Medi Mania

What is Trachoma?

2011-07-10T01:04:00.000-07:00

Trachoma (Ancient Greek: "rough eye"), also called "Egyptian ophthalmia" in older times, is an infectious eye disease, and remains the leading cause of infectious blindness in the world. Globally, 41 million people suffer from active infection and nearly 8 million people are visually impaired as a result of this disease. Globally this disease results in considerable disability.

Causes

Trachoma is caused by Chlamydia trachomatis and it is spread by direct contact with eye, nose, and throat secretions from affected individuals, or contact with fomites (inanimate objects), such as towels and/or washcloths, that have had similar contact with these secretions. Flies can also be a route of mechanical transmission. Untreated, repeated trachoma infections result in entropion—a painful form of permanent blindness when the eyelids turn inward, causing the eyelashes to scratch the cornea. Children are the most susceptible to infection due to their tendency to easily get dirty, but the blinding effects or more severe symptoms are often not felt until adulthood.

Blinding endemic trachoma occurs in areas with poor personal and family hygiene. Many factors are indirectly linked to the presence of trachoma including lack of water, absence of latrines or toilets, poverty in general, flies, close proximity to cattle, crowding and so forth. However, the final common pathway seems to be the presence of dirty faces in children that facilitates the frequent exchange of infected ocular discharge from one child’s face to another. Most transmission of trachoma occurs within the family.

Signs and symptoms

The bacterium has an incubation period of 5 to 12 days, after which the affected individual experiences symptoms of conjunctivitis, or irritation similar to "pink eye." Blinding endemic trachoma results from multiple episodes of reinfection that maintains the intense inflammation in the conjunctiva. Without reinfection, the inflammation will gradually subside.

The conjunctival inflammation is called “active trachoma” and usually is seen in children, especially pre-school children. It is characterized by white lumps in the undersurface of the upper eyelid (conjunctival follicles or lymphoid germinal centres) and by non-specific inflammation and thickening often associated with papillae. Follicles may also appear at the junction of the cornea and the sclera (limbal follicles). Active trachoma will often be irritating and have a watery discharge. Bacterial secondary infection may occur and cause a purulent discharge.

The later structural changes of trachoma are referred to as “cicatricial trachoma”. These include scarring in the eyelid (tarsal conjunctiva) that leads to distortion of the eyelid with buckling of the lid (tarsus) so the lashes rub on the eye (trichiasis). These lashes will lead to corneal opacities and scarring and then to blindness. Linear scar present in the Sulcus subtarsalis is called Arlt's line(named after Carl Ferdinand von Arlt). In addition, blood vessels and scar tissue can invade the upper cornea (pannus). Resolved limbal follicles may leave small gaps in pannus (Herbert’s Pits).
Most commonly children with active trachoma will not present with any symptoms as the low grade irritation and ocular discharge is just accepted as normal.

However, further symptoms may include:

Eye discharge
Swollen eyelids
Trichiasis (turned-in eyelashes)
Swelling of lymph nodes in front of the ears
Seeing bright lights
Increased heart rate
Further ear, nose and throat complications.

The major complication or the most important one is corneal ulcer occurring due to rubbing by concentrations, or trichiasis with superimposed bacterial infection.

Alternative therapy for Psoriasis

2011-07-10T00:59:00.000-07:00

Some studies suggest psoriasis symptoms can be relieved by changes in diet and lifestyle. Fasting periods, low energy diets and vegetarian diets have improved psoriasis symptoms in some studies, and diets supplemented with fish oil (in this study cod liver oil) have also shown beneficial effects. Fish oils are rich in the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and contain Vitamin E, furthermore cod liver oil contains Vitamin A and Vitamin D.

The severity of psoriasis symptoms may also be influenced by lifestyle habits related to alcohol, smoking, weight, sleep, stress and exercise.

Another treatment is ichthyotherapy, which is practised at some spas in Turkey, Croatia, Ireland, Hungary and Serbia. Doctor fish living in outdoor thermal pools are encouraged to feed on the psoriatic skin, only consuming the affected areas. The outdoor location of the spa may also have a beneficial effect. This treatment can provide temporary relief of symptoms. A revisit to the spas every few months is often required. This treatment has been examined in two small clinical trials, with positive results.

Hypnotherapy may be effective for psoriasis.

A psychological symptom management programme has been reported as being a helpful adjunct to traditional therapies in the management of psoriasis. In the UK, The Psoriasis and Psoriatic Arthritis Alliance (PAPAA, a not-for-profit charity) has funded research, carried out by the University of Manchester, to develop a symptom management programme called Electronic Targeted Intervention for Psoriasis (eTIPs) using a modified Cognitive Behaviour Therapy model. This research follows research by Fortune, et al. on psychological stress, distress and disability in patients with psoriasis.

It has been suggested that cannabis might treat psoriasis, due to the anti-inflammatory properties of its cannabinoids, and the regulatory effects of THC on the immune system. The adverse effects of cannabis might be overcome by use of more specific cannabinoid receptor medications, to inhibit keratinocyte proliferation.

On 17 November 2008, researchers led by Yin-Ku Lin of Chang Gung Memorial Hospital and Chang Gung University in Taoyuan, Taiwan, told Reuters by telephone that Indigo naturalis (qing dai, 青黛), a dark blue plant used in traditional Chinese medicine, appears to be effective in treating psoriasis. In the latest issue of Archives of Dermatology, they wrote, "The Indigo naturalis ointment-treated lesions showed an 81 percent improvement, the (nonmedicated) ointment-treated lesions showed a 26 percent improvement."

What is Psoriasis?

2011-07-10T00:55:00.000-07:00

Psoriasis ( /səˈraɪ.əsɨs/) is a chronic immune-mediated disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. There are five types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. The most common form, plaque psoriasis, is commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis (skin). Some patients, though, have no dermatological symptoms.

In plaque psoriasis, skin rapidly accumulates at these sites, which gives it a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp, palms of hands and soles of feet, and genitals. In contrast to eczema, psoriasis is more likely to be found on the outer side of the joint.

The disorder is a chronic recurring condition that varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) and can be seen as an isolated symptom. Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. Between 10% and 40% of all people with psoriasis have psoriatic arthritis.

The cause of psoriasis is not fully understood, but it is believed to have a genetic component and local psoriatic changes can be triggered by an injury to the skin known as the Koebner phenomenon,see Koebnerisin. Various environmental factors have been suggested as aggravating to psoriasis, including stress, withdrawal of systemic corticosteroid, as well as other environmental factors, but few have shown statistical significance.

There are many treatments available, but because of its chronic recurrent nature, psoriasis is a challenge to treat.

Hairy elbow syndrome

2011-07-10T00:53:00.000-07:00

Hypertrichosis cubiti (HC) or hairy elbow syndrome consists of a localised form of long vellus hair on the extensor surfaces of the distal third of the upper arm and the proximal third of the forearm bilaterally, or occasionally on other parts of the body.

In the 28 cases reported in the literature so far the elbow hair abnormality was either isolated or associated with short stature or other physical abnormalities. Most of these cases were sporadic, but autosomal dominant as well as autosomal recessive inheritance patterns have been postulated.

We report on three unrelated girls (aged 7 to 11 years) of whom one presented with excess hair in the elbows alone and the other two had associated abnormalities including short stature, dysmorphic facial features and mental retardation. The literature on this subject has been reviewed and the authors focus on cases of HC with associated anomalies.

A pathogenic explanation by somatic mosaicism is proposed.

What is Liver transplantation?

2011-07-10T00:49:00.000-07:00

Liver transplantation or hepatic transplantation is the replacement of a diseased liver with a healthy liver allograft. The most commonly used technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic location as the original liver. Liver transplantation nowadays is a well accepted treatment option for end-stage liver disease and acute liver failure. It is also one of the most expensive treatments in modern medicine.

Typically 3 surgeons and 1 anesthesiologist are involved, with up to 4 supporting nurses. The surgical procedure is very demanding and ranges from 4 up to 18 hours depending on outcome. Numerous anastomoses and sutures, and many disconnections and reconnections of abdominal and hepatic tissue, must be made for the transplant to succeed, requiring an eligible recipient and a well-calibrated live or cadaveric donor match. By any standard, hepatic transplantation is a major surgical procedure with an appreciable degree of risk.

Techniques

Before transplantation, liver support therapy might be indicated (bridging-to-transplantation). Artificial liver support like liver dialysis or bioartificial liver support concepts are currently under preclinical and clinical evaluation. Virtually all liver transplants are done in an orthotopic fashion, that is, the native liver is removed and the new liver is placed in the same anatomic location. The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the postimplantation phase. The operation is done through a large incision in the upper abdomen. The hepatectomy involves division of all ligamentous attachments to the liver, as well as the common bile duct, hepatic artery, hepatic vein and portal vein. Usually, the retrohepatic portion of the inferior vena cava is removed along with the liver, although an alternative technique preserves the recipient's vena cava ("piggyback" technique).

The donor's blood in the liver will be replaced by an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft liver is implanted. Implantation involves anastomoses (connections) of the inferior vena cava, portal vein, and hepatic artery. After blood flow is restored to the new liver, the biliary (bile duct) anastomosis is constructed, either to the recipient's own bile duct or to the small intestine. The surgery usually takes between five and six hours, but may be longer or shorter due to the difficulty of the operation and the experience of the surgeon.

The large majority of liver transplants use the entire liver from a non-living donor for the transplant, particularly for adult recipients. A major advance in pediatric liver transplantation was the development of reduced size liver transplantation, in which a portion of an adult liver is used for an infant or small child. Further developments in this area included split liver transplantation, in which one liver is used for transplants for two recipients, and living donor liver transplantation, in which a portion of a healthy person's liver is removed and used as the allograft. Living donor liver transplantation for pediatric recipients involves removal of approximately 20% of the liver (Couinaud segments 2 and 3).

Further advance in liver transplant involves only resection of the lobe of the liver involved in tumors and the tumor-free lobe remains within the recipient. This speeds up the recovery and the patient stay in the hospital quickly shortens to within 5–7 days.

Many major medical centers are now using radiofrequency ablation of the liver tumor as a bridge while awaiting for liver transplantation. This technique has not been used universally and further investigation is warranted.

Management of Liver Cirrhosis.

2011-07-10T00:45:00.000-07:00

Generally, liver damage from cirrhosis cannot be reversed, but treatment could stop or delay further progression and reduce complications. A healthy diet is encouraged, as cirrhosis may be an energy-consuming process. Close follow-up is often necessary. Antibiotics will be prescribed for infections, and various medications can help with itching. Laxatives, such as lactulose, decrease risk of constipation; their role in preventing encephalopathy is limited.

Treating underlying causes

Alcoholic cirrhosis caused by alcohol abuse is treated by abstaining from alcohol. Treatment for hepatitis-related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis. Cirrhosis caused by Wilson's disease, in which copper builds up in organs, is treated with chelation therapy (e.g., penicillamine) to remove the copper.

Preventing further liver damage

Regardless of underlying cause of cirrhosis, alcohol and paracetamol, as well as other potentially damaging substances, are discouraged. Vaccination of susceptible patients should be considered for Hepatitis A and Hepatitis B.

Preventing complications

Ascites
Salt restriction is often necessary, as cirrhosis leads to accumulation of salt (sodium retention). Diuretics may be necessary to suppress ascites.

Esophageal variceal bleeding
For portal hypertension, propranolol is a commonly used agent to lower blood pressure over the portal system. In severe complications from portal hypertension, transjugular intrahepatic portosystemic shunting is occasionally indicated to relieve pressure on the portal vein. As this can worsen encephalopathy, it is reserved for those at low risk of encephalopathy, and is generally regarded only as a bridge to liver transplantation or as a palliative measure.

Hepatic encephalopathy
High-protein food increases the nitrogen balance, and would theoretically increase encephalopathy; in the past, this was therefore eliminated as much as possible from the diet. Recent studies show that this assumption was incorrect, and high-protein foods are even encouraged to maintain adequate nutrition.

Hepatorenal syndrome
The hepatorenal syndrome is defined as a urine sodium less than 10 mmol/L and a serum creatinine > 1.5 mg/dl (or 24 hour creatinine clearance less than 40 ml/min) after a trial of volume expansion without diuretics.

Spontaneous bacterial peritonitis
Cirrhotic patients with ascites are at risk of spontaneous bacterial peritonitis.

Transplantation

If complications cannot be controlled or when the liver ceases functioning, liver transplantation is necessary. Survival from liver transplantation has been improving over the 1990s, and the five-year survival rate is now around 80%, depending largely on the severity of disease and other medical problems in the recipient.[20] In the United States, the MELD score is used to prioritize patients for transplantation. Transplantation necessitates the use of immune suppressants (cyclosporine or tacrolimus).

Decompensated cirrhosis
In patients with previously stable cirrhosis, decompensation may occur due to various causes, such as constipation, infection (of any source), increased alcohol intake, medication, bleeding from esophageal varices or dehydration. It may take the form of any of the complications of cirrhosis listed above.

Patients with decompensated cirrhosis generally require admission to hospital, with close monitoring of the fluid balance, mental status, and emphasis on adequate nutrition and medical treatment - often with diuretics, antibiotics, laxatives and/or enemas, thiamine and occasionally steroids, acetylcysteine and pentoxifylline. Administration of saline is generally avoided as it would add to the already high total body sodium content that typically occurs in cirrhosis.

Cirrhosis of Liver - Signs and symptoms

2011-07-10T00:40:00.000-07:00

Cirrhosis (pronounced /sɪˈroʊsɪs/) is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated), leading to loss of liver function. Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease, but has many other possible causes. Some cases are idiopathic, i.e., of unknown cause.

Ascites (fluid retention in the abdominal cavity) is the most common complication of cirrhosis, and is associated with a poor quality of life, increased risk of infection, and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from esophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis the only option is a liver transplant.

