mah-health

Dengue fever facts

2011-11-23T04:42:00.000-08:00

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes.

Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever.
Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred recently in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and in Paraguay in South America, and Costa Rica in Central America.
Because dengue fever is caused by a virus, the
re is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is purely concerned with relief of the symptoms (symptomatic).
The acute phase of the illness with fever and myalgias lasts about one to two weeks.
Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).
The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus that causes dengue.
There is currently no vaccine available for dengue fever.

What is dengue fever?

2011-11-23T04:38:00.000-08:00

Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.

Dengue (pronounced DENG-gay) can affect anyone but tends to be more severe in people with compromised immune systems. Because it is caused by one of four serotypes of virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular serotype to which the patient was exposed.

Dengue goes by other names, including "breakbone" or "dandy fever." Victims of dengue often have contortions due to the intense joint and muscle pain, hence the name breakbone fever. Slaves in the West Indies who contracted dengue were said to have dandy fever because of their postures and gait.

Dengue hemorrhagic fever is a more severe form of the viral illness. Symptoms include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red or purple splotches or blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

What are dengue fever symptoms and signs?

2011-11-23T04:36:00.000-08:00

After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear in stages. Dengue starts with chills, headache, pain upon moving the eyes, and low backache. Painful aching in the legs and joints occurs during the first hours of illness. The temperature rises quickly as high as 104 F (40 C), with relatively low heart rate (bradycardia) and low blood pressure (hypotension). The eyes become reddened. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen.

Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature (defervescence) with profuse sweating. This precedes a period with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature follows. A characteristic rash appears along with the fever and spreads from the extremities to cover the entire body except the face. The palms and soles may be bright red and swollen.

How is dengue fever diagnosed?

2011-11-23T04:34:00.000-08:00

The diagnosis of dengue fever is usually made when a patient exhibits the typical clinical symptoms of headache, fever, eye pain, severe muscle aches and petechial rash and has a history of being in an area where dengue fever is endemic. Dengue fever can be difficult to diagnose because its symptoms overlap with those of many other viral illnesses, such as West Nile virus and chikungunya fever.

In 2011, the U.S. Food and Drug Administration (FDA) approved a blood test to diagnose people with dengue fever, called the DENV Detect IgM Capture ELISA. The FDA notes that the new test may also give a positive result when a person has a closely related virus, such West Nile disease.

What is the treatment for dengue fever?

2011-11-23T04:33:00.000-08:00

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important. Aspirin and nonsteroidal anti-inflammatory drugs should only be taken under a doctor's supervision because of the possibility of worsening bleeding complications. Acetaminophen (Tylenol) and codeine may be given for severe headache and for joint and muscle pain (myalgia).

What is the prognosis for typical dengue fever?

2011-11-23T04:31:00.000-08:00

Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgias lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks.

What is dengue hemorrhagic fever?

2011-11-23T04:26:00.000-08:00

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome.

DHF starts abruptly with high continuous fever and headache. There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis).

In DHF, there is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums, and nosebleeds (epistaxis). Pneumonia is common, and inflammation of the heart (myocarditis) may be present.

Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding.

The mortality (death) rate with DHF is significant. With proper treatment, the World Health Organization estimates a 2.5% mortality rate. However, without proper treatment, the mortality rate rises to 20%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF

How can dengue fever be prevented?

2011-11-23T04:20:00.000-08:00

The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer contagious.

The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. In nations plagued by dengue fever, people are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes also help to keep the disease in check but have been poorly effective.

To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellant sprays that contain DEET when visiting places where dengue is endemic. There are no specific risk factors for contracting dengue fever, except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes by avoiding standing water and staying indoors two hours after sunrise and before sunset will help. The Aedes aegypti mosquito is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.

There is currently no vaccination available for dengue fever. There is a vaccine undergoing clinical trials, but it is too early to tell if it will be safe or effective. Early results of clinical trials show that a vaccine may be available by 2015.

Who needs HIV prevention?

2010-01-31T04:58:00.000-08:00

Anyone can become infected with HIV, and so promoting widespread awareness of HIV through basic HIV and AIDS education is vital for preventing all forms of HIV transmission. Specific programmes can target key groups who have been particularly affected by a country’s epidemic, for example children, women, injecting drug users and sex workers. Older people are also a group who require prevention measures, as in some countries an increasing number of new infections are occurring among those aged over 50.3
HIV prevention needs to reach both people who are at risk of HIV infection and those who are already infected:
People who do not have HIV need interventions that will enable them to protect themselves from becoming infected.
People who are already living with HIV need knowledge and support to protect their own health and to ensure that they don’t transmit HIV to others - known as “positive prevention”. Positive prevention has become increasingly important as improvements in treatment have led to a rise in the number of people living with HIV.4 5 6
HIV counselling and testing are fundamental for HIV prevention. People living with HIV are less likely to transmit the virus to others if they know they are infected and if they have received counselling about safer behaviour. For example, a pregnant woman who has HIV will not be able to benefit from interventions to protect her child unless her infection is diagnosed. Those who discover they are not infected can also benefit, by receiving counselling on how to remain uninfected.7 8 9
The availability and accessibility of antiretroviral treatment is crucial; it enables people living with HIV to enjoy longer, healthier lives, and as such acts as an incentive for HIV testing. Continued contact with health care workers also provides further opportunities for prevention messages and interventions. Studies suggest that HIV-positive people may be less likely to engage in risky behaviour if they are enrolled in treatment programmes.10 11

Aids through sexual transmission

2010-01-31T04:12:00.000-08:00

What works?
Someone can eliminate or reduce their risk of becoming infected with HIV during sex by choosing to:
Abstain from sex or delay first sex
Be faithful to one partner or have fewer partners
Condomise, which means using male or female condoms consistently and correctly
There are a number of effective ways to encourage people to adopt safer sexual behaviour, including media campaigns, social marketing, peer education and small group counselling. These activities should be carefully tailored to the needs and circumstances of the people they intend to help.12 13 14
Comprehensive sex education for young people is an essential part of HIV prevention. This should include training in life skills such as negotiating healthy sexual relationships, as well as accurate and explicit information about how to practise safer sex. Studies have shown that this kind of comprehensive sex education is more effective at preventing sexually transmitted infections than education that focuses solely on teaching abstinence until marriage.15 16

A condom vending machine in Vatican City
Numerous studies have shown that condoms, if used consistently and correctly, are highly effective at preventing HIV infection.17 Also there is no evidence that promoting condoms leads to increased sexual activity among young people. Therefore condoms should be made readily and consistently available to all those who need them.18
There is now very strong evidence that male circumcision reduces the risk of HIV transmission from women to men by around 50%, which is enough to justify its promotion as an HIV prevention measure in some high-prevalence areas.19 However, studies of circumcision and HIV suggest that the procedure does not reduce the likelihood of male-to-female transmission, and the effect on male-to-male transmission is unknown.20
Some sexually transmitted infections - most notably genital herpes - have been found to facilitate HIV transmission during sex. Treating these other infections may therefore contribute to HIV prevention.21 22 Trials in which HIV-negative people were given daily treatment to suppress genital herpes have found no reduction in the rate at which they become infected with HIV. Nevertheless, there is evidence to suggest that treating genital herpes in HIV positive people may reduce the risk of them transmitting HIV to their partners. Further research is ongoing.23
What are the obstacles?
It is usually not easy for people to sustain changes in sexual behaviour. In particular, young people often have difficulty remaining abstinent, and women in male-dominated societies are frequently unable to negotiate condom use, let alone abstinence. Many couples are compelled to have unprotected sex in order to have children. Others associate condoms with promiscuity or lack of trust.24
Some societies find it difficult to discuss sex openly, and some authorities restrict what subjects can be discussed in the classroom, or in public information campaigns, for moral or religious reasons. .

