Epilepsy Seizures

Epilepsy represents a particular disease due to its special impact upon social perception in the community. It is a disease with potential complex consequences (economic, social, psychological) that affect both the patient and its family, and although the patients bear no more the stigma of being “devil possessed” they are not exempted from the burden of prejudices of all sorts.

Epilepsy is a chronic cerebral disorder manifested by recurrent, spontaneous epileptic seizures. An epileptic attack or a seizure is an acute, stereotype dysfunctional motor, sensory, sensorial, behavioral and/or consciousness alteration episode. It is caused by a sudden paroxysmal uncontrolled brain activation of a neuronal population followed by the abnormal function. This epileptic attack represents a symptom, not a disease.

Epilepsy

Repeated epileptic seizures represent seizures that repeat at short time intervals (minutes, hours) separated by a clinically normal state in between (called free interval)
Status epilepticus represents the circumstance in which there are repeated epileptic seizures that occur in close succession without regaining the consciousness (no free interval).
Morpheic epileptic seizures (hypnic seizures) are seizures occurring during sleep.
The epileptic syndrome represents an epileptic condition defined by clinical aspects (the semiological seizure type), electroencephalographical data, neurological status, etiology, prognosis and sometimes therapeutic response.

Prevalence

Epilepsy is a disease with a prevalence of 1% out of the general population meaning that an estimated 50 million of persons worldwide have the disease. Lifetime prevalence accounts for 2-5% (estimated as a percentage of the odds of an individual to experience a non-febrile seizure sometime during lifetime) as anyone with the right provoking circumstances (e.g electroconvulsive therapy) may have a seizure. There are two onset peaks one in the first decade of life and another one after 65-75 years.
Causes

There are many causes that can induce epileptic seizures. It is now of classical reference, the statistical data found in a survey in Minnesota, Rochester during 1935-1984 regarding the cause percentage in 100 new diagnosed epilepsy patients

• 65,5% idiopathic or cryptogenetic;
• 10,9% vascular cause;
• 8,0% congenital cause
• 5,5% post traumatic;
• 4,1% neoplastic (cancer)
• 3,5% degenerative;
• 2,5% infectious causes;

Epilepsy Causes can be classified as follows

Hereditary

• Chromosomial disorders (ex trisomy, chromosomial partial deletions)
• Mithocondrial DNA abnormalities (MELAS);
• Metabolic abnormalities (leucodistrophyi, mucopolyzaharidoses, galacto-zemia, pyridoxine deficit, etc.);
• Neurocutaneous diseases (tuberous sclerosis, neurofibromatosis Sturge-Weber syndrome);

Inherited

• Cortical dysplasia or neural migration disorders (schizencephalia, lisencephalia, neuronal heterotopias, complex cerebral malformations)
• Intrauterine central nervous system infections (rubella,toxoplasmosis, cytomegalovirus infections); – materno-fetal medication induced intoxication)
• Hypoxia or ischemic encephalophies as a consequence of dystocic births (pelvic dystocia, ombilical cord abnormalities, forceps aided births, pelvine presentations, prolonged births);
• Spontaneous cerebral hemorrhages (prematurity) or as a consequence of concussions (obstetrical trauma)
• Bacterial meningo-encephalitic infection (hemophilus lissteria ) or viral (herpetic);
• metabolic abnormalities (hypoglicemia, hypocalcemia etc.)
• Toxic encephalopathy due to drug intake by the mother –

Postnatal  (after birth)

• Viral encephalitis;
• Cerebral abscesses (bacterial, tuberculous)- 70% risk
• Parasitic (cysticercosis)
• Prion diseases (Jakob-Kreutzfeld)
• AIDS  associated with: opportunistic infections, cerebral lymphoma, cerebral infarction, encephalopathy, alcoholic withdrawal, electrolytic disturbances.-
• Cerebral trauma – late onset post traumatic seizures occurring after 1 week up to 5 years from the cerebral trauma with an estimated risk of 9-40%. It is more frequently the consequence of severe trauma such as cerebral concussion, to a lesser extent due to loss of consciousness, amnesia after 24 hours, age above 65 years, early onset seizures ;
• Cerebral tumors (accountable for 40% of focal late onset seizures), more frequently associated with slow evolution tumors such as disembrioplasic, meningiomas.
• Alcohol induced seizures occurs in 5-15 % of the alcoholics, it occurs either in acute intoxication or in the withdrawal period in(generally 48 hours after intake cessation) or as recurrent seizures due to chronic alcoholic intoxication;
• Medication related (neuroleptics, antidepressive, fenothyazine, phyline, oral antidiabetic or insulin, penicillin, antihystaminics and occasionally cyclosporin,  anaesthetics, radiological contrast substances, anticonvulsivant medication withdrawal – benzodiazepine, barbiturates) amphetamins, opioids, baclofen, can induce epileptic seizures
• Drugs related (cocaine, amphetamines, canabis, LSD)-
• Toxic substances related insecticides (organo-phospforic or chlorinated carbone monoxyde, organic solvants, antigel, insect poison)
• After cerebral infarcts (5-10%) mainly in the middle-cerebral artery territory;
• After cerebral hemorrages (2-25%) – the main cause of symptomatic epilepsy in elderly and generally occurs in the first 2 years after stroke as partial seizures with possible generalisation;
• Immune system diseases (disseminated lupus erythematous, myasthenia gravis,: primary IgA deficit, multiple sclerosis, other cerebral vasculitis
• Degenerative diseases (Alzheimer disease)

Prostate Adenoma

Almost 16% of urology consultations are determined by prostate adenoma. After 40 years, over 50% of men suffer from a form of prostate adenoma , the number increasing in direct proportion with advanced age, reaching 90% at 85 years.

