. This suggests that the tumor is malignant.
1:14 – Positron Emission Tomography scan (PET scan): Used to detect spread of cancer to other parts of the body. The parotid tumor had high metabolic activity levels, which suggests that it is a cancer. Fortunately for this patient, the PET scan did not detect any other areas of increased metabolic activity. PET scans do not provide good anatomical information. PET scans are combined with CT scans to provide anatomical correlation. PET/CT scan showed an area of high metabolic activity in the right parotid gland. But the rest of the body is clear of tumor spread.
1:50 – Next, we have to remove the tumor. The facial nerve (or seventh cranial nerve) supplies the muscles of facial expression. This includes the orbicularis oculi muscle which allows us to close our eyes. It also includes the orbicularis oris muscle with controls our lip movements.
2:19 – Anatomy of the Facial Nerve: The facial nerve is only one of twelve cranial nerves. The facial nerve leaves the brain and enters the temporal bone. It travels horizontally through the middle ear. It descends vertically through the mastoid bone. Then, it exits through the stylomastoid foramen, just next to the styloid process.
3:02 - At the undersurface (ventral aspect) of the right temporal bone, the styloid process is identified. The facial nerve exits the temporal bone at the stylomastoid foramen, behind the styloid process. After exiting the stylomastoid foramen, the facial nerve enters the parotid gland. The facial nerve divides the parotid gland into a small deep lobe and a large superficial lobe.
3:52 – The main trunk of the facial nerve first divides into 2 large branches: the zygomatico-temporal branch and the cervico-facial branch. The zygomatico-temporal branch gives rise to the temporal branch, zygomatic branch, and the buccal branches. The cervico-facial branch gives rise to the marginal mandibular branch, and the cervical branches.
4:08 – The facial nerve branches look like the feet of a goose. They are sometimes called PES ANSERINUS (or goose feet).
4:19 – NIM Response 2.0 Nerve Integrity Monitor. The nerve integrity monitor facilitates safe facial nerve identification and dissection.
4:37 – Demonstration of Parotidectomy Procedure: The incision is marked out carefully to hide the scar. The incision is planned along natural skin creases. NIM electrode placement into the orbicularis oculi muscle. This electrode monitors the temporal and zygomatic branches of the facial nerve. NIM electrode placement within the nasolabial groove into the orbicularis oris muscle. This monitors the buccal and marginal mandibular branches of the facial nerve. The nerve integrity monitor is then turned on. The electrodes are tested to ensure correct placement.
5:19 – The sub-platysmal skin flap is elevated. The skin flap is sutured down. The great auricular nerve is identified. We have to dissect here to look for the main trunk of facial nerve. We can now see the main trunk of the facial nerve.
6:58 – At the completion of parotid surgery, the nerve integrity monitor is used to confirm nerve integrity. Stimulate both proximally and distally to confirm nerve integrity. The stimulator checks the integrity of the main trunk of facial nerve. Then we check the upper branches and the lower branches.
Disclaimer: The Liver in on the right side of your body, NOT left. 🙈🫠
Back on What to Expect it's Hospice Nurse Julie to talk to you about Pancreatic Cancer and what to expect when it comes to the end of life in Hospice Care and Pancreatic Cancer. Pancreatic Cancer involves a number of different situations and symptoms that can arise and there are a couple things to look out for!
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** রাজ টিভি বাংলাদেশের সর্ব প্রথম স্বাস্থ্য বিষয়ক টিভি চ্যানেল । বাংলাদেশের প্রত্যেকটা মানুষের কাছে স্বাস্থ্য তথ্য পৌঁছে দেয়াই আমাদের একমাত্র লক্ষ ।
রাজ টিভিতে স্বাস্থ্য বিষয়ক অনুষ্ঠানে প্রতিদিন থাকেন বাংলাদেশের স্বনামধন্য সব ডাক্তার । বিজ্ঞ ডাক্তারগন স্বাস্থ্য বিষয়ক বিষয় ভিত্তিক আলোচনা করে থাকেন, পাশাপাশি দর্শকরাও
যুক্ত হোন ফোন ও ফেসবুকের কমেন্টের মাধ্যমে । ডাক্তার সরাসরি দর্শকের প্রশ্নের উত্তর দিয়ে থাকেন ও সঠিক পরামর্শ দেন ।
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Season 3: OHNI Case Files - Episode 8: Rosbi
Rosbi is a woman from Guatemala with a very large facial mass. After seeing a video of Dr. Ryan Osborne and Dr. Jason Hamilton removing a large parotid tumor off of a woman, Rosbi and her family cancel her scheduled surgery. Faced with a language barrier, Rosbi and her family travel to the United States to have her surgery at OHNI.
