Cervical cancer is one cancer the most common for women. Every one hour, one woman died in Indonesia due to cervical cancer or cervical cancer this. The fact is that millions of women in the world infected with HPV, which is considered a disease through sexual relations most common in the world.
In Indonesia, every one hour, one woman died of cervical cancer
According to the World Health Organization (WHO), this infection is the major risk factor for cervical cancer. Every year, hundreds of thousands of undiagnosed cases of HPV in the world and thousands of women died of cervical cancer, caused by the infection. Given the fact that this horrible, the various measures of prevention and treatment have been made to address cervical cancer or cervical cancer.
Cervical cancer occurs in the reproductive organs of a woman. The cervix is the narrow section at the bottom between the vagina and uterus of a woman. In part this is happening and where the growth of cervical cancer. What causes cervical cancer or cervical cancer? How do I prevent it? And how to handle it if it is infected with HPV?
HPV
Cervical cancer caused by HPV infection (human papillomavirus) or human papilloma virus. HPV cause warts in men and women, including genital warts, called condyloma akuminatum. Only a few of the hundreds of variants of HPV that can cause cancer. Cervical cancer or cervical cancer can occur if an infection that does not heal for a long time. In contrast, most HPV infections will go away, overcome by the immune system.
Causes and Symptoms of Cervical Cancer
Attack cervical cancer or cervical area of the cervix caused by HPV infection (human papillomavirus) that do not heal in a long time. If the immune system decreases, the HPV infection will be acute and can lead to cervical cancer. The symptoms did not appear at an early stage, which is why cervical cancer that starts from HPV infection is considered as "The Silent Killer".
Some symptoms can be observed although not always an indication of HPV infection. Whitish or spend a little blood after intercourse is little sign of symptoms of this cancer. In addition, a yellowish liquid that smells in the genital area can also be an indication of HPV infection. This virus can be transmitted from one patient to another and infect the person. Transmission can be through direct contact and because of sex.
When there is virus in a person's hand, then touching the genital area, the virus will move and can infect your cervix area. Another transmission method is in the closet in a public restroom that was contaminated by the virus. A cancer patient may use a closet, the HPV virus in patients who have moved to the closet. If you use it without cleaning it, the virus could then move into your genital area.
Bad lifestyle can be a supporting increased numbers of this cancer. Smoking, lack of vitamin C, vitamin E and folic acid may be the cause. If the consume nutritious foods will make the immune system can drive up and HPV virus.
Risk of cervical cancer is an active woman having sex since very early age, which frequently change sex partners, or who have sex with a man who changed partner. Another causative factor is the Pill for a long time or come from families who have a history of cancer.
Often times, a man who showed no symptoms of HPV infection that is spread it to their partner. A man who had sex with a woman who suffered from cervical cancer, will be a media virus carriers. Furthermore, when this man having sex with his wife, the virus was able to move and infect his wife.
Detection of Cervical Cancer
How do I detect that a woman infected with HPV that cause cervical cancer? Symptoms of a person infected with HPV are not visible and not easily observed. The easiest way to find out by doing cervical cytological examination. These checks currently popular with a Pap smear or Papanicolaou smear taken from a Greek doctor who discovered this method of George N. Papanicolaou. However, there are also many other methods for early detection of HPV infection and cervical cancer as follows:
• IVA
IVA is an abbreviation of Visual Inspection with Acetic acid. Method of examination with cervical smear or cervix with acetic acid. Then observed if there are abnormalities such as white areas. If no color change, then there can be no infection in the cervix. You can make the health center with a relatively cheap price. This can be done only for early detection. If you see any suspicious signs, the other detection methods are more to be done.
• Pap smear
Pap smear testing methods that doctors commonly use a scraper or brush to remove a small sample of cervical cells. Then these cells will be analyzed in the laboratory. The test can reveal whether there is infection, inflammation, or abnormal cells. According to the world, with a regular Pap smear tests have reduced the number of deaths due to cervical cancer.
• Colposcopy
If all the test results on the previous method showed an infection or irregularities, colposcopy procedure will be done by using a tool equipped with a magnifying lens to observe the infected part. The goal was to determine whether there is a lesion or abnormal tissue in the cervix or cervix. If there is an abnormal, a biopsy (taking a small amount of tissue from the body) made and treatment for cervical cancer begin.
Treating Cervical Cancer
If infected with HPV, do not worry, because today is the various ways of treatment that can control HPV infection. Some treatments aim to kill the cells that contain the HPV virus. Another way is to remove the damaged or infected with electric surgery, laser surgery, or cryosurgery (remove the abnormal tissue by freezing).
If cervical cancer has reached an advanced stage, it will be chemotherapy treatment. In some severe cases a hysterectomy may also be of a hysterectomy or a total content. The aim is to remove cells that have cervical cancer develop in the body.
However, prevention is better than cure. Therefore, how to prevent infection with HPV and cervical cancer? Here are some ways you can do to prevent cervical cancer.
Preventing Cervical Cancer
Although cervical cancer scary, but we all can prevent it. You can do a lot of precautionary measures before ultimately infected with HPV and cervical cancer. Some practical ways you can do in everyday life include:
• Have a healthy diet, rich in vegetables, fruit and cereal to stimulate the immune system. For example consuming various carotene, vitamins A, C, and E, and folic acid can reduce the risk of cervical cancer.
• Avoid smoking. Much evidence indicates the use of tobacco can increase the risk of cervical cancer.
• Avoid sex before marriage or at a very young age or a dozen years.
• Avoid having sex during menstrual period proved effective to prevent and inhibit the formation and development of cervical cancer.
• Avoid having sex with many partners.
• Routine Pap smear tests regularly. We have a Pap smear test can be done even at the level of affordable health center.
• Alternative Pap smear test is a test IVA with a cheaper cost of Pap smears. The goal for the early detection of HPV infection.
• Provision of HPV vaccine or vaccination to prevent HPV infection.
• Perform intimate organs or vagina known as a toilet. This can be done alone or can be also with the help of expert doctors. The goal is to clean the female sex organs of filth and disease.
Healthy Living Without Cervical Cancer.
Cervical cancer can be prevented and treated. Early detection and routine Pap smears done to minimize the risk of cervical cancer. Change your lifestyle and your diet to avoid a disease that killed many women in this world. Thus, the health of the cervix or the cervix is more secure. With proper treatment, cervical cancer is not something frightening.
Dec 24, 2009
Dec 18, 2009
DNA
DNA stands for deoxyribonucleic acid, or in Indonesian language is often called Eden which stands for deoxyribonucleic acid. DNA or of Eden is the genetic material contained in the body of every person who inherited from their parents. DNA present in the cell nucleus in the structure of chromosomes and the mitochondria.
Function as a blueprint that serves as the code for each man as to hair color, eye shape, face shape, skin color, and others. Introduction of the DNA structure was introduced by Francis Crick, a British scientist and James Watson from the United States in 1953.
DNA structure to facilitate what we understand as DNA, you try to think of a sentence. The sentence is composed of several words. And every word is formed from some alphabet. In other words, the alphabet is a basic element of many languages. A similar principle can be applied to DNA. At the molecular level, "alphabet" of DNA provided by the primary. What amazing is that the "alphabet" consists only of four letters A, C, G, and T, which is a symbol of the chemical bases adenine, cytosine (cytosine), guanine, and thymine. These compounds form an exclusive bond, in which adenine is always paired with thymine and guanine always pairs with cytosine.
The shape of the DNA double helix is like the one with the meeting. DNA consists of 4 base pairs A, C, G, and T which are chemical components that contain nitrogen. The sequence of bases in the DNA molecule is the determining genetic information contained in it. In short, this sequence determines almost everything about you, from hair color, skin color, to shape your nose.
Every human being has 23 pairs of chromosomes consisting of 22 pairs of somatic chromosomes and 1 pair of sex determining chromosomes. XX chromosomes determine the sex of a person with a female and XY for a man who sex male. Chromosome is obtained from the parents, half from the mother and half from the father.
DNA test
On mitochondrial DNA known as mitochondrial DNA obtained from the mothers overall. Test by taking one's mitochondrial DNA could identify whether someone has a family relationship with the family of the mother or the maternal family relationships. Way by comparing the mitochondrial DNA that has a biological mother, grandmother or siblings from the mother.
Because a mother fully lowered mitochondrial DNA to her son, what about fathers? A father will inherit a Y chromosome in her son (because the Y chromosome has only male XY sex chromosomes). While girls do not have Y chromosomes (XX female sex chromosome).
To prove the family's relationship with his father's side can be done by comparing the Y chromosomes of a child with her biological father or the brother of the father. Because the Y chromosome examination only for boys, then how to do DNA tests on a girl?
DNA testing is done by taking DNA from somatic chromosomes. Ties of DNA in the somatic almost the same in every person from serving form and function of organs. Sequence errors can cause interference with the human in question. But at the core of these cells also have the area known as the area of STR (short tandem repeats). This area does not give the code to do something.
STR is what is unique because it is different for each person. The difference lies in the sequence of base pairs generated and the sequence repetition STR. AGACC sequence will be different with someone who has a string of AGACT. So is the order of repetition that is unique. STR pattern is inherited from parents.
How do DNA test?
In this example is a DNA test to prove whether a child really is the biological child of a husband and wife. How to check the DNA tests done by taking the child STR. Furthermore, the laboratory will be analyzed this sequence string STR same whether the order with someone who made the pattern of a child. The order is not the only one because the examination is continued by looking at the number of chromosomes.
For example, a child's examination found that the chromosome number 3 has a sequence repetition AGACT with 2 times. When the father or mother who claimed his biological parents also have the same loop on the same chromosome number, it can be concluded between the 2 people that have family connections.
A person can be said to have a blood relationship if you have 16 STR is equal to her birth family. When the order and repetition of the same, then the two people who checked has ties siblings or close blood relations. This amount is quite small compared to the overall bonding in the spiral of our bodies, amounting to billions.
DNA tests done by taking a little part of your body to compare with other people. Parts that can be taken to check the hair, saliva, urine, vagina fluid, semen, blood and other body tissues. This sample will not change one's lifetime. The use of alcohol, tobacco or drugs will not change the structure of DNA. The results of DNA tests will be run from a new patient can be 2-4 weeks. The cost required for DNA tests this time around 7 to 8 million rupiah.
Benefits of DNA testing
DNA testing has now become a trend to prove the link one's blood relations. Given the many infidelities and free sex, has produced many children who questioned the origin of their parents. Because of that, many couples do DNA tests to prove the origin of these children were born.
Even in some countries, many DNA testing clinics. Many also are using DNA tests because of suspicion against her partner. Some people leave personal items owned by his partner to the clinic to be tested whether the spouses connect with others who are not spouses.
In the police, DNA testing is also used for forensic tests. DNA testing is the most accurate evidence to test a person identification than fingerprints. With DNA testing, police can provide authentic evidence of the bodies that have been destroyed, provided that tissue samples can be taken on these corpses.
In addition to detect family relationships, DNA testing also serves to detect a particular disease until the disease is complex. With a DNA test to know the cause of a disease that is much less hereditary.
Technological advances have made more new things to learn. DNA is now the tests identify the most accurate and reliable. Information about the DNA tests on the hope to help you know more closer to the process.
Dec 9, 2009
10 Tips for Better Sleep
Getting a full night's sleep is as important to good health as maintaining a proper diet and getting enough exercise. Yet a third of Americans get less than 6 ½ hours of sleep each night - much less the recommended 7-8 hours.
Lack of sleep is associated with an inflammation causing increase of cytokine molecules. Long term insomnia leads to chronic inflammation. This significantly increases the risk of hardening of the arteries, high blood pressure, stroke, and heart disease.
Scary health consequences aside, we simply feel better after we get a good night's rest. So here are 10 tips you can use right away to improve your odds of getting to sleep faster and staying asleep longer.
1) Avoid caffeine late in the day. Caffeine affects your body up to 8 hours, so switch to decaf or herbal teas after lunch. Watch out for caffeinated drinks like sodas and hot chocolate too.
2) Exercise earlier - at least 45 minutes to an hour before bedtime. Exercise is important and will help you obtain a more restful sleep, but your body needs time to wind down.
3) Avoid drinking before bedtime. Give your body at least an hour to eliminate excess fluids. Otherwise you're more likely to wake for a midnight bathroom run to empty your bladder.
4) Stick to a schedule so your body can get into a routine. Keep the same bedtime and waking routine even on non-work days for improved sleep quality.
5) Skip long naps as they can throw off your sleep cycle. Power naps of 15-20 minutes are better.
6) Find your best sleep position. Back sleep is recommended as the most stable position for the spine. Placing a pillow under your legs can reduce lower back stress. If you prefer sleeping on your side, try placing a pillow between your legs for better hip support and comfort. Experiment to find what helps you get the best night's sleep without waking up sore.
7) Use the right size and number of pillows. Your head and neck should maintain a roughly straight line while you sleep. Your head should not be propped up or tilted down at an angle.
8) Dress (or undress) for comfort so heat or cold won't keep you awake or prevent you from sleeping through the night.
9) Keep your room dark. Turn off the lights, close the curtains, even cover electronic lights if you have to. If you must use a TV or radio to fall asleep, use the sleep timer.
10) Eat a "sleepy snack" such as turkey, yogurt, ice cream, or peanuts. These all have high levels of tryptophan which helps your body produce serotonin and relax for sleep – but eat them an hour before bed.
Bonus sleep tip!
When all else fails, many will try sleeping pills which can lead to drug dependence. Try using a safer and non-habit forming herbal sleep aid instead which won't leave you feeling drugged out in the morning.
About the Author
Jesse Cannone is co-founder of the Healthy Back Institute and author of "The 7 Day Back Pain Cure". Get the facts on what's realling causing your pain here http://www.losethebackpain.com/conditions
Lack of sleep is associated with an inflammation causing increase of cytokine molecules. Long term insomnia leads to chronic inflammation. This significantly increases the risk of hardening of the arteries, high blood pressure, stroke, and heart disease.
Scary health consequences aside, we simply feel better after we get a good night's rest. So here are 10 tips you can use right away to improve your odds of getting to sleep faster and staying asleep longer.
1) Avoid caffeine late in the day. Caffeine affects your body up to 8 hours, so switch to decaf or herbal teas after lunch. Watch out for caffeinated drinks like sodas and hot chocolate too.
2) Exercise earlier - at least 45 minutes to an hour before bedtime. Exercise is important and will help you obtain a more restful sleep, but your body needs time to wind down.
3) Avoid drinking before bedtime. Give your body at least an hour to eliminate excess fluids. Otherwise you're more likely to wake for a midnight bathroom run to empty your bladder.
4) Stick to a schedule so your body can get into a routine. Keep the same bedtime and waking routine even on non-work days for improved sleep quality.
5) Skip long naps as they can throw off your sleep cycle. Power naps of 15-20 minutes are better.
6) Find your best sleep position. Back sleep is recommended as the most stable position for the spine. Placing a pillow under your legs can reduce lower back stress. If you prefer sleeping on your side, try placing a pillow between your legs for better hip support and comfort. Experiment to find what helps you get the best night's sleep without waking up sore.
7) Use the right size and number of pillows. Your head and neck should maintain a roughly straight line while you sleep. Your head should not be propped up or tilted down at an angle.
8) Dress (or undress) for comfort so heat or cold won't keep you awake or prevent you from sleeping through the night.
9) Keep your room dark. Turn off the lights, close the curtains, even cover electronic lights if you have to. If you must use a TV or radio to fall asleep, use the sleep timer.
10) Eat a "sleepy snack" such as turkey, yogurt, ice cream, or peanuts. These all have high levels of tryptophan which helps your body produce serotonin and relax for sleep – but eat them an hour before bed.
Bonus sleep tip!
When all else fails, many will try sleeping pills which can lead to drug dependence. Try using a safer and non-habit forming herbal sleep aid instead which won't leave you feeling drugged out in the morning.
About the Author
Jesse Cannone is co-founder of the Healthy Back Institute and author of "The 7 Day Back Pain Cure". Get the facts on what's realling causing your pain here http://www.losethebackpain.com/conditions
Nov 26, 2009
What Is Cirrhosis? What Causes Cirrhosis?
Cirrhosis is an abnormal liver condition in which there is irreversible scarring of the liver. The main causes are sustained excessive alcohol consumption, viral hepatitis B and C, and fatty liver disease - however, there are many possible causes.
People with cirrhosis may develop jaundice (yellowing of the skin, eyes and tongue), itching and extreme tiredness.
For cirrhosis to develop long-term, continuous damage to the liver needs to occur. When healthy liver tissue is destroyed and replaced by scar tissue the condition becomes serious, as it can start blocking the flow of blood through the liver.
Cirrhosis is a progressive disease, developing slowly over many years, until eventually it can stop liver function (liver failure).
The liver carries out several essential functions, including the detoxification of harmful substances in the body. It also purifies the blood and manufactures vital nutrients.