The word "cirrhosis" derives from Greek κιρρός [kirrhós] meaning yellowish, tawny (the orange-yellow colour of the diseased liver) + Eng. med. suff. -osis. While the clinical entity was known before, it was René Laennec who gave it the name "cirrhosis" in his 1819 work in which he also describes the stethoscope.

Signs and symptoms

Some of the following signs and symptoms may occur in the presence of cirrhosis or as a result of the complications of cirrhosis. Many are nonspecific and may occur in other diseases and do not necessarily point to cirrhosis. Likewise, the absence of any does not rule out the possibility of cirrhosis.

Spider angiomata or spider nevi. Vascular lesions consisting of a central arteriole surrounded by many smaller vessels because of an increase in estradiol. These occur in about 1/3 of cases.

Palmar erythema. Exaggerations of normal speckled mottling of the palm, because of altered sex hormone metabolism.

Nail changes.
Muehrcke's lines - paired horizontal bands separated by normal color resulting from hypoalbuminemia (inadequate production of albumin).
Terry's nails - proximal two-thirds of the nail plate appears white with distal one-third red, also due to hypoalbuminemia
Clubbing - angle between the nail plate and proximal nail fold > 180 degrees
Hypertrophic osteoarthropathy. Chronic proliferative periostitis of the long bones that can cause considerable pain.
Dupuytren's contracture. Thickening and shortening of palmar fascia that leads to flexion deformities of the fingers. Thought to be caused by fibroblastic proliferation and disorderly collagen deposition. It is relatively common (33% of patients).

Gynecomastia. Benign proliferation of glandular tissue of male breasts presenting with a rubbery or firm mass extending concentrically from the nipples. This is caused by increased estradiol and can occur in up to 66% of patients.
Hypogonadism. Manifested as impotence, infertility, loss of sexual drive, and testicular atrophy because of primary gonadal injury or suppression of hypothalamic or pituitary function.

Liver size. Can be enlarged, normal, or shrunken.

Splenomegaly (increase in size of the spleen). Caused by congestion of the red pulp as a result of portal hypertension.
Ascites. Accumulation of fluid in the peritoneal cavity giving rise to flank dullness (needs about 1500 mL to detect flank dullness).

Caput medusa. In portal hypertension, the umbilical vein may open. Blood from the portal venous system may be shunted through the periumbilical veins into the umbilical vein and ultimately to the abdominal wall veins, manifesting as caput medusa.

Cruveilhier-Baumgarten murmur. Venous hum heard in epigastric region (on examination by stethoscope) because of collateral connections between portal system and the remnant of the umbilical vein in portal hypertension.
Fetor hepaticus. Musty odor in breath as a result of increased dimethyl sulfide.

Jaundice. Yellow discoloring of the skin, eye, and mucus membranes because of increased bilirubin (at least 2–3 mg/dL or 30 mmol/L). Urine may also appear dark.

Asterixis. Bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy.

Other. Weakness, fatigue, anorexia, weight loss.

What is Hepatitis?

2011-07-10T00:35:00.000-07:00

Hepatitis is a disease of the liver. In hepatitis, the liver is inflamed. There can be several reasons, why the liver is inflamed, for this reason there are several kinds of hepatitis. The most common forms are Hepatitis A, Hepatitis B and Hepatitis C. Most cases of Hepatitis are caused by viruses. Some forms are caused by bacteria, fungi or parasites. The bacteria that cause Tuberculosis or Syphilis can also cause hepatitis, as can the parasite responsible for Malaria.

Hepatitis can also be caused by alcohol. About one in four people who drink more than three alcoholic drinks a day, (over a period of 10-15 days) will have some form of hepatitis caused by alcohol.

Various drugs and chemicals can also cause Hepatitis, most notably Paracetamol (overdose), yellow phosphorous, and others. Hepatitis may also be caused by other diseases.

Hepatitis A

Hepatitis A can be transmitted through infected food. The patient's immune system makes antibodies against hepatitis A. This will make the patient immune against future infection. People with hepatitis A should rest, drink a lot of water and avoid alcohol. A vaccine is available. It will protect against infection from hepatitis A for life. Hepatitis A can be spread through personal contact, consumption of raw sea food or by drinking contaminated water. This occurs primarily in third world countries. Strict personal hygiene and avoiding raw and unpeeled foods can help prevent an infection. Infected people excrete the hepatitis A virus with their stool two weeks before and one week after the appearance of jaundice. The time between the infection and the start of the illness can run from 15 to 45 days, and approximately 15% of sufferers may experience relapsing symptoms from six months to a year after the first diagnosis.

Hepatitis B

Hepatitis B is not spread by food or casual contact. Instead, hepatitis B is spread by blood or body fluids from an infected person. A baby can get it from its mother during childbirth, and it can also be spread by sexual contact, use of street drugs, and unsafe medical care. Some people just have hepatitis B for a little while and then suppress the infection, but others can be infected for life usually with few or no symptoms for many years. Hepatitis B sometimes damages the liver severely, and can cause cancer. There is a vaccine that works very well to prevent hepatitis B, and there is treatment for people with serious disease cause by hepatitis B.The vaccine can be found in the clinics near you.

Hepatitis C

Hepatitis C is not spread by food or casual contact. It is spread in ways that are similar to hepatitis B. There is no vaccine, and the treatment is somewhat unpleasant. People with hepatitis C who drink alcohol greatly increase their risk for liver damage.

Lung Cancer

2011-07-10T00:31:00.000-07:00

Lung cancer is the malignant change and growth of lung tissue. It causes 1.3 million people to die each year, more than any other cancer. Although lung cancer was once an illness that affected males much more than it did women, the number of cases in women has been increasing in the last few decades, which has been blamed on the rising ratio of female to male smokers.

Currently, lung cancer is the leading causing of cancer death in women, killing more women than breast cancer, ovarian cancer and uterine cancers together.The large majority of people who get lung cancer have smoked for many years.

However, there are certain types of lung cancers that appear in otherwise healthy patients who have never smoked. There are 2 main types of Lung cancer, small cell lung cancer and non-small cell lung cancer. Small cell lung cancer typically responds well to chemotherapy and radiotherapy, and non-small cell lung cancer is more commonly treated with surgical removal of the lung tumor.

Bevacizumab is effective in the treatment of Non-small cell lung cancer.

How does Erection happens?

2011-07-10T00:28:00.000-07:00

The penis is shaped like a banana or sausage. It has a duct or tube called the urethra running right through it. Semen and urine pass along the urethra to get out of the body. Around the whole urethra is tissue called the corpus spongiosum penis (which is Latin for "body of the penis that is like a sponge"). It is near the lower surface of the penis. Also inside the penis near its upper surface are two cylindrical tissues called the corpora cavernosa penis (Latin for "bodies of the penis that are like caves"). (One of these tissues by itself is called a corpus cavernosum.) The corpus spongiosum penis and corpora cavernosa penis are filled with many blood vessels called arteries which carry blood.
When a man is sexually aroused or stimulated (made sexually excited) by touch – for example, if he masturbates or another person touches him in a sexual way – the touching is picked up by nerves in the arteries of the corpus spongiosum penis and corpora cavernosa penis. The nerves then cause a chemical called nitric oxide to be released into the arteries. This makes the arteries dilate (become wider), and they fill up with blood. Thus, the corpus spongiosum penis and corpora cavernosa penis all fill with blood and become larger and harder. This makes the penis grow longer, thicker and harder. The corpora cavernosa penis press against blood vessels called veins that let blood flow out of the penis. Since less blood can flow out of the penis through the veins, more of it stays in the penis, which remains hard. During an erection, a valve stops urine from entering the urethra so that only semen flows along it. This is why it is very difficult for a man to urinate when he is having an erection.
A man can also become sexually aroused without being touched, for example, if he sees a naked person or thinks about having sex with someone. In this case, his brain sends messages through his spinal cord (which is inside his vertebral column or backbone) to his penis and makes an erection happen. The brain can also stop an erection from happening, even if the man is being touched sexually.
An erection of the penis can also happen by itself when a man is asleep, often when he is dreaming. The scientific term for this is nocturnal penile tumescence (which means "swelling of the penis at night"). It is also common for a man to wake up after a night's sleep to find that he has an erection. This is often caused by his bladder being full of urine, which presses on the tissues in the penis. Such an erection is sometimes informally called a morning glory or morning wood.
After a man has had an orgasm and has ejaculated, his erection usually ends. How long this takes depends on the length and thickness of his penis. A man can also stop having an erection without having an orgasm and ejaculating, if he is no longer sexually aroused. Nerves in his body cause the arteries in the penis to constrict (become narrower). This forces blood out of the corpus spongiosum penis and corpora cavernosa penis. As they go back to their normal size, they do not press so much on the veins leading out of the penis. This lets blood flow faster out of the corpus spongiosum penis and corpora cavernosa penis. The scientific term for this process is detumescence.

Prvention of Esophageal varices

2011-07-09T07:29:00.000-07:00

Ideally, patients with known varices should receive treatment to reduce their risk of bleeding.

The non-selective β-blockers (e.g., propranolol 10 mg PO TID, timolol or nadolol 20 mg PO OD) and nitrates (e.g. isosorbide mononitrate (IMN) 20 mg BD to TID) have been evaluated for secondary prophylaxis. Non-selective β-blockers (but not cardioselective β-blockers like atenolol) are preferred because they decrease both cardiac output by β1 blockade and splanchnic blood flow by blocking vasodilating β2 receptors at splanchnic vasculature. The effectiveness of this treatment has been shown by a number of different studies.

Unfortunately, non-selective β-blockers do not prevent the formation of esophageal varices.

Ultimately the treatment of portal hypertension can prevent development of esophageal varices.

Treatment of Esophageal varices

2011-07-09T07:26:00.000-07:00

In emergency situations, the care is directed at stopping blood loss, maintaining plasma volume, correcting disorders in coagulation induced by cirrhosis, and appropriate use of antibiotics (usually a quinolone or ceftriaxone, as infection by gram-negative strains is either concomitant, or a precipitant).

Blood volume resuscitation should be done promptly and with caution. Goal should be hemodynamic stability and hemoglobin of over 8. Resuscitation of all lost blood leads to increase in portal pressure leading to more bleeding. Volume resuscitation can also worsen ascites and increase portal pressure. (AASLD guildlines)

Therapeutic endoscopy is considered the mainstay of urgent treatment. Two main therapeutic approaches exist:

Variceal ligation, or banding
Sclerotherapy

In cases of refractory bleeding, balloon tamponade with Sengstaken-Blakemore tube may be necessary, usually as a bridge to further endoscopy or treatment of the underlying cause of bleeding (usually portal hypertension). Methods of treating the portal hypertension include: transjugular intrahepatic portosystemic shunt (TIPS), or a distal splenorenal shunt procedure or a liver transplantation.
Nutritional supplementation is not necessary if the patient is not eating for four days or less.
Terlipressin and octreotide (50mcg bolus IV followed by 25-50mcg/h IVF for 1 to 5 days) have also been used.

Esophageal varices

2011-07-09T07:24:00.000-07:00

In medicine (gastroenterology), esophageal varices are extremely dilated sub-mucosal veins in the lower esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis; patients with esophageal varices have a strong tendency to develop bleeding.

Esophageal varices are diagnosed with endoscopy.

The majority of blood from the esophagus is drained via the esophageal veins, which carry deoxygenated blood from the esophagus to the azygos vein, which in turn drains directly into the superior vena cava. These veins have no part in the development of esophageal varices. The remaining blood from the esophagus is drained into the superficial veins lining the esophageal mucosa, which drain into the coronary vein (left gastric vein), which in turn drains directly into the portal vein. These superficial veins (normally only approximately 1mm in diameter) become distended up to 1–2 cm in diameter in association with portal hypertension.

Normal portal pressure is approximately 9 mmHg compared to an inferior vena cava pressure of 2-6 mmHg. This creates a normal pressure gradient of 3-7 mmHg. If the portal pressure rises above 12mmHg, this gradient rises to 7-10 mmHg.[2] A gradient greater than 5 mmHg is considered portal hypertension. At gradients greater than 10 mmHg, blood flow though the hepatic portal system is redirected from the liver into areas with lower venous pressures. This means that collateral circulation develops in the lower esophagus, abdominal wall, stomach, and rectum. The small blood vessels in these areas become distended, becoming more thin-walled, and appear as varicosities. In addition, these vessels are poorly supported by other structures, as they are not designed for high pressures.

In situations where portal pressures increase, such as with cirrhosis, there is dilation of veins in the anastomosis, leading to esophageal varices. Splenic vein thrombosis is a rare condition which causes esophageal varices without a raised portal pressure. Splenectomy can cure the variceal bleeding due to splenic vein thrombosis. The most common cause of esophageal varices is from aging changes in the vessels.

Varices can also form in other areas of the body, including the stomach (gastric varices), duodenum (duodenal varices), and rectum (rectal varices). Treatment of these types of varices may differ.

Focal nodular hyperplasia

2011-07-09T07:22:00.000-07:00

Focal nodular hyperplasia (FNH) is a benign tumour of the liver (hepatic tumour), which is the second most prevalent tumour of the liver (the first is hepatic hemangioma). It is usually asymptomatic, rarely grows or bleeds, and has no malignant potential. This tumour is often resected because it is difficult to distinguish from hepatic adenoma.

Presentation

Focal nodular hyperplasia's most recognizable gross feature is a central stellate scar seen in 60-70% of cases. Microscopically, a lobular proliferation of bland-appearing hepatocytes with a bile ductular proliferation and malformed vessels within the fibrous scar is the most common pattern. Other patterns include telangiectatic, hyperplastic-adenomatous, and lesions with focal large-cell dysplasia.[ Rarely, these lesions may be multiple or can occur as part of a syndrome with hemangiomas, epithelioid hemangioendothelioma, hepatic adenomas, fibrolamellar hepatocellular carcinoma, vascular malformations of the brain, meningiomas, and/or astrocytomas.