For more information or to schedule and appointment at the Osborne Head and Neck Institute, please visit: https://www.parotid.net/
http://www.cincinnatichildrens.org
medical animation:
Pediatric ERCP ((Endoscopic Retrograde Cholangiopancreatography)_
This medical animation illustrates some of the indications for performing ERCP in children at Cincinnati Children's. ERCP is an advanced endoscopy therapeutic procedure more commonly performed in adult patients. It allows the physician to examine pancreatic and bile ducts using a bendable, lighted tube called an endoscope. Pediatric disease processes in need of an ERCP are similar but may be different from the indications in adult patients.
Credits:
Medialab at Cincinnati Children's
Animation: Jeff Cimprich and Ren Wilkey
Medialab Direction and additional content expertise: Ken Tegtmeyer, MD
Content Expert: Tom K. Lin, MD
Voiceover: Nitya Nair, MD
Medical animation text:
ERCP is an endoscopy procedure for the purpose of evaluating and treating abnormalities of the biliary and/or pancreatic ducts.
When indicated it can be performed in patients as young as newborn babies.
A flexible endoscope is passed through the mouth down to the small opening where the bile duct and pancreas drain.
A small, narrow catheter is passed through the scope to gain access to the drainage duct, followed by advancement of a wire deep into the duct.
In this example, a stone was found to be obstructing the bile duct.
A small cut is made at the bile duct opening to help facilitate stone removal.
The catheter is exchanged for an extraction balloon that is passed above the stone. The balloon is inflated above the stone, which is then removed from the bile duct pulling the stone into the intestines, where it will pass out of the body within the stool.
At the end of the procedure, the wire is removed along with the endoscope.
In this second example, a child with chronic pancreatitis has developed an obstructive narrowing within the pancreatic duct.
A dilating catheter is passed through the narrowing and the balloon is inflated to open the duct.
A temporary flexible stent is then placed through the previous ductal narrowing to allow the duct to heal.
After a few weeks in place, the stent is removed.
Cincinnati Children's provides ERCP and other advanced endoscopic capabilities to patients of all ages.
Hope You All Are Doing Good !!
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It gives us immense pleasure to invite and connect you to the 43rd Annual Conference of AOGD on 19, 20 & 21 November 2021. The Theme of the Conference has been aptly chosen as "Safe Practises Quality Services". We intend to offer a basket of approaches and recent advances to safeguard Women's Health.
As this Corona Pandemic has challenged us with unique and unknown situations, we have devised strategies to overcome them and strive for a safer and better future. It's important that we adhere to the safety norms, as well as continue with the academic activities. Keeping this in mind, we have organized the 43rd Annual Conference of AOGD as the 2nd Annual Virtual Conference of our members.
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Esophageal Cancer Signs & Symptoms (& Why They Occur)
Esophageal cancer (esophageal carcinoma) is a cancer of the esophagus. There are 2 main types of esophageal cancer, each of which has different pathophysiological mechanisms and risk factors. In this lesson, we discuss the signs and symptoms of esophageal cancer, including why these symptoms occur.
I hope you find this lesson helpful. If you do, please like and subscribe for more lessons like this one!
JJ
**MEDICAL LEGAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal. Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.