If cirrhosis is mild the liver can make repairs and continue functioning properly. If the cirrhosis is advanced and more and more scar tissue forms in the liver, the damage is irreparable. The liver tissue is replaced by fibrous scar tissue as well as regenerative nodules (lumps that appear as a consequence of a process in which damaged tissue is regenerated).
According to Medilexicon's medical dictionary:
Cirrhosis is "A chronic liver disease of highly various etiology characterized by inflammation, degeneration, and regeneration in differing proportions; pathologic hallmark is formation of microscopic or macroscopic nodules separated by bands of fibrous tissue; impairment of hepatocellular function and obstruction to portal circulation often lead to jaundice, ascites, and hepatic failure."
What are the signs and symptoms of cirrhosis?
A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or a nurse may detect. For example, pain may be a symptom while a rash may be a sign.
Symptoms are not common during the early stages of cirrhosis. However, as scar tissue accumulates the liver's ability to function properly is undermined. The following signs and symptoms may occur:
* Blood capillaries become visible on the skin on the upper abdomen
* Fatigue
* Insomnia
* Itchy skin
* Loss of appetite
* Loss of bodyweight
* Nausea
* Pain or tenderness in the area where the liver is located
* Red or blotchy palms
* Weakness
The following signs and symptoms may appear as the disease progresses:
* Abdomen fills up with fluid, giving the patient a large tummy (ascites)
* Accelerated heartbeat
* Altered personality (as blood toxins build up and affect the brain)
* Bleeding gums
* Body and upper arms lose mass
* Body finds it harder to process alcohol
* Body finds it harder to process drugs
* Confusion
* Dizziness
* Fluid buildup on ankles, feet and legs (edema)
* Hair loss
* Higher susceptibility to bruising
* Jaundice (yellowing of the skin, whites of the eyes, and tongue)
* Loss of libido (sex drive)
* Memory problems
* More frequent fevers (susceptibility to infections)
* Muscle cramps
* Nosebleeds
* Pain on the right shoulder
* Panting (breathlessness)
* Stools become black and tarry, or very pale
* Urine becomes darker
* Vomiting blood
* Walking problems (staggering)
What are the causes of cirrhosis?
The most common causes of cirrhosis are long-term alcohol abuse, hepatitis B and C infection, and fatty liver disease.
Overconsumption of alcohol
According to the NHS (National Health Service), UK, excessive alcohol consumption is when a man drinks more than 21 units and a woman drinks more than 14 units per week.
Toxins, including alcohol, are broken down by the liver. However, if the amount of alcohol is too high the liver will be overworked and liver cells can eventually become damaged.
Heavy, regular, long-term drinkers are much more likely to develop cirrhosis, compared to other healthy people. It is a myth that only alcoholics are at risk - regular and heavy social drinking is also linked to a higher probability of developing cirrhosis.
Typically, heavy drinking needs to be sustained for at least ten years for cirrhosis to develop. The period varies according to each individual.
Regular heavy female drinkers are more likely to develop symptoms compared to men who consume the same amount.
Heavy drinkers will eventually develop fatty liver. The liver breaks down alcohol into carbon dioxide and water, causing fatty liver. As soon as excessive drinking stops the symptoms of fatty liver go away. However, 20% to 30% of those who continue drinking heavily will develop alcoholic hepatitis, the next stage. Approximately 10% of heavy drinkers will subsequently develop cirrhosis - the third stage of alcoholic liver disease.
Health authorities in the UK urge males not to exceed three to four units of alcohol consumption per day, and women should not have more than two to three units daily - to reduce the risk of developing alcohol hepatitis and cirrhosis.
Hepatitis and cirrhosis
Hepatitis C, a bloodborne infection, can damage the liver and eventually lead to cirrhosis. Hepatitis C is a common cause of cirrhosis in Western Europe, North America, and many other parts of the world. Cirrhosis can also be caused by hepatitis B and D.
Non-alcoholic steatohepatitis (NASH)
NASH is more likely to occur with people who are obese, diabetes patients, those with high blood lipid (fat) levels, as well as individuals with hypertension (high blood pressure). NASH, in its early stages, begins with the accumulation of too much fat in the liver. The fat causes inflammation and scarring, resulting in possible cirrhosis later on.
Autoimmune hepatitis
The person's own immune system attacks healthy organs in the body as though they were foreign substances. Sometimes the liver is attacked. Eventually the patient can develop cirrhosis.
Some genetic conditions
* Hemochromatosis - iron accumulates in the liver and other parts of the body.
* Wilson's disease - copper accumulates in the liver and other parts of the body.
Blockage of bile ducts
Some conditions and diseases, such as cancer of the bile ducts, or cancer of the pancreas can block the bile ducts, increasing the risk of cirrhosis.
Budd-Chiari syndrome
There is thrombosis (blood clots) in the hepatic vein, the blood vessel that carries blood from the liver, leading to liver enlargement and the development of collateral vessels.
Some other diseases and conditions
* Cystic fibrosis
* Primary sclerosing cholangitis - hardening and scarring of the bile ducts
* Galactosemia - inability to process sugars in milk
* Schistosomiasis - a parasite commonly found in some developing countries
* Biliary atresia - badly formed bile ducts in babies
* Glycogen storage disease - problems in the storage and energy release vital for cell function
Diagnosis of cirrhosis
Cirrhosis in its early stages is often diagnosed when the patient is being tested for some other condition or disease because symptoms are not present.
Anybody who has the following symptoms should see their doctor immediately:
* Fever with shivering
* Panting (shortness of breath)
* Vomiting blood
* Dark stools, or tarry stools (as if covered with tar)
* Episodes of drowsiness or confusion
A GP (general practitioner, primary care physician) will examine the patient and feel around the liver area to determine whether it is enlarged. The patient will be asked about his/her medical history and lifestyle (drinking, etc).
The following tests may also be ordered:
A blood test - to measure how well the liver is functioning and determine whether there is any damage. If levels of ALT (alanine transaminase) are high the patient may have hepatitis.
Imaging tests - this may involve an ultrasound, CT (computerized tomography), or MRI (magnetic resonance imaging) scan of the liver. Apart from seeing whether the liver is enlarged, the doctor will also be able to detect any scarring.
A biopsy - a small sample of liver cells are extracted and examined under a microscope. The doctor inserts a fine needle in between the ribs and into the liver. The patient will receive a local anesthetic. The biopsy not only confirms or rules out cirrhosis, but may also reveal its cause (if it is cirrhosis).
Endoscopy - an endoscope, a long, thin tube with a light and video camera at the end goes down the patient's windpipe (esophagus) and into their stomach. The doctor sees the inside of the stomach on a screen, and looks out for swollen blood vessels (varices); a hallmark sign of cirrhosis.
Child-Pugh Score
Also known as the Child-Turcotte-Pugh score, assesses the prognosis (outlook) of chronic liver disease, mainly cirrhosis. Originally, it was used to predict mortality during surgery, but is now used to determine prognosis, as well as the required treatment strength, and whether or not the patient needs a liver transplant. It is a combination of numbered points and the letters A, B, C (see below):
Class Points One year survival Two year survival
A 5-6 100% 85%
B 7-9 81% 57%
C 10-15 45% 35%
What are the treatment options for cirrhosis?
If the cirrhosis is diagnosed early enough, damage may be minimized by treating its underlying cause.
Alcohol dependency (alcoholism) treatment - it is important for the patient to stop drinking if their cirrhosis was caused by long-term, regular heavy alcohol consumption. In many cases the doctor will recommend a treatment program for alcoholism.
Medications - the patient may be prescribed drugs to control liver cell damage caused by hepatitis B or C.
Treating cirrhosis complications
Ascites or edema - ascites (accumulation of fluid in the abdomen) or edema (fluid retention in the legs) can be treated with a low-sodium (salt) diet and water pills. In severe cases the fluid may have to be drained. Sometimes surgery is required.
Pressure in the portal vein and collateral smaller veins - hypertension (high blood pressure) drugs are usually prescribed to control the increasing pressure in the blood vessels around the liver; the aim is to prevent severe bleeding. In some cases a stent may be surgically placed in the portal vein to hold it open. Signs of bleeding can be detected via an endoscopy.
Treatment of swollen varices - if the patient vomits blood or passes bloody stools they probably have esophageal varices (in the food pipe). Urgent medical attention is required. The following procedures may help:
* Banding - a small band is placed around the base of the varices to control bleeding. An endoscope gores down the patient's throat and esophagus during the procedure.
* Injection sclerotherapy - after an endoscopy a substance is injected into the varices which triggers a blood clot and scar tissue to form; this helps stem the bleeding.
* A Sengstaken tube with a balloon - the balloon is at the end of the tube. If endoscopy does not stop the bleeding a tube goes down the patient's throat and into their stomach. The balloon is inflated; this places pressure on the varices and stops the bleeding.
* TIPSS (transjugular intrahepatic portosystemic stent shunt) - if the above-mentioned therapies do not stem the bleeding, a stent (metal tube) is passed across the liver to join the portal and hepatic veins, creating a new route for the blood to flow through. This reduces pressure - pressure which was causing the varices.
Infections - the patient will be given antibiotics, and some other treatments.
Screening for liver cancer - patients with cirrhosis have a much higher risk of developing liver cancer. The doctor may recommend regular blood tests and imaging scans.
Hepatic encephalopathy (high blood toxin levels) - drugs can help treat excessive blood toxin levels. The signs and symptoms need to be explained to the patient so that they know what to look out for.
Liver transplant - if the cirrhosis is advanced and there is liver failure (liver does not function) the patient may need a liver transplant.
Prevention of cirrhosis
Alcohol - do not exceed the recommended daily/weekly alcohol limit.
* Men: maximum of 21 units per week, or three/four units per day
* Women: maximum of 14 units per week, or two/three units per day
Individuals who have cirrhosis should abstain from alcohol completely. Alcohol accelerates the progression of the disease.
Hepatitis B and C
* Use a condom when having sex
* Do not share needles when injecting drugs
* People at risk of becoming infected with hepatitis B, such as health care workers, social care workers, and police personnel can be vaccinated (there is currently no vaccine for hepatitis C)
Written by Christian Nordqvist
Copyright: Medical News Today
People with cirrhosis may develop jaundice (yellowing of the skin, eyes and tongue), itching and extreme tiredness.
For cirrhosis to develop long-term, continuous damage to the liver needs to occur. When healthy liver tissue is destroyed and replaced by scar tissue the condition becomes serious, as it can start blocking the flow of blood through the liver.
Cirrhosis is a progressive disease, developing slowly over many years, until eventually it can stop liver function (liver failure).
The liver carries out several essential functions, including the detoxification of harmful substances in the body. It also purifies the blood and manufactures vital nutrients.
If cirrhosis is mild the liver can make repairs and continue functioning properly. If the cirrhosis is advanced and more and more scar tissue forms in the liver, the damage is irreparable. The liver tissue is replaced by fibrous scar tissue as well as regenerative nodules (lumps that appear as a consequence of a process in which damaged tissue is regenerated).
According to Medilexicon's medical dictionary:
Cirrhosis is "A chronic liver disease of highly various etiology characterized by inflammation, degeneration, and regeneration in differing proportions; pathologic hallmark is formation of microscopic or macroscopic nodules separated by bands of fibrous tissue; impairment of hepatocellular function and obstruction to portal circulation often lead to jaundice, ascites, and hepatic failure."
What are the signs and symptoms of cirrhosis?
A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or a nurse may detect. For example, pain may be a symptom while a rash may be a sign.
Symptoms are not common during the early stages of cirrhosis. However, as scar tissue accumulates the liver's ability to function properly is undermined. The following signs and symptoms may occur:
* Blood capillaries become visible on the skin on the upper abdomen
* Fatigue
* Insomnia
* Itchy skin
* Loss of appetite
* Loss of bodyweight
* Nausea
* Pain or tenderness in the area where the liver is located
* Red or blotchy palms
* Weakness
The following signs and symptoms may appear as the disease progresses:
* Abdomen fills up with fluid, giving the patient a large tummy (ascites)
* Accelerated heartbeat
* Altered personality (as blood toxins build up and affect the brain)
* Bleeding gums
* Body and upper arms lose mass
* Body finds it harder to process alcohol
* Body finds it harder to process drugs
* Confusion
* Dizziness
* Fluid buildup on ankles, feet and legs (edema)
* Hair loss
* Higher susceptibility to bruising
* Jaundice (yellowing of the skin, whites of the eyes, and tongue)
* Loss of libido (sex drive)
* Memory problems
* More frequent fevers (susceptibility to infections)
* Muscle cramps
* Nosebleeds
* Pain on the right shoulder
* Panting (breathlessness)
* Stools become black and tarry, or very pale
* Urine becomes darker
* Vomiting blood
* Walking problems (staggering)
What are the causes of cirrhosis?
The most common causes of cirrhosis are long-term alcohol abuse, hepatitis B and C infection, and fatty liver disease.
Overconsumption of alcohol
According to the NHS (National Health Service), UK, excessive alcohol consumption is when a man drinks more than 21 units and a woman drinks more than 14 units per week.
Toxins, including alcohol, are broken down by the liver. However, if the amount of alcohol is too high the liver will be overworked and liver cells can eventually become damaged.
Heavy, regular, long-term drinkers are much more likely to develop cirrhosis, compared to other healthy people. It is a myth that only alcoholics are at risk - regular and heavy social drinking is also linked to a higher probability of developing cirrhosis.
Typically, heavy drinking needs to be sustained for at least ten years for cirrhosis to develop. The period varies according to each individual.
Regular heavy female drinkers are more likely to develop symptoms compared to men who consume the same amount.
Heavy drinkers will eventually develop fatty liver. The liver breaks down alcohol into carbon dioxide and water, causing fatty liver. As soon as excessive drinking stops the symptoms of fatty liver go away. However, 20% to 30% of those who continue drinking heavily will develop alcoholic hepatitis, the next stage. Approximately 10% of heavy drinkers will subsequently develop cirrhosis - the third stage of alcoholic liver disease.
Health authorities in the UK urge males not to exceed three to four units of alcohol consumption per day, and women should not have more than two to three units daily - to reduce the risk of developing alcohol hepatitis and cirrhosis.
Hepatitis and cirrhosis
Hepatitis C, a bloodborne infection, can damage the liver and eventually lead to cirrhosis. Hepatitis C is a common cause of cirrhosis in Western Europe, North America, and many other parts of the world. Cirrhosis can also be caused by hepatitis B and D.
Non-alcoholic steatohepatitis (NASH)
NASH is more likely to occur with people who are obese, diabetes patients, those with high blood lipid (fat) levels, as well as individuals with hypertension (high blood pressure). NASH, in its early stages, begins with the accumulation of too much fat in the liver. The fat causes inflammation and scarring, resulting in possible cirrhosis later on.
Autoimmune hepatitis
The person's own immune system attacks healthy organs in the body as though they were foreign substances. Sometimes the liver is attacked. Eventually the patient can develop cirrhosis.
Some genetic conditions
* Hemochromatosis - iron accumulates in the liver and other parts of the body.
* Wilson's disease - copper accumulates in the liver and other parts of the body.
Blockage of bile ducts
Some conditions and diseases, such as cancer of the bile ducts, or cancer of the pancreas can block the bile ducts, increasing the risk of cirrhosis.
Budd-Chiari syndrome
There is thrombosis (blood clots) in the hepatic vein, the blood vessel that carries blood from the liver, leading to liver enlargement and the development of collateral vessels.
Some other diseases and conditions
* Cystic fibrosis
* Primary sclerosing cholangitis - hardening and scarring of the bile ducts
* Galactosemia - inability to process sugars in milk
* Schistosomiasis - a parasite commonly found in some developing countries
* Biliary atresia - badly formed bile ducts in babies
* Glycogen storage disease - problems in the storage and energy release vital for cell function
Diagnosis of cirrhosis
Cirrhosis in its early stages is often diagnosed when the patient is being tested for some other condition or disease because symptoms are not present.
Anybody who has the following symptoms should see their doctor immediately:
* Fever with shivering
* Panting (shortness of breath)
* Vomiting blood
* Dark stools, or tarry stools (as if covered with tar)
* Episodes of drowsiness or confusion
A GP (general practitioner, primary care physician) will examine the patient and feel around the liver area to determine whether it is enlarged. The patient will be asked about his/her medical history and lifestyle (drinking, etc).
The following tests may also be ordered:
A blood test - to measure how well the liver is functioning and determine whether there is any damage. If levels of ALT (alanine transaminase) are high the patient may have hepatitis.
Imaging tests - this may involve an ultrasound, CT (computerized tomography), or MRI (magnetic resonance imaging) scan of the liver. Apart from seeing whether the liver is enlarged, the doctor will also be able to detect any scarring.
A biopsy - a small sample of liver cells are extracted and examined under a microscope. The doctor inserts a fine needle in between the ribs and into the liver. The patient will receive a local anesthetic. The biopsy not only confirms or rules out cirrhosis, but may also reveal its cause (if it is cirrhosis).
Endoscopy - an endoscope, a long, thin tube with a light and video camera at the end goes down the patient's windpipe (esophagus) and into their stomach. The doctor sees the inside of the stomach on a screen, and looks out for swollen blood vessels (varices); a hallmark sign of cirrhosis.
