Mesothelioma presentation

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The discovery of malignant cells in pleural fluid and/or parietal pleura signifies disseminated or advanced disease and a reduced life expectancy in patients with cancer.Median survival following diagnosis ranges from 3 to 12 months and is dependent on the stage and type of the underlying malignancy. The shortest survival time is observed in malignant effusions secondary to lung cancer and the longest in ovarian cancer, while malignant effusions due to an unknown primary have an intermediate survival time.Historically, studies showed that median survival times in effusions due to carcinoma of the breast are 5-6 months. However, more recent studies have suggested longer survival times of up to 15 months. A comparison of survival times in breast cancer effusions in published studies to 1994 calculated a median survival of 11 months.9 Currently, lung cancer is the most common metastatic tumour to the pleura in men and breast cancer in women.Together, both malignancies account for 50- 65% of all malignant effusions. Lymphomas, tumours of the genitourinary tract and gastrointestinal tract account for a further 25% Pleural effusions from an unknown primary are responsible for 15% of all malignant pleural effusions.Few studies have estimated the proportion of pleural effusions due to mesothelioma: studies from 1975, 1985 and 1987 identified mesothelioma in 1/271, 3/472 and 22/592 patients, respectively, but there are no more recent data to update this in light of the increasing incidence of mesothelioma.

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www.mesoth.net - What is Mesothelioma? Mesothelioma is considered a rare form of cancer that occurs in the mesothelium, a thin layer of tissue that covers most of your internal organs. Mesothelioma is categorized by which area of the body that it’s located. The most common form of mesothelioma is pleural malignant mesothelioma which attacks the tissue surrounding the lungs, the pleural. Mesothelioma іs a form of cancer affectіng the abdomіnal cavіty, chest cavіty, and the regіon surroundіng the heart. Due to іts uncommon nature, mesothelioma іs typіcally dіffіcult to dіagnose and treat. It has been connected wіth exposure to asbestos, a materіal formerly present іn many work envіronments. Only about 3,000 іndіvіduals are dіagnosed annually. This form of mesothelioma accounts for an estimated 70% of all cases. Peritoneal mesothelioma, which occurs in the lining of the abdominal cavity (the peritoneum) and pericardial mesothelioma, which occurs in the lining surrounding the heart (pericardium). The most rare form of mesothelioma is mesotheliomas of the tunica vaginalis which covers the testicles. Mesothelioma can also be classified into 4 types based on the appearance of the cells when looked at under the microscope. These 4 types are: Epithelioid: Roughly 50% to 60% of mesotheliomas are this type. The prognosis of this type of mesothelioma is better than the other three. Sarcomatoid (fibrous): Roughly 10% to 20% of mesotheliomas are this type Mixed (biphasic): Roughly 30% to 40% of mesotheliomas are this type. These mesotheliomas comprise of both epithelioid and sarcomatoid cell areas. Desmoplastic: Extremely rare There are numerous risk factors that scientists have linked to mesothelioma. Asbestos, Zeolities, Radiation and the SV40 virus have all been linked to causing mesothelioma. Roughly 75% of those suffering from mesothelioma are over the age of 65 and this form of cancer affects men 4 times more than women. http://www.mesoth.net/2016/02/what-is-mesothelioma.html

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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/

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