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Books on the topic 'High malignancy'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, and Gareth Morris-Stiff. Malignancy of unknown primary. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0026.

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Bone and soft tissue malignancies describes a large group of sarcomas, some of which require highly specialist management, including osteosarcoma, Ewing’s sarcoma, and rhabdomyosarcoma, so that referral to an appropriate multidisciplinary team (MDT) is mandatory. Limb conserving surgery combined with pre- and postoperative chemotherapy is curative in the majority of osteosarcomas, and similar approach which may include local radiotherapy also holds for Ewing’s. Other primary bone tumours are reviewed including malignant fibrous histiocytoma, chondrosarcoma, chordoma, solitary plasmacytoma, and

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2

Shinmura, Shuichi. High-dimensional Microarray Data Analysis: Cancer Gene Diagnosis and Malignancy Indexes by Microarray. Springer, 2019.

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3

Govindan, Kalyani. Thyroid Mass Resection. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0045.

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Pediatric thyroid nodules are fairly uncommon. However, thyroid nodules that do exist in the pediatric population are more likely to be of a malignant nature compared to the adult population. Malignancy occurs anywhere from 16% to as high as 26% in pediatrics compared to 5% in the adult population. The thyroid mass poses several concepts to consider. Depending on the size of the mass, potential for discomfort, and respiratory compromise, the anesthesiologist must be able to identify patients who are at risk for cardiopulmonary complications and formulate an acceptable anesthetic plan. This cha

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4

Durand, Melissa A. Architectural Distortion (Cancer). Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0029.

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An architectural distortion (AD) is an alteration of the breast parenchyma, which results in radiating lines or spicules emanating from a point without a distinct mass. It can occur as the primary finding, or it may be an associated feature of a mass, asymmetry, or calcifications. AD is a mammographic finding with a high positive predictive value for malignancy and is a major cause of false-negative screening exams. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols, differential diagnoses, management reco

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5

Ajzensztejn, Daniel. Prostate cancer. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0326.

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Prostate cancer is the commonest male malignancy, with approximately 35 000 new cases in the UK annually, equating to a lifetime risk of 1 in 10. When diagnosed early, it has a high chance of cure with surgery, external beam radiotherapy, or brachytherapy. Even for metastatic disease, the prognosis is usually several years.

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6

Swales, Catherine. Inflammatory connective tissue disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.010005.

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♦ Systemic lupus erythematosus (SLE) is the commonest multisystem connective tissue disease♦ All patients with SLE are antinuclear antibody (ANA) positive, but not all ANA-positive patients have SLE♦ Renal lupus carries a high mortality and requires aggressive immunosuppression♦ Dermatomyositis may be associated with malignancy in the elderly♦ The vasculitides are classified according to vessel size and ANCA (antineutrophil cytoplasmic antibody) profile♦ Therapy for vasculitis includes corticosteroids, steroid-sparing agents, and cytotoxics.

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7

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Madhumita Bhattacharyya. Gynaecological cancers. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0020_update_001.

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Genitourinary cancers examines the malignancies arising in the kidney, ureter, bladder, prostate, testis, and penis. Renal cancer has high propensity for systemic spread, largely mediated by overexpression of vascular endothelial growth factor (VEGF). Treatments include surgery, immunotherapy, and targeted therapy. Wilms tumour, a childhood malignancy of the kidney, warrants specialist paediatric oncology management to provide expertise in its unique pathology, staging, and treatment, often with surgery and chemotherapy. Cancer of the bladder and ureters, another tobacco related cancer, may pr

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8

Blot, William J., and Robert E. Tarone. Esophageal Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0030.

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Cancer of the esophagus is the eighth most common malignancy worldwide in terms of incident cases and the sixth most common for cancer deaths. The two main histopathologic subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EADC), have strikingly different clinical and epidemiologic features. ESCC occurs throughout the esophagus and is the most common histologic subtype globally; over 90% of cases in the traditionally high-risk regions of Eastern Asia and Eastern and Southern Africa are ESCC. The incidence of ESCC is decreasing worldwide. In some high-risk areas

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9

Kadioglu, Ates, and Emre Salabaş. Scrotal swelling. Edited by David John Ralph. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0110.

