...Multiple Myeloma Multiple Myeloma is a form of cancer which affects the plasma cells of the body, which are white blood cells. Multiple Myeloma, first described in 1848, is a disease “characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein.” To understand how Multiple Myeloma affects an infected person’s plasma cells, it helps to have a general understanding of how normal blood cells are formed and how they act. Most blood cells develop from stem cells, which can be found in bone marrow (soft material inside our bones – the “filling”). Stem cells mature into white blood cells, red blood cells, or platelets.2 The purpose of white blood cells is to fight off infection, while red blood cells carry oxygen and platelets aid in blood clotting, which controls bleeding. Plasma cells make antibodies, which are parts of the immune system and help the body protect itself from germs and other harmful substances (Exhibit 1).2 Myeloma begins when a plasma cell begins dividing uncontrollably, which sets off a chain reaction of abnormal cell divisions. These abnormal plasma cells are called myeloma cells. Eventually, there is a large buildup of myeloma cells in the bone marrow, potentially damaging the outer, solid part of the bone. The reason the disease is called multiple myeloma because it usually affects several bones in any given infected person. The myeloma cells, instead of creating the normal antibodies, create...
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...Multiple Myeloma Pamela Haverly B.S.N., R.N. Multiple Myeloma Multiple Myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. Plasma cells become cancerous and grow out of control they can produce a tumor called a plasmacytoma. Theses tumors can develop in a bone but are also rarely found in other tissues. If there is only a single plasma cell tumor, it is called an isolated or solitary plasmacytoma. When there is more than one plasma cell tumor, it is called multiple myeloma. In the United States , the risk of getting multiple myeloma is 1 in 149% (0.67%). The American Cancer Society estimates in 2013: About 22,350 new cases will be diagnosed (12,440 men and 9,910 women). About 10,710 deaths will occur (6,070 men and 4,640 women). (https://www.cancer.org/cancer/multiplemyeloma/detailsguide/multiple-myeloma-key-statistics.) Most people who develop multiple myeloma have no clear risk factors: However some risk factors have been identified. Risk factors concerning multiple myeloma included: age, gender, race, obesity, employment in the petroleum industry and exposure to radiation. Most first diagnosis is usually seen in patient’s in the early to mid 60’s, men are diagnosed much more frequently than women, African American’s are diagnosed twice as often as white Americans, a study by the American Cancer Society shows that obesity increases the risk of multiple myeloma, exposure...
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...Evidence-Based Nursing Care for Multiple Myeloma Patients Evidence-Based Nursing Care for Multiple Myeloma Patients Comprised of the blood cells, blood, lymph, and other organs involved in the formation or storage of blood, the hematologic system allows the human body to maintain adequate oxygenation and tissue perfusion (Ignatavicius & Workman, 2010, p. 876). Because every cell, tissue, organ, and system is dependent on blood circulation for survival, hematologic problems involving impaired production, impaired function, or abnormal destruction of blood cells are likely to have wide-reaching effects on the patient's health and wellness (Ignatavicius & Workman, 2010, p. 876). This is especially clear when examining cancers of the hematologic system, including multiple myeloma. A cancer of certain white blood cells in the bone marrow known as plasma cells, “myeloma” refers to a tumor of the bone marrow, and “multiple” refers to more than one area of the bone marrow being affected (Mangan, 2006, p. 64hn1). Because the disease is incurable, and because only 30 percent of patients survive longer than five years after diagnosis, living with multiple myeloma can be difficult for patients and their families (Mangan, 2006, p. 64hn1). As health care providers on the front lines of patient care, nurses must be aware of the multi-system manifestations of multiple myeloma, be able to make the assessments needed to identify and prevent complications...
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...BS/TUMOR - Type x collagen is important for mineralization (locations include in cartilage deep to the tidemark and in the ZPC of the growth plate) - Myositis Ossificans should not be resected until completely ossified - Desmoid tumors contain E receptors and Tamoxifen is useful in the Treatment - A mutation in CBFA 1 leads to Cleidocranial Dysplasia - Chromium and Tantulum are very resistant to corrosion - Molybdenum is added to cobalt alloys to increase strength - IGN is the sole motor innervation of gluteus maximus - Lipomas are bright on T1 - Osteoarthritis leads to increase water and decreased proteoglycans and collagen in cartilage (very commonly asked) - CD 31 is a sensitive marker for angiosarcoma - AIIS is the origin of Rectus Femoris - Anakinra is an IL-1 antagonist used as Tx of RA - Etaneracept and Adalimumab block TNF alpha in the Tx of RA - TOC for PVNS is total synovectomy - Joint motion improves chondrocyte nutrition - Synovial Chondromatosis is a benign metaplastic process of joints that leads to stippled calcifications and loose bodies - If PE is irradiated in air, catastrophic failure and delamination occur - Osteocalcin is the most abundant non collagenous protein in bone - High Rates of Telomerase results in increased recurrence rates in patients with chondrosarcoma - X linked hypophosphatemic rickets caused by mutation in the PEX gene; MHE caused by defects in the EXT-1 or 2 genes - Synovial Sarcoma a/w translocation of X;18, Ewings...
