(BQ) Part 1 book "Basic musculoskeletal imaging" presents the following contents: Imaging modalities used in musculoskeletal radiology, axial skeletal trauma, pediatric skeletal trauma, arthritis and infection, metabolic bone diseases, bone infarct and osteochondrosis,...
I wanted to write this report to you for quite some time, it ended up taking much longer than I anticipated getting it to you, as I kept on refining the way I wanted to write, and deliver it to you. The reason for that is… The information you will read in this report has the power to absolutely transform your life in a way you have never imagined, or conceived possible. It has helped turn terminal patients(people labeled “soon to be dead” with no hope) into lively, thriving, and healthy individuals. It has cured cancer, arthritis, brittle bone disease,...
Because the field of nutrition is actively evolving and creating major new principles in the care of the
pediatric patient, we have embarked on the third edition of this textbook. The editors continue to support
the premise that a comprehensive text as a reference source in pediatric nutrition is essential for the proper care
of infants and children. As medical care in the twenty-first century is predicated on prevention of disease, the
discipline of pediatric nutrition becomes that much more important.
Harrison's Internal Medicine Chapter 4. Screening and Prevention of Disease
Screening and Prevention of Disease: Introduction
A primary goal of health care is to prevent disease or to detect it early enough that intervention will be more effective. Strategies for disease screening and prevention are driven by evidence that testing and intervention are practical and effective. Currently most screening tests are readily available and inexpensive. Examples include tests that are biochemical (e.g., cholesterol, glucose), physiologic (e.g., blood pressure, growth curves), radiologic (e.g.
TRUS is the imaging technique most frequently used to assess the primary tumor, but its chief use is directing prostate biopsies, not staging. No TRUS finding consistently indicates cancer with certainty. CT lacks sensitivity and specificity to detect extraprostatic extension and is inferior to MRI in visualization of lymph nodes. In general, MRI performed with an endorectal coil is superior to CT to detect cancer in the prostate and to assess local disease extent.
Pure Red Cell Aplasia: Treatment History, physical examination, and routine laboratory studies may disclose an underlying disease or a suspect drug exposure. Thymoma should be sought by radiographic procedures. Tumor excision is indicated, but anemia does not necessarily improve with surgery. The diagnosis of parvovirus infection requires detection of viral DNA sequences in the blood (IgG and IgM antibodies are commonly absent). The presence of erythroid colonies has been considered predictive of response to immunosuppressive therapy in idiopathic PRCA.
Epidemiology Idiopathic MDS is a disease of the elderly; the mean age at onset is 68 years. There is a slight male preponderance. MDS is a relatively common form of bone marrow failure, with reported incidence rates of 35 to 100 per million persons in the general population and 120 to 500 per million in the elderly. MDS is rare in children, but monocytic leukemia can be seen.
Therapy-related MDS is not age-related and may occur in as many as 15% of patients within a decade following intensive combined modality treatment for cancer. Rates of MDS have increased over time,...
Nonsteroidal antiandrogens such as flutamide, bicalutamide, and nilutamide block the binding of androgens to the receptor. When an antiandrogen is given alone, testosterone levels remain the same or increase. Compared to testosteronelowering therapies, antiandrogens cause fewer hot flashes, less of an effect on libido, less muscle wasting, fewer personality changes, and less bone loss. Gynecomastia remains a significant problem but can be alleviated in part by tamoxifen.
Metastatic Disease: Castrate
Castration-resistant disease can manifest in many ways. For some it is a rise in PSA with no change in radiographs and no new symptoms. In others it is a rising PSA and progression in bone with or without symptoms of disease. Still others will show soft tissue disease with or without osseous metastases, and others have visceral spread. The prognosis, which is highly variable, can be predicted using nomograms designed for the castration-resistant disease state.
Pathophysiology Bone marrow failure results from severe damage to the hematopoietic cell compartment. In aplastic anemia, replacement of the bone marrow by fat is apparent in the morphology of the biopsy specimen (Fig. 102-1) and MRI of the spine. Cells bearing the CD34 antigen, a marker of early hematopoietic cells, are greatly diminished, and in functional studies, committed and primitive progenitor cells are virtually absent; in vitro assays have suggested that the stem cell pool is reduced to ≤1% of normal in severe disease at the time of presentation.
Persistent Parvovirus B19 Infection Chronic parvovirus infection is an important, treatable cause of PRCA. This common virus causes a benign exanthem of childhood (fifth disease) and a polyarthralgia/arthritis syndrome in adults. In patients with underlying hemolysis (or any condition that increases demand for red blood cell production), parvovirus infection can cause a transient aplastic crisis and an abrupt but temporary worsening of the anemia due to failed erythropoiesis.
Incidence and Epidemiology
Bone sarcomas are rarer than soft tissue sarcomas; they accounted for only 0.2% of all new malignancies and 2370 new cases in the United States in 2007. Several benign bone lesions have the potential for malignant transformation. Enchondromas and osteochondromas can transform into chondrosarcoma; fibrous dysplasia, bone infarcts, and Paget's disease of bone can transform into either malignant fibrous histiocytoma or osteosarcoma.
G1,2 low grade
G1,2 low grade
Stage IVA T
Stage IVB T
Any T N
Osteosarcoma, accounting for almost 45% of all bone sarcomas, is a spindle cell neoplasm that produces osteoid (unmineralized bone) or bone.
Myelodysplasia, and Related Bone Marrow Failure Syndromes
Aplastic Anemia, Myelodysplasia, and Related Bone Marrow Failure Syndromes: Introduction
macrocytic and are characterized by a low reticulocyte count. Deficient production of RBCs occurs with marrow damage and dysfunction, which may be secondary to infection, inflammation, and cancer.
Aplastic anemia is pancytopenia with bone marrow hypocellularity. Acquired aplastic anemia is distinguished from iatrogenic marrow aplasia, marrow hypocellularity after intensive cytotoxic chemotherapy for cancer. Aplastic anemia can also be constitutional: the genetic diseases Fanconi's anemia and dyskeratosis congenita, while frequently associated with typical physical anomalies and the development of pancytopenia early in life, can also present as marrow failure in normal-appearing adults.
Outcomes following both transplant and immunosuppression have improved with time. High doses of cyclophosphamide, without stem cell rescue, have been reported to produce durable hematologic recovery, without relapse or evolution to MDS, but this treatment can produce sustained severe fatal neutropenia and response is often delayed. New immunosuppressive drugs in clinical trial may further improve outcome.
Discoid lupus erythematosus.
Violaceous, hyperpigmented, atrophic plaques, often with evidence of follicular plugging, which may result in scarring, are characteristic of discoid lupus erythematosus (also called chronic cutaneous lupus erythematosus).
Scleroderma and Morphea
The skin changes of scleroderma (Chap. 316) usually begin on the hands, feet, and face, with episodes of recurrent nonpitting edema.
(BQ) Part 2 book "Clinical medicine" presents the following contents: Malignant disease, palliative medicine and symptom control, rheumatology and bone disease, kidney and urinary tract disease, water, electrolytes and acid–base balance, diabetes mellitus and other disorders of metabolism;... and other contents.