Monday, February 6, 2012

Rhinoplasty


Rhinoplasty is a procedure from the beauty surgery, with the nose of a patient can be remodeled. Many people are dissatisfied with their nose. Some like their symmetry does not, others do not agree with their contours. Others are disturbed by a "hump" on the nose, her nose are too small or too big for her face. A nose job can there be a big help. But not everyone who is dissatisfied with his nose, is also suitable for such a cosmetic operation.

How important is the correction of your nose?
A nose job falls into the realm of cosmetic surgeons. So it is in most cases, not medically necessary. The reasons for a rhinoplasty are almost always aesthetic, but also an accident may disfigure the nose so that there will be something medically corrected. As a rhinoplasty is a surgical procedure and any surgery carries a risk in itself, should you really be sure that you want this plastic surgery.

Very important: Get more information!
Who plays with the idea of ​​a nose job, which should prepare themselves mentally to. This includes first of all, that you obtain comprehensive information about this intervention. The more you know about the nose job, the more secure you will be even more quiet and you will be able to tackle the nose job. When searching for information, it is important that you can explain both the advantages and the disadvantages (ie about side effects and risks).
The most convenient and easiest way to find this information is online via the Internet. Here you will find many articles on rhinoplasty and Erfahrungsbereichte of people can read, which have had a nose job is to perform. On the Internet you can look at before and after pictures and see what adjustments are possible with this procedure. The Internet is also a good source of information if you are looking for a practice for cosmetic surgery or a plastic surgeon.

Arrange a consultation
Prior to any cosmetic surgery a consultation is necessary. And that's a good thing. The Internet, you can indeed learn about nose jobs, but never replaced the call with a plastic surgeon. For a consultation, you have the opportunity to ask any questions that arise in connection with the nose correction. The plastic surgeon will tell you exactly what results can reach the nose correction. Using before and after pictures, he will tell you which correction is realistic in your special case. This is especially important: be realistic! If you have unrealistic expectations, you will be disappointed after rhinoplasty may very.
Of course, the doctor will examine you physically and ask you questions about your medical history. He will teach you about risks and side effects and give you tips on behavior before and after surgery. The form of anesthesia is of course discussed also in this context.

You should know how the healing process will proceed.
Some people think that they can admire directly after the nose job her new nose. Which is not so. After the nose job, you will be wearing a bandage, which is usually removed after two days. The nose may be swollen at the time and have bruises. In the first week after the operation there to unpleasant stresses and occasionally also cause pain. Gradually, these things are better but after about two weeks and you can watch the full results of the rhinoplasty.

The best candidate for a nose job is a person who is fully informed about this procedure and go with realistic expectations of a plastic surgeon. You should not allow this operation to make on a whim, but to bring really good reasons for wanting a nose job. A nose job is not suitable for people who suffer from depression and poor self-esteem.

Cosmetic surgery - rhinoplasty
Our nose for our appearance plays a crucial role. Many people find their nose but not as nice. Do you belong to? The most common reasons for a rhinoplasty are the so-called bump noses, which is located on the nose a "bump". Also, too much or too little noses and noses, which have an unpleasant form, are reasons to decide to sign up for a nose job.

By means of a rhinoplasty, the nose may be remodeled. Studies to follow are the best at up to 30 people Expected life. Rhinoplasty is usually performed for aesthetic reasons. More rarely, a correction of the nose from a medical point of view is necessary - but also there is. If there are, for example by the shape of the nose, nasal breathing disorders, the nose surgery is medically justified.

There are many different treatment options in cosmetic surgery. In addition to liposuction, lip augmentation, eyelid drooping eyelids when, facelift and wrinkle treatment with Botox is the nose job with the most desired treatment in plastic surgery.

A rhinoplasty is usually not provided by statutory health insurance. At least not if the reasons are aesthetic in nature for it. Once the nose job but medically necessary, take over the health insurance the surgery costs. A nose job costs about 3,000 euros. The costs depend on but always on the type of correction and the cost of treatment.

For a nose job, general anesthesia is necessary. Some surgeons perform this surgery outpatient and the patient can go on the same day after surgery back home. Mostly, however, hospitalization is recommended. Here, patients have significantly more sleep than at home. Tip: Rhinoplasty cost (in Czech).

For rhinoplasty, you must be 18 years old. The operation lasts between one and three hours. If you are having the surgery outpatient, so make sure someone to drive you home. They even allowed to drive after plastic surgery, no vehicle.
After surgery there may be swelling and bruising on his face. sometimes occurs a slight nosebleed. You can reduce these symptoms, if you strictly adhere to the instructions of your doctor and take care of himself above all.

Rhinoplasty - you should know
The nose job is one of the most difficult procedures in cosmetic surgery. Did you know that a demand of four rhinoplasty surgery for a further readjustment? The decision for a nose job should never be taken lightly.
A nose job (rhinoplasty refers to as) is a method of Plastic Surgeons, which is performed to model the appearance of the nose and to improve Sun Depending on the type of correction, the surgeon uses the incisions inside or outside of the nose. Do not worry: there are none, or remain very small, barely visible scar.
In a so called nasal hump of excess bone or cartilage is removed. The nose and the nasal side walls can be remodeled. If the nose is wrong, it will be addressed during surgery. Sometimes you need to remove any cartilage, but added. The opposite of a hooked nose, a broken nose, which means that there is an indentation on the nose. These can be filled with cartilage and so the nose can be adjusted. Most body's own cartilage from other parts of the nose is used. Less commonly, this is not possible and the surgeon takes cartilage from the ear or the ribs of the patient.
After rhinoplasty, which is usually performed under general anesthesia, the nose gets a dressing. It is removed after about two days. It is very important to the area around the nose to cool well. Periodic cooling may reduce any possible swelling. Keep yourself after a nose job please advice given her surgeon as it may otherwise lead to a deterioration in wound healing or cause infection.
It is very important that you can perform rhinoplasty only by a well trained plastic surgeons. A reputable, experienced doctor will vorschwärmen not only the benefits of a rhinoplasty. He will discuss with you may have about the risks of plastic surgery and tell you what side effects can have the surgery itself and the anesthesia.

For what reasons rhinoplasty be performed?
Our nose is among us as our arms and our eyes. Some of us are born with a well-shaped nose to the world that annoy other since childhood about their hooked nose or a crooked nose. The shape of our nose, we can also affect how much their size. Whether too much or too little nose - it's genetic. We have only two possibilities: either we find from our nose and we opt for a nose job.
Can accept and do not want many people with their nose. The nose is now sitting right in the face once and therefore draws attention to them immediately. Many people who have an ugly nose are exposed to since childhood or youth to the ridicule of other people. That can do hurt a lot and it's only natural that falls at some point the decision: I let my nose surgically corrected.
Different it looks when the nose is malformed right from birth and their actual function can not do justice. This can lead to disorders of nasal respiration. A nose job in such cases is absolutely necessary and medically justified. Even an accident can destroy the whole nose or parts thereof so that the plastic surgeon needs to perform a nose job.
In principle, the nose job are paid out of pocket. It is worthwhile but in any case, check with the insurance company and describe your own personal case. If the correction of the nose is medically necessary, including the statutory health insurance costs is to take it. If desired, however, only de rhinoplasty for aesthetic reasons, the patient must pay the full cost yourself. From € 3,000 cost of a rhinoplasty. Add to this the cost of anesthesia and the cost of a hospital stay may be necessary.
Cases the decision for a nose job never carelessly or on a whim. Sometimes it happens that other people do not like our nose, but even so we have no problems. Then you should not only make the people because of this intervention. The decision for a nose job should always correspond to their own needs and are made only when one has to thoroughly investigate.

