Appropriate Patients for Hormonal Therapy

Hormonal treatments for breast cancer are used for women who:

• Are at high risk, but have not had breast cancer
• Had non-invasive breast cancer (DCIS) and want to reduce the risk of recurrence and a new breast cancer
• Have hormone receptor-positive breast cancer that appears to have been completely removed by surgery (Hormonal therapy is used as adjuvant therapy to get rid of any remaining breast cancer cells. It may be used alone or in combination with chemotherapy.)
• Have invasive breast cancer and need to shrink a large tumor before surgery or radiation
• Have cancer that remains after surgery or cancer that has recurred (come back)
• Have advanced disease

Hormone drugs are only effective in women whose cancer has the estrogen or progesterone receptor. Every breast cancer is tested for these receptors and your physician will share these results with you. If the cancer is negative for both these receptors, you will not benefit from the treatment.

notes from: http://www.fccc.edu/cancer/types/breast/treatment/hormonal/index.html

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Hormonal Therapy

Hormonal therapy is one of the major modalities of medical treatment for cancer. It involves the manipulation of the endocrine system through exogenous administration of specific hormones, particularly steroid hormones, or drugs which inhibit the production or activity of such homones (hormone antagonists). Because steroid hormones are powerful drivers of gene expression in certain cancer cells, changing the levels or activity of certain hormones can cause certain cancers to cease growing, or even undergo cell death.

Hormonal therapy is used for several types of cancers derived from hormonally responsive tissues, including the breast, prostate, endometrium, and adrenal cortex. Hormonal therapy may also be used in the treatment of paraneoplastic syndromes or to ameliorate certain cancer- and chemotherapy-associated symptoms, such as anorexia. Perhaps the most familiar example of hormonal therapy in oncology is the use of the selective estrogen-response modulator tamoxifen for the treatment of breast cancer, although another class of hormonal agents, aromatase inhibitors, now have an expanding role in that disease.

information obtain and edited from: wikipedia.com

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Carotid Sinus Massage

Definition

Carotid sinus massage involves rubbing the large part of the arterial wall at the point where the common carotid artery, located in the neck, divides into its two main branches.

Purpose

Sinus, in this case, means an area in a blood vessel that is bigger than the rest of the vessel. This is a normal dilation of the vessel. Located in the neck just below the angle of the jaw, the carotid sinus sits above the point where the carotid artery divides into its two main branches. Rubbing the carotid sinus stimulates an area in the artery wall that contains nerve endings. These nerves respond to changes in blood pressure and are capable of slowing the heart rate. The response to this simple procedure often slows a rapid heart rate (for example, atrial flutter or atrial tachycardia) and can provide important diagnostic information to the physician.

Description

The patient will be asked to lie down, with the neck fully extended and the head turned away from the side being massaged. While watching an electrocardiogram monitor, the doctor will gently touch the carotid sinus. If there is no change in the heart rate on the monitor, the pressure is applied more firmly with a gentle rotating motion. After massaging one side of the neck, the massage will be repeated on the other side. Both sides of the neck are never massaged at the same time.

Preparation

No special preparation is needed for carotid sinus massage.

Aftercare

No aftercare is required.

Risks

The physician must be sure there is no evidence of blockage in the carotid artery before performing the procedure. Massage in a blocked area might cause a clot to break loose and cause a stroke.

Normal results

Carotid sinus massage will slow the heart rate during episodes of atrial flutter

source from: http://www.healthline.com/galecontent/carotid-sinus-massage

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Listen to Your Heart

Go on this website to play and learn some interactive application on subjects like ECG or heart anatomy.

http://www.skillstat.com/learn.htm

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Video: Examination of Head and Neck Part 2

Check the links below to upload this video. This is especially for MSU students taking Clinical Medicine...also for you guys out there that want to learn.

http://www.4shared.com/file/205523426/4ccfa567/08V01.html
http://www.4shared.com/file/205523521/d3695af3/08V02.html
http://www.4shared.com/file/205523463/58c994ec/08V03.html
http://www.4shared.com/file/205662486/7d88fee6/08V04.html
http://www.4shared.com/file/205662509/242c0348/08V05.html

Should the link fail to direct you to the file, copy the link and paste it on your search box. May you will be able to gain benefit from this video.

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Video: Examination of Head and Neck Part 1

Check the links below to upload this video. This is especially for MSU students taking Clinical Medicine...also for you guys out there that want to learn.

http://www.4shared.com/file/205089183/b54112ff/07V01.html
http://www.4shared.com/file/205089297/a97159fe/07V02.html
http://www.4shared.com/file/205089238/c321ace5/07V03.html
http://www.4shared.com/file/205116335/227d1bed/07V04.html
http://www.4shared.com/file/205116527/d1e53732/07V05.html
http://www.4shared.com/file/205116450/1025e61/07V06.html
http://www.4shared.com/file/205231418/a360a20/07V07.html
http://www.4shared.com/file/205231557/ff27b882/07V08.html
http://www.4shared.com/file/205231497/52509db9/07V09.html

Should the link fail to direct you to the file, copy the link and paste it on your search box. May you will be able to gain benefit from this video.