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Scrotal swelling is a common urological pathology composed of both benign and malign diseases originating from testicles, epididymis, tunical layers, or the scrotum wall itself. Emergencies usually present with pain and short onset time while malign lesions are usually palpated as smooth, solid, painless masses. Hydrocele is the abnormal collection of serous fluids encapsulated between tunica albuginea and vaginalis of the testis. Hydrocele might be primary or occur secondary to trauma, infection, epididymitis, or tumours. Although physical examination is enough for diagnosis, ultrasound shoul

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10

Liu, Yang. Perioperative Management of Pheochromocytoma. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0044.

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Pheochromocytomas are rare neuroendocrine tumors that arise from catecholamine producing cells in the adrenal glands. In the pediatric population, catecholamine-secreting tumors typically present around ages 11 and 12 and occur in 0.8% to 1.7% of hypertensive children. Pheochromocytomas represent significant management challenges to the anesthesiologist, particularly when undiagnosed. Many different anesthetic techniques and various antihypertensive agents have been successfully used to attenuate the intraoperative variations in blood pressure. After resection, periodic follow-up is highly rec

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11

Chang, Ellen T., and Allan Hildesheim. Nasopharyngeal Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0026.

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The main epithelial malignancy arising in the nasopharynx is nasopharyngeal carcinoma (NPC). Although rare throughout most of the world, NPC has a unique geographic distribution, with high-risk endemic areas in southern China and parts of Southeast Asia, intermediate incidence rates elsewhere in Southeast Asia, North Africa, the Arctic, the Middle East, and among Asian and Pacific Islander migrants, and very low risk in other areas. The great majority of NPC cases worldwide are non-keratinizing tumors; these predominate in endemic, high-incidence areas and comprise up to half of tumors in low-

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12

Williams, Erin S. Malignant Hyperthermia. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0007.

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Malignant hyperthermia (MH) is one of the most feared syndromes in anesthesiology. Due to its rarity and adequate precautions instituted for susceptible patients, most anesthesiologist have never been involved in a case of MH. However, the lack of familiarity with the early signs of MH and quick and effective treatment can increase the potential for increased morbidity and mortality. MH involves a derangement at the molecular level at the ryanodine R1 receptor. This leads to abnormally high levels of intracellular calcium and extracellular potassium. These biochemical mechanisms lead to a hype

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13

Hartley, Alice E., and Toby Page. Renal and retroperitoneal abscess. Edited by Rob Pickard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0005.

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Retroperitoneal infections are often difficult to diagnose as their clinical presentation is often non-specific. They generally occur in people with anatomical abnormalities, malignancy, injury, or infection of the retroperitoneal organs, but may result from lymphatic or haematogenous spread. Delayed diagnosis can lead to abscess formation with associated high morbidity and risk of mortality. The retroperitoneum can be divided into anterior, perinephric, and posterior compartments and an understanding of this anatomy can help localize the source of infection. Both aerobic and anaerobic organis

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14

Montironi, Rodolfo, Liang Cheng, Antonio Lopez-Beltran, Roberta Mazzucchelli, Matteo Santoni, and Marina Scarpelli. Prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0060.

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The incidence of prostate cancer (PCa) has risen dramatically in the last years. This event may be partially explained by the employment of digital rectal examination (DRE), serum prostate-specific antigen (PSA), and transrectal ultrasonography. In developed countries, PCa is the most frequent non-skin malignancy in males. It is estimated that one in six males will be diagnosed with PCa during their lifetime, the risk of death due to metastatic PCa being 1 in 30. Multiple factors contribute to the development of PCa, as well as to its progression to an androgen-independent state: dietary facto

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15

Chang, Ellen T., and Hans-Olov Adami. Nasopharyngeal Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190676827.003.0008.

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The distinctive global incidence patterns and risk factors for nasopharyngeal carcinoma (NPC) make this a unique malignancy that represents an epidemiologic challenge. NPC is rare throughout most of the world but relatively common in southern China, Southeast Asia, the Arctic, North Africa, and the Middle East. This pattern is determined in part by the geographic and ethnic distribution of established risk factors for NPC, which include early/aberrant Epstein Barr virus infection, Chinese-style salted fish consumption, family history, certain human leukocyte antigen alleles, and tobacco smokin

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16

Lester, Rebecca, and John Rex. Fungaemia and disseminated infection. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0025.