The prostate is a structure, part of the male reproductive apparatus that surrounds the bladder. In men with normal androgen production, along with age, the gland tends to increase its overall volume (benignant hyperplasia), more pronounced in some areas, resulting in prostate adenoma that can cause strangulation of the urethra and urination problems.

Prostate Adenoma

Prostate Adenoma Causes

Prostate adenoma is the most common noncancerous tumor of the over 60 years male, developed due to a deficiency in testicular activity. Prostate adenoma does not manifested in patients with reduced activity of the pituitary gland or in those who underwent vasectomy surgery (resection of the vas deferens through which sperm reach from the epididymis into the posterior urethra ) before the age of 40 years. The appearance of prostate adenoma is considered therefore an metabolism alteration, one of the factors being represented by testosterone.

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Natural evolution of the prostate adenoma allows classification into three stages:

• Microscopic phase
• Macroscopic phase
• Clinical stage (manifested)

The treatment attitude for prostate adenoma is varied. There are drug and surgical treatments, preventive and surveillance procedures.

Prostate Adenoma

Prostate Adenoma Symptoms

The Prostatic capsule is elastic and when the gland increases in size it compresses the urethra (the channel through which urine is eliminated from the bladder). Expulsion of urine from the bladder is achieved with muscle contraction and abdominal muscles pressure. The appearance of prostate adenoma leads to changes in natural urination so, urination becomes more difficult, more frequent, but incomplete (drop by drop, the bladder does not empty completely). Normally bladder residue liquid is 20-40 cm, but in benign prostatic hyperplasia when there so-called combat bladder, can reach 100 cm. Of course, the presence and persistence of this unevacuated remnant of urine favors bacterial infections.  Other symptoms

• Urinary frequency (frequent urination urge)
• Intermittent urinary flow
• Nocturia (frequent nighttime urination)
• Urinary incontinence
• Urinary retention
• Dysuria (burning discomfort when urinating )
• Pain
• Sometimes hematuria (presence of blood or red blood cells in urine). People who have nocturia do not rest properly due to the frequent interruption of sleep to go to the toilet. Prostate adenoma, as well as all lower urinary tract diseases (acute and chronic prostatitis, prostate cancer, cystitis, urethritis) can lead to limitation of normal daily activities and lifestyle involves adapting according to urinary problems. Complications of the disease include: bladder stones, which is the result of stagnation of urine in the bladder and the presence of an obstacle on the path of discharge, inflammation of the prostate adenoma, urinary tract infections, acute epididymitis, etc..

Prostate Adenoma Prevention

Prostate Adenoma Treatment

10-15% of patients with benign prostate adenoma need surgery, the rest can benefit from medication to reduce the urinating disorders. The immediate goal is to reduce the gland volume for urinating ease, bladder evacuation, and most important for reducing the risk of stones, polyps, diverticulitis, infections or cancer, local problems that can eventually lead to loss of kidney function.

Prostate Adenoma Surgery

Drug treatment

Because prostate adenoma is an androgen dependent process, pharmacological treatment aims at the hormonal component of the disease. Finasteride is responsible for inhibiting 5-alpha reductase, the enzyme responsible for conversion of testosterone to dihydrotestosterone (DHT), and significantly reduces symptoms. Alpha-adrenergic blockers quickly determines a rise in urine output. Anti-aromatase enzyme complex is responsible for transforming the androgen hormones in estrogen.
A study at the University of Arizona showed that a 200 mcg tablet with selenium (mcg) taken daily did not only greatly reduce the risk of prostate cancer, but other types of cancers too. A group of researchers in Finland has demonstrated the importance of an increased intake of vitamin E as a protective factor against prostate malignancies. After 50 years, each man should consume at least 240 IU (international units) of vitamin E.

Resources

1.https://www.healthyprostate.co

2.https://www.nhs.uk/livewell/prostatehealth/Pages/prostatehome.aspx

3.https://www.health.harvard.edu/healthbeat/10-diet-and-exercise-tips-for-prostate-health

Anal Cancer

Anal cancer is a disease in which malignant cell (cancer) develop in the tissues of the anal region. The anus is the terminal portion ofthe large intestine after the rectum through which stool is eliminated from the body. The anus is formed partly from the external skin and partly from the intestine. Two muscle open and close the anus to allow faeces to be removed from the body. The anal canal (portion between the rectum and anus), has a length of about 1.5 inch (3.75 cm). The skin around the anus is called the perianal area. Tumors in this area are skin cancers not anal cancers. Infection with human papilomatos virus (HPV) is considered to be a risk factor for anal cancer.

Colon

The Risk factors for anal cancer are:

• Age over 50 years
• Presence of human papilomatos virus infection (HPV)
• Multiple sex partners
• Anal intercourse
• The frequent presence of erythema (redness), inflammation and pruritus (itching)
• Anal fistulas (abnormal connection between two cavities
• Smoking

Symptoms

Possible signs of anal cancer is bleeding from the anus or rectum or a lump near the anus. There are however other reasons for such accusations, besides anal cancer.

Consult a doctor if you experience any of these signs:

• Bleeding from the anus or rectum
• Pain or pressure in the anus
• Itching or discharge from the anus
• A swelling near the anus
• Stool changes (diarrhea or constipation).

Investigations

Tests that examine the rectum and anus are used to find and diagnose anal cancer.