Asbestosis

2011-07-09T07:19:00.000-07:00

Asbestosis is a chronic inflammatory and fibrotic medical condition affecting the parenchymal tissue of the lungs caused by the inhalation and retention of asbestos fibers. It usually occurs after high intensity and/or long-term exposure to asbestos (particularly in those individuals working on the production or end-use of products containing asbestos) and is therefore regarded as an occupational lung disease. People with extensive occupational exposure to the mining, manufacturing, handling or removal of asbestos are at risk of developing asbestosis. Sufferers may experience severe dyspnea (shortness of breath) and are at an increased risk for certain malignancies, including lung cancer but especially mesothelioma. Asbestosis specifically refers to interstitial (parenchymal) fibrosis from asbestos, and not pleural fibrosis or plaquing.

Signs and symptoms

The signs and symptoms of asbestosis do not manifest until after an appreciable latency (time since first exposure), often several decades under current conditions in the US. The primary symptom of asbestosis is generally the slow onset of dyspnea, especially on exertion.Clinically advanced cases of asbestosis may lead to respiratory failure. On auscultation of the lungs, the physician may hear inspiratory rales.

The characteristic pulmonary function finding in asbestosis is a restrictive ventilatory defect. This manifests as a reduction in lung volumes, particularly the Vital Capacity (VC) and Total Lung Capacity (TLC). The TLC may be reduced through alveolar wall thickening; however this is not always the case. Large airway function, as reflected by FEV1/FVC, is generally well preserved. In the more severe cases, the drastic reduction in lung function due to the stiffening of the lungs and reduced TLC may induce right-sided heart failure (cor pulmonale).[ In addition to a restrictive defect, asbestosis may produce reduction in Diffusion Capacity and arterial hypoxemia.

What is Mesothelioma?

2011-07-09T07:14:00.000-07:00

Mesothelioma, more precisely malignant mesothelioma, is a rare form of cancer that develops from the protective lining that covers many of the body's internal organs, themesothelium. It is usually caused by exposure to asbestos.
Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the pericardium (a sac that surrounds the heart), or the tunica vaginalis (a sac that surrounds the testis).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos and glass particles, or they have been exposed to asbestos dust and fiber in other ways. It has also been suggested that washing the clothes of a family member who worked with asbestos or glass can put a person at risk for developing mesothelioma.Unlike lung cancer, there is no association between mesothelioma and smoking, but smoking greatly increases the risk of other asbestos-induced cancers. Those who have been exposed to asbestos have collected damages for asbestos-related disease, including mesothelioma. Compensation via asbestos funds or lawsuits is an important issue in law practices regarding mesothelioma (see asbestos and the law).

The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with abiopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research aboutscreening tests for the early detection of mesothelioma is ongoing.

Prevention and treatment for Computer Vision Syndrome?

2011-04-06T03:11:00.000-07:00

Image Source: http://en.wikipedia.org/wiki/Ergonomic

Computer Vision Syndrome results due to the strain on eyes during long hours of computing. Common symptoms includes dry eyes and blurry vision.

Prevention

CVS can be easily avoided using following ways:

Use proper lighting. Low or very bright lighting will result in strain on eyes. So avoid it. The light should not reflect on screen.
Choose large fonts during reading (press CTRL + for Mozilla FF or Google Chrome or increase zoom for IE).
Place the Monitor or Laptop screen at a level so that it is comfortable with the eyes. (see image). Position the monitor 20 to 26 inches away from the eyes.
After working for 20-30 min, take a break and look away from the computer screen. Blink your eyes to maintain the moisture.. Put your both palms on both eyes for a min. That will relax your eyes.
Do not work on computer wearing contact lenses for more than 2 hours.
Use the protective anti reflective screen for monitor.
Use LCD monitors over CRT ones. The LCD monitors are costly than CRT but are more energy efficient and protective for eyes.

Treatment

Regularly check your eyes with ophthalmologist. Ask for computer glasses.
Use eye drops after consulting your doctor.

What is Computer Vision Syndrome (CVS)?

2011-03-12T06:30:00.000-08:00

As per wiki Computer vision syndrome (CVS) is a temporary condition resulting from focusing the eyes on a computer display for protracted, uninterrupted periods of time. This condition occurs in the peoples who spends hours on computers. Proper ergonomic design is necessary to prevent repetitive strain injuries.

Common symptoms of Computer Vision Syndrome (CVS)

Eyestrain
Blurry Vision
Dry Eyes
Headaches
Double Vision
Back and Neck pain
Difficulty refocusing the eyes
Polyopia

Computer Vision Syndrome can be easily prevented. Read more about prevention and treatment of CVS here.

What is Biomechatronics?

2010-11-29T23:45:00.000-08:00

Biomechatronics is an applied interdisciplinary science that aims to integrate mechanical elements, electronics and parts of biological organisms. Biomechatronics includes the aspects of biology, mechanics, and electronics. It also encompasses the fields of robotics and neuroscience. One example of Biomechatronics is a study done by Hugh Herr a professor at M.I.T.. Herr excised the muscles of frog legs, to attach to a mechanical fish and by pulsing electrical current through the muscle fibers, he caused the fish to swim. The goal of these experiments is to make devices that interact with human muscle, skeleton, and nervous systems.
The end result is that the devices will help with human motor control that was lost or impaired by trauma, disease or birth defects.
How It Works

Biomechatronics devices have to be based on how the human body works. For example, four different steps must occur to be able to lift the foot to walk. First, impulses from the motor center of the brain are sent to the foot and leg muscles. Next the nerve cells in the feet send information to the brain telling it to adjust the muscle groups or amount of force required to walk across the ground. Different amounts of force are applied depending on the type of surface being walked across. The leg's muscle spindle nerve cells then sense and send the position of the floor back up to the brain. Finally, when the foot is raised to step, signals are sent to muscles in the leg and foot to set it down.

Biosensors

Biosensors are used to detect what the user wants to do or their intentions and motions. In some devices the information can be relayed by the user's nervous system or muscle system. This information is related by the biosensor to a controller which can be located inside or outside the biomechatronic device. In addition biosensors receive information about the limb position and force from the limb and actuator. Biosensors come in a variety of forms. They can be wires which detect electrical activity, needle electrodes implanted in muscles, and electrode arrays with nerves growing through them.

Mechanical Sensors

The purpose of the mechanical sensors is to measure information about the biomechatronic device and relate that information to the biosensor or controller.

Controller

The controller in a biomechatronic device relays the user's intentions to the actuators. It also interprets feedback information to the user that comes from the biosensors and mechanical sensors. The other function of the controller is to control the biomechatronic device's movements.

Actuator

The actuator is an artificial muscle. Its job is to produce force and movement. Depending on whether the device is orthotic or prosthetic the actuator can be a motor that assists or replaces the user's original muscle.

The demand for biomechatronic devices are at an all time high and show no signs of slowing down. Many biomechatronic researchers are closely collaborating with military organizations. The US Department of Veterans Affairs and the Department of Defense are giving funds to different labs to help soldiers and war veterans

What is Biomedical engineering?

2010-11-29T23:42:00.000-08:00

Biomedical engineering is the application of engineering principles and techniques to the medical field. This field seeks to close the gap between engineering and medicine: It combines the design and problem solving skills of engineering with medical and biological sciences to improve healthcare diagnosis, monitoring and therapy.

Biomedical engineering has only recently emerged as its own discipline, compared to many other engineering fields; such an evolution is common as a new field transitions from being an interdisciplinary specialization among already-established fields, to being considered a field in itself. Much of the work in biomedical engineering consists of research and development,

spanning a broad array of subfields (see below). Prominent biomedical engineering applications include the development of biocompatible prostheses, various diagnostic and therapeutic medical devices ranging from clinical equipment to micro-implants, common imaging equipment such as MRIs and EEGs, biotechnologies such as regenerative tissue growth, and pharmaceutical drugs and biopharmaceuticals.

History of Medicine

2010-11-29T23:38:00.000-08:00

Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine. The Egyptian Imhotep (3rd millennium BC) is the first physician in history known by name. Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found.The Indian surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery.

The Greek physician Hippocrates, considered the "father of medicine", laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence".

The Greek physician Galen was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Dark Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

After 750 CE, the Muslim Arab world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the polymath, Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine". He wrote The Canon of Medicine, considered one of the most famous books in the history of medicine. Others include Abulcasis, Avenzoar, Ibn al-Nafis, and Averroes. Rhazes was one of first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine. The Islamic Bimaristan hospitals were an early example of public hospitals.

However, the fourteenth and fifteenth century Black Death was just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Ibn al-Nafis and Vesalius improved upon or disproved some of the theories from the past.

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900.

The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austrian doctors (such as Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner, and Otto Loewi) made contributions. In the United Kingdom Alexander Fleming, Joseph Lister, Francis Crick, and Florence Nightingale are considered important. From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet).

In the United States William Williams Keen, Harvey Cushing, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburō), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca and others did significant work). Russian Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century not only animal and plant products were used as medicine, but also human body parts and fluids. Pharmacology developed from herbalism and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc.). Vaccines were discovered by Edward Jenner and Louis Pasteur.

The first antibiotic was arsphenamine / Salvarsan discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by French chemists originally from azo dyes.

Pharmacology has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by modern global information science, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols which are then disseminated to healthcare providers. One problem with this 'best practice' approach is that it could be seen to stifle novel approaches to treatment[citation needed]. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.

What is Medicine?

2010-11-29T23:34:00.000-08:00

Medicine is the science and art (ars medicina) of healing humans. It includes a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practiced along with "Eastern medicine" — which are typically based in traditional, story-told, or otherwise non-scientific practices.

Contemporary medicine applies health science, biomedical research, and medical technology to diagnose and treat injury and disease, typically through medication, surgery, or some other form of therapy. The word medicine is derived from the Latin ars medicina, meaning the art of healing.

Though medical technology and clinical expertise are pivotal to contemporary medicine, successful face-to-face relief of actual suffering continues to require the application of ordinary human feeling and compassion, known in English as bedside manner.

What is health?

2010-11-29T23:32:00.000-08:00

Health is the general condition of a person in all aspects. It is also a level of functional and/or metabolic efficiency of an organism, often implicitly human.
The Caduceus.

At the time of the creation of the World Health Organization (WHO), in 1948, health was defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity".

Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. Some of them highlight its lack of operational value and the problem created by use of the word "complete." Others declare the definition, which has not been modified since 1948, "simply a bad one."

In 1986, the WHO, in the Ottawa Charter for Health Promotion, said that health is "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." Classification systems such as the WHO Family of International Classifications (WHO-FIC), which is composed of the International Classification of Functioning, Disability, and Health (ICF) and the International Classification of Diseases (ICD) also define health.

Overall health is achieved through a combination of physical, mental, and social well-being, which, together is commonly referred to as the Health Triangle.

Diagnosis of UTI

2009-09-28T18:17:00.000-07:00

Following are the symptoms of Urinary Tract Infection.

Burning sensation in urinary tract.
Nausea and vomiting.
Rise in body temperature.
Chill

In severe condintion pain in left side of abdomen.

Leg Cramps during Pregnancy? Cause and Precaution.

2009-09-23T02:45:00.000-07:00

Image source: ehow.com

Leg cramps are a very common during pregnancy. Main cause is increased weight of mother. Increased calcium intake also can cause leg cramps.

Precautions:

* Drink plenty of water
* Wear supportive stockings.
* Do not stand for long time
* Massage calf and leg muscles during the day and before bed.
* Take a short walk.
* Bath your legs with warm water.

Building Long-Term Health in Breast cancer

2007-12-06T22:20:00.000-08:00

Breast cancer treatment has progressed at a quick pace in recent years, and more advances are coming out all the time. This is great news for improving the health and survival odds for women with breast cancer. But it also means a confusing array of treatment options and often many months—and even years—of treatment.

After surgery, you might have months of chemotherapy, radiation treatment, or both. These may be followed by years of hormonal treatment or other targeted therapy.

But after the initial treatment—surgery, radiation, and possibly chemotherapy—is over, you might just want to put it all behind you. Done! You got through it, and you never want to deal with cancer again. You crave that normal feeling when you wake up, go through the day, and sleep through the night without any signs or thoughts of cancer. Like anyone else, you want to be able to think and plan for your future without the fear of cancer in your way.

All of these very strong wishes are totally normal. Yet you probably know you'll be dealing with some fear or concerns about cancer for the rest of your life. You may also have decided with your doctor that the best treatment plan for you includes long-term hormonal therapy or other medication that you have to take regularly—every day, week, or month—for years. And even many years after your initial treatment is over, you should be checked regularly so your doctors can monitor your health and make sure you're continuing to do well.

In this way, breast cancer has become similar to other serious, chronic conditions, like heart disease and diabetes. It's something you live with and take care of for the rest of your life.

So how do you take baby steps, and then bigger and bigger steps, beyond your initial therapy to ensure the healthiest possible future for you?

One of the big steps you need to take after your main treatment is over is to focus the strength of your mind on what's most important: your good health. You have to take a stand for getting the best ongoing care and living the best life possible well into your future.

Make a deal with yourself: you will do the best job you can to love yourself, speak up for yourself, take care of yourself, and take advantage of the best medical care available to you. Remember: there is only one of you, and you deserve the best care possible.

Of course, you don't have to do this all alone! Reach out and accept help from family and friends who are looking for ways to support you.

Think about your doctors and nurses as your "extra-special personal health-care team" that you've brought into your world to guard and cherish your life. Look at tests as an important way to know what's going on inside your body as a guide for your long-term treatment. View your ongoing therapy as an important insurance plan for extra protection beyond your initial treatment to keep you healthy well into your future.

The treatment plan, or regimen, that you and your doctors put together for you is designed to strengthen your outlook for a healthy future. By following it fully, you'll have the best chances of living a long, disease-free life.

This section of breastcancer.org is intended to help you remain committed to your treatment plan, so you can maintain the best possible long-term health and quality of life.

