Medical Information

Menopause

noreply@blogger.com (Anonymous) — Fri, 26 Apr 2013 13:40:00 +0000

Menopause (signs, symptoms, diagnosis, treatment)

Menopause is a normal part of ageing for a woman and literally means "last period". The term, however, is commonly used to describe the years when the ovaries gradually begin to produce fewer eggs and less of the female hormones oestrogen and progesterone. This reduction in hormone production causes the periods to become progressively more irregular until they stop altogether, and produces physical and psychological symptoms in many women.

Menopause is generally considered complete when a woman has not had a period for one year. Menopause, often referred to as "the change of life", usually occurs between the ages of 45 – 55 years with the average age being 52 years. Premature (early onset) menopause is when periods stop before the age of 40 years.

Consideration of treatment and lifestyle change options may depend on the severity of a woman's symptoms.

Why does menopause occur?

At birth, the ovaries contain a lifetime supply of eggs stored in small follicles. At puberty, hormones produced by the pituitary gland in the brain stimulate the ovaries to begin releasing eggs each month (ovulation). This prompts oestrogen and progesterone to be released by the ovaries, which in turn stimulate the lining of the uterus (endometrium) to thicken in preparation for the implantation of a fertilised egg. If an egg is not fertilised the endometrium is shed and a period occurs. This entire process is known as the menstrual cycle.

As a woman ages the number of follicles in her ovaries decreases and the ovaries produce fewer hormones. Menopause occurs when the ovaries fail to produce enough hormones to stimulate the monthly growth of the endometrium, and periods stop permanently.

The timeframe from when symptoms first appear to when menopause occurs may be several years. This timeframe is medically referred to as the climacteric or the perimenopause.

After menopause a woman's risk of heart disease (including high blood pressure, heart attack and stroke) increases and becomes as high as it is for men. The risk of developing osteoporosis (bone thinning) is also increased.

There are three types of menopause: natural, premature, and artificial.

Natural menopause occurs when levels of oestrogen and progesterone decline naturally.

Premature (early) menopause is when periods stop before the age of 40 years. This can be due to many reasons including medical conditions such as diabetes or thyroid disease, and surgery or medications that have affected the blood supply to the ovaries. Genetic factors may also play a part as premature menopause can run in families. Women who smoke are also more likely to go through premature menopause. Sometimes, however, there is no identifiable cause.

Artificial (surgical) menopause is a consequence of surgical removal of both ovaries or destruction of the ovaries by some cancer treatments. With artificial menopause there is a sudden drop in hormone levels and menopausal symptoms begin abruptly. Often the symptoms experienced are more severe than those experienced with natural or premature menopause.

Signs and symptoms

Often the first symptom of impending menopause is a change in bleeding patterns. Periods may become lighter or heavier, longer or shorter, the time between periods may increase and there may be occasional missed periods. These changes may occur gradually in some women, yet are more abrupt in others.

There are also a wide range of physical and psychological signs and symptoms associated with menopause. In some women they are very mild while in others they are more severe. They may last for only a few months, or may continue for several years. The average length of time for menopausal symptoms to be experienced is three to five years.

Physical signs and symptoms may include:

Hot flushes (occurring in approximately 60% of women)
Sweats (often at night)
Tiredness
Headaches
Joint and bone pain
Palpitations
Unusual skin sensations
Vaginal dryness, incontinence and infections of the urinary tract and vagina may occur due to the thinning of the vagina and bladder walls.

Psychological signs and symptoms may include:

Anxiety
Reduced interest in sex
Irritability and mood swings
Difficulty concentrating
Loss of confidence
Forgetfulness
Difficulty sleeping
Depression

Diagnosis

There is no one test to diagnose menopause. Symptoms experienced may indicate that menopause is imminent, however menopause can only be confirmed retrospectively after periods have been absent for one year. Blood tests may be taken at this time as the levels of hormones produced by the pituitary gland - follicle stimulating hormone (FSH) and luteinizing hormone (LH) – may be higher if menopause has occurred.

A change in bleeding patterns, particularly where periods become heavier, and an absence of periods (amenorrhoea) can indicate various medical conditions. It is therefore advisable to consult a doctor before assuming that the changes are menopausal symptoms. Also, if bleeding occurs after periods have been absent for a year, a doctor should be consulted, as this is not considered normal.

Treatment

The intensity and frequency of menopausal symptoms vary from woman to woman. If symptoms are problematic, or a woman is at high risk of developing osteoporosis or heart disease, medical treatment may be recommended. Ultimately, the decision to have treatment is a very personal one and should be made by the woman only after receiving a full explanation from her doctor of the benefits and counter benefits of the various treatment options.

Treatment options include:

Hormone Replacement Therapy (HRT)

HRT involves replacing hormones previously produced by the ovaries. It can be effective in relieving the symptoms of hot flushes, night sweats and dryness of the vagina. HRT can also help to reduce the risk of heart disease and osteoporosis following menopause. Facial hirsutism (excess hair growth) can increase after menopause due to hormonal changes. This growth may be slowed with HRT.

HRT can be given as tablets, skin patches and as vaginal preparations such as creams and pessaries. Vaginal preparations can help to reduce symptoms of vaginal dryness, incontinence and bladder and vaginal infections.

Some forms of HRT may increase the risk of endometrial cancer and using some forms of HRT for longer than 5 years may increase the risk of breast cancer. However, recent research has indicated that some forms of HRT may help to reduce the risk of Alzheimer's disease and bowel cancer and may help to prevent some aspects of skin ageing. As there are many different forms of HRT it is important to discuss with a doctor which type and delivery method is most appropriate.

Alternative therapies

Some women have found that alternative therapies have proved successful in reducing menopausal symptoms. These include natural hormones, herbal preparations, vitamins and minerals and homeopathic remedies.

Examples of these include black cohosh, ginkgo biloba, evening primrose oil, vitamins B, C and E, ginseng, garlic, camomile, St. Johns Wort and soy based phyto-oestrogens (natural hormones). Treatments such as acupuncture, massage and reflexology have also proved successful for some women.

Unsupervised use of alternative therapies, particularly herbal preparations, can cause adverse effects and monitoring by a health practitioner trained in their use is strongly advised. It is also advisable to discuss the intended use of these therapies with a doctor, especially if taking prescription medications.

Lifestyle factors

Changes in lifestyle can help to reduce the severity of menopausal symptoms and decrease the risk of osteoporosis and heart disease. Diet and exercise are two very important aspects of these lifestyle changes.

Diet

Women need a higher intake of calcium and vitamin D after menopause to help reduce the risk of osteoporosis. Excellent dietary sources of calcium include low fat dairy products (milk, cheese, yoghurt), nuts, dark green vegetables (eg: broccoli, spinach) and fish with bones in (eg: sardines, salmon). Vitamin D, which helps the body to absorb calcium, is manufactured by the skin after exposure to sunlight. Small quantities are found in foods such as dairy products and eggs.

An intake of at least 1000mg of calcium daily is recommended for women after menopause. If the diet contains insufficient amounts of calcium and vitamin D, dietary supplements may be required.

Eating a healthy balanced diet that is low in fat and refined sugars and maintaining a healthy body weight is recommended. Limiting alcohol and caffeine and not smoking are also important.

Exercise

Regular weight-bearing exercise such as walking, dancing, tennis, aerobics or golf helps in maintaining a healthy weight, fitness and general wellbeing. Exercise also helps to decrease the risk of osteoporosis by strengthening the bones and may assist in reducing the severity of menopausal symptoms such as hot flushes. Specific pelvic floor exercises can help to reduce urinary problems such as incontinence and pain on urination.

Rest and stress reduction also play an important role in managing menopause symptoms. Fatigue and stress can worsen symptoms, so employing strategies to ensure adequate rest is attained and stress is managed will assist in alleviating symptoms.

What is Cholesterol? What Causes High Cholesterol?

noreply@blogger.com (Anonymous) — Fri, 19 Apr 2013 14:17:00 +0000

Cholesterol is a lipid (fat) which is produced by the liver. Cholesterol is vital for normal body function. Every cell in our body has cholesterol in its outer layer.

Cholesterol is a waxy steroid and is transported in the blood plasma of all animals. It is the main sterol synthesized by animals - small amounts are also synthesized in plants and fungi. A sterol is a steroid sub-group.

Cholesterol levels among US adults today are generally higher than in all other industrial nations. During the 1990s there was some concern about cholesterol levels in American children. According to the CDC (Centers for Disease Control and Prevention), nearly 1 in every 10 children/adolescents in the USA has elevated total cholesterol levels; and this was after concentrations had dropped over a 20-year period.

The word "cholesterol" comes from the Greek word chole, meaning "bile", and the Greek wordstereos, meaning "solid, stiff".

What are the functions of cholesterol?

It builds and maintains cell membranes (outer layer), it prevents crystallization of hydrocarbons in the membrane
It is essential for determining which molecules can pass into the cell and which cannot (cell membrane permeability)
It is involved in the production of sex hormones (androgens and estrogens)
It is essential for the production of hormones released by the adrenal glands (cortisol, corticosterone, aldosterone, and others)
It aids in the production of bile
It converts sunshine to vitamin D. Scientists from the Rockefeller University were surprised to find that taking vitamin D supplements do not seem to reduce the risk of cholesterol-related cardiovascular disease.
It is important for the metabolism of fat soluble vitamins, including vitamins A, D, E, and K
It insulates nerve fibers

There are three main types of lipoproteins

Cholesterol is carried in the blood by molecules called lipoproteins. A lipoprotein is any complex or compound containing both lipid (fat) and protein. The three main types are:

LDL (low density lipoprotein) - people often refer to it as bad cholesterol. LDL carries cholesterol from the liver to cells. If too much is carried, too much for the cells to use, there can be a harmful buildup of LDL. This lipoprotein can increase the risk of arterial disease if levels rise too high. Most human blood contains approximately 70% LDL - this may vary, depending on the person.

HDL (high density lipoprotein) - people often refer to it as good cholesterol. Experts say HDL prevents arterial disease. HDL does the opposite of LDL - HDL takes the cholesterol away from the cells and back to the liver. In the liver it is either broken down or expelled from the body as waste.

Triglycerides - these are the chemical forms in which most fat exists in the body, as well as in food. They are present in blood plasma. Triglycerides, in association with cholesterol, form the plasma lipids (blood fat). Triglycerides in plasma originate either from fats in our food, or are made in the body from other energy sources, such as carbohydrates. Calories we consume but are not used immediately by our tissues are converted into triglycerides and stored in fat cells. When your body needs energy and there is no food as an energy source, triglycerides will be released from fat cells and used as energy - hormones control this process.

What are normal cholesterol levels?

The amount of cholesterol in human blood can vary from 3.6 mmol/liter to 7.8 mmol/liter. The National Health Service (NHS), UK, says that any reading over 6 mmol/liter is high, and will significantly raise the risk of arterial disease. The UK Department of Health recommends a target cholesterol level of under 5 mmo/liter. Unfortunately, two-thirds of all UK adults have a total cholesterol level of at least five (average men 5.5, average women 5.6).

Below is a list of cholesterol levels and how most doctors would categorize them in mg/dl (milligrams/deciliter) and 5mmol/liter (millimoles/liter).

Desirable - Less than 200 mg/dL
Bordeline high - 200 to 239 mg/dL
High - 240 mg/dL and above

Optimum level: less than 5mmol/liter
Mildly high cholesterol level: between 5 to 6.4mmol/liter
Moderately high cholesterol level: between 6.5 to 7.8mmol/liter
Very high cholesterol level: above 7.8mmol/liter

Dangers of high cholesterol levels

High cholesterol levels can cause:

Atherosclerosis - narrowing of the arteries.

Higher coronary heart disease risk - an abnormality of the arteries that supply blood and oxygen to the heart.

Heart attack - occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. This causes your heart muscle to die.

Angina - chest pain or discomfort that occurs when your heart muscle does not get enough blood.

Other cardiovascular conditions - diseases of the heart and blood vessels.

Stroke and mini-stroke - occurs when a blood clot blocks an artery or vein, interrupting the flow to an area of the brain. Can also occur when a blood vessel breaks. Brain cells begin to die.

If both blood cholesterol and triglyceride levels are high, the risk of developing coronary heart disease rises significantly.

7 Sex Positions Men Love

noreply@blogger.com (Anonymous) — Sun, 14 Apr 2013 15:44:00 +0000

7 Sex Positions Men Love

The bedroom moves that men love: try these sex positions tonight.

Want to spice things up in the bedroom? Make his night anddrive him crazy with these sex positions that men love. Ultimately, sex is about love and intimacy, so while the positions are part of the fun, the real payoff is the way various maneuvers allow you to connect and explore each other in different ways.

1. Woman on Top: Ask your guy what drives him crazy in the bedroom, and we're betting he'll say it's pleasing you. This sexy position puts you in the driver's seat, and that's exactly where he wants you. Take advantage of being in control and set the pace according to what you like, leaving his hands free to roam. The bonus? He loves having your curves in full view…so flip on the lights and give him a show.

More from YourTango: What Is 'Honey Sex' And Why Is It Bad For You?

2. Missionary: This standard go-to is a favorite because it puts him in control, while still being intimate: your hips are free to do all the work, and you can lock lips and eyes with ease. And while he's in the power position on top of you, the two of you can set the pace together. If you want him to go slower or deeper, put your hands on his hips and guide him. The best sex is like a conversation, and missionary allows you to communicate with your bodies.

3. Reverse Cowgirl: This reverse variation of the woman on top position is the best of both worlds for your guy. It gives him the sexy view he gets during doggie style but it puts you in control. This position doesn't allow for a ton of touching or eye contact, but it's a nice contrast to some of the more classic, romantic positions. If you're craving a connection flash a look back at him while you're doing your thing—it'll drive both of you over the edge.

4. Doggie Style: This rear entry positions puts him in control, allowing him to call the shots and to go at the speed that's best for him. Plus, it allows for deeper penetration, making him feel like king in the bedroom. Some women love the intense full feeling, but if it feels like too much, let him know. Communication is key to enjoying sex and experiencing the full psychological benefits of physical intimacy.

5. Standing Up: Getting it on while standing up is probably not your go-to move, but it's perfect for that sweaty, gotta-have-you-now sex that'll make him feel irresistible. Whether he's bending you over the new kitchen table or you're steadying yourself against the wall, this spontaneous position is perfect for a quickie.

Breast Implants -- Through the Armpits

noreply@blogger.com (Anonymous) — Sat, 30 Mar 2013 14:15:00 +0000

When M.A. starting thinking about getting breast implants, she remembered a co-worker who once had the same procedure. (M.A. asked to remain unidentified for medical privacy.)

A 30-year-old, single working mom of a seven-year-old son, M.A. watched as the co-worker searched the Internet for just the right Las Vegas plastic surgeon with impressive training and the best possible before and after pictures of his work.

Before M.A. had a child, she was a full D cup. But child birth and nursing naturally cause changes in the body, and her bust line shrunk to a full C and then to a full A.

“Breast augmentation was something I wanted to do just for myself”

Breast Enlargement

"Breast augmentation was something I wanted to do just for myself," says M.A. who, inspired by her friend's experience, turned to the Internet. There, she found a discussion group that explained what breast augmentation was like from the very first consult to final healing. She also watched each and every episode of Dr. 90210 with a hungry eye.

Moreover, M.A. has a special medical consideration and kept an eye out for a Las Vegas plastic surgeon who has some extra experience with her particular condition.

"My ethnic background is Philipino and I know from past experience that my scars will be keloid." (Read more about scar revision.)

Keloid scars result from an overgrowth of tissue at the site of a surgical incision or other skin injury. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can be lighter or darker than the surrounding skin. (Read more about keloids.)

"Due to the keloid scarring, the surgical incisions to place the implants could only be in my armpits where they would be hidden," she says.

Breast Augmentation Photos

Patient M.A. at age 29 before her breasts implant procedure (left), and three months after the procedure (right), M.A. is a full D cup.(Photos, courtesy of Dr. Cambeiro, M.D.)