• Physical examination and full patient history: generally physical examination is searching for different signs of disease, such as lumps or other unusual aspects, also diseases that had previously received medication, the lifestyle aspects and not last the eating habits
• Digital rectal examination (TR) is an exam of the anus and rectum, the doctor or a nurse, using surgical gloves,introduces a previously lubricated finger in the lower rectum to look for any swelling sings or unusual aspects.
• Anoscope: represents an examination of the anus and rectum in its lower portion using a short tube with a dot at the end called anoscope
• Biopsy: consist in the removing  of cells or small pieces of tissues that are studied under a microscope by a pathologist to look for signs of cancer or precancerous lessions

Anal Cancer Examination

Prognosis

There are certain factors that can affect the prognosis (in other words the chances of recovery) and treatment options:

• Tumor size
• Exact localization of the tumor in the anus
• If the cancer has spread to lymph nodes or

Treatment options depend on the following factors:

• Stage of cancer
• Tumor in anus
• If the patient is infected or not with human papilomatos virus (HPV)
• If cancer is still present after the initial treatment or is it a recurrence (initially cured but came back).

Treatment
For patients who are suffering from anal cancer there are several treatment options available. Some treatments are standard while others are only during the testing period (clinical trials). Before starting treatment, the patient may think if he wants to be part of such a clinical trial. If the clinical trial proves that a new and better treatment is superior to the standard therapy, the new treatment is made standard treatment.

Choosing the most appropriate treatment is a decision that ideally should be taken by the patient and his family after consulting the doctor.

Currently use three types of standard treatment:

1. Radiation. Radiation therapy is used for treating cancer with the aid of  high energy X-rays or other radiation to get rid of cancer cells. There are two types of radiation. External radiation therapy uses a device located outside of the body to send radiation toward the cancer area. Internal radiation therapy uses radioactive substances introduced by needles, implants, wires or catheters placed in / or near the tumor. The type of radiation applied depends on the type and stage of cancer.
   

   Radiation Therapy

2. Chemotherapy. Chemotherapy uses drugs that prevent cancer cells to grow, either by actual killing them or by stopping their multiplication. After the intravenous injection, the drugs enter the bloodstream and travel throughout the body. This is systemic chemotherapy. When chemotherapy is placed directly into the spinal column, an organ or a cavity such as the abdomen, the drug has an effect only on cancer cells in that certain area. This is called regional chemotherapy.
3. Surgery. Several types of surgical interventions are available: local resection: a surgical procedure in which the tumor is removed from the anus with an area of surrounding healthy tissue. This kind of local resection can be achieved if the tumor is small and has not spread. This kind of procedure may save the sphincter muscles  this method can be used especially for tumors that develop in the lower anus. Low resection: a surgical procedure in which the anus, rectum and a variable part of the sigmoid colon are resected (removed) through an incision made in the abdomen. Afterwards the intestine is sutured with one end to the external skin of the abdomen (stoma), leaving a communication, through which the faeces can be collected in a bag outside the body.

Anal Cancer Stoma

The presence of HPV virus can affect anal cancer treatment. Patients infected with human immunodeficiency virus (HIV) who already have a poor immune system are further aggravated by the use of cancer treatments. Therefore, patients who have concomitant HIV infection and anal cancer are treated with chemotherapy and radiotherapy doses lower than patients without HIV.

Other treatments are in clinical trials stage. An example of such treatment are some medicines that aim making cancer cells more sensitive to radiotherapy. By combining radiotherapy with the administration of these kind of drugs more cancer cells will pe affected by the treatment in a shorter time, reducing the side effects of radiotherapy.

Ovarian Cyst

Ovarian cysts are benign formations that develop in the ovaries, they look like round bags of varying sizes, at least three inches, with thin walls, filled with clear liquid. These cysts are seen on the surface of the ovary like small bumps. In most cases ovarian cysts are usually asymptomatic, being discovered during routine gynecological controls or a after a pelvic ultrasound exam. Ovarian cysts most frequently occur in women of childbearing age.

Causes

Normally, every month, the ovarian follicle is formed. The ovarian follicle contains inside the female sex cell, called oocyte. The oocyte is released into the fallopian tube and then empty follicle becomes obsolete. In pathological cases, it happens that the follicle does not release the oocyte, continuing to grow and filling with liquid – turns into an ovarian cyst.
Another case that may lead to the appearance of ovarian cyst is when follicle debris do not dissolve, but continue to fill with fluid. This form is called a corpus luteum cyst and is the most common type of ovarian cyst diagnosed in practice.

Ovarian Cyst

There are two types of ovarian cysts:

1. Functional – up 90% of ovarian tumors. Stand the origin of their appearance excessive ovarian stimulation during the menstrual cycle, makes a follicle or yellow body to turn into cysts. Can occur throughout life, with a high prevalence between puberty and menopause. This type of cysts are benign, a link between their presence and development of ovarian cancer was not proven. Generally these types of ovarian cysts regress spontaneously or under drug treatment. If the ovarian cyst is present at the onset of pregnancy it is not recommended to interfere with them until after the first quarter.
2. Organic. Characterized by the presence of vegetation and internal diameter greater than six millimeters, which presents a solid part (like the skin tissue), caused by the proliferation of the uterine lining. These kind of ovarian cysts do not resolve spontaneously, and require treatment. These criteria allow proper evolution evaluation (benign or malignant). Early detection is very important as a correct and early diagnosis grows the chances fo a complete healing. To determine the correct nature of these cysts it is often necessary that, besides pelvic abdominal or endovaginal ultrasound exam , a Doppler study of tumor blood flow is recommended.

