MALATTIE DELL'INVECCHIAMENTO ED ONCOLOGIA - channel 4

7 CFU - 1° Semester

Teaching Staff

ENZO SARETTO VICARI - Module MEDICINA INTERNA MODULO GERIATRIA E GERONTOLOGIA - MED/09 - 3 CFU
GIOVANNA BRANCATO - Module GERIATRIC SURGERY - MED/18 - 2 CFU
PAOLO VIGNERI - Module Disease of the Elderly and Medical Oncology - MED/06 - 2 CFU

Learning Objectives

MEDICINA INTERNA MODULO GERIATRIA E GERONTOLOGIA
To provide the cultural basis to learn about the epidemiology, specificity and clinical presentation of the elderly's illnesses. Main aspects of geriatric diseases. Development of the decision-making process for an appropriate assessment request (differential diagnostics) of the most common pathologies of geriatric interest and the knowledge necessary to conduct the multidimensional evaluation of the elderly patient. Approach to therapeutic, pharmacological and non-pharmacological orientation in the elderly patient. Approach to preventive measures in elderly patients.
GERIATRIC SURGERY
to provide knowledge on the most frequent surgical pathologies: etiopathogenesis, symptoms, clinic signs, diagnosis, treatment
Disease of the Elderly and Medical Oncology
Students will have to describe the main mechanisms underlying cancer pathogenesis and will have to define the appropriate procedures required for the diagnosis and treatment of the most common forms of cancer. Description of the current staging techniques will also be required, as well as the ability to outline the mechanisms of action, the clinical usefulness and the main toxicities of both conventional chemotherapeutic drugs and novel anti-tumoral biological compounds. Critical emphasis will be dedicated to the clinical identification and the therapeutic management of oncologic emergencies.

Course Structure

MEDICINA INTERNA MODULO GERIATRIA E GERONTOLOGIA
Frontal lessons
GERIATRIC SURGERY
lectures
Disease of the Elderly and Medical Oncology
Frontal Teaching and Interactive Discussion of Clinical Cases.

Detailed Course Content

MEDICINA INTERNA MODULO GERIATRIA E GERONTOLOGIA
GERONTOLOGY Biology, physiology, demographic and epidemiological aspects of aging: classification and types of aging. Aging theories and hallmarks (distinctive traits). Age-related changes in the endocrine system: somatopause, adrenopause, late-onset hypogonadism (LOH)

GERIATRIC MEDICINE: the geriatric patient and his clinical evaluation: Care models in Geriatrics (bio-medical, bio-psycho-social, functional). Specific aspects of presentation of diseases in old age: the elderly "complex"; the frail elderly, the polypathology, the concept of disability and the multidimensional assessment tools (VMD)

Geriatric Syndromes: cognitive impairment, incontinence, falls, malnutrition, s. from immobilization, bedsores;

Sarcopenia. Osteoporosis - Pain in the elderly - Parkinson's disease and parkinsonism --Dementia (primary and secondary) - Depression. --Delirium

BPH -- Urinary tract infections in the elderly -- Inflammatory prostatitis in the elderly and its comorbidities (UPOINT phenotype)

Sexual dysfunction in the elderly male --

Cardiovascular diseases: arterial hypertension in the elderly; heart failure. Syncope; AOCP; stroke

Endocrine diseases in the elderly: senile diabetes, hypo and hyperthyroidism, s. from low T3

DVT and pulmonary embolism.

Anemias in the elderly

Principles of care for the elderly in different care situations: integrated network of services in geriatrics; the Geriatric Evaluation Unit; the continuity of care between the hospital and the territory; Healthcare Residences.
GERIATRIC SURGERY
Thyroid diseases

- Benign breast pathologies

- Breast cancer

- Dyskinesias of the esophagus

- Esophageal diverticula

- Malignant tumors of the esophagus

- Hiatal hernia

- Gastro-esophageal reflux disease

- Esophageal varices

- Gastritis

- Peptic ulcer

- Gastric tumors

- Ernie of the wall

- Laparoceli

- Peritonitis

- Echinococcal cyst

- Hepatocarcinoma

- Metastatic tumors of the liver

- Calculosis of the gallbladder and biliary tract

- Biliary tract tumors

- Acute pancreatitis

- Chronic pancreatitis

- Pancreatic carcinoma

- Tumors of the papilla

- Endocrine tumors of the pancreas

- Small tumor

- Short bowel syndrome

Intestinal infarction

- Meckel's diverticulum

-Acute appendicitis

- Chronic appendicitis

- Cancer of the appendix

- Crohn's disease

- Ulcerative rectal colitis

- Diverticular disease of the colon

- Malignant tumors of the colon

- Tumors of the rectum

- Hemorrhoidal disease

- Fistulas and anal fissures

- Acute abdomen

- Bowel obstruction

- Tumors of the testicle

- Hydrocele

- Varicocele
Disease of the Elderly and Medical Oncology
Tumor Biology
- Oncogenes, Tumor Suppressor Genes, Stochastic Cancerogenesis and Cancer Stem Cells
- Angiogenesis, Tumor Heterogeneity and Metastasis
Epidemiology and Cancer Prevention

· Incidence, Prevalence and Mortality Rates in Oncology

· Risk Factors for the Most Common Tumors

· Primary, Secondary and Tertiary Prevention

Clinical Methodology in Oncology

· Tumor Signs and Symptoms

· Tumor Classification and Staging

· Evaluation of Therapeutic Response and Clinical Follow-up

Principles of Cancer Therapy

· Conventional Chemotherapeutic Drugs

· Routes of Drug Administration and Drug Dosage. Dose Intensity and Dose Density

· Neo-Adjuvant, Cytoreductive, Adjuvant Chemotherapy. Chemotherapy in the Metastatic setting

· Hormonal Therapy

· Targeted Therapies in Oncology and Modulators of the Immune Checkpoint Blockade

· Supportive and Palliative Cancer Care

· Major Side-Effects of Cancer Therapies

· Clinical Emergencies in Oncology

Treatment of the Most Common Forms of Cancer

· Cancer of the Lung and the Pleural Cavity

· Breast Cancer

· Colon and Rectal Cancer

· Prostate Cancer
- Fundamentals in the Treatment of: Head and Neck Cancer, Cancers of the Esophagus, the Stomach and the Duodenum, Pancreatic Cancer, Cancers of the Genito-Urinary Tract, Soft Tissue Sarcomas, Neuro-Endocrine Tumors, Melanoma

Textbook Information

MEDICINA INTERNA MODULO GERIATRIA E GERONTOLOGIA
1. Manuale Merck di Geriatria;
2. Linee guida nel trattamento e nella gestione delle malattie geriatriche. M. Palleschi, S.M. Zuccaro, F. Nico. Cesi
3. Paziente anziano, paziente geriatrico e medicina della complessità. Fondamenti di gerontologia e geriatria. U. Senin, A, Cherubini, P. Mecocci - Edises
GERIATRIC SURGERY
Dionigi: Chirurgia. Masson Editore
Disease of the Elderly and Medical Oncology
1. R. Labianca, S. Cascinu - La Medicina Oncologica - 2013 - Edra
2. J. Niederhuber, J. Armitage, J. Doroshow, M. Kastan, J. Tepper - Abeloff’s Clinical Oncology - 6th Edition - 2019 - Elsevier
3. Collegio degli Oncologi Medici Italiani - Manuale di Oncologia Medica - 2018 - Edizioni Minerva Medica

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