Breast Implant Surgery

Being ever the wise consumer, M.A. arranged consults with several Las Vegas plastic surgeons. Her continuing research kept bringing her back to information about a board certified Las Vegas plastic surgeon, Arthur Cambeiro, M.D., who appeared to be the only local board certified plastic surgeon with patients who were also subject to keloid scarring. She saw a second surgeon and made a non-refundable deposit on a breast enlargement.

"While waiting for the appointment, I continued researching and was constantly referred back to Dr. Cambeiro," she says. "Eventually, I decided to go with him, even though I had to forfeit the deposit with the second surgeon."

After the procedure, M.A. was delighted with the results. However, the keloids did, as expected, develop on her incisions.

Breast Surgery

M.A. chose saline breast implants, placed under the chest muscle, and inserted through the armpit (this method reduces the visibility of scaring). She had the procedure on a Friday and returned to work the following Tuesday, wearing loose, flowing clothing. She reports feeling pain only in her back from sitting up while sleeping during recuperation. It was such an effort to get back up after reclining, she decided to just sit on her couch for a while.

“I continued researching and was constantly referred back to Dr. Cambeiro”

"Even though I wanted breast enlargement, I'm still shy and modest and did not want to show off my new bust line with a plunging neckline and the like," she says. "Happily, nobody at work noticed I had the enhancement done."

Next, Dr. Cambeiro worked over the next year to lessen the appearance of her keloid scars and made sure that they were even with the rest of her skin. Untreated keloids scars almost always bulge above the surface of the surrounding skin.

"The scars are now just a little darker and rougher than the rest of my skin but are completely hidden," M.A. says. "The people who've seen me in a bathing suit, and knew me before I got pregnant, tell me the implants are just the right size for me and that I look totally natural.

"I couldn't be more pleased!"

Malaria

noreply@blogger.com (Anonymous) — Mon, 04 Mar 2013 16:35:00 +0000

The Facts on Malaria

Malaria is a parasitic infection spread by Anopheles mosquitoes. The Plasmodium parasite that causes malaria is neither a virus nor a bacterium - it is a single-celled parasite that multiplies in red blood cells of humans as well as in the mosquito intestine.

When the female mosquito feeds on an infected person, male and female forms of the parasite are ingested from human blood. Subsequently, the male and female forms of the parasite meet and mate in the mosquito gut, and the infective forms are passed into another human when the mosquito feeds again.

Malaria is a significant global problem. There are approximately 216 million cases of the disease worldwide, killing about 655,000 people every year. Malaria is prevalent in Africa, Asia, the Middle East, Central South America, Hispaniola (Haiti and the Dominican Republic), and Oceania (Papua New Guinea, Irian Jaya, and the Solomon Islands).

Each year, up to 1 million Canadians travel to malaria-endemic areas. This results in 350 to 1,000 annual cases of malaria in Canada.

Although the parasite has progressively developed resistance to several older antimalarial medications, there are still many safe and effective medications both for treatment and prevention.

There are four species of the Plasmodium parasite that can cause malaria in humans: P. falciparum, P. vivax, P. ovale, and P. malariae. The first two types are the most common. Plasmodium falciparum is the most dangerous of these parasites because the infection can kill rapidly (within several days), whereas the other species cause illness but not death. Falciparum malaria is particularly frequent in sub-Saharan Africa and Oceania.

Causes of Malaria

You can only get malaria if you're bitten by an infected mosquito, or if you receive infected blood from someone during a blood transfusion. Malaria can also be transmitted from mother to child during pregnancy.

The mosquitoes that carry Plasmodium parasite get it from biting a person or animal that's already been infected. The parasite then goes through various changes that enable it to infect the next creature the mosquito bites. Once it's in you, it multiplies in the liver and changes again, getting ready to infect the next mosquito that bites you. It then enters the bloodstream and invades red blood cells. Eventually, the infected red blood cells burst. This sends the parasites throughout the body and causes symptoms of malaria.

Malaria has been with us long enough to have changed our genes. The reason why many people of African descent suffer from the blood disease sickle cell anemia is because the gene that causes it also confers some immunity to malaria. In Africa, people with a sickle cell gene are more likely to survive and have children. The same is true of thalassemia, a hereditary disease found in people of Mediterranean, Asian, or African American descent. (See the article on "Anemia" for more information.)

Symptoms and Complications of Malaria

Symptoms usually appear about 12 to 14 days after infection. People with malaria have the following symptoms:

abdominal pain
chills and sweats
diarrhea, nausea, and vomiting (these symptoms only appear sometimes)
headache
high fevers
low blood pressure causing dizziness if moving from a lying or sitting position to a standing position (also called orthostatic hypotension)
muscle aches
poor appetite

In people infected with P. falciparum, the following symptoms may also occur:

anemia caused by the destruction of infected red blood cells
extreme tiredness, delirium, unconsciousness, convulsions, and coma
kidney failure
pulmonary edema (a serious condition where fluid builds up in the lungs, which can lead to severe breathing problems)

P. vivax and P. ovale can lie inactive in the liver for up to a year before causing symptoms. They can then remain dormant in the liver again and cause later relapses.P. vivax is the most common type in North America.

Bones Cancer

noreply@blogger.com (Anonymous) — Wed, 27 Feb 2013 16:33:00 +0000

What Is Bone Cancer?

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Cancers can be discovered in bones in a number of different circumstances. When canceris located in the bones, it is important to differentiate whether this cancer has spread from another site to the bones or whether the cancer originated in the bone tissue itself. This distinction is important not only for the sake of correct terminology, but also to accurately determine which treatment options are appropriate.

There are more than 100 types of cancer, and each cancer type is named for the organ or tissue in which it begins. When cancer cells spread, they may travel via the lymphatic channels to lymph nodes, or they may enter the bloodstream and travel to other organs or locations in the body that are distant from the site of the original, or primary, tumor. It is not unusual for cancers that originate in other parts of the body to spread to the bones and begin growing there. Certain types of cancers are particularly likely to spread to the bones. Cancers that commonly metastasize, or spread, to the bones include breast cancer, lung cancer, thyroid cancer, prostate cancer, and cancers of the kidney.

It is important to note that when these other types of cancer spread to the bone, they are still named for the tissue or organ where they arose and are not termed "bone" cancer. For example, breast cancer that has spread to the bones is referred to as metastatic breast cancer and not bone cancer.

In contrast to cancers which have spread to the bone, true bone cancers are tumors that arise from the tissues of the bones. These cancers, called primary bone cancers, are quite rare in comparison to cancers that have spread to the bones.

True bone cancer affects over 2,000 people in the United States each year. It is found most often in the bones of the arms and legs, but it can occur in any bone. Children and young people are more likely than adults to develop bone cancer. The symptoms of bone cancer tend to develop slowly and depend on the type, location, and size of the tumor. Pain is the most frequent symptom of bone cancer, but sometimes a lump on the bone can be felt through the skin.

Get the facts on the types, treatment, and prognosis of bone cancer »

Bone cancer facts

The majority of cancer involving the bones is metastatic disease from other remote cancers. Primary bone cancer is much rarer.
Not all bone tumors are cancerous.
The most common symptom of bone cancer is pain. The pain is usually mild initially and gradually becomes more intense.
Treatment of bone cancer includes a combination of surgery,chemotherapy, and radiation therapy.
Treatment is based on the size and location of the cancer and whether or not the cancer has spread from the bone to surrounding tissues.

What are bones for?

Your body has 206 bones. These bones serve many different functions. First, your bones provide structure to your body and help provide its shape. Muscles attach to the bones and allow you to move. Without the bones, your body would be an unstructured pile of soft tissues and you would be unable to stand, walk, or move. Second, the bones help to protect the more fragile organs of the body. For example, the bones of the skull protect the brain, the vertebrae of the spine protect the spinal cord, and the ribs protect the heart and lungs. Third, the bones contain bone marrow, which produces and stores new blood cells. Finally, the bones help control your body's collection of various proteins and nutrients including calcium and phosphorus.

What is cancer?

Your body is made up of many small structures called cells. There are many different types of cells that grow to form the different parts of your body. During normal growth and development, these cells continuously grow, divide, and make new cells. This process continues throughout life even after you are no longer growing. The cells continue to divide and make new cells to replace old and damaged cells. In a healthy person, the body is able to control the growth and division of cells according to the needs of the body. Cancer is when this normal control of cells is lost and the cells begin to grow and divide in an uncontrolled manner. The cells also become abnormal and have altered functions in patients with cancer. The cancer cells can become very destructive to the surrounding cells and can invade normal organs and tissues, disrupting their function.

There are many different type of cancer. The cancer is usually named based on the type of cell from which the cancer initially grows. For example,lung cancer is caused by uncontrolled cells that form the lungs and breast cancer by cells that form the breast. A tumor is a collection of abnormal cells grouped together. However, not all tumors are cancerous. A tumor can be benign (not cancerous) or malignant (cancerous). Benign tumors are usually less dangerous and are not able to spread to other parts of the body. Benign tumors can still be dangerous. They can continue to grow and expand locally. This can lead to compression and damage to the surrounding structures. Malignant tumors are usually more serious and can spread to other areas in the body. The ability of cancer cells to leave their initial location and move to another location in the body is called metastasis. Metastasis can occur by the cancer cells entering the body's bloodstream or lymphatic system to travel to other sites in the body. When cancer cells metastasize to other parts of the body, they are still named by the original type of abnormal cell. For example, if a group of breast cells becomes cancerous and metastasizes to the bones or liver, it is called metastatic breast cancer instead of bone cancer or liver cancer. Many different types of cancer are able to metastasize to the bones. The most common types of cancer that spread to the bones are cancers of the lung, breast, prostate, thyroid, and kidney. Cancers arising from lymphatic or blood cells, includinglymphoma and multiple myeloma, can also frequently affect the bones.

Most of the time, when people have cancer in their bones, it is caused by cancer that has spread from elsewhere in the body to the bones. It is much less common to have a true bone cancer, a cancer that arises from cells that make up the bone. It is important to determine whether the cancer in the bone is from another site or is from a cancer of the bone cells themselves. The treatments for cancers that have metastasized to the bone are often based on the initial type of cancer.

Cataracts

noreply@blogger.com (Anonymous) — Tue, 26 Feb 2013 12:20:00 +0000

What Are Cataracts? What Causes Cataracts?

Cataracts are cloudy areas in the lens inside the eye - which is normally clear. Cataracts can develop in one or both eyes. If they develop in both eyes, one will be more severely affected than the other. A normally clear lens allows light to pass through to the back of the eye, so that the patient can see well-defined images. If a part of the lens becomes opaque light does not pass through easily and the patient's vision becomes blurry - like looking through cloudy water or a fogged-up window. The more opaque (cloudier) the lens becomes, the worse the person's vision will be.

According to Medilexicon's medical dictionary, cataract is "Complete or partial opacity of the ocular lens.".

There are two types of cataracts:

Age related cataracts - they appear later in life; the most common form.

Congenital cataracts (childhood cataracts) - these may be present when the baby is born, or shortly after birth. Cataracts may also be diagnosed in older babies and children - these are sometimes referred to as developmental, infantile or juvenile cataracts.Researchers from the University Zurich were the first to identify the chromosomal location and exact molecular defect in the coding region of the gene responsible for a childhood cataract.

The rest of this article focuses just on age-related cataracts.

A patient with cataracts will eventually find it hard to read, or drive a car - especially during the night. Even seeing people's facial expressions becomes difficult. Cataracts are not usually painful. The patient's long-distance vision is more severely affected at first.

Articles About Eye Diseases

What Is AMD? What Is Macular Degeneration?

What Is Glaucoma? What Causes Glaucoma?

As cataracts develop very slowly most people do not know they have them at first. However, the clouding progresses and vision will gradually get worse. Stronger lighting and eyeglasses can help improve vision. Nevertheless, eventually the vision impairment affects the patient's ability to carry out everyday tasks. At this point the individual will need surgery. Fortunately, cataract surgery is usually a very effective and safe procedure.

Cataracts cause more vision problems globally than any other eye condition or disease - especially in developing countries, where they are much more common among poor people,according to a study carried out in Kenya, The Philippines, and Bangladesh.

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Includes the latest news and research on vision problems and eye disorders, visual pathways in the brain, areas surrounding the eye, age related macular degeneration (AMD), glaucoma, cataracts, and much more.

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Some studies indicate that cataracts are more common among elderly people further down the socioeconomic ladder in the USA - prevalence of cataracts causing significant visual problems appears high among older U.S. Hispanics who also often encounter barriers to access to care (in the USA "Hispanics" refers to Americans of Latin American origin, not people who originate from Spain).

Both men and women are affected equally.

According to the National Health Service (NHS), UK, approximately one third of people aged 65 or over have cataracts in one or both eyes.

Factors that may increase the risk of developing cataracts

We are all at risk of developing cataracts because we will all get old one day - the greatest risk factor is age. In the USA approximately 50% of people aged 65 or more have some degree of lens clouding. 70% of Americans aged 75 or more have their vision significantly impaired by cataracts.

Researchers at the Wilmer Eye Institute at The Johns Hopkins Medical Institutions, Baltimore predicted that the number of people in the USA affected by cataracts is estimated to rise to 30.1 million people in the next 20 years, an increase of 50 percent, because people will live longer.

The following factors may increase a person's chances of developing cataracts:

Close relatives who have/had cataracts (family history)

Diabetes

Ionizing radiation exposure - airline pilots have an increased risk of nuclear cataracts compared with non-pilots, and that risk is associated with cumulative exposure to cosmic radiation, scientists from the University of Iceland reported.

The five-year incidence of nuclear cataract was 40% lower for statin users after adjusting for several factors, compared to non-statin users, another study found.

Long-term exposure to bright sunlight

Long-term use of corticosteroids - many people with asthma rely on inhaled, and sometimes oral, steroids, as do people with chronic obstructive pulmonary disease. A study conducted by the Centre for Vision Research, University of Sydney, Australia, revealed that cataract risk is higher for patients taking these medications.

Previous eye inflammation

Previous eye injury

Exposure to lead - lifetime lead exposure may increase the risk of developing cataracts, scientists from the National Institute of Environmental Health Sciences, USA revealed.

Crystallins loss of function - A specific type of protein (crystallins) begins to lose function as the eye ages. As the protein loses function, small peptides, made of 10 to 15 amino acids, start forming and accelerate cataract formation in the eye, a study revealed.

What are the symptoms of age-related cataracts?

Symptoms usually creep up many years after onset - usually when the person is elderly. Progressively, more of the lens becomes cloudy. People with mild cataracts will not notice they have it for a long time.

Cataracts often affect both eyes, but rarely equally.

People with cataracts may have the following symptoms:

Blurry, cloudy, or misty vision.

Some describe it as similar to looking through frosted glass.

Vision may be affected by small spots or dots.

The patient sees small patches which blur parts of his/her field of vision.

Vision gets worse when lights are dim.

Vision is sometimes worse when light is very bright (glare).

Some people with cataracts also comment that colors appear less clear and faded.

Reading becomes very difficult, and eventually impossible.

Glasses need to be changed more frequently.

Eventually wearing glasses becomes less effective.

In some rare cases patients can see a halo around bright objects, such as car headlights or street lights.

Double vision in one eye (rare).

As the person's vision deteriorates, and the glare of oncoming headlights and street lights gets worse, driving becomes awkward and potentially very dangerous - research carried out by optometrists and psychologists in Australia shows that motorists suffering from cataracts are less able to spot potentially dangerous hazards on the roads. Drivers with cataracts eventually start suffering from eyestrain and find themselves blinking more frequently in an attempt to clear their vision.

Cataracts do not usually cause any change in the appearance of the eye. Any discomforts, such as irritation, aching, itching or redness are most likely caused by some other eye disorder.

Cataracts are not hazardous to the sufferer's health, or the health of the eye. If the cataract becomes hypermature (completely white), the sufferer may experience inflammation, headacheand some pain. Hypermature cataracts need to be removed if there is inflammation or pain.

How are cataracts diagnosed?

Anybody who experiences vision problems should see a GP (general practitioner, primary care physician), an ophthalmologist, or an optometrist. The GP will most likely refer the patient to an ophthalmologist, or an optometrist.