Ovarian Cyst

Treatment

Most ovarian cysts are benign, asymptomatic and resolve without treatment. However, there are situations when they are at the origin of various symptoms such as irregular periods, pelvic pain, feeling of pressure in the small intestine, difficulty urinating, pain during intercourse, increased breast sensitivity similar to that of pregnancy . In such cases symptom medication should be taken in case of intene pain and contraceptives to prevent other cysts (as a result of the cessation of ovulation).

Surgical removal of the ovarian cyst through a small incision (laparoscopy) is recommended if a functional painful ovarian cyst does not disappear after medical treatment. If the ovarian cyst looks abnormal at ultrasound or if there are other risk factors for ovarian cancer, surgery is recommended through a larger incision (laparotomy) instead of laparoscopy.

Complications

Complications can be severe. The most common and most dangerous complication is torsion (twisting) of the ovarian cyst, in which case it is a medical emergency because it may lead also to fallopian tube rotating, situation that can cause necrosis. Ovarian cyst torision is manifested by atrocious stomach pain, unilateral, that usually radiates down on foot. In these circumstances, the patient must be rushed to a hospital. If surgery is done in the first 6 hours after onset of crisis the intervention of untwisting of the cyst. If the torsion has exceeded 6 hours, and the fallopian tube is necrotizing unfortunately the patient loses her fallopian tube.

Ovarian Cyst Torsion

Another complication is bleeding or rupture of a cyst  with signs of ascites that may be confused easily with an ectopic pregnancy. This situation also requires emergency surgery. The dominant symptom of this complication is strong pain located on one side of the abdomen (in the ovary that has the cyst). Another unpleasant result following the rupture of an ovarian cyst is anemia.
Ruptured ovarian cyst is difficult to recognize, because in many cases it has no symptoms. The first sign that can occur is pain felt in the lower abdomen, nausea, vomiting and fever.

Infection can follow any complications of the ovarian cyst. Undetected or poorly diagnosed, can lead to death due to septicemia. The first  infection symptoms usually are fever, malaise, chills, pelvic pain.

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Sources

1. https://www.ovariancystmiracle.com/Ovarian-Cyst-Video.php

2. https://news.psu.edu/story/320417/2014/07/09/research/letrozole-may-help-women-pcos-become-pregnant

3. https://www.nhs.uk/conditions/ovarian-cyst/Pages/Introduction.aspx

4. https://www.womenshealth.gov/publications/our-publications/fact-sheet/ovarian-cysts.html

Uterine Fibroids

Uterine fibroids are among the most common female problems. Uterine fibroids are often asymptomatic, making diagnosis difficult and delayed and the therapeutic possibilities limited. It is therefore important to know the signs that may announce such problems and know how to relieve suffering without exposing you to later dangerous complications. Often discovered by chance during a routine gynecological exam, fibroids are most often benign tumors that do not turn into cancer but in very rare cases. In general, fibroids have the appearance of a ball and size as a nut, as a grapefruit or larger. Fobroids develop on the surface of the uterus, muscular layer of this organ (myometrium), and may be the origin of very severe symptoms that require specific treatment.

Fibroids

It is estimated that between 20% and 40% of women aged between 30 and 45 have been or are diagnosed with such tumors. Only 25% of them need therapy, in most cases the treatment consists of hysterectomy (surgical ablation of the uterus).

Formations develop independently of each other, and half of them are based on genetic aberrations.
There are several types of fibroids:

• Subserous fibroids located near the external surface of the uterus, develop in the abdominal cavity and can compress neighboring organs especially leading to a painful bladder and digestive tract.
• Interstitial fibroids that develop in the uterine wall depth.
• Submucous fibroids that develop in the uterine submucous layer.

Uterine Fibroids

Causes

Despite the high frequency, up to now the causes of appearance of uterine fibroids are unknown, thus different assumptions have been issued. Some researchers support the genetic origin of fibroids.

• Women whose close relatives are suffering or have suffered from such disorders have an increased risk of becoming victims of fibrosis also.
• Hormonal factors. Fibroids development is favored  directly or indirectly by the estrogen in the blood and, to a lesser extent that of progesterone. This explains why some tumors disappear after menopause, when natural hormone production ceases.
• Obesity, age at first menstruation occurred – more than 12 years, infertility, lack of birth or ethnicity (black women are more likely to develop large fibroids and at younger ages) are also contributing factors.

Symptoms

In most cases, this is asymptomatic fibroids, they do not cause any disorder. There are sometimes a series of changes that may signal the presence of fibroids.

• Heavy menstrual bleeding, frequent and
• Pelvic pain
• Abdominal cramps
• Bloating
• Urinary disorders
• Bowel disorders
• Fertility problems

Diagnosis

Diagnosis is established based on gynecological examination and an ultrasound or MRI. Around 30% of patients with appropriate age for procreation, present one or more fibroids and one third of these cases requiring treatment for stabilizing menstruation, relieveing pain, improving fertility and reducing obstetrical risks.

Fibroid

Treatment

Currently there are a variety of therapeutic options to treat fibroids that are causing severe symptoms. Hormonal treatment, surgery and arterial embolization are just some of the many options available.
Drug treatment aims to reduce the production of progesterone, leading to fibroid atrophy. It generally uses derivatives of progesterone and antigonadotropic agents used as synthesis contraceptives, dosed particullary for each person. Hemostatics and NSAIDs (to limit bleeding) can complement the treatment. Unfortunately, using this type of therapy is transient and involves numerous side effects similar to those that accompany menopause, also it does not prevent reconstruction of fibroid a few months after the treatment ends.