Child-Pugh Score
Also known as the Child-Turcotte-Pugh score, assesses the prognosis (outlook) of chronic liver disease, mainly cirrhosis. Originally, it was used to predict mortality during surgery, but is now used to determine prognosis, as well as the required treatment strength, and whether or not the patient needs a liver transplant. It is a combination of numbered points and the letters A, B, C (see below):
Class Points One year survival Two year survival
A 5-6 100% 85%
B 7-9 81% 57%
C 10-15 45% 35%
What are the treatment options for cirrhosis?
If the cirrhosis is diagnosed early enough, damage may be minimized by treating its underlying cause.
Alcohol dependency (alcoholism) treatment - it is important for the patient to stop drinking if their cirrhosis was caused by long-term, regular heavy alcohol consumption. In many cases the doctor will recommend a treatment program for alcoholism.
Medications - the patient may be prescribed drugs to control liver cell damage caused by hepatitis B or C.
Treating cirrhosis complications
Ascites or edema - ascites (accumulation of fluid in the abdomen) or edema (fluid retention in the legs) can be treated with a low-sodium (salt) diet and water pills. In severe cases the fluid may have to be drained. Sometimes surgery is required.
Pressure in the portal vein and collateral smaller veins - hypertension (high blood pressure) drugs are usually prescribed to control the increasing pressure in the blood vessels around the liver; the aim is to prevent severe bleeding. In some cases a stent may be surgically placed in the portal vein to hold it open. Signs of bleeding can be detected via an endoscopy.
Treatment of swollen varices - if the patient vomits blood or passes bloody stools they probably have esophageal varices (in the food pipe). Urgent medical attention is required. The following procedures may help:
* Banding - a small band is placed around the base of the varices to control bleeding. An endoscope gores down the patient's throat and esophagus during the procedure.
* Injection sclerotherapy - after an endoscopy a substance is injected into the varices which triggers a blood clot and scar tissue to form; this helps stem the bleeding.
* A Sengstaken tube with a balloon - the balloon is at the end of the tube. If endoscopy does not stop the bleeding a tube goes down the patient's throat and into their stomach. The balloon is inflated; this places pressure on the varices and stops the bleeding.
* TIPSS (transjugular intrahepatic portosystemic stent shunt) - if the above-mentioned therapies do not stem the bleeding, a stent (metal tube) is passed across the liver to join the portal and hepatic veins, creating a new route for the blood to flow through. This reduces pressure - pressure which was causing the varices.
Infections - the patient will be given antibiotics, and some other treatments.
Screening for liver cancer - patients with cirrhosis have a much higher risk of developing liver cancer. The doctor may recommend regular blood tests and imaging scans.
Hepatic encephalopathy (high blood toxin levels) - drugs can help treat excessive blood toxin levels. The signs and symptoms need to be explained to the patient so that they know what to look out for.
Liver transplant - if the cirrhosis is advanced and there is liver failure (liver does not function) the patient may need a liver transplant.
Prevention of cirrhosis
Alcohol - do not exceed the recommended daily/weekly alcohol limit.
* Men: maximum of 21 units per week, or three/four units per day
* Women: maximum of 14 units per week, or two/three units per day
Individuals who have cirrhosis should abstain from alcohol completely. Alcohol accelerates the progression of the disease.
Hepatitis B and C
* Use a condom when having sex
* Do not share needles when injecting drugs
* People at risk of becoming infected with hepatitis B, such as health care workers, social care workers, and police personnel can be vaccinated (there is currently no vaccine for hepatitis C)
Written by Christian Nordqvist
Copyright: Medical News Today
Nov 12, 2009
UCLA Researchers Reconstitute Enzyme That Synthesizes Cholesterol Drug Lovastatin
Researchers from the UCLA Henry Samueli School of Engineering and Applied Science have for the first time successfully reconstituted in the laboratory the enzyme responsible for producing the blockbuster cholesterol-lowering drug lovastatin.
The research, published Oct. 23 in the journal Science, could potentially lead to the development of other compounds with similarly beneficial effects.
The lovastatin-synthesizing enzyme is one of the most interesting but least understood of the polyketide synthases, which are found in filamentous fungi and which play a crucial role in the synthesis of "small molecule natural products" - pharmacologically or biologically potent compounds produced by living organisms, many of which are the active ingredients in pharmaceuticals.
Commonly used antibiotics, such as tetracycline, are produced by polyketide synthases. Polyketides represent a class of 7,000 known structures, of which more than 20 are commercial drugs, including the immunosuppressant rapamycin, the antibiotic erythromycin and the anticancer drug doxorubicin.
"In this study, we studied the enzyme that makes a small-molecule precursor to lovastatin. And what's really different about this enzyme, compared to all other enzymes people have studied, is that this enzyme is extraordinarily large," said Yi Tang, associate professor of chemical and biomolecular engineering. "It's one of the largest enzymes ever to be reconstituted in a test tube. It is 10 times the size of most enzymes people study."
The enzyme used in Tang's study has seven active sites and catalyzes more than 40 different reactions that eventually result in an important precursor to lovastatin.
By understanding how this large assembly line works, Tang's team hopes to retune the assembly line to be able to produce other natural products - something nature doesn't currently do.
"It's like having an assembly line with seven stations, and in one round you have to go through a combination of these seven stations. Remarkably, this enzyme uses the assembly line eight times to make this small molecule - every time, it uses a different combination of the individual stations," Tang said. "So the large enzyme is programmed to utilize these stations differentially at every cycle, in different combinations, and now we can do it in a test tube."
Tang's team has been able to recapture all of the steps needed to make the lovastatin precursor molecule. And with this, Tang hopes they will be able to disrupt, tweak and change some of the steps to make slightly different molecules that can be just as beneficial.
"It's biosynthetic engineering of an assembly line to make a molecule that nature doesn't make," Tang said. "So our eventual goal, once we understand how the enzyme works, is to rationally manipulate the individual stations or manipulate how a set of stations is used in each iteration to generate new compounds that nature doesn't make that will result in new activities, new molecules."
The research was supported in part by a grant from the National Institutes of Health and a fellowship from the David and Lucille Packard Foundation.
Source: Wileen Wong Kromhout
University of California - Los Angeles
The research, published Oct. 23 in the journal Science, could potentially lead to the development of other compounds with similarly beneficial effects.
The lovastatin-synthesizing enzyme is one of the most interesting but least understood of the polyketide synthases, which are found in filamentous fungi and which play a crucial role in the synthesis of "small molecule natural products" - pharmacologically or biologically potent compounds produced by living organisms, many of which are the active ingredients in pharmaceuticals.
Commonly used antibiotics, such as tetracycline, are produced by polyketide synthases. Polyketides represent a class of 7,000 known structures, of which more than 20 are commercial drugs, including the immunosuppressant rapamycin, the antibiotic erythromycin and the anticancer drug doxorubicin.
"In this study, we studied the enzyme that makes a small-molecule precursor to lovastatin. And what's really different about this enzyme, compared to all other enzymes people have studied, is that this enzyme is extraordinarily large," said Yi Tang, associate professor of chemical and biomolecular engineering. "It's one of the largest enzymes ever to be reconstituted in a test tube. It is 10 times the size of most enzymes people study."
The enzyme used in Tang's study has seven active sites and catalyzes more than 40 different reactions that eventually result in an important precursor to lovastatin.
By understanding how this large assembly line works, Tang's team hopes to retune the assembly line to be able to produce other natural products - something nature doesn't currently do.
"It's like having an assembly line with seven stations, and in one round you have to go through a combination of these seven stations. Remarkably, this enzyme uses the assembly line eight times to make this small molecule - every time, it uses a different combination of the individual stations," Tang said. "So the large enzyme is programmed to utilize these stations differentially at every cycle, in different combinations, and now we can do it in a test tube."
Tang's team has been able to recapture all of the steps needed to make the lovastatin precursor molecule. And with this, Tang hopes they will be able to disrupt, tweak and change some of the steps to make slightly different molecules that can be just as beneficial.
"It's biosynthetic engineering of an assembly line to make a molecule that nature doesn't make," Tang said. "So our eventual goal, once we understand how the enzyme works, is to rationally manipulate the individual stations or manipulate how a set of stations is used in each iteration to generate new compounds that nature doesn't make that will result in new activities, new molecules."
The research was supported in part by a grant from the National Institutes of Health and a fellowship from the David and Lucille Packard Foundation.
Source: Wileen Wong Kromhout
University of California - Los Angeles
Oct 30, 2009
Cataract Surgery Helps AMD Patients; Steroid Improves DME; Online Eye Health Forum
This month's Ophthalmology, the journal of the American Academy of Ophthalmology (Academy) reports on a national study that finds cataract surgery is likely to benefit patients with age-related macular degeneration (AMD) at all stages of the disease, on a clinical trial showing that the steroid triamcinolone may be effective in advanced diabetic macular edema (DME) patients when standard treatment fails, and on the public's use of two Academy-sponsored online eye health forums.
Multicenter Study Finds AMD Patients Benefit from Cataract Surgery
Cataract surgery improved vision in patients with any stage - from mild to advanced - AMD in the first study to include an adequate number of advanced AMD patients. Data was obtained from the multicenter, prospective Age-Related Eye Disease Study (AREDS), funded by the National Eye Institute (NEI), which was organized primarily to evaluate the effects of high-dose vitamin and mineral supplements on cataract and AMD. As the American population ages AMD prevalence is expected to rise, and many patients will concurrently develop cataract; both diseases can cause blindness if untreated.
"Earlier epidemiology had suggested cataract surgery might worsen AMD, so the data from the AREDS cohort study were evaluated to answer this important question," said Emily Y. Chew, MD, who led the study for NEI.
The cohort, comprising 1,939 eyes (1,244 patients) with various stages of AMD, was evaluated for visual acuity (sharpness) after cataract surgery. On average, patients with AMD, ranging from mild to advanced, gained visual acuity after cataract surgery; the best gains were in patients with vision worse than20/40 before surgery. No difference in improvement was noted between patients with "wet" (neovascular) or "dry" (central geographic atrophy) AMD. About one year later vision gains remained statistically significant in the 865 eyes available for follow-up. Results for the primary focus of AREDS, regarding the effect of nutritional supplements, showed that high doses of vitamins C, E and beta-carotene did not affect the development or progression of cataract, but this vitamin combination plus zinc did reduce the risk of progression to advanced AMD by 25 percent in the five years of the study.
Steroids Helps Diabetic Macular Edema Patients When Other Treatment Fails
A five-year study based at the University of Sydney, Australia, found that intravitreal triamcinolone (IVTA) effectively improved vision in patients with DME, a form of diabetic retinopathy, whose eyes had continued to deteriorate despite receiving standard laser treatment.
"The majority of patients who improved with IVTA after initial treatment continued to enjoy better vision at the five year conclusion of our clinical trial, and no new safety concerns were found in these patients," said lead researcher Mark Gillies, PhD. "We believe treatment with IVTA may be considered in carefully selected advanced DME patients when standard treatment has failed to improve vision," he added.
In the first three months after treatment, the patients initially treated with both IVTA and laser showed significantly better gains in vision than control group patients, who were treated with laser only. After two years, patients in the original control group were also treated with IVTA. The beneficial effects persisted in most IVTA-treated patients throughout the five-year study; however, 80 percent of patients in the initial IVTA group developed elevated intraocular pressure and 56 percent of them required glaucoma therapy. Also, two-thirds of all patients required cataract surgery during the study period. Similar outcomes have been noted in other studies of steroid-based treatment and thus were not considered new safety concerns by Dr. Gillies' group.
What Do People Ask About in Online Eye Health Forums?
To identify the topics of highest interest to people who access eye health information on line, John C. Hagan, MD, and colleagues analyzed 4,485 questions over six months (September 1, 2008 to March 1, 2009) posted on the "Ask a Doctor: Ophthalmology" and "Eye Care Community" forums sponsored by the Academy on MedHelp (http://www.medhelp.org), one of the 10 largest health information websites. Dr. Hagan and three other ophthalmologists provide free, timely advice to a large and growing number of people with eye health and vision problems through these forums. Serious problems, such as life-threatening retinoblastomas in babies, have been caught and treated in time thanks to these forums, as have thousands of other eye and vision problems.
Concerns related to the retina topped the list at nearly 20 percent of all questions; many people asked about "flashes," "floaters," or retinal detachment. About 19 percent of questions were related to the cornea, the clear outer surface of the eye that helps focus light to make vision possible. Cataract and implanted lens questions were next in prevalence, followed by brain-eye problems (neuro-ophthalmology), children's eye alignment (strabismus), eye cancers, and general discomfort or blurry vision. Two-to-three percent of questions related to each of three vision correction topics: refractive surgery (LASIK and others), eyeglasses, or contact lenses. A smaller number were related to eye care products or medical insurance. The analysis also found many people submit postings to express their gratitude for the medical advice provided.
Source:
Mary Wade
American Academy of Ophthalmology
Multicenter Study Finds AMD Patients Benefit from Cataract Surgery
Cataract surgery improved vision in patients with any stage - from mild to advanced - AMD in the first study to include an adequate number of advanced AMD patients. Data was obtained from the multicenter, prospective Age-Related Eye Disease Study (AREDS), funded by the National Eye Institute (NEI), which was organized primarily to evaluate the effects of high-dose vitamin and mineral supplements on cataract and AMD. As the American population ages AMD prevalence is expected to rise, and many patients will concurrently develop cataract; both diseases can cause blindness if untreated.
"Earlier epidemiology had suggested cataract surgery might worsen AMD, so the data from the AREDS cohort study were evaluated to answer this important question," said Emily Y. Chew, MD, who led the study for NEI.
The cohort, comprising 1,939 eyes (1,244 patients) with various stages of AMD, was evaluated for visual acuity (sharpness) after cataract surgery. On average, patients with AMD, ranging from mild to advanced, gained visual acuity after cataract surgery; the best gains were in patients with vision worse than20/40 before surgery. No difference in improvement was noted between patients with "wet" (neovascular) or "dry" (central geographic atrophy) AMD. About one year later vision gains remained statistically significant in the 865 eyes available for follow-up. Results for the primary focus of AREDS, regarding the effect of nutritional supplements, showed that high doses of vitamins C, E and beta-carotene did not affect the development or progression of cataract, but this vitamin combination plus zinc did reduce the risk of progression to advanced AMD by 25 percent in the five years of the study.
Steroids Helps Diabetic Macular Edema Patients When Other Treatment Fails
A five-year study based at the University of Sydney, Australia, found that intravitreal triamcinolone (IVTA) effectively improved vision in patients with DME, a form of diabetic retinopathy, whose eyes had continued to deteriorate despite receiving standard laser treatment.
"The majority of patients who improved with IVTA after initial treatment continued to enjoy better vision at the five year conclusion of our clinical trial, and no new safety concerns were found in these patients," said lead researcher Mark Gillies, PhD. "We believe treatment with IVTA may be considered in carefully selected advanced DME patients when standard treatment has failed to improve vision," he added.
In the first three months after treatment, the patients initially treated with both IVTA and laser showed significantly better gains in vision than control group patients, who were treated with laser only. After two years, patients in the original control group were also treated with IVTA. The beneficial effects persisted in most IVTA-treated patients throughout the five-year study; however, 80 percent of patients in the initial IVTA group developed elevated intraocular pressure and 56 percent of them required glaucoma therapy. Also, two-thirds of all patients required cataract surgery during the study period. Similar outcomes have been noted in other studies of steroid-based treatment and thus were not considered new safety concerns by Dr. Gillies' group.
What Do People Ask About in Online Eye Health Forums?
To identify the topics of highest interest to people who access eye health information on line, John C. Hagan, MD, and colleagues analyzed 4,485 questions over six months (September 1, 2008 to March 1, 2009) posted on the "Ask a Doctor: Ophthalmology" and "Eye Care Community" forums sponsored by the Academy on MedHelp (http://www.medhelp.org), one of the 10 largest health information websites. Dr. Hagan and three other ophthalmologists provide free, timely advice to a large and growing number of people with eye health and vision problems through these forums. Serious problems, such as life-threatening retinoblastomas in babies, have been caught and treated in time thanks to these forums, as have thousands of other eye and vision problems.
Concerns related to the retina topped the list at nearly 20 percent of all questions; many people asked about "flashes," "floaters," or retinal detachment. About 19 percent of questions were related to the cornea, the clear outer surface of the eye that helps focus light to make vision possible. Cataract and implanted lens questions were next in prevalence, followed by brain-eye problems (neuro-ophthalmology), children's eye alignment (strabismus), eye cancers, and general discomfort or blurry vision. Two-to-three percent of questions related to each of three vision correction topics: refractive surgery (LASIK and others), eyeglasses, or contact lenses. A smaller number were related to eye care products or medical insurance. The analysis also found many people submit postings to express their gratitude for the medical advice provided.