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Invasive fungal disease can present without localization or obvious target organ involvement. These disseminated mycoses occur predominantly in patients who are immunocompromised, particularly from haematological malignancy and HIV. Candidiasis and aspergillosis are the commonest forms of disseminated fungal infection worldwide, but an increasing number of non-Candida yeasts and non-Aspergillus moulds have emerged as important causes of invasive disease in recent years. Endemic fungi such as Histoplasma capsulatum are important causes of invasive disease within limited geographic regions. Feve

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17

Bryant, Richard J., and James W. F. Catto. General overview of bladder cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0074.

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Bladder cancer (BC) is a common malignancy and is one of the most expensive to manage. This tumour typically affects middle-aged and elderly patients and is more common in men. These demographics reflect the aetiological links between BC and tobacco smoking and occupational exposure to carcinogens. While the presenting symptom of BC is usually painless visible haematuria, around one-quarter of tumours present with irritative voiding symptoms, recurrent or antibiotic-refractory urinary tract infections, non-visible haematuria, or are found by chance during the investigation of unrelated symptom

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18

Antwi, Samuel O., Rick J. Jansen, and Gloria M. Petersen. Cancer of the Pancreas. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0032.

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Pancreatic cancer (PC) is an uncommon but often rapidly lethal malignancy. Worldwide, PC is the twelfth most commonly diagnosed cancer and the seventh most common for cancer deaths. Globally, the estimated number of incident cases (338,000) and deaths from PC (330,400) were almost identical in 2012 Etiologic research on PC is complicated by the relatively inaccessible location of the pancreas, obstacles to early diagnosis, aggressiveness and resistance to therapy of these malignancies, and the tendency of PC to progress rapidly. Until recently, the only etiologic factors considered to be defin

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19

Harper, Lorraine, and David Jayne. The patient with vasculitis. Edited by Giuseppe Remuzzi. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0160.

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The goals of treatment in renal vasculitis are to stop vasculitic activity and recover renal function. Subsequent strategies are required to prevent vasculitis returning and to address longer-term co-morbidities caused by tissue damage, drug toxicity, and increased cardiovascular and malignancy risk.Cyclophosphamide and high-dose glucocorticoids remain the standard induction therapy with alternative immunosuppressives, such as azathioprine, to prevent relapse. Plasma exchange improves renal recovery in severe presentations. Refractory disease resulting from a failure of induction or remission

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20

Crous-Bou, Marta, Immaculata de Vivo, and Pagona Lagiou. Endometrial Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190676827.003.0018.

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Lifestyle factors contribute appreciably to endometrial cancer risk, with obesity accounting for over one-third of incident cases in high-income societies. Unlike cervical cancer, which is a model of viral carcinogenesis, endometrial cancer is considered a model of hormonal carcinogenesis, as use of unopposed estrogens postmenopausally and obesity are the best-established risk factors. Endometrial cancer is also the only known malignancy for which cigarette smoking has been shown to confer protection. Risk reduction conferred by current smoking, past oral contraceptive use, childbearing, and p

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21

Oliver, Nora, and Elizabeth Chiao. Malignant Diseases in HIV. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0033.

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Malignancies were one of the earliest recognized manifestations that led to the eventual description of the AIDS epidemic. Kaposi’s sarcoma was one of the first entities described in association with AIDS. Subsequently, intermediate-grade and high-grade non-Hodgkin’s lymphoma, invasive cervical cancer, and primary central nervous system lymphoma were defined by the Centers for Disease Control and Prevention as “AIDS-defining conditions.” Since the advent of combination antiretroviral therapy, several other cancers that are not AIDS-defining have been found to have an increased incidence in pat

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22

Huntoon, Kristin, and J. Bradley Elder. High-Grade Gliomas. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0001.

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Glioblastoma is the most common primary malignant brain tumor. This chapter discusses the clinical presentation and initial workup for a patient with a suspected glioblastoma, as well as the optimal treatment strategy and prognosis. Diagnosis is typically made using magnetic resonance imaging. Optimal treatment involves maximal safe surgical resection followed by adjuvant chemotherapy and radiation therapy. Surgical adjuncts including intraoperative imaging modalities and brain mapping techniques help improve neurologic morbidity associated with surgery. Despite maximal treatment, virtually al

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23

Key, Timothy J., and Alison J. Price. Epidemiology of prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0058.