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...| 2012 | | Leukemia and Lymphoma Society Tawanda Bryant | [Leukemia and Lymphoma Society] | The Leukemia & Lymphoma Society (LLS) is: Cure leukemia, lymphoma, Hodgkin’s disease and myeloma, and improves the quality of life of patients and their families. Providing free information and support services, Leukemia and Lymphoma funds lifesaving blood cancer research around the world. | LEUKEMIA & LYMPHOMA SOCIETY TAWANDA BRYANT 11410 COUNTY ROAD 20 BOLIGEE, AL 35443 (205) 336-9851 tbryant3030@yahoo.com LEADERSHIP and ORGANIZATIONAL MAR12 SEC AA March 9, 2012 INSTRUCTOR: SHAROLYN HERGOTT LEUKEMIA & LYMPHOMA SOCIETY I have picked this organization because my best friend passed away last year with leukemia and I wanted to find out more on this disease and what I can do to help. Been passionate and concern about not only her health but the health of her kids, my research will show why it is important to me as well as others. Having a passion for helping other in any way I can is what I am going for. I also like the face that I can somewhat relate to their illness and pain they endure within their life. I would love to find a quicker cure for these diseases, but I know others are working on something better. Having someone close to you with any type of disease, not just leukemia or lymphoma is hard to take in and understand. Having the ability to communicate, have critical thinking, collaboration, and the ability to problem solve is what I aim...
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...Overview Hypercalcemia is the most common life-threatening metabolic disorder associated with neoplastic diseases, occurring in an estimated 10% to 20% of all adults with cancer. It also occurs in children with cancer, but with much less frequency (approximately 0.5%–1%).[1-3] Solid tumors (such as lung or breast cancer tumors) as well as certain hematologic malignancies (particularly multiple myeloma) are most frequently associated with hypercalcemia.[4] Although early diagnosis followed by hydration and treatment with agents that decrease serum calcium concentrations (hypocalcemic drugs) can produce symptomatic improvements within a few days, diagnosis may be complicated because symptoms may be insidious at onset and can be confused with those of many malignant and nonmalignant diseases. However, diagnosis and timely interventions not only are lifesaving in the short term but also may enhance the patient’s compliance with primary and supportive treatments and may improve quality of life.[5] When a patient has a refractory, widely disseminated malignancy for which specific therapy is no longer being pursued, the patient may want to consider withholding therapy for hypercalcemia. For patients or families who have expressed their wishes regarding end-of-life issues, this may represent a preferred timing and/or mode of death (as compared with a more prolonged death from advancing metastatic disease). This option is best considered long before the onset of severe hypercalcemia or...
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...various types of cancers. One type of cancer that seemed to have a presence among farmers who sprayed their crops with pesticides was cancer known as non-Hodgkin’s Lymphoma. This cancer is the most prevalent when relating to the people who administer the pesticides. Alavanja states that “Non-Hodgkin’s lymphoma (NHL) is among the most widely studied cancers in relation to pesticide use. In reviews of the literature, Blair & Zahm (32, 34) reported that NHL has been linked with phenoxyacetic acid herbicides, organochlorine pesticides, and organophosphate pesticides in analytical epidemiological studies”(Alavanja). This shows how many different types of these pesticides have been traced back to these chemicals that are found in something as simple as a Granny Smith apple. Alavanja also discusses other types of cancer that have been linked to the use of pesticides including Leukemia, Multiple Myeloma, Soft-Tissue Sarcoma, Prostate Cancer, Lung Cancer, Ovarian...
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...Know your acid-bases! Week 5 Topic 5 Cardiovascular Causes of Fatigue Cor-pulmonale, cardiomyopathies Week 6 Topic 6 Thyroid, Adrenal, Liver Fatigue Hashimoto’s thyroiditis vs. DeQuervain vs. nodular goiter vs. secondary hypothyroidism Cirrhosis, Addison disease lab tests and hormone responsible. Is it high or low? Week 7 Topic 7 Bleeding as Indicator of Disease Pathophysiology of Disseminated Intravascular Coagulation Pathophysiology of Hemophilia Ulcers Week 8 Topic 8 Fever and Chills Beta-hemolytic streptococcus and Rheumatic fever signs/symptoms and lab findings (and Infective Endocarditis). Acute lymphocytic leukemia, Acute myelogenous leukemia, Chronic myelogenous leukemia, Hodgkin lymphoma, Burkitt lymphoma, Multiple Myeloma signs, symptoms, and lab findings Glomerulonephritis, mononucleosis Week 9 Topic 9 Respiratory...