In this section, we'll help you understand why it's so important to stick to your plan, suggest ways to handle possible difficulties in following radiation, chemotherapy, and hormonal therapy regimens, and encourage you to talk with your doctors and nurses to find other effective treatments and regimens

Types of Complementary Techniques for Breast cancer

2007-12-06T22:19:00.001-08:00

There are literally hundreds of complementary treatments. While some treatments have been studied in breast cancer patients, others have not. We have noted which treatments have and have not been studied in breast cancer patients. ALWAYS check with your doctor before beginning any complementary treatment.

Although not every complementary technique is listed here, we've included information about the most widely used complementary techniques.
Complementary medicine treatments

* Acupuncture *
* Music Therapy *
* Aromatherapy
* Progressive Muscle Relaxation
* Chiropractic *
* Reiki *
* Guided Imagery
* Shiatsu *
* Hypnosis *
* Spirituality and Prayer
* Journaling
* Support Groups *
* Massage *
* Tai Chi
* Meditation
* Yoga

*Requires a practitioner. The others can be self-taught or done alone after a few sessions with a teacher. Always talk to your doctor before trying a new therapy.

Chemotherapy for Breast cancer

2007-12-06T22:17:00.000-08:00

Chemotherapy is a systemic therapy; this means it affects the whole body by going through the bloodstream. The purpose of chemotherapy and other systemic treatments is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.

Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. The side effects of chemotherapy come about because cancer cells aren't the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the chemotherapy is going to affect them, too.

Still, chemotherapy is much easier to tolerate today than even a few years ago. And for many women it's an important "insurance policy" against cancer recurrence. It's also important to remember that organs in which the cells do not divide rapidly, such as the liver and kidneys, are rarely affected by chemotherapy. And doctors and nurses will keep close track of side effects and can treat most of them to improve the way you feel.

In this section, you'll learn more about how chemotherapy works and the best ways to manage nausea, hair loss, and other chemotherapy side effects.

You'll also read about the different chemotherapy regimens and about deciding together with your medical oncologist which regimen would be best suited to you.

It's important to remember that every woman's ideal treatment plan is different. Be aware that your "chemo" regimen may be different from someone else's, based on very individual—and sometimes subtle—breast cancer factors. These include: lymph node involvement, tumor size, hormone receptor status, grade, and oncogene expression. Be prepared for your doctor to recommend a combination of chemotherapies—together or in a series.

Hormonal Therapy for breast cancer

2007-12-06T22:16:00.001-08:00

Hormonal therapy is a very effective treatment against breast cancer that is hormone-receptor-positive. Find out if you should be tested to see if you need other therapies, as well. Sometimes called "anti-estrogen therapy," hormonal therapy blocks the ability of the hormone estrogen to turn on and stimulate the growth of breast cancer cells.

For years, tamoxifen was the hormonal medicine of choice for all women with hormone-receptor-positive breast cancer. But in 2005, the results of several major worldwide clinical trials showed that aromatase inhibitors (Arimidex [chemical name: anastrozole], Aromasin [chemical name: exemestane], and Femara [chemical name: letrozole]) worked better than tamoxifen in post-menopausal women with hormone-receptive-positive breast cancer.

Aromatase inhibitors are now considered the standard of care for post-menopausal women with hormone-receptor-positive breast cancer. Tamoxifen remains the hormonal treatment of choice for pre-menopausal women.

Targeted Breast cancer Therapies

2007-12-06T22:12:00.000-08:00

Targeted cancer therapies are cancer treatments that target specific characteristics of cancer cells, such as a protein, an enzyme, or the formation of new blood vessels. Targeted therapies don't harm normal, healthy cells. Most targeted therapies are antibodies that work like the antibodies made by the immune system. So targeted therapies are also called immune targeted therapies. In this way, targeted therapies are very different from more traditional types of anti-cancer therapies.

* Herceptin
Herceptin (chemical name: trastuzumab) is the best known targeted therapy for breast cancer. Herceptin only works against breast cancers that have extra HER2 genes and make too many HER2 protein receptors. Herceptin does have a number of potentially serious side effects.
* Tykerb
Tykerb (chemical name: lapatinib) is another targeted therapy that works against breast cancers that have extra HER2 genes. Tykerb has been approved by the FDA to be given in combination with Xeloda (chemical name: capecitabine) to treat advanced, HER2-positive breast cancer that has stopped responding to anthracyclines, taxanes, and Herceptin.
* Avastin
Avastin (chemical name: bevacizumab) is also a targeted therapy. Avastin targets the new blood vessels that feed cancer cells. Avastin has been approved by the FDA to treat certain types of advanced cancers of the lung, colon and rectum. Researchers are studying Avastin in combination with Taxol (chemical name: paclitaxel) to see if the combo can slow the progression of advanced breast cancer better than Taxol alone.

New targeted therapies are emerging on a regular basis. Stay tuned to breastcancer.org for the latest research results in this area of treatment.

The role of surgery in breast cancer treatment

2007-12-06T22:10:00.000-08:00

For well over a century, surgery has been the first line of attack against breast cancer. But things have changed a lot in recent years. Today, the goal is precise, targeted surgery that aims to preserve as much of the healthy breast and surrounding areas as possible. Even mastectomy (breast removal) is a more refined, less drastic option than it was a generation ago.

The most important of these deciding factors are: the stage of the cancer, the overall "personality" of the cancer, and what is acceptable to you in terms of your long-term peace of mind.

kinds of surgery

* breast-conserving surgery, (commonly known as lumpectomy) in which only the tumor is removed from the breast. This is usually followed by radiation therapy to the remaining breast tissue.
* mastectomy, an operation in which the whole breast is removed. Sometimes radiation is given after mastectomy.

For invasive breast cancer, both of these procedures may also be accompanied by an axillary lymph node dissection. Recommendations for whole body or "systemic" treatments such as hormonal therapy, chemotherapy, or both, may follow either approach.

The need for systemic treatment is independent of which surgical procedure you choose. Do not elect to have a mastectomy thinking that this will eliminate the need for chemotherapy.

If you have early-stage breast cancer, ask your doctor about the sentinel lymph node dissection as an alternative to traditional lymph node dissection. Find out if you are a good candidate. If you are, ask if your surgeon has a high level of experience with this new technique, before proceeding.

Treatment of breast cancer

2007-12-06T22:08:00.000-08:00

In recent years, there's been an explosion of life-saving treatment advances against breast cancer, bringing new hope and excitement. Instead of only one or two options, today there's an overwhelming menu of treatment choices that fight the complex mix of cells in each individual cancer. The decisions—surgery, then perhaps radiation, hormonal (anti-estrogen) therapy, and/or chemotherapy—can feel overwhelming.

breastcancer.org can help you understand your cancer stage and appropriate options, so you and your doctors can arrive at the best treatment plan for YOU.

In the following pages of the Treatment section, you can learn about:

* Surgery
Breast-conserving surgery (lumpectomy), mastectomy, and lymph node dissection, and what to expect from each.

* Radiation Therapy
Radiation therapy—also called radiotherapy—is a highly targeted, highly effective way to destroy cancer cells that may linger after surgery. Radiation can reduce the risk of recurrence by 50% to 66% (about a half to two-thirds reduction in risk). Despite what many women fear, radiation therapy is relatively easy to tolerate, and its side effects are limited to the treated area.

Your radiation treatment will be overseen by a radiation oncologist, a cancer doctor who specializes in radiation treatment.

* Targeted Therapies
Including Herceptin: How they work, who should get them, how they're given, side effects, and major studies.

* Hormonal Therapy
The link between hormones and breast cancer and how different groups of drugs—including ERDs, SERMs, and aromatase inhibitors—can affect that link.

* Chemotherapy
Who should get it, how it works, different types, side effects, and how to manage them.

* Complementary Medicine
How complementary medicine techniques such as acupuncture, meditation, and yoga could be a helpful addition to your regular medical treatment. Includes research on complementary techniques and ways to find qualified practitioners.

* Building Long-Term Health
Why it's so important to stick to your treatment plan, take the full course of medications, and continue with regular tests and doctors' visits to keep yourself healthy into the future.

Stages of Breast Cancer

2007-12-06T21:38:00.000-08:00

The purpose of the staging system is to help organize the different factors and some of the personality features of the cancer into categories, in order to:

* best understand your prognosis (the most likely outcome of the disease)
* guide treatment decisions, since clinical studies of breast cancer treatments that you and your doctor will consider are partly organized by the staging system, and
* provide a common way to describe the extent of breast cancer for doctors and nurses all over the world, so that results of your treatment can be compared and understood.

Tumor sizes:
3 spheres measuring 1 cm, 3cm, 5cm

Stage 0

This stage is used to describe non-invasive breast cancer. There is no evidence of cancer cells breaking out of the part of the breast in which it started, or of getting through to or invading neighboring normal tissue. LCIS and DCIS are examples of stage 0.
Stage I

This stage describes invasive breast cancer (cancer cells are breaking through to or invading neighboring normal tissue) in which

* The tumor measures up to two centimeters, AND
* No lymph nodes are involved.

Stage II

This stage describes invasive breast cancer in which:

* The tumor measures at least two centimeters, but not more than five centimeters, OR
* Cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Affected lymph nodes have not yet stuck to one another or to the surrounding tissues, a sign that the cancer has not yet advanced to stage III. (The tumor in the breast can be any size.)

Stage III

Stage III is divided into subcategories known as IIIA and IIIB.
Stage IIIA

Stage IIIA describes invasive breast cancer in which:

* the tumor measures larger than five centimeters, OR
* there is significant involvement of lymph nodes. The nodes clump together or stick to one another or surrounding tissue.

Stage IIIB

This stage describes invasive breast cancer in which a tumor of any size has spread to the breast skin, chest wall, or internal mammary lymph nodes (located beneath the breast right under the ribs, inside the middle of the chest).

Stage IIIB includes inflammatory breast cancer, a very uncommon but very serious, aggressive type of breast cancer. The most distinguishing feature of inflammatory breast cancer is redness involving part or all of the breast. The redness feels warm. You may see puffiness of the breast's skin that looks like the peel of a navel orange ("peau d'orange"), or even ridges, welts, or hives. And part or all of the breast may be enlarged and hard. A lump is present only half of the time. Inflammatory breast cancer is sometimes misdiagnosed as a simple infection.

Stage IV

This stage includes invasive breast cancer in which

* a tumor has spread beyond the breast, underarm, and internal mammary lymph nodes, and
* a tumor may have spread to the supraclavicular lymph nodes (nodes located at the base of the neck, above the collarbone), lungs, liver, bone, or brain.

"Metastatic at presentation" means that the breast cancer has spread beyond the breast and nearby lymph nodes, even though this is the first diagnosis of breast cancer. The reason for this is that the primary breast cancer was not found when it was only inside the breast. Metastatic cancer is considered stage IV.

How Breast Cancer Happens

2007-12-06T21:34:00.001-08:00

Breast profile:
A Ducts
B Lobules
C Dilated section of duct to hold milk
D Nipple
E Fat
F Pectoralis major muscle
G Chest wall/rib cage

Enlargement
A Normal duct cells
B Basement membrane
C Lumen (center of duct)

The breast is a gland designed to make milk. The lobules in the breast make the milk, which then drains through the ducts to the nipple.

Like all parts of your body, the cells in your breasts usually grow and then rest in cycles. The periods of growth and rest in each cell are controlled by genes in the cell's nucleus. The nucleus is like the control room of each cell. When your genes are in good working order, they keep cell growth under control. But when your genes develop an abnormality, they sometimes lose their ability to control the cycle of cell growth and rest.
Breast cancer is an uncontrolled growth of breast cells.

Cancer has the potential to break through normal breast tissue barriers and spread to other parts of the body. While cancer is always caused by a genetic "abnormality" (a "mistake" in the genetic material), only 5–10% of cancers are inherited from your mother or father. Instead, 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and life in general.

While there are things every woman can do to help her body stay as healthy as possible (such as eating a balanced diet, not smoking, minimizing stress, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is counterproductive.

Signs, Symptoms & Diagnosis of Breast cancer

2007-12-06T21:13:00.000-08:00

Symptoms

Early breast cancer usually does not cause pain. In fact, when breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for:

* A lump or thickening in or near the breast or in the underarm area.
* A change in the size or shape of the breast.
* A discharge from the nipple.
* A change in the color or feel of the skin of the breast, areola, or nipple (dimpled, puckered, or scaly).

A woman should see her doctor if she notices any of these changes. Most often, they are not cancer, but only a doctor can tell for sure.

Diagnosis

An abnormal area on a mammogram, a lump, or other changes in the breast can be caused by cancer or by other, less serious problems. To find out the cause of any of these signs or symptoms, a woman's doctor does a careful physical exam and asks about her personal and family medical history. In addition to checking general signs of health, the doctor may do one or more of the breast exams described below.

* Palpation. The doctor can tell a lot about a lump—its size, its texture, and whether it moves easily—by palpation, carefully feeling the lump and the tissue around it. Benign lumps often feel different from cancerous ones.

* Mammography. X-rays of the breast can give the doctor important information about a breast lump. If an area on the mammogram looks suspicious or is not clear, additional x-rays may be needed.

* Ultrasonography. Using high-frequency sound waves, ultrasonography can often show whether a lump is solid or filled with fluid. This exam may be used along with mammography.

Based on these exams, the doctor may decide that no further tests are needed and no treatment is necessary. In such cases, the doctor may need to check the woman regularly to watch for any changes. Often, however, the doctor must remove fluid or tissue from the breast to make a diagnosis.

Aspiration or needle biopsy. The doctor uses a needle to remove fluid or a small amount of tissue from a breast lump. This procedure may show whether a lump is a fluid-filled cyst (not cancer) or a solid mass (which may or may not be cancer). Using special techniques, tissue can be removed with a needle from an area that is suspicious on a mammogram but cannot be felt.

