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Small cell lung cancer, which occurs almost exclusively in smokers, is a malignancy characterised by rapid doubling time, high growth fraction and widespread metastasis at presentation. In this presentation, we will briefly discuss the classification of pulmonary Neuro-endocrine tumours by the World Health Organisation followed by a detailed discussion of the clinical features, lab evaluation and management of SCLC, both limited and extended stage. The frontline therapy in small cell lung cancer is etoposide and cisplatin along with thoracic radiotherapy and prophylactic cranial irradiation in patients who have a good response to therapy. Hyperfractionation of radiotherapy may provide some benefit but is also associated with increase incidence of complications. Newer agents for SCLC include Vandetanib and immunotherapy molecules, such as Iplimumab and nivolumab.
Barrett's esophagus is a complication of chronic (long lasting) and usually severe gastrointestinal reflux disease (GERD), but occurs in only a small percentage of patients with GERD. Criteria are needed for screening patients with GERD for Barrett's esophagus. Until validated criteria are available, it seems reasonable to do screening endoscopies in GERD patients who cannot be taken off acid suppression therapy after two to three years. The diagnosis of Barrett's esophagus rests upon seeing (at endoscopy) a pink esophageal lining that extends a short distance (usually less than 2.5 inches) up the esophagus from the gastroesophageal junction and finding intestinal type cells (goblet cells) on biopsy of the lining. There is a small but definite increased risk of cancer of the esophagus (adenocarcinoma) in patients with Barrett's esophagus.
Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract camera.gif and pass from the body. See a picture of ESWL camera.gif. You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone. The process takes about an hour. You may receive sedatives or local anesthesia. Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.
Aortoiliac occlusive disease (AIOD) occurs commonly in patients with PAD. Significant lesions in the aortoiliac arterial segment are exposed easily by palpation of the femoral pulses. Any diminution of the palpable femoral pulse indicates that a more proximal obstruction exists. Obstructive lesions may be present in the infrarenal aorta, common iliac, internal iliac (hypogastric), external iliac, or combinations of any or all of these vessels. Occasionally, degenerated nonstenotic atheromatous disease exists in these vessels and may manifest by atheroembolism to the foot, the "blue toe" or "trash foot" syndrome. Generally, patients with aortoiliac PAD have a poorer general prognosis than those with more distal PAD.
Symptoms Burning stomach pain Feeling of fullness, bloating or belching Fatty food intolerance Heartburn Nausea The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night. Nearly three-quarters of people with peptic ulcers don't have symptoms. Less often, ulcers may cause severe signs or symptoms such as: Vomiting or vomiting blood — which may appear red or black Dark blood in stools, or stools that are black or tarry Trouble breathing Feeling faint Nausea or vomiting Unexplained weight loss Appetite changes
The anus is close to the vagina and sometimes it’s hard to say what’s going on inside the body. Is it possible to get pregnant from anal sex? The answer is yes and this video explains the circumstances. Please protect yourselves and stay curious.
Abdominal aortic aneurysms can weaken the aorta, your body’s largest blood vessel. This can develop into a potentially serious heath problem that can be fatal if the aneurysm bursts, causing massive internal bleeding. Endovascular stent grafting, or endovascular aneurysm repair (EVAR), is a newer form of treatment for abdominal aortic aneurysm that is less invasive than open surgery. Endovascular stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing.
nee joint aspiration and injection are performed to aid in diagnosis and treatment of knee joint diseases. The knee joint is the most common and the easiest joint for the physician to aspirate. One approach involves insertion of a needle 1 cm above and 1 cm lateral to the superior lateral aspect of the patella at a 45-degree angle. Once the needle has been inserted 1 to 1½ inches, aspiration aided by local compression is performed. Local corticosteroid injections can provide significant relief and often ameliorate acute exacerbations of knee osteoarthritis associated with significant effusions. Among the indications for arthrocentesis are crystal-induced arthropathy, hemarthrosis, unexplained joint effusion, and symptomatic relief of a large effusion. Contraindications include bacteremia, inaccessible joints, joint prosthesis, and overlying infection in the soft tissue. Large effusions can recur and may require repeat aspiration. Anti-inflammatory medi
This 3D medical animation contains the discharge instructions for removal of a Foley catheter from a man. The step-by-step procedures for emptying the Foley bag and removing the Foley catheter are shown. Symptoms requiring a follow-up call to the surgeon are listed.
The MINI tummy-tuck is a lesser variant of the classic tummy tuck. The MINI tummy-tuck always involved skin excision (often a scar revision and skin excision of the flabby skin over a C-section scar or hysterectomy or laparotomy scar) but may also involve liposuction, umbilical floating, etc. Commonly it will not include any muscle repair otherwise it it now a classic tummy tuck (aka abdominoplasty). Cost varies depending on the components involved. Here, Toronto Aesthetic Plastic Surgeon Dr Marc DuPéré describes a MINI tummy-tuck done on a patient who had a Brazilian Butt Lift before (and skin harvesting from abdomen) and a recent 20 lbs weight loss, a patient who wants more liposuction to abdomen and flanks and whose skin has now lost elasticity, hence the requirement for this small skin excision. Dr DuPéré also explains what UMBILICAL floating means. Dr DuPéré performs more than 5 different techniques of tummy-tucks in Toronto and the technique chosen reflects the patient’s expectations and anatomy. Call us if interested in learning about YOUR options for a flatter tummy! 📱 416-929-9800
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Visage Clinic Toronto
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