Aids transmission through blood

2010-01-31T04:07:00.000-08:00

What works?
People who share equipment to inject recreational drugs risk becoming infected with HIV from other drug users who have HIV. Methadone maintenance and other drug treatment programmes are effective ways to help people eliminate this risk by giving up injected drugs altogether. However, there will always be some injecting drug users who are unwilling or unable to end their habit, and these people should be encouraged to minimise the risk of infection by not sharing equipment.25
Used syringes collected by a needle exchange in Puerto Rico
Needle exchange programmes have been shown to reduce the number of new HIV infections without encouraging drug use. These programmes distribute clean needles and safely dispose of used ones, and also offer related services such as referrals to drug treatment centres and HIV counselling and testing. Needle exchanges are a necessary part of HIV prevention in any community that contains injecting drug users.26
Also important for injecting drug users are community outreach, small group counselling and other activities that encourage safer behaviour and access to available prevention options.27
Transfusion of infected blood or blood products is the most efficient of all ways to transmit HIV. However, the chances of this happening can be greatly reduced by screening all blood supplies for the virus, and by heat-treating blood products where possible. In addition, because screening is not quite 100% accurate, it is sensible to place some restrictions on who is eligible to donate, provided that these are justified by epidemiological evidence, and don’t unnecessarily limit supply or fuel prejudice. Reducing the number of unnecessary transfusions also helps to minimise risk.28 29
The safety of medical procedures and other activities that involve contact with blood, such as tattooing and circumcision, can be improved by routinely sterilising equipment. An even better option is to dispose of equipment after each use, and this is highly recommended if at all possible.
Health care workers themselves run a risk of HIV infection through contact with infected blood. The most effective way for staff to limit this risk is to practise universal precautions, which means acting as though every patient is potentially infected. Universal precautions include washing hands and using protective barriers for direct contact with blood and other body fluids.30
What are the obstacles?
Despite the evidence that they do not encourage drug use, some authorities still refuse to support needle exchanges and other programmes to help injecting drug users. Restrictions on pharmacies selling syringes without prescriptions, and on possession of drug paraphernalia, can also hamper HIV prevention programmes by making it harder for drug users to avoid sharing equipment.
Many resource-poor countries lack facilities for rigorously screening blood supplies.31 In addition a lot of countries have difficulty recruiting enough donors, and so have to resort to importing blood or paying their citizens to donate, which is not the best way to ensure safety.
In much of the world the safety of medical procedures in general is compromised by lack of resources, and this may put both patients and staff at greater risk of HIV infection.

Aids mother-to-child transmission

2010-01-31T04:03:00.000-08:00

What works?
HIV can be transmitted from a mother to her baby during pregnancy, labour and delivery, and later through breastfeeding. The first step towards reducing the number of babies infected in this way is to prevent HIV infection in women, and to prevent unwanted pregnancies.
There are a number of things that can be done to help a pregnant woman with HIV to avoid passing her infection to her child. A course of antiretroviral drugs given to her during pregnancy and labour as well as to her newborn baby can greatly reduce the chances of the child becoming infected. Although the most effective treatment involves a combination of drugs taken over a long period, even a single dose of treatment can cut the transmission rate by half.32
A caesarean section is an operation to deliver a baby through its mother’s abdominal wall, which reduces the baby’s exposure to its mother’s body fluids. This procedure lowers the risk of HIV transmission, but is likely to be recommended only if the mother has a high level of HIV in her blood, and if the benefit to her baby outweighs the risk of the intervention.33 34
Weighing risks against benefits is also critical when selecting the best feeding option. The World Health Organisation advises mothers with HIV not to breastfeed whenever the use of replacements is acceptable, feasible, affordable, sustainable and safe. However, if safe water is not available then the risk of life-threatening conditions from replacement feeding may be greater than the risk from breastfeeding. An HIV positive mother should be counselled on the risks and benefits of different infant feeding options and should be helped to select the most suitable option for her situation.35
What are the obstacles?
In much of the world a lack of drugs and medical facilities limits what can be done to prevent mother-to-child transmission of HIV. Antiretroviral drugs are not widely available in many resource-poor countries, caesarean section is often impractical, and many women lack the resources needed to avoid breastfeeding their babies.
HIV-related stigma is another obstacle to preventing mother-to-child transmission. Some women are afraid to attend clinics that distribute antiretroviral drugs, or to feed their babies formula, in case by doing so they reveal their HIV status.

Skin cancer

2009-08-02T23:28:00.000-07:00

Skin cancer is a malignant growth on the skin which can have many causes. The most common skin cancers are basal cell cancer, squamous cell cancer, and melanoma which all trace back to the mutilation of melanin cells. Skin cancer generally develops in the epidermis (the outermost layer of skin), so a tumor is usually clearly visible. This makes most skin cancers detectable in the early stages. There are three common and likely types of skin cancer, each of which is named after the type of skin cell from which it arises. Unlike many other cancers, including those originating in the lung, pancreas, and stomach, only a small minority of those afflicted will actually die of the disease.

[1] Skin cancer represents the most commonly diagnosed cancer, surpassing lung, breast, colorectal and prostate cancer.

[1] Melanoma is less common than basal cell carcinoma and squamous cell carcinoma, but it is the most serious—for example, in the UK there are 9,500 new cases of melanoma each year, and 2,300 deaths.

[2] More people now die of melanoma in the UK than in Australia. It is the most common cancer in the young population (20 – 39 age group).

[3] It is estimated that approximately 85% of cases are caused by too much sun.[citation needed] Non-melanoma skin cancers are the most common skin cancers. The majority of these are called basal cell carcinomas. These are usually localised growths caused by excessive cumulative exposure to the sun and do not tend to spread.

Risk factors

Skin cancer is most closely associated with chronic inflammation of the skin. This includes:
Overexposure to UV-radiation can cause skin cancer either via the direct DNA damage or via the indirect DNA damage mechanism. UVA & UVB have both been implicated in causing DNA damage resulting in cancer. Sun exposure between 10AM and 4PM is most intense and therefore most harmful. Natural (sun) & artificial UV exposure (tanning salons) are associated with skin cancer.[citation needed] Since sunbeds cause mostly indirect DNA damage (free radicals) their use is associated with the deadliest form of skin cancer, malignant melanoma.[citation needed] UVA rays affect the skin at a deeper level than UVB rays, reaching through the epidermis and the dermis to the hypodermis where connective tissues and blood vessels are located. UVA activates the melanin of the epidermis causing changes in pigmentation as well as loss of elasticity of the skin, which contributes to premature wrinkling, sagging and aging of the skin. UVB rays primarily affect the epidermis causing sunburns, redness, and blistering of the skin. The melanin of the epidermis is activated with UVB just as with UVA; however, the effects are longer lasting with pigmentation continuing over 24 hours. Chronic non-healing wounds, especially burns. These are called Marjolin's ulcers based on their appearance, and can develop into squamous cell carcinoma. Genetic predisposition, including "Congenital Melanocytic Nevi Syndrome". CMNS is characterized by the presence of "nevi" or moles of varying size that either appear at or within 6 months of birth. Nevi larger than 20 mm (3/4") in size are at higher risk for becoming cancerous. Human papilloma virus (HPV) is often associated with squamous cell carcinoma of the genital, anal, oral, pharynx, and fingers. It is believed that the HPV vaccine might help to prevent these cancers as well as cervical cancers. Skin cancer is one of the potential dangers of ultraviolet germicidal irradiation. Many believe that skin cancer can be prevented altogether by avoiding sunlight entirely, or wearing protective clothing while outdoors. However, studies show that Melanoma Skin Cancer is more common in those who work indoors. Skin Cancer is most common on areas of the body that are not normally exposed to the sun, and then exposing the skin to UV rays excessively.
Skin cancer generally has a 20- to 30-year latency period[citation needed]. Many instances of skin cancer in older individuals today can be traced to behaviours as young adults in the 1970s and early 1980s[citation needed]. Deep tans at that time were routinely spoken of as "healthy." Sunburns represented an inconvenient rite of spring or an awkward preliminary stage in the process of acquiring a "healthy" tan. Severe burns were commonplace. Today we know the approach to be reckless. The incidence rates of skin cancer today in persons over 50 years of age reflect that day's popular ignorance[citation needed].