If tissue is removed in a needle biopsy, it goes to a lab to be checked for cancer cells. Clear fluid removed from a cyst may not need to be checked by a lab.

Surgical biopsy. The surgeon cuts out part or all of a lump or suspicious area. A pathologist examines the tissue under a microscope to check for cancer cells.

When a woman needs a biopsy, these are some questions she may want to ask her doctor:

* What type of biopsy will I have? Why?
* How long will the biopsy or aspiration take? Will I be awake? Will it hurt?
* How soon will I know the results?
* If I do have cancer, who will talk with me about treatment? When?

When Cancer Is Found

When cancer is present, the pathologist can tell what kind of cancer it is (whether it began in a duct or a lobule) and whether it is invasive (has invaded nearby tissues in the breast).

Special laboratory tests of the tissue help the doctor learn more about the cancer. For example, hormone receptor tests (estrogen and progesterone receptor tests) can help predict whether the cancer is sensitive to hormones. Positive test results mean hormones help the cancer grow and the cancer is likely to respond to hormonal therapy. Other lab tests are sometimes done to help the doctor predict whether the cancer is likely to grow slowly or quickly.

If the diagnosis is cancer, the patient may want to ask these questions:

* What kind of breast cancer do I have? It is invasive?
* What did the hormone receptor test show? What other lab tests were done on the tumor tissue, and what did they show?
* How will this information help the doctor decide what type of treatment or further tests to recommend?

The patient's doctor may refer her to doctors who specialize in treating cancer, or she may ask for a referral. Treatment generally begins within a few weeks after the diagnosis. There will be time for the woman to talk with the doctor about her treatment choices, to get a second opinion, and to prepare herself and her loved ones.

How Breast Cancer Happens

Home remedies and natural treatments for acne

2007-09-20T07:24:00.000-07:00

Acne Remedies

Here are some home remedies and natural treatments for acne.
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Tea Tree Oil

Tea tree oil is a popular home remedy for acne. It is an essential oil that is diluted and applied topically to acne lesions.

How is tea tree oil believed to work? Tea tree oil contains a constituent called terpinen-4-ol that's thought to be responsible for most of tea tree oil's anti-bacterial activity. Because tea tree oil can kill bacteria, applying topical tea tree oil to acne lesions is believed to kill Propionibacterium acnes, the skin-dwelling bacteria involved in causing acne. Read more about tea tree oil and acne: Tea Tree Oil for Acne? and learn more about Tea Tree Oil
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Zinc

Zinc is another popular home remedy for acne. A couple of research studies have found that zinc is somewhat effective. While it was more effective than a placebo, antibiotic medication was still more effective. In light of this, it may not be the best option when scarring is a possibility.

Side effects of zinc include digestive upset and a metallic taste in the mouth. At high doses, zinc may lead to copper deficiency, weakened immune function, anemia, and heart problems. There is some concern that higher doses may reduce levels of HDL ("good") chholesterol.

Zinc may also interfere with the absorption of magnesium and iron from food and supplements. It can interfere with the absorption of tetracycline and fluoroquinolone antibiotics and penicillamine. There is also some concern that a particular diuretic, amiloride, can reduce zinc excretion and lead to a toxic build-up in the body.

Acne-Treatment

2007-09-06T07:46:00.000-07:00

Treatment

Acne treatments work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection or doing all three. With most prescription acne treatments, you may not see results for four to eight weeks, and your skin may get worse before it gets better. Oral prescription medications for acne should not be used during pregnancy, especially during the first trimester.
Your doctor or dermatologist may recommend one or more of the following treatments for acne:

Topical treatments. Acne lotions may dry up the oil, kill bacteria and promote sloughing of dead skin cells. Over-the-counter lotions are generally mild and contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or lactic acid as their active ingredient. These products can be helpful for very mild acne. If your acne doesn't respond to these treatments, you may want to see a doctor or dermatologist to get a stronger prescription lotion. Tretinoin (Avita, Retin-A, Renova) and adapalene (Differin) are examples of topical prescription products derived from vitamin A. They work by promoting cell turnover and preventing plugging of the hair follicle. A number of topical antibiotics also are available. They work by killing excess skin bacteria. Often, a combination of such products is required to achieve optimal results.
Antibiotics. For moderate to severe acne, prescription oral antibiotics may be needed to reduce bacteria and fight inflammation. You may need to take these antibiotics for months, and you may need to use them in combination with topical products.
Isotretinoin. For deep cysts, antibiotics may not be enough. Isotretinoin (Accutane) is a powerful medication available for scarring cystic acne or acne that doesn't respond to other treatments. This medicine is reserved for the most severe forms of acne. It's very effective, but people who take it need close monitoring by a dermatologist because of the possibility of severe side effects. Isotretinoin is associated with severe birth defects, so it can't be taken by pregnant women or women who may become pregnant during the course of treatment or within several weeks of concluding treatment. In fact, the drug carries such serious potential side effects that women of reproductive age must participate in an FDA-approved monitoring program to receive a prescription for the drug. In addition, isotretinoin may increase the levels of triglycerides and cholesterol in the blood and may increase liver enzyme levels. For most people, however, these levels return to normal when the medication is stopped.
Oral contraceptives. Oral contraceptives, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen), have been shown to improve acne in women. However, oral contraceptives may cause other side effects that you'll want to discuss with your doctor.
Cosmetic surgery. Doctors may be able to use cosmetic surgery to diminish scars left by acne. Procedures include peeling away damaged skin with chemicals or by freezing it, dermabrasion, intense light therapy and laser resurfacing. Peeling procedures eliminate superficial scars. Dermabrasion, which is usually reserved for more severe scarring, involves removing the top layers of skin with a rapidly rotating wire brush. Laser resurfacing involves using short pulses of intense light to remove the outer layer of your skin. If your skin tends to form scar tissue, these procedures can make your complexion worse.

Acne-Risk factors

2007-09-06T07:43:00.000-07:00

Hormonal changes in your body can provoke or aggravate acne. Such changes are common in:

Teenagers, both boys and girls
Women and girls, two to seven days before their periods
Pregnant women
People using certain medications, including cortisone

Other risk factors include:

Exposing your skin directly to greasy or oily substances, or to certain cosmetics.
Having a family history of acne. If your parents had acne, you may be likely to develop it too.
Friction or pressure on your skin caused by items such as telephones or cell phones, helmets, tight collars and backpacks.

ACNE-Myth Breaker

2007-09-06T07:38:00.000-07:00

Myth:Washing your face more often will help clear up acne
Reality:Facial blemishes are not caused by dirt. Contrary to what you may have seen in commercials, pores do not get blocked from the top down due to "impurities". Rather, the walls of a pore stick together within the skin, starting acne formation. Far from preventing acne, frequent washing may actually irritate pores and cause them to become clogged. A washcloth can add even more irritation. The best bet is to wash very gently with bare hands, and only wash twice a day.
Myth:Stress causes acne
Reality:Stress may have an effect on hormones and theoretically can promote acne. However, an effective acne treatment regimen is more powerful than a bout of stress any day. Some psychiatric medications may have acne as a side effect, but stress itself is no big deal. Your time is better spent determining the right course of acne treatment rather than feeling guilt about stress.
Myth:Masturbation or sex causes acne
Reality:This antiquated notion, originating as early as the 17th century to dissuade young people from having premarital sex, is just plain wrong. Don't believe the hype.
Myth:The sun will help get rid of acne
Reality:The sun may work in the short-term to hasten the clearing of existing acne while reddening your skin, thus blending your skin tone with red acne marks. However, a sun burn is actually skin damage. Sun exposure causes irritation which can make acne worse. People will often notice their skin breaking out as it heals from sun damage. The sun is a short-term band-aid which will often bite back with more acne in the weeks following exposure. Having said that, I don't want to give the impression that the sun is evil. It is not. We get our vitamin D from the sun for instance. Limiting sun exposure on acne prone areas of your body is most likely prudent, but some exposure from time to time is not only unavoidable, but is perfectly okay.
Myth:Diet and acne are related
Reality:The bottom line is we need more research. We do know that people in some indigenous societies do not experience acne whatsoever across the entire population. This is in stark contrast to the widespread presence of acne throughout all modern society. It leaves us to ponder the question of whether the indigenous people's diet contributes to their acne-free skin. Discovering a dietary way of preventing acne may be a future reality, however, we may live so differently from our hunter/gatherer ancestors that it has become close to impossible to replicate our ancestral diet. But, let's see if we can work together to come to some concensus from our own experiences.

Non-inflammatory acne

2007-09-06T07:34:00.000-07:00

Microcomedones become non-inflamed skin blemishes called comedones--either a whitehead or a blackhead:

WhiteheadWhen the trapped sebum and bacteria stay below the skin surface, a whitehead is formed. Whiteheads may show up as tiny white spots, or they may be so small that they are invisible to the naked eye.

BlackheadA blackhead occurs when the trapped sebum and bacteria partially open to the surface and turn black due to melanin, the skin's pigment. It is not dirt and can not be washed away. Blackheads can last for a long time because the contents very slowly drain to the surface
.

A blackhead or whitehead can release its contents to the surface and heal. Or, the follicle wall can rupture and inflammatory acne can ensue (see below). This rupture can be caused by random occurence or by picking or touching the skin. This is why it is important to leave acne prone skin relatively untouched.

Acne-a normal follicle

2007-09-06T07:30:00.000-07:00

A normal follicle looks like this:

For reasons no one completely understands, follicles, often called pores, sometimes get blocked. Sebum (oil) which normally drains to the surface gets blocked and bacteria begins to grow. Both whiteheads and blackheads start out as a microcomedone. The picture below is a microcomedone:

Primary Pulmonary Hypertension-Treatment

2007-09-06T06:10:00.000-07:00

What therapy is available for patients with primary pulmonary hypertension?
Doctors can choose from a variety of drugs that help lower blood pressure in the lungs and improve heart performance in many patients.

Physicians now know that patients with PPH respond differently to the different medications that dilate or relax blood vessels and that no one drug is consistently effective in all patients.

Because individual reactions vary, different drugs have to be tried before chronic or long-term treatment begins.

During the course of the disease, the amount and type of medicine also may have to be changed.

To find out which medicine works best for a particular patient, doctors evaluate the drugs during cardiac catheterization.

At present, about one-quarter of patients can be treated with calcium channel-blocking drugs given orally.
Intravenous prostacyclin is a vasodilator. It helps patients who don't respond to treatment with calcium channel blockers given by mouth. It's continuously delivered by a portable, battery-operated infusion pump. Despite this complexity, prostacyclin improves pulmonary hypertension and permits increased physical activity. This improves the quality of life for patients of all ages. Prostacyclin is sometimes used as a bridge to help patients waiting for a transplant. In other cases it's used for long-term treatment.

Besides oral calcium channel blockers and chronic intravenous prostacyclin, clinical trials are under way to evaluate new drugs to improve the treatment of PPH.
Some patients also do well by taking medicines that make the right ventricle's work easier.

Anticoagulants, for example, can decrease the tendency of the blood to clot, thus permitting the blood to flow more freely.
Diuretics reduce the amount of fluid in the body, further reducing the amount of work the heart has to do.
Some patients also require supplemental oxygen delivered through nasal prongs or a mask if breathing becomes difficult. Some need oxygen around the clock.

Transplantation (heart-lung or lung) is reserved for patients who don't respond to medical therapy. The decision whether a patient requires heart-lung transplantation or lung transplantation is made after a thorough evaluation at a lung transplantation center.

What are the long-term prospects for patients with primary pulmonary hypertension?
Despite the complexity of some of the various medical therapies, accurate, early diagnosis and initiation of treatment have saved the lives of many patients with PPH.

With optimal medical and/or surgical therapy, patients can often return to a virtually normal lifestyle, including running a household, returning to school and participating in many physical activities.
Most doctors and patients agree that it's very important for both patients and families to be as informed as possible.

This lets everyone understand the illness and apply the information to what is happening. In addition to family and close friends, support groups can help PPH patients.

Primary Pulmonary Hypertension-causes & symptoms

2007-09-06T06:08:00.000-07:00

What causes primary pulmonary hypertension?
We don't know the cause; there may be one or more causes.

The low incidence makes learning more about the disease extremely difficult.

Studies of PPH also have been difficult because a good animal model of the disease hasn't been available.

We think that in most people who develop primary pulmonary hypertension, the blood vessels are very sensitive to certain factors that trigger this disease to develop.

For example, people with Raynaud's syndrome seem more likely than others to develop PPH.
In addition, appetite suppressants, cocaine and HIV are some factors believed to trigger the constriction, or narrowing, of the pulmonary artery.

What are the symptoms of primary pulmonary hypertension?

The first symptom is often fatigue or tiredness. Many patients think that they're simply "out of shape."
Difficulty in breathing, dizziness and even fainting spells can occur.
Swelling in the ankles or legs, bluish discoloration of the lips and skin, and chest pain more often occur later in the disease.

One of the great difficulties in treating PPH is that the diagnosis is often delayed due to the slowly progressive and insidious onset of the symptoms.

How is a patient with primary pulmonary hypertension evaluated?
Significant advances in PPH therapy over the past decade have markedly affected the survival and quality of life for people with this disease.
The optimal medical and/or surgical treatment for patients with PPH depends upon a thorough evaluation at a medical center with expertise in pulmonary hypertension.
The evaluation includes a right heart cardiac catheterization.

In this procedure the doctor places a thin, flexible tube (a catheter) through an artery or vein in the patient's arm, leg or neck, then threads it into the right ventricle and pulmonary artery.

This is the only way to measure the pressure in the pulmonary artery and find out what medical therapy is appropriate for a given patient.

Primary or Unexplained Pulmonary Hypertension

2007-09-06T06:04:00.000-07:00

AHA Recommendation
There is extremely wide variability in the severity of pulmonary hypertension among various patients.

Evaluating, accurately diagnosing and treating the condition is also very complex.