Important information for the period after the nose job
A nose corrector (also known as rhinoplasty) is a surgical procedure that corrects the cosmetic surgeon to shape or size of the nose. The surgery itself takes between one and three hours - depending on what exactly should be corrected to the patient's nose. The nose surgery is usually performed under general anesthesia and requires two to three day hospital stay. Tip: rhinoplasty rhinoplasty Munich. In rare cases, rhinoplasty is an outpatient procedure in the practice of a plastic surgeon.

After rhinoplasty, there are some things to consider. We will explain the most important rules for the operation.

- Enjoy after nose surgery alone. In the clinic, you will see this calm rather than at home. If you are back home, so are all you have homework and protect yourself. Make sure that even before the nose job that you have after surgery, a help for the household and for childcare.

- Do you sleep with increased upper body. Even if it is uncomfortable: You should not lie down flat on the nose job. So you can reduce swelling in the face.

- Cool the areas around the nose. Cooling may also help to avoid or at least reduce swelling.

- Avoid physical activities and sports. And this for several weeks after surgery. Then increase the load gradually and only as it gets to you.

- You may shower 24 hours after the nose job again. Be careful and make sure that no water comes up to the nose and the Association.

- Do you need a visual aid, so after the procedure will only contact lenses in question. A pair of glasses, you should only wear resist if your surgeon gives the OK to do so.

Many people look forward to soon be able to admire the new nose job her nose. Here you have to practice patience. In the early days of the nose can look like anything other than beautiful: it can cause unsightly swelling and bruising and nosebleeds can also occur. These symptoms are all normal and no cause for concern. It was not until about two weeks after the nose job, you can see the whole success of cosmetic surgery.
Common questions about nose surgery (rhinoplasty)

A rhinoplasty is a procedure in cosmetic surgery. It comes into use when people are very unhappy with her nose and thus can not resign. In connection with a nose job usually take a lot of questions - we want to try the most of it to give an answer.


 Why Rhinoplasty be performed?
Rhinoplasty can be performed on the one hand, for aesthetic and other medical reasons. Some people find their nose is too small, too big, too wide, too narrow or too pointed, too square ... and some are suffering from a nasal hump or a so-called saddle nose. A nose job can remodel the nose again and give it a nice shape that suits the patient's face.

 Is it necessary for the nasal correction, general anesthesia?
Yes. Most plastic surgeons operate on their patients with this procedure under general anesthesia. Rare is used only local anesthesia. Discuss any questions about anesthesia, please contact your plastic surgeon.

 What are the risks of a nose job?
When the nose surgery can lead to impaired wound healing and infections. Nerves may be affected and consequently it can cause numbness in the face and especially the nose come. It can also cause swelling, bruising and bleeding from the nose. These symptoms usually on their own within a few days after the surgery. Some rhinoplasty nose is built up. There may be a necessary implant use. Implants are usually tolerated very well - in some cases it may also lead to rejection.

 The shape of the nose after rhinoplasty is always what I wanted?
Mostly yes. However, it may happen that the nose has after correcting unsightly bumps. These are usually caused by bone or cartilage tissue and regress almost always alone. Should not that be the case, it must again be a nose job done.

 Is it necessary for a nose job a hospital stay?
Yes, most plastic surgeons perform this surgery through the clinic and recommend hospitalization of two or three days. In the clinic, you have the necessary rest to recover after the surgery and to spare.

 When will the association after the nose job?
All patients who have undergone rhinoplasty want to quickly see the results of the surgery. Until then, you have to wait about two days. Only then, the association comes from the nose.
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Saturday, February 4, 2012

Symptoms and treatment of Psoriasis


Definition
Chronic skin disease, benign, characterized by an erythematous, scaly rash, which evolves in spurts, predominantly on the elbows, knees, scalp.
Psoriasis is characterized by an abnormal proliferation and differentiation of keratinocytes associated with infiltration of the dermis and epidermis by T cells and neutrophils forming microabscesses in the stratum corneum.

Prevalence
Psoriasis is a chronic skin disease which affects around 2% of the population.

Etiology
The etiopathogenesis is still unknown:
- Existence of hereditary factors in particular admitted with an attack family (inconstant connection to certain HLA groups),
- Role of psychological trauma (hormonal changes, stress ..) and infections in the determination of relapses (streptococcal infections),
- Some research suggests that psoriasis results from immune abnormalities.

Symptoms and signs
Psoriasis manifests itself in several ways, most often by the appearance of red or pink skin patches covered with dry scales and whitish more or less thick material that detach discovering a red skin and saignottante.
The plates, especially those present on the scalp, crumble and lamellae white, similar to dandruff, become detached from the epidermis.
Psoriasis is sometimes accompanied by itching and fissures (particularly on the hands and feet).
Particularly serious forms exist:
- Because of the localization: face, folds, genitals, scalp, with palmoplantar or nail,
- Pustular in character: it is localized amicrobiennes pustules on the hands and feet and diffuse or generalized,
- By their extension: generalized forms bearing the clinical features of psoriasis (psoriasis universalis) or taking on the appearance of erythroderma,
- Because of inflammatory joint diseases: psoriatic arthritis, psoriatic spondylitis, inflammatory joint flare accompanying forms generalis

Location

Psoriasis affects certain specific areas of the body:
- The most frequently: The scalp, elbows, knees, back
- The less frequently: the groin, armpits, the palms, soles, nails (which have multiple punctate depressions giving a corner "in thimble"), buttocks, around the navel The inside of the cheeks, the external genitalia.

Diagnosis
The diagnostic elements:
- Location at the extensor surface of the members
- Raised red, scaly plates
- The scales removed with a curette, which gives a whitish spot "in the task of candle"
- Itching is variable and inconstant

In most cases, the diagnosis does not pose a problem. However, some atypical forms and certain locations are more difficult to diagnose:
- Folds psoriasis (inverse psoriasis) that realizes an aspect of chronic intertrigo resistant to usual treatment,
- Nail psoriasis may be mistaken for onychomycosis (in half the cases the two are related),
- Psoriasis of the scalp and face that is very similar to seborrheic dermatitis,
- Guttate psoriasis, eruptive child and adolescent who may be mistaken for a viral rash or pityriasis rosea.
In these particular forms, the biopsy provides only rarely a definitive diagnosis. This is essentially the presence of typical lesions remote, and especially the evolution of chronic lesions that are useful for diagnosis.

Evolution
The age of onset is highly variable, the evolution is undefined, unpredictable, made outbreaks and remissions of varying length and more or less complete (persistence of lesions of the elbows and knees) in which the lesions disappear without scars, hyperpigmentation at best or a stain amelanotic transient.
Some medications worsen psoriasis (blockers, inhibitors of angiotensin converting enzyme - ACE inhibitors, lithium).