Types

The most common types of skin cancers are:
Basal Cell Carcinoma Squamous Cell Carcinoma Melanoma Basal cell carcinomas (BCC) is the most common. They are present on sun-exposed areas of the skin, especially the face. They rarely metastasize, and rarely cause death. They are easily treated with surgery or radiation. Squamous cell carcinomas(SCC) are common, but much less common than basal cell cancers. They metastasize more frequently than BCCs. Even then, the metastasis rate is quite low, with the exception of SCCs of the lip, ear, and in immunosuppressed patients. Melanomas are the least frequent of the 3 common skin cancers. They frequently metastasize, and are deadly once spread.
Less common skin cancers include: Dermatofibrosarcoma protuberans, Merkel cell carcinoma, Kaposi's sarcoma, keratoacanthoma, spindle cell tumors, sebaceous carcinomas, microcystic adnexal carcinoma, Pagets's disease of the breast, atypical fibroxanthoma, leimyosarcoma, and angiosarcoma
The BCC and the SCC often carry a UV-signature mutation indicating that these cancers are caused by UV-B radiation via the direct DNA damage. However the malignant melanoma is predominantly caused by UV-A radiation via the indirect DNA damage.[citation needed] The indirect DNA damage is caused by free radicals and reactive oxygen species. Research indicates that the absorption of three sunscreen ingredients into the skin, combined with a 60-minute exposure to UV, leads to an increase of free radicals in the skin, if applied in too little quantities and too infrequently. [4] However, the researchers add that newer creams often do not contain these specific compounds, and that the combination of other ingredients tends to retain the compounds on the surface of the skin. They also add the frequent re-application reduces the risk of radical formation.

Signs and symptoms

There are a variety of different skin cancer symptoms. These include changes in the skin that do not heal, ulcering in the skin, discolored skin, and changes in existing moles. Such as jagged edges to the mole, and enlargement of the mole
Basal cell carcinoma usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck or shoulders. Sometimes small blood vessels can be seen within the tumor. Crusting and bleeding in the center of the tumor frequently develops. It is often mistaken for a sore that does not heal. This form of skin cancer is the least deadly and with proper treatment can be completely eliminated with not so much as a single scar Squamous cell carcinoma is commonly a red, scaling, thickened patch on sun-exposed skin. Ulceration and bleeding may occur. When SCC is not treated, it may develop into a large mass. Squamous cell is the second most common skin cancer. It is dangerous, but not nearly as dangerous as a melanoma. Most melanomas are brown to black looking lesions. Signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching, ulceration or bleeding. Merkel cell carcinomas are most often rapidly growing, non-tender red, purple or skin colored bumps that are not painful or itchy. They may be mistaken for a cyst or other type of cancer.[13]

Diagnosis

Clinical diagnosis is made with visual appearance or with the aid of a dermatoscope. The ABCD guideline is helpful for identifying dysplastic nevus and melanoma. Clinical diagnosis can only be confirmed with a skin biopsy. Most skin biopsies are done under local anesthetic with an injection. A shave biopsy is good for diagnosing basal cell carcinoma, while not as well for squamous cell carcinoma. A punch biopsy is preferred for diagnosing squamous cell carcinoma and melanoma over the shave biopsy technique. Excisional biopsy (where the entire lesion is removed down to the deep dermis and subcutanous fat) is the method of choice for diagnosing melanomas. However, for cosmetic reason and practical reasons, a punch biopsy is often used to initially diagnose many large melanomas or melanomas of cosmetically important anatomic locations (nose, face, eyelids, nails, fingers and toes).

Treatment

Treatment is dependent on type of cancer, location of the cancer, age of the patient, and if the cancer is primary or recurrence. One should look at the specific type of skin cancer (basal cell carcinoma, squamous cell carcinoma, or melanoma) of concern in order to determine the correct treatment required. An example would be a small basal cell cancer on the cheek of a young man, where the treatment with the best cure rate (Mohs surgery) might be indicated. In the case of an elderly frail man with multiple complicating medical problems, a difficult to excise basal cell cancer of the nose might warrant radiation therapy (slightly lower cure rate) or no treatment at all. Topical chemotherapy might be indicated for large superficial basal cell carcinoma for good cosmetic outcome, whereas it might be inadequate for invasive nodular basal cell carcinoma or invasive squamous cell carcinoma

For low-risk disease, radiation therapy, topical chemotherapy (imiquimod or 5-fluorouracil) and cryotherapy (freezing the cancer off) can provide adequate control of the disease; both, however, may have lower overall cure rates than certain type of surgery. Other modalities of treatment such as photodynamic therapy, topical chemotherapy, electrodessication and curettage can be found in the discussions of basal cell carcinoma and squamous cell carcinoma.

Mohs' micrographic surgery (mohs surgery) is a technique used to remove the cancer with the least amount of surrounding tissue and the edges are checked immediately to see if tumor is found. This provides the opportunity to remove the least amount of tissue and provide the best cosmetically favorable results. This is especially important for areas where excess skin is limited, such as the face. Cure rates are equivalent to wide excision. Special training is required to perform this technique.
In the case of disease that has spread (metastasized), further surgical procedures or chemotherapy may be required.[14]
Scientists have recently been conducting experiments on what they have termed "immune- priming". This therapy is still in its infancy but has been shown to effectively attack foreign threats like viruses and also latch onto and attack skin cancers. More recently researchers have focused their efforts on strengthening the body's own naturally produced "helper T cells" that identify and lock onto cancer cells and help guide the killer cells to the cancer. Researchers infused patients with roughly 5 billion of the helper T cells without any harsh drugs or chemotherapy. This type of treatment if shown to be effective has no side effects and could change the way cancer patients are treated. [15]
A cream used to treat pre-cancerous skin lesions also reverses signs of ageing, a study released in April 2009 indicated.[16]

Reduction of risk

Although it is impossible to completely eliminate the possibility of skin cancer, the risk of developing such a cancer can be reduced significantly with the following steps:
reducing exposure to ultraviolet (UV) radiation, especially in early years avoiding sun exposure during the day, especially from 9 AM to 4 PM when the sun is highest in the sky wearing protective clothing (long sleeves and hats) when outdoors using a broad-spectrum sunscreen that blocks both UVA and UVB radiation reapply sun block every 2 hours and after swimming chemoprevention using topical imiquimod or 5-fluorouracil[citation needed] Australian scientist Ian Frazer who developed a vaccine for cervical cancer, says that a vaccine effective in preventing for certain types of skin cancer has proven effective on animals and could be available within a decade. The vaccine would only be effective against Squamous Cell Carcinoma.

liver cancer

2009-07-31T04:16:00.000-07:00

Signs and Symptoms

Liver cancer is a disease involving uncontrolled growth of cells within the liver.
Cancer in the liver may be primary or secondary, also called metastatic. Primary cancer arises within the liver and in its early stages exists only within the liver. People who have hepatitis B or C, viral infections of the liver, or cirrhosis of the liver are more likely than other people to develop primary liver cancer. At an early stage primary liver cancer may cause no symptoms at all. More advanced disease may cause loss of appetite, weight loss, fever, fatigue and weakness.
Secondary liver cancer is term for cancer that originates in another organ, such as the colon, stomach, pancreas and breast and then spreads to the liver. Because secondary cancer is present in at least two organs, the treatment possibilities are more limited than for primary liver cancer. As the cancer grows, pain may develop in the upper abdomen on the right side and may extend into the back and shoulder. With advanced disease, the signs of liver failure appear, which include abdominal swelling and a feeling of fullness or bloating and jaundice, a condition in which the skin and the whites of the eyes become yellow and the urine becomes dark.

Diagnosis

In making a diagnosis of liver cancer, your doctor will evaluate your medical history and perform a careful physical examination. Certain tests also will be recommended. For people at increased risk of developing primary liver cancer, such as those with chronic viral hepatitis or cirrhosis, the current recommendation is to have an alpha-fetoprotein blood test and an ultrasound examination of the liver, at least annually. While not perfect, these tests increase the chances of detecting liver cancer at an early stage.
Certain blood tests are used to see how well the liver is functioning. X-rays of the chest and abdomen, angiograms or X-rays of blood vessels; CT scans , or X-rays put together by computer; and MRIs, or magnetic resonance images, created by using a magnetic field, may be part of the diagnostic process. If there is uncertainty about the diagnosis, the presence of liver cancer may be confirmed with a biopsy. Tissue from the liver is removed through a needle or during an operationand checked under a microscope for the presence of cancer cells. Your doctor also may look at the liver with an instrument called a laparoscope, which is a small tube-shaped instrument with a light on one end. For this procedure, a small cut is made in the abdomen so that the laparoscope can be inserted. Your doctor may take a small piece of tissue during the laparoscopy. A pathologist then examines the tissue under the microscope to see if cancer cells are present. Once primary liver cancer is found, more tests will be performed to determine if cancer cells have spread to other parts of the body. The following stages are used for adult primary liver cancer:
Localized respectable: Cancer is found in one place in the liver and can be totally removed in an operation.
Localized unrespectable: Cancer is found only in one part of the liver, but the cancer cannot be totally removed.
Advanced: Cancer has spread through much of the liver or to other parts of the body.
Recurrent: Cancer has come back or recurred after it was treated. It may come back in the liver or in another part of the body.