For these reasons, patients with symptoms that suggest pulmonary hypertension require thorough evaluation at a medical center with expertise and experience in pulmonary hypertension.

What is primary pulmonary hypertension (or unexplained pulmonary hypertension)?
Primary or unexplained pulmonary hypertension (PPH) is a rare lung disorder in which the blood pressure in the pulmonary artery rises far above normal levels for no apparent reason.

The pulmonary artery is a blood vessel carrying oxygen-poor blood from the right ventricle (one of the heart's pumping chambers) to the lungs.

In the lungs, the blood picks up oxygen, then flows to the heart's left side, where the left ventricle pumps it to the rest of the body through the aorta.
Hypertension is a medical term for abnormally high blood pressure. Normal average (also called "mean") pulmonary artery pressure is about 14 mm Hg at rest.
In patients with PPH, the average blood pressure in the pulmonary artery is greater than 25 mm Hg at rest and greater than 30 mm Hg during exercise.

This abnormally high pressure (pulmonary hypertension) is linked with changes in the small blood vessels in the lungs.

These changes increase resistance to blood flowing through the vessels.

This increased resistance puts a strain on the right ventricle, which now must work harder than usual to move enough blood through the lungs.

In the United States, an estimated 500 to 1,000 new cases of primary pulmonary hypertension are diagnosed each year.
The greatest number is reported in women between ages 20 and 40. However, men and women in all age ranges — as well as very young children — can develop PPH.

Hair Removal Information & Techniques

2007-08-31T20:50:00.000-07:00

For decades now, women have been removing unwanted body hair, using different techniques. Not only does it add to the woman's beauty but it is better for her personal hygiene as well. Today getting rid of unwanted hair has become easier than ever. There are a number of easy techniques that you can use at home or you can visit a beauty parlor for professional treatment. Given below in some information about the different techniques that are available today.

Shaving: Shaving is a popular technique as it can be done at short notice and gives you instant results without much effort. Most women still continue to shave inspite of alternate techniques being available. This method is quick and cheap, though the hair grows back rapidly and when the hair grows back it is very coarse. You should soften the hair by washing the area with warm soapy water. Use light gentle strokes in the direction of the hair growth, to remove the hair. After you finish moisturize the skin. There are different kinds of razors, electrical, disposable, with twin blades and moisturizing strips. Choose one that suits you the best.
Hair Removal Creams: These creams are manufactured in such a way that they dissolve the hair. These creams have an ingredient called keratolytic that will damage the skin if it is left on for a long time. Use a patch test the first time you are using a cream. But there is no doubt that they make the skin hair free, smooth and soft.
Waxing: Though this method is a little painful, it is good to remove hair from the arms, legs and bikini line. Hair re-growth after waxing is slow and may take as much as two months. It is best to do a patch test for waxing as well. For best results one should continue waxing on a regular basis. Hair is removed from its root and when it re-grows it is finer. The problem with waxing is that the hair has to grow a little for waxing to be efficient. It helps to dust a little talcum powder on the area before waxing.
Sugaring: This technique is similar to waxing. Here the removal solution is warmed and then applied on the area required with the help of a palette knife. The solution is applied in the direction of the hair growth. Then a cotton strip is used to cover the solution and torn away in the opposite direction and thus the hair is removed. Hair re-growth takes about six to eight weeks and it is fine.
Electrolysis: This is a salon treatment and is expensive, but last longer and could be permanent as well. This requires a series of sittings if the results are to be good. A fine needle passes a very low electrical current into the hair follicle. After a session there will be slight swelling, redness and scarring which will take a few days to disappear.
Laser treatment: This is another salon-based treatment that is expensive too. You need a few sessions for good results. Black activating lotion is applied over the area, to enable the hair follicle to absorb the laser energy. In this technique the best results are got from people with thick body hair.

Pleural Mesothelioma

2007-08-31T20:49:00.001-07:00

Malignant pleural mesotheliomaPleural Mesothelioma as compared to a healthy lung. is the most common type of mesothelioma, making up over two-thirds of all cases. Pleural mesothelioma affects the lining of the lung and chest cavity known as the pleura.

The pleura is made up of the parietal and visceral pleura. The parietal pleura lines the chest wall and diaphragm while the visceral pleura lines the lungs.

Asbestos fibers work their way into the smallest passageways of the lungs and then into the pleura. Once there, an unknown chemical reaction causes cancerous cell development. As the cells begin to divide abnormally, the pleural lining thickens and excess fluid may accumulate. Pleural thickening gradually contracts the breathing space, causing shortness of breath—often the first symptom for pleural mesothelioma. The fluid, once carefully measured to allow smooth movement between the lungs and other organs, now causes increased pressure, further hindering breathing. This excess fluid is often seen on X-rays, and is referred to as a pleural effusion.

Pleural mesothelioma, like all kinds of mesothelioma, can be difficult to diagnose or easily misdiagnosed. If you are aware of prior asbestos exposure, it is important to inform your physician so that mesothelioma symptoms can be correctly identified.

While a diagnosis of pleural mesothelioma is certainly serious, it is not without options. A variety of new and novel mesothelioma treatments are available, as are a variety of clinical trials.

How does asbestos cause asbestosis?

Asbestos fibers inhaled into the lungs become imbedded in the delicate lining of the lungs. The fibers are so small and thin that they are able to beat the body's natural defenses. They accumulate in the lower portion of the lungs, becoming lodged into narrow airways. This causes scarring and inflammation, leading to a chronic cough and chest pain, the first symptoms of Asbestosis.

Asbestos, cancer, and smoking

While smoking increases your risk for a variety of other cancers, it does not by itself create a predisposition for pleural mesothelioma. In conjunction with asbestos exposure, however, smoking does increase the risk of developing pleural mesothelioma. The combination of smoking and asbestos exposure also increases the risk of developing lung cancer, as does prolonged exposure to asbestos.

Peritoneal Mesothelioma Information

2007-08-31T20:41:00.000-07:00

Peritoneal Mesothelioma -Cancer of the Stomach Lining

Peritoneum mesothelioma or Peritoneal mesothelioma is mesothelioma cancer in the lining that surrounds the abdomen (stomach).

Diffuse malignant peritoneal mesothelioma is mesothelioma cancer in the lining that surrounds the abdomen (stomach).
Diffuse means that is the cancer is spread out.

Peritoneal or Peritoneum is a smooth membrane, which lines the cavity of the abdomen (stomach).
It helps to protect the contents of the abdomen. It also produces a lubricating fluid.
This helps the organs to move smoothly inside the abdomen as we move around.

Peritoneal mesothelioma accounts for approximately 10% of mesothelioma cases.

Symptoms of Peritoneal Mesothelioma

When the symptoms of peritoneal mesothelioma appear, they typically include abdominal pains,abdominal weakness, weight loss, loss of appetite, nausea, and abdominal swelling.

Fluid often accumulates in the peritoneal space, a condition known as ascites. Over time the wasting symptoms can become more and more severe.

The growing peritoneal mesothelioma tumor can exert increasing pressure on the organs in the abdomen, leading to bowel obstruction and distention.

If the peritoneal mesothelioma tumor presses upward, it can impair breathing capacity.

If the peritoneal mesothelioma tumor pushes against areas with many nerve fibers, and the bowel distends, the amount of pain can increase.

The Truth About LASIK Risks

2007-08-19T06:29:00.000-07:00

While LASIK outcomes are overwhelmingly favorable, remember that there is still that fraction of less than 1% of people who do experience sometimes serious and ongoing vision problems following LASIK.

These are likely the people who operate anti-LASIK web sites filled with chilling warnings regarding dangers of the procedure, with nothing positive ever said.

You should rationally consider what unhappy LASIK patients have to say in light of your own needs and the fact that it is absolutely true that no surgical procedure is ever risk-free.

A very small number of LASIK patients with excellent vision based on eye chart testing still can have bothersome side effects.

For example, it is rare but possible that a patient may see 20/20 or better with uncorrected vision while at the same time having symptoms such as double vision (diplopia), unresolved dry eye, or difficulty seeing at night because of glare or halos around lights.

When you sign the LASIK consent form provided by your eye surgeon, you should do so with a full understanding that, even in the best of circumstances, there is a slight chance that something unintended could occur.

Even so, most problems eventually can be resolved

LASIK Complication Rates Are Decreasing

2007-08-19T06:27:00.000-07:00

Complications generally were more common in the early years of LASIK, when studies in the late 1990s indicated that up to 5% of people undergoing the procedure experienced some type of problem.

Experienced LASIK surgeons now report in trade journals that serious complication rates can be held well below 1%, but only if surgical candidates are selected very carefully.

You may be eliminated as a LASIK candidate, for example, if you have certain conditions such as pregnancy or diabetes that affect how well your eye heals.

Any health condition you have that might hamper your ability to heal should be mentioned and discussed in detail with your eye surgeon.

Large pupil sizes also might be risk factors for LASIK complications, because pupils in dark conditions could expand beyond the area of the eye that was treated.

Again, make sure you discuss any concerns about these or other matters with your eye surgeon.
[See a list of conditions that might contribute to adverse LASIK outcomes, or try taking our LASIK screening quiz.]

How Common Are LASIK Complications?

2007-08-19T06:26:00.000-07:00

Public confidence in the LASIK procedure has grown in recent years because of a solid success rate involving millions of successful procedures in the United States.

With increasingly sophisticated technology used for the procedure, most LASIK outcomes these days are very favorable.

The U.S. military also has adopted widespread use of refractive surgery including LASIK to decrease reliance of troops on artificial lenses or eyewear as evidenced by the more than 16,000 U.S. Army personnel who underwent refractive surgery from 2000 through 2003.

Studies of these outcomes showed that 86% achieved 20/20 or better uncorrected vision and 98% achieved 20/40 or better, which legally is considered good enough for driving without eyewear or contact lenses.

"Reports of night vision difficulties, LASIK flap dislocation, and dry eye are infrequent, and do not seem to have a significant negative impact on military operations or individual readiness," researchers who studied these outcomes concluded in the February 2005 issue of Ophthalmology journal.

Lasik risks

2007-08-19T06:22:00.000-07:00

If you are considering LASIK and worried that something could go wrong, you might take comfort in knowing that it's extremely rare for complications from this procedure to cause permanent, significant vision loss.

Also, many complications can be resolved through re-treatment or enhancements of the eye.

Selecting the right eye surgeon probably is the single most important step you can take to decrease any risks associated with LASIK.

An experienced, reputable surgeon will make sure you are properly screened to let you know up front if you aren't a good candidate for LASIK eye surgery.

Even if you are not qualified for LASIK, you might still be able to undergo vision correction through other means such as PRK, LASEK, or implantable lenses (phakic IOLs).

If you do decide to undergo LASIK, a responsible eye surgeon will work closely with you to resolve problems if they do develop

THE LASIK PROCEDURE

2007-08-17T21:13:00.000-07:00

This is an outpatient procedure that usually takes 5-10 minutes per eye.
The actual laser treatment usually takes a few seconds.
First you will lie on the motorized bed. The eyes are anesthetized with eye drops only. The head is positioned under the laser. A soft clip keeps the eyelids gently and comfortably open during the treatment.
You will be asked to look at a soothing green blinking light during the entire procedure.

During the treatment, an instrument called the microkeratome creates a corneal flap to make it a painless procedure.
The computerized Excimer laser uses a beam of light to gently reshape the cornea so as to alter its curvature to the desired extent.
The flap when replaced on the new corneal curvature allows images to be sharply focused on the retina. The goal is to eliminate or greatly reduce the dependence on glasses or contact lenses.

Once the procedure is completed, a soft contact lens or shield is sometimes placed on the eye. A post - procedure eye examination is performed and eye drops are prescribed. There may be mild discomfort for a few hours after the procedure.

Principles Of LASIK

2007-08-17T21:12:00.001-07:00

Light falling on the cornea [the front surface of the eye] has a smooth curvature- referred to as a "wavefront".

As this smooth wavefront shape courses through the various optics of the eye, ocular aberrations [imperfections] are induced.

It results in an irregular wavefront curvature reaching the retinal surface, which degrades the retinal image quality.

An aberration-free eye would result in a smooth wavefront image on the retinal surface. Wavefront-guided customized LASIK, also referred to as "customized ablation" or custom LASIK performs corrections based on individual wavefront measurements.

Current refractive procedures such as traditional or standard LASIK correct lower order aberrations such as spherical and cylindrical numbers alone.

However, higher order aberrations affect the quality of vision and may not significantly affect the vision as read on the chart.

It is these subtle deviations from the ideal optical system, which can be corrected by wavefront procedures, and thereby improve image quality.

REASONS TO UNDERGO LASIK

2007-08-17T21:02:00.000-07:00

Some of the common reasons why people undergo LASIK or get rid of their spectacles and contact lenses are :
1.contact lens intolerance
2.cosmetic reasons
3. social (marriage)
4.tired of wearing glasses
5. lifestyle activities that are inhibited due to glasses or lens wear such as outdoor sports like golf, football, water sports or hiking.
In some careers such as Merchant Navy and Airways it is a requirement to have 20/20 or 6/6 vision.
LASIK helps tremendously here.

Spectacles are cosmetically unappealing for some. There is a degree of distortion when looking through the periphery of the glasses, the field of vision is reduced and on leaving a cold room moisture can fog the glasses and blur vision for a few minutes. Hence glasses are unacceptable for certain careers. Contact lenses require motivation with great attention to hygiene during insertion and removal, failing which sight - threatening infections may result.
LASIK overcomes all these disadvantages.

Spectacles are cosmetically unappealing for some. There is a degree of distortion when looking through the periphery of the glasses, the field of vision is reduced and on leaving a cold room moisture can fog the glasses and blur vision for a few minutes. Hence glasses are unacceptable for certain careers. Contact lenses require motivation with great attention to hygiene during insertion and removal, failing which sight - threatening infections may result.

LASIK overcomes all these disadvantages.

What is LASIK?