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Prostate cancer is the second most common malignancy and the sixth most common cause of cancer death for men worldwide. The highest incidence and mortality rates are in populations that originated in Africa, such as African Americans. Rates are also high in Western countries and generally low in East and South Asia. Incidence rates are increasing in some countries which until recently had low rates, but are not changing much in countries which already have high rates. The only well-established risk factors are increasing age, African ancestry, family history of the disease, and certain genetic

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24

Jayne, David. Treatment of ANCA-associated vasculitis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0132.

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The goals of treatment in anti-neutrophil cytoplasm antibody (ANCA) vasculitis are to stop vasculitic activity, to prevent vasculitis returning, and to address longer-term comorbidities caused by tissue damage, drug toxicity, and increased cardiovascular and malignancy risk. Cyclophosphamide and high-dose glucocorticoids remain the standard induction therapy with alternative immunosuppressives, such as methotrexate or azathioprine, to prevent relapse. Refractory disease resulting from a failure of induction or remission maintenance therapy requires alternative agents and rituximab has been par

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25

Watts, Richard A., and David G. I. Scott. Vasculitis—classification and diagnosis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0130.

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The vasculitides are a group of conditions characterized by inflammation and necrosis of blood vessels; they are generally of unknown aetiology. The classification of vasculitides is based on the size of vessel involved and whether there is a known cause (secondary) or not (primary). This approach has stood the test of time. The American College of Rheumatology (ACR) in 1990 produced classification criteria for the major types of vasculitis and in 1994 definitions were promulgated by the Chapel Hill Consensus Conference. These did not include anti-neutrophil cytoplasm antibodies (ANCA) and the

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26

Woolf, Eric C., and Adrienne C. Scheck. Ketogenic Diet as Adjunctive Therapy for Malignant Brain Cancer. Edited by Jong M. Rho. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190497996.003.0013.

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Malignant brain tumors are devastating, and increased survival requires new therapeutic modalities. Metabolic dysregulation results in an increased need for glucose in tumor cells, suggesting that reduced tumor growth could be achieved with decreased glucose availability either through pharmacological means or use of a high-fat, low-carbohydrate ketogenic diet (KD). KD provides increased blood ketones to support energy needs of normal tissues and has been shown to reduce tumor growth, angiogenesis, inflammation, peritumoral edema, migration, and invasion. Furthermore, this diet can enhance the

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27

Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, Gareth Morris-Stiff, and Amen Sibtain. Colorectal cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0015_update_001.

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Breast cancer reviews the epidemiology and aetiology of this malignancy, with particular attention to the genetics underlying familial breast cancer, its pathology along with its receptors, oestrogen receptor (ER), the growth factor receptor HER2, and epidermal growth factor receptor (EGFR), and the bearing these have on treatment and prognosis. The benefits of breast cancer screening in the population and families at higher risk are discussed. Presenting symptoms and signs are followed by investigation including examination, bilateral mammography, and core biopsy of suspicious lesions. Manage

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28

Grant, Warren, and Martin Scott-Brown. Principles of oncogenesis. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0322.

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It is obvious that the process of developing cancer—oncogenesis—is a multistep process. We know that smoking, obesity, and a family history are strong independent predictors of developing malignancy; yet, in clinics, we often see that some heavy smokers live into their nineties and that some people with close relatives affected by cancer spend many years worrying about a disease that, in the end, they never contract. For many centuries scientists have struggled to understand the process that make cancer cells different from normal cells. There were those in ancient times who believed that tumo

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29

De Braganca, Kevin C., and Roger J. Packer. Medulloblastoma. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0139.

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Medulloblastoma is the most common malignant brain tumor in pediatric patients. Patients are presently stratified to either standard or high-risk groups based on clinical and pathologic criteria. Approximately 80% of patients with standard risk disease are cured of their primary disease. High-risk and recurrent disease groups have a poorer outcome; 5-year progression-free survival is only 65% with high-risk disease. Disease control after recurrence is very poor. Treatment is multimodal and also aims to limit short- and long-term toxicities. Recent identification of four molecular subtypes of m

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30

Denham, S. LeeAnn, and Heidi R. Umphrey. Radiology–Pathology Correlation. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0058.