Treatment

SurgerySurgery is the most common treatment for cancer of the liver.
Radiation therapyRadiation therapy is the use of X-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation comes from a machine outside the body, or external radiation therapy. Radiation can be used alone or in addition to surgery and chemotherapy.
ChemotherapyChemotherapy is the use of drugs to kill cancer cells. Chemotherapy for liver cancer is usually put into the body by inserting a needle into a vein or artery. This type of chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the liver. In another type of chemotherapy called regional chemotherapy, a small pump containing drugs is placed in the body. The pump puts drugs directly into the blood vessels, called arteries, that go to the tumor.

Bladder Cancer

2009-07-15T04:28:00.000-07:00

What is bladder cancer?

Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, called tumors. In bladder cancer, these growths happen in the bladder.
The bladder is the part of your urinary tract that stores your urine until you are ready to let it out. See a picture of the female urinary system or male urinary system.
Bladder cancer can usually be cured if it is found and treated early. And most bladder cancer is found early.

What causes bladder cancer?

We don't know what causes bladder cancer. But we do know that smokers are much more likely to get it than nonsmokers. In fact, experts believe that smoking causes about half of bladder cancer in men and more than one-fourth of bladder cancer in women.

What are the symptoms?

Blood in the urine is the main symptom. Other symptoms may include having to urinate often or feeling pain when you urinate.
These symptoms can be caused by other problems, including a urinary tract infection. Always call your doctor if you see blood in your urine.

How is bladder cancer diagnosed?

To diagnose bladder cancer, your doctor will:

Ask about your medical history and do a physical exam, including a vaginal or rectal exam.

Test your urine to look for blood or abnormal cells.

Do a cystoscopy, a test that lets your doctor look into your bladder with a thin, lighted viewing tool. Small tissue samples (biopsies) are taken and looked at under a microscope to find out if there are cancer cells.

How is it treated?

Treatment choices for bladder cancer include surgery to remove the cancer, anti-cancer drugs (chemotherapy), medicines that help your immune system (biological therapy), and radiation.
The treatment depends a lot on how much the cancer has grown. Most bladder cancers are treated without having to remove the bladder.
Sometimes doctors do have to remove the bladder. For some people, this means having urine flow into a bag outside of the body. But in many cases, doctors can make a new bladder—using other body tissue—that works very much like the old one.
Bladder cancer often comes back. The new tumors can often be treated easily if they are caught early. So it’s very important to have regular checkups after your treatment is done.
It’s common to feel scared, sad, or angry after finding out that you have bladder cancer. Talking to others who have had the disease may help you feel better. Ask your doctor about support groups in your area. You can also find people online who will share their experiences with you.

What increases your chances of getting bladder cancer?

Anything that increases your chances of getting a disease is called a risk factor. The main risk factor for bladder cancer is smoking. Cigarette smokers are much more likely than other people to get bladder cancer.

Other risk factors include:

Being older than 40.

Being male. Men are 4 times more likely than women to get bladder cancer.

Being exposed to cancer-causing chemicals, such as those used in the wood, rubber, and textile industries.

Ovarian Cancer

2009-07-01T00:43:00.000-07:00

What is ovarian cancer?

Ovarian cancer happens when cells that are not normal grow in one or both of your ovaries. This topic is about epithelial ovarian cancer, the most common type.
This cancer is often cured when it is caught early. But most of the time, the cancer has already spread by the time it is found.
It is frightening to hear that you or someone you love may have ovarian cancer. It may help to talk with your doctor or join a support group to deal with your feelings.

What causes ovarian cancer?

We do not know what causes it. Some women who have it also have a family history of cancer. But most do not.
Some women are more likely than others to get this rare cancer. Women who are past menopause or who have never been pregnant are more likely to get ovarian cancer.

What are the symptoms?

Ovarian cancer does not usually cause symptoms at first. But most women do have some symptoms in the 6 to 12 months before ovarian cancer is found. The most common symptoms are gas and pain or swelling in the belly. Other symptoms are diarrhea or constipation, or an upset stomach.
But these symptoms are so general that they are more likely to be blamed on a number of other causes. Most of the time, the cancer has already spread by the time it is found.

How is ovarian cancer diagnosed?

Sometimes the doctor may feel a lump in or on an ovary during a routine pelvic exam. Often a lump may be seen during an ultrasound. Most lumps are not cancer.
The only way to know for sure that a woman has ovarian cancer is with biopsies taken during surgery. The doctor makes an incision in the belly so that he or she can look inside. The doctor will remove bits of any tumors that are found and send them to a lab to confirm that they contain cancer.
There is a blood test called CA-125 (cancer antigen 125) that is sometimes done to look for cancer in women at high risk. So far, there is not enough proof to show that this test works to find ovarian cancer early in most women. Too much CA-125 in the blood can be caused by many things, like the menstrual cycle, endometriosis, and uterine fibroids, as well as many types of cancer.

How is it treated?

Surgery is the main treatment. The doctor will remove any tumors that he or she can see. This usually means taking out one or both ovaries. It may also mean taking out the fallopian tubes and uterus. After surgery, most women have several months of chemotherapy, which means taking drugs that kill cancer cells.
This cancer often comes back after treatment. So you will need regular checkups for the rest of your life. If your cancer does come back, treatment may help you feel better and live longer.
Ovarian cancer is very serious, but many women do survive it. It depends on your age and overall health, how far the cancer has spread, and how much cancer is left behind during surgery.
It may help to talk to other women who are going through the same thing. People who take part in support groups usually feel better, sleep better, and feel more like eating. Your doctor or your local branch of the American Cancer Society can help you find a support group. You can also look on the Internet to find support sites where women with this cancer can talk to each other.

What are your chances of getting ovarian cancer?

This cancer most often affects women who are past menopause. Women are more likely to get ovarian cancer if others in their family have had it. They are more likely to get it if they have had breast cancer.

You may also be more likely to get this cancer if:

You never had a baby.

You started your menstrual cycles before age 12 and went through menopause after age 50.

you are unable to become pregnant.

You have used hormone replacement therapy for menopause symptoms.

Lung Cancer

2009-07-01T00:19:00.000-07:00

What is lung cancer?

Lung cancer starts when abnormal cells grow out of control in the lung. They can invade nearby tissues and form tumors. Lung cancer can start anywhere in the lungs and affect any part of the respiratory system.
The cancer cells can spread, or metastasize, to the lymph nodes and other parts of the body.

What causes lung cancer?

Most lung cancer is caused by smoking. Secondhand smoke also can cause lung cancer. Lung cancer is the leading cause of cancer deaths.
Being exposed to arsenic, asbestos, radioactive dust, or radon can increase your chances of getting lung cancer. People who are exposed to radiation at work or elsewhere have a higher chance of getting lung cancer.

What are the symptoms?

Early lung cancer doesn't usually cause any symptoms. This is why it's not usually found early.
In its advanced stage, cancer may affect how your lungs work. The first signs of lung cancer may include:

Coughing.

Wheezing.

Feeling short of breath.

Having blood in any mucus that you cough up. If you have these symptoms and are worried about lung cancer, call your doctor.
Lung cancer may spread to the chest and then to other parts of the body. For example, if it spreads to the spine or bones, it may cause pain in the back or other bones or weakness in the arms or legs. If it spreads to the brain, it may cause seizures, headaches, or vision changes.

How is lung cancer diagnosed?

Your doctor will check your symptoms and ask questions about whether you smoke or have been exposed to another person's smoke or to any cancer-causing substances. He or she will also ask about your medical history, including any history of cancer in your family. This information will help your doctor decide how likely it is that you have lung cancer and whether you need tests to be sure.
Lung cancer is usually first found on a chest X-ray or a CT scan. More tests are done to find out what kind of cancer cells you have and whether they have spread beyond your lung. These tests help your doctor and you find out what stage the cancer is in. The stage is a rating to measure how big the cancer is and how far it has spread.

