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.

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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.
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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.

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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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Pleural Mesothelioma

from wikipedia

Mesothelioma is a malignant tumor of the mesothelium, envelope consists of two layers between which is a lubricating fluid. The mesothelium surrounding many organs: it called for the lung pleura, peritoneum for digestive viscera, pericardium to the heart.

The most common is that of the pleura: pleural mesothelioma is

It is almost always secondary to the inhalation of asbestos dust (this is known since the 60s) and possibly some RCFs. Microfibers inhaled asbestos will be housed deep within the respiratory tree in the cells, these high strength fibers migrate to the pleura where mechanical irritation of the pleura, the lesion base is primarily physical, not chemical. The time between exposure and disease, often by several decades, but may be shorter in some cases. This exposure can be short (one or two years) and therefore difficult to find and prove 40 or 50 years later.

Mesothelioma is one of the pathologies induced by asbestos (see our article on the subject)

Smoking increases the risk of lung injury but does not affect the risk of developing mesothelioma.

The signs of the disease are not very evocative and often late: Chest pain, neuralgia in the arm, back pain in the shoulder blade. Therefore considered to be rather banal
More evocative: pleural effusion (fluid between the often bloody layers of the pleura) with dyspnea (breathlessness)

The chest X-ray is rarely helpful except at an advanced stage.
Microscopic examination of aspirated fluid if effusion malignant cells can be found
CT and MRI examinations are the most useful and the diagnosis will be confirmed by a biopsy of the pleura or by thoracoscopy

Treatment: early surgery may be successful, then radiation therapy may slow the progression finally chemotherapy will be only palliative. The prognosis is generally awful (one year survival in many cases only).

Prevention is essential: removal of sprayed asbestos, protection of workers and their families (wife who cleans clothes for example)
Asbestos is banned in France since 1997 and in many Western countries (but there are other countries where everything needs to be done ...)

Occupations exposed are numerous.
Those who pay the highest price were, are and will (if the maximum is expected between 2010 and 2020):

Plumbers, welders, pipe fitters
Workers in the construction of iron or steel (carpenters, shipbuilding and rail car)
Sheet metal workers, boilermakers, auto mechanics and truck
Electricians
Construction workers in general
DIYers "madmen"
Employment in the manufacture of articles containing asbestos (asbestos cement, asbestos textile industry until 1996 with activity of carding, spinning or weaving)
Employment in the insulation (thermal or acoustic), in the manufacture of electrical insulators in power plants, refineries
Automotive repair and other vehicles (brake and clutch)
Assemblers in ventilation / heating / cooling, boiler installer
Steel industry (blast furnaces, coke ovens, steel mills)
Glass Industry
Dockers
And so on. ...

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Joints of the Upper limb

Shoulder joint:

The glenohumeral joint (colloquially called the shoulder joint) is the highly mobile ball and socket joint between the glenoid cavity of the scapula and the head of the humerus. Lacking the passive stabilisation offered by ligaments in other joints, the glenohumeral joint is actively stabilised by the rotator cuff, a group of short muscles stretching from the scapula to the humerus. Little inferior support is available to the joint and dislocation of the shoulder almost exclusively occurs in this direction.

The large muscles acting at this joint perform multiple actions and seemingly simple movements are often the result of composite antagonist and protagonist actions from several muscles. For example, pectoralis major is the most important arm flexor and latissimus dorsi the most important extensor at the glenohumeral joint, but, acting together, these two muscles cancel each other's action leaving only their combined medial rotation component. On the other hand, to achieve pure flexion at the joint the deltoid and supraspinatus must cancel the adduction component and the teres minor and infraspinatus the medial rotation component of pectoralis major. Similarly, abduction (moving the arm away from the body) is performed by different muscles at different stages. The first 10° is performed entirely by the supraspinatus, but beyond that fibres of the much stronger pectoralis major are in position to take over the work. Furthermore, to achieve the full 180° range of abduction the arm must be rotated medially and the scapula most be rotate about itself to direct the glenoid cavity upward.

Elbow joint:

The elbow joint is formed by three bones, the humerus, radius, and ulna. Articulations between the trochlea of the humerus with the ulna and the capitulum of the humerus with the head of the radius comprise the joint. The elbow is an example of a hinge joint, or a joint that moves in only one direction.

Wrist:

composed of the carpal bones, articulates at the wrist joint (or radiocarpal joint) proximally and the carpometacarpal joint distally. The wrist can be divided into two components separated by the midcarpal joints. The small movements of the eight carpal bones during composite movements at the wrist are complex to describe, but flexion mainly occurs in the midcarpal joint whilst extension mainly occurs in the radiocarpal joint; the latter joint also providing most of adduction and abduction at the wrist. 

How muscles act on the wrist is complex to describe. The five muscles acting on the wrist directly — flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis, extensor carpi ulnaris, and palmaris longus — are accompanied by the tendons of the extrinsic hand muscles (i.e. the muscles acting on the fingers). Thus, every movement at the wrist is the work of a group of muscles; because the four primary wrist muscles (FCR, FCU, ECR, and ECU) are attached to the four corners of the wrist, they also produce a secondary movement (i.e. ulnar or radial deviation). To produce pure flexion or extension at the wrist, these muscle therefore must act in pairs to cancel out each others secondary action. On the other hand, finger movements without the corresponding wrist movements require the wrist muscles to cancel out the contribution from the extrinsic hand muscles at the wrist.

Sources: Wikipedia, Upper Extremity Anatomy Peter W. Johnson

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Anatomy of Upper limb

Tissues of the Upper Extremity:

Muscles
– Provide the forces for movement
• Tendons
– Connect muscles to bones
– Transmit forces to/from muscle and bones
– Relatively inelastic

Ligaments
– Connect bone to bone
– Stabilize joints
– Relatively elastic

Cartilage
– Protect and cover bones at the joints
– Devoid of nerves and blood vessels
– Takes a long time to heal

Bursa
– Fluid filled sac
– Protects and lubricates joints

Synovium
– Fluid filled sac
– Protects and lubricates tendons
crossing joints

Nerves
– Send signals to and from brain and
spinal cord

Sources: Wikipedia, Upper Extremity Anatomy Peter W. Johnson

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