Adverse effects during fibroids treatment:

• Headaches
• Hot flashes
• Vaginal dryness
• Bone decalcification
• Fatigue

Surgery can be performed both classically (with the scalpel) and laparoscopically through the abdomen or vagina, depending on location and size of the fibroid. Thanks to medical advances in this field the number of days of hospitalization and complexity of the surgical act have reduced significantly. Myomectomy, myolysis, arterial embolization are the latest achievements in the field. These techniques allow the destruction of fibroids using an electric current or by limiting the fibroids blood perfusion, without affecting the uterus and hormonal cycles.

Complications

Complications of fibroids are rare, but when they exist they can be very serious:

• Anemia. Fibroids can be the origin of large amounts of blood loss, that can be the cause of an anemia.
• Aseptic necrosis. Stopping localized blood flow to fibroid tissue can cause brutal pelvic pain, fever and intense brown bleeding.
• Fibroid Torsion
• Compression of neighboring organs. Large fibroids may press on other organs: bladder, veins (edema, varicose veins, hemorrhoids), nerves (neuralgia), rectum and sigmoid.

Actinic Keratosis

Actinic keratosis is an early warning sign of skin cancer. This lesion involves the appearance of rough patches on the skin and occurs in areas that were exposed to sunlight over time. Although it is not considered a form of skin cancer, it can turn into cancer if left untreated.

Like skin cancer, actinic keratosis is caused by prolonged exposure to UV light such as sunlight. People who have low levels of melanin in the skin are the most susceptible to sunburns and are at greater risk of developing actinic keratosis.

How is actinic keratosis diagnosed?

Check the skin and especially exposed to the sun, any scaly, rough, flesh-colored, pinkish, gray, pink, brown portion. These injuries are often covered with a crust. Actinic keratosis is often found in the facial area, scalp, ears, neck, arms and hands.

If a person considers that it may suffer from skin disease or any other pathological change, the dermatologist should be consulted.

If your doctor diagnoses actinic keratoses, there are various treatment options. Sometimes surgery may be necessary to eliminate or reduce the chances of tumor formation, using liquid nitrogen, or using a laser to destroy the cells that caused the injury. For healing, drugs like fluorouracil and imiquimod will be applied on the skin.

Photodynamic therapy uses a special light source combined with medication, that can be used to treat actinic keratosis.

How can actinic keratosis be prevented?

Preventive measures are the same as for protection against skin cancer: avoid exposure to ultraviolet light. Regular checking of the skin. Be sure to also apply sunscreen to avoid UV light during peak periods (10-16) when sunbathing, the body should be completely covered with loose clothing and sunglasses if you will go outdoors when the sun is very strong (sun can damage your eyes too) Monthly self-examination is recommended to detect early signs of cancer.

Skin Cancer

Overexposure to ultraviolet rays can cause skin cancer. UV light is very damaging to the skin cells. When the skin cell are affected, they begin to multiply uncontrollably, resulting in skin cancer. UV light can prevent the immune system from detecting and destroying skin cancer cells.

Skin Cancer Risk Factors

Among the conditions that diminish natural protection against UV rays include:

• Skin that burns easily (people with darker skin have more melanin, the pigment that helps protect skin from UV light)
• Living in Ecuador area, at high altitudes or spening  long periods of time, outdoors at times when the UV index is high
• The occurrence of some diseases (like HIV) or the result of various treatments such as cancer or transplant treatments, which suppress the immune system – as this decreases the body’s ability to find and destroy specific cells that are causing skin cancer.
• Other factors that increase the risk of developing skin cancer are: severe sunburns, overexposure to ultraviolet rays, arsenic poisoning or burns caused by radium. If a certain type of skin cancer (melanoma) other elements are aslo involved that predispose to its occurrence: a family history of skin cancer, a large number of moles or abnormal types of moles.

Skin Cancer Prevention

The most important thing you can do to avoid skin cancer is to minimize light exposure to ultraviolet rays. This means protecting your skin from the sun and avoiding taning salons.

Here are some tips that could allow anyone to enjoy the time spent in the sun outside, safely

• Use a moisturizer with SPF (sun protection factor) of at least 20. Ideal would be to buy a product that protects against both UVA and UVB types. To increase comfort, some moisturizing creams also have hydration properties in addition to UV protection
• Program of outdoor activities will be limited or avoided between 10 AM – 4PM
• The body should be covered as much as possible with a hat, sunglasses with side protection and clothing (long pants, long sleeve blouse, long skirt)
• Babies under the age of one will be protected from direct sunlight using an umbrella, or using a stroller canopy. Adequate clothing and hats that cover as much skin as possible are recommended.
• Read the prospectus carefully that there are certain drugs used for medicinal substances that increase the risk of skin burns. Some antibiotics and some drugs used to treat acne, can increase sensitivity to sunlight. Women who use contraceptive pills may appear darker on the cheek and forehead when these areas are not protected from sunlight. Any of these situations should be discussed with your doctor or pharmacist.

Sun Protection

People who love tanned skin can try products in the form of gels or creams that contain a dye that gives the skin a tanned appearance. Usually, the color disappears in about a week, where dead cells from the skin (colored) are removed. These cream products must be applied regularly to maintain color uniformity. Wash hands thoroughly with soap and water after application to avoid transferring the cream to other parts of the body. Usually, these products offer protection against the sun.

Regular examination of the skin is another way to prevent skin cancer. Everyone should self exam their skin monthly. This will help them understand the skin better, so any changes will be detected easily.  Visiting a dermatologist is madatory if you discover significant changes on your skin .

Skin Cancer Early Diagnosis

Most types of skin cancers can be cured if diagnosed early. The secret is to know very well your own skin with it moles and spots.