Treatments
In the current state of knowledge, there is no treatment that can cure psoriasis and all treatments can only claim a suspensive action. The hopes of radical treatment are related to the discovery of genes responsible for disease.
First look for triggers: infections, drugs.
The treatment of psoriasis limited to a few spots, called first-line derivatives of vitamin D that can be associated with local corticosteroid.
There are also topical retinoid (Tazarotene)
In the most extensive psoriasis, phototherapy is the treatment of choice, whether ultraviolet B (usually narrow spectrum - 311 nm) or PUVA introduces these ultraviolet A decision of psoralen (Méladinine most often).
Finally in severe (generalized psoriasis, erythrodermic or pustular) should be called to Methotrexate, retinoids (Soriatane) or cyclosporin.
These therapies are not without major side effects and require a complete pre-therapeutic and regular monitoring in specialized settings.

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Thursday, February 2, 2012

Influenza Pneumonia


Description
Pneumonia is a generic term used to describe several diseases in which an infection or a chemical cause inflammation of the alveoli. These cavities are filled with fluid or pus, preventing the lungs to transfer oxygen efficiently into the bloodstream.
Before the advent of antibiotics in the 1930s, pneumonia was a leading causes of death. Although it has become easier to treat, pneumonia remains a public health problem.
Pneumonia comes in many different forms with a spectrum of severity varies widely. There are basically four types:
the community-acquired pneumonia (CAP), is the form of pneumonia the most common. It is caused by bacteria, viruses and other acquired outside a hospital or other health care settings;
pneumonia hospital (PH) or nosocomial (NP) said at least 48 hours after admission to a hospital. It can be triggered by bacteria or other organisms different from those usually are the cause of community-acquired pneumonia. Hospital pneumonia is usually more serious than community-acquired pneumonia because the presence of bacteria and organisms can make it more difficult to treat, and because it strikes people are already sick;
aspiration pneumonia is caused by the inhalation of liquids or other irritants in the lungs. Aspiration pneumonia is the most common is caused by the inhalation of the contents of the stomach after vomiting. People who have health problems (eg. A stroke, Lou Gehrig's disease) that affect swallowing are more susceptible to this type of pneumonia;
Opportunistic pneumonia reached the people who have a weakened immune system (eg. by AIDS, cancer, organ transplant). The organisms that cause these infections do not normally affect people enjoying healthy immune systems.
The healthy people aged under 65 will rarely serious complications following pneumonia. People with chronic lung disease or whose immune systems are generally at higher risk of pneumonia.


Causes
The most common causes of pneumonia are caused by infections:
bacteria - the most common cause of pneumonia in adults;
viruses - virus pneumonia especially for children;
mycoplasma - these microorganisms to the characteristics of viruses and bacteria cause less severe infections;
microorganisms opportunistic - a threat to people with weakened immune systems (eg. Pneumocystis carinii pneumonia in AIDS patients).
Most forms of pneumonia are transmitted in the same way as influenza or the common cold, that is to say by the contact of hands and by tiny droplets from the mouth and nose. In fact, the same viruses that cause colds and flu can also cause pneumonia. When these viruses infect the throat, sinuses or upper respiratory tract, it is a cold. If the virus reaches the lungs is pneumonia.

Bacteria that are present at all times in the throat (or pharynx) cause many people some of the most serious forms of pneumonia. Under normal conditions, the immune system effectively combat these bacteria. By cons, if the immune system is weakened by a virus in the pharynx, these bacteria can invade the respiratory tract. Bacterial pneumonia is most often caused by the bacterium Streptococcus pneumoniae (pneumococcus).
Most pneumonia affecting infants and young children are caused by respiratory syncytial virus (RSV). The incidence of this disease is increasing sharply in December and January, but it does not life threatening. Viruses cause about half of all cases of pneumonia.
Mycoplasmas cause a disease called "walking pneumonia", so called because the people affected are not confined to bed.
A fungus called Pneumocystis carinii is not normally found only in people with AIDS. Under normal conditions, this fungus is harmless, but in people infected with HIV, it can cause an aggressive and often fatal pneumonia.
In addition to infectious diseases, pneumonia can be caused by chemicals that enter the lungs and cause inflammation. Aspiration pneumonia is caused by accidental aspiration of food, vomiting or stomach acid into the lungs. The inhaled substance may become infected, or it may inflame the lungs and cause a consolidation (the alveoli fill with fluid).

The risk of pneumonia is higher in the following cases:
younger than 1 year or greater than 65;
smoking;
the presence of a cold or flu;
a weakened immune system due to cancer treatment, an HIV infection or other illness;
surgical treatment;
an addiction to alcohol;
a chronic condition like heart disease, lung disease or diabetes;
chronic lung disease, eg. asthma or chronic obstructive pulmonary disease.

Symptoms
Symptoms of pneumonia vary depending on its cause and the general health of the person affected.
Pneumonia always causes a cough, and it is often productive, that is to say, it is accompanied by sputum. Sputum of a reddish brown, green or yellow can be a sign of bacterial infection. Clear and whitish sputum is a possible sign of infection with a mycoplasma.
In bacterial pneumonia, the lungs, in whole or in part, slowly fill with liquid, this is called consolidation. Some bacterial lung infections settle in a few hours. There is usually a high fever that sometimes reached 40.9 ° C (105 ° F).
Here are some other possible symptoms of bacterial pneumonia:
shortness of breath;
tremors,
chills,
a headache,
delirium (the confusion),
a very bad breath,
muscle pain,
weakness,
a chest pain, especially deep breathing,
blue lips and nail beds due to lack of oxygen in the blood.
Viral pneumonia does not cause fluid accumulation in the lungs, it causes more inflammation of the lung tissue itself. It is usually less severe than bacterial pneumonia. Pneumonia caused by influenza viruses can be very serious and is an exception to this rule.
Viral pneumonia produced the characteristic symptoms include:
dry cough,
little sputum,
headaches,
muscle pain,
weakness and fatigue,
moderate fever, up to 39 ° C (102 ° F),
shortness of breath;
blue lips and nail beds.


Treatment
Bacterial pneumonia can be treated with antibiotics, as well as pneumonia caused by mycoplasma. It is extremely important to take antibiotics exactly as prescribed by your doctor and complete the full treatment, even if you feel better. There is no cure for most viral infections, we must simply wait until the body gets rid of. Your doctor will advise you on ways to relieve the symptoms of viral pneumonia. Fungal infections can be treated with antifungal medications.
There are four ways to prevent pneumonia. The first is to adopt a diet rich in fruits and vegetables, stay physically fit and get enough sleep. These measures help to preserve the strength of the immune system.
The second way is vaccination. There is no vaccine against most forms of pneumonia, but the two most common forms are preventable with vaccines: a vaccine against the flu virus and the vaccine against pneumococcus. In Canada, it is recommended that the entire population be vaccinated against influenza each year. In some provinces, influenza vaccine is administered free of charge. In addition, a new vaccine against pneumococcus has been developed to protect children against Streptococcus pneumoniae and is now recommended as part of the primary vaccination in infants.
The third way to prevent pneumonia is to consult the doctor when coughing continues to deteriorate after three or four days. Consult your doctor immediately if your sputum contains blood or have an unusual color or smell. While the initial disease was a common cold, bacteria can easily cause a secondary infection resulting in a severe pneumonia.
The fourth way to prevent the spread of viruses and bacteria that can cause pneumonia is to wash your hands thoroughly and frequently.