Ophthalmologist - a doctor who specializes in the medical and surgical care of the eye.

Optometrist - a person practicing eye care, but does not perform surgery.

The eye specialist will carry out a number of tests. These may include:

Visual acuity test - this tests how clearly the individual can see an object. It tests the person's sharpness of vision. The patient reads letters from across a room. The two eyes are tested separately (one is covered). By using a chart with progressively smaller letters, the specialist can determine how acute the patient's vision is. The chart is called a Snellen Eye Chart.

Sometimes the chart has to be read twice - once with, and once without bright lights. This will give an indication of glare sensitivity.

Slit-lamp examination - this is a microscope which allows the specialist to see the structures at the front of the eye. An intense line of sight (a slit) is used to illuminate the cornea, iris, lens, as well as the space between the iris and the cornea. The slit makes it possible for the specialist to see these structures in small sections, making it easier to spot any problems.

Retinal examination - eye drops are administered which dilate the pupils, providing a bigger window to the back of the eyes. The specialist examines the lens for signs of cataract with either an ophthalmoscope or a slit lamp. If signs of cataract are found, the specialist can also determine how dense the clouding is. Most specialists will check forglaucoma at the same time, and perhaps some other eye conditions/diseases.

The pupils will remain dilated for a few hours after the examination before the eye drops gradually lose their effect. During this time the patient may find it harder to focus on close objects. It is advisable to wear sunglasses, especially if it is a bright day. Driving is not advisable until the pupils are back to their normal size.

Measuring a protein related to cataract formation - A device based on a laser light technique called dynamic light scattering can safely eye test for measuring a protein related to cataract formation, according to researchers at the National Eye Institute, USA.

Although an eye test may help confirm a cataract diagnosis, it may not always reflect the patient's quality of life. Some patients who do badly in a test seem to have no problem with daily function, while others who may do well insist that their eyesight is poor and does interfere with ordinary activities.

Treatment for cataracts

If the patient is found to be only mildly affected surgical treatment may not be needed. During its early stages, stronger glasses and brighter lights may help improve vision. The following simple approaches may assist people who are not ready yet to have surgery:

Make sure your glasses are the most accurate prescription possible.
Use a magnifying glass for reading.
Get brighter lamps for your house. Halogen lights may help a lot.
Wear sunglasses to reduce glare on sunny days.
Try to refrain from driving at night.

Surgery

However, these are only temporary measures - the cataracts will continue developing and gradually impair eyesight more.

Patients who take alpha-blockers or are considering taking alpha-blockers should be aware that the drugs may increase the difficulty of cataract surgery. While Flomax (an alpha-blocker) is largely prescribed to men to treat prostate enlargement, some women also take the drug to treat urinary retention problems. Other alpha-blockers are used to treat hypertension. The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery issued an advisory telling patients and GPs to inform their surgeon if they are taking alpha-blockers, or took them in the past. Once informed, the ophthalmologist can anticipate certain problems and employ different surgical techniques that help to achieve excellent outcomes.

When the cataracts are severe the only effective treatment is surgery. The specialist will recommend surgery if the patient:

Is having trouble looking after himself/herself.
Is having difficulties looking after someone else.
Cannot drive, or finds driving difficult.
Has problems leaving the house.
Finds it hard to see or recognize people's faces.
Has problems doing his/her job.
Cannot read properly.
Can no longer watch television properly.

The cloudy lens is removed from the eye and an artificial clear plastic one is put in its place - an intraocular implant (intraocular lens). In most developed countries, and a growing number of developing countries, cataract operations are performed as keyhole surgery. The patient will be given a local anesthetic. He/she will not usually have to spend the night in hospital. The operation is commonly known as phacoemulsification or phaco extracapsular extraction. Laser surgery is not used for cataract procedures. (There are more details about the operation further down this page)

Pre-operative assessment (assessment before surgery)

The specialist will assess the patient's eyes and general health. During the pre-operative assessment the eye will be measured so that the replacement artificial lens can be prepared.

The day of the operation - before it begins

Eye drops that dilate (widen) the pupils will be administered just before the procedure. Sometimes the eye drops will also have anesthetic in them, or the doctor may inject the tissue around the eye for a local anesthetic. As soon as the anesthetic starts working the area will be numbed and the patient will feel nothing. During the operation he/she will be aware of a bright light, but will not be able to see what is happening.

Various types of replacement lenses may be used:

Monofocal lens - this is a fixed-strength lens which is set for one level of vision - usually distance vision.

Multifocal lens - this type of lens may have two or more different strengths; near and distance vision.

Accommodating lens - this type of lens is the most similar to the natural human lens. It allows the eye to focus on near and distant objects.

The operation

The eye surgeon makes a tiny cut in the cornea at the front. He/she then inserts a minute probe through the cut. The probe uses ultrasound and breaks up the cloudy lens into very small pieces which are sucked out.

The artificial lens is then inserted through the cut. The lens sits in the lens capsule to keep it in place - the lens capsule is like a little pocket. When it is first inserted the lens is folded - it unfolds when in position.

The whole procedure should not take more than about 30 minutes. Most patients will wear an eye pad for protection for a short while.

Other procedures

Manual extracapsular extraction - the lens is removed in one piece. No ultrasound is used to break it up. The surgeon will make a slightly larger cut in the eye.

Intracapsular extraction - the lens capsule as well as the lens is removed. The artificial lens is sewn into the eye. This type of procedure is much less common.

After the operation

Most patients will experience vision improvement virtually immediately. It may take a while for the eye to settle down completely. The cut in the eye may occasionally need a stitch - in most cases, however, it is so small that it heals by itself.

Patients should avoid vigorous activities for a while. Most individuals find they can go about their daily activities as soon as they get home. An appointment will be made to test the patient's vision. Most patients will need different glasses after their operation. The new glasses can only be determined after his/her vision has settled down - this can take several weeks.

There is no other way to cure cataracts. Medications, dietary supplements, exercise or optical devices are not effective. As mentioned earlier, during the early stages there are some things the patient can do to help see things better - but they are only temporary.

Prevention of cataracts

To prevent suffering the complications of cataracts it is advisable to have regular eye exams, especially as you get older. The following steps are advisable to lower your risk of developing cataracts - some of them have convincing circumstantial evidence of their worth, while others (smoking, diet) are proven measures:

Give up smoking - several studies have indicated that a higher percentage of smokers develop cataracts, compared to non-smokers. There are also indications that smokers are likely to experience cataract symptoms earlier. Smoking also increases the risk of other eye disease/conditions.

Nutrition - eat plenty of fruits and vegetables, whole grains, unrefined carbohydrates, good quality fats (avocado, olive oil, omega oils), and either plant sourced proteins or lean animal sourced proteins.

The findings by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, USA suggest that vitamins and polyunsaturated fatty acids - two categories of nutrients believed to have health benefits - may both affect cataract development, although not necessarily in beneficial ways.

Women who consume plenty of dark leafy vegetables which are rich in lutein and zeaxanthin, as well as sufficient vitamin E from supplements/foods seem to have better protection against developing cataracts, scientists from the Brigham & Women's Hospital and Harvard Medical School, Boston found.

Sunlight - wear sunglasses that block ultraviolet B rays (UV radiation). Many people are not aware of the damage UV radiation can cause to the eyes - a study found that only 49% of Americans said UV protection was the most important factor when purchasing sunglasses.

Sleep - make sure you get at least 7 hours of good quality, continuous sleep every night.

Obesity - obesity significantly raises the risk of developing diabetes type 2, which in turn is an important cataract risk factor. Keeping your weight within the recommended limits will help prevent your risk from increasing.

Diabetes - be careful to have your diabetes under control; follow your treatment plan assiduously.

Exercise - Researchers from the U.S. Department of Energy's Lawrence Berkeley National Laboratory reported that running reduces the risk of both cataracts and age-related macular degeneration.

Complications

Blindness - If the cataracts are left untreated, they may lead to blindness.

Higher mortality rates - people aged 49 and older with cataract and those aged 49 to 74 years with age-related macular degeneration appear to have higher mortality rates over an 11-year period than those without such visual impairments, according to a study carried out by researchers at the University of Sydney, Australia.

What Is Leukemia? What Causes Leukemia?

noreply@blogger.com (Anonymous) — Mon, 25 Feb 2013 13:29:00 +0000

Leukemia (British spelling: leukaemia ) is cancer of the blood or bone marrow (which produces blood cells). A person who has leukemia suffers from an abnormal production of blood cells, generally leukocytes (white blood cells).

The word Leukemia comes from the Greekleukos which means "white" and aima which means "blood".

The DNA of immature blood cells, mainly white cells, becomes damaged in some way. This abnormality causes the blood cells to grow and divide chaotically. Normal blood cells die after a while and are replaced by new cells which are produced in the bone marrow. The abnormal blood cells do not die so easily, and accumulate, occupying more and more space. As more and more space is occupied by these faulty blood cells there is less and less space for the normal cells - and the sufferer becomes ill. Quite simply, the bad cells crowd out the good cells in the blood.

In order to better understand what goes on we need to have a look at what the bone marrow does.

Function of the bone marrow

The bone marrow is found in the inside of bones. The marrow in the large bones of adults produces blood cells. Approximately 4% of our total bodyweight consists of bone marrow.

There are two types of bone marrow: 1. Red marrow, made up mainly of myeloid tissue. 2. Yellow marrow, made up mostly of fat cells. Red marrow can be found in the flat bones, such as the breast bone, skull, vertebrae, shoulder blades, hip bone and ribs. Red marrow can also be found at the ends of long bones, such as the humerus and femur.

White blood cells (lymphocytes), red blood cells and platelets are produced in the red marrow. Red blood cells carry oxygen, white blood cells fight diseases. Platelets are essential for blood clotting. Yellow marrow can be found in the inside of the middle section of long bones.

If a person loses a lot of blood the body can convert yellow marrow to red marrow in order to raise blood cell production.

White blood cells, red blood cells and platelets exist in plasma - Blood plasma is the liquid component of blood, in which the blood cells are suspended.

Types of leukemia

Chronic and Acute

Experts divide leukemia into four large groups, each of which can be Acute, which is a rapidly progressing disease that results in the accumulation of immature, useless cells in the marrow and blood, or Chronic, which progresses more slowly and allows more mature, useful cells to be made. In other words, acute leukemia crowds out the good cells more quickly than chronicleukemia.

Lymphocytic and Myelogenous

Leukemias are also subdivided into the type of affected blood cell. If the cancerous transformation occurs in the type of marrow that makes lymphocytes, the disease is calledlymphocytic leukemia. A lymphocyte is a kind of white blood cell inside your vertebrae immune system. If the cancerous change occurs in the type of marrow cells that go on to produce red blood cells, other types of white cells, and platelets, the disease is called myelogenous leukemia.

To recap, there are two groups of two groups - four main types of leukemia, as you can see in the illustration below:

Acute Lymphocytic Leukemia (ALL), also known as Acute Lymphoblastic Leukemia - This is the most common type of leukemia among young children, although adults can get it as well, especially those over the age of 65. Survival rates of at least five years range from 85% among children and 50% among adults. The following are all subtypes of this leukemia: precursor Bacute lymphoblastic leukemia, precursor T acute lymphoblastic leukemia, Burkitt's leukemia, and acute biphenotypic leukemia.

Chronic Lymphocytic Leukemia (CLL) - This is most common among adults over 55, although younger adults can get it as well. CLL hardly ever affects children. The majority of patients with CLL are men, over 60%. 75% of treated CLL patients survive for over five years. Experts say CLL is incurable. A more aggressive form of CLL is B-cell prolymphocytic leukemia.

Acute Myelogenous Leukemia (AML) - AML is more common among adults than children, and affects males significantly more often than females. Patients are treated withchemotherapy. 40% of treated patients survive for over 5 years. The following are subtypes of AMS - acute promyelocytic leukemia, acute myeloblastic leukemia, and acute megakaryoblastic leukemia.

Researchers from the Memorial Sloan-Kettering Cancer Center reported in the March 2012 issue of NEJM (New England Journal of Medicine that they identified a series of genetic mutations in people with AML. They explained that their findings may help doctors to more accurately predict patient outcomes, as well as choosing therapies they are most likely to respond to.

Chronic Myelogenous Leukemia (CML) - The vast majority of patients are adults. 90% of treated patients survive for over 5 years. Gleevec (imatinib) is commonly used to treat CML, as well as some other drugs. Chronic monocytic leukemia is a subtype of CML.

Symptoms of leukemia

Blood clotting is poor - As immature white blood cells crowd out blood platelets, which are crucial for blood clotting, the patient may bruise or bleed easily and heal slowly - he may also develop petechiae (a small red to purple spot on the body, caused by a minor hemorrhage).

Affected immune system - The patient's white blood cells, which are crucial for fighting off infection, may be suppressed or not working properly. The patient may experience frequent infections, or his immune system may attack other good body cells.

Anemia - As the shortage of good red blood cells grows the patient may suffer fromanemia - this may lead to difficult or labored respiration (dyspnea) and pallor (skin has a pale color caused by illness).

Other symptoms - Patients may also experience nausea, fever, chills, night sweats, flu-like symptoms, and tiredness. If the liver or spleen becomes enlarged the patient may feel full and will eat less, resulting in weight loss. Headache is more common among patients whose cancerous cells have invaded the CNS (central nervous system).

Precaution - As all these symptoms could be due to other illnesses. A diagnosis of leukemia can only be confirmed after medical tests are carried out.

What causes leukemia?

Experts say that different leukemias have different causes. The following are either known causes, or strongly suspected causes:

Artificial ionizing radiation
Viruses - HTLV-1 (human T-lymphotropic virus) and HIV (human immunodeficiency virus)
Benzene and some petrochemicals
Alkylating chemotherapy agents used in previous cancers
Maternal fetal transmission (rare)
Hair dyes
Genetic predisposition - some studies researching family history and looking at twins have indicated that some people have a higher risk of developing leukemia because of a single gene or multiple genes.
Down syndrome - people with Down syndrome have a significantly higher risk of developing leukemia, compared to people who do not have Down syndrome. Experts say that because of this, people with certain chromosomal abnormalities may have a higher risk.
Electromagnetic energy - studies indicate there is not enough evidence to show that ELF magnetic (not electric) fields that exist currently might cause leukemia. The IARC (International Agency for Research on Cancer) says that studies which indicate there is a risk tend to be biased and unreliable.

Treatments for leukemia

As the various types of leukemias affect patients differently, their treatments depend on what type of leukemia they have. The type of treatment will also depend on the patient's age and his state of health.

In order to get the most effective treatment the patient should get treatment at a center where doctors have experience and are well trained in treating leukemia patients. As treatment has improved, the aim of virtually all health care professionals should be complete remission - that the cancer goes away completely for a minimum of five years after treatment.

Treatment for patients with acute leukemias should start as soon as possible - this usually involves induction therapy with chemotherapy, and takes place in a hospital.

When a patient is in remission he will still need consolidation therapy or post induction therapy. This may involve chemotherapy, as well as a bone marrow transplant (allogeneic stem celltransplantation).

If a patient has Chronic Myelogenous Leukemia (CML) his treatment should start as soon as the diagnosis is confirmed. He will be given a drug, probably Gleevec (imatinib mesylate), which blocks the BCR-ABL cancer gene. Gleevec stops the CML from getting worse, but does not cure it. There are other drugs, such as Sprycel (dasatinib) and Tarigna (nilotinb), which also block the BCR-ABL cancer gene. Patients who have not had success with Gleevec are usually given Sprycel and Tarigna. All three drugs are taken orally. A bone marrow transplant is the only current way of curing a patient with CML. The younger the patient is the more likely the transplant will be successful.

Synribo (omacetaxine mepesuccinate) was approved by the FDA, on 26th October 2012, for the treatment of chronic myelogenous leukemia (CML) in adult patients who had been treated with at least two drugs, but whose cancer continued to progress. Resistance to medications is common in CML. Synribo is an alkaloid from Cephalotaxus harringtonia which inhibits proteins that trigger the development of cancerous cells. The drug is administered subcutaneously.