How is it treated?

Treatment for lung cancer includes surgery, anti-cancer medicines (chemotherapy), radiation, or a mix of all three. It depends on what type of cancer you have and how much it has spread.
Few lung cancers are found in the early stages when treatment is most effective.
It can be very scary to learn that you may have lung cancer. Talking with your doctor or joining a support group may help you deal with your feelings. Having support from family and friends can help a lot. And staying as active as possible will also help.
Less than half of people who get lung cancer live 1 more year after the cancer is found. And only about 16 out of 100 people with lung cancer live for 5 or more years. 1 It’s important to remember that everyone’s case is different and that these numbers may not show what will happen in your case.

Can you prevent lung cancer?

Lung cancer is one of the easiest cancers to prevent because most lung cancer is caused by smoking. So it is important to stop smoking—or to stop being around someone else’s smoke.
Even if you have smoked a long time, quitting can lower your chances of getting cancer. If you already have lung cancer, quitting makes your treatment work better and can help you live longer.

Vaginal Cancer

2009-05-28T06:02:00.000-07:00

Signs & Symptoms

Unfortunately, vaginal cancer in its early stages is asymptomatic. Symptoms occur when the cancer is already advanced. Some of the most common signs of vaginal cancer include:
Unusual bleeding or abnormal vaginal discharge not related to the period.
Difficulties or pain during urination.
Pain during sexual intercourse.
Constipation.
Pain within the pelvic area.
Pain in the back or legs.
Edema (swelling in the legs).
The presence of a lump inside the vagina.
However, these can be symptoms or signs of other medical conditions, and is recommended to consult a specialist when the above signs occur. Only a doctor can establish a cancer diagnosis.

Treatment Options
The treatment plan varies from patient to patient, and depends on a number of factors such as: (1) the patient age and general overall health state, (2) the tumor location and size, (3) and the need to maintain the function of the vagina. The course of treatment is often a group decision between the patient and the specialist team (gynecologic oncologist, surgeon, and radiation oncologist).
SurgerySurgery is one of the most common treatment for patients with vaginal cancer, and is mainly used as a primary treatment. According to the tumor size and cancer stage, there are five type of surgeries performed to treat vaginal cancer:
1. Laser surgery: This is a type of surgery that uses a laser beam (a narrow beam of intense light) to remove the tumor. The laser beam is used as a knife, only that the cut is bloodless or leaves no bleeding. The laser removes the tumor by burning off the tissue. This type of surgery is usually used for patients with early stages of cancer, where the tumor together with additional tissue are removed to reduce the risk of a relapse.
2. Wide local excision: This is a surgical procedure where the cancer is removed together with the tissue around it. In some cases, the patient needs reconstructive surgery to rebuild the vagina. This is done with the help of skin grafts removed from other parts of the body (usually buttock or thigh).
3. Vaginectomy: This is a surgical procedure where parts of the entire vagina are removed in some cases together with the lymph nodes (if they are also affected by the cancer), in a procedure called lymphadenectomy.
4. Radical (total) hysterectomy: This is a surgical procedure where the entire vagina is removed together with the surrounding organs or structures (such as the uterus, ovaries, fallopian tubes, or cervix). There are two type of radical hysterectomy:
Abdominal hysterectomy: During this procedure the vagina and adjacent organs are removed through a large incision in the abdomen.
Laparoscopic hysterectomy: During this procedure the vagina and adjacent organs are removed through small incision with the help of a special instrument called a laparoscope (slender endoscope inserted through an incision in the abdominal wall in order to examine the abdominal organs or to perform surgery).
5. Pelvic exenteration: This is a surgical procedure where the vagina is removed together with the rectum, colon, bladder, and/or part of the bowel (if the cancer invaded this organs or structures). This surgery is followed by a reconstructive operation where artificial openings, called stomas, are created. These stomas allow the stool and urine to collect into a special bag.
The surgery’s most common side effects include:
Intercourse discomfort.
Little or no natural lubrication of the vagina.
Body changes (the urine and stool might be flow out of the body through new ways).
Psychological problems (caused by the new body changes).
Radiation TherapyRadiation therapy or radiotherapy uses high-energy rays or particles (that focuses on a specific area) to destroy cancerous cells. This type of treatment can be administrated as: (1) a primary treatment, in the attempt to avoid the uncomfortable side effects of the surgery, or (2) an adjuvant treatment, in addition to the surgery to lower the risk of a cancer relapse, or in combination with chemotherapy for a better outcome.Vaginal cancer patients receive two types of radiation therapy:
I. External beam radiation therapy: This is the most common procedure to deliver the radiation beam through a device called a linear accelerator. The linear accelerator generates an external beam that is concentrated on the tumor area and breaks it up into smaller pieces. The treatment is administered for about 6 weeks (or more depending on the cancer type and size), 5 days a week. Unfortunately, this treatment does not only destroy the tumor, it also affects the healthy tissue causing a series of side effects, such as:
Skin burning sensations
Fatigue
Nausea
Diarrhea
Irritation of the intestines and rectum
Urethral stricture (the tube that carries out the urine from the bladder narrows)
Intestine perforations
Fistulas (abnormal connections) between the vagina and the bladder, rectum, or uterus.
The four last side effects occur only when the treatment uses high doses of radiation for patients with advanced stages of vaginal cancer.
II. Internal radiation therapy or brachytherapy: This is a type of treatment where the beam is received from inside the body close to the tumor location (inside the vagina). There are two types of brachytherapy used for patient with vaginal cancer:
1. Intracavitary radiation: This treatment uses low doses of radiation therapy, where the radioactive materials are placed within a cylindrical container inserted into the vagina. Usually, this type of treatment is administered for one or two days, and in most cases the patient has to stay in bed to keep the device inside the vagina. The doctor places gauze packing to assure that the radioactive device will not come out.
2. Interstitial radiation: This type of treatment uses needles (with radioactive material) placed directly into the tumor to administer the radiation beam.
In some cases, for a better outcome, the patient receives a combination of the two types of brachytherapy.
The most common side effects caused by the internal radiation therapy include:
Vaginal stenosis (the vagina shrinks or narrows).
Damages to the normal tissue inside the vagina.
Intercourse difficulties or problems.
Irritation of the intestines.
Diarrhea.
ChemotherapyChemotherapy is a type of treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the cancerous cells, or to kill them. This treatment involves either a single drug, or a combination of several drugs, and it is usually administered in cycles where a treatment period is followed by a recovery period. Chemotherapy can be administrated intravenous in the vain or through a catheter, as pills, or direct into the tumor.
When the treatment is received through pills or intravenously, the chemotherapy is classified as a systemic type of therapy, because the drugs enters the bloodstream and circulates throughout the body to reach and destroy the cancer cells. Unfortunately, chemotherapy as a systemic therapy has not proven to be effective in treating vaginal cancer. However, it is mostly used in women with advanced stages of vaginal cancer.
The main side effects of this approach are:
Lower resistance to infections (caused by a reduced number of white blood cells).
Easy bruising and bleeding (caused by a reduced number of platelets which help the blood to clot).
Anemia (caused by a reduced number of red blood cells).
Nausea and vomiting.
Mouth sores.
Temporary hair loss.
Loss of appetite.
Fatigue.
Some of these side effects can be diminished and controlled with proper medication. The intensity of the side effects depend mainly on the drug dosage and the length of the treatment period.
When the treatment is administrated directly into the tumor, the chemotherapy is called regional chemotherapy. This type of treatment is used in women with early stages of vaginal cancer.

kidney cancer

2009-05-28T05:15:00.000-07:00

Kidney Cancer Symptoms

There are many variations of kidney cancer. The most commonly diagnosed type of kidney cancer is renal cell carcinoma. It accounts for more than 85% of kidney cancer diagnosis'.The most commonly experienced kidney cancer symptoms (renal cell carcinoma) are:
Chronic fatigue
Unexplained, rapid weightloss
Leg and ankle swelling
Hypertension (high blood pressure)
Fever
Presence of blood in urine (seen either by the eye, or microscopically)
Pain in side or lower back
Mass or lump in the abdomenKeep in mind that these symptoms are also the signs for many other illnesses. Please see a health care professional if you are experiencing anything abnormal for further diagnosis.