Source:
Mary Wade
American Academy of Ophthalmology
Oct 22, 2009
Research Indicates Gaps In Care For Diabetes, Cholesterol, Hypertension Among The Uninsured
A new study shows uninsured American adults with chronic illnesses like diabetes or high cholesterol often go undiagnosed and undertreated, leading to an increased risk of costly, disabling and even lethal complications of their disease.
The study, published online in Health Affairs, analyzed data from a recent national survey conducted by the Centers for Disease Control and Prevention (CDC). The researchers, based at Harvard Medical School and the affiliated Cambridge Health Alliance, analyzed data on 15,976 U.S. non-elderly adults from the National Health and Nutrition Examination Survey (NHANES), a CDC program, between 1999 and 2006.
Respondents answered detailed questions about their health and economic circumstances. Then doctors examined them and ordered laboratory tests.
The study found that about half of all uninsured people with diabetes (46 percent) or high cholesterol (52 percent) did not know they had these diseases. In contrast, about one-quarter of those with insurance were unaware of their illnesses (23 percent for diabetes, 29.9 percent for high cholesterol).
Undertreatment of disease followed similar patterns, with the uninsured being more likely to be undertreated than their insured counterparts: 58.3 percent vs. 51.4 percent had their high blood pressure poorly controlled, and 77.5 percent vs. 60.4 percent had their high cholesterol inadequately treated.
Surprisingly, being insured was not associated with a widely used measure of diabetes control (a hemoglobin A1c level below 7), a finding the authors attribute to the stringent definition of good diabetes control used in the NHANES survey. Even with excellent medical care, many diabetics fail to achieve such low hemoglobin A1c levels. Using less stringent hemoglobin A1c thresholds of 8 and 9, uninsured adults had significantly worse blood sugar control than their insured counterparts, the researchers found.
Lead author Dr. Andrew Wilper, who worked at Harvard when the study was done and who now teaches at the University of Washington Medical School, said: "Our study should lay to rest the myth that the uninsured can get the care they need. Millions have serious chronic conditions and don't even know it. And they're not getting care that would prevent strokes, heart attacks, amputations and kidney failure."
Referring to a study released in the American Journal of Public Health last month, which has been widely quoted by Sen. Max Baucus and others, he added: "Our previous work demonstrated 45,000 deaths annually are linked to lack of health insurance. Our new findings suggest a mechanism for this increased risk of death among the uninsured. They're not getting life-saving care."
Dr. Steffie Woolhandler, professor of medicine at Harvard and study co-author, said: "The uninsured suffer the most, but even Americans with insurance have shocking rates of undertreatment, in part because high co-payments and deductibles often make care and medications unaffordable. We need to upgrade coverage for the insured, as well as covering the uninsured. Only single-payer national health insurance would make care affordable for the tens of millions of Americans with chronic illnesses."
Dr. David Himmelstein, associate professor of medicine at Harvard and study co-author, said: "The Senate Finance Committee's bill would leave 25 million Americans uninsured and unable to get the ongoing, routine care that could save their lives and prevent disability. No other wealthy nation tolerates this, yet Congress is turning its back on tens of millions of Americans."
"Hypertension, diabetes and elevated cholesterol among insured and uninsured U.S. adults," Andrew P. Wilper, M.D., M.P.H.; Steffie Woolhandler, M.D., M.P.H.; Karen Lasser, M.D., M.P.H.; Danny McCormick, M.D., M.P.H.; David H. Bor, M.D.; David U. Himmelstein, M.D. Health Affairs, Oct. 20, 2009 (online).
Source:
Mark Almberg
Physicians for a National Health Program
The study, published online in Health Affairs, analyzed data from a recent national survey conducted by the Centers for Disease Control and Prevention (CDC). The researchers, based at Harvard Medical School and the affiliated Cambridge Health Alliance, analyzed data on 15,976 U.S. non-elderly adults from the National Health and Nutrition Examination Survey (NHANES), a CDC program, between 1999 and 2006.
Respondents answered detailed questions about their health and economic circumstances. Then doctors examined them and ordered laboratory tests.
The study found that about half of all uninsured people with diabetes (46 percent) or high cholesterol (52 percent) did not know they had these diseases. In contrast, about one-quarter of those with insurance were unaware of their illnesses (23 percent for diabetes, 29.9 percent for high cholesterol).
Undertreatment of disease followed similar patterns, with the uninsured being more likely to be undertreated than their insured counterparts: 58.3 percent vs. 51.4 percent had their high blood pressure poorly controlled, and 77.5 percent vs. 60.4 percent had their high cholesterol inadequately treated.
Surprisingly, being insured was not associated with a widely used measure of diabetes control (a hemoglobin A1c level below 7), a finding the authors attribute to the stringent definition of good diabetes control used in the NHANES survey. Even with excellent medical care, many diabetics fail to achieve such low hemoglobin A1c levels. Using less stringent hemoglobin A1c thresholds of 8 and 9, uninsured adults had significantly worse blood sugar control than their insured counterparts, the researchers found.
Lead author Dr. Andrew Wilper, who worked at Harvard when the study was done and who now teaches at the University of Washington Medical School, said: "Our study should lay to rest the myth that the uninsured can get the care they need. Millions have serious chronic conditions and don't even know it. And they're not getting care that would prevent strokes, heart attacks, amputations and kidney failure."
Referring to a study released in the American Journal of Public Health last month, which has been widely quoted by Sen. Max Baucus and others, he added: "Our previous work demonstrated 45,000 deaths annually are linked to lack of health insurance. Our new findings suggest a mechanism for this increased risk of death among the uninsured. They're not getting life-saving care."
Dr. Steffie Woolhandler, professor of medicine at Harvard and study co-author, said: "The uninsured suffer the most, but even Americans with insurance have shocking rates of undertreatment, in part because high co-payments and deductibles often make care and medications unaffordable. We need to upgrade coverage for the insured, as well as covering the uninsured. Only single-payer national health insurance would make care affordable for the tens of millions of Americans with chronic illnesses."
Dr. David Himmelstein, associate professor of medicine at Harvard and study co-author, said: "The Senate Finance Committee's bill would leave 25 million Americans uninsured and unable to get the ongoing, routine care that could save their lives and prevent disability. No other wealthy nation tolerates this, yet Congress is turning its back on tens of millions of Americans."
"Hypertension, diabetes and elevated cholesterol among insured and uninsured U.S. adults," Andrew P. Wilper, M.D., M.P.H.; Steffie Woolhandler, M.D., M.P.H.; Karen Lasser, M.D., M.P.H.; Danny McCormick, M.D., M.P.H.; David H. Bor, M.D.; David U. Himmelstein, M.D. Health Affairs, Oct. 20, 2009 (online).
Source:
Mark Almberg
Physicians for a National Health Program
Oct 13, 2009
What Is Testicular Cancer? What Causes Testicular Cancer?
Testicular cancer, or cancer of the testes, occurs in the testicles (testes), inside the scrotum. The scrotum is a loose bag of skin under the penis. Male sex hormones, testosterone, and sperm for reproduction are produced in the testicles. The testicles are a pair of male sex glands, also known as gonads. Testosterone controls the development of the reproductive organs, and other male physical characteristics.
Although testicular cancer is uncommon compared to other cancers (0.7% of all cancers), it is the most common cancer in males aged between 15 and 35 in North America and Europe. Just under 2,000 men are diagnosed with this type of cancer annually in the United Kingdom. About 70 British males die each year from testicular cancer. 8,000 American males are diagnosed and 390 die each year in the USA of this disease.
Testicular cancer occurs when the cells become malignant (cancerous) in either one or both testicles. White (Caucasian) males, especially those of Scandinavian descent are more susceptible to developing the disease compared to other men.
The incidence of testicular cancer in the USA has more than doubled over the last four decades among Caucasian males, and has recently started to rise among afro-American males. Experts are not sure why people of different ancestries have varying incidence rates.
What are the risk factors for testicular cancer?
Although scientists are not sure what the specific causes of testicular cancer are, there are some factors which may raise a man's risk of developing the disease. These risk factors include:
* Cryptorchidism (undescended testicle) - testicles usually descend from the inside of the abdomen into the scrotum before a baby boy is born. If a testicle has not moved down when a male is born there is a greater risk that he will develop testicular cancer later on. The increased risk applies to both testicles, and is not lowered if surgery is performed to move it down.
* Congenital abnormalities - males born with abnormalities of the penis, kidneys or testicles have a higher risk.
* Inguinal hernia - males born with a hernia in the groin area have a higher risk than others.
* Having had testicular cancer - if a male has had testicular cancer he is more likely to develop it in the other testicle, compared to a man who has never had testicular cancer.
* Family history - a male who has a close relative - sibling or father - with testicular cancer is more likely to develop it himself compared to other men.
* Abnormal testicular development - conditions, such as Klinefelter's syndrome, where the testicles do not develop normally, may increase a person's risk of testicular cancer.
* Mumps orchitis - this is an uncommon complication of mumps in which one or both testicles become inflamed. This painful complication can also raise a male's risk of developing testicular cancer later on.
* Race - testicular cancer is more common among Caucasian males, compared to men of African or Asian descent. Highest rates are found in Scandinavia, Germany and New Zealand.
Having a vasectomy does not increase a man's risk of developing testicular cancer.
What are the signs and symptoms of testicular cancer?
A symptom is something the patient feels or reports, while a sign is something other people, including a doctor, may detect. For example, pain may be a symptom while a rash could be a sign.
In most cases the patient finds the cancer himself. Sometimes they are discovered by doctors during a routine physical exam. If you notice anything unusual about your testicles you should see your doctor, especially if you detect any of the following:
* A lump or swelling in a testicle (painless)
* Pain in a testicle or scrotum
* Discomfort in a testicle or scrotum
* A sensation of heaviness in the scrotum
* A dull ache in the lower back
* A dull ache in the groin
* A dull ache in the abdomen
* A sudden accumulation of fluid in the scrotum
* Unexplained tiredness or malaise
These symptoms may not necessarily be caused by cancer. In fact, less than 4% of lumps in the testicles are found to be cancerous. You should not ignore a lump or swelling in the testicle, though. It is important to see your doctor, who can find out what the cause is.
In rare cases the man may notice that his breast area is enlarged and tender. His nipples may feel sore and tender as well. This is caused by hormonal changes occurring in his body.
Even though testicular cancer can spread to the lymph nodes, it hardly ever travels to other organs. If the cancer does spread, the patient may experience:
* Coughing
* Breathing difficulties
* Swallowing difficulties
* Swelling in the chest
How is testicular cancer diagnosed?
The doctor will interview the patient; perform a physical examination, and possibly order laboratory and diagnostic tests. These may include:
* Blood tests - the aim here is to measure levels of tumor markers. Tumor markers are substances which exist in higher-than-normal levels when cancer is present. If levels of alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG), and lactate dehydrogenase (LDH) are higher than normal it may suggest there is a testicular tumor, even if a physical exam or imaging tests did not detect it.
Not all forms of testicular cancer produce these markers. It is possible that blood tests come back normal, even though cancer is present.
* Ultrasound - this is a test that uses high-frequency sound waves that bounce off internal organs and tissues. Their echoes are processed and a picture is viewed on a monitor. An ultrasound of the scrotum can reveal the presence and also the size of a tumor. The doctor may also be able to determine the nature of any lump, whether they are solid or filled with fluid, inside or outside the testicle. This information helps the health care provider decide whether or not the lump is cancerous.
* Biopsy - a small sample of tissue is taken from the targeted area in the testicle and examined under a microscope by a pathologist to determine whether the lump is malignant (cancerous) or benign (non-cancerous).
In most cases the only way to perform a biopsy safely is to remove the whole testicle - to perform an orchidectomy. This is because the risk of the cancer spreading if a conventional biopsy is taken is high. The specialist will only remove the testicle for a biopsy if it seems very likely the lump is cancerous. If a patient has two testicles and has one removed he can still produce sperm from the other one and procreate.
Determining what type of testicular cancer it is
When the doctor has determined the type of testicular cancer the patient has, he/she can then devise a treatment plan and make a prognosis. There are two main types of testicular cancer:
* Seminoma testicular cancer - these contain only seminoma cells. All age groups can get this type of cancer. However, most older men who do develop testicular cancer will probably have this type. It is less aggressive than non-seminomas and responds well to radiation therapy.
* Non-seminoma testicular cancer - these may contain many different cancer cells. Non-seminoma tumors tend to affect younger patients and will spread more rapidly than seminoma ones. Many types of non-seminoma tumors exist, including:
o Choriocarcinoma
o Embryonal carcinoma
o Teratoma
o Yolk sac tumor
This type of cancer is also sensitive to radiation therapy, but less so compared to seminomas. Chemotherapy is usually effective for non-seminomas.
Most testicular cancers start in the germ cells - the cells in the testicles that produce immature sperm. We don't know what causes those cells to become abnormal and cancerous.
Sometimes both types of cancers may be present. If this is the case the doctor will use non-seminoma treatment.
Staging the cancer
If the doctor diagnoses testicular cancer, it is important to determine how advanced it is. In order to find out whether the cancer has left its site of origin (whether it has spread), the doctor may order an MRI (medical resonance imaging) scan, CT (computerized tomography) scan, and X-rays.
Blood tests will help determine whether cancer is still in the patient's body after the testicle was surgically removed.
After carrying out all the relevant tests, the doctor will then be able to stage the cancer. This helps determine what treatment to use.
* Stage I - the cancer is only in the testis (testicle). It has not spread outside.
* Stage II - the cancer has reached the lymph nodes in the abdomen.
* Stage III - the cancer has spread further, to other parts of the body. This could include the lungs, liver, brain and bones.
What are the treatment options for testicular cancer?
Testicular cancer treatment has a success rate of about 95% - in other words, 95% of all testicular cancer patients who receive treatment make a full recover. The sooner a patient is diagnosed and treated the better his prognosis is.
Treatment for testicular cancer may involve surgery, radiotherapy, chemotherapy, or a combination.
Surgery
* Orchidectomy - usually the first line of treatment. The testicle is surgically removed to prevent the tumor from spreading. If the patient is diagnosed and treated in Stage I, surgery may be the only treatment needed.
An orchidectomy is a straightforward operation. The patient receives a general anesthetic. A small incision is made in the groin and the whole testicle is removed through the incision. Patients have the option of having a prosthetic testicle, made of silicon, inserted into the scrotum - this will be for esthetic reasons only (not health reasons).
The patient remains in hospital for a few days.
If the man still has one testicle after the operation, his sex life and chances of reproducing should not be affected.
o Ending up with no testicles
If the male either had both testicles removed, or only had one testicle before the operation; in other words, if after the operation the patient has no testicles, he will be infertile. He will not be able to produce sperm. Males who wish to have children one day should consider banking their sperm before the operation - some sperm is kept in a sperm-bank before the testicle or testicles are removed.
o Hormone replacement therapy
The body will stop producing testosterone if the man has no testicles. Testosterone is a male hormone, which among other things, is involved in driving his libido (sex drive) and maintaining an erection. Testosterone replacement therapy involves providing the patient with testosterone. The patient either receives injections or applies patches to his skin. Injections are given every two to three weeks. Testosterone replacement therapy helps maintain a male's libido and erectile function.
* Lymph node surgery - if the cancer has reached the lymph nodes they will need to be surgically removed. This usually involves the lymph nodes in the abdomen and chest. Sometimes lymph node surgery can result in infertility. Patients who wish to have children one day should consider banking their sperm.
Nerve sparing lymph node dissection is a surgical technique which significantly lowers the risk of subsequent infertility. The procedure is carried out by very specialist surgeons who may not be available in many parts of the world. The risk of cancer recurrence is higher with this procedure because not all of the lymph node is taken out.
Radiation therapy (radiotherapy)
Radiotherapy, also known as radiation therapy, radiation oncology and XRT, is used for treating cancer, thyroid disorders and some blood disorders. Approximately 40% of patients of all types of cancer undergo some kind of radiotherapy. It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce.
Patients with seminoma testicular cancer will typically require radiotherapy as well as surgery. The radiotherapy is used to prevent cancer recurrence.
Patients whose cancer has spread to their lymph nodes will need radiation therapy.
Radiation therapy may cause the following temporary side effects:
* Tiredness
* Rashes
* Muscle stiffness
* Joint stiffness
* Loss of appetite
* Nausea
Chemotherapy
Chemotherapy is the use of chemicals (medication) to treat disease - more specifically, it usually refers to the destruction of cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing. When health care professionals talk about chemotherapy today, they generally tend to refer more to cytotoxic medication than others. Cytotoxic simply means it is toxic to cells, it kills cells, which in the case of chemotherapy refers to cancer cells.
Chemotherapy (chemo) drugs either interfere with a cancer cell's ability to divide and reproduce, or kills them.
Chemotherapy is usually given to patients with advanced testicular cancer - cancer that has spread to other parts of the body.
Chemotherapy is also used to prevent recurrence of cancer - to stop the cancer from coming back.
Most commonly, chemotherapy is used for the treatment of non-seminoma tumors.
Treatment is administered either orally (tablets by mouth) or injection.