Patients with Chronic Lymphocytic Leukemia (CLL) may not receive any treatment for a long time after diagnosis. Those who do will normally be given chemotherapy or monoclonal antibody therapy. Some patients with CLL may benefit from allogeneic stem cell transplantation (bone marrow transplant).

Rabbit antibodies help Leukemia patients - scientists from Virginia Commonwealth University reported in the journal Bone Marrow Transplantation (July 2012 issue) that rabbit antibodies can improve survival and reduce the occurrence of relapses in patients with leukemia and myelodysplasia who are receiving a stem transplant from an unrelated donor.

Leukemia patients' own T-cells achieve remission for over two years - patients who were infused with their own T-cells after they had been genetically altered to fight cancer tumors stayed in full remission for over 24 months. Researchers from the Perelman School of Medicine at the University of Pennsylvania presented their findings at the American Society of Hematology's Annual Meeting and Exposition in December 2012. All those who took part in the human study had advanced cancers - ten of them had chronic lymphocytic leukemia, and two children had acute lymphoblastic leukemia.

All leukemia patients, regardless of what type they have or had, will need to be checked regularly by their doctors after the cancer has gone (in remission). They will undergo exams and blood tests. The doctors will occasionally test their bone marrow. As time passes and the patient continues to remain free of leukemia the doctor may decide to lengthen the intervals between tests.

How common is leukemia?

According to the Leukemia and Lymphoma Society, there were approximately 13,410 new cases of AML (2007), 5,200 new cases of ACL (2007), 4,570 cases of CML (2007), and 15,110 new cases of CLL (2008) diagnosed in the USA.

What is the difference between Leukemia and Lymphoma?

Leukemia is a cancer of the blood. Lymphoma is of the lymphatic system (lymph glands).

High Blood Pressure

noreply@blogger.com (Anonymous) — Sat, 23 Feb 2013 11:02:00 +0000

Causes of High Blood Pressure

What causes high blood pressure?

Blood pressure is the measure of the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and contributes to hardening of the arteries, or atherosclerosis, and to the development of heart failure.

What Is "Normal" Blood Pressure?

A blood pressure reading has a top number (systolic) and bottom number (diastolic). The ranges are:

Normal: Less than 120 over 80 (120/80)
Prehypertension: 120-139 over 80-89
Stage 1 high blood pressure: 140-159 over 90-99
Stage 2 high blood pressure: 160 and above over 100 and above

People whose blood pressure is above the normal range should consult their doctor about steps to take to lower it.

What Causes High Blood Pressure?

The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development, including:

Smoking
Being overweight or obese
Lack of physical activity
Too much salt in the diet
Too much alcohol consumption (more than 1 to 2 drinks per day)
Stress
Older age
Genetics
Family history of high blood pressure
Chronic kidney disease
Adrenal and thyroid disorders

Essential Hypertension

In as many as 95% of reported high blood pressure cases in the U.S., the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension.

Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.

Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.

The majority of all people with high blood pressure are "salt sensitive," meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that can raise the risk of having essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.

Secondary Hypertension

When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels.

Who Is More Likely to Develop High Blood Pressure?

People with family members who have high blood pressure
Smokers
African-Americans
Pregnant women
Women who take birth control pills
People over the age of 35
People who are overweight or obese
People who are not active
People who drink alcohol excessively
People who eat too many fatty foods or foods with too much salt
People who have sleep apnea

Breast cancer

noreply@blogger.com (Anonymous) — Thu, 21 Feb 2013 11:38:00 +0000

Breast cancer (symptoms, diagnosis, treatment)

Breast cancer is the most common form of cancer among New Zealand women. Every year in New Zealand around 2800 women are diagnosed with breast cancer and approximately 650 women die from the disease. One in nine New Zealand women will develop breast cancer at some stage of their lives.

Men can develop breast cancer though it is rare. Around 20 men are diagnosed with the condition in New Zealand each year, which equates to around 1% of all breast cancer diagnoses. Signs and symptoms are similar to those for women and treatments are the same.

General information

Causes of breast cancer

Types of breast cancer

Signs and symptoms

Diagnosis

Stages of breast cancer

Treatment

Follow up

Prevention

Further information and support

References

General information

Breast cancer occurs when breast cells develop abnormally and grow out of control forming a malignant (cancerous) tumour. It is possible for cancer cells to spread (metastasise) from the breast to other parts of the body via the lymphatic system and by direct entry into the blood vessels. Once there, they can form "secondary" cancers.

Prior to menopause the majority of new breast lumps found are benign (non-cancerous). However after menopause one in two new breast lumps found will be malignant. Approximately 75% of all breast cancers will occur in women over the age of 50 years. Internationally, breast cancer rates have increased in most developed countries over the last 40 years.

Breast cancer can recur. Once a woman has had breast cancer her chances of developing it again are increased fivefold.

About breasts

Breasts are composed of fibrous (connective) tissue, fatty tissue and glandular tissue. They lie on a band of strong muscle that sits on the ribs of the chest. Breasts have no useful biological function other than to provide milk for babies.

Fibrous tissue gives the breast its shape and helps to support the fatty tissue and glandular tissue. As women age, the fibrous tissue is replaced with fatty tissue. This leads to changes in the shape and texture of the breasts.

The glandular tissue is made up of a series of lobules. These are small structures that produce milk when stimulated by female hormones during pregnancy. The milk produced in the lobules drains into small channels called ducts which eventually open into the nipple. Glandular tissue also responds to menstrual related hormonal changes, which can cause the breasts to be occasionally tender and lumpy.

Picture reproduced with the kind permission of the Anti-Cancer Council of Victoria

In the breast, armpit and neck there are small glands called lymph nodes, which, along with the lymph vessels into which the nodes drain, are part of the lymphatic system. The role of the fluid filled lymphatic system is to filter infections and prevent them entering the blood stream. Each breast has a network of lymph vessels that drain into a system of about 24 lymph nodes in the armpit. These are called the axillary lymph nodes. There are also lymph nodes behind the breastbone called the internal mammary nodes. Some of these nodes drain into the axillary lymph nodes, with the remainder draining into other nodes in the chest.

Axillary lymph nodes

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Causes of breast cancer

The causes of breast cancer are not known. However, it is known which women are more at risk of developing the condition. The main risk factors for developing breast cancer are:

Being a woman over the age of 40 years.
Having a family history of breast cancer - the younger the family member was when they developed breast cancer, the greater the risk.
Having had breast cancer previously.
Having had a biopsy showing an "at risk" breast lump or thickening.
Having a breast cancer gene (BRCA-1 or BRCA-2). Women with a breast cancer gene have a 50% chance of developing breast cancer before the age of 70.

Other risk factors include:

Having had an early onset of periods or the late onset of menopause.
Having had a first child after the age of 30 years or not having had children at all.
A diet high in fat, excessive alcohol and a reduced intake of fibre, fruits and vegetables.
Being on HRT medication for longer than 5-7 years.
Taking the oral contraceptive pill may slightly increase the risk of developing breast cancer, but this has not been conclusively proven.
Having dense breasts - dense breasts do not increase the risk of developing breast cancer, but they may make lumps difficult to feel and see.
Being in a high socio-economic group or having Jewish ancestry may also be risk factors for developing breast cancer.

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Types of breast cancer

There are several different types of breast cancer. The two most common types are ductal breast cancer (to do with the milk ducts) and lobular breast cancer (to do with the milk lobules). Each of these breast cancers can be either “in situ” or “invasive”.

In situ carcinoma: These are pre cancers and are the earliest stage of breast cancer; they can either develop into invasive breast cancer or raise the risk of developing invasive cancer. Caught and treated early, they are often completely curable.

Ductal carcinoma in situ (DCIS): This is where the breast cancer cells are completely contained within the milk ducts and have not spread into the surrounding breast tissue. DCIS is usually treated with surgery (mastectomy) or combined surgery (partial mastectomy) and radiotherapy.

Lobular carcinoma in situ (LCIS): This is where the breast cancer cells are completely contained within the milk lobules and have not spread into the surrounding breast tissue. Often LCIS does not need treatment. Instead, regular breast exams and mammograms may be used to monitor for the early changes of developing breast cancer.

Invasive carcinoma: This is where the ductal or lobular cancer spreads into the surrounding tissues. Approximately 90% of invasive breast cancers are ductal cancers.

Other less common breast cancers include inflammatory breast cancer and medullary breast cancer.

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Signs and symptoms

Most commonly, the first sign of breast cancer is a new lump in the breast. The lump is usually painless.

Other signs of breast cancer include:

A new area of thickened tissue in the breast.
Nipple discharge or a change in the nipple.
Dimpling or puckering of the skin of the breast.
A change in breast size or shape.

While these symptoms may not be related to breast cancer, it is important to see a doctor promptly for assessment and accurate diagnosis if any of these symptoms are present. Early detection is vital in the successful treatment of breast cancer.

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Diagnosis

If an abnormal lump is found, or other symptoms are present, a referral to a breast specialist for assessment and diagnosis will probably be recommended. In order for an accurate diagnosis to be made the three step approach of clinical examination, imaging (mammography and ultrasound scanning), and biopsy will be required.

Clinical examination:
The doctor will begin by examining both breasts. They will then check the abnormal lump's size, location and other characteristics such as whether it is mobile, hard or soft, regular or irregular. The doctor will ask about the history of the lump such as how long it had been there, has it grown, is it painful. Risk factors such as family history or previous breast lumps will be asked about.

Imaging (mammograms and / or ultrasound scanning):A mammogram (specialised breast x-ray) shows the soft tissue of the breast and can indicate any suspicious areas. Ultrasound scanning uses sound waves to form an image of the breast tissue. Pictures of any suspicious areas can be taken. Ultrasound scanning is particularly useful for assessing whether a lump is fluid filled or solid.

Biopsy:
There are different types of biopsies used to take cells or tissue samples from a suspicious lump so they can be sent to a laboratory for analysis under a microscope.

Fine needle aspiration: This is usually the first type of biopsy used. It is performed using a local anaesthetic and involves inserting a fine needle into the lump and removing a small sample of cells and/or fluid. At the laboratory the sample is spread onto a glass slide and analysed. The insertion of the needle may be guided by ultrasound.
Core biopsy: This uses a larger needle to remove a sample of tissue from the lump. A local anaesthetic is used and a very small incision (1-2mm) is made in the skin over the lump. The needle is usually guided into the lump by ultrasound. At the laboratory the tissue sample is sliced very finely and placed on a glass slide for analysis.
Stereotactic core biopsy: This is a core biopsy performed on a special x-ray table allowing three dimensional computerised images of the lump to be taken and used to guide the biopsy needle into the lump. This is useful for testing lumps seen on a mammogram that cannot be felt or visualised using an ultrasound scanner.
Excision biopsy: This is a minor surgical procedure where part or all of the abnormal area is removed. It can be performed using a local or general anaesthetic. If the lump is unable to be precisely located using mammogram or ultrasound scanning, it may need to be marked by a thin wire called a "hookwire". This is inserted under x-ray guidance using a local anaesthetic just prior to the surgery.

If a diagnosis of breast cancer is made, blood tests, x-rays and scans of the bones and liver may be performed to assess whether the cancer has spread to other organs.

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Stages of breast cancer

After diagnosis, breast cancers are given a "stage". The stage indicates the tumour's size and how far it has spread within the breast, surrounding tissues or to other organs in the body. Stages range from 0 to IV - a higher stage indicates more severe cancer.

Stage 0: The cancer has not spread beyond the ducts of the breast (ie ductal carcinoma in situ or DCIS).

Stage I: These tumours measure less than two centimetres. The axillary lymph nodes are not affected and there are no signs that the cancer has spread elsewhere in the body.

Stage II: These tumours measure between two and five centimetres, or the axillary lymph nodes are affected, or both. There are no signs that the cancer has spread elsewhere in the body.

Stage III: These tumours are larger than five centimetres, the axillary lymph nodes are usually affected, but there are no signs that there has been any further spread.

Stage IV: These tumours are of any size, but the axillary lymph nodes are usually affected and the cancer has spread to other parts of the body.

Breast cancer tumours are also classified as being "hormone receptor positive" or "hormone receptor negative". Approximately 60% of all breast cancer tumours are hormone receptor positive meaning that they rely on oestrogen or progesterone to grow. The hormone receptor status of the tumour will be taken into account when treatment is planned.

Another classification given is the HER-2 status of the cancer. HER-2 stands for “human epidermal growth factor receptor – type 2.” It is a type of protein that is attached to the surface of normal cells and influences the cell’s growth and reproduction. In HER-2 positive breast cancers there are an abnormally large number of HER-2 proteins on the cancer cells. This can cause the cancer cells to grow and spread at a faster rate. Approximately 20% of all breast cancers are classified as HER-2 positive. Women with this type of breast cancer have a poorer prognosis than women who are not HER-2 positive.

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Treatment

Treatment of breast cancer depends on the type of breast cancer, its size and position, whether it has spread, the woman's age and general health, and the woman's preference. In general, some type of surgery is recommended followed by additional treatments (adjuvant therapies).

Surgery and radiotherapy are classed as local treatments (as they affect a localised, specific area) while chemotherapy and hormone therapy are classed as systemic treatments (as they have the potential to affect the whole body).

SURGICAL TREATMENT

Lumpectomy/Partial mastectomy: In most cases, the breast cancer tumour can be removed without having to remove the entire breast (referred to as breast conserving surgery). The area of the cancer is removed along with a ''margin" of healthy surrounding tissue (usually about 1cm), to ensure that all of the breast cancer is removed.

Mastectomy: This operation involves removing the entire breast and all of the breast tissue from just below the collarbone to the upper abdomen. A "simple mastectomy" is when just breast tissue is removed. A "modified radical mastectomy" is when the lymph glands under the arm are also removed.

Mastectomy may be recommended if the tumour is large, there is more than one area of breast cancer in the breast, or for cases of recurrent breast cancer. A hospital stay of 2-5 days and a recovery period of 3-6 weeks can be expected after a mastectomy.

Surgical treatment may also involve:

Axillary node dissection:It is usual practice during breast cancer surgery to remove up to half of the axillary lymph nodes for testing. Testing of the lymph nodes can indicate whether the cancer has spread into the lymphatic system, thus increasing the risk of the cancer spreading to the rest of the body.

Axillary node dissection is usually well tolerated but there is a risk that the remaining lymph nodes will not be able to adequately cope with the drainage from the lymphatic vessels in the breast. This can lead to shoulder stiffness, changes in sensation in the area, and a condition known as lymphoedema which is marked by arm swelling.

Sentinel node biopsy:This type of lymph node biopsy is used in some cases to minimise problems associated with axillary node dissection. During a sentinel node biopsy two special dyes are injected around the breast cancer tumour. One is visible to the naked eye during the biopsy surgery and the other is a weak radioactive substance detectable by either a Gamma camera or a hand-held device like a Geiger counter. The dyes drain through the lymph vessels and into the first node to be involved - the sentinel node. This node is then removed for analysis. If the sentinel node is clear of cancer cells, then it can safely be presumed that the cancer has not spread to the rest of the axillary nodes. If however the sentinel node is positive for cancer cells, a subsequent procedure to remove the remaining lymph nodes would be needed.

Breast reconstruction:After mastectomy, some women may choose to have the breast reconstructed. This can be done at the time of the mastectomy or at a later date. The surgery is usually performed by a plastic surgeon. The aim of breast reconstruction is to recreate a breast that feels and looks as natural as possible.

The majority of breast reconstructions are performed using muscle and tissue taken from the abdomen in a procedure known as a TRAM flap procedure. Less commonly, muscle and tissue from the back can also be used in a procedure called a Latissimus Dorsi flap. Artificial breast implants can also be used to reconstruct the breast. This is usually done in conjunction with stretching the skin in order to accommodate the implant.

With TRAM flap or Latissimus Dorsi flap breast reconstruction a hospital stay of 4-6 days and a recovery period of 4-6 weeks can be expected.