How to perform a self-examination

• First you need a well illuminated a room, two mirrors, one lower and one higher in order to be able to see  difficult to visualize areas. Another person would be very helpful
• Analyze the skin all over your body. To help you remember certain parts you will follow a routine evaluation: for example you might start with large areas of the front of the body, then the back and finally the sides. Then it will move to other areas such as hands and feet (including the skin of the fingers and toes), genital area, buttocks, behind the ears, neck. Also check the sik folds and scalp.
• Moles and birthmarks already present at birth are very important to know about.

Skin Self Examination

The skin should be reexaminated every month and any changes or unusual thing must be reported to your doctor. Annual monitoring should be carried out by a doctor.

When will examine moles will take into account the ABCD’s of skin cancer:

Skin Cancer ABCD

1. A – asymmetry – this means that the mole has asymmetrical edges, and the two halfs that form the mole have different shapes
2. B – border – moles with jagged edges or notched may signal the presence of skin cancer
3. C – color – moles that change color after certain periods of time
4. D – diameter – moles larger than 6 mm can be a sign of skin cancer.

Heimlich Maneuver

Worldwide, every year over 100,000 people die suffocated due to food or other foreign objects that accidentally reach into the trachea. If breathing is not resumed after two – three minutes after the onset of asphyxia, processes of brain destruction begin and the victim is on the brink of death.

In the U.S. until 1974, when the Heimlich maneuver was introduced, asphyxiation was the sixth leading cause of accidental death. Due to the fact that the suffocated victims can not speak, the problem is sometimes misinterpreted as an heart attack.

Heimlich Maneuver

Combustible materials, solar radiation, electricity, necrotizing substances can burn our skin, sharp objects can cause swelling or open injuries. Pieces of food or foreign bodies into the trachea can suffocate us. Everywhere around us there are elements which, due to inattention or haste, can affect more or less our physical integrity. Knowing some first aid basic rules can make the difference between life and death in such a situation.

Heimlich maneuver is very easy, requires no special equipment or medical training. The mechanism is very simple: when the respiratory process was stopped, sudden mobilization of the remaining air in the lungs unblocks the obstructed airway.

Heimlich Maneuver

Practical recommendations

• Savior will be placed behind the person who is choking and will introduce one of his legs between the legs of the victim, so that he can easily keep the person upright. A  punch in the stomach above the navel, below the breastbone, with the thumb towards the body.
• The savior will grab firmly the clenched fist with another hand and push on the stomach suddenly, leaning back and pulling up in the same time with enough force that the victim’s feet rise slightly from the ground (not so hard if the victim is a minor) . Strong compression of the diaphragm will cause the lungs to expell  the remaining air and the obstacle is easily mobilized. If the object has not emerged from the first attempt, repeat the procedure until successful or until the victim faints.

What To Do If

Asphyxia led to loss of consciousness.

Place the  unconscious victim on the ground and immediately call the ambulance. Until the arrival of the ambulance, start CPR, including chest compressions. No more abdominal presses (Hemlich maneuver). Each time the airways are open, check if the object has not reached the mouth or throat, case in wich you can extract it, otherwise continue until the victim regains consciousness or until medical personnel arrives.

Suffocation occurs when you are alone

The victim can apply the Heimlich maneuver on his own or he can lean on the back of a chair, pressing rhythmically, strong and suddenly the diaphragm until the foreign body is out.

Heimlich Maneuver

The victim is an infant.

Place the infant faceing down on the forearm, supporting his head with the palm of the same hand, so that it is lower than the chest. Child’s mouth should be free, between the thumb and fingers and the neck not twisted. Apply to your baby’s back between the shoulder blades, four to five strokes with the open palm. If the object has not come out of the airways, the back baby will be placed faceing up, (always maintaining the head), on the open legs of the rescuer. Apply the three and four finger just below the breastbone and hit five times, with short-acting downwards movements, towards the chin. If the foreign the object can be seen in the mouth, it should be removed immediately. You can do two mouth to mouth breaths. If despite these measures the foreign body has not come out,  call the ambulance and continue the respiratory resuscitation.

Fibromyalgia – Causes, Symptoms, Risk Factors And Treatment

Fibromyalgia is a chronic medical condition, characterized by diffuse pain and tenderness in muscles and soft tissue (tendons, ligaments), localized hotspots and sleep disturbances, weakness and a variety of other symptoms. These problems can be annoying and can disrupt daily activities. Fortunately, this syndrome does not permanently affect the muscles, joints or internal organs. Fibromyalgia is defined as a chronic pain syndrome.

Fibromyalgia Causes

The exact causes of fibromyalgia are unknown. There are theories about possible causes, but there is insufficient evidence to support any of these assumptions. Because fibromyalgia is a syndrome with varied symptomatology it is very difficult to point a specific cause. This syndrome was discovered  in 1980.

• Fibromyalgia is associated with highly sensitive nerve cells in the spinal cord and brain. Exaggerated sensitivity may result from chemical changes in the brain or spinal cord that control pain. As a result of these changes, the person feels pain more quickly and diffuse muscle pain is present.
• Fibromyalgia is linked to brain chemical imbalance that leads to lower tolerance to pain and restless sleep with daytime fatigue. From here there is only one step to a decreased physical activity, muscles become more sensitive, more painful and more easily irritable.
• Fibromyalgia is caused by hormonal imbalance between cortisol and growth hormone (somatotrope hormone). The release of these hormones is controlled by the pituitary gland and hypothalamus. Hormonal imbalances lead to fatigue, mood changes, memory problems, low pain tolerance and other symptoms.