Cancer Treatment

By Lisa Fayed, About.com Guide to Cancer
Cancer treatment can involve one or several different treatments. Surgery, radiation therapy, and chemotherapy are standard methods of treatment in many types of cancer. Before you begin any treatment regimen, you should become aware of what to expect, side effects, and the risks and benefits of treatment. The more educated you are about your cancer treatment, the better you can communicate with your healthcare team and be proactive in your treatment decisions.

Surgery
Surgery is often recommended for many types of cancer. Primarily, surgery is done to treat cancer, but can also serve as a prevention and diagnostic tool. Preparing for surgery can help you to become a more confident patient and also contribute to a timely recovery.

Chemotherapy and Other Medications
Chemotherapy is another widely used type of cancer treatment. It is often combined with another therapy, like surgery or radiation therapy, to ensure treatment success. While chemotherapy and other treatment medications can be common, they aren't for everyone

Radiation Therapy
Radiation therapy is also an option for treating cancer. This type of treatment uses certain types of high energy beams to shrink tumors or eliminate cancer cells. It is not effective in all types of cancer and isn't meant for everyone.

Managing Treatment Side Effects
Treatment for cancer can include surgery, chemotherapy, and radiation. Many times it is a combination of two or three types, which can compromise your quality of life, both physically and mentally.

Clinical Trials
Clinical trials are research studies conducted with volunteers, who participate for a variety of reasons, mainly when their body has stopped responding to treatment or when no treatment is available. Before beginning a clinical trial, you should consider a few issues.

Breast Cancer

2009-05-28T05:06:00.000-07:00

Symptoms

The first sign of breast cancer is often a painless lump. But early breast cancer is often found on a mammogram before a lump can be felt. Other symptoms of breast cancer may not appear until the cancer is more advanced. These include: A thickening in the breast or armpit. A change in the size or shape of the breast. Changes in the skin of the breast, such as a dimple or skin that looks like an orange peel. A change in the nipple, such as scaling of the skin or a nipple that turns in. A green or bloody fluid that comes from the nipple. A change in the color or feel of the skin around the nipple (areola). About 1% of breast cancer occurs in men. Although most men diagnosed with breast cancer are older than 65, the disease can appear in younger men. For this reason, any breast lump in an adult male is considered abnormal.7 Inflammatory breast cancer is a specific type of breast cancer that involves the skin of the breast. It occurs when breast cancer cells form "nests" and block the lymphatic drainage from the skin of the breast. Symptoms include redness, tenderness, and warmth. Thickening of the skin of the breast (an orange-peel appearance), rapid breast enlargement, and ridging of the skin of the breast may also be present. Some women may also develop a lump in the breast. For more information, see the topic Inflammatory Breast Cancer.

Treatment Overview

Breast cancer is usually treated with surgery, medicine, and radiation therapy. Because of improved screening methods, diagnosis at an early stage, and improved treatment techniques, the number of deaths from breast cancer has been steadily declining over the past few years. Decisions about how to treat breast cancer are based on a combination of factors that include specific information about the cancer, your preferences, and your health. When making decisions about treatment for your breast cancer, you and your doctor will consider: The size and location of your breast cancer (stage). How aggressive the breast cancer is. Whether your breast cancer has receptors to the hormones estrogen and progesterone, called estrogen receptor/progesterone receptor (ER/PR) status. Whether your breast cancer cells contain human epidermal growth factor (HER-2/neu). Whether your breast cancer has spread to the lymph nodes in your underarm area (axilla). You and your doctor will also consider your personal preferences and health when developing a treatment plan for you. This will include: Your feelings about keeping your breast. Your personal and family history of breast cancer. Your age and whether you have other serious health problems. Most people with breast cancer have surgery to remove the cancer from the breast. Some or all of the lymph nodes under the arm are also usually removed to find out whether the breast cancer has spread to this area. Even if your doctor removes all the cancer that can be seen at the time of your surgery, you may be treated with radiation therapy. Chemotherapy or hormone therapy may also be recommended to make sure that the breast cancer cells have been destroyed. You may also be given chemotherapy or hormone therapy to shrink your breast cancer before surgery. This is called neoadjuvant therapy. Initial treatmentInitial treatment of breast cancer may include: Surgery to remove the cancer. This may be done by removing the whole breast (mastectomy) or just the part of the breast that contains the breast cancer (breast-conserving surgery, or lumpectomy). Some of the lymph nodes under the arm will also be removed using either axillary lymph node dissection or sentinel node biopsy. Radiation therapy, which is the use of high-dose X-rays to destroy cancer cells and shrink tumors. Chemotherapy, which is the use of medicine to destroy cancer cells. Chemotherapy is called a systemic treatment, because the medicines enter the bloodstream, travel through the body, and can destroy cancer cells outside the target area. Hormone therapy with tamoxifen or an aromatase inhibitor, to change the way hormones in the body cause cancer growth. Treatment with trastuzumab (Herceptin) if your breast cancer tests positive for human epidermal growth factor (HER-2/neu).

Gastro-esophageal Reflux Disease (GERD) In Newborns

2009-04-16T07:58:00.000-07:00

Gastro-esophageal Reflux Disease, more popularly abbreviated as GERD, can be described as the ailment in which the gas or liquid in the stomach of the baby goes up the esophagus. The result is that that baby 'spits up'. It is not unusual for babies to suffer from the problem, mainly because their muscles, which are involved in opening and closing the top of the stomach, are quite relaxed. If, and when, they get relaxed after the consumption of food, the gas and fluid manage to escape from the stomach and go up the esophagus. While having reflux is common, it is only when it becomes severe that it takes the shape of Gastro-esophageal Reflux Disease, making the baby spit up too much, not get enough nourishment from food and even suffer from breathing problems.

Need For TreatmentIt is common for newborn babies and infants to suffer from Gastroesophageal Reflux Disease (GERD). However, it is only in the following conditions that you need to visit a doctor.

Baby is spitting up often

Baby has apnea (breathing stops for 15-20 seconds at a time)

Baby is growing poorly

Baby gets pneumonia or breathing difficulties from aspirating spit-up liquid

Causes Of Gastroesophageal Reflux One of the main reasons of Gastro-esophageal Reflux

Disease in children comprises of a poorly coordinated gastrointestinal tract. The immature digestive system results in unnecessary opening of the stomach, after eating food, as a result of which gas and fluid manage to escape to the esophagus. This leads to reflex in children. It has been seen that majority of the infants grow out of GERD by the time they are one year old.

Symptoms of Gastroesophageal Reflux

Frequent vomiting

Persistent cough

Refusing to eat or difficulty in eating

Choking or gagging while feeding

Heartburn

Abdominal pain

Colic

Colicky behavior (frequent crying and fussiness)

Regurgitation

Re-swallowing

Poor growth

Breathing problems

Recurrent pneumonia

Cure For Gastroesophageal Reflux

For Babies:

Try to keep the head of the baby's crib or bassinet elevated, as much as you can.

Every time you feed baby, hold him/her upright for the next 30 minutes

You can make the bottle feeds a bit thicker by adding some cereal. However, it is advisable to consult a doctor before doing this.

Try to bring some changes in the feeding schedule of the baby.

You can try giving some solid food to the baby, though with the doctor's approval.

For Older Children

Try to keep the head of your child's bed elevated, as much as you can

Instead of giving your baby three large meals in a day, give him/her several small meals spaced at small, but regular intervals.

Keep a track of the foods and beverages worsen your child's reflux and limit their consumption.

Encourage your child to indulge in exercise, on a regular basis.

For at least two hours after your child takes a meal, make sure to keep him/her upright.