Occasionally the healthy breast needs to be made smaller to match the breast that has been reconstructed. This surgery would be performed at the same time as the breast reconstruction.

For women who do not wish to have breast reconstruction, an external breast prosthesis can be used. This is a jelly-like breast-shaped mould that fits into a specially fitted bra and comes in a variety of shapes and sizes. When worn, the appearance is the same as that of a normal breast. Wearing the prosthesis also helps to maintain proper balance and posture. The New Zealand government provides funding of $600 every four years for the prosthesis and bras.

NON-SURGICAL TREATMENT

Additional treatments are commonly given after surgical removal of a breast cancer. One or a combination of these treatments may be recommended. An oncologist (cancer specialist) will be involved in deciding which treatments will be given.

Radiotherapy:This uses radiation to destroy any cancer cells that may be left in the breast. It is most commonly used after lumpectomy/partial mastectomy. However, it may be used after mastectomy if there was more than one tumour, the tumour was large, or the tumour was growing close to the chest wall. A course of radiotherapy is usually given over 4-6 weeks, consisting of daily treatments from Monday to Friday. Side effects of the treatment include severe tiredness and burns similar to bad sunburn on the treated area.

Chemotherapy:
This may be given if spread of the cancer is suspected or confirmed and is usually given soon after surgery. Chemotherapy medications can be given by tablet or as injections into the blood stream. Usually it is a combination of both. The medications aim to kill off any cancer cells that may be circulating in the body. There are different strengths and combinations of chemotherapy medications, which are given in cycles. Side effects of chemotherapy treatment may include nausea, hair loss, sores in the mouth and diarrhoea.

Hormone therapy:
For cases where the breast cancer is hormone receptor positive, hormone therapy may be prescribed to help prevent recurrence of the breast cancer. These medications work by blocking the hormone receptors on the breast cancer cells, preventing hormones binding to them and stimulating growth. One common example of this type of medication is tamoxifen. This is commonly given for up to five years after diagnosis of breast cancer. Other types of hormone treatments include anastrozole (Arimidex) or letrozole (Letara).

Biological therapy:This type of treatment includes a class of anticancer medications called “monoclonal antibodies”. These medications are formulated to target cancer cells, rather than normal healthy cells. A monoclonal antibody medication used in New Zealand is Herceptin (trastuzumab). This is used to treat women with HER-2 positive breast cancer. Herceptin works by binding to the HER-2 proteins, preventing them from stimulating the cancer cells to grow. It also acts to “flag” the cancer cells to the body, which then stimulates the immune system to destroy the abnormal cells.

In New Zealand, Herceptin is funded and approved for up to 12 months use in the treatment of women with HER-2 positive breast cancer.

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Follow Up

After the diagnosis and treatment of breast cancer, regular follow up visits with the healthcare specialists involved in the treatment will be scheduled. This will include seeing the oncologist and surgeon. Initially this may be as frequently as every three months, but will eventually be less often. During these visits monitoring procedures such as imaging (mammograms/ultrasound scans), blood tests and clinical examinations will be conducted.

Other healthcare professionals who may be involved in the ongoing care and monitoring include the patient's GP, a breast physician, breast care nurse and physiotherapist.

Some women may find it beneficial to see a counsellor to help them deal with the emotional and psychological impact of the breast cancer diagnosis and the implications of treatment.

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Prevention

As the cause of breast cancer is unknown, the condition cannot be prevented as such. However, there are many things women can do to minimise their risk of developing breast cancer. Women who are at increased risk of breast cancer should be monitored by their GP or a specialist. This may include clinical examinations and imaging. Early detection is vital. Breast cancer detected early has a much better chance of being effectively treated than breast cancer that has been detected late.

Ways in which all women can work to reduce their risk of breast cancer include:

Screening:It is recommended that all women have screening mammograms from the age of 40 years. Women in high-risk groups may be recommended to start having regular mammograms at an earlier age.

Women aged from 45 to 69 years who have had no history of breast abnormalities can have two-yearly mammograms through Breast Screen Aotearoa, a free national screening program.

Breast self examination (BSE):It is recommended that women check their breasts regularly. This enables them to learn what their breasts feel like normally so that they are better able to detect any changes or abnormalities in the breast.

Lifestyle factors:Eating a diet low in fat, undertaking regular exercise and limiting alcohol intake may also help to reduce the risk of breast cancer.

In rare cases where there is a strong family history of breast cancer or other factors such as a cancer gene or previous breast cancer, a woman may choose to have both breasts removed - usually with breast reconstruction. This will reduce her chances of developing breast cancer. However, it is possible for the cancer to develop in remaining breast tissue.

International trials of genetic testing are underway. The hope is to be better able to clearly identify which women are at risk of developing breast cancer.

Does Vagina Size Matter?

noreply@blogger.com (Anonymous) — Tue, 19 Feb 2013 14:59:00 +0000

The age-old question of whether or not size matters is typically directed at men, but this is a somewhat hidden concern for women as well.

Though they might not talk about it, some women may worry about the size of theirvagina and how it affects sexual pleasure, particularly after having a baby. Not a lot of research has been done in this area and because there are so many variables at play in women’s sexuality it is difficult to tell if vagina size and sexual pleasure are linked.

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“Our ability to understand size as it relates to sexual function is poorly understood,” Christopher Tarnay, MD, director of the division of female pelvic medicine and reconstructive surgery at the UCLA Medical Center, tells WebMD. “But in the last 10 to 15 years, there has been a lot more attention paid to the field of sexual medicine.”

Accommodating and Changeable

The vagina is a very “elastic” organ, says Christine O’Connor, MD, director of adolescent gynecology and well women care at Mercy Medical Center in Baltimore. It is small enough to hold a tampon in place, but can expand enough to pass a child through. This is because the walls of the vagina are similar to those of the stomach, they have rugae, meaning they fold together to collapse when unused, then expand when necessary.

“It doesn’t stay one particular size,” O’Connor says. “It changes to accommodate whatever is going on at that time.”

The most commonly used measurements regarding the size of vaginas come from Masters and Johnson’s work from the 1960s. They looked at 100 women who had never been pregnant and found that vagina lengths, unstimulated, range from 2.75 inches to about 3¼ inches. When a woman is aroused, it increased to 4.25 inches to 4.75 inches. Regardless of how long the vagina is, the area that is thought to be important for most women’s sexual response is the outer one-third.

So how does length relate to sexual satisfaction? No one seems to know for sure.

Tarnay says the main issues he sees women have is discomfort during sex. This typically occurs if the vagina is too short or tight or they have a prolapse, where the uterus, bladder, or other organs fall out of place, typically after childbirth.

“It probably doesn’t matter,” Tarnay says. “There is such a wide range of normal, one can be completely assured that in the absence of prolapse, length has no impact on sexual satisfaction.”

Muscle Tone

What may make a difference, Tarnay says, is what he calls the genital hiatus -- the vaginal opening. The complaints he hears from his patients are typically after childbirth.

“Women will come in describing a change in sexual function and say it feels loose and they feel less satisfied,” he says. “But just having a baby changes the sexual experience, so it may not have to do with the changes in the vaginal opening.”

The vaginal opening likely changes only slightly after birth, Tarnay says. In 1996, doctors began using a measurement called the pelvic organ prolapse quantification system as a way of helping them see how well they were doing repairing that area after childbirth.

This was the first time there was a true before-and-after measurement, Tarnay says. Doctors have used the system to look at populations of women and found that there is a slight increase in the size of the opening after vaginal deliveries. The issue may be more related to muscular weakness or injury in that area, Tarnay says.

“Women who are able to contract the pelvic floor muscles can increase or decrease the size of the hiatus,” he says. “Increasing pelvic floor muscle tone can reduce looseness.”

Kegel exercises can be very effective at strengthening these muscles, Tarnay says, and they may generally improve sex.

A study published in the Australian & New Zealand Journal of Obstetrics and Gynaecology in 2008 found that women who regularly performed Kegel exercises reported greater sexual satisfaction than women who didn’t do Kegels.

The problem with Kegels is that many women don’t know how to do them properly.

“When I ask someone to do a bicep curl, they can do it,” he says. “But a pretty significant subset of the women who say they do Kegels, when I ask them to show me what they are doing, aren’t doing [the exercise] properly or can’t connect between the brain and those muscles.”

To find the muscles you use to do Kegels, either insert a finger into the vagina and squeeze the surrounding muscles or stop the flow when urinating. After you’ve found the muscles, practice contracting them for five to 10 seconds, and then relax. If you can’t hold for that long, work your way up. Repeat the process 10 to 20 times, three times a day. While exercising, be sure to breathe normally and try not to use the muscles in your legs, stomach, or bottom.

Some women sustain nerve injury during birth and can’t feel these muscles. Others just don’t use the proper technique. Tarnay says there are even physical therapists who specialize in helping women perform Kegels properly.

What Really Matters

Worrying about size and whether or not it changes over time is the wrong concern, O’Connor says. Factors like sufficient lubrication and arousal and a good relationship with a partner have a much greater impact on sexual enjoyment for women.

A 2010 study published in the International Urogynecology Journal bears out her opinion. Researchers used medical records, an exam, and questionnaire of 500 gynecological patients aged 40 and older to see if there was a correlation between vaginal length and opening size and sexual satisfaction.

The researchers found that desire, arousal, orgasm, pain, and sexual satisfaction were not linked to vagina size. Instead, the best predictors of sexual inactivity were advanced age, higher BMI, and not being in a committed relationship.

“It is not an exact physical fit you are looking for in terms of sexual function,” O’Connor says. “It is more about the communication between the two partners and making sure both are getting what they need out of the experience and are comfortable.”

Syphilis

noreply@blogger.com (Anonymous) — Mon, 18 Feb 2013 13:38:00 +0000

Syphilis

What Causes Syphilis?

Syphilis is caused by the bacteria Treponema pallidum.

How Common Is Syphilis?

Syphilis was once a major public health threat, commonly causing serious long-term health problems such as arthritis, brain damage, and blindness. It defied effective treatment until the late 1940s, when the antibiotic penicillin was first developed.

According to the CDC, the rate of new cases of syphilis had plummeted in the 1990's and in the year 2000 it reached an all time low since reporting began in 1941. However, there has been a gradual rise since then with over 36,000 cases being reported in 2006.

How Do I Know If I Have Syphilis?

Syphilis infection occurs in three distinct stages:

Early or primary syphilis. People with primary syphilis will develop one or more sores. The sores resemble large round bug bites and are often hard and painless. They occur on the genitals or in or around the mouth somewhere between 10-90 days (average three weeks) after exposure. Even without treatment they heal without a scar within six weeks.

Secondary stage rash on the palms of the hands.

The secondary stage may last one to three months and begins within six weeks to six months after exposure. People with secondary syphilis experience a rosy "copper penny" rash typically on the palms of the hands and soles of the feet. However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases. They may also experience moist warts in the groin, white patches on the inside of the mouth, swollen lymph glands, fever, andweight loss. Like primary syphilis, secondary syphilis will resolve without treatment.

Latent syphilis. This is where the infection lies dormant (inactive) without causing symptoms.

Tertiary syphilis. If the infection isn't treated, it may then progress to a stage characterized by severe problems with the heart, brain, and nerves that can result in paralysis, blindness, dementia, deafness, impotence, and even death if it's not treated.

How Is Syphilis Diagnosed?

Syphilis can be easily diagnosed with a quick and inexpensive blood test given at your doctor's office or at a public health clinic.

How Is Syphilis Treated?

If you've been infected with syphilis for less than a year, a single dose of penicillin is usually enough to destroy the infection. For those allergic to penicillin, tetracyclineor doxycycline can be given instead. If you are in a later stage of disease, more doses will be needed.

People who are being treated for syphilis must abstain from sexual contact until the infection is completely gone. Sexual partners of people with syphilis should be tested and, if necessary, treated.

What if Syphilis Is not Treated?

If syphilis is left untreated, it can cause serious and permanent problems such as dementia, blindness, or death.

How Does Syphilis Affect a Pregnant Woman and Her Baby?

Depending on how long a pregnant woman has been infected with syphilis, she has a good chance of having a stillbirth (birth of an infant who has died prior to delivery) or of giving birth to a baby who dies shortly after birth.

If not treated immediately, an infected baby may be born without symptoms but could develop them within a few weeks. These signs and symptoms can be very serious. Untreated babies may become developmentally delayed, have seizures, or die.

How Can I Prevent a Syphilis Infection?

To reduce your risk of syphilis infection:

Avoid intimate contact with a person you know is infected
If you do not know if a sexual partner is infected, use a condom in every sexual encounter

What Is the Outlook for People With Syphilis?

Syphilis is a curable disease with prompt diagnosis and treatment. However, if treated too late, there may be permanent damage to the heart and brain even after the infection is destroyed.

Sex Diseases

noreply@blogger.com (Anonymous) — Sat, 16 Feb 2013 13:10:00 +0000

HIV/AIDS, Tuberculosis & Malaria

NTD control is also important for success in fighting other important diseases – notably HIV/AIDs, tuberculosis and malaria. In Africa, there are high rates of co-infection among NTDs and HIV/AIDs, tuberculosis and malaria, demonstrating an increased need for more research to unlock the links between these diseases, as well as a number of opportunities for treating comprehensive programming to treat these diseases simultaneously.

NTDs weaken the immune system, making it more likely for an individual to contract other diseases and less likely that they will be able to fight them. Women with female genital schistosomiasis (FGS) have three times the chance of contracting HIV than those women without it; in Africa, at least 16 million women may be infected with FGS. Additionally, the presence of soil-transmitted helminthes (ascariasis, trichuriasis and hookworm) is a risk factor for the development of active pulmonary tuberculosis. Hookworm and malaria both cause anemia, which leads to increased morbidity and mortality for those who are co-infected, particularly women and children.

In some cases, NTDs can also reduce the efficiency of treatment and prevention of other diseases. Soil-transmitted helminthes have shown to reduce the effectiveness of tuberculosis treatment as well as reducing the effectiveness of the BCG vaccine – which prevents tuberculosis. Those with HIV and soil-transmitted helminthes may also have alower response to T-cell treatments. There may be links between NTDs and the efficacy of other vaccines, though more research is needed.

The high level of co-infection means that there are opportunities for integrated treatment programs. The average cost of NTD medication - approximately $0.50 annually - means that it can easily and cheaply be integrated into treatment programs for other diseases, ensuring that they are as effective as possible. Other disease prevention methods, such as mosquito control, will have positive impacts on the reduction of both malaria and lymphatic filariasis in areas like Africa, where the diseases are co-endemic.

VAGINAL PROBLEM

noreply@blogger.com (Anonymous) — Thu, 14 Feb 2013 23:35:00 +0000

Vaginal Problems - Topic Overview

Most women experience minor vaginal problems from time to time. These problems can be related to menstrual cycles, sex, infection, birth control methods, aging, medicines, or changes after pregnancy.

A change in your normal vaginal discharge may be the first sign of a vaginal problem. Changes in urination, such as having to urinate more frequently or having a burning feeling when you urinate, also may be a symptom of a vaginal problem.

Conditions that may cause a change in your normal vaginal discharge include:

Infections of the vagina, such as a yeast infection, bacterial vaginosis,trichomoniasis, human papillomavirus (HPV), or herpes.
Infection of the cervix (cervicitis).
An object in the vagina, such as a forgotten tampon.
Sexually transmitted infections (STIs), such as chlamydia or gonorrhea.
Various sex practices, such as oral-to-vaginal and anal-to-vaginal contact.
Vaginal medicines or douching.

Pelvic Pain

The exact cause of pelvic pain may be hard to find. The severity of your pain and other symptoms you have may help determine what is causing the pain. For example: A condition, such as functional ovarian cysts , may cause pelvic pain and vaginal bleeding when you are not having your period.

Vaginal infections

If you think you may have symptoms of an STI:

Do not have sexual contact or activity while waiting for your appointment. This will prevent the spread of the infection.
Women should not douche. Douching changes the normal balance of bacteria in the vagina. Douching may flush an infection up into your uterus or fallopian tubes and cause pelvic inflammatory infection (PID).