As chemotherapy attacks healthy (good) cells as well as cancerous ones, the patient may experience the following temporary side effects:
* Nausea
* Vomiting
* Hair loss
* Mouth sores
* Tiredness
* Malaise
Most people immediately link chemotherapy with uncomfortable side effects. However, side-effect management has improved considerably over the last twenty years. Many side effects that were once inevitable can be either prevented or well controlled today. There is no reliable way to predict how patients may react to chemotherapy. Some experience very mild side-effect, others will have none at all, while some people will report various symptoms.
Prevention of testicular cancer
Preventing testicular cancer may not be possible, but making sure it does not advance before diagnosis and treatment is. In other words, if you check yourself regularly for signs and symptoms of testicular cancer you are more likely to be one of those 95% of patients who make a full recovery if you do develop testicular cancer.
How to check yourself
The best time to check yourself is when the scrotal skin is relaxed; usually after a warm shower or bath.
* Gently hold your scrotum in the palms of both your hands. Stand in front of the mirror and look for any swelling on the skin of the scrotum.
* Feel the size and weight of your testicles first.
* With your fingers and thumbs press around and be receptive for any lumps or unusual swellings. Become familiar with your own testicles. Some men have one testicle that hangs lower than the other. Some people have one testicle which is bigger than the other. This is normal.
* Each time you check yourself try to detect any significant increase in the size or weight of your testicles.
* Feel each testicle individually. Place the index and middle fingers under the testicle while your thumbs are on the top. Gently roll the testicle between the thumbs and the fingers - it should be smooth, oval shaped, and somewhat firm; there should be no lumps or swellings. The top and back of each testicle should have a tube-like section which may be slightly tender - this is where sperm is stored (epididymis). It is normal for it to feel tender.
If you are not sure what a testicle should feel like, remember this:
* They should both have a similar feel.
* As cancer in both testicles is extremely rare, you are unlikely to feel two identical testicles that have cancer.
* If one feels different from the other, tell your doctor.
* Also, tell your doctor if a testicle does not have the same feel compared to your last self-check.
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Although testicular cancer is uncommon compared to other cancers (0.7% of all cancers), it is the most common cancer in males aged between 15 and 35 in North America and Europe. Just under 2,000 men are diagnosed with this type of cancer annually in the United Kingdom. About 70 British males die each year from testicular cancer. 8,000 American males are diagnosed and 390 die each year in the USA of this disease.
Testicular cancer occurs when the cells become malignant (cancerous) in either one or both testicles. White (Caucasian) males, especially those of Scandinavian descent are more susceptible to developing the disease compared to other men.
The incidence of testicular cancer in the USA has more than doubled over the last four decades among Caucasian males, and has recently started to rise among afro-American males. Experts are not sure why people of different ancestries have varying incidence rates.
What are the risk factors for testicular cancer?
Although scientists are not sure what the specific causes of testicular cancer are, there are some factors which may raise a man's risk of developing the disease. These risk factors include:
* Cryptorchidism (undescended testicle) - testicles usually descend from the inside of the abdomen into the scrotum before a baby boy is born. If a testicle has not moved down when a male is born there is a greater risk that he will develop testicular cancer later on. The increased risk applies to both testicles, and is not lowered if surgery is performed to move it down.
* Congenital abnormalities - males born with abnormalities of the penis, kidneys or testicles have a higher risk.
* Inguinal hernia - males born with a hernia in the groin area have a higher risk than others.
* Having had testicular cancer - if a male has had testicular cancer he is more likely to develop it in the other testicle, compared to a man who has never had testicular cancer.
* Family history - a male who has a close relative - sibling or father - with testicular cancer is more likely to develop it himself compared to other men.
* Abnormal testicular development - conditions, such as Klinefelter's syndrome, where the testicles do not develop normally, may increase a person's risk of testicular cancer.
* Mumps orchitis - this is an uncommon complication of mumps in which one or both testicles become inflamed. This painful complication can also raise a male's risk of developing testicular cancer later on.
* Race - testicular cancer is more common among Caucasian males, compared to men of African or Asian descent. Highest rates are found in Scandinavia, Germany and New Zealand.
Having a vasectomy does not increase a man's risk of developing testicular cancer.
What are the signs and symptoms of testicular cancer?
A symptom is something the patient feels or reports, while a sign is something other people, including a doctor, may detect. For example, pain may be a symptom while a rash could be a sign.
In most cases the patient finds the cancer himself. Sometimes they are discovered by doctors during a routine physical exam. If you notice anything unusual about your testicles you should see your doctor, especially if you detect any of the following:
* A lump or swelling in a testicle (painless)
* Pain in a testicle or scrotum
* Discomfort in a testicle or scrotum
* A sensation of heaviness in the scrotum
* A dull ache in the lower back
* A dull ache in the groin
* A dull ache in the abdomen
* A sudden accumulation of fluid in the scrotum
* Unexplained tiredness or malaise
These symptoms may not necessarily be caused by cancer. In fact, less than 4% of lumps in the testicles are found to be cancerous. You should not ignore a lump or swelling in the testicle, though. It is important to see your doctor, who can find out what the cause is.
In rare cases the man may notice that his breast area is enlarged and tender. His nipples may feel sore and tender as well. This is caused by hormonal changes occurring in his body.
Even though testicular cancer can spread to the lymph nodes, it hardly ever travels to other organs. If the cancer does spread, the patient may experience:
* Coughing
* Breathing difficulties
* Swallowing difficulties
* Swelling in the chest
How is testicular cancer diagnosed?
The doctor will interview the patient; perform a physical examination, and possibly order laboratory and diagnostic tests. These may include:
* Blood tests - the aim here is to measure levels of tumor markers. Tumor markers are substances which exist in higher-than-normal levels when cancer is present. If levels of alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG), and lactate dehydrogenase (LDH) are higher than normal it may suggest there is a testicular tumor, even if a physical exam or imaging tests did not detect it.
Not all forms of testicular cancer produce these markers. It is possible that blood tests come back normal, even though cancer is present.
* Ultrasound - this is a test that uses high-frequency sound waves that bounce off internal organs and tissues. Their echoes are processed and a picture is viewed on a monitor. An ultrasound of the scrotum can reveal the presence and also the size of a tumor. The doctor may also be able to determine the nature of any lump, whether they are solid or filled with fluid, inside or outside the testicle. This information helps the health care provider decide whether or not the lump is cancerous.
* Biopsy - a small sample of tissue is taken from the targeted area in the testicle and examined under a microscope by a pathologist to determine whether the lump is malignant (cancerous) or benign (non-cancerous).
In most cases the only way to perform a biopsy safely is to remove the whole testicle - to perform an orchidectomy. This is because the risk of the cancer spreading if a conventional biopsy is taken is high. The specialist will only remove the testicle for a biopsy if it seems very likely the lump is cancerous. If a patient has two testicles and has one removed he can still produce sperm from the other one and procreate.
Determining what type of testicular cancer it is
When the doctor has determined the type of testicular cancer the patient has, he/she can then devise a treatment plan and make a prognosis. There are two main types of testicular cancer:
* Seminoma testicular cancer - these contain only seminoma cells. All age groups can get this type of cancer. However, most older men who do develop testicular cancer will probably have this type. It is less aggressive than non-seminomas and responds well to radiation therapy.
* Non-seminoma testicular cancer - these may contain many different cancer cells. Non-seminoma tumors tend to affect younger patients and will spread more rapidly than seminoma ones. Many types of non-seminoma tumors exist, including:
o Choriocarcinoma
o Embryonal carcinoma
o Teratoma
o Yolk sac tumor
This type of cancer is also sensitive to radiation therapy, but less so compared to seminomas. Chemotherapy is usually effective for non-seminomas.
Most testicular cancers start in the germ cells - the cells in the testicles that produce immature sperm. We don't know what causes those cells to become abnormal and cancerous.
Sometimes both types of cancers may be present. If this is the case the doctor will use non-seminoma treatment.
Staging the cancer
If the doctor diagnoses testicular cancer, it is important to determine how advanced it is. In order to find out whether the cancer has left its site of origin (whether it has spread), the doctor may order an MRI (medical resonance imaging) scan, CT (computerized tomography) scan, and X-rays.
Blood tests will help determine whether cancer is still in the patient's body after the testicle was surgically removed.
After carrying out all the relevant tests, the doctor will then be able to stage the cancer. This helps determine what treatment to use.
* Stage I - the cancer is only in the testis (testicle). It has not spread outside.
* Stage II - the cancer has reached the lymph nodes in the abdomen.
* Stage III - the cancer has spread further, to other parts of the body. This could include the lungs, liver, brain and bones.
What are the treatment options for testicular cancer?
Testicular cancer treatment has a success rate of about 95% - in other words, 95% of all testicular cancer patients who receive treatment make a full recover. The sooner a patient is diagnosed and treated the better his prognosis is.
Treatment for testicular cancer may involve surgery, radiotherapy, chemotherapy, or a combination.
Surgery
* Orchidectomy - usually the first line of treatment. The testicle is surgically removed to prevent the tumor from spreading. If the patient is diagnosed and treated in Stage I, surgery may be the only treatment needed.
An orchidectomy is a straightforward operation. The patient receives a general anesthetic. A small incision is made in the groin and the whole testicle is removed through the incision. Patients have the option of having a prosthetic testicle, made of silicon, inserted into the scrotum - this will be for esthetic reasons only (not health reasons).
The patient remains in hospital for a few days.
If the man still has one testicle after the operation, his sex life and chances of reproducing should not be affected.
o Ending up with no testicles
If the male either had both testicles removed, or only had one testicle before the operation; in other words, if after the operation the patient has no testicles, he will be infertile. He will not be able to produce sperm. Males who wish to have children one day should consider banking their sperm before the operation - some sperm is kept in a sperm-bank before the testicle or testicles are removed.
o Hormone replacement therapy
The body will stop producing testosterone if the man has no testicles. Testosterone is a male hormone, which among other things, is involved in driving his libido (sex drive) and maintaining an erection. Testosterone replacement therapy involves providing the patient with testosterone. The patient either receives injections or applies patches to his skin. Injections are given every two to three weeks. Testosterone replacement therapy helps maintain a male's libido and erectile function.
* Lymph node surgery - if the cancer has reached the lymph nodes they will need to be surgically removed. This usually involves the lymph nodes in the abdomen and chest. Sometimes lymph node surgery can result in infertility. Patients who wish to have children one day should consider banking their sperm.
Nerve sparing lymph node dissection is a surgical technique which significantly lowers the risk of subsequent infertility. The procedure is carried out by very specialist surgeons who may not be available in many parts of the world. The risk of cancer recurrence is higher with this procedure because not all of the lymph node is taken out.
Radiation therapy (radiotherapy)
Radiotherapy, also known as radiation therapy, radiation oncology and XRT, is used for treating cancer, thyroid disorders and some blood disorders. Approximately 40% of patients of all types of cancer undergo some kind of radiotherapy. It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce.
Patients with seminoma testicular cancer will typically require radiotherapy as well as surgery. The radiotherapy is used to prevent cancer recurrence.
Patients whose cancer has spread to their lymph nodes will need radiation therapy.
Radiation therapy may cause the following temporary side effects:
* Tiredness
* Rashes
* Muscle stiffness
* Joint stiffness
* Loss of appetite
* Nausea
Chemotherapy
Chemotherapy is the use of chemicals (medication) to treat disease - more specifically, it usually refers to the destruction of cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing. When health care professionals talk about chemotherapy today, they generally tend to refer more to cytotoxic medication than others. Cytotoxic simply means it is toxic to cells, it kills cells, which in the case of chemotherapy refers to cancer cells.
Chemotherapy (chemo) drugs either interfere with a cancer cell's ability to divide and reproduce, or kills them.
Chemotherapy is usually given to patients with advanced testicular cancer - cancer that has spread to other parts of the body.
Chemotherapy is also used to prevent recurrence of cancer - to stop the cancer from coming back.
Most commonly, chemotherapy is used for the treatment of non-seminoma tumors.
Treatment is administered either orally (tablets by mouth) or injection.
As chemotherapy attacks healthy (good) cells as well as cancerous ones, the patient may experience the following temporary side effects:
* Nausea
* Vomiting
* Hair loss
* Mouth sores
* Tiredness
* Malaise
Most people immediately link chemotherapy with uncomfortable side effects. However, side-effect management has improved considerably over the last twenty years. Many side effects that were once inevitable can be either prevented or well controlled today. There is no reliable way to predict how patients may react to chemotherapy. Some experience very mild side-effect, others will have none at all, while some people will report various symptoms.
Prevention of testicular cancer
Preventing testicular cancer may not be possible, but making sure it does not advance before diagnosis and treatment is. In other words, if you check yourself regularly for signs and symptoms of testicular cancer you are more likely to be one of those 95% of patients who make a full recovery if you do develop testicular cancer.
How to check yourself
The best time to check yourself is when the scrotal skin is relaxed; usually after a warm shower or bath.
* Gently hold your scrotum in the palms of both your hands. Stand in front of the mirror and look for any swelling on the skin of the scrotum.
* Feel the size and weight of your testicles first.
* With your fingers and thumbs press around and be receptive for any lumps or unusual swellings. Become familiar with your own testicles. Some men have one testicle that hangs lower than the other. Some people have one testicle which is bigger than the other. This is normal.
* Each time you check yourself try to detect any significant increase in the size or weight of your testicles.
* Feel each testicle individually. Place the index and middle fingers under the testicle while your thumbs are on the top. Gently roll the testicle between the thumbs and the fingers - it should be smooth, oval shaped, and somewhat firm; there should be no lumps or swellings. The top and back of each testicle should have a tube-like section which may be slightly tender - this is where sperm is stored (epididymis). It is normal for it to feel tender.
If you are not sure what a testicle should feel like, remember this:
* They should both have a similar feel.
* As cancer in both testicles is extremely rare, you are unlikely to feel two identical testicles that have cancer.
* If one feels different from the other, tell your doctor.
* Also, tell your doctor if a testicle does not have the same feel compared to your last self-check.
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Oct 7, 2009
Hearing Loss
Hearing Loss Risk In Men Can Be Reduced By Higher Folates, Not Antioxidants
ncreased intakes of antioxidant vitamins have no bearing on whether or not a man will develop hearing loss, but higher folate intake can decrease his risk by 20 percent, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA.
The study, which identified 3,559 cases of men with hearing loss, found that there was no beneficial association with increased intakes of antioxidant vitamins such as C, E, and beta carotene. However, the authors found that men over the age of 60 who have a high intake of foods and supplement high in folates have a 20 percent decrease in risk of developing hearing loss.
Hearing loss is the most common sensory disorder in the United States, affecting more than 36 million people. High folate foods include leafy vegetables such as spinach, asparagus, turnip greens, lettuces, dried or fresh beans and peas, fortified cereal products, sunflower seeds and certain other fruits and vegetables are rich sources of folate. Baker's yeast, liver and liver products also contain high amounts of folate.
The authors believe this is the largest study to delve prospectively into the relation between dietary intake and hearing loss. They used the most recent figures from the Health Professionals Follow-up Study cohort from years 1986 to 2004, a group consisting of 51,529 male health professionals. They were first enrolled into this study in 1986 and filled out detailed health and diet questionnaires every other year. The authors believe their findings can allow greater education, prevention, and screening efforts.
Title:
Vitamin Intake and Risk of Hearing Loss in Men
Author:
Josef Shargorodsky, MD; Gary Curhan, MD; Sharon Curhan, MD; Ronald Eavey, MD
Noise-Induced Hearing Loss Nearly 3 Times As Likely To Occur In Men
A comprehensive study of the prevalence and risk factors for noise-induced hearing loss (NIHL) show that men, especially those who are white and married, are significantly more at risk than women, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA.
The study, which analyzed the audiometric testing data from 5,290 people between the ages of 20 and 69 years indicates that more than 13 percent of subjects suffer from NIHL, which would correspond with approximately 24 million Americans suffering from the ailment. The strongest association was of gender, where men are 2.5 times more likely to develop NIHL than women. Among that group, married white (non-Hispanic) men represent the highest risk group for developing NIHL.
NIHL is a preventable and increasingly prevalent disorder that results from exposure to high-intensity sound, especially over a long period of time.
The authors believe this is the first study of its kind to delve in to the demographics of NIHL using the most recent figures from 1999-2004 National Health and Nutrition Examination Surveys (NHANES). They believe this information can allow greater education, preventative, and screening efforts.
Title:
Prevalence and Risk Factors for Noise Induced Hearing Loss
Author:
Shawn Zardouz; Hamid Djalilian, MD; Vanessa Rothholtz, MD, MSc; Mohsen Barazgan
Source:
Matt Daigle
American Academy of Otolaryngology -- Head and Neck Surgery
ncreased intakes of antioxidant vitamins have no bearing on whether or not a man will develop hearing loss, but higher folate intake can decrease his risk by 20 percent, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA.