Anemia in newborns

2009-04-16T07:50:00.000-07:00

Anemia is a disorder in which there are too few red blood cells in the blood.
Normally, the newborn's bone marrow does not produce new red blood cells between birth and 3 or 4 weeks of age. Anemia can occur when red blood cells are broken down too rapidly, too much blood is lost, or more than one of these processes occurs at the same time.
Any process that leads to red blood cell destruction, if sufficiently severe, results in anemia and high levels of bilirubin (hyperbilirubinemia). Hemolytic disease of the newborn may cause the newborn's red blood cells to be destroyed rapidly. The red blood cells may also be rapidly destroyed if the newborn has a hereditary abnormality of the red blood cells. An example is hereditary spherocytosis, in which the red blood cells appear small and spherical in shape when viewed under a microscope.
Infections acquired before birth, such as toxoplasmosis, rubella, cytomegalovirus, herpes simplex, or syphilis, may also rapidly destroy red blood cells, as can bacterial infections of the newborn acquired during or following birth.
Another cause of anemia is blood loss. Blood loss can occur in many ways, for example, if there is a large transfusion of the fetal blood across the placenta and into the mother's circulation (fetal-maternal transfusion) or if too much blood gets trapped in the placenta at delivery, when the umbilical cord is clamped. The placenta may separate from the uterine wall before delivery (placental abruption), leading to hemorrhage of the fetal blood. Rarely, anemia may result from a failure of the fetal bone marrow to produce red blood cells. One example of this is a genetic disorder called Fanconi's anemia. Another rare example is that due to exposure of the mother and fetus to certain drugs used during pregnancy.
Symptoms and Treatment
A newborn who has suddenly lost a large amount of blood during labor or delivery may appear pale and have a rapid heart rate and low blood pressure, along with rapid, shallow breathing. Milder anemia may result in lethargy, poor feeding, or no symptoms. When the anemia is a result of rapid breakdown of red blood cells, there is also increased production of bilirubin, and the newborn's skin and the whites of the eyes appear yellow (jaundice).
A newborn who has rapidly lost a large amount of blood, often during labor and delivery, is treated with intravenous fluids followed by a blood transfusion. Very severe anemia caused by hemolytic disease may also require a blood transfusion, but the anemia is more often treated with an exchange blood transfusion, in which part of the newborn's blood is gradually removed and replaced with equal volumes of fresh donor blood. The exchange transfusion also removes bilirubin in the circulation and thus treats the hyperbilirubinemia.

'Silent' Chagas disease killing newborns

2009-04-16T07:45:00.000-07:00

BUENOS AIRES] For every newborn detected with Chagas disease in Argentina, another six to twelve cases are not even diagnosed, with potentially fatal consequences, according to researchers there. Chagas disease — caused by the parasite Trypanosoma cruzi — affects around 17 million people worldwide. Transmission of the disease is generally associated with a blood-sucking insect known as the ‘assassin bug’, which lives in cracks and crevices of poor-quality houses, particularly in rural areas.But while the number of vector-transmitted infections is now under control in Argentina — for example through insecticide spraying, housing improvement and education — 'vertical' (i.e. mother-to-child) transmission is becoming an even greater threat, according to a study published last month in the journal Emerging Infectious Diseases. "The congenital transmission of [Chagas] appears to be a sizeable public health problem in Argentina, where it has already surpassed the number of vector-mediated acute cases by a factor of ten," say the study's authors. Cases of newborns with Chagas disease can remain undetected because the infection has a period in which no symptoms are present. “A lot of pregnant women cannot access prenatal diagnosis because they live in rural areas, or the maternity hospitals do not have the facilities to diagnose Chagas disease,” explains lead author Ricardo Gürtler, a researcher at the University of Buenos Aires.And although vertical transmission is not preventable, early detection and treatment of congenital infection can achieve cure rates close to 100 per cent. The authors call for improved diagnosis of pregnant women, treatment of infected newborns, and greater awareness of the problem among medical practitioners.

Abnormal brain development in newborns with congenital heart disease

2009-04-16T07:28:00.000-07:00

Department of Neurology, University of California at San Francisco, San Francisco, USA. smiller6@cw.bc.ca

BACKGROUND: Congenital heart disease in newborns is associated with global impairment in development. We characterized brain metabolism and microstructure, as measures of brain maturation, in newborns with congenital heart disease before they underwent heart surgery. METHODS: We studied 41 term newborns with congenital heart disease--29 who had transposition of the great arteries and 12 who had single-ventricle physiology--with the use of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and diffusion tensor imaging (DTI) before cardiac surgery. We calculated the ratio of N-acetylaspartate to choline (which increases with brain maturation), the ratio of lactate to choline (which decreases with maturation), average diffusivity (which decreases with maturation), and fractional anisotropy of white-matter tracts (which increases with maturation). We compared these findings with those in 16 control newborns of a similar gestational age. RESULTS: As compared with control newborns, those with congenital heart disease had a decrease of 10% in the ratio of N-acetylaspartate to choline (P=0.003), an increase of 28% in the ratio of lactate to choline (P=0.08), an increase of 4% in average diffusivity (P<0.001), and a decrease of 12% in white-matter fractional anisotropy (P<0.001). Preoperative brain injury, as seen on MRI, was not significantly associated with findings on MRS or DTI. White-matter injury was observed in 13 newborns with congenital heart disease (32%) and in no control newborns. CONCLUSIONS: Term newborns with congenital heart disease have widespread brain abnormalities before they undergo cardiac surgery. The imaging findings in such newborns are similar to those in premature newborns and may reflect abnormal brain development in utero. Copyright 2007 Massachusetts Medical Society. PMID: 17989385 [PubMed - indexed for MEDLINE]BACKGROUND: Congenital heart disease in newborns is associated with global impairment in development. We characterized brain metabolism and microstructure, as measures of brain maturation, in newborns with congenital heart disease before they underwent heart surgery. METHODS: We studied 41 term newborns with congenital heart disease--29 who had transposition of the great arteries and 12 who had single-ventricle physiology--with the use of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and diffusion tensor imaging (DTI) before cardiac surgery. We calculated the ratio of N-acetylaspartate to choline (which increases with brain maturation), the ratio of lactate to choline (which decreases with maturation), average diffusivity (which decreases with maturation), and fractional anisotropy of white-matter tracts (which increases with maturation). We compared these findings with those in 16 control newborns of a similar gestational age. RESULTS: As compared with control newborns, those with congenital heart disease had a decrease of 10% in the ratio of N-acetylaspartate to choline (P=0.003), an increase of 28% in the ratio of lactate to choline (P=0.08), an increase of 4% in average diffusivity (P<0.001), and a decrease of 12% in white-matter fractional anisotropy (P<0.001). Preoperative brain injury, as seen on MRI, was not significantly associated with findings on MRS or DTI. White-matter injury was observed in 13 newborns with congenital heart disease (32%) and in no control newborns. CONCLUSIONS: Term newborns with congenital heart disease have widespread brain abnormalities before they undergo cardiac surgery. The imaging findings in such newborns are similar to those in premature newborns and may reflect abnormal brain development in utero. Copyright 2007 Massachusetts Medical Society. PMID: 17989385 [PubMed - indexed for MEDLINE]

Urine Blockage in Newborns

2009-04-16T06:00:00.000-07:00

The urinary tract consists of:
two kidneys, which filter waste materials and excess water from the blood
two ureters, which carry urine from the kidneys to the bladder
the bladder, where urine is stored until it is released
the urethra, where urine flows out of the body
We rely on our kidneys and urinary system to keep fluids and natural chemicals in our bodies balanced. While a baby is developing in the mother’s womb, much of that balancing is handled by the mother’s placenta. The baby’s kidneys begin to produce urine at about 10 to 12 weeks after conception, but the mother’s placenta continues to do most of the work until the last few weeks of the pregnancy. Wastes and excess fluid are removed from the baby’s body through the umbilical cord. The baby’s urine is released into the amniotic sac and becomes part of the amniotic fluid. This fluid plays a role in the baby’s lung development.
Sometimes, a birth defect in the urinary tract will block the flow of urine in an unborn baby. As a result, urine backs up and causes the ureters and kidneys to swell. Swelling in the kidneys is called hydronephrosis. Swelling in the ureters is called hydroureter.

Normal urinary tract.
Swelling in the kidney is called hydronephrosis. Swelling in the ureter is called hydroureter.
Hydronephrosis is the most common problem found during ultrasound examination of babies in the womb. The swelling may be barely detectable or very noticeable. The results of hydronephrosis may be mild or severe, but the long-term outcome for the child’s health cannot always be judged by the severity of swelling. Urine blockage may damage the developing kidneys and reduce their ability to filter. The blockage may also raise the risk that the child will develop a urinary tract infection (UTI). Recurring UTIs can lead to more permanent kidney damage. In the most severe cases of urine blockage, the amniotic sac is so reduced that the lack of fluid threatens the baby’s lung development.