The presence or excess growth of yeast cells, bacteria, or viruses can cause a vaginal infection. A vaginal infection may occur when there is a change in the normal balance of organisms in your vagina.

The three most common types of vaginal infections are:

Candida vulvovaginitis (yeast infections).
Bacterial infections (bacterial vaginosis).
Parasitic infections (trichomoniasis).

Common symptoms of vaginal infection include:

Increase or change in the vaginal discharge, including gray, green, or yellow discharge.
Vaginal redness, swelling, itching, or pain.
Vaginal odor.
Burning with urination.
Pain or bleeding with sex.

If you are pregnant and have vaginal symptoms, talk with your doctor about your symptoms before considering any home treatment measures. Some home treatment measures may not be appropriate, depending on the cause of your vaginal infection. Conditions such as bacterial vaginosis can affect your pregnancy, so it is important to talk with your doctor and be treated appropriately.

Vaginal infections may increase the risk for pelvic infections, such as pelvic inflammatory disease (PID).

Vaginal or vulvar problems

Other vaginal or vulvar problems may occur from the use of birth control methods, the use of medicines, or aging, or as a result of changes after pregnancy. These problems include:

Vaginal prolapse, which may cause urination and bowel changes.
Retained tampon, birth control device, or foreign object. See how to remove an object from the vagina.
Vulvar or vaginal injury, such as landing on a metal bar such as on a bike orplayground equipment or from an object in the vagina.
Vulvar pain (vulvodynia).
Pudendal neuralgia, from pressure on the pudendal nerve in the genital area.
Noninfectious vaginitis. Examples of this include:
- An allergic reaction or irritation from chemicals, such as those found in vaginal sprays, douches, or spermicides.
- Hormone changes related to menopause, such as atrophic vaginitis.
- Use of antibiotics and other medicines, which may change the balance of organisms in your vagina.
- A young girl with unusual vaginal symptoms should be evaluated by her doctor to determine the cause. Vaginitis in a young girl may be caused by:
  
  A ball of toilet paper in her vagina.
  
  Pinworms that have spread from the anus to the vagina.
  
  The spread of bacteria from an upper respiratory infection of the ears (otitis media) or throat (tonsillitis) to the vagina by her hands.
  
  A young girl with vaginal symptoms must also be evaluated for possible sexual abuse.
  
  Rashes, sores, blisters, or lumps in the vaginal or vulvar area
  
  Many conditions can cause a rash, sore, blister, or lump in your vaginal area (vulva ). One of the most common causes of a rash is genital skin irritation that may occur when soap is not rinsed off the skin or when tight-fitting or wet clothes rub against the skin. A sore, blister, or lump in your vaginal area may require a visit to your doctor.
  
  Treatment of a vaginal problem depends on the cause of the problem, the severity of your symptoms, and your overall health condition.
  
  Check your symptoms to decide if and when you should see a doctor.

BREAST CANCER

noreply@blogger.com (Anonymous) — Wed, 13 Feb 2013 23:58:00 +0000

Cancer - breast; Carcinoma - ductal; Carcinoma - lobular; DCIS; LCIS; HER2-positive breast cancer; ER-positive breast cancer; Ductal carcinoma in situ; Lobular carcinoma in situ

Last reviewed: November 17, 2012.
Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk.
In rare cases, breast cancer can start in other areas of the breast.

Breast cancer can be invasive or noninvasive. Invasive means it has spread from the milk duct or lobule to other tissues in the breast. Noninvasive means it has not yet invaded other breast tissue. Noninvasive breast cancer is called "in situ."
- Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues. It may progress to invasive cancer if untreated.
- Lobular carcinoma in situ (LCIS) is a marker for an increased risk of invasive cancer in the same or both breasts.
Many breast cancers are sensitive to the hormone estrogen. This means that estrogen causes the breast cancer tumor to grow. Such cancers have estrogen receptors on the surface of their cells. They are called estrogen receptor-positive cancer or ER-positive cancer.

Some women have HER2-positive breast cancer. HER2 refers to a gene that helps cells grow, divide, and repair themselves. When cells (including cancer cells) have too many copies of this gene, they grow faster. In the past, women with HER2-positive breast cancer have a more aggressive disease. They have a higher risk that the disease will return (recur) than in women who do not have this type. This may be changing with specifically targeted treatments against HER2.
Causes, incidence, and risk factors

Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer.

Risk factors you cannot change include:

Age and gender -- Your risk of developing breast cancer increases as you get older. Most advanced breast cancer cases are found in women over age 50. Men can slo get breast cancer. But they are 100 times less likely than women to get breast cancer.

Family history of breast cancer -- You may also have a higher risk of breast cancer if you have a close relative who has had breast, uterine, ovarian, or colon cancer. About 20 - 30% of women with breast cancer have a family history of the disease.

Genes -- Some people have genetic mutations that make them more likely to develop breast cancer. The most common gene defects are found in the BRCA1 and BRCA2 genes. These genes normally produce proteins that protect you from cancer. If a parent passes you a defective gene, you have an increased risk of breast cancer. Women with one of these defects have up to an 80% chance of getting breast cancer sometime during their life.

Menstrual cycle -- Women who got their periods early (before age 12) or went through menopause late (after age 55) have an increased risk of breast cancer.

Other risk factors include:

Alcohol use -- Drinking more than 1 - 2 glasses of alcohol a day may increase your risk of breast cancer.

Childbirth -- Women who have never had children or who had them only after age 30 have an increased risk of breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.

DES -- Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer after age 40. This drug was given to the women in the 1940s - 1960s.

Hormone replacement therapy (HRT) -- You have a higher risk of breast cancer if you have received hormone replacement therapy with estrogen for several years or more.

Obesity -- Obesity has been linked to breast cancer, although this link is not completely understood. The theory is that obese women produce more estrogen. This can fuel the development of breast cancer.

Radiation -- If you received radiation therapy as a child or young adult to treat cancer of the chest area, you have a very high risk of developing breast cancer. The younger you started such radiation and the higher the dose, the higher your risk. This is especially true if the radiation was given during breast development.

Breast implants, using antiperspirants, and wearing underwire bras do not raise the risk of breast cancer. There is also no evidence of a direct link between breast cancer and pesticides.
Symptoms

Early breast cancer usually does not cause symptoms. This is why regular breast exams are important. As the cancer grows, symptoms may include:

Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt

Change in the size, shape, or feel of the breast or nipple -- for example, you may have redness, dimpling, or puckering that looks like the skin of an orange

Fluid coming from the nipple -- may be bloody, clear to yellow, green, and look like pus

Men can get breast cancer, too. Symptoms include breast lump and breast pain and tenderness.

Symptoms of advanced breast cancer may include:

Bone pain

Breast pain or discomfort

Skin ulcers

Swelling of in the armpit (next to the breast with cancer)

Weight loss
Signs and tests

The doctor will ask you about your symptoms and risk factors. Then the doctor will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area.

Tests used to diagnose and monitor patients with breast cancer may include:

Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram

Breast ultrasound to show whether the lump is solid or fluid-filled

Breast biopsy, using methods such as needle aspiration, ultrasound-guided, stereotactic, or open

CT scan to check if the cancer has spread

Mammography to screen for breast cancer or help identify the breast lump

PET scan to check if the cancer has spread

Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes

If your doctor learns that you do have breast cancer, more tests will be done. This is to check if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up. It also gives you an idea of what to expect in the future.

Breast cancer stages range from 0 to IV. The higher the staging number, the more advanced the cancer.
Treatment

Treatment is based on many factors, including:

Type and stage of the cancer

Whether the cancer is sensitive to certain hormones

Whether the cancer overproduces (overexpresses) a gene called HER2/neu

Cancer treatments may include:

Chemotherapy medicines to kill cancer cells

Radiation therapy to destroy cancerous tissue

Surgery to remove cancerous tissue -- a lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possible nearby structures

Hormone therapy is prescribed to women with ER-positive breast cancer to block certain hormones that fuel cancer growth.

An example of hormonal therapy is the drug tamoxifen. This drug blocks the effects of estrogen. Estrogen allows breast cancer cells to survive and grow. Most women with estrogen-sensitive breast cancer benefit from this drug.

Another class of hormone therapy medicines is called aromatase inhibitors. Medicines such as exemestane (Aromasin) work as well or even better than tamoxifen in postmenopausal women with breast cancer. Aromatase inhibitors block estrogen from being made in the body.

Targeted therapy is also called biologic therapy. It uses special anticancer drugs that target certain changes in a cell that can lead to cancer. One such drug is trastuzumab (Herceptin). It may be used for women with HER2-positive breast cancer.

Cancer treatment can be local or systemic.

Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment.

Systemic treatments affect the entire body. Chemotherapy is a type of systemic treatment.

Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (curing). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.

Stage 0 and DCIS -- Lumpectomy plus radiation or mastectomy is the standard treatment. Doctors do not quite agree on how best to treat DCIS.

Stage I and II -- Lumpectomy plus radiation or mastectomy with some sort of lymph node removal is the standard treatment. Hormone therapy, chemotherapy, and biologic therapy may also be recommended after surgery.

Stage III -- Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and biologic therapy.

Stage IV -- Treatment may involve surgery, radiation, chemotherapy, hormone therapy, or a combination of these treatments.

After treatment, some women will continue to take medicines such as tamoxifen for a time. All women will continue to have blood tests, mammograms, and other tests after treatment.

Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.
Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Expectations (prognosis)

New, improved treatments are helping persons with breast cancer live longer. Even with treatment, though, breast cancer can spread to other parts of the body. Sometimes, cancer returns even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free.

How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors used to determine the risk of recurrence and the likelihood of successful treatment include:

Location of the tumor and how far it has spread

Whether the tumor is hormone receptor-positive or -negative

Tumor markers, such as HER2

Gene expression

Tumor size and shape

Rate of cell division or how quickly the tumor is growing

After considering all of the above, your doctor can discuss your risk of having a recurrence of breast cancer.
Complications

You may experience side effects or complications from cancer treatment. For example, radiation therapy may cause temporary swelling of the breast (lymphedema), and aches and pains around the area.

Lymphedema may start 6-8 weeks after surgery or after radiation treatment for cancer. It can also start slowly after cancer treatment is over. You may not notice symptoms until 18-24 months after treatment. Sometimes it can take years to develop.

Ask your doctor about the side effects you may have during treatment.
Calling your health care provider

Contact your health care provider if:

You have a breast or armpit lump

You have nipple discharge

Call your health care provider if you develop symptoms after being treated for breast cancer:

Nipple discharge

Rash on the breast

New lumps in the breast

Swelling in the area

Pain, especially chest pain, abdominal pain, or bone pain
Prevention

Tamoxifen is approved for breast cancer prevention in women aged 35 and older who are at high risk. Discuss this with your doctor.

Women at very high risk of breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is ever diagnosed. Possible candidates include:

Women who have already had one breast removed due to cancer

Women with a strong family history of breast cancer

Women with genes or genetic mutations that raise their risk of breast cancer (such as BRCA1 or BRCA2)

Your doctor may do a total mastectomy to reduce your risk of breast cancer. This may reduce, but does not eliminate the risk of breast cancer.

Many risk factors, such as your genes and family history, cannot be controlled. But making healthy lifestyle changes may reduce your overall chance of getting cancer. This includes eating health foods:

Choose foods and portion sizes that promote a healthy weight

Choose whole grains instead of refined grain products

Eat more fruits and vegetables each day

Limit processed and red meat in the diet

Limit alcohol consumption to one drink per day (women at high risk of breast cancer should not drinking alcohol at all)

Brain Damage: Symptoms, Causes, Treatments

noreply@blogger.com (Anonymous) — Sat, 09 Feb 2013 23:02:00 +0000

Brain damage is an injury that causes the destruction or deterioration of brain cells.
In the U.S., every year, about 1.5 million people have some type of brain injury. And approximately 5.3 million people suffer from the effects of brain damage. About 50,000 die as a result of brain injury. Medical costs and lost productivity are estimated at between $48 billion and $60 billion per year.

Recommended Related to Brain & Nervous System

General Information About Adult Brain Tumors

An adult brain tumor is a disease in which abnormal cells form in the tissues of the brain. There are many types of brain and spinal cordtumors. The tumors are formed by the abnormal growth of cells and may begin in different parts of the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system (CNS). The tumors may be benign (not cancer) or malignant (cancer). Benign brain tumors grow and press on nearby areas of the brain. They rarely spread into other tissues...

Read the General Information About Adult Brain Tumors article > >

What Are the Types of Brain Damage and How Severe Are They?

All traumatic brain injuries are head injuries. But head injury is not necessarily brain injury. There are two types of brain injury: traumatic brain injury and acquired brain injury. Both disrupt the brain’s normal functioning.

Traumatic Brain Injury (TBI) is caused by an external force -- such as a blow to the head -- that causes the brain to move inside the skull or damages the skull. This in turn damages the brain.
An Acquired Brain Injury (ABI) occurs at the cellular level. It is most often associated with pressure on the brain. This could come from a tumor. Or it could result from neurological illness, as in the case of a stroke.

Both traumatic brain injury and acquired brain injury occur after birth. And neither is degenerative. Sometimes, the two terms are used interchangeably.
There is a kind of brain damage that results from genetics or birth trauma. It's called congenital brain damage. It is not included, though, within the standard definition of brain damage or traumatic brain injury.
Some brain injuries cause focal -- or localized -- brain damage, such as the damage caused when a bullet enters the brain. In other words, the damage is confined to a small area. Closed head injuries frequently cause diffuse brain damage, which means damage to several areas of the brain. For example, both sides of the brain are damaged and the nerves are stretched throughout the brain. This is called diffuse axonal injury or DAI.
The severity of brain damage can vary with the type of brain injury. A mild brain injury may be temporary. It causes headaches, confusion, memory problems, and nausea. In a moderate brain injury, symptoms can last longer and be more pronounced. In both cases, most patients make a good recovery although even in mild brain injury 15% of people will have persistent problems after one year.
With a severe brain injury, the person may suffer life-changing and debilitating problems. He or she will have cognitive, behavioral, and physical disabilities. People who are in a coma or a minimally responsive state may remain dependent on the care of others for the rest of their lives. .

What Causes Brain Damage?

When the brain is starved of oxygen for a prolonged period of time, brain damage may occur. Brain damage can occur as a result of a wide range of injuries, illnesses, or conditions. Because of high-risk behaviors, males between the ages of 15 and 24 are most vulnerable. Young children and the elderly also have a higher risk.
Causes of traumatic brain injury include:

Car accidents
Blows to the head
Sports injuries
Falls or accidents
Physical violence

Causes of acquired brain injury include:

Poisoning or exposure to toxic substances
Infection
Strangulation, choking, or drowning
Stroke
Heart attacks
Tumors
Aneurysms
Neurological illnesses
Abuse of illegal drugs

What Are the Symptoms of Brain Damage?

There are numerous symptoms of brain damage, whether traumatic or acquired. They fall into four major categories:

Cognitive
Perceptual
Physical
Behavioral/emotional

Cognitive symptoms of brain damage include:

Difficulty processing information
Difficulty in expressing thoughts
Difficulty understanding others
Shortened attention span
Inability to understand abstract concepts
Impaired decision-making ability
Memory loss

Perceptual symptoms of brain damage include:

Change in vision, hearing, or sense of touch
Spatial disorientation
Inability to sense time
Disorders of smell and taste
Balance issues
Heightened sensitivity to pain

Physical symptoms of brain damage include:

Persistent headaches
Extreme mental fatigue
Extreme physical fatigue
Paralysis
Tremors
Seizures
Sensitivity to light
Sleep disorders
Slurred speech
Loss of consciousness

Behavioral/emotional symptoms of brain damage include:

Irritability and impatience
Reduced tolerance for stress
Sluggishness
Flattened or heightened emotions or reactions
Denial of disability
Increased aggressiveness

How Are Brain Damage and Brain Injuries Treated?