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Wednesday, February 1, 2012

Pancreatic cancer, symptoms and treatment


Introduction
Pancreatic cancer is the fifth cause of cancer death in industrialized countries. It affects more men in general over the age of 50 years.
It affects almost always part of the gland that secretes digestive enzymes.
This is a very serious tumor whose chances of recovery are low because usually when symptoms appear, the tumor was already advanced, not eradicate.
Often, indeed, the tumor has already formed metastases in the lymph nodes or the liver or other organs.


Symptoms
Unfortunately, pancreatic cancer is often diagnosed when it is already at an advanced stage.
However, the possibility of total resection of pancreatic cancer now include early diagnosis. This early diagnosis can be achieved by selecting patients with known high risk of developing this disease, as patients with chronic pancreatitis or diabetes for example.
The symptoms of pancreatic cancer are still unusual and occur most frequently by:
weight loss and appetite,
Acute back pain,
dark urine,
colored stools,
superficial phlebitis or thrombosis,
a depression,
jaundice or jaundice when there is compression of the bile ducts.


Risk factors
Smoking is certainly a risk factor, smokers are much more affected than non-smokers.
In countries where the diet is high in fat, the incidence of pancreatic cancer is higher.
Coffee and alcohol are also implicated but the current data do not mean to establish a direct relationship with pancreatic cancer.
Finally, people with chronic pancreatitis have a high risk of developing this cancer.


Diagnosis
The diagnosis must be made ??at an early stage, and the classification is based on staging.
Imaging techniques have become essential with:
ultrasound,
CT or MRI
endoscopy and endoscopic ultrasonography.
These have greatly improved the visualization of vascular invasion, a major element of operability or not.
The scanner also provides sensitivity in addition to the location of the tumor, its staging


Treatment 
Surgical removal of the tumor is the only chance of cure for the disease where the tumor is confined to the pancreas, this procedure does, however, that 25% of patients.

The procedure involves removal of part of the stomach, gall bladder, part of the biliary tract, head of the pancreas and the entire duodenum.

Most patients whose tumor is advanced jaundice or jaundice due to compression of the bile ducts. If the tumor compresses the duodenum also, it can make difficult the passage of the bolus in the gut. Surgery in these cases can relieve the patient by performing biliary bypass or stomach directly into the small intestine.


1. The treatment of locally advanced or metastatic cancers
Chemotherapy

Very few products of chemotherapy showed effective anti-tumor activity when used in mono-chemotherapy for pancreatic cancer is known to be chemo-resistant. Some molecules such as Gemcitabine or Docetaxel is increasingly used.
In terms of poly-chemotherapy, a few new combinations but recent assessment provides hope.
Chemotherapy aims to improve the quality of life by reducing symptoms associated with the disease.

Radio-chemotherapy

The combination of concomitant radio-chemotherapy is often used in locally advanced non-operable but not metastatic.


2. Adjuvant treatment
The effectiveness of adjuvant chemotherapy after surgery has not yet been demonstrated.
The post-operative radiotherapy plus or minus associated with concomitant chemotherapy potentiation is often used in high-risk forms.
Radiotherapy reduces the abdominal pain experienced by many patients but it is much more effective than injection of analgesics.
In conclusion, the conventional medical treatment retains an even limited support for adenocarcinoma of the pancreas. Clinical research is active in this area.


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Tuesday, January 31, 2012

Cancer of the cervix


Description
The cervical cancer affects the cervix is ??an organ of the female genital tract. Although it is at the top of the vagina, it is the lowest part of the uterus (womb).
The term cancer refers to a type of disorder characterized by abnormal cell proliferation and uncontrolled. The cervix is ??made up of healthy cells particularly susceptible to abnormal cell changes. The term applies to tumor or neoplasm cells in abnormal development. Tumors may be noncancerous (benign) or cancerous (malignant). A benign tumor does not invade the tissues or organs nearby and it does not usually reappear after being removed. By cons, a malignant tumor can spread (eg. From the cervix) and infiltrate other tissues or spread to other organs.
The cervical cancer is the second type of the most common gynecological cancer in North America. The incidence of cervical cancer has declined dramatically since the 1950s. Testing performed using the Pap test (also known as Pap smear) is a factor that played a role of major importance in the decline. The Pap test can detect changes in cervical cells.
As mentioned previously, some of these changes are not cancerous, but a few of them can become cancerous. If precancerous cells are not detected and no treatment is used, they can develop into cancer that invades the uterine cervix. Therefore, regular screening using the Pap test for early detection of precancerous cells and the institution of treatment before the cells become cancerous.
It is estimated that each year 1,300 new diagnoses of cervical cancer are laid in Canada. Among the patients, 390 women die from this cancer. The lifetime risk of cervical cancer is estimated at 1 in 148 for a resident of Canada. Almost all cervical cancers can be cured happily when the diagnosis is raised at an early stage. The cure rate of cervical cancer in stage 1 (invasive cancer confined to the cervix) is between 80% and 90%.
Since some types of human papillomavirus (HPV) can cause cancer of the cervix, a vaccine against HPV is available in Canada since 2006. It is desirable that the female population aged 9 to 26 years receive the vaccine against HPV to protect against strains of HPV responsible for about 70% of cervical cancers.
Most cases of cervical cancers can be prevented or cured when they are detected in the initial stages.

Causes
Some factors increase the risk of cancer of the cervix. Until now, it is not clear what causes cell abnormalities and their uncontrolled proliferation.
HPV: The most important risk factor is an infection of the cervix with HPV. An HPV infection is one of the most common sexually transmitted infections (STIs). An estimated 75% of people of childbearing age will be affected at least one time in their lives by an HPV infection. While some types of HPV cause genital warts, some strains of the virus can infect the cervix and cause abnormal cell changes that lead to a slow cancer. It should be noted that most women with cervical cancer have suffered previously from an HPV infection, but all women with a disease with HPV do not develop this cancer.
Sexual activity: sexual life early (before age 18) was associated with an increased risk of cervical cancer. In addition, certain sexual behaviors (like many sexual partners or a partner with multiple sexual partners) may increase the likelihood of HPV infection, and therefore the risk of cervical cancer.
Smoking: People who smoke are at greater risk of cervical cancer and other cancers. The occurrence of cervical cancer was also associated with smoking and exposure to secondhand smoke (environmental tobacco smoke). In fact, the risk increases with duration of smoking and the number of cigarettes smoked daily.
Weakened immune system: Our immune system helps your body fight infections. Therefore, drugs and diseases that weaken the immune system may increase the risk of HPV infections and the possibility of cervical cancer. Drugs that weaken the immune systems are corticosteroids (long term) and chemotherapy drugs. Women infected with human immunodeficiency virus (HIV) are at higher risk of precancerous changes in the cervix when they become infected with HPV.
Diethylstilbestrol (DES): DES is a form of estrogen that was prescribed between 1940 and 1971 in pregnant women. According to some studies, daughters of these women at increased risk of precancerous changes and squamous cell carcinoma of the cervix.
Age: most cervical cancers tend to affect women who are under 50 years.
Socioeconomic status: it is less likely that Pap tests are carried out regularly among women with lower incomes, they are therefore at higher risk of cervical cancer.
Other risk factors: other possible risk factors were associated with an increased risk of cervical cancer. However, there is insufficient evidence at present to keep them as major risk factors. These factors include prolonged use of oral contraceptives (more than 10 years), family history of cervical cancer and STIs in the background.