2007-08-17T20:55:00.000-07:00

By learning more about Lasik eye surgery and Custom LASIK surgey, you are taking the first important step towards achieving improved, normal, natural vision.
Most people who wear glasses and contact lenses wish that they did not have to.
Now, thanks to advanced laser eye surgery, there is an alternative to reduce your dependence on glasses or contact lenses, or possibly eliminate them completely.
LASIK surgery and Custom LASIK transformed peoples' lives. The ability to see better without the hassles of contact lenses or glasses has inspired patients to explore new opportunities in their personal lives, in their workplace and recreational activities.
LASIK patients have freed themselves from the many restrictions glasses or contact lenses can create and thus can enjoy this new found freedom with improved vision.
LASIK eye surgery and Custom Lasik are not for everyone.
You should make a well informed decision when choosing this treatment.
A LASIK surgeon can help you decide if LASIK or Custom Lasik is right for you.
If you decide that LASK Eye Surgery or Custom Lasik is right for you, you will join more than 4 million people in the United states who are already enjoying the benefits of LASIK Laser Eye Surgery, and we are confident that you will realize that LASIK Eye Surgery is truly a gift of sight.

Surgical treatment of hernia.

2007-08-14T06:07:00.000-07:00

What is laparoscopic hernia repair?

A number of factors have led to the recent development of a new method of repair called laparoscopic hernia repair. This technique is really an extension of a traditional mesh repair method (preperitoneal repair) that was usually used in patients who had already experienced several hernia recurrences at the same site. Previously, this mesh repair approach had required a separate incision somewhat removed from the target area. However, with the progressive development of the instruments and techniques for laparoscopic surgery, the same procedure can now be done with several relatively small incisions. This allows the surgeon to enter the space behind the hernia defect and place the mesh with minimal injury to the surface of the abdomen. The apparent advantages of this method include coverage of all the potential sites of groin hernia, which reduces the risks of recurrence while also decreasing the amount of post-surgical pain.
The potential disadvantages of the technique are: (1) a general anesthetic is required; (2) the risk of injury to blood vessels in the abdomen is increased; and (3) the long-term effects of placement of the mesh in this location remain unknown.
What about the use of a laser in hernia repair?

This is a relatively common question. It arises because, for a time, there were some surgeons marketing "Laser Hernia Repair." While a laser may have been used to make the incision and to separate the tissues, the laser really has no application in the repair of a hernia. It is impossible to perform the necessary structural repair with a laser, which is essentially a cutting tool. Hopes that somehow an incision made with a laser would significantly reduce pain have not been confirmed. This is probably because no matter how the incision is made, the majority of the post surgical pain arises from the deeper structures that require suturing.

Investigations & Treatment

2007-08-13T05:52:00.000-07:00

*Investigations-
If you have an obvious hernia, the doctor will not require any other tests (if you are healthy otherwise). If you have symptoms of a hernia (dull ache in groin or other body area with lifting or straining but without an obvious lump), the doctor may feel the area while increasing abdominal pressure (having you stand or cough). This action may make the hernia able to be felt. If you may have an indirect inguinal hernia, the doctor will feel for the potential pathway and look for a hernia by inverting the skin of the scrotum with his or her finger.

*Hernia Treatment-

Self care at home-
In general, all hernias should be repaired unless severe pre-existing medical conditions make surgery unsafe. The possible exception to this is a hernia with a large opening and a relatively small sac. Trusses and surgical belts or bindings may be helpful in holding back the protrusion of selected hernias when surgery is not possible or delayed. However, they should never be used in the case of femoral hernias.
Avoid activities that increase intra-abdominal pressure (lifting, coughing, or straining) that may cause the hernia to increase in size.

Medical Treatment

Treatment of a hernia depends on whether it is reducible or irreducible and possibly strangulated.

Reducible

In general, all hernias should be repaired to avoid the possibility of future intestinal strangulation.
If you have pre-existing medical conditions that would make surgery unsafe, your doctor may not repair your hernia but will watch it closely.
Rarely, your doctor may advise against surgery because of the special condition of your hernia.
- Some hernias have or develop very large openings in the abdominal wall, and closing the opening is not possible because of its large size.
- These kinds of hernias may be treated without surgery, perhaps using abdominal binders.
- Some doctors feel that the hernias with large openings have a very low risk of strangulation and that surgery is not needed if you are relatively symptom free.
The treatment of every hernia is individualized, and a discussion of the risks and benefits of surgical versus nonsurgical management needs to take place.

Irreducible

All acutely irreducible hernias need emergency treatment because of the risk of strangulation.
An attempt to reduce (push back) the hernia will generally be made, often with medicine for pain and muscle relaxation.
If unsuccessful, emergency surgery is needed.

If successful, however, treatment depends on the length of the time that the hernia was irreducible.
- If the intestinal contents of the hernia had the blood supply cut off, dead (gangrenous) bowel is possible in as little as 6 hours.
- In cases where the hernia has been strangulated for an extended time, surgery is performed to check whether the intestine has died and repair the hernia.
- In cases where the length of time that the hernia was irreducible was short and gangrenous bowel is not suspected, you may be discharged.

Because a hernia that becomes irreducible has a dramatically increased risk of doing so again, if you have had an irreducible hernia, you should have surgery sooner rather than later.

Occasionally, the long-term irreducible hernia is not a surgical emergency. These hernias, having passed the test of time without signs of strangulation, may be repaired electively.

Hernia Causes & Symptoms

2007-08-13T05:48:00.000-07:00

*Causes-

Although one type of abdominal hernia can be present at birth (umbilical hernia), the others happen later in life. Some involve pathways formed during fetal development, existing openings in the abdominal cavity, or areas of abdominal wall weakness.

Any condition that increases the pressure of the abdominal cavity may contribute to the formation or worsening of a hernia.

Obesity
Heavy lifting
Coughing
Straining during a bowel movement or urination
Chronic lung disease
Fluid in the abdominal cavity

A family history of hernias can make you more likely to develop a hernia.

*Symptoms-
The signs and symptoms of a hernia can range from noticing a painless lump to the painful, tender, swollen protrusion of tissue that you are unable to push back into the abdomen—possibly a strangulated hernia.

Asymptomatic reducible hernia

New lump in the groin or other abdominal wall area
May ache but is not tender when touched
Sometimes pain precedes the discovery of the lump
Lump increases in size when standing or when abdominal pressure is increased (such as coughing)
May be reduced (pushed back into the abdomen) unless very large

Irreducible hernia

Usually painful enlargement of a previous hernia that cannot be returned into the abdominal cavity on its own or when you push it
Some may be long term without pain
Also known as incarcerated hernia
Can lead to strangulation
Signs and symptoms of bowel obstruction may occur, such as nausea and vomiting

Strangulated hernia

Irreducible hernia where the entrapped intestine has its blood supply cut off
Pain always present followed quickly by tenderness and sometimes symptoms of bowel obstruction (nausea and vomiting)
You may appear ill with or without fever
Surgical emergency
All strangulated hernias are irreducible (but all irreducible hernias are not strangulated)

Hernia Overview

2007-08-13T05:46:00.000-07:00

A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are often enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal wall hernias).
Hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the hernia sac contents have their blood supply cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency.
Different types of abdominal wall hernias include the following:

Inguinal hernia: Making up 75% of all abdominal wall hernias and occurring up to 25 times more often in men than women, these hernias are divided into 2 different types, direct and indirect. Both occur in the area of where the skin crease at the top of the thigh joins the torso (the inguinal crease), but they have slightly different origins. Both of these types of hernias can similarly appear as a bulge in the inguinal crease. Distinguishing between the direct and indirect hernia, however, is not that important because both are treated the same.

Indirect inguinal hernia: An indirect hernia follows the pathway that the testicles made during prebirth development. It descends from the abdomen into the scrotum. This pathway normally closes before birth but remains a possible place for a hernia. Sometimes the hernial sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age but becomes more common as people age.

Direct inguinal hernia: The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in a place where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum. Unlike the indirect hernia, which can occur at any age, the direct hernia almost always occurs in the middle-aged and elderly because their abdominal walls weaken as they age.

Femoral hernia: The femoral canal is the way that the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) into the canal. A femoral hernia causes a bulge below the inguinal crease in roughly the middle of the thigh. Rare and usually occurring in women, femoral hernias are particularly at risk of becoming irreducible and strangulated.

Umbilical hernia: These common hernias (10-30%) are often noted at birth as a protrusion at the bellybutton (the umbilicus). This is caused when an opening in the abdominal wall, which normally closes before birth, doesn’t close completely. If small (less than three quarters of an inch) this type of hernia usually closes gradually by age 2. Larger hernias and those that do not close by themselves usually require surgery at age 2-4 years. Even if the area is closed at birth, umbilical hernias can appear later in life because this spot remains a weaker place in the abdominal wall. Umbilical hernias most often appear later in elderly people and middle-aged women who have had children.

Incisional hernia: Abdominal surgery causes a flaw in the abdominal wall that must heal on its own. This flaw can create an area of weakness where a hernia may develop. This occurs after 2-10% of all abdominal surgeries, although some people are more at risk. After surgical repair, incisional hernias have a high rate of returning (20-45%).

Spigelian hernia: This rare hernia occurs along the edge of the rectus abdominus muscle, which is several inches to the side of the middle of the abdomen.

Obturator hernia: This extremely rare abdominal hernia happens mostly in women. This hernia protrudes from the pelvic cavity through an opening in your pelvic bone (obturator foramen). This will not show any bulge but can act like a bowel obstruction and cause nausea and vomiting.

Epigastric hernia: Occurring between the navel and the lower part of the rib cage in the midline of the abdomen, epigastric hernias are composed usually of fatty tissue and rarely contain intestine. Formed in an area of relative weakness of the abdominal wall, these hernias are often painless and unable to be pushed back into the abdomen when first discovered.

Select a Mesothelioma Attorney

2007-07-15T22:52:00.000-07:00

Questions to ask when selecting a mesothelioma attorney.

These pages provide consumer tips for how to deal with the financial aspects of selecting a mesothelioma attorney. They do not provide any information regarding the medical aspects of this serious disease.

Since so much is at stake, selecting the right mesothelioma lawyer is very important. According the Wall Street Journal, lawyers say a typical mesothelioma award in a mesothelioma settlement is $1 million, and attorneys get 40% of this amount. If the case actually goes to trial, the average award was $6 million in 2001, which was triple the amount awarded just two years earlier.

So, mesothelioma attorneys are very eager to find mesothelioma patients. And it's vital that patients select the mesothelioma attorneys that are best for them.

A Brief Background on Your Legal Rights Regarding Mesothelioma-
Companies that manufacture products that contain asbestos have known for over 60 years that asbestos can cause serious diseases.

Unfortunately, because many of these companies wanted to increase their profits, they kept this information quiet, thereby seriously endangering their workers.

There are now laws that help protect the workers who have been harmed by their exposure to these asbestos-related products.

However, since representing mesothelioma can be so profitable to attorneys, it is important that people who have mesothelioma be especially careful selecting attorneys who are really qualified to represent them.

Important Questions to Ask When Selecting a Mesothelioma Attorney

Question #1 to Ask When Selecting a Mesothelioma Attorney:

What is your personal experience in representing mesothelioma patients? Your goal is to find out how many cases the attorney has actually handled.

You also want to know: how many of these were settled, and how many of these went to trial? What were the results of each case?

You should ask the same questions about his or her law firm. You're goal is to find out about the firm -- is this an area the firm specializes in?

Question #2 to Ask When Selecting a Mesothelioma Attorney:

Next, you want to ask if the lawyer intends to actually handle your case him or herself. Many attorneys simply refer these cases to another law firm and receive part of the fee in exchange. This may not be in your best interest.

Mesothelioma latest research

2007-07-15T22:43:00.000-07:00

Mesothelioma Research 1

According to Science Daily, an online resource for latest research news, mesothelioma patients who got treated by a combination of 2 drugs had an improved chance of surviving. Their survival rate increased by a minimum of 3 months. The two drugs used for the treatment were PEMETREXED and CISPLATIN. The clinical trials were done on 448 mesotheliomic patients.

About 80% of the mesotheliomic patients were men with an average age of 61 years. Some patients received only cisplatin whereas some patients received a combination of pemetrexed, cisplatin, vitamin supplements, folic acid and B12. Not only did their life span increase by three months but also the patients felt less tired, had improved appetite, experienced less pain and had smaller coughing spells. The clinical trial and research was done at the Clatterbridge Center for Oncology in England.
Mesothelioma Research 2

A research published in The New England Journal of Medicine says that researchers in New York University School of Medicine and Wayne State University have discovered a molecular particle that shows the beginnings of pleural mesothelioma. The blood levels of a protein called OSTEOPONTIN rises significantly in patients with early stages of pleural mesothelioma.

This is a breakthrough discovery as it may lead to the development of a blood diagnostic test which can detect the disease pleural mesothelioma in its earliest stages. Currently the patient has to wait for mesothelioma to become a full blown case before it is properly diagnosed. Although it is incurable, the detection of pleural mesothelioma in its earliest stages, will lead to swifter treatment options with the patient having a longer survival rate and a reduced pain free life.
Mesothelioma Research 3

A study conducted by a team of researchers at University of Cincinnati have found that all those workers who used were employed at a Ohio manufacturing plant in Marysville and were exposed to vermiculite ore had abnormally high rates of chest wall lining disfigurement.

Vermiculite ore is known to contain asbestos fibers and exposure to it means that previous workers have a high chance of developing asbestosis, lung diseases and mesothelioma. Because of mesothelioma’s long latency period, researchers will not know about the development of mesothelioma in these people till the next 30-50 years.

Mesothelioma survival rate

2007-07-15T22:37:00.000-07:00

Because mesothelioma is so hard to detect, and can easily seem to be just an upset stomach or other minor issue, it is often the case that by the time you realize you have mesothelioma, it is too late to do anything about it. The only reason you realize that you have a cancer in your chest cavity is that something truly awful has gone wrong, and you are on the final stages.