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...Australian obstetrician Dr. William McBride discovered that the drug also alleviated morning sickness, helping improve overall women’s health. When this was discovered McBride started recommending this off-label drug to pregnant women, initiating a worldwide trend. With its popularity growing in European countries and its multiple uses, sales of Thalidomide almost reached that of aspirin. Grunenthal saw Thalidomide as an Innocent-until-proven-guilty case and pushed for its rapid production and minimal research into the effects on humans of all stages of development because of its high demand. Less than a year after it was originally produced the first documented baby born with the effects of Thalidomide was a little girl, daughter of an employee of Grunenthal, born without ears. The defect was not attributed to the drug until years later, during the time the drug was waiting for approval by the FDA in the United States. Dr. Frances Kelsey, a newly employed doctor by the FDA was assigned Thalidomide as her first case. Because the rest of the world expected its quick approval, almost two million capsules were produced and ready for distribution. When Dr. Kelsey declined the production of Thalidomide in the United States everyone was shocked. Despite the pressure from pharmaceutical...
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...IMPLANT DENTISTRY / VOLUME 20, NUMBER 5 2011 331 Identification and Treatment of Bisphosphonate-Associated Actinomycotic Osteonecrosis of the Jaws Cameron Y. S. Lee, DMD, MD, PHD,* Francis D. Pien, MD, MPH,† and Jon B. Suzuki, DDS, PHD, MBA‡ isphosphonates (BPs) are a pharmacologic class of synthetic analogs of inorganic pyrophosphate that has an affinity for calcium.1 They are used in the treatment of various malignant and benign metabolic conditions, such as hypercalcemia of malignancy; Paget’s disease of bone; multiple myeloma; and metastases from distant sites such as breast, thyroid, prostate glands, and lung. The oral form of BPs is indicated in the management of osteoporosis, fibrous dysplasia, and most recently, osteogenesis imperfecta in the pediatric population.2,3 Currently, there are 5 bisphosphonates in clinical use: alendronate (Fosamax; Merck, Whitehouse Station, NJ), risedronate (Actonel; Proctor & Gamble Pharmaceuticals, Cincinnati, OH), ibandronate (Boniva; Roche Pharmaceuticals, Nutley, NY), zoledronate (Zometa; Novartis Pharmaceuticals, East Hanover, NJ), and pamidronate (Aredia; Novartis Pharmaceuticals). All 5 medications differ in their binding affinity to bone, potency, and duration.2–5 B Osteonecrosis of the jaws (ONJ) is a condition characterized by necrotic exposed bone in the jaws of patients receiving intravenous or oral bisphosphonate therapy. A review of the medical and dental literature reveals that the pathoetiology of ONJ remains...
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...Chronic Obstructive Pulmonary Disease | INTRODUCTION We are doing a case study on medical, nursing, pharmacological management of COPD (Chronic Obstructive Pulmonary Disease). We took a COPD patient and assessed the patient for clinical manifestation, the medical, nursing, pharmacological care given to the patient. In our case study we will include the care Hawwa is receiving now and the care we can add to daily routine to help her recover faster. Hawwa Ismail is admitted to Medical ward with diagnosis of COPD. She is 145cm tall, slim, with dark complexion. She is 79 years old. She said that she has difficulty in breathing, she cannot sleep in night time ,she do not feel like eating food and she was having cough. Physical assessment revealed BP 138/47mmHg right arm in lying position, pulse 84 regular and strong, and breathing pattern was irregular labored, tachypnic at 40 breathes per minute,SpO2 99% in room air and temperature 360C (96.80F).Her facial color and lips are ruddy, but nails are clean ,pale and clubbed. She has a little barrel chest, uses accessory muscle to breathe. She has prolonged expiration. While auscultating lungs, diminished breath sound in most of the lower lobes and a small wheezing sound in right lower lobe was noted. PERSONAL DETAILS PATIENT NAME: Hawwa Ismail ADDRESS:Iruvaige/R.Inguraidhoo GUARDIAN: NAME: Abdul HameedHussain CONTACT NO: 7772099 AGE: 79yrs SEX: female NATIONALITY: Maldivian LANGUAGE: Dhivehi RACE: Asian ...