Fibromyalgia Risk Factors

Some factors may increase the risk of developing fibromyalgia. Females are prone to this syndrome. A rheumatic disease (rheumatoid arthritis), an infectious disease (Lyme disease) or psychiatric problems (severe depression) may increase the chance of developing fibromyalgia. There is evidence for increased risk for fibromyalgia due to family history.
The patient who has fibromyalgia is more likely to report recurrent or persistent pain symptoms if:

• Has frequent episodes of emotional or physical stress
• Has more than 11 hotspots in the initial evaluation
• Presented symptoms for many years
• Presents insomnia or other sleep disorders
• Is depressed or has anxiety disorders.

Stress – Fibromyalgia Risk Factor

Fibromyalgia Symptoms

The variety and severity of  fibromyalgia symptoms vary from person to person. Chronic pain is the most common symptom. This is usually gradual. Other symptoms besides pain:

• Fatigue, which interferaza work and daily activities
• Sleep disturbances (difficulty sleeping or awakening with fatigue)
• Morning stiffness lasting less than an hour
• Migraines
• Constipation or diarrhea associated with irritable bowel syndrome
• Impaired memory and concentration
• The feeling of anesthesia or tingling in hands and other body segments
• Can be very sensitive skin, pressing firmly to react with tingling, or stinging anesthesia
• Raynaud’s syndrome
• Anxiety and depression
• Flu-like symptoms
• Pruritus (itching)
• Weakness and bowel dysfunction
• Pain in joints and muscles can be annoying especially at night, when awakening from sleep or in the morning
• Difficulty concentrating due to fatigue.

Fibromyalgia

Symptoms may last from several days to several months. People with fibromyalgia have periods of asymptomatic and symptomatic periods. Fatigue and muscle or joint pain are very common, especially after physical or mental stress. Many people experience pronounced paon at low temperatures or high humidity, do not sleep enough, are very tired, stressd or exhausted. Because fibromyalgia symptoms mimic other syndromes, the presence of other medical problems with similar symptoms must be eliminated through differential diagnosis, so that final diagnosis of fibromyalgia is correct . In many cases, other diseases are associated with fibromyalgia.

For most people, symptoms of fibromyalgia consist of low tolerance to pain and decreased physical activity. Increasing pain leads the person to be less active. Muscles that are not used for certain periods of time are prone to irritation during activity. People with fibromyalgia are more sensitive to pain and the muscles are more easily irritable. Muscle pain is associated with sleep disturbances and daytime fatigue. Together they lead to decreased activity.

Although fibromyalgia is a chronic syndrome with no treatment this condition is autolimited and does not affect muscles, joints or internal organs. Symptoms can be controlled with treatment at home, especially with exercise. Drug treatment is indicated for sleep disorders, intense pain or depression. Unfortunately, many people do not respond to several applied treatments Many people with fibromyalgia symptoms adapt on their own and continue to work and participate in daily activities, more or less. Many will have to adjust their work and lifestyle according to the severity of symptoms.

Speciality consult

You should see a doctor if you have these symptoms for more than 6 weeks without any obvious cause. These may be signs of fibromyalgia, especially if they appear gradually:

• Diffuse muscle pain and muscle tenderness, symmetrically above and below the waist
• Sleep disturbances (often twists during sleep), and fatigue after awakening
• Stiff muscles and joints that do not improve with movement
• Patients with fibromyalgia should be supervised to prevent depression. This can be successfully treated if the doctor is aware of this possibility

Medical specialists recommended .

Not every doctor finds it easy to diagnose and treat  fibromyalgia as a medical problem wich is not yet well defined. A doctor accustomed with fibromyalgia symptoms is recommended. Most experienced fibromyalgia doctors include:

• Rheumatologist
• Specialists in pain management physicians.

Other doctors that may be able to help patients with fibromyalgia are:

• GPs
• Medical interns
• Physiotherapists

Pain management programs can help. They usually include a team of doctors, counselors, nurses and pharmacists that can help patients to find a strategy to address pain. Personal program may include medication, complementary therapy, diet, exercise and counseling.

Fibromyalgia Treatment

Currently, there is no cure for fibromyalgia. Treatment is focused on pain, fatigue, depression and other symptoms of fibromyalgia, hoping to break the vicious circle of low tolerance to pain and reduced physical activity.

Treatment may include:

• Sleep medications as tricyclic antidepressants, selective serotonin inhibitors, antidepressants or skeletal muscle relaxants
• Lowering pain medications, painkilles with free prescription
• Physiotherapy for muscle pain and loss for energy
• Home treatment is probably the moast important step in treating fibromyalgia. Patient efforts to do regular exercise, improve sleep and reduce stress are as important to treat fibromyalgia as any medication prescribed by your doctor.

Initial treatment

If the patient was diagnosed recently with fibromilagie, initial treatment may include:

• Initiating a regular exercise program
• Identification of sleep disorders
• Decreasing pain and stiffness sensation with medication, heat and cold applications
• Gradual reduction of stress
• Identifying factors that accentuate symptoms.
• Coordinated by the physician, the patient may continue treatment at home

Ongoing treatment

As for the initial treatment, home treatment is essential to treat fibromyalgia. Exercise, sleep, stress reduction, can be very useful in controlling symptoms. Fibromyalgia symptoms are present in spikes, so it is important to continue long-term treatment at home.
Prescription drugs can be useful for the improvement of symptoms as pain or sleep disorders. Treatment reconsidered by the treating physician, if the patient does not sleep. There are other alternatives. It is important to know that drugs may  need  to be changed over time.
Another important component of treatment is avoiding or limiting as favoring factors or stress that accentuate symptoms. Cold or wet weather, poor sleep, fatigue, stress and physical exhaustion or emotional factors seem to be stressful for people with fibromyalgia. Sometimes, not all of these factors can be avoided, but can find ways to reduce stress, improve sleep and avoid exhaustion.
Warning signs of depression or anxiety, common in people with fibromyalgia! These apot be successfully treated if recognized and discussed with your doctor.
Fibromyalgia patients often have other joint or muscle diseases (eg rheumatoid arthritis or lupus), which also should be treated. Any new or increased symptoms should be communicated to the physician.