Symptoms and Complications
Symptoms do not always occur during the initial stages of cervical cancer. It is very important to note that another condition may trigger symptoms similar to those of cervical cancer:
abnormal vaginal bleeding or spotting between periods;
of pain during sex or bleeding after intercourse;
serous vaginal discharge with light or nauseating;
an increased amount of vaginal discharge.
At later stages, symptoms may occur as tumors grow or invade other organs:
pelvic pain or back;
Leakage of urine (incontinence) or blood in the urine (hematuria);
weight loss;
loss of appetite or anorexia;
shortness of breath;
anemia (causing a lack of energy and shortness of breath);
blood in the stool;
of constipation.

Diagnosis
The cervical cancer is detected primarily by the Pap test. It is used to highlight cancer or precancerous cells that could lead to cancer. This review is named after its inventor George Papanicolaou.
The Pap test is a rapid and simple method which does not usually cause pain. A doctor rubs the surface of the cervix using a small brush or a spatula to collect cells that are then examined in a laboratory.
If the Pap test show a transformation or abnormalities in cervical cells, additional tests or surgical procedures could take place. Your doctor will tell you what tests or interventions suit you best:
another Pap test in a few months to see if the changes persist;
a test for HPV can occur in combination with the Pap test to highlight a cervical cancer. It may be a further review if the Pap smear abnormalities. Since the majority of cervical cancers start with a HPV infection, this review can detect the virus in cervical cells. Specifically, the HPV test determines whether a woman is infected with one HPV type likely to cause cervical cancer;
colposcopy performed using a colposcope (an instrument with a light and a dissecting microscope) examines the cervix. A dye is applied on fabrics to make more visible abnormalities;
biopsy involves extracting a small amount of tissue to be dealt with in a laboratory that will confirm if the cervical cells are benign, precancerous or cancerous.
At present, it is recommended to the Canadian women aged 18 to 69 years (or under 18 who are sexually active) to perform regular cervical smears for screening. The Pap test should be performed one time each year or one every three years, according to screening guidelines in force in your jurisdiction, and the results of your previous review. Women at high risk of cervical cancer may need more frequent testing. Ask your doctor how often a Pap test should occur to you.

Treatment and Prevention
Treatment options given in the case of cervical cancer include surgery, radiotherapy and chemotherapy.
The treatment decisions are made by an oncologist (a doctor specializing in cancer) according to the following factors: the size of the tumor, cancer stage (severity or presence of precancerous changes), personal factors of women (eg. his age, his desire to have children), his general health and any previous treatment. The oncologist will discuss treatment options that best suit a particular case.

Surgery
Cryosurgery is a method of destroying abnormal cells by freezing them with liquid nitrogen. This type of surgery is usually performed to treat precancerous cervical changes.
Laser surgery uses a high energy beam to destroy abnormal cells. It can destroy the precancerous or cancerous cells. Laser surgery is usually performed when the area of ??the cervix is ??injured can not be achieved by cryosurgery.
The loop electrosurgical excision is an ablation technique performed under local anesthesia through a small loop of fine wire metal driven by electric power.
Hysterectomy is surgical removal of the uterus. It is required in the case of invasive cancer (tumors more scalable or larger). Other organs such as ovaries, fallopian tubes, lymph nodes and parts of the vagina can also be removed simultaneously. There are different types of hysterectomy:
total hysterectomy, which involves extracting the cervix and uterus;
radical hysterectomy that includes removal of the cervix, uterus, the upper vagina, supporting tissues and lymph nodes.
Radiotherapy
Radiation therapy involves the use of high-energy radiation, or to particles of radioactive elements to destroy cancer cells in a localized area of ??the body. Radiotherapy is to kill cancer cells while sparing normal cells nearby.

Chemotherapy
Chemotherapy can be used in combination with radiotherapy. Chemotherapy has at least one anticancer drug that prevents cancer cells from dividing and reproducing. It can seek in the treatment of metastatic cancer (which spread to other organs) and recurrent tumors.

Prevention
Women can minimize their risk of cervical cancer by not getting an HPV infection. The virus is most commonly transmitted by sexual contact and during sexual intercourse. By refraining from touching the genitals of an infected person, and using a condom will reduce the risk of HPV infection. It is important to remember that condoms are relatively effective because they only protect the body part they cover. Other forms of female contraceptives like birth control pills, diaphragms and IUDs do not protect women against infection with HPV.
When a woman who used to smoke to quit, it decreases the risk of cervical cancer.
Vaccination is another way to prevent cervical cancer. The first vaccine against HPV in the world has been approved in Canada and the United States in 2006. Vaccination provides immunity against four different HPV types. It is estimated that these two types of HPV cause 70% of cases of cervical cancer.
The vaccine is currently available for females aged 9 to 26. Since the vaccine is more effective for women who have not yet been exposed to HPV, it is preferable that the women receive before they n'amorcent their sex lives. But women who are already sexually active can also take advantage of the benefits of the vaccine if they have not contracted HPV. The vaccine is given in three doses over a period of 6 months.
Whereas the vaccine does not confer protection against all types of HPV that can cause cervical cancer, it is essential that a regular Pap test is done to prevent a disease caused by HPV infection.

[ source ]
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Monday, January 30, 2012

Eczema: Diagnosis and treatment


pic from Wikipedia 
Diagnosis
In most cases the diagnosis of AD is clinical and requires no further exploration. In atypical forms can be used in certain laboratory tests (specific IgE, Phadiatop, etc..) And allergy.
Prick tests to aeroallergens (mites, pollens, etc..) And food allergens (food).
Lower cost, they have almost the same sensitivity and same specificity as the measurement of specific IgE.
An exploration allergy will be decided when the lesions persist despite treatment well followed, or when lesions appear on atypical locations of atopic dermatitis. It may include depending on the etiology suspected, the installation of patch tests in search of contact sensitization. Tests to foods, supplemented if positive tests for reintroduction are considered mainly in children and severe forms of eczema.
The allergens most frequently found in atopic dermatitis of the child in order of frequency are: egg white, peanut, mustard, cow's milk and fish.
Photobiological exploration will be considered in case of worsening during sun exposure.

Complications
Superinfection of lesions and exudative excoriated.
Bacterial and fungal favored by itching, scratching and corticosteroids.

Viral.
Kaposi's sarcoma-Juliusberg varioliform or pustulosis. This is a serious complication caused by a skin-tropic virus, usually herpes (primary infection mainly), rarely coxsackie and influenza. The eruption highly febrile with altered general condition, occurs in a exacerbation of atopic dermatitis. It begins quite suddenly on the face and then spreads in the form of vesiculo-pustules varioliform umbilicated, necrotic and hemorrhagic.
The evolution is favorable in antiviral. Complications from visceral dissemination are now rare (herpes encephalitis).
Prevention in atopic thrust should be the removal of all about the environment herpes.