The study, which identified 3,559 cases of men with hearing loss, found that there was no beneficial association with increased intakes of antioxidant vitamins such as C, E, and beta carotene. However, the authors found that men over the age of 60 who have a high intake of foods and supplement high in folates have a 20 percent decrease in risk of developing hearing loss.
Hearing loss is the most common sensory disorder in the United States, affecting more than 36 million people. High folate foods include leafy vegetables such as spinach, asparagus, turnip greens, lettuces, dried or fresh beans and peas, fortified cereal products, sunflower seeds and certain other fruits and vegetables are rich sources of folate. Baker's yeast, liver and liver products also contain high amounts of folate.
The authors believe this is the largest study to delve prospectively into the relation between dietary intake and hearing loss. They used the most recent figures from the Health Professionals Follow-up Study cohort from years 1986 to 2004, a group consisting of 51,529 male health professionals. They were first enrolled into this study in 1986 and filled out detailed health and diet questionnaires every other year. The authors believe their findings can allow greater education, prevention, and screening efforts.
Title:
Vitamin Intake and Risk of Hearing Loss in Men
Author:
Josef Shargorodsky, MD; Gary Curhan, MD; Sharon Curhan, MD; Ronald Eavey, MD
Noise-Induced Hearing Loss Nearly 3 Times As Likely To Occur In Men
A comprehensive study of the prevalence and risk factors for noise-induced hearing loss (NIHL) show that men, especially those who are white and married, are significantly more at risk than women, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA.
The study, which analyzed the audiometric testing data from 5,290 people between the ages of 20 and 69 years indicates that more than 13 percent of subjects suffer from NIHL, which would correspond with approximately 24 million Americans suffering from the ailment. The strongest association was of gender, where men are 2.5 times more likely to develop NIHL than women. Among that group, married white (non-Hispanic) men represent the highest risk group for developing NIHL.
NIHL is a preventable and increasingly prevalent disorder that results from exposure to high-intensity sound, especially over a long period of time.
The authors believe this is the first study of its kind to delve in to the demographics of NIHL using the most recent figures from 1999-2004 National Health and Nutrition Examination Surveys (NHANES). They believe this information can allow greater education, preventative, and screening efforts.
Title:
Prevalence and Risk Factors for Noise Induced Hearing Loss
Author:
Shawn Zardouz; Hamid Djalilian, MD; Vanessa Rothholtz, MD, MSc; Mohsen Barazgan
Source:
Matt Daigle
American Academy of Otolaryngology -- Head and Neck Surgery
231 New Genes Associated With Head And Neck Cancer Revealed By Study
A Henry Ford Hospital study has identified 231 new genes associated with head and neck cancer, one of the most deadly cancers responsible for 2.1 percent of all cancer deaths in the United States.
Previously, only 33 genes were reported associated with head and neck cancer.
"These new genes should advance selection of head and neck-specific gene targets, opening the door to promising new molecular strategies for the early detection and treatment of head and neck cancer," says study lead author Maria J. Worsham, Ph.D., director of research in the Department of Otolaryngology at Henry Ford Hospital. "It also may offer the opportunity to help monitor disease progression and a patient's response to treatment."
Results from the study were presented Sunday, Oct. 4 at the American Academy of Otolaryngology - Head & Neck Surgery Foundation Annual Meeting & OTO EXPO in San Diego.
This year alone, more than 55,000 Americans will develop head and neck cancer, which includes cancers of the mouth, nose, sinuses, salivary glands, throat and lymph nodes in the neck; nearly 13,000 of them will die from it.
According to the National Cancer Institute, 85 percent of head and neck cancers are linked to tobacco use. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone.
Treatment for head and neck cancer varies based on the location and stage of the tumor, but most often includes surgery, radiation therapy or chemotherapy.
To identify new genes that could ultimately aid in future diagnosis and treatment of head and neck cancer, Dr. Worsham's study used a whole-genome methylation approach to detect genes with altered promoter gene regions due to DNA methylation. DNA methylation - a type of chemical modification of DNA where a methyl group (CH3) can be added (hypermethylation) or removed (hypomethylation) - allows the researchers to look for genetic abnormalities within tumor samples.
Using five DNA samples from tumor tissue, the researchers looked for 1,043 possible cancer genes. Those genes were cross-examined with those already reported in PubMeth, a cancer methylation database. Of the 441 genes in the database, only 33 genes were referenced in connection with head and neck cancer.
In all, the whole-genome methylation approach revealed 231 potential new genes not previously reported in head and neck cancer. Of those, 50 percent were present in three or more of the DNA samples, and 20 percent were represented in all five samples.
"DNA methylation is emerging as one of the most promising molecular strategies for early detection of cancer, independent of its role in tumor development," says Dr. Worsham. "Abnormal methylation can result in shutting off or silencing gene function. However, treatment with more recent drugs can reverse abnormal DNA methylation patterns, reactivating silenced genes, and restoring normal gene function. Therefore, a validated head and neck cancer-specific gene panel is likely to signify potential demethylation treatment targets."
Reference: "DNA Hypermethylation Markers of Poor Outcome in Laryngeal Cancer," 2009 AAO - HNSF Annual Meeting & OTO Expo. The study was presented by Dr. Worsham Sunday, Oct. 4.
Research Support: Grant R01 NIH DE 15990
Source:
Krista Hopson
Henry Ford Health System
Previously, only 33 genes were reported associated with head and neck cancer.
"These new genes should advance selection of head and neck-specific gene targets, opening the door to promising new molecular strategies for the early detection and treatment of head and neck cancer," says study lead author Maria J. Worsham, Ph.D., director of research in the Department of Otolaryngology at Henry Ford Hospital. "It also may offer the opportunity to help monitor disease progression and a patient's response to treatment."
Results from the study were presented Sunday, Oct. 4 at the American Academy of Otolaryngology - Head & Neck Surgery Foundation Annual Meeting & OTO EXPO in San Diego.
This year alone, more than 55,000 Americans will develop head and neck cancer, which includes cancers of the mouth, nose, sinuses, salivary glands, throat and lymph nodes in the neck; nearly 13,000 of them will die from it.
According to the National Cancer Institute, 85 percent of head and neck cancers are linked to tobacco use. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone.
Treatment for head and neck cancer varies based on the location and stage of the tumor, but most often includes surgery, radiation therapy or chemotherapy.
To identify new genes that could ultimately aid in future diagnosis and treatment of head and neck cancer, Dr. Worsham's study used a whole-genome methylation approach to detect genes with altered promoter gene regions due to DNA methylation. DNA methylation - a type of chemical modification of DNA where a methyl group (CH3) can be added (hypermethylation) or removed (hypomethylation) - allows the researchers to look for genetic abnormalities within tumor samples.
Using five DNA samples from tumor tissue, the researchers looked for 1,043 possible cancer genes. Those genes were cross-examined with those already reported in PubMeth, a cancer methylation database. Of the 441 genes in the database, only 33 genes were referenced in connection with head and neck cancer.
In all, the whole-genome methylation approach revealed 231 potential new genes not previously reported in head and neck cancer. Of those, 50 percent were present in three or more of the DNA samples, and 20 percent were represented in all five samples.
"DNA methylation is emerging as one of the most promising molecular strategies for early detection of cancer, independent of its role in tumor development," says Dr. Worsham. "Abnormal methylation can result in shutting off or silencing gene function. However, treatment with more recent drugs can reverse abnormal DNA methylation patterns, reactivating silenced genes, and restoring normal gene function. Therefore, a validated head and neck cancer-specific gene panel is likely to signify potential demethylation treatment targets."
Reference: "DNA Hypermethylation Markers of Poor Outcome in Laryngeal Cancer," 2009 AAO - HNSF Annual Meeting & OTO Expo. The study was presented by Dr. Worsham Sunday, Oct. 4.
Research Support: Grant R01 NIH DE 15990
Source:
Krista Hopson
Henry Ford Health System
Sep 29, 2009
Government Of Canada Partners With Alberta Lung Association To Reduce Tobacco Use In The Workplace
he Honourable Rona Ambrose, federal Minister of Labour, announced funding for a project administered through The Lung Association, Alberta & NWT that is designed to reduce tobacco use among employees who work in industries with higher than average smoking rates. Today's announcement is being made on behalf of the Honourable Leona Aglukkaq, Minister of Health.
"The Government of Canada is proud to be working with The Lung Association, Alberta & NWT and its partners to help curb cigarette smoking among employees in industry sectors that have been traditionally hard to reach," said Minister Ambrose. "I look forward to seeing the progress that is made on this front in the months and years ahead."
Funding from today's announcement will go towards the Smart Steps...towards a smoke-free life project. Although the Smart Steps program is designed for all employees in workplaces across Alberta, the project will focus on helping employees who work in industries with higher than average smoking rates quit smoking. The project hopes to reach young adults who work in retail, construction, transportation as well as the oil and gas sector with on-site tobacco cessation programming and personalized action plans to help them quit. Funding for this project will help deliver smoking cessation workshops in 25 additional workplaces located in seven cities across Alberta.
"We are thrilled about the funding support from Health Canada. It shows the government's commitment to tobacco reduction and the health of all Canadians," said Tony Hudson, The Lung Association, Alberta & NWT's President & CEO, "Today's investment by the federal government will ensure that our organization can provide workplaces across the province with an effective cessation program that will empower Albertans to quit smoking. This is an exciting moment for The Lung Association, and Albertans who want to breathe easier."
Smoking remains the most preventable cause of disease and premature death in Canada. More than 37,000 people die prematurely each year in Canada due to tobacco use and more than 830 non-smokers died in Canada from second-hand smoke. Given these statistics, Health Canada is pleased to have contributed $184,071 to the Smart Steps...towards a smoke-free life project.
For more information on Health Canada's tobacco control efforts, please visit http://www.gosmokefree.ca.
Source
Health Canada
"The Government of Canada is proud to be working with The Lung Association, Alberta & NWT and its partners to help curb cigarette smoking among employees in industry sectors that have been traditionally hard to reach," said Minister Ambrose. "I look forward to seeing the progress that is made on this front in the months and years ahead."
Funding from today's announcement will go towards the Smart Steps...towards a smoke-free life project. Although the Smart Steps program is designed for all employees in workplaces across Alberta, the project will focus on helping employees who work in industries with higher than average smoking rates quit smoking. The project hopes to reach young adults who work in retail, construction, transportation as well as the oil and gas sector with on-site tobacco cessation programming and personalized action plans to help them quit. Funding for this project will help deliver smoking cessation workshops in 25 additional workplaces located in seven cities across Alberta.
"We are thrilled about the funding support from Health Canada. It shows the government's commitment to tobacco reduction and the health of all Canadians," said Tony Hudson, The Lung Association, Alberta & NWT's President & CEO, "Today's investment by the federal government will ensure that our organization can provide workplaces across the province with an effective cessation program that will empower Albertans to quit smoking. This is an exciting moment for The Lung Association, and Albertans who want to breathe easier."
Smoking remains the most preventable cause of disease and premature death in Canada. More than 37,000 people die prematurely each year in Canada due to tobacco use and more than 830 non-smokers died in Canada from second-hand smoke. Given these statistics, Health Canada is pleased to have contributed $184,071 to the Smart Steps...towards a smoke-free life project.
For more information on Health Canada's tobacco control efforts, please visit http://www.gosmokefree.ca.
Source
Health Canada
Experts Recommend New Name, More Research On Nonmalignant Breast Tumor
On Thursday, a panel of medical experts convened by NIH recommended that the word "carcinoma" be removed from the name of a nonmalignant breast tumor called ductal carcinoma in situ because the current terminology can mislead some women into believing they are likely to develop breast cancer, Reuters reports. DCIS is a condition in which abnormal cells have grown in the milk duct but not spread to breast tissue. The panel said more research is needed to determine the likelihood that a woman's DCIS will progress into actual invasive breast cancer.
Since the start of widespread mammography in the late 1980s, DCIS diagnosis rates have increased sevenfold. By 2020, approximately one million U.S. women are expected to be living with the condition (Steenhuysen, Reuters, 9/24). More than 50,000 women are diagnosed with DCIS annually (Neergaard, AP/Baltimore Sun, 9/24).
Because DCIS is believed to be a risk factor for developing invasive breast cancer, the abnormal cells are removed, and only about 2% of DCIS patients die of breast cancer within 10 years. However, doctors have no way of knowing which women were at risk of developing invasive cancer and which would have remained healthy without treatment. In addition, there are vast differences in how the condition is treated, ranging from simple surgeries to chemotherapy or even protective removal of the opposite, healthy breast, the AP/Baltimore Sun reports (AP/Baltimore Sun, 9/24).
The panel concluded that a significant amount of new research is needed to determine which women can safely forgo intensive treatment (AP/Baltimore Sun, 9/24). "Despite having had a century of knowledge of the disease, we do not understand the natural history of DCIS, and probably never will," according to panel Chair Carmen Allegra, an oncologist at the University of Florida (Reuters, 9/24).
The panel said that changing the name of the condition will help doctors better convey that while growth should not be ignored, there is no need for panic. While the experts did not offer an alternative name, Allegra said that the current inclusion of "carcinoma" in the name "carries with it such a disproportionate level of anxiety relative to the relatively indolent nature of the disease" (AP/Baltimore Sun, 9/24). Panel member Arnold Schwartz, a surgical pathologist at the George Washington University Hospital, disagreed with the panel's recommendation to change the name. He said that many other cancers and precursor cancers include the name carcinoma in situ -- including those of the skin, head and neck, esophagus and bladder -- "without any emotional impact" (Reuters, 9/24).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Since the start of widespread mammography in the late 1980s, DCIS diagnosis rates have increased sevenfold. By 2020, approximately one million U.S. women are expected to be living with the condition (Steenhuysen, Reuters, 9/24). More than 50,000 women are diagnosed with DCIS annually (Neergaard, AP/Baltimore Sun, 9/24).
Because DCIS is believed to be a risk factor for developing invasive breast cancer, the abnormal cells are removed, and only about 2% of DCIS patients die of breast cancer within 10 years. However, doctors have no way of knowing which women were at risk of developing invasive cancer and which would have remained healthy without treatment. In addition, there are vast differences in how the condition is treated, ranging from simple surgeries to chemotherapy or even protective removal of the opposite, healthy breast, the AP/Baltimore Sun reports (AP/Baltimore Sun, 9/24).
The panel concluded that a significant amount of new research is needed to determine which women can safely forgo intensive treatment (AP/Baltimore Sun, 9/24). "Despite having had a century of knowledge of the disease, we do not understand the natural history of DCIS, and probably never will," according to panel Chair Carmen Allegra, an oncologist at the University of Florida (Reuters, 9/24).
The panel said that changing the name of the condition will help doctors better convey that while growth should not be ignored, there is no need for panic. While the experts did not offer an alternative name, Allegra said that the current inclusion of "carcinoma" in the name "carries with it such a disproportionate level of anxiety relative to the relatively indolent nature of the disease" (AP/Baltimore Sun, 9/24). Panel member Arnold Schwartz, a surgical pathologist at the George Washington University Hospital, disagreed with the panel's recommendation to change the name. He said that many other cancers and precursor cancers include the name carcinoma in situ -- including those of the skin, head and neck, esophagus and bladder -- "without any emotional impact" (Reuters, 9/24).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Sep 21, 2009
Wear Ease Designs The Latest Fashions With Mastectomy Patients In Mind
One in eight U.S. women will be diagnosed with breast cancer during their lifetime, and currently slightly more than half, 56 percent, undergo mastectomy. Few fashion options exist for those who don't seek reconstructive surgery or postpone it until after their treatment and recovery - a condition the clothier Wear Ease (http://www.WearEase.com) seeks to remedy.
"Fighting breast cancer is a big enough challenge," says Wear Ease owner Phyllis Keith. "We're trying to help ensure women don't also lose their self-esteem, dignity, and femininity."
Wear Ease designs and markets post-surgery and mastectomy bras, camisoles, loungewear, and lingerie. According to several specialty boutiques, its clothing is in vogue.
"We started ordering their Dawn post-surgery camisole because it's prettier than other brands, and they're flying off the shelves," says Michele Yett, a certified mastectomy fitter at Expressions Appearance Center at St. Jude Medical Center in Fullerton, Calif. "They're great products - they come with fiber-filled breast forms and a pair of pouches for drain tubes and bulb syringes, plus they're comfortable, they come in a variety of colors, and they're very desirable in terms of femininity."
Pamela Ludwig, who owns Pretty in Pink Boutiques in Franklin and Nashville, Tenn., concurs. "The post-op camisole is so comfortable and stylish a lot of my patients wear them far beyond the post-op period," Ludwig says. "Often they wear a black one as a fashion camisole under a black blouse."
Retailers also say the Wear Ease line helps women feel whole. "They're very up to date with fashion trends," says Sheila Robertsdahl, a certified orthotic/mastectomy fitter and manager of the Just for Women boutique at MeritCare HealthCare Accessories in Fargo, N.D. "And with the way the pockets for the prostheses are designed, nobody can even tell it's a pocketed mastectomy garment."