Treatment if the condition gets worse

Fibromyalgia is a progressive disease and does not lead to permanent physical dysfunction. However, symptoms can be debilitating and patients may experience periods when they feel worse than usual. If new or present symptoms get worse, it is recommend to discuss them with your doctor. It can reassess treatment. Medication dosage can be adjusted or new drugs can be tryed. Patients can do too much exercise or too little depending on the case
At the same time it is possible that changes to be correlated with symptoms of other diseases apart from fibromyalgia. Your doctor can assess this possibility only if you communicate with him.

Fibromyalgia Home treatment

Although fibromyalgia is a chronic syndrome, the patient can do very much to reduce and control symptoms. Home treatment is the most important part of treatment of fibromyalgia and is based on:

• Regular exercise. Of all the treatments of fibromyalgia, exercise seems to bring the most benefit in reducing pain and other symptoms and improve the overall condition
• Improving sleep
• Relieving pain. High temperatures and low therapy, massage, light exercise and administration of pain killers.
• Reducing stress
• Information about fibromyalgia.

Lifestyle should be adjusted so that it includes treatment, especially regular exercise. It may take some time until there is a program adapted to each case. The person must have patience and continue the treatment at home that will eventually relieve or control symptoms of fibromyalgia.

Fibromyalgia Home Treatment

Other treatments

A variety of drugs have been used to treat some chronic pain conditions. Most of these alternative complementary therapy treatments are not specific for fibromyalgia, but can help and can improve quality of life. Safe complementary therapies like acupuncture or massage, for example, can help reduce stress, decrease muscle tension and improve overall. Other treatments that can be used for fibromyalgia include:

• Physiotherapy
• Massage therapy
• Injection of anesthetic sensitive point
• Attitude of knowledge of the disease and forms of counseling

Studies show that some relaxation techniques may be effective in relieving fibromyalgia pain

• Biofeedback
• Acupuncture
• Meditation or prayer
• Transcutaneous electrical nerve stimulation

Other complementary therapies that have been tried by people with fibromyalgia are:

• Dietary supplements
• Vitamins
• Phytotherapy
• Reflexology, which consists of applying pressure on certain points of the body with effects on other body parts
• Chiropractic treatment

Sun Does More Damage To Your Eyes Than To Your Skin

Protect your eyes from sun.

There is no secret that prolonged exposure to the summer sun can cause severe inconvenience to the skin. What is less known is that the eyes can be seriously affected or more affected by strong radiation too. These troubles can be prevented by constant protection.

Learn how.

Summer has special features. The sun emits ultraviolet radiation during the entire year, but during hot weather they are about three times stronger than in winter. Also, their intensity increases with altitude, so people who are exposed to sunlight on mountain peaks are more prone to develop various related diseases. People who work outdoors, those with green or blue eyes, or who are receiving certain medications such as sulfonamides, tetracycline, phenothiazines, psoralens or allopurinol  are most affected by the ultraviolet rays.

Ultraviolet radiation and their effects on the eyes

UV rays the most harmful solar radiation. Ultraviolet radiation consists of three types of radiation according to wavelength: UVA, UVB and UVC. Ultraviolet type C are those with the shortest wavelength and the most pronounced risk for the body. But most often they are absorbed in the atmosphere, which makes them less harmful than the type A or B.

Eye Sunburns

Exposure to UV radiation, especially reflected by sand in summer or snow in winter can cause severe burns to the eye. Like those of the skin they are painful, but temporary. A long exposure can affect not only the structure of the eye surface (cornea and conjunctiva), but aslo the elements of internal structure, such as retina or lens.
A recent study by the National Eye Institute – USA show that people who have spent four to five hours as a teenager in the sun every day during the summer are subject to 50% higher risk of developing macular degeneration.

Simple or severe events?

Sunburns in the eye can often determine a series of temporary symptoms such as:

• Sensation of sand in eyes
• The need to blink excessively
• Watery eye
• Difficult to tolerate bright light
• Eye inflammation

Those are, however, exaggerating a little bit, “the happy scenarios”. Sometimes the effects are irreversible. Prolonged exposure during  life leads to the installation of cataracts. The cornea may also be affected by sunburns, sometimes causing temporary blindness. The sun is also responsible for developing cancers of the conjunctiva or eyelids. New studies show that sun causes macular degeneration that can lead to blindness.
Cataract is an opaque thin film in the lens. It blocks the light beam passage to the retina (nerve component of the eyeball that forms the image), causing vision problems. Worldwide according to the World Health Organization, there are 16 million people who have lost their sight due to cataracts, of which 20% have acquired the disease after exposure to UV rays of the sun.

Eye Cataract

What can we do?

A number of measures are recommended, that everyone should take the time and consider, to avoid inconveniences caused by harmful sun rays:

• Constantly seek the benefits of sunglasses even on cloudy days or in winter.
• Select your sunglasses carefully. They should lock in efficiently UV type A and B, but maintaining a good visibility of 75-90%.
• Check carefully to avoid different lens imperfections that could allow light penetration. Also, the sunglasses should not cause  image distortions.
• It is best to choose gray lenses that protect against radiation without distorting colors
• Children and teenagers should be given special attention because, in most cases, they are the ones who spend longer periods in the sun than adults.
• Regular checks done by an