Warts, multiple and chronic molluscum contagiosum frequent and profuse.

Erythroderma: sometimes secondary to an abrupt withdrawal of corticosteroids or local extent of corticosteroids (cons-indicated).
Relationship problems. Possible complications secondary to psycho chronic itching in erythematous skin or oozing lichenified must be taken into account in the treatment of atopic dermatitis.


Treatment
The treatment consists of several points: the treatment of pressure that will appeal mainly to topical corticosteroids, and treatment of etiology when possible (foreclosure of a contact allergen, elimination of aggravating factors). This treatment is not always easy to explain and must therefore be assured that it was well understood by the patient.

Treatment of eczema flare: antisepsis, topical steroids and antihistamines.
Antisepsis and potentially draining lesions. Be used antiseptics colorless and low awareness such as chlorhexidine, silver nitrate 0.5% in water (weeping forms), etc.. The mercury derivatives, hexamidine potentially allergenic will be avoided. Topical antibiotics are not necessary in uncomplicated forms.
1. Local corticosteroid.
Corticosteroid therapy is generally essential for the treatment of eczema flare, and it must be short to avoid the complications and habituation. Creams are preferred for areas hairless and child, ointments for very dry forms, and lotions for hairy areas. The application method can be done according to several schemes: one twice daily for 5-7 days with gradual reduction over a week, or morning and evening for five days, in the evening for 5 days, 1 night of 2 for 8 days.

2. Tacrolimus (Protopic)
This new treatment can be an alternative when there is a failure of topical corticosteroids. It does not cause skin atrophy and can be used on the eyelids without risk to the eye. However, it induces side effects, the most important thing is irritation sometimes requiring discontinuation.
It can be prescribed by dermatologists and pediatricians on special orders.
3. Antihistamines.
They are often very effective, but may be associated with the start of treatment in cases of pruritus bothersome.
[ source ]


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Sunday, January 29, 2012

skin cancer


Description

The skin cancer is the cancer most common in Canada. It is estimated that each year about 75,000 people in Canada are diagnosed with skin cancer in non-melanoma, and this number continues to rise.

The skin cancers are classified into three types: basal cell carcinoma, squamous cell carcinoma, and melanoma. This article focuses on the first two forms of skin cancer, known both as the "cancer of the skin non-melanoma". Unlike melanoma, the mortality rate for cancer of the skin of non-melanoma is low and is often treated very easily. For information on melanoma, please see our Melanoma article.

Basal cell carcinoma (BCC) is the only skin cancer the most common, but also the most common form of cancer. It grows from the basal (deepest) of the epidermis (the outer layer of skin). Cancer cells almost always appears on sun-exposed skin areas like the forehead, hands, lips, or the top of the pinna. BCC makes up about 75% of all skin cancers non-melanoma. There are three main types of BCC:

superficial basal cell carcinoma (CBS): This type of cancer often appears on the chest and upper body (torso) and possibly in the face. In most cases, it is a well-circumscribed scaly patch that looks like eczema. It is often surrounded by a raised edge of pearly color.
Nodular basal cell carcinoma: This type of CB appears on areas exposed to sunlight, including the head and neck. It has the form of a lump usually pink or pearly.
morpheaform basal cell carcinoma: This type of CB appears as ivory scar in areas that have never undergone surgery or injury. The tumor is slightly raised and waxy, often white or yellowish. The outline of the tumor is not accurate.
There are also two more unusual types of BCC: pigmented (tattoo) (similar to nodular BCC, but with white and brown pigmentation) and cystic BCC (bluish-gray with liquid center).

Squamous cell carcinoma is less common than basal cell carcinoma, but still represents the second form of skin cancer the most common. It grows from the top layers of the skin, and it occurs most often on sun-exposed surfaces.

Other cancers such as Merkel cell carcinoma, Kaposi's sarcoma or cutaneous T-cell lymphoma are cancers of the skin very rare, representing approximately 1% of cancers of non-melanoma.


Causes

Like melanoma, basal and squamous cell carcinomas are associated with a significant exposure to sunlight. Most people accumulate the majority of their total exposure to sunlight during childhood, and studies have shown that even a single sunburn in childhood increases the risk of skin cancer later in of life. But there is no need to catch a sunburn to suffer skin lesions. A tan is a sign of skin damage caused by ultraviolet (UV).

In Canada, skin cancer is rare in people under 40. Sunbathing at the origin of skin tumors were taken mostly 30, 40 or 50 years ago. In Australia, where people are much more exposed to ultraviolet radiation from an early age, skin cancer strikes people in their twenties and thirties.

People with fair skin, blond or red hair, blue eyes or green, who have freckles, or who tan easily are at higher risk of cancer of the skin because their skin is less pigmented and they are less well protected from the sun.

In general, tumors are formed when the DNA of a healthy cell undergoes a mutation that causes deregulated cell proliferation. Scientists now believe that in basal cell carcinoma, a gene called PTC is damaged by UV radiation. Under normal conditions, this gene induces the production by the cell of a protein that prevents reproduction of adjustment. A similar scenario may be at work in the case of squamous cell carcinoma.

Other causes of skin cancer, stress X-rays, skin contact with arsenic or radium, or simply bad luck. Even if a person is poorly exposed to sunlight, an error can occur spontaneously in cell division. We also know that a sexually transmitted cancer-causing virus, human papillomavirus (HPV) can cause a rare form of squamous cell carcinoma.


Symptoms and Complications

Basal cell carcinoma (BC) generally appears to skin sites exposed to sunlight. It first appears as a small blister pink and round, but that depends on the type of CB (eg. Superficial, nodular or morpheaform). Over time, the tumor can continue to grow and after a few months or years, it is sometimes surrounded by tiny blood vessels, but visible. The lesion often forms crusts repeatedly, and then cured, forming new crust. The crust formation is sometimes accompanied by bleeding.

If the lesion is not treated, its appearance can be very different, because cancer cells destroy the skin. The lesion takes the appearance of a bite, in which case, the tumor is called a rodent ulcer.

The CB is the type of superficial basal cell carcinoma the least aggressive, whereas the CB morpheaform is the most aggressive and most dangerous of these cancers. The CB surface develops outside its border (edge) and damage over time, the surrounding tissue. Since the CB surface develops slowly, people do not always consult their doctor immediately. Detection and early treatment are often the best way to increase its chances of survival in many types of cancer. The CB nodules have irregular contours and often remain flat. This type of cancer often causes bleeding followed by crusting or flaking. The CB morpheaform develop rapidly and are more difficult to treat.

Squamous cell carcinoma usually begins with a small hard mass. In most cases it develops from actinic keratosis (AK), a rough, scaly lesions of the skin that appears on the surface of the skin exposed to sunlight. It can be the same color as the surrounding skin, but it can also be brown, pink or red. The KA is simply an alteration of the size, shape and organization of skin cells. Because they can cause skin cancer, we recommend screening and treatment of KA as soon as possible.