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Video: Examination of Gastrointestinal System

Check the links below to upload this video. This is especially for MSU students taking Clinical Medicine...also for you guys out there that want to learn.

http://www.4shared.com/file/200940899/8e912dcb/04V01.html
http://www.4shared.com/file/200941569/b96dc532/04V02.html
http://www.4shared.com/file/200942554/fe4445a2/04V03.html
http://www.4shared.com/file/200956997/70e01c97/04V04.html
http://www.4shared.com/file/200957007/164ffb34/04V05.html
http://www.4shared.com/file/201259660/f69339e7/04V06.html
http://www.4shared.com/file/201057689/bcdb7af5/04V07.html
http://www.4shared.com/file/201063658/b6b0d9a9/04V08.html
http://www.4shared.com/file/201078632/ea5e3980/04V09.html

Should the link fail to direct you to the file, copy the link and paste it on your search box. May you will be able to gain benefit from this video.

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Importance of Pterion

The pterion is area where four bones, the pariental and frontal bones, the greater wing of the sphenoid bone, and the squamous part of the temporal bone, approach each other.

The pterion overlies the anterior branch of the middle meningeal artery on the internal aspect of the skull, and it corresponds to the stem of the lateral sulcus of the brain.

The center of the pterion is about 4 cm above the midpoint of the zygomatic arch and nearly the same distance behind the zygomatic process of the frontal bone.

The pterion is identifying as the weakest part of the skull.

Clinically, the pterion is relevant because the anterior division of the middle meningeal artery runs beneath it, on the inner side of the skull, which is quite thin at this point. The combination of both a vital artery in this area and the relatively thin bone structure has lent itself to the name "God's little joke" by some physicians.

A blow to the pterion (e.g. in boxing) may rupture the artery causing an extradural haematoma. The pterion may also fracture indirectly. Blows to the top or back of the head may not cause fracture at the site of impact, but may place sufficient force on the skull that its weakest part, the pterion, will fracture.

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Laboratory Notes

Laboratory notes of Pathophysiology of Nervous System

http://www.4shared.com/file/189658783/a716380/_2__3rd_lab.html
http://www.4shared.com/file/189668641/ea85d47/_2__pNS_lab_11.html
http://www.4shared.com/file/189670040/85f6103c/pNS_lab_12.html
http://www.4shared.com/file/189755480/a808871b/pNS_lab_2.html
http://www.4shared.com/file/189755573/b75ba059/pNS_lab_32.html
http://www.4shared.com/file/189755629/28bf035b/pNS_lab_31.html

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Video: Examination of Respiratory System

Check the links below to upload this video. This is especially for MSU students taking Clinical Medicine...also for you guys out there that want to learn.

http://www.4shared.com/file/189580136/26d2ac86/02V01.html
http://www.4shared.com/file/189581303/c6adb8c1/02V02.html
http://www.4shared.com/file/189582040/2b3b3dc8/02V03.html
http://www.4shared.com/file/189585182/f5954166/02V04.html
http://www.4shared.com/file/189590434/f37726f1/02V05.html
http://www.4shared.com/file/189592580/bc25999f/02V06.html
http://www.4shared.com/file/189597533/f106e1dc/02V07.html
http://www.4shared.com/file/189601171/d282a22b/02V08.html
http://www.4shared.com/file/189604472/7a9ec148/02V09.html
http://www.4shared.com/file/189610470/26921e83/02V10.html
http://www.4shared.com/file/189611920/eb811ef0/02V11.html

Should the link fail to direct you to the file, copy the link and paste it on your search box. May you will be able to gain benefit from this video.

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Video: Examination of Cardiovascular System

Check the links below to upload this video. This is especially for MSU students taking Clinical Medicine...also for you guys out there that want to learn.

http://www.4shared.com/file/186018104/8dd035ad/01V01.html
http://www.4shared.com/file/186020106/e1ca06be/01V02.html
http://www.4shared.com/file/186027675/af1aefff/01V05.html
http://www.4shared.com/file/186028179/fb80a507/01V06.html
http://www.4shared.com/file/186031570/c53dd345/01V07.html
http://www.4shared.com/file/186031858/f108aaa6/01V08.html
http://www.4shared.com/file/186039476/e82834a8/01V03.html
http://www.4shared.com/file/186041481/8640493b/01V04.html

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