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Over 1 million image-guided breast biopsies, guided by mammography, ultrasound, or magnetic resonance imaging, are performed annually in the United States. When the imaging characteristics of a lesion correspond to the histopathological diagnosis (e.g., suspicious imaging findings and malignant pathology), the biopsy results are deemed concordant. However, when the imaging characteristics differ from the pathological results (e.g., suspicious imaging findings but benign pathology), this biopsy result is considered discordant. This chapter, appearing in the section on interventions and surgical

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31

Bouchama, Abderrezak. Pathophysiology and management of hyperthermia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0353.

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Hyperthermia is a state of elevated core temperature that rises rapidly above 40°C, secondary to failure of thermoregulation. Hyperthermia has many causes, but it is the hallmark of three conditions—heatstroke, malignant hyperthermia, and neuroleptic malignant syndrome. The clinical and metabolic alterations of hyperthermia, if left untreated, can culminate in multiple organ system failure and death. High temperature causes direct cellular death and tissue damage. The extent of tissue injury is a function of the degree and duration of hyperthermia. Heat-induced ischaemia-reperfusion injury, an

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32

Proportional analysis of associations between elementary and secondary school teachers and death from malignant neoplasms using 1983 and 1984 Pennsylvania death data. State Health Data Center, 1986.

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33

Bertz, Simone, and Arndt Hartmann. Pathology of bladder and upper urinary tract tumours. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0072.

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Bladder cancer is the most common malignant tumour of the urinary tract, with approximately 386,000 new cases worldwide per year, and is the fifth most common cancer in humans. Mortality rates range between 1.1 per 100,000 for women to 4 per 100,000 in men. Most bladder and urinary tract cancers are urothelial carcinoma. The remainder are squamous cell carcinoma (5%), adenocarcinoma (<5%) and other rare tumours (<1%). Around 5–10% of urothelial carcinoma are found in the upper urinary tract. Unlike the majority of malignant tumours in other anatomical sites, most urothelial carcinoma hav

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34

Hjalgrim, Henrik, Ellen T. Chang, and Sally L. Glaser. Hodgkin Lymphoma. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0039.

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Hodgkin lymphoma (HL) is a malignant neoplasm of the lymphatic system. The malignant cell clone derives from germinal center B lymphocytes in ~98% of cases, the rest being of T-lymphocyte origin. Each year, HL is diagnosed in roughly 66,000 individuals worldwide. HL is curable with modern therapy in the vast majority of patients, with five-year survival rates exceeding 90% for early-stage disease. However, so far this excellent prognosis has been achieved at the expense of a high incidence of severe long-term treatment complications such as secondary malignancies, and endocrine and cardiovascu

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35

Kettler, Mark D. Circumscribed Mass: Invasive Cancer. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0018.

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Most invasive breast cancers present as focal asymmetries, areas of architectural distortion, or irregular masses with indistinct or spiculated margins. Some present as round or oval masses with circumscribed margins; however, most round or oval masses have microlobulated, indistinct, or spiculated margins and may be associated with characteristic malignant calcifications. This chapter, appearing in the section on circumscribed mass, reviews the key clinical and imaging features, differential diagnosis, and management recommendations for invasive breast cancers, which can present as circumscri

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Felberg, Mary A. Mitochondrial Disease and Anesthesia. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0042.

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Mitochondrial disease is a genetically, biochemically, and clinically heterogeneous group of disorders that arise from defects in cellular oxidative phosphorylation, most commonly within the electron transport chain. All mitochondrial diseases involve disruption in energy production; clinical symptoms usually manifest in tissues with high energy demands although all organs may be affected. The extent of disease depends not only on the mitochondrial defect but on the numbers of dysfunctional mitochondria present in each tissue. Despite in vitro evidence that almost every anesthetic agent studie

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37

Martin, Colin J., and David G. Sutton. Risk control in diagnostic medical exposures. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199655212.003.0011.