Squamous cell carcinoma is characterized by redness, scaling, crusting or ulcers. In addition, it can cause itching and be slow to heal. Gradually, as the tumor of squamous cell carcinoma grows, the skin tends to degenerate and becomes scarred tissue. The tumor bleed easily if scratched, without it being painful so far. Squamous cell carcinoma is more likely to develop in the form of metastases (spread to other parts of the body) that the CB. Fortunately, early treatment increases survival and healing.

Complications arise when the tumor invades the tissues that have other functions, such as tissues of the mouth, anus or eye. In general, cancers of the mucous membranes (eg. The lips) are more likely to develop into metastases (spread of the disease to other organs). Similarly, cancerous tumors that sit between your fingers or between the index finger and thumb or the first phalanx (before the first joint of a finger) may also be further developed in the form of metastases. Metastases are unlikely in these cancers.

Although basal cell carcinoma or squamous cell carcinomas rarely cause death, these tumors can disfigure the patient. Untreated, cancer can develop and cause disfigurement. Treatment can sometimes disfiguring the patient if a large amount of skin tissue to be excised.

diagnosis

The skin cancer is diagnosed by microscopic analysis of a sample of skin taken from the bump or spot suspicious. This is called a biopsy. Under normal conditions, it is not necessary to perform complex tests to determine if the cancer has spread to other parts of the body as it rarely happens.

There are three types of biopsies to confirm the diagnosis of cancer of the skin non-melanoma. They include:

biopsy surface
biopsy punch,
excision.
Depending on the biopsy, removing a portion or all of the tumor. All of these biopsies require local anesthesia.

Treatment and Prevention

Is usually treated skin cancer by surgery. However, the doctor never told the patient that the cancer is completely cured, because there is always a risk that the cancer will return if cancer cells have invaded parts and tissues adjacent to the tumor. Surgeons typically cut an extra margin around skin tumors to reduce the risk of recurrence.

Tumors at high risk, such as tumors of the hand or lip, is often excised by Mohs micrographic surgery, which allows a surgeon to remove skin layer by using a microscope to accurately follow the contour the cancer. This technique reduces the risk of recurrence.

Sometimes the tumors are destroyed by the application of liquid nitrogen (cryogenic) or using a laser that burns the tumor. In addition to surgery, radiotherapy and chemotherapy are suitable for the treatment of cancer has recurred or in the case of metastatic potential.

Topical medications (applied to the skin) are sometimes used to treat basal cell carcinoma (BC). Topical medications include 5-fluorouracil (also known as fluorouracil) and imiquimod. 5-fluorouracil (5-FU) belongs to the group of medicines known as topical antineoplastics. It works by inhibiting the growth of cancer cells. Imiquimod belongs to a new group of topical medications called biological response modifiers. This type of drug works by stimulating the immune system to produce substances that fight cancer.

In cases where the cancer has spread to other parts of the body, chemotherapy may be used in combination with other treatments such as radiotherapy and surgery. The doctor decides on the appropriate mix for each individual based on their medical history.

To prevent skin cancer, protect your skin against the sun by wearing long clothing and using sunscreen with an SPF of at least 15 (SPF 15) that filters out UVA and UVB rays. Apply a generous amount of sunscreen on your body at least half an hour before going outside. Check your skin every month to detect changes, growths or sores that do not heal. If necessary, consult a doctor as soon as possible.



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The thyroid cancer


The thyroid cancer usually develops in the form of a nodule in the thyroid gland it is normal or increased in size (goiter). This is a rare cancer, most common in young patients with good prognosis in papillary form since healing occurs in 90% of cases.

 Epidemiology
The thyroid cancer is a rare cancer. It represents approximately 1% of cancers occurring in the general population in France. Its annual incidence is low or about 2.5 per 100 000 people.

The network "Francim" cancer registries set up to monitor the incidence and analyze the role of the Chernobyl accident, has made an update of data on thyroid cancer. This update covering the period 1978-1997 indicates in particular that the increase in thyroid cancer is about 6.2% per year in men and 8.1% per year in women.

The prevalence of thyroid nodules is variable according to the means testing. It is more common in women, the elderly, individuals living in areas of iodine deficiency or who have undergone irradiation of the neck during childhood but these nodules are benign in more than 90% of cases. Young subjects are more susceptible to cancer because of greater sensitivity of the thyroid to radiation.

 Classification

The classification of the disease is important because of its determination follows the diagnostic and therapeutic approach.
1 / TNM Classification

Primary tumor:

T0: no palpable tumor
T1: tumor limited to a single lobe or the isthmus, mobility intact, no deformation of the gland
T2: single or multiple tumor distorting the gland intact mobility
T3: tumor beyond the gland or fixed or infiltration device

Cervical lymphadenopathy:

N0: no palpable lymphadenopathy
N1: one or more lymph nodes, palpable, mobile, ipsilateral
N2: contralateral lymph and / or bilateral, mobile
N3: One or more nodes attached

Visceral metastases:

M0: no metastases detectable
+ M: metastasis detected

2 / histological classification

Following the international histological classification, there are four main histological types of thyroid carcinoma:

The papillary carcinomas,
the follicular carcinomas (or follicular, Anglo-Saxon term)
the medullary carcinomas,
the squamous anaplastic (or undifferentiated).
These tumors may be solitary or multifocal.

Papillary cancers are more common. They predominate in young subjects and about 80% of thyroid cancers.

Gallbladder cancers represent about 10% of thyroid cancers and are especially common around the quarantine.
Papillary and follicular cancers represent the group of differentiated thyroid cancers radiosensitive. They secrete thyroglobulin.

Medullary cancers account for 5% of thyroid cancers and correspond to a tumor or parafollicular C cells derived from neural crest. C cells secrete calcitonin, which the immunoassay in plasma is an excellent marker for this cancer.

Undifferentiated or anaplastic cancers are rare (less than 5% of cases) and extremely serious.

There are other much less common histological types: squamous metaplastic squamous, connective sarcoma, lymphoma ...

 Risk Factors

Sources: Institut de Veille Sanitaire - Epidemiological surveillance of thyroid cancers.

The risk factor most recognized is that of external irradiation of the thyroid gland in adulthood and childhood. Other factors were mentioned but none of them has clearly established a causal role in thyroid cancers. It was noted in particular:

The endemic goiter by iodine deficiency.
Food: the risk increased slightly by eating fish or shellfish in areas without iodine deficiency. Crucifers contain compounds that can interfere with thyroid metabolism.
Some drugs, such as pentobarbital, griseofulvin, spironolactone, have been implicated in thyroid cancer.
Occupational factors: it was noted an increased risk for certain occupations exposed to X-rays, and in women of fishermen in Norway (consumption of fish or seafood).
Individual factors: hormonal and reproductive factors in women - thyroid disease (the presence of a goiter or thyroid nodules is strongly associated with risk of thyroid cancer, Hashimoto's thyroiditis also seems to be a predisposing factor for lymphoma thyroid).
Family factors: familial forms of cancer are well described for the rare forms of medullary thyroid cancer, as part of MEN syndrome (multiple endocrine neoplasia).
 Diagnosis

The most frequent clinical form of thyroid cancer is the single thyroid nodule. The diagnosis is based on nodule palpation neck that will search for items suspected of malignancy as an irregular, hard nodule.
Palpation can also provide information on the shape and volume of the thyroid gland, to assess the consistency of the thyroid tissue, its potential sensitivity, and mobility training in relation to the thyroid tissue adjacent. The cervical lymph nodes and supraclavicular must be systematically examined.