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*Check Out Some of My Other Lessons*
Medical Terminology - The Basics - Lesson 1:
https://www.youtube.com/watch?v=04Wh2E9oNug
Infectious Disease Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Dermatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Pharmacology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Hematology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Rheumatology Playlist
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Endocrinology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Nephrology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Fatty Acid Synthesis Pathway:
https://www.youtube.com/watch?v=WuQS_LpNMzo
Wnt/B Catenin Signaling Pathway:
https://www.youtube.com/watch?v=NGVP4J9jpgs
Upper vs. Lower Motor Neuron Lesions:
https://www.youtube.com/watch?v=itNd74V53ng
Lesson on the Purine Synthesis and Salvage Pathway:
https://www.youtube.com/watch?v=e2KFVvI8Akk
Gastrulation | Formation of Germ Layers:
https://www.youtube.com/watch?v=d6Kkn0SECJ4
Introductory lesson on Autophagy (Macroautophagy):
https://www.youtube.com/watch?v=UmSVKzHc5yA
Watch the full episode and view show notes here: https://bit.ly/3LCmXHD
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Rhonda Patrick, Ph.D., is a scientist with expertise in the areas of aging, cancer, and nutrition who translates complex scientific topics into actionable insights on her podcast, Found My Fitness. In this episode, Rhonda provides her latest thinking as it relates to Alzheimer's disease including the possibility of a vascular hypothesis as well as the factors that can impact disease risk such as type 2 diabetes, blood pressure, omega supplementation, exercise, sauna, and more. She also touches on cancer risk including the relationship between cancer and exercise as well as the link between alcohol consumption and cancer. Additionally, Rhonda explains her new focus on exercise and protein consumption as well as how her perspective has shifted as it pertains to fasting and time-restricted feeding.
We discuss:
0:00:00 - Intro
0:00:38 - Alzheimer’s disease: Rhonda’s evolved thinking on neurodegenerative diseases
0:08:00 - The breakdown of the blood-brain barrier in neurodegenerative disease
0:16:03 - An explanation for the observation that type 2 diabetes increases risk of Alzheimer’s disease
0:20:53 - The role of omega-3 fatty acids (EPA and DHA) in brain health and prevention of neurodegeneration
0:35:30 - Comparing the preventable nature of type 2 diabetes, atherosclerosis, cancer, and dementia
0:38:53 - Blood pressure: an important modifiable lifestyle factor that can affect Alzheimer's disease risk
0:43:08 - Rhonda’s outlook on “precision medicine” as it pertains to one’s genetic predispositions
0:51:28 - Possible mechanisms by which exercise reduces the risk of Alzheimer’s disease
1:01:09 - Building your aerobic pyramid: neurobiological effects of exercise, benefits of lactate peaks, and more
1:06:55 - Maximizing mitochondrial biogenesis: alternative training approaches and strategies
1:19:44 - Possible brain benefits of sauna, and Rhonda’s personal protocol
1:27:30 - The relationship between cardiorespiratory fitness and dementia risk
1:33:45 - How exercise may reduce the risk of cancer
1:49:09 - The overarching impact of exercise of health, and the importance of focusing the factors that matter most
1:55:07 - Impact of alcohol consumption on breast cancer risk and overall health
2:00:45 - Exercise as an intervention for poor sleep habits
2:05:25 - The longevity benefits of consuming adequate protein and strength training to preserve muscle mass and strength
2:27:15 - How to get enough of the right kind of protein in your diet
2:35:35 - Fasting: weighing the risk vs. reward
2:39:38 - How Rhonda’s views have shifted on diet and exercise
2:46:17 - How to follow Rhonda’s work and more about the benefits of lactate for the brain