Ludwig, a registered nurse who worked for 10 years in clinical oncology before opening Pretty in Pink in 2005, agrees, adding, "With off-the-shelf products like these available, women can achieve the look they want without having to undergo reconstructive surgery." However, she says many patients undergoing breast reconstruction use Wear Ease products, too. "A lot of times reconstruction doesn't give a woman the exact symmetrical look she wants," she says, "so you can sometimes fix that with a bra or partial prosthesis."
This month Wear Ease is introducing a brand-new line: the Alicia adjustable-strap camisole. "This beautiful camisole enables a woman who has undergone breast surgery to wear an alternative top just like she would have worn beforehand," Keith says. "It is designed to accommodate her breast forms and does not require her to wear a special bra underneath." Available in black, coral, kiwi green, and aqua blue, the Alicia camisole comes in S, M, L, XL, 1X, and 2X sizes.
The new product is a hit among retailers. "The new Alicia camisole with the lace is going to be a super seller," Robertsdahl says, and Yett says, "We all think it looks darling." "I love the colors available with the Alicia," Ludwig says. "They're very fresh - there's nothing else on the market with colors like those."
In addition to the Alicia and Dawn mastectomy camisoles, Wear Ease sells post-surgery bras and post-mastectomy nightgowns and T-shirts with reversible necklines. It also sells compression garments, including compression bras, slimmers, and shapers to facilitate healing after surgery or treat swelling in the trunk caused by Lymphedema. Wear Ease garments come standard with shelf bras and pockets for breast forms. All insurance, including Medicare, covers breast forms and pocketed breast-surgery bras and camisoles.
Keith founded Wear Ease in 2001 to offer the Sarah Bra designed for women with limited mobility. In 2005 the company diversified into the post-mastectomy specialty market and has since grown to include 20 products across five lines.
Source
Wear Ease
"Fighting breast cancer is a big enough challenge," says Wear Ease owner Phyllis Keith. "We're trying to help ensure women don't also lose their self-esteem, dignity, and femininity."
Wear Ease designs and markets post-surgery and mastectomy bras, camisoles, loungewear, and lingerie. According to several specialty boutiques, its clothing is in vogue.
"We started ordering their Dawn post-surgery camisole because it's prettier than other brands, and they're flying off the shelves," says Michele Yett, a certified mastectomy fitter at Expressions Appearance Center at St. Jude Medical Center in Fullerton, Calif. "They're great products - they come with fiber-filled breast forms and a pair of pouches for drain tubes and bulb syringes, plus they're comfortable, they come in a variety of colors, and they're very desirable in terms of femininity."
Pamela Ludwig, who owns Pretty in Pink Boutiques in Franklin and Nashville, Tenn., concurs. "The post-op camisole is so comfortable and stylish a lot of my patients wear them far beyond the post-op period," Ludwig says. "Often they wear a black one as a fashion camisole under a black blouse."
Retailers also say the Wear Ease line helps women feel whole. "They're very up to date with fashion trends," says Sheila Robertsdahl, a certified orthotic/mastectomy fitter and manager of the Just for Women boutique at MeritCare HealthCare Accessories in Fargo, N.D. "And with the way the pockets for the prostheses are designed, nobody can even tell it's a pocketed mastectomy garment."
Ludwig, a registered nurse who worked for 10 years in clinical oncology before opening Pretty in Pink in 2005, agrees, adding, "With off-the-shelf products like these available, women can achieve the look they want without having to undergo reconstructive surgery." However, she says many patients undergoing breast reconstruction use Wear Ease products, too. "A lot of times reconstruction doesn't give a woman the exact symmetrical look she wants," she says, "so you can sometimes fix that with a bra or partial prosthesis."
This month Wear Ease is introducing a brand-new line: the Alicia adjustable-strap camisole. "This beautiful camisole enables a woman who has undergone breast surgery to wear an alternative top just like she would have worn beforehand," Keith says. "It is designed to accommodate her breast forms and does not require her to wear a special bra underneath." Available in black, coral, kiwi green, and aqua blue, the Alicia camisole comes in S, M, L, XL, 1X, and 2X sizes.
The new product is a hit among retailers. "The new Alicia camisole with the lace is going to be a super seller," Robertsdahl says, and Yett says, "We all think it looks darling." "I love the colors available with the Alicia," Ludwig says. "They're very fresh - there's nothing else on the market with colors like those."
In addition to the Alicia and Dawn mastectomy camisoles, Wear Ease sells post-surgery bras and post-mastectomy nightgowns and T-shirts with reversible necklines. It also sells compression garments, including compression bras, slimmers, and shapers to facilitate healing after surgery or treat swelling in the trunk caused by Lymphedema. Wear Ease garments come standard with shelf bras and pockets for breast forms. All insurance, including Medicare, covers breast forms and pocketed breast-surgery bras and camisoles.
Keith founded Wear Ease in 2001 to offer the Sarah Bra designed for women with limited mobility. In 2005 the company diversified into the post-mastectomy specialty market and has since grown to include 20 products across five lines.
Source
Wear Ease
Sep 10, 2009
Women Urged Not To Drink While Pregnant
Learning disabilities, mental health issues and behavior problems are just some of the issues that afflict babies exposed to alcohol in the womb, yet some doctors still tell their patients it is safe to have a drink now and then while pregnant.
Those hoping to change that are meeting on September 9, the ninth day of the ninth month, for a forum dedicated to raising awareness about the dangers of drinking while pregnant and the plight of children and families affected by Fetal Alcohol Spectrum Disorders (FASD). State legislators, health care professionals, parents, social workers and drug prevention and treatment specialists are coming together at Prairie State College in Chicago to mark international FASD Awareness Day.
A new brochure titled "It's Only Nine Months" is also being released by Prevention First, a nonprofit drug prevention organization participating in the forum, addressing some of the common questions and misperceptions women have about drinking while pregnant.
"Our research found that women are getting conflicting information about drinking while pregnant," explained Karel Ares, executive director of Prevention First. One focus group participant said she had heard that wine or Champagne were good for a woman's blood while pregnant, Ares said. Others thought drinking was safe in the first few months of pregnancy. "There is no research that proves that any amount of alcohol is safe at any time for unborn babies," Ares pointed out. "But there is a great deal of research about the many lifelong problems caused by permanent brain damage from drinking alcohol while pregnant."
Ares said that one of the most important groups of people she wants to get this message are doctors. "FASD is preventable, yet some obstetricians are still telling their patients they can have a glass of alcohol now and then. It's like playing Russian Roulette with babies' lives, and we are working to educate them about the risks."
Dr. Todd Ochs, a clinical instructor of pediatrics at Northwestern University's Feinberg School of Medicine, one of the scheduled speakers at the forum, said that part of the problem is that doctor training hasn't changed to reflect new research about pre-natal alcohol exposure. "We used to worry about women using heroin or other illegal drugs while pregnant, but there are too many variables with alcohol that we don't yet understand, so the best advice a doctor can give is that they shouldn't drink at all," Ochs noted.
Dr. Ochs has diagnosed and treated many children with Fetal Alcohol Spectrum Disorders and points out, "We know that drinking will cause damage, we just don't know how much damage will occur or what amount of alcohol will cause the damage, so why would anyone do something that's known to be harmful to a baby?"
Among the speakers at the FASD Day forum are State Rep. Al Riley (D-Hazel Crest), State Sen. Maggie Crotty (D-Oak Forest) and psychologist Dr. Jacquelyn Bertrand from the Centers for Disease Control and Prevention.
Source: Prevention First
Those hoping to change that are meeting on September 9, the ninth day of the ninth month, for a forum dedicated to raising awareness about the dangers of drinking while pregnant and the plight of children and families affected by Fetal Alcohol Spectrum Disorders (FASD). State legislators, health care professionals, parents, social workers and drug prevention and treatment specialists are coming together at Prairie State College in Chicago to mark international FASD Awareness Day.
A new brochure titled "It's Only Nine Months" is also being released by Prevention First, a nonprofit drug prevention organization participating in the forum, addressing some of the common questions and misperceptions women have about drinking while pregnant.
"Our research found that women are getting conflicting information about drinking while pregnant," explained Karel Ares, executive director of Prevention First. One focus group participant said she had heard that wine or Champagne were good for a woman's blood while pregnant, Ares said. Others thought drinking was safe in the first few months of pregnancy. "There is no research that proves that any amount of alcohol is safe at any time for unborn babies," Ares pointed out. "But there is a great deal of research about the many lifelong problems caused by permanent brain damage from drinking alcohol while pregnant."
Ares said that one of the most important groups of people she wants to get this message are doctors. "FASD is preventable, yet some obstetricians are still telling their patients they can have a glass of alcohol now and then. It's like playing Russian Roulette with babies' lives, and we are working to educate them about the risks."
Dr. Todd Ochs, a clinical instructor of pediatrics at Northwestern University's Feinberg School of Medicine, one of the scheduled speakers at the forum, said that part of the problem is that doctor training hasn't changed to reflect new research about pre-natal alcohol exposure. "We used to worry about women using heroin or other illegal drugs while pregnant, but there are too many variables with alcohol that we don't yet understand, so the best advice a doctor can give is that they shouldn't drink at all," Ochs noted.
Dr. Ochs has diagnosed and treated many children with Fetal Alcohol Spectrum Disorders and points out, "We know that drinking will cause damage, we just don't know how much damage will occur or what amount of alcohol will cause the damage, so why would anyone do something that's known to be harmful to a baby?"
Among the speakers at the FASD Day forum are State Rep. Al Riley (D-Hazel Crest), State Sen. Maggie Crotty (D-Oak Forest) and psychologist Dr. Jacquelyn Bertrand from the Centers for Disease Control and Prevention.
Source: Prevention First
Anticancer Compound Found In American Mayapple
A common weed called American mayapple may soon offer an alternative to an Asian cousin that's been harvested almost to extinction because of its anti-cancer properties. The near-extinct Asian plant, Podophyllyum emodi, produces podophyllotoxin, a compound used in manufacturing etoposide, the active ingredient in a drug used for treating lung and testicular cancer. Podophyllyum emodi is a cousin of the common mayapple weed found in the United States.
Podophyllotoxin is found in Indian mayapple (Podophyllum emodii Wall.), American mayapple (Podophyllum peltatum L.), and other species. Podophyllotoxin and its derivatives are used in several commercially available pharmaceutical products such as the anticancer drugs etoposide, teniposide, and etopophos, which are used in the treatment of small-cell lung cancer, lymphoblastic leukemia, testicular cancer, and brain tumors. Podophyllotixin derivatives are also used for the treatment of psoriasis and malaria, and some are being tested for the treatment of rheumatoid arthritis. Currently, podophyllotoxin is produced commercially using the roots and rhizomes of Indian mayapple, an endangered species harvested from the wild in India, Pakistan, Nepal, and China.
Researchers at Mississippi State University and the University of Mississippi recently set out to identify American mayapple types with high podophyllotoxin content. Valtcho D. Zheljazkov and colleagues at Mississippi State University published the research results in HortScience. According to Zheljazkov; "The objective of this study was to estimate podophyllotoxin concentration in American mayapple across its natural habitats in the eastern United States and to identify high podophyllotoxin types that could be used for further selection and cultivar development."
Mayapple has been long been grown as a cash crop in Europe and Russia, but has never been introduced or domesticated in the United States, although the idea was suggested by researchers more than 30 years ago. Previous research demonstrated that American mayapple leaves contain podophyllotoxin, making way for the development of American mayapple as a high-value crop for American growers. Zheljazkov explained that, until now, there has been no comprehensive study on the genetic resources of American mayapple colonies across the United States. "We hypothesized that there might be great variation with respect to podophyllotoxin content within American mayapple across the eastern United States."
The researchers studied the effect of location, plant nutrient concentration, and phytoavailable nutrients in soil on podophyllotoxin concentration in American mayapple across its natural habitats in the eastern United States. The study was the largest of its kind ever conducted; American mayapple leaves were collected from 37 mayapple colonies across 18 states.
This groundbreaking study confirmed that mayapple colonies in the eastern part of the United States can be used for the development of high podophyllotoxin cultivars, which could subsequently provide the base for commercial production of podophyllotoxin in the United States. The results from this study will help to develop a Geographic Information System (GIS) map of the genetic resources of American mayapple in the U.S.
The complete study and abstract are available on the ASHS Hortscience electronic journal web site: http://hortsci.ashspublications.org/cgi/content/abstract/44/2/349
Source:
Michael W. Neff
American Society for Horticultural Science
Podophyllotoxin is found in Indian mayapple (Podophyllum emodii Wall.), American mayapple (Podophyllum peltatum L.), and other species. Podophyllotoxin and its derivatives are used in several commercially available pharmaceutical products such as the anticancer drugs etoposide, teniposide, and etopophos, which are used in the treatment of small-cell lung cancer, lymphoblastic leukemia, testicular cancer, and brain tumors. Podophyllotixin derivatives are also used for the treatment of psoriasis and malaria, and some are being tested for the treatment of rheumatoid arthritis. Currently, podophyllotoxin is produced commercially using the roots and rhizomes of Indian mayapple, an endangered species harvested from the wild in India, Pakistan, Nepal, and China.
Researchers at Mississippi State University and the University of Mississippi recently set out to identify American mayapple types with high podophyllotoxin content. Valtcho D. Zheljazkov and colleagues at Mississippi State University published the research results in HortScience. According to Zheljazkov; "The objective of this study was to estimate podophyllotoxin concentration in American mayapple across its natural habitats in the eastern United States and to identify high podophyllotoxin types that could be used for further selection and cultivar development."
Mayapple has been long been grown as a cash crop in Europe and Russia, but has never been introduced or domesticated in the United States, although the idea was suggested by researchers more than 30 years ago. Previous research demonstrated that American mayapple leaves contain podophyllotoxin, making way for the development of American mayapple as a high-value crop for American growers. Zheljazkov explained that, until now, there has been no comprehensive study on the genetic resources of American mayapple colonies across the United States. "We hypothesized that there might be great variation with respect to podophyllotoxin content within American mayapple across the eastern United States."
The researchers studied the effect of location, plant nutrient concentration, and phytoavailable nutrients in soil on podophyllotoxin concentration in American mayapple across its natural habitats in the eastern United States. The study was the largest of its kind ever conducted; American mayapple leaves were collected from 37 mayapple colonies across 18 states.
This groundbreaking study confirmed that mayapple colonies in the eastern part of the United States can be used for the development of high podophyllotoxin cultivars, which could subsequently provide the base for commercial production of podophyllotoxin in the United States. The results from this study will help to develop a Geographic Information System (GIS) map of the genetic resources of American mayapple in the U.S.
The complete study and abstract are available on the ASHS Hortscience electronic journal web site: http://hortsci.ashspublications.org/cgi/content/abstract/44/2/349
Source:
Michael W. Neff
American Society for Horticultural Science
Australian Research Suggests HPV Vaccine Could Prevent Breast Cancer
Vaccinating women against the human papillomavirus (HPV) may prevent some forms of breast cancer and save tens of thousands of lives each year, new Australian research suggests.
Using genetic probes, researchers at the University of New South Wales tested cancerous breast cells and found several strains of HPVs known to have a high risk of initiating cancer of the cervix. HPV has a causal role in 90-95 per cent of cervical cancers.
The research was conducted by a team from the UNSW School of Biotechnology and Biomolecular Sciences, led by Visiting Professor James Lawson, and is published in the British Journal of Cancer.
The team confirmed the presence of high-risk HPV in the nuclei of breast cancer epithelial cells in five (39 per cent) of 13 ductal carcinoma in situ and three (21 per cent) of 14 invasive ductal carcinoma (IDC) breast cancer specimens. Non-invasive or in situ cancers are those confined to the milk-making glands and do not spread to other parts of the breast or body. Invasive cancers such as IDC are more serious and account for 70-80 percent of all breast cancers.
"The finding that high risk HPV is present in a significant number of breast cancers indicates they may have a causal role in many breast cancers," says UNSW researcher, Dr Noel Whitaker, a co-author of the new report. "Confirming a cancer-causing role for HPV in some breast cancers establishes the possibility of preventing some breast cancers by vaccination against HPV," he says.
The idea that HPV has an involvement in breast cancer is controversial. Scientific reports from 15 countries around the world have identified the presence of high-risk types of HPV in breast tissue and breast cancer specimens.
But those studies have also showed widely varying results, with the prevalence of HPV-positive breast cancer in ranging from as low as four per cent to as high as 86 per cent, and have been clouded by difficulties in detecting the virus in breast specimens.
As well, the genetic probe technique used - polymerase chain reaction (PCR) - has been criticized for its propensity for contamination.
The technique is based on taking small genetic samples and rapidly copying them to provide a large enough sample to study.
The UNSW researchers addressed these issues by using a technique (in situ PCR) that avoids cross-contamination and that provides evidence about whether HPV genetic material is present in the nuclei of human breast cancer specimens. They validated their findings by looking for "telltale" changes linked to HPV such as enlarged nucleus surrounded by a characteristic "halo". The researchers are working on a new method that will make testing even quicker, cheaper and simpler.