The average person who finally finds a doctor to determine they have mesothelioma often has less than a year left to live at that point - even with the best treatment. The current 5 year survival rate is between 7%-20% depending on which study you read. Again, this is not necessarily because mesothelioma is "nastier" than other forms of cancer - it is more that it is so hard to detect. It festers away in the core of your chest for years and years, causing damage but not being noticed.

In fact, on a webpage for a drug being tested for mesothelioma patients, the drug makers claim with pride, "Some of the patients survived two years after the study which is very unusual for mesothelioma." It is a pretty harsh disease, when helping you make it to 2 years is a great victory.
Part of the problem with helping patients survive is that there are so few known people with mesothelioma - and they die so quickly after being discovered. There aren't a lot of people to do clinical trials on, to figure out what works and what doesn't work.

There are hundreds of thousands of people who HAVE mesothelioma right now, according to most doctors. But all of those sick people do not realize yet that they have it. They typically only really know they have mesothelioma right before they die. So by then it is often impossible to do any real tests to see what might have helped them, if it had been caught earlier.

Alternative methods for mesothelioma

2007-07-15T05:14:00.000-07:00

Alternative methods for mesothelioma cure include the following.

-- Acupuncture
-- Herbs
-- Massage
-- Homoeopathy
-- Visual / Guided Imagery
-- Yoga
-- Meditation
-- Breathing techniques
-- Specialized diet
-- Spiritual Healing

Acupuncture Treatment for Mesothelioma
Acupuncture is an ancient Chinese remedy used for curing many ailments. Sterile acupuncture needles are placed on specific energy points on the skin to release positive energy to diseased parts of the body, helping restore a perfect balance in the body. It is a technique that is very helpful in relieving pain associated with mesothelioma.

Herbs Used for Treating Mesothelioma
As with acupuncture, treatment with herbs too has its origins in China. Traditional Chinese doctors have an assortment of herbs that will cure / reduce the intensity of various ailments. These herbs are used in addition to conventional mesothelioma treatment.

Massage for Mesothelioma
Massages are known to increase blood circulation and relieve body stress. Massages are not used for curing mesothelioma, but for stress and pain relief during / after conventional treatments used to cure mesothelioma.

Meditation for Mesothelioma
Meditation techniques are centuries old and practiced worldwide for various spiritual reasons. It is one of the best ways known to relax the mind and body. If done with proper guidance it can destress the mesothelioma patient and help control pain. Meditation is also claimed to strengthen the immune system. The advantages of meditation are many. Meditation can be performed by the patient in the comforting confines of home. At a time when alternative therapies cost a lot monetarily, meditation once learned will not cost anything. Unlike most medication, meditation does not have any negative side-effects.

Don't Stop Conventional Mesothelioma Treatment
Many of those practicing alternative mesothelioma treatments will make you believe that they can cure you of the dreaded cancer without the need for conventional treatment. Most of these claims are not true and could end in disaster, since time is of essence in any mesothelioma treatment.

Even though not proven scientifically (which will never happen), many alternative treatments (most of which are based on spirituality) have proved to be beneficial when combined with conventional treatment. Whenever you decide to opt for an alternative treatment, try to locate and speak to someone who has undergone the specific treatment. Also speak to the physician / surgeon treating you and let them know of your alternative treatment choice.

As of today, mesothelioma is not curable using conventional methods such as surgery, radiation therapy, chemotherapy, or combination therapy. Keeping this fact in mind, and also the fact that most alternative treatments for mesothelioma do not have any negative side-effects, it is a good option to combine conventional treatment with an alternative treatment to help fight mesothelioma.

Alternative treatments for mesothelioma could cost a lot. Before opting for a particular type of alternative treatment, find out if insurance will cover this treatment. If it does, good. If not, go in for alternative treatments such as meditation, yoga, or specialized breathing techniques that once learned will help you get better, at the same time not burden you financially.

Asbestos and Mesothelioma

2007-07-15T05:07:00.000-07:00

Asbestos and Mesothelioma

Mesothelioma is a type of cancer caused by an exposure to asbestos. When asbestos fibers Danger%3A Asbestos are inhaled, they attack the wall lining the inside of the abdomen, heart or lungs, which leads to mesothelioma.

Symptoms can take decades to surface, so those affected often do not receive the proper mesothelioma diagnosis until the cancer is far advanced.

Mesothelioma lawyers have helped prove that many companies knowingly put their employees at risk for mesothelioma by allowing them to work in environments with a high risk of asbestos exposure.
Asbestos Exposure
Asbestos was most commonly used from the 1940s to the 1970s. During this time, more than 27 million Americans were exposed to the cancer-causing asbestos without even knowing of the link between asbestos and mesothelioma. Recent mesothelioma lawsuits have helped hold companies accountable for failing to warn employees of this link.

mesothelioma mortality

Those between the ages of 50 and 70 are most commonly diagnosed with mesothelioma. Some mesothelioma treatment do exist, but there is no cure for this type of cancer. When mesothelioma is diagnosed early, these treatment options are more successful.

Doctors often struggle to make the correct diagnosis, as the symptoms of mesothelioma are shared with a number of other illnesses. When a patient is diagnosed, the survival rate range is from one to five years.

Mesothelioma lawyers in the United States file roughly 3,000 cases every year, making asbestos lawsuits the most expensive mass tort in the nation’s history.

How to prevent Mesothelioma?

2007-07-15T05:06:00.001-07:00

In terms of asbestos, mesothelioma prevention is extremely important to reduce the risks of this serious cancer . Mesothelioma is a fatal cancer that affects the lining of the heart, lung, or abdominal cavity. Mesothelioma has been almost exclusively linked to asbestos exposure, a group of hazardous fibers that were manufactured in hundreds of industries around the world. There are many ways that people to protect themselves against workplace or non-occupational exposure to asbestos in an effort to prevent mesothelioma.

The U.S. Occupational Safety and Health Administration has enacted a number of workplace asbestos regulations to aid in mesothelioma prevention. Under workplace asbestos laws , the permissible level of exposure is 01. fibers per cubic centimeter for an eight-hour work day and one fiber per cubic centimeter in any thirty minute time frame. Furthermore, workplace regulations to prevent asbestos exposure require employers to frequently monitor and regulate the work environment in addition to providing their employees with protective clothing and respiratory equipment, sufficient hygiene facilities, routine medical exams, and training .

The Environmental Protection Agency recommends a number of steps and precautions people can take to help protect themselves against non-occupational asbestos exposure that may lead to mesothelioma. These mesothelioma prevention methods include, but are not limited to: Regular inspection and monitoring of asbestos-containing products or materials around the home since asbestos was commonly used in the production of roof shingles, insulation, flooring, and more. Don't attempt to remove any asbestos-containing materials. It is vital that you enlist the help of an asbestos removal who is properly trained to handle the material and can ensure safe removal.

Avoid vacuuming, sweeping, drilling, sanding, or scraping any surfaces that may contain asbestos fibers. Once these fibers are airborne, they may be inhaled or ingested greatly increasing the risk of mesothelioma. Quit smoking, especially if you work in an industry in which you are frequently exposed to high levels of asbestos. Studies have indicated that asbestos workers who smoke cigarettes have a 50 to 100 times greater risk of dying from mesothelioma or lung cancer. If you or a loved one is suffering from mesothelioma side effects, it is vital that you seek immediate medical attention at the first sign of symptoms such as chest pains, shortness of breath, coughs, severe weight loss, and more . Early diagnosis of mesothelioma is the best form of prevention and can produce the most favorable outcome of the disease.

Treatment:surgery

2007-07-14T04:51:00.000-07:00

Which Surgery for Mesothelioma?
The possible operations for pleural mesothelioma are

* Extrapleural pneumonectomy
* Pleurectomy

Surgery is not suitable for everyone and won't cure your mesothelioma. The aim of the operation is to try and keep the disease under control and enable you to stay well for as long as possible. If you are having major surgery for mesothelioma, it should be as part of an overall treatment plan that includes radiotherapy and chemotherapy as well. From what we know from research so far, this is the best way to try to control mesothelioma for as long as possible.

Mesothelioma is often diagnosed too late to make a big operation worthwhile. If pleural mesothelioma is diagnosed early enough, you may be able to have an extrapleural pneumonectomy. If the cancer has already spread, a pleurectomy can help to control symptoms. But it will not cure your mesothelioma and may not actually make any difference to how long you live.

An operation can help some people who have peritoneal mesothelioma. This operation can only be done if it is diagnosed early enough.

There is more about what happens before and after surgery in this section of CancerHelp UK.

Extrapulmonary pneumectomy(EPP)

This is major surgery. It means removing the lung on the affected side. The pleura, diaphragm and covering of the heart (pericardium) are also removed.

EPP is not suitable for everyone with pleural mesothelioma. You need to be fit enough to walk up and down two flights of stairs without becoming breathless. Your cancer must be at an early stage. This means that is must not have spread to lymph nodes, or be growing into any other major body parts outside the lung.

To do the operation, your surgeon will open your chest, either at the front or at the side. An opening at the side is called a thoracotomy. An opening at the front is called a sternotomy. You will have a wound about 9 inches long. You will have to stay in hospital for about 2 weeks afterwards. It will take you about 6 to 8 weeks to fully recover.

This major surgery cannot cure your mesothelioma. But it can help you to live longer. The people who have lived longest after a diagnosis of mesothelioma have had this operation, together with chemotherapy or radiotherapy. You and your family need to understand that this is a very big operation and has risks. About 6 or 7 out of every 100 people who have this particular operation die during or just after the surgery.

Pleurectomy

You may be offered pleurectomy to help control symptoms. It can help to control fluid build up in the chest and relieve some chest pain. This is a major operation, but can be done using keyhole surgery. If you have keyhole surgery you will have 3 wounds, each about an inch long (2cm).

The surgeon will take away as much of the tumour as possible. This means removing the outside covering of the lung - the pleura - on one side on one side of the chest. You will have to stay in hospital for about 7 days afterwards. It will take you about 3 to 4 weeks to fully recover.

Surgery for peritoneal mesothelioma

Surgery is not possible for everyone with peritoneal mesothelioma. If surgery is possible, the operation is called a peritonectomy. This means removing the peritoneum (the lining of the abdomen). In recent years some doctors have been developing a technique known as cytoreductive surgery for peritoneal mesothelioma. Cytoreductive surgery involves the surgeon carrying out up to 6 different peritonectomy procedures, to remove as much of the cancer as possible. Then chemotherapy may be given straight into the peritoneal cavity. Some studies have suggested that this can work better if it is heated to a few degrees above body temperature first. This is called hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). Doctors have achieved some promising results using these techniques; in one review, about half of the patients who had been treated in this way were still alive 5 years after. But this is still very experimental treatment and, if it is available, may only be so as part of a clinical trial.

Mesothelioma Symptoms and Diagnosis

2007-07-14T04:19:00.001-07:00

The primary risk factor for developing mesothelioma is asbestos exposure. In the past, asbestos was used as a very effective type of insulation. The use of this material, however, has been declining since the link between asbestos and mesothelioma has become known. It is thought that when the fibers of asbestos are inhaled, some of them reach the ends of the small airways and penetrate into the pleural lining. There the fibers may directly harm mesothelial cells and eventually cause mesothelioma. If the fibers are swallowed, they can reach the abdominal cavity, where they can contribute to the formation of peritoneal mesothelioma.

Exposure to certain types of radiation as well as to a chemical related to asbestos known as zeolite has also been related to incidences of mesothelioma.

The early symptoms of mesothelioma are often ignored, because they may be caused by a variety of ailments. These symptoms include:

* pain in the lower back or at the side of the chest
* shortness of breath
* difficulty swallowing
* cough
* fever
* fatigue
* abdominal pain,weight loss and nasuea & vomiting(symptoms of peritoneal mesothelioma)

About Mesothelioma

2007-07-14T04:14:00.001-07:00

Definition:

Mesothelioma is a rare form of cancer. In mesothelioma, malignant cells are found in the sac lining of the chest (the pleura) or the abdomen (the peritoneum). The majority of people with mesothelioma have a history of jobs that exposed them to asbestos,as insulation material.

Description:

In the chest and abdominal cavities, as well as in the cavity around the heart (pericardial sac), there is a layer of specialized cells called mesothelial cells. These cells also surround the outer surface of most internal organs. These cells form tissue called mesothelium.
The mesothelium performs a protective function for the internal organs by producing a lubricating fluid that permits the organs to move around. For example, this fluid makes it easier for the lungs to move inside the chest while a person breathes. The mesothelium of the abdomen is known as the peritoneum, and the mesothelium of the chest is called the pleura. The pericardium refers to the mesothelium of the pericardial cavity.
There are three primary types of malignant mesotheliomas:

Epithelioid. About 50% to 70% of mesotheliomas are of this type and have the best outlook for survival.
Sarcomatoid. Approximately 7% to 20% of cases are of this type.
Mixed/biphasic. From 20% to 35% of mesothelioma cases fall into this category.

Approximately three fourths of all mesotheliomas begin in the chest cavity and are known as pleural mesotheliomas. Peritoneal mesotheliomas begin in the abdomen, and make up around 10% to 20% of all cases. Mesotheliomas arising in the cavity around the heart are quite rare.

Demographics:

Mesothelioma is a fairly rare form of cancer. According to the American Cancer Society, there are an estimated 2, 000 to 3, 000 new cases per year of the disease in the United States, but this figure seems to be rising. This rising figure is related to the widespread use of asbestos from the 1940s to the end of the 1970s. European researchers studying the disease expect deaths from mesothelioma to peak around the year 2020 and then drop off, because asbestos use has been cut back greatly since the early 1980s.
The average age of a person with mesothelioma is 50 to 70 years old. It affects men three to five times more often than women and is less common in African-Americans than in Caucasian American

Rosenthals Room

2007-06-06T01:00:00.000-07:00