Anyone who has a head or brain injury needs immediate medical attention.
A brain injury that seems mild -- referred to as a concussion -- can be as dangerous as clearly severe injuries. The key factor is the extent and location of the damage. Brain injury does not necessarily result in long-term disability or impairment. But the correct diagnosis and treatment is needed to contain or minimize the damage.
The extent and effect of brain damage is determined by a neurological exam, neuroimaging testing such as MRI or CT scans, and neuropsychological assessments . Doctors will stabilize the patient to prevent further injury, ensure blood and oxygen are flowing properly to the brain, and ensure that blood pressure is controlled.
Almost all patients will benefit from rehabilitation to assist in long-term recovery. That may include:

Physical therapy
Occupational therapy
Speech and language therapy
Psychological support

Can I Prevent Brain Injuries?

Most injuries that cause brain damage are preventable. Here are some rules to follow to reduce the risk of brain damage:

Never shake a child.
Install window guards to keep young children from falling out of open windows.
Install shock-absorbing material on playgrounds.
Wear helmets during sports or cycling.
Wear seatbelts in cars, and drive carefully.
Avoid falls by using a stepstool when reaching for high items.
Install handrails on stairways.
Don't keep guns; if you do, keep them unloaded and locked away.
Don't use illegal drugs.
Drink alcohol only in moderation, and never drink and drive.

HYPERTENSION

noreply@blogger.com (Anonymous) — Fri, 08 Feb 2013 23:34:00 +0000

Hypertension

Hypertension; HBP; Blood pressure - high

Last reviewed: June 10, 2011.

Hypertension is the term used to describe high blood pressure.
Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body.
Blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high.
The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.

Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

If you have pre-hypertension, you are more likely to develop high blood pressure.
If you have heart or kidney problems, or if you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions.

Causes, incidence, and risk factors

Many factors can affect blood pressure, including:

How much water and salt you have in your body
The condition of your kidneys, nervous system, or blood vessels
The levels of different body hormones

You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, and early death.
You have a higher risk of high blood pressure if you:

Are African American
Are obese
Are often stressed or anxious
Drink too much alcohol (more than one drink per day for women and more than two drinks per day for men)
Eat too much salt in your diet
Have a family history of high blood pressure
Have diabetes
Smoke

Most of the time, no cause of high blood pressure is found. This is called essential hypertension.
High blood pressure that is caused by another medical condition or medication is called secondary hypertension. Secondary hypertension may be due to:

Chronic kidney disease
Disorders of the adrenal gland (pheochromocytoma or Cushing syndrome)
Pregnancy (see: preeclampsia)
Medications such as birth control pills, diet pills, some cold medications, and migraine medications
Narrowed artery that supplies blood to the kidney (renal artery stenosis)
Hyperparathyroidism

Symptoms

Most of the time, there are no symptoms. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere.
Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure.
If you have a severe headache, nausea or vomiting, bad headache, confusion, changes in your vision, or nosebleeds you may have a severe and dangerous form of high blood pressure called malignant hypertension.

Signs and tests

Your health care provider will check your blood pressure several times before diagnosing you with high blood pressure. It is normal for your blood pressure to be different depending on the time of day.
Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your doctor's office. Make sure you get a good quality, well-fitting home device. It should have the proper sized cuff and a digital readout.
Practice with your health care provider or nurse to make sure you are taking your blood pressure correctly. See also: Blood pressure monitors for home
Your doctor will perform a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.
Tests may be done to look for:

High cholesterol levels
Heart disease, such as an echocardiogram or electrocardiogram
Kidney disease, such as a basic metabolic panel and urinalysis or ultrasound of the kidneys

Treatment

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. You and your health care provider should set a blood pressure goal for you.
If you have pre-hypertension, your health care provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension.
You can do many things to help control your blood pressure, including:

Eat a heart-healthy diet, including potassium and fiber, and drink plenty of water. See: High blood pressure and diet
Exercise regularly -- at least 30 minutes of aerobic exercise a day.
If you smoke, quit -- find a program that will help you stop.
Limit how much alcohol you drink -- one drink a day for women, two a day for men.
Limit the amount of sodium (salt) you eat -- aim for less than 1,500 mg per day.
Reduce stress -- try to avoid things that cause you stress. You can also try meditation or yoga.
Stay at a healthy body weight -- find a weight-loss program to help you, if you need it.

Your health care provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral from your doctor to a dietitian, who can help you plan a diet that is healthy for you.
There are many different medicines that can be used to treat high blood pressure. See: High blood pressure medicines
Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. It is very important that you take the medications prescribed to you. If you have side effects, your health care provider can substitute a different medication.

Expectations (prognosis)

Most of the time, high blood pressure can be controlled with medicine and lifestyle changes.

Complications

When blood pressure is not well controlled, you are at risk for:

Calling your health care provider

If you have high blood pressure, you will have regular appointments with your doctor.
Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your yearly check-up, especially if someone in your family has or had high blood pressure.
Call your health care provider right away if home monitoring shows that your blood pressure is still high.

Prevention

Adults over 18 should have their blood pressure checked regularly.
Lifestyle changes may help control your blood pressure.
Follow your health care provider's recommendations to modify, treat, or control possible causes of high blood pressure.

ULCER

noreply@blogger.com (Anonymous) — Thu, 07 Feb 2013 23:13:00 +0000

Digestive health centre

What is peptic ulcer disease?

Peptic ulcer disease refers to painful sores or ulcers in the lining of the stomach (gastric ulcers) or the first part of the small intestine, called the duodenum (duodenal ulcers)

What causes ulcers?

Ulcers can be caused by:

Infection with a type of bacteria called Helicobacter pylori (H pylori). This is responsible for about 80% of stomach ulcers and about 95% of duodenal ulcers.
Use of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, ibuprofen and many others. Even coated aspirin can cause ulcers.
Very rarely, excess acid production from gastrinomas. These tumours of the acid-producing cells in the stomach - increase acid output - a phenomenon seen in Zollinger-Ellison syndrome

What are the symptoms of an ulcer?

An ulcer may or may not produce symptoms. When symptoms occur, they include:

A gnawing or burning pain in the middle or upper stomach between meals or at night
Bloating
Heartburn
Nausea or vomiting

In severe cases, symptoms can include:

Dark or black stool (due to bleeding)
Vomiting blood (which may look like "coffee grounds")
Weight loss
Severe pain in the mid- to upper abdomen

How serious is an ulcer?

Although ulcers often heal on their own, you shouldn't ignore the warning signs. If not properly treated, ulcers can lead to serious health problems, including:

Bleeding
Perforation (a hole in the wall of the stomach)
Gastric outlet obstruction from swelling or scarring that blocks the passageway leading from the stomach to the small intestine.

Taking NSAIDs can cause any of the above without warning. The risk is of particular concern for the elderly and for people with a prior history of peptic ulcer disease.

Who is more likely to get ulcers?

You may be more likely to develop ulcers if you:

Are infected with the H pylori bacterium
Take NSAIDs such as aspirin, ibuprofen naproxen
Have a family history of ulcers
Have another illness, such as liver, kidney or lung disease
Drink alcohol regularly
Smoke
Are 50 or over

How are ulcers diagnosed?

Your doctor may suspect an ulcer diagnosis just by talking with you about your symptoms. To confirm the diagnosis, however, you will need to have one or more tests:

A urea breath test - your breath is tested for carbon dioxide after drinking a special solution containing a chemical that is digested by H pylori
A stool antigen test - to look for H pylori excreted in faeces
A blood test to look for antibodies to H pylori
An upper endoscopy. This involves inserting a small, illuminated tube (endoscope) through the throat and into the stomach and duodenum to look for abnormalities. A biopsy of a suspected ulcer site or other abnormal area may be taken at the same time, and the tissue sample can also be tested for H pylori.
What is peptic ulcer disease?

(continued)

How are ulcers treated?
If tests show that you have H Pylori infection, you will need treatment to get rid of it. If tests do not show H Pylori infection, then you will probably be given treatment to reduce the amount of stomach acid you produce, to give the ulcer time to heal.
In addition, if your ulcer is believed to be due to NSAID use, you will be advised to stop taking these if possible. Your GP may be able to suggest an alternative analgesic, such as paracetamol. If you have a condition such as arthritis and need to take an NSAID, you GP may add another medicine to protect your intestinal lining while you are taking the NSAID.
Your symptoms may also be improved more quickly if you stop smoking or drinking alcohol.

Ulcer medications
Ulcer medications can include
Proton pump medications (PPI). Proton pump inhibitors reduce acid levels and allow the ulcer to heal. They include omeprazole, esomeprazole, lansoprazole and rabeprazole.
Antibiotics. If you have H Pylori infection, then antibiotics are used. Usually you will be prescribed a combination of two antibiotics along with a PPI treatment known as "triple therapy". You need to take these for a week and then have another test to make sure that the H Pylori has cleared up. If tests are still positive, you may need another course of treatment with different antibiotics.

Other treatment
Upper endoscopy Some bleeding ulcers can be treated through an endoscope.
Surgery Sometimes an operation is needed if the ulcer has created a hole in the wall of the stomach or if there is serious bleeding.

Will drinking milk help cure an ulcer?

No. Milk can make your ulcer worse. Milk provides brief relief from ulcer pain because it coats the stomach lining. But milk can also stimulate your stomach to produce more acid and digestive juices, which can aggravate ulcers.

How can I prevent ulcers?

To try and prevent ulcers from developing:

Don't smoke.
Avoid alcohol.
Don't overuse aspirin and/or NSAIDs.
If you have symptoms of an ulcer, seek medical advice.

Fat Burner Facts

noreply@blogger.com (Anonymous) — Wed, 06 Feb 2013 23:44:00 +0000

Fat Burner Facts: Get The Skinny On 5 Fat-Burning Ingredients

Yeah, I know: Those last 10 pounds are a b!tch to burn. In order to win a fight-to-the-death battle with chubby-blubber, some people add fat-burning supplements to their supplement arsenal.

Before you hit the store and start typing in your credit card number, get some information about the ingredients in those products. If you are a better-informed consumer, you'll have a better chance finding the best product for your health and fitness goals.

These five ingredients each help you burn fat, but they each work a bit differently. Harness their power to hit your goals!

Caffeine

Most of us get a hit of caffeine in our morning cup of joe. While it helps you feel less zombie-like in the morning, caffeine also has some powerful fat-fighting benefits.

When you're dieting, your energy level often takes a nose dive, leaving you lethargic and unmotivated at work, school and the gym. Caffeine can help alleviate that. With more energy, you can maintain a higher level of activity and burn more fat by getting more done.

Dieters who consume caffeine prior to a workout report that their workouts feel easier than those who don't use caffeine.

A study in the Journal Of Medicine And Science In Sports reported that those who consumed a beverage containing 330 mg of caffeine 60 minutes prior to exercise experienced a higher rate of fat oxidation during that workout session, accompanied by a lower rate of carbohydrate oxidation.

This high fat-oxidation rate is great because it means you're burning more fat for energy while sparing muscle glycogen. When you are glycogen depleted, your workouts suffer and you'll definitely feel fatigued. Caffeine can help you use body fat for fuel, getting lean while feeling great.

People also report that they feel less hunger after ingesting caffeine. Having a little caff might help you stay away from the snack tray.

If you do choose a product with caffeine, make sure to first test your tolerance for stimulants. If you are sensitive, you may want look for stimulant-free products.

CAFFEINE

Caffeine is not only great for quick energy, but it's also becoming a popular fat loss support supplement and workout performance booster.

Get your caffeine today.

Yohimbe

Yohimbe comes from the bark of a particular African tree. It may be particularly good for burning off stubborn body fat. By enhancing blood flow, yohimbe may make the oxidation of fatty acids easier. This can translate to fat-loss support, potentially when you need it most.

Increased blood flow to the muscle cells might also support recovery by shuttling more oxygen and nutrients to your working muscles.

YOHIMBE

Yohimbe is one of the top supplements to use when you want to take fat burning to a new level.

Get your yohimbe today.

Green Tea Extract

Like caffeine, green tea extract may increase the rate of fat oxidation in the body, improving your overall rate of fat loss.Green tea extract also contains catechins, which may help boost your metabolic rate by helping your body burn more calories right after consumption.

While green tea extract won't burn hundreds of calories on its own, its effects can compound over time and could make a big difference in your results.

A study published by the American Institute of Nutrition noted that consumption of green tea extract in study participants during physical activity produced a greater overall rate of fat loss.

GREEN TEA

Green tea may help support healthy immune system function, so if want to shed body fat and support overall health, consider a green tea supplement.

Get your green tea today.

Hoodia Gordonii

If you're an always-hungry snacker, hoodia gordonii may help. Hoodia comes from a plant in the South African desert and was originally used by hunters to ward off hunger on long hunting expeditions.

This splendid plant from South Africa can help you bide your time between meals!

Hopefully most of you don't have to worry about long hunting expeditions in the desert, but using hoodia gordonnii may help you manage hunger pangs caused by a reduced-calorie diet.

Some people find that this particular ingredient takes a few weeks to really kick in, so give it a bit of time before you judge whether it's working for you.

HOODIA GORDONII

Hoodia has long been used by indigenous populations of South Africa to help regulate their appetite and thirst during long hunting expeditions.

Get your hoodia gordonii today.

7-Keto

7-Keto might sound like some alien compound, but it's actually a natural, non-hormonal metabolite (breakdown product) of DHEA. Just like DHEA, 7-Keto is produced naturally in the body. As we age, levels of 7-Keto drop.

Supplementing with 7-Keto may help increase your metabolic rate and help you burn fat more effectively. 7-Keto might also improve protein synthesis, which means it may help you preserve more lean muscle on a caloric deficit.

7-KETO

7-Keto has been used to support weight loss efforts when combined with a fat loss nutrition and exercise plan.

Get your 7-Keto today.

Exercise, Eat, Burn

Keep in mind that no fat burner is meant to replace a good diet and exercise plan. Fat-burning supplements help you burn fat; they don't burn fat for you

What is Cholesterol? What Causes High Cholesterol?

noreply@blogger.com (Anonymous) — Mon, 04 Feb 2013 16:52:00 +0000

What are the functions of cholesterol?

It builds and maintains cell membranes (outer layer), it prevents crystallization of hydrocarbons in the membrane
It is essential for determining which molecules can pass into the cell and which cannot (cell membrane permeability)
It is involved in the production of sex hormones (androgens and estrogens)
It is essential for the production of hormones released by the adrenal glands (cortisol, corticosterone, aldosterone, and others)
It aids in the production of bile
It converts sunshine to vitamin D. Scientists from the Rockefeller University were surprised to find that taking vitamin D supplements do not seem to reduce the risk of cholesterol-related cardiovascular disease.
It is important for the metabolism of fat soluble vitamins, including vitamins A, D, E, and K
It insulates nerve fibers

There are three main types of lipoproteins

Cholesterol is carried in the blood by molecules called lipoproteins. A lipoprotein is any complex or compound containing both lipid (fat) and protein. The three main types are:

LDL (low density lipoprotein) - people often refer to it as bad cholesterol. LDL carries cholesterol from the liver to cells. If too much is carried, too much for the cells to use, there can be a harmful buildup of LDL. This lipoprotein can increase the risk of arterial disease if levels rise too high. Most human blood contains approximately 70% LDL - this may vary, depending on the person.

HDL (high density lipoprotein) - people often refer to it as good cholesterol. Experts say HDL prevents arterial disease. HDL does the opposite of LDL - HDL takes the cholesterol away from the cells and back to the liver. In the liver it is either broken down or expelled from the body as waste.

Triglycerides - these are the chemical forms in which most fat exists in the body, as well as in food. They are present in blood plasma. Triglycerides, in association with cholesterol, form the plasma lipids (blood fat). Triglycerides in plasma originate either from fats in our food, or are made in the body from other energy sources, such as carbohydrates. Calories we consume but are not used immediately by our tissues are converted into triglycerides and stored in fat cells. When your body needs energy and there is no food as an energy source, triglycerides will be released from fat cells and used as energy - hormones control this process.

What are normal cholesterol levels?