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 45 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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A couple of years ago, a Tennessee mom and dad got the news no parent ever wants to hear. Their daughter had cancer, a tumor the size of a baseball, in her chest. The 8 year old is undergoing experimental treatment at St. Jude for a rare form of cancer that so far she's beating. Grinning from ear to ear, little 8 year old Audrey Stranger looks every bit like a little girl beating cancer. She's got her St. Jude cheerleaders to thank.I wasn't really keeping up at the gym with kids at school when we were running and stuff like that, says Audrey.The pediatrician took a really long time listening to her heart, lungs and heard a brushing sound, says Lynn Stanger. Which led to the xray.The problem was in her little lung. An inflammatory myofibroblastic tumor, IMT for short.Really the thing that scared me more than anything was the size of it, says Marshall Stanger.It just shocked me to the core, says Lynn. That's impossible. She's a tiny kid, how can a baseball size tumor be in this child?7 hour surgery and left a 9 scar on her back, says Marshall. She was in the hospital for a while.Doctors back home in West Tennessee told them it probably wouldn't come back. The family celebrated with Mickey, but in just 2 months it was back, the size of a baseball again.I was really scared, says Audrey.It scared us pretty bad to see that it would grow that fast, says Marshall.Their local doctors sent them to the only place that could help, the children's research hospital that treats the sickest of the sick and takes the children everyone else has given up on. There were some long days and nights at the world renowned hospital. Instead of surgery, doctors opted for a ground-breaking protocol, an oral chemotherapy drug. The tumor is undetectable now.Something out of a movie or something, we're just so blessed they're giving us, says Marshall. Hey take this oral medicine twice a day like you would take benadryl or something and it's going to wipe out this baseball size tumor in your daughter and it's overwhelming. I can't describe to you how elated we are about how successful the treatment has been.Audrey has emerged a nearly healed 2nd grader. To celebrate this time, AC and the Tough Kids ran the St. Jude Country Music Marathon, raising $100,000 for this one of a kind hospital. Audrey will stay on the experimental drug for nearly a year as doctors treat her case with extreme caution. She told us she wants to be a teacher when she grows up. We told her she could teach us all a thing or 2 about living every day to the fullest and holding on to hope.
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Did you know that when a woman has a mastectomy she has four options: 1. Reconstruction (Paid for by Medicare), 2. Off-the-shelf prosthesis (Paid for by Medicare), 3. Custom Breast Prosthesis (Covered by some insurances, not Medicare) or 4. Do nothing.
Some women are not interested or are unable to have reconstruction and some women can't find an off-the-shelf prosthesis to fit them. So they are left with "do nothing" as off-the-shelf prosthesis are not covered. Join the Make Me Whole Again Campaign and help advocate for custom breast prosthesis coverage for Medicare patients; help make women feel whole again. www.makemewholeagain.com
Red Light Scrambler Series // Appendix Cancer Awareness 135 @ Kentucky
Happy Birthday Dawn Oldani
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Cancer in the urinary tract, bladder, and kidney can occur due to a variety of factors, including genetic mutations, exposure to environmental toxins, chronic inflammation, and lifestyle factors such as smoking.
Cancer is not "owned" by any one individual or group. It is a complex disease that can affect anyone regardless of age, gender, or ethnicity. While some individuals may have a higher risk of developing urinary tract, bladder, or kidney cancer due to genetic or environmental factors, anyone can develop these types of cancers.
It is important to understand the risk factors associated with urinary tract, bladder, and kidney cancer and to take steps to reduce your risk, such as maintaining a healthy lifestyle, avoiding exposure to environmental toxins, and getting regular medical check-ups. If you have concerns about your risk for these types of cancer, you should speak with your healthcare provider.
অধ্যাপক ডাঃ নিতাই পদ বিশ্বাস
এমবিবিএস, এফসিপিএস (সার্জারী)
এমএস (ইউরোলজি), এমআরসিএস (যুক্তরাজ্য)
ইউরোলজিস্ট ও ল্যাপারোস্কপিক সার্জন
অধ্যাপক ও বিভাগীয় প্রধান, ইউরোলজি
ন্যাশনাল ইন্সটিটিউট অব কিডনী ডিজিজেজ এন্ড ইউরোলজি, ঢাকা
চেম্বারঃ হেলথ এন্ড হোপ হাসপাতাল, পান্থপথ, ঢাকা। সিরিয়ালঃ ০১৬১১-০৭০০০৭, ০১৬৭৮-১৩১২৫২
Professor Dr. Nitai Pad Biswas
MBBS, FCPS (Surgery)
MS (Urology), MRCS (UK)
Urologist and laparoscopic surgeon
Professor and Head of Department, Urology
National Institute of Kidney Disease and Urology, Dhaka
Chamber: Health and Hope Hospital, Panthpath, Dhaka. Serial: 01611-070007, 01678-131252
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