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All medical exposures to ionizing radiation carry an increased risk of malignant disease. This chapter describes methods for evaluating the risks from exposures of varying magnitude from either the effective dose or doses to individual organs. Risk factors which can be utilized in assessments are included. Procedures should only be carried out if they will influence patient management and factors to be considered in the justification process are considered. In addition, techniques should be optimized so that doses to individual patients are as low as compatible with the medical requirements of

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38

Morgan, Jenna, and Lynda Wyld. Breast surgery (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198749813.003.0005.

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Breast disease is a common surgical problem. It constitutes symptomatic disease, including breast lumps, nipple discharge, and breast abscesses, as well as asymptomatic disease detected on the NHS Breast Screening Programme (BSP) and patients identified at high risk of familial cancers. It is a busy subspecialty. Referrals for symptomatic breast disease primarily arise from primary care, where they constitute approximately 3% of general practice consultations. In addition, the NHS BSP screened over 2,000,000 women in 2014, of which 4.3% were referred for assessment. The cases in this chapter c

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Michaud, Dominique, David Savitz, and Lorelei Mucci. Brain Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190676827.003.0024.

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cBrain tumors constitute an array of histologic types, the most common being meningioma and glioma. Unlike other cancers, both benign and malignant brain tumors are concerning for survival because of their anatomic location. Two-thirds of brain tumors are benign. The most well established risk factor is high dose ionizing radiation, based on studies of atomic bomb survivors as well as children treated for tinea capitis. In contrast, nonionizing radiation including from cellular telephones, is not a risk factor. Tobacco use does not appear to be associated with glioma or meningioma. There is fa

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40

Cantu, Robert V., and Robert C. Cantu. Injuries to the head and cervical spine. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0046.

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Traumatic brain and cervical spine injuries in young athletes encompass a wide spectrum, with some injuries occurring in otherwise ‘safe’ sports, and others in high-risk sports where head and cervical spine injuries are the norm. Athletic brain injuries include concussion, intracranial haemorrhage, malignant brain oedema syndrome, and axonal shear. In the cervical spine, injuries include muscle strains, contusions, fractures, or ligamentous disruptions with nerve root or spinal cord injury. Knowledge of these injuries and their signs and symptoms is important for the physician covering a sport

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Sherman, Mark E., Melissa A. Troester, Katherine A. Hoadley, and William F. Anderson. Morphological and Molecular Classification of Human Cancer. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0003.

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Accurate and reproducible classification of tumors is essential for clinical management, cancer surveillance, and studies of pathogenesis and etiology. Tumor classification has historically been based on the primary anatomic site or organ in which the tumor occurs and on its morphologic and histologic phenotype. While pathologic criteria are useful in predicting the average behavior of a group of tumors, histopathology alone cannot accurately predict the prognosis and treatment response of individual cancers. Traditional measures such as tumor stage and grade do not take into account molecular

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Farghaly, Samir A. Adoptive Cell Immunotherapy for Epithelial Ovarian Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190248208.003.0005.

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The standard management for epithelial ovarian cancer (EOC) is a combination of aggressive debulking surgery with residual tumor of less than 1 cm and platinum-based chemotherapy. However, a high percentage of patients experience disease recurrence. Extensive efforts to find new therapeutic options have been made, albeit cancer cells develop drug resistance and malignant progression occurs. Novel therapeutic strategies are needed to enhance progression-free survival and overall survival of patients with advanced EOC. Several preclinical and clinical studies investigated feasibility and efficac

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Keshav, Satish, and Alexandra Kent. Gastrointestinal tumours. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0204.

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Gastrointestinal (GI) tumours can affect any part of the GI tract, and colorectal cancer is the most common. Throughout the GI tract, chronic inflammation seems to promote the development of neoplasia: for example, chronic reflux oesophagitis is linked to oesophageal adenocarcinoma; chronic Helicobacter pylori infection is linked to gastric cancer; chronic pancreatitis is linked to pancreatic cancer; cirrhosis is linked to hepatocellular cancer; chronic biliary inflammation is linked to cholangiocarcinoma; untreated coeliac disease is linked to intestinal lymphoma; and chronic inflammatory bow

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Ho, Vanessa P., and Philip S. Barie. Acute acalculous cholecystitis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0188.