Desirable - Less than 200 mg/dL
Bordeline high - 200 to 239 mg/dL
High - 240 mg/dL and above

Optimum level: less than 5mmol/liter
Mildly high cholesterol level: between 5 to 6.4mmol/liter
Moderately high cholesterol level: between 6.5 to 7.8mmol/liter
Very high cholesterol level: above 7.8mmol/liter

Dangers of high cholesterol levels

High cholesterol levels can cause:

Atherosclerosis - narrowing of the arteries.

Higher coronary heart disease risk - an abnormality of the arteries that supply blood and oxygen to the heart.

Heart attack - occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. This causes your heart muscle to die.

Angina - chest pain or discomfort that occurs when your heart muscle does not get enough blood.

Other cardiovascular conditions - diseases of the heart and blood vessels.

Stroke and mini-stroke - occurs when a blood clot blocks an artery or vein, interrupting the flow to an area of the brain. Can also occur when a blood vessel breaks. Brain cells begin to die.

If both blood cholesterol and triglyceride levels are high, the risk of developing coronary heart disease rises significantly.

Heart Attack

noreply@blogger.com (Anonymous) — Sun, 03 Feb 2013 16:36:00 +0000

Heart attack symptoms: Know what's a medical emergency

By Mayo Clinic staff

Typical heart attack symptoms

Symptom	Description
Chest discomfort or pain	This discomfort or pain can feel like a tight ache, pressure, fullness or squeezing in the center of your chest lasting more than a few minutes. This discomfort may come and go.
Upper body pain	Pain or discomfort may spread beyond your chest to your shoulders, arms, back, neck, teeth or jaw. You may have upper body pain with no chest discomfort.
Stomach pain	Pain may extend downward into your abdominal area and may feel like heartburn.
Shortness of breath	You may pant for breath or try to take in deep breaths. This often occurs before you develop chest discomfort or you may not experience any chest discomfort.
Anxiety	You may feel a sense of doom or feel as if you're having a panic attack for no apparent reason.
Lightheadedness	In addition to chest pressure, you may feel dizzy or feel like you might pass out.
Sweating	You may suddenly break into a sweat with cold, clammy skin.
Nausea and vomiting	You may feel sick to your stomach or vomit.

Most heart attacks begin with subtle symptoms — with only discomfort that often is not described as pain. The chest discomfort may come and go. Don't be tempted to downplay your symptoms or brush them off as indigestion or anxiety.

Don't "tough out" heart attack symptoms for more than five minutes. Call 911 or other emergency medical services for help. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options.

Heart attack symptoms vary widely. For instance, you may have only minor chest discomfort while someone else has excruciating pain. One thing applies to everyone, though: If you suspect you're having a heart attack, call for emergency medical help immediately.

Heart attack symptoms: Know what's a medical emergency

Additional heart attack symptoms in women

Women may have all, none, many or a few of the typical heart attack symptoms. For women, the most common heart attack symptom is still some type of pain, pressure or discomfort in the chest. But women are more likely than are men to also have heart attack symptoms without chest pain, such as:

Neck, jaw, shoulder, upper back or abdominal discomfort
Shortness of breath
Nausea or vomiting
Abdominal pain or "heartburn"
Sweating
Lightheadedness or dizziness
Unusual or unexplained fatigue

Lung Cancer Symptoms

noreply@blogger.com (Anonymous) — Sat, 02 Feb 2013 13:25:00 +0000

One fourth of all people with lung cancer have no symptoms when the cancer is diagnosed. These cancers are usually identified incidentally when a chest X-ray is performed for another reason. The other three fourths of people develop some symptoms. The symptoms are due to direct effects of the primary tumor; to effects of cancer spread to other parts of the body (metastases); or to disturbances of hormones, blood, or other systems.
Symptoms of lung cancer include cough, coughing up blood or rusty-colored phlegm, fatigue, unexplained weight loss, recurrent respiratory infections, hoarseness, new wheezing, and shortness of breath.

A new cough in a smoker or a former smoker should raise concern for lung cancer.
A cough that does not go away or gets worse over time should be evaluated by a health care provider.
Coughing up blood (hemoptysis) occurs in a significant number of people who have lung cancer. Any amount of coughed-up blood should be evaluated by a health care provider.
Pain in the chest area is a symptom in about one fourth of people with lung cancer. The pain is dull, aching, and persistent.
Shortness of breath usually results from a blockage in part of the lung, collection of fluid around the lung (pleural effusion), or the spread of tumor through the lungs.
Wheezing or hoarseness may signal blockage or inflammation in the lungs that may go along with cancer.
Repeated respiratory infections, such as bronchitis or pneumonia, can be a sign of lung cancer.

Symptoms of metastatic cancer depend on the extent and location of the cancer spread. About 30-40% of people with lung cancer have some symptoms or signs of metastatic disease.

Lung cancer most often spreads to the liver, the bones, and the brain.
Metastatic lung cancer in the liver may cause yellowing of the skin and eyes (jaundice) but it may not cause any noticeable symptoms at the time of diagnosis.
Lung cancer that has metastasized to the bone causes bone pain, usually in the bones of the spine (vertebrae), the thigh bones, and the ribs.
Lung cancer that spreads to the brain can cause difficulties with vision, weakness on one side of the body, and/or seizures.

Paraneoplastic syndromes are the remote, indirect effects of cancer not related to direct invasion. Symptoms include the following:

New bone formation - particularly in the fingertips that can be painful
High levels of calcium in the blood
Blood clots
Low sodium levels in the blood

Diabetes

noreply@blogger.com (Anonymous) — Wed, 30 Jan 2013 16:13:00 +0000

How to Avoid Diabetes

Diabetes is a serious disease. Following your diabetes treatment plan takes round-the-clock commitment. But your efforts are worthwhile. Careful diabetes care can reduce your risk of serious — even life-threatening — complications.

Here are 10 ways to take an active role in diabetes care and enjoy a healthier future.

1. Make a commitment to managing your diabetes.

Members of your diabetes care team — doctor, diabetes nurse educator and dietitian, for example — will help you learn the basics of diabetes care and offer support and encouragement along the way. But it's up to you to manage your condition. After all, no one has a greater stake in your health than you.

Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight. Monitor your blood sugar level, and follow your doctor's instructions for keeping your blood sugar level within your target range. Don't be afraid to ask your diabetes treatment team for help when you need it.

2. Don't smoke.

If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.

3. Keep your blood pressure and cholesterol under control.

Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Sometimes medication is needed, too.

4. Schedule yearly physicals and regular eye exams.

Your regular diabetes checkups aren't meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

5. Keep your vaccines up to date.

High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:

Flu vaccine. A yearly flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you're age 65 or older, you may need a five-year booster shot.
Hepatitis B vaccine. The Centers for Disease Control and Prevention (CDC) currently recommends hepatitis B vaccination if you haven't previously been vaccinated against hepatitis B and you're an adult aged 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you're age 60 or older and have diabetes and haven't previously received the vaccine, talk to your doctor about the whether it's right for you.
Other vaccines. Stay up to date with your tetanus shot and its 10-year boosters. Depending on the circumstances, your doctor may recommend other vaccines as well.
6. Take care of your teeth.

Diabetes may leave you prone to gum infections. Brush your teeth at least twice a day, floss your teeth once a day, and schedule dental exams at least twice a year. Consult your dentist right away if your gums bleed or look red or swollen.

7. Pay attention to your feet.

High blood sugar can damage the nerves in your feet and reduce blood flow to your feet. Left untreated, cuts and blisters can lead to serious infections. To prevent foot problems:
- Wash your feet daily in lukewarm water.
- Dry your feet gently, especially between the toes.
- Moisturize your feet and ankles with lotion.
- Check your feet every day for blisters, cuts, sores, redness or swelling.
- Consult your doctor if you have a sore or other foot problem that doesn't start to heal within a few days.
8. Consider a daily aspirin.

Aspirin reduces your blood's ability to clot. Taking a daily aspirin can reduce your risk of heart attack and stroke — major concerns when you have diabetes. Ask your doctor whether daily aspirin therapy is appropriate for you, including which strength of aspirin would be best.

9. If you drink alcohol, do so responsibly.

Alcohol can cause low blood sugar, depending on how much you drink and whether you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Remember to include the calories from any alcohol you drink in your daily calorie count.

10. Take stress seriously.

If you're stressed, it's easy to neglect your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.

Above all, stay positive. Diabetes care is within your control. If you're willing to do your part, diabetes won't stand in the way of an active, healthy life.

What is hyperemesis gravidarum (severe morning sickness)?

noreply@blogger.com (Anonymous) — Tue, 29 Jan 2013 23:41:00 +0000

Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy. (1) In fact, the words ‘hyperemesis’ (pronounced ‘hye-pur-em-ee-sis’) and ‘gravidarum’ (pronounced ‘gra-vid-ah-room’) literally translate to ‘excessive vomiting’ ‘during pregnancy’. (10)

What are the symptoms of hyperemesis gravidarum (HEG)?

The main symptoms of hyperemesis gravidarum are:

continued and severe nausea and vomiting – particularly if vomiting occurs more than 3-4 times a day and prevents one from keeping down food or fluids
weight loss – which may be over 10% of body weight
nutritional deficiencies
infrequent urination
dehydration – which in turn may cause headaches, palpitations, confusion andhypotension (low blood pressure) when standing
fainting
feeling tired and dizzy
ketosis caused by a raised number of poisonous acidic chemicals in the blood
pale skin
jaundice
muscle wasting
Ptyalism – excessive secretion of saliva (1-4, 13)

How long does hyperemesis gravidarum last?

Hyperemesis gravidarum can last much longer than normal morning sickness – which tends to settle down around 12-14 weeks of pregnancy. Hyperemesis gravidarum generally diminishes around 21 weeks into the pregnancy, but it may continue much longer. (1, 2)

What causes hyperemesis gravidarum?

There are several theories regarding what causes hyperemesis gravidarum. Some theories concern the hormonal changes that occur in pregnancy. In particular, theories focus on the increase in human chorionic gonadotropin (hCG). This hormone is said to be associated with the peak in symptoms of morning sickness. There have been difficulties with directly demonstrating a link between hCG concentrations and severity of morning sickness however due to the variation in hCG concentrations in the population. (2, 3, 5)

Other potential causes of hyperemesis gravidarum include:

emotional changes
nutritional deficiencies – in particular a deficiency in vitamin B6
gastric problems
increased estrogen levels (1, 2)

How common is hyperemesis gravidarum?

According to the NHS, hyperemesis gravidarum is thought to affect around 1 in 200 women. (1) Estimates do, however, vary depending on how hyperemesis gravidarum is defined. The estimated incidence rates of severe morning sickness tend to be between 0.5% and 2% of pregnancies. (1, 3, 4)

Who is most likely to develop hyperemesis gravidarum?

Certain women are more likely to develop hyperemesis gravidarum than others. These include:

women who suffer from migraines
women who have previously suffered from motion sickness
those with a family history of hyperemesis gravidarum
women with a multiple pregnancy – such as twins or triplets
increased bodyweight
a female fetus
women who have had hyperemesis gravidarum in a previous pregnancy
molar pregnancies – where a mass of abnormal cells (referred to as a “mole”) grow instead of the normally developing baby
fetal anomalies e.g. trisomy 21 and hydrops fetalis (6-9)

How is hyperemesis gravidarum diagnosed?

Diagnosis of hyperemesis gravidarum involves:

determining weight loss - via weight measurement
determining electrolyte imbalance - via blood tests

A doctor may also assess overall condition, such as ability to perform daily activities and psychological state of mind. Many women with hyperemesis gravidarum feel ambivalent towards their pregnancy due to their symptoms. (4, 6, 7)

It is also important for other causes of the symptoms of hyperemesis gravidarum to be ruled out. In particular, the following causes should be dismissed:

gastrointestinal problems – such as gastric outlet obstruction from peptic ulcer disease
metabolic disorders such as thyroid problems
diabetic ketoacidosis
Addison’s disease
hypercalcemia
liver problems – such as viral hepatitis
kidney stones
urinary tract infection
neurological disorders
migraines
molar pregnancy
HELLP syndrome
pancreatitis
appendicitis
gallbladder disease (3, 11, 12, 13)

How is hyperemesis gravidarum treated?

In the early stages of hyperemesis gravidarum, the following is advised:

rest
eating small pieces of dry toast, crackers, or bananas before getting out of bed
consuming ginger-containing foods or drinks
eating small meals several times a day and not allowing yourself to get too hungry or too full
eating a diet high in protein and complex carbohydrates and low in fatty foods
eating bland or dry foods
drinking plenty of water
acupressure on the inside of the wrist – this may be done by pressing a finger against the wrist or wearing a special wristband
anti-nausea medications may be prescribed by a doctor, however, it is important that the potential benefits and risks have first been considered (2, 3, 4, 10)

For more severe cases of hyperemesis gravidarum, hospitalization for a few days may be necessary. Whilst in hospital the following treatments may be given:

intravenous (IV) fluids to treat dehydration
parental nutrition (nutrition by vein)
treatment for ketosis (1, 2, 3, 4)

Is hyperemesis gravidarum harmful to your baby?

In most mild cases of hyperemesis gravidarum no harm is caused to the baby. However, severe hyperemesis gravidarum, in particular the weight loss and nutritional deficiencies, may cause problems for fetal growth. This may lead to the baby being born with a low birth weight.

Other problems that may occur as a result of severe hyperemesis gravidarum include:

premature labor
pre-eclampsia
Mallory-Weiss tears – tears to the stomach due to excessive vomiting
Wernicke’s encephalopathy – which causes disorientation, confusion and potentially coma due to a lack of thiamin (1, 2, 3, 6)

If you experience hyperemesis gravidarum in your first pregnancy, will you necessarily experience it in a future pregnancy?

It is thought that around two-thirds of women who experience hyperemesis gravidarum in their first pregnancy will also experience it in a future pregnancy. (14)

Medical Information

Menopause

Menopause (signs, symptoms, diagnosis, treatment)

What is Cholesterol? What Causes High Cholesterol?

What are the functions of cholesterol?

There are three main types of lipoproteins

What are normal cholesterol levels?

Dangers of high cholesterol levels

7 Sex Positions Men Love

Breast Implants -- Through the Armpits

“Breast augmentation was something I wanted to do just for myself”

Breast Enlargement

Breast Augmentation Photos

Breast Implant Surgery

Breast Surgery

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Malaria

The Facts on Malaria

Causes of Malaria

Symptoms and Complications of Malaria

Bones Cancer

What Is Bone Cancer?

Bone cancer facts

What are bones for?

What is cancer?

Cataracts

What Are Cataracts? What Causes Cataracts?

There are two types of cataracts:

Factors that may increase the risk of developing cataracts

What are the symptoms of age-related cataracts?

How are cataracts diagnosed?

Treatment for cataracts

Prevention of cataracts

Complications

What Is Leukemia? What Causes Leukemia?

Function of the bone marrow

Types of leukemia

Symptoms of leukemia

What causes leukemia?

Treatments for leukemia

How common is leukemia?

What is the difference between Leukemia and Lymphoma?

High Blood Pressure

Causes of High Blood Pressure

What causes high blood pressure?

What Causes High Blood Pressure?

Who Is More Likely to Develop High Blood Pressure?

Breast cancer

Breast cancer (symptoms, diagnosis, treatment)

Does Vagina Size Matter?

Recommended Related to Women

Accommodating and Changeable

Muscle Tone

What Really Matters

Syphilis

Syphilis

What Causes Syphilis?

How Common Is Syphilis?

How Do I Know If I Have Syphilis?

How Is Syphilis Diagnosed?

How Is Syphilis Treated?

What if Syphilis Is not Treated?

How Does Syphilis Affect a Pregnant Woman and Her Baby?

How Can I Prevent a Syphilis Infection?

What Is the Outlook for People With Syphilis?

Sex Diseases

HIV/AIDS, Tuberculosis & Malaria

VAGINAL PROBLEM

Vaginal Problems - Topic Overview

Pelvic Pain

Vaginal infections

Vaginal or vulvar problems

Rashes, sores, blisters, or lumps in the vaginal or vulvar area

BREAST CANCER

Causes, incidence, and risk factors

Symptoms

Signs and tests

Treatment

Support Groups

Expectations (prognosis)