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...sedentary lifestyle.” said John, one of many victims of obesity. At first, he was not sure to share his story but after sharing he narrated as was his experience when he started gaining weight as a teenager: “I was 12 years old when I started putting the weight on and like many children today, I spent long hours in front of screens, TV, video games, movies and the computer, coupled with sugary treats, pop, chips and other snacks. Became my after school past-time. At the age of, 14 I woke up one morning, had a shower like I did every morning, but this morning was different. I normally avoided mirrors whenever I could, but not that day. As I stepped from the shower I caught myself in the mirror. I saw my protruding belly, chubby cheeks and multiple chins, my gaze wandering until eventually ending in a standoff, staring face-to-face with what I had become. As I looks into my own eyes, I started to sob, shedding uncontainable tears. It was that exact moment, my turning point, when I came to a stark realization that something had to change.” He thought “Enough is enough!” and that was in that moment he never looked back and his life changed forever. Nowadays, obesity in adolescents is a serious issue because they eat more and more junk food and this occurs because adolescents have a sedentary lifestyle, lack of adequate physical activity and poor eating habits. Unfortunately, this brings consequences like physical and psychological problems, lower self-steem, risk of heart disease, depression...
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...Genetically Modified Organisms. This is extremely alarming because GMOs are plants or animals that have been genetically engineered with DNA from bacteria, viruses or other plants and animals. These experimental combinations cannot occur in nature or in traditional cross breeding (“Non GMO Project”). Obesity, chronic disease, and food allergies have skyrocketed in the United States over the past two decades. Many people think it is due to poor eating and exercise habits. While a portion of this may be true, the more logical explanation is the fact that corporations have altered the food supply in a way that is harmful to the human body. GMO crops adversely affect human health. Numerous studies have been done recently and even more are currently being conducted around the globe. These studies illustrate the correlation between the introduction of GMOs into the food supply and the increase in health issues. This is such an important issue to literally every human being on the planet. Not all countries are addressing the issue in the same manner. It is crucial to know what the United States is doing as compared to other industrialized nations around the world. There were several reasons that corporations began altering the DNA of seeds. One of those reasons was that GMOs were supposed to reduce the amount of pesticides necessary to keep weeds under control. The GMO seeds were produced to be Roundup Ready (RR). A Roundup Ready seed means that plants are resistant to the pesticide...
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...Leading Edge Review Immunity, Inflammation, and Cancer Sergei I. Grivennikov,1 Florian R. Greten,2 and Michael Karin1,* 1Laboratory of Gene Regulation and Signal Transduction, Departments of Pharmacology and Pathology, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA 22nd Department of Medicine, Klinikum rechts der Isar, Technical University Munich, 81675 Munich, Germany *Correspondence: karinoffice@ucsd.edu DOI 10.1016/j.cell.2010.01.025 Inflammatory responses play decisive roles at different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis. Inflammation also affects immune surveillance and responses to therapy. Immune cells that infiltrate tumors engage in an extensive and dynamic crosstalk with cancer cells, and some of the molecular events that mediate this dialog have been revealed. This review outlines the principal mechanisms that govern the effects of inflammation and immunity on tumor development and discusses attractive new targets for cancer therapy and prevention. Introduction The presence of leukocytes within tumors, observed in the 19th century by Rudolf Virchow, provided the first indication of a possible link between inflammation and cancer. Yet, it is only during the last decade that clear evidence has been obtained that inflammation plays a critical role in tumorigenesis, and some of the underlying molecular mechanisms have been elucidated (Box 1)...
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...sector had a stellar 2013 (NBI: +65%; S&P: +29%) driven by strong demand for the sector’s key products, many positive phase 3 studies and a wave of successful IPOs. Looking to 2014, we think the fundamental backdrop is very similar with 1) beatable revenue growth expectations (2014e: +16% vs. 2012/2013: +12%) including several high-profile drug launches, 2) many pivotal studies set to read out and 3) a stable/favorable regulatory and reimbursement environment. Notably, these factors should continue to make biotech attractive to generalist investors, who played a major role in the 2013 outperformance. Our bias is to stick with large caps as well as mid-caps with approved products; revenue/EPS/cash flow forecasts for 2015 and beyond look broadly beatable, in our view. In contrast, we suspect that “pure pipeline” or tech platform small caps could be more volatile in 2014. We continue to believe that the biotech industry is in the early innings of an innovation cycle with many labelexpansion opportunities and novel agents in phase 2 or 3 trials that are largely unaccounted for in Street models. Hence, we are bullish on the group for 2014. Please join us for a call today at 11am ET to discuss our sector outlook/favorite names (US dial-in: 888-889-1309; OUS: 773-756-0161; Passcode: BIOTECH). Large-cap biotech: We don’t believe that a strict assessment of P/E multiples accurately addresses the nuances of the sector (2014e – Biotech: 22x vs. S&P 500: 15x). In our view, large caps are poised...
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