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Acute acalculous cholecystitis (AAC) may occur in surgical or injured, critically-ill, and systemically-ill patients, with diabetes mellitus, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, shock, and cardiac arrest. Children may also be affected, especially following a viral illness. The pathogenesis of AAC is complex and multifactorial. Ischaemia/reperfusion injury and the associated pro-inflammatory response and oxidative tissue stress, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and parent

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Kuypers, Dirk R. J., and Maarten Naesens. Immunosuppression. Edited by Jeremy R. Chapman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0281_update_001.

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Combination immunosuppressive therapy produces excellent short-term results after kidney transplantation. Long-term graft survival has improved, but less dramatically. Death with a functioning graft remains the primary cause of graft loss. Dosing of current immunosuppressive therapy balances between careful clinical interpretation of time-driven immunological risk assessments and drug-related toxicity on the one hand, and the use of simple surrogate drug exposure indicators like blood/plasma concentrations on the other. The combined use of calcineurin-inhibitors (CNIs) with mycophenolic acids

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Grant, Warren, and Martin Scott-Brown. Prevention of cancer. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0350.

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In the UK, the four commonest cancers—lung cancer, breast cancer, colon cancer, and prostate cancer—result in around 62 000 deaths every year. Although deaths from cancer have fallen in the UK over the last 20 years, the UK still suffers from higher cancer death rates than many other countries in Western Europe. In 1999, the UK government produced a White Paper called Saving Lives: Our Healthier Nation that outlined a national target to reduce the death rate from cancer by at least 20% in people under 75 by 2010. The subsequent NHS Cancer Plan of 2000 designed a framework by which to achieve t

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Cassidy, Jim, Donald Bissett, Roy A. J. Spence OBE, Miranda Payne, and Gareth Morris-Stiff. Principles of chemotherapy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199689842.003.0005.

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Principles of radiation oncology outlines the physical and biological effects of ionising radiation, and its use in clinical oncology. Radiobiology, examining the response of tissue to ionising radiation, is described with regards to normal and malignant tissues. The effect of fractionation, the delivery of radiotherapy in a series of repeated exposures, is examined. The damaging effects on normal tissues are considered, particularly nonreversible late effects including carcinogenesis. Therapeutic exposure to ionising radiation is contrasted between radical and palliative radiotherapy. The phy

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Merry, Alan F., Simon J. Mitchell, and Jonathan G. Hardman. Hazards in anaesthetic practice: body systems and occupational hazards. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0045.

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“Can’t intubate, can’t oxygenate” crises and aspiration of gastric contents are important hazards in anaesthesia, and may result in the death of relatively young and healthy patients. Airway difficulties may manifest at the end of anaesthesia as well as at induction and are commoner in emergency departments and intensive care settings than during anaesthesia in operating rooms. Elements of poor management characterize the majority of airway complications. Emergency cricothyroidotomy performed by anaesthetists is associated with a high rate of failure. Other important hazards associated with an

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Singer, Peter W., and Allan Friedman. Cybersecurity and Cyberwar. Oxford University Press, 2014. http://dx.doi.org/10.1093/wentk/9780199918096.001.0001.

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Dependence on computers has had a transformative effect on human society. Cybernetics is now woven into the core functions of virtually every basic institution, including our oldest ones. War is one such institution, and the digital revolution’s impact on it has been profound. The American military, which has no peer, is almost completely reliant on high-tech computer systems. Given the Internet’s potential for full-spectrum surveillance and information disruption, the marshaling of computer networks represents the next stage of cyberwar. Indeed, it is upon us already. The recent Stuxnet episo

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Reddy, Ugan, and Nicholas Hirsch. Diagnosis, assessment, and management of myasthenia gravis and paramyasthenic syndromes. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0244.

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Diseases that affect the neuromuscular junction (NMJ) interfere with normal nerve transmission and cause weakness of voluntary muscles. The two most commonly encountered are acquired myasthenia gravis (MG) and the Lambert–Eaton myasthenic syndrome (LEMS). Acquired MG is an autoimmune disease in which antibodies are directed towards receptors at the NMJ. In 85% of patients, IgG antibodies against the postsynaptic acetylcholine receptor (AChR) are found (seropositive MG). The thymus gland appears to be involved in the production of these which cause an increase rate of degradation of AChR result

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