Types of Defects in the Urinary Tract:
Hydronephrosis can result from many types of defects in the urinary tract. Doctors use specific terms to describe the type and location of the blockage.

· Vesicoureteral reflux (VUR). The openings where the ureters empty urine into the bladder should work like valves to keep urine from backing up into the ureters. Sometimes the valve doesn’t work properly and urine flows back into the kidneys. The urine may flow only a short way back into the ureters, or it may go all the way back to the kidneys, causing the ureters and kidneys to swell. VUR may occur in only one ureter or in both. Kidneys with severe reflux may not develop normally, and after birth kidneys with reflux may be at risk for damage from infections.
· Ureteropelvic junction (UPJ) obstruction. The point where the ureter joins the kidney is called the ureteropelvic junction. If urine is blocked here, only the kidney swells. The ureter remains at a normal size. UPJ obstruction usually only occurs in one kidney.
· Bladder outlet obstruction (BOO). BOO describes any blockage in the urethra or at the opening of the bladder. The obstruction may occur in boys or girls. The most common form of BOO seen in newborns and during prenatal ultrasound examinations is posterior urethral valves (PUV). BOO caused by PUV occurs only in boys.

· Posterior urethral valves (PUV). In boys, sometimes an abnormal fold of tissue in the urethra keeps urine from flowing freely out of the bladder. This defect may cause swelling in the entire urinary tract, including the urethra, bladder, ureters, and kidneys.

· Ureterocele. If the end of the ureter does not develop normally, it can bulge, creating what is called a ureterocele. The ureterocele may obstruct part of the kidney or the bladder.
Ureterocele. The inset shows a cross-section of the ureter bulging into the interior of the bladder.

· Nerve dsease. Urination requires coordinated nerve signals between the bladder, spinal cord, and brain. Spina bifida and other birth defects that affect the spinal cord may interrupt nerve signals and lead to urine retention in newborns.
Ureteropelvic junction (UPJ) is the point where the ureter joins the kidney.

Syndromes That May Affect the Urinary Tract:
In addition to defects that occur in a single spot in the urinary tract, some babies are born with genetic conditions that affect several different systems in the body. A condition that includes multiple, seemingly unrelated problems, is called a syndrome.
Prune belly syndrome (PBS). Occurring only in boys, PBS causes a baby to have an enlarged abdomen because the normal abdominal wall muscles are missing or very weak. The entire urinary tract is enlarged, and both testicles remain inside the body instead of descending into the scrotum. The skin over the abdomen is wrinkled, giving the appearance of a prune. Most children with PBS have hydronephrosis and VUR.

Esophageal atresia (EA). EA is a birth defect in which the esophagus is incomplete. The esophagus is the tube that carries food from the mouth to the stomach. About 30 percent of babies born with EA will have problems in other body systems, such as the heart or urinary tract.
Congenital heart defects. Heart defects range from mild to life threatening. Children born with heart defects also have a higher rate of problems in the urinary tract than children in the general population, suggesting that some types of heart and urinary defects may have a common genetic cause.

Diagnosis:
Birth defects and other problems of the urinary tract may be discovered before the baby is born, at the time of birth, or later, when the child is brought to the doctor for a urinary tract infection or urination problem.
Prenatal Screening
Tests during pregnancy can help determine if the baby is developing normally in the womb.
Ultrasound. Ultrasound uses sound waves to produce a picture on a television screen. A wand gliding on the mother’s abdomen directs harmless sound waves into the womb. The sound waves bounce off the baby and back into the wand to create a black-and-white image on the screen. Ultrasound images can even display internal organs within the baby, so enlarged kidneys, ureters, or bladder may be visible.
Amniocentesis. In amniocentesis, the doctor inserts a needle through the mother’s skin into the amniotic sac to collect about an ounce of amniotic fluid. The fluid contains genetic material from the baby that can be analyzed for signs of defects.

Ultrasound allows evaluation of a baby’s internal organs, even before birth.

Chorionic villus sampling (CVS). In CVS, the doctor collects a small piece of tissue from the placenta using a needle passed through the mother’s vagina and cervix. The placenta has the same genetic makeup as the baby.Most healthy women do not need all the tests. Ultrasound examinations during pregnancy are routine, although they are not always required and rarely influence treatment decisions. Amniocentesis and CVS are recommended only when a risk of genetic problems exists because of family history or something detected during an ultrasound. Amniocentesis and CVS carry a slight risk of harming the baby and mother, or ending the pregnancy in miscarriage, so those risks should be weighed carefully against the potential benefits of learning about the baby’s condition.

Examination of Newborn:
Sometimes a newborn does not urinate as expected, even though prenatal testing showed no sign of urine blockage. The baby may urinate only small amounts or not at all. An enlarged kidney may be felt during the newborn examination as well. Different imaging techniques are available to determine the cause of the problem.

Ultrasound. Once the baby is born, ultrasound can be used to view the baby’s urinary tract directly for a clearer image than could be achieved while the baby was in the womb.
Voiding cystourethrogram (VCUG). If the doctor suspects that urine is backing up into the ureters or that the bladder outlet is obstructed, a VCUG may be needed. In this test, a catheter is used to fill the child’s bladder with warm liquid containing iodine to make it visible on an x ray. A video records the x-ray images of the bladder as it is filled and as the child urinates. The video will reveal reflux if the liquid enters the ureters and blockage of the bladder in the case of an obstruction, such as PUV.

Nuclear scan. A nuclear scan involves injecting a very small amount of radioactive material, just enough to show up using a camera that captures gamma rays. The amount of radioactive substance used is determined by the child’s weight. The liquid is injected into the child’s bloodstream and eventually passes through the kidneys, where it is filtered from the blood and directed down the ureters to the bladder. The camera may be mounted above or below a table where the patient lies. The camera passes over or under the urinary tract as the child lies on the table.

Later Diagnosis
Sometimes urine blockage is not apparent until the child develops the symptoms of a urinary tract infection. These symptoms include
fever
irritability
poor appetite
vomiting
unusual smelling urine
dark urine
If these symptoms persist, the child should be seen by a doctor. For any fever in the first 2 months of life, the child should be seen by a doctor immediately. The doctor will ask for a urine sample to test for bacteria. The doctor may also recommend imaging tests including ultrasound, VCUG, or nuclear scan.

Treatment:
Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born will rarely require immediate action, especially if it is only on one side. Often the condition goes away without any treatment before birth or sometimes after. The doctor will keep track of the condition with frequent ultrasounds. With few exceptions, treatment can wait until the baby is born.

Prenatal Shunt
If the urine blockage threatens the life of the unborn baby, the doctor may recommend a procedure to insert a small tube, called a shunt, into the baby’s bladder to release urine into the amniotic sac. The placement of the shunt is similar to an amniocentesis, in that a needle is inserted through the mother’s abdomen. Ultrasound guides the placing of the shunt. This fetal surgery carries many risks, so it is performed only in special circumstances, such as when the amniotic fluid is absent and the baby’s lungs aren’t developing or when the kidneys are very severely damaged.

Antibiotics
Antibiotics are medicines that kill bacteria. A newborn with possible urine blockage or VUR may be given antibiotics to prevent urinary tract infections from developing until the urinary defect corrects itself or is surgically corrected.

Surgery
If the urinary defect doesn’t correct itself and the child continues to have urine blockage, surgery may be needed. The decision to operate depends upon the degree of blockage. The surgeon will remove the obstruction to restore urine flow. A small tube, called a stent, may be placed in the ureter or urethra to keep it open temporarily while healing occurs.
Intermittent Catheterization
If the child has urine retention because of nerve disease, the condition may be treated with intermittent catheterization. The parent, and later the child, will be taught to drain the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder. Emptying the bladder in this way helps prevent kidney damage, overflow incontinence, and urinary tract infections.

Hope through Research
Researchers from universities and government agencies are working to understand the causes of urinary birth defects and to find more effective treatments. Through its Pediatric Urology Program, the National Institute of Diabetes and Digestive and Kidney Diseases funds research into bladder and urinary tract development, prenatal interventions for urinary tract disorders, and bladder abnormalities associated with spina bifida. Additionally, the Eunice Kennedy Shriver National Institute of Child Health and Human Development has established the Birth Defects Initiative to study the genetic and molecular mechanisms underlying developmental processes of the fetus.