In addition to the history and palpation, the differential diagnosis is done using the diagnostic tests:

Laboratory tests. The dosage of thyroid stimulating hormone (TSH) gives indirect information on thyroid function. Calcitonin is a good marker of medullary thyroid cancer type.
The fine needle aspiration cytology (CAF). Performed by an experienced cytologist is examining the most reliable and least invasive to distinguish malignant nodules from benign nodules with a specificity and sensitivity of 95%.
Ultrasound allows the description of a suspected nodule on palpation: situation in the gland, measurements, solid character, fluid or mixed echogenicity, an isolated or combined with other nodules.
Scintigraphy is indicated when there are signs of hyperthyroidism, in search of a toxic nodule. It is not necessary when the nodule is infracentimétrique.
 Treatments

1 / surgery

In the presence of a malignant thyroid nodule, the basic treatment is surgery. Shall include at least the removal of the lobe bearing the lesion and adjacent isthmus. Treatment of medullary thyroid cancer requires a specific act consisting of total thyroidectomy with at least one of the central compartment lymph node dissection. In all cases, these actions must be performed by a surgeon trained. Complications, hypoparathyroidism or laryngeal paralysis are rare.

2 / I-131

If he persists in the residual functional tissue, a dose of 1.11 to 3.7 GBq (30-100 mCi) of iodine-131 is administered in single room, 4 to 6 weeks after total thyroidectomy, in order to sterilize all.
40% of metastases of thyroid cancers bind iodine and can be treated by this method.

3 / hormone therapy

After total thyroidectomy and sterilization of the thyroid with iodine-131, is administered thyroxine, a hormone inhibiting the secretion of TSH. The dosage is 100 to 200 mg / day following the patient's clinical status.
This hormone also helps to ensure an adequate balance in terms of thyroid function.

source
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Hepatitis A, reduce the risk



Hepatitis A is spread primarily by the absorption of food or water contaminated by feces. Precarious hygiene thus favors the transmission of the disease. But to protect themselves from the virus, the vaccine against hepatitis A is very efficient. That vaccine? On what occasion? The point to avoid contracting a "yellow".

  3rd Day hepatitis: Bounce!

Hepatitis A supervised

Since January 2006, physicians and laboratories are required to report hepatitis A cases to health authorities. Abandoned in 1984, this special surveillance becomes valid when the rare cases occur more often late with more serious consequences.
Read our article

Hepatitis A: which vaccine?

Hepatitis A hits every year several million people each year worldwide, some countries are more at risk than others. Also recommended vaccination in France for some people is also recommended for travelers staying in endemic areas.
Read our article

Traveler's immunizations

Before going abroad, it is necessary to use caution. In this area, it is essential to verify your coverage. You should talk with your doctor before you leave for personal advice. However Doctissimo offers a wake-up call.
Read our article

Hepatitis A: usually benign

Viral Hepatitis ... mild illness or serious illness? In practice, this depends on the virus involved and the form of the disease. Case of hepatitis A, the disease can be long and the cause of extreme fatigue. Without exception, the healing is complete.

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Lung Cancer




Description

A greater number of men and women, generally aged 65 to 75, dying of lung cancer than any other cancer.

The majority of lung cancer develops in the bronchi, that is to say, in the upper airway leading to the lungs. There are different types of lung cancer. The most common is lung cancer "non-small cell", which includes adenocarcinoma, large cell carcinoma and squamous cell carcinoma. The other type of lung cancer is that of small cell carcinoma (or carcinoma cells "oat").

Each category is evolving at a different rate and responds differently to treatment. Most lung cancers are smoking related, with the exception of adenocarcinoma. Often as a head cancer in other parts of the body spreads to the lungs.

Causes

Smoking is the main risk factor for lung cancer, and is the cause of over 80% of lung cancers. The more a person has smoked for a long time and she smokes, the greater her risk of lung cancer. If you quit smoking before cancer develops, the lung tissue damage caused by smoking begin to heal. The risk of cancer for an ex-smoker will not be as weak as a person who never smoked, but it still will fall over time. The use of the cigar and pipe smoking causes almost the same degree of risk of lung cancer as cigarette smoking.

Even second-hand smoke, that is to say that a person inhales the smoke in the presence of smoking can cause lung cancer. Non-smokers whose spouse smokes are at higher risk of 30% of suffering from lung cancer than the spouse of a person who does not smoke.

Living in an environment where the air is heavily polluted, or having a job that requires handling of radioactive minerals or asbestos can also increase the risk of lung cancer. The research to better understand how these risk factors produce certain changes in DNA in the cells of the lung. These changes induce abnormal growth of cells and the formation of cancerous tumors.

DNA is the genetic material that contains instructions for all cell functions, or almost. Some genes (that is to say parts of the DNA) regulate growth and cell division. The risk factors that we described earlier can trigger changes, also known as mutations of these genes, which will then cause the development of cancer. Moreover, the risk of suffering from certain forms of cancer (eg. Breast cancer, ovarian, colorectal cancer, and many others) can be hereditary. However, scientists believe that in many lung cancer, heritable genetic mutations do not cause cancer.

Symptoms and Complications

The first symptom, and the most common lung cancer is coughing. When chronic bronchitis is followed by lung cancer, cough caused by bronchitis worse. Cancer cells can develop in blood vessels, which results in the presence of blood in the sputum (secretions coughed up). Cancer can still develop at the expense of the bronchi or put pressure on them, reducing their diameter and cause wheezing. Cancer can also develop in the chest wall and cause chest pain. The tumor can also cause pneumonia, which is accompanied by cough, fever, chest pain and shortness of breath. People with lung cancer have more advanced stage of appetite, are weakened and lose weight.

Lung cancer can invade adjacent tissues to the lungs or other distant tissues such as liver, brain and bones, which also causes pain. The tumor may also develop in a vein that carries blood from the upper body to the heart, and the block. This condition, called compression syndrome of the superior vena cava, is characterized by the reflux of blood in the veins of the face, neck and upper chest and swelling of the veins.

Cancer can cause fluid accumulation in the envelopes of the heart or lungs, making breathing very difficult. Cancer cells sometimes exert pressure on the lung and may crush it (collapse) when the tumor presses on the spinal cord, the patient feels pain or has a disorder of nerve function. Some cancers produce more hormones that affect metabolism.

Diagnosis

In general, the doctor suspects a lung cancer when chest radiograph showed a shadow on a lung. To confirm the diagnosis, the doctor makes analyzing sputum. Your doctor may confirm the lesion with a CT scan of the chest and use this image to take a biopsy (a sample) of the lesion using a long needle inserted into the chest cavity.

Usually, doctors use a device to directly observe the bronchi: the bronchoscope is introduced into the trachea into the bronchi. This examination is called bronchoscopy. A biopsy can also be performed during bronchoscopy. This process involves taking a sample of tumor tissue for examination under a microscope later. A surgeon can also take a sample of tissue during surgery, after an incision in the chest.
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