Globally 1.1 million women were diagnosed with breast cancer and more than 500,000 women lost their life to the disease in 2004. Australia data reveals that 12,265 women were diagnosed with breast cancer in 2005, and 2,618 women died from breast cancer in 2006. During the past quarter century 213,658 Australian women were diagnosed with breast cancer (1982 - 2005) and 63,632 died from the disease (1981 - 2006).
Source:
Dr Noel Whitaker
University of New South Wales
Using genetic probes, researchers at the University of New South Wales tested cancerous breast cells and found several strains of HPVs known to have a high risk of initiating cancer of the cervix. HPV has a causal role in 90-95 per cent of cervical cancers.
The research was conducted by a team from the UNSW School of Biotechnology and Biomolecular Sciences, led by Visiting Professor James Lawson, and is published in the British Journal of Cancer.
The team confirmed the presence of high-risk HPV in the nuclei of breast cancer epithelial cells in five (39 per cent) of 13 ductal carcinoma in situ and three (21 per cent) of 14 invasive ductal carcinoma (IDC) breast cancer specimens. Non-invasive or in situ cancers are those confined to the milk-making glands and do not spread to other parts of the breast or body. Invasive cancers such as IDC are more serious and account for 70-80 percent of all breast cancers.
"The finding that high risk HPV is present in a significant number of breast cancers indicates they may have a causal role in many breast cancers," says UNSW researcher, Dr Noel Whitaker, a co-author of the new report. "Confirming a cancer-causing role for HPV in some breast cancers establishes the possibility of preventing some breast cancers by vaccination against HPV," he says.
The idea that HPV has an involvement in breast cancer is controversial. Scientific reports from 15 countries around the world have identified the presence of high-risk types of HPV in breast tissue and breast cancer specimens.
But those studies have also showed widely varying results, with the prevalence of HPV-positive breast cancer in ranging from as low as four per cent to as high as 86 per cent, and have been clouded by difficulties in detecting the virus in breast specimens.
As well, the genetic probe technique used - polymerase chain reaction (PCR) - has been criticized for its propensity for contamination.
The technique is based on taking small genetic samples and rapidly copying them to provide a large enough sample to study.
The UNSW researchers addressed these issues by using a technique (in situ PCR) that avoids cross-contamination and that provides evidence about whether HPV genetic material is present in the nuclei of human breast cancer specimens. They validated their findings by looking for "telltale" changes linked to HPV such as enlarged nucleus surrounded by a characteristic "halo". The researchers are working on a new method that will make testing even quicker, cheaper and simpler.
Globally 1.1 million women were diagnosed with breast cancer and more than 500,000 women lost their life to the disease in 2004. Australia data reveals that 12,265 women were diagnosed with breast cancer in 2005, and 2,618 women died from breast cancer in 2006. During the past quarter century 213,658 Australian women were diagnosed with breast cancer (1982 - 2005) and 63,632 died from the disease (1981 - 2006).
Source:
Dr Noel Whitaker
University of New South Wales
Children With Autism Use Alternative Keyboard To Communicate With Their Families And Their World
Children With Autism Use Alternative Keyboard To Communicate With Their Families And Their World
Autism can build a wall of poor communication between those struggling with the condition and their families. While a personal computer can help bridge the divide, the distraction and complexity of a keyboard can be an insurmountable obstacle.
Using a unique keyboard with only two "keys" and a novel curriculum, teachers with Project Blue Skies are giving children with autism the ability to both communicate and to explore the online world.
At the heart of the project is a device called the OrbiTouch. Human-factors engineer Pete McAlindon of BlueOrb in Maitland, Fl., conceived of the concept behind the OrbiTouch more than a decade ago as a way to prevent carpal tunnel syndrome and provide computer access to people with limited or no use of their fingers.
Developed with the support of two National Science Foundation (NSF) Small Business Innovation Research awards (9661259 and 9801506), the concept of representing keyboard strokes with paired movements was critical to the design from the start.
"If you are unable to use a keyboard and mouse effectively or at all because of a physical disability, what chance do you have of using a computer?," asked McAlindon. "The OrbiTouch is designed to keep people with physical or developmental disabilities connected to their computers."
The Project Blue Skies curriculum is based on the functions of the OrbiTouch, which allows a user to input letters, symbols and any other command by independently manipulating two computer-mouse shaped grips forward, back, diagonally and to the sides.
For people with carpal tunnel syndrome, as well as other hand and finger ailments, the motions driving the OrbiTouch are far kinder than those for a keyboard.
With Project Blue Skies, the hardware is matched to lesson plans, training aids such as games, and assessment tools. The two-grip device is ideal for people with autism because it is less distracting than a keyboard and does not require finger motion.
In addition, the various letter and number combinations are created by matching color schemes indicated on the two grips, so the training curriculum matches well to a game-like environment.
Teachers guide the students and monitor their progress, ultimately helping the kids better communicate with their families. While the primary goal of Project Blue Skies is to help people with autism develop stronger social skills, McAlindon is working with partners to start integrating standard coursework into the program.
"I have watched Pete McAlindon grow and change over the last decade," said Sara Nerlove, now program director for NSF's Partnerships for Innovation program. "He has taken the concept that he developed as dissertation research, and using his skills as a human factors engineer, turned it into a very creative device to help people with disabilities. The result of his skill and persistence is the evolution of his technology into an ingenious adaptation, one that makes his goal of providing for persons with disabilities a sustainable effort."
McAlindon continues to work with his colleagues to find applications for his approach, most recently applying the system to video game controllers, allowing hundreds of thousands of online gamers to say goodbye to their keyboards using BlueOrb's Switchblade software. The gaming approach grew exponentially last year when it was paired to the launch of one of the largest online multiplayer games in the world.
Source:
Joshua A. Chamot
National Science Foundation
Autism can build a wall of poor communication between those struggling with the condition and their families. While a personal computer can help bridge the divide, the distraction and complexity of a keyboard can be an insurmountable obstacle.
Using a unique keyboard with only two "keys" and a novel curriculum, teachers with Project Blue Skies are giving children with autism the ability to both communicate and to explore the online world.
At the heart of the project is a device called the OrbiTouch. Human-factors engineer Pete McAlindon of BlueOrb in Maitland, Fl., conceived of the concept behind the OrbiTouch more than a decade ago as a way to prevent carpal tunnel syndrome and provide computer access to people with limited or no use of their fingers.
Developed with the support of two National Science Foundation (NSF) Small Business Innovation Research awards (9661259 and 9801506), the concept of representing keyboard strokes with paired movements was critical to the design from the start.
"If you are unable to use a keyboard and mouse effectively or at all because of a physical disability, what chance do you have of using a computer?," asked McAlindon. "The OrbiTouch is designed to keep people with physical or developmental disabilities connected to their computers."
The Project Blue Skies curriculum is based on the functions of the OrbiTouch, which allows a user to input letters, symbols and any other command by independently manipulating two computer-mouse shaped grips forward, back, diagonally and to the sides.
For people with carpal tunnel syndrome, as well as other hand and finger ailments, the motions driving the OrbiTouch are far kinder than those for a keyboard.
With Project Blue Skies, the hardware is matched to lesson plans, training aids such as games, and assessment tools. The two-grip device is ideal for people with autism because it is less distracting than a keyboard and does not require finger motion.
In addition, the various letter and number combinations are created by matching color schemes indicated on the two grips, so the training curriculum matches well to a game-like environment.
Teachers guide the students and monitor their progress, ultimately helping the kids better communicate with their families. While the primary goal of Project Blue Skies is to help people with autism develop stronger social skills, McAlindon is working with partners to start integrating standard coursework into the program.
"I have watched Pete McAlindon grow and change over the last decade," said Sara Nerlove, now program director for NSF's Partnerships for Innovation program. "He has taken the concept that he developed as dissertation research, and using his skills as a human factors engineer, turned it into a very creative device to help people with disabilities. The result of his skill and persistence is the evolution of his technology into an ingenious adaptation, one that makes his goal of providing for persons with disabilities a sustainable effort."
McAlindon continues to work with his colleagues to find applications for his approach, most recently applying the system to video game controllers, allowing hundreds of thousands of online gamers to say goodbye to their keyboards using BlueOrb's Switchblade software. The gaming approach grew exponentially last year when it was paired to the launch of one of the largest online multiplayer games in the world.
Source:
Joshua A. Chamot
National Science Foundation
Tips For Dealing With Fall Allergies From DampRid
For America's 60 million seasonal allergy sufferers, fall can be one of the most difficult times of year as ragweed begins to release its pollen into the air and mold and fungus spores increase due to the decay of leaves and other plants. Each ragweed plant produces one billion pollen grains per average season. This generally continues until the first frost, usually in October.
According to the Asthma and Allergy Foundation of America, allergies are considered the fifth leading chronic disease and are a major cause of work absenteeism, resulting in nearly four million missed or lost workdays each year.
Seasonal allergies can be further aggravated by poor air quality inside the home. Allergy sufferers can begin to take control of their condition by improving the quality of their home environment and create cleaner, fresher air. Moisture control is the key to preventing mold and mildew growth and the resulting allergens from forming. Removing excess moisture also protects against moisture damage to clothing, furniture and valuables and eliminates musty odors.
The U.S. Environmental Protection Agency warns that exposure to mold can cause symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation. Particularly susceptible are pregnant women, infants, the elderly, and those with pre-existing health conditions. Severe reactions can include asthma episodes, fever, shortness of breath, and mold infection in the lungs.
To minimize exposure to ragweed pollen and mold and fungus spores and to improve indoor air quality, DampRid recommends:
- Stay indoors as much as possible, especially in the early morning when pollen is released.
- Monitor pollen counts in your area by visiting the National Allergy Bureau at http://www.aaaai.org/nab.
- After spending time outside, take a shower to remove pollen from your hair and skin.
- Remove shoes and jackets immediately upon entering the house to minimize the spread of pollen.
- Keep windows at home and in the car shut.
- Use air conditioning as long as possible to clean the air.
- Wash sheets, blankets, and comforters weekly in hot water to reduce dust mites.
- Vacuum regularly, using a machine with a good filtration system.
- Eliminate cockroaches, as their waste produces allergens.
- Wash pets weekly to reduce dander.
To further manage indoor moisture and humidity, DampRid recommends:
- Install exhaust fans in bathrooms, kitchen, laundry room and any other space water vapor is created.
- Inspect doors, windows and the foundation for water seepage or excessive air infiltration.
- Replace worn caulk and seals.
- Place DampRid moisture absorbers in bathrooms, kitchen and laundry areas, and closets to create fresher, healthier indoor air.
DampRid offers a line of moisture absorber products that create fresher, healthier indoor air, prevent mold and mildew and the resulting allergens, and eliminate musty odors. For more ideas on how to use DampRid in the home, visit http://www.damprid.com.
Source
DampRid
According to the Asthma and Allergy Foundation of America, allergies are considered the fifth leading chronic disease and are a major cause of work absenteeism, resulting in nearly four million missed or lost workdays each year.
Seasonal allergies can be further aggravated by poor air quality inside the home. Allergy sufferers can begin to take control of their condition by improving the quality of their home environment and create cleaner, fresher air. Moisture control is the key to preventing mold and mildew growth and the resulting allergens from forming. Removing excess moisture also protects against moisture damage to clothing, furniture and valuables and eliminates musty odors.
The U.S. Environmental Protection Agency warns that exposure to mold can cause symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation. Particularly susceptible are pregnant women, infants, the elderly, and those with pre-existing health conditions. Severe reactions can include asthma episodes, fever, shortness of breath, and mold infection in the lungs.
To minimize exposure to ragweed pollen and mold and fungus spores and to improve indoor air quality, DampRid recommends:
- Stay indoors as much as possible, especially in the early morning when pollen is released.
- Monitor pollen counts in your area by visiting the National Allergy Bureau at http://www.aaaai.org/nab.
- After spending time outside, take a shower to remove pollen from your hair and skin.
- Remove shoes and jackets immediately upon entering the house to minimize the spread of pollen.
- Keep windows at home and in the car shut.
- Use air conditioning as long as possible to clean the air.
- Wash sheets, blankets, and comforters weekly in hot water to reduce dust mites.
- Vacuum regularly, using a machine with a good filtration system.
- Eliminate cockroaches, as their waste produces allergens.
- Wash pets weekly to reduce dander.
To further manage indoor moisture and humidity, DampRid recommends:
- Install exhaust fans in bathrooms, kitchen, laundry room and any other space water vapor is created.
- Inspect doors, windows and the foundation for water seepage or excessive air infiltration.
- Replace worn caulk and seals.
- Place DampRid moisture absorbers in bathrooms, kitchen and laundry areas, and closets to create fresher, healthier indoor air.
DampRid offers a line of moisture absorber products that create fresher, healthier indoor air, prevent mold and mildew and the resulting allergens, and eliminate musty odors. For more ideas on how to use DampRid in the home, visit http://www.damprid.com.
Source
DampRid
Sep 5, 2009
New Study To Assess Societal Costs Following Revelation That 100 Million Women In The Prime Of Their Lives Have Endometriosis
The World Endometriosis Research Foundation (WERF) and the European Society of Human Reproduction and Embryology (ESHRE) are proud to announce the first ever prospective study to assess the hidden cost of endometriosis to society and to women with the disease.
13 centres in ten countries kick-off the EndoCost study with a goal to identify areas which can be addressed for improvement and subsequent reduction in cost from a very prevalent - yet largely unknown - disease, which affects women during the prime of their lives.
Endometriosis affects an estimated 1 in 10 women during their reproductive years. An average diagnostic delay of up to 12 years, coupled with "hit and miss" treatments, has put an estimated cost to society in the United States alone at $22 billion a year - higher than the cost of migraine and Crohn's disease. There are no comparable data - yet - in Europe, which WERF and ESHRE now seek to address.
Endometriosis is the biggest cause of infertility and chronic pelvic pain in women. All treatments have side effects and there is no known cure. Yet, there is a lack of government funding given to research into a cure - or even a long term treatment.
28-year old Lisa Gellert has suffered from endometriosis for nine years. "I have seen numerous doctors, and finally had surgery - where none of the disease was removed. Despite having supposedly had 'treatment' I still live in pain and take several days off every month because I am incapacitated", said Gellert.
WERF chief executive, Lone Hummelshoj worries what mis-management such as Gellert's is costing national healthcare systems. But, it is not about healthcare systems alone according to Hummelshoj: "A large proportion of women with endometriosis have to take time off work every month either due to severe symptoms, or because of doctors' appointments and treatment regimes. This has a profound effect on society, but most certainly also on the women themselves, whose personal cost - both financially and emotionally - is substantial. The effect on relationships, not least when fertility becomes an issue, must not be under-estimated either! The EndoCost study will be the first ever to investigate this direct and indirect cost, at a societal and personal level. We hope the results will spur national governments on to take endometriosis seriously and invest in research to prevent the next generation of women having to suffer during the prime of their lives the way this generation has", said Hummelshoj.
Results from the EndoCost study are expected to be published during the second quarter of 2010.
See also: http://www.endometriosisfoundation.org/endocost.php
Source:
Hanna Hanssen
European Society for Human Reproduction and Embryology
13 centres in ten countries kick-off the EndoCost study with a goal to identify areas which can be addressed for improvement and subsequent reduction in cost from a very prevalent - yet largely unknown - disease, which affects women during the prime of their lives.
Endometriosis affects an estimated 1 in 10 women during their reproductive years. An average diagnostic delay of up to 12 years, coupled with "hit and miss" treatments, has put an estimated cost to society in the United States alone at $22 billion a year - higher than the cost of migraine and Crohn's disease. There are no comparable data - yet - in Europe, which WERF and ESHRE now seek to address.
Endometriosis is the biggest cause of infertility and chronic pelvic pain in women. All treatments have side effects and there is no known cure. Yet, there is a lack of government funding given to research into a cure - or even a long term treatment.
28-year old Lisa Gellert has suffered from endometriosis for nine years. "I have seen numerous doctors, and finally had surgery - where none of the disease was removed. Despite having supposedly had 'treatment' I still live in pain and take several days off every month because I am incapacitated", said Gellert.
WERF chief executive, Lone Hummelshoj worries what mis-management such as Gellert's is costing national healthcare systems. But, it is not about healthcare systems alone according to Hummelshoj: "A large proportion of women with endometriosis have to take time off work every month either due to severe symptoms, or because of doctors' appointments and treatment regimes. This has a profound effect on society, but most certainly also on the women themselves, whose personal cost - both financially and emotionally - is substantial. The effect on relationships, not least when fertility becomes an issue, must not be under-estimated either! The EndoCost study will be the first ever to investigate this direct and indirect cost, at a societal and personal level. We hope the results will spur national governments on to take endometriosis seriously and invest in research to prevent the next generation of women having to suffer during the prime of their lives the way this generation has", said Hummelshoj.
Results from the EndoCost study are expected to be published during the second quarter of 2010.
See also: http://www.endometriosisfoundation.org/endocost.php
Source:
Hanna Hanssen
European Society for Human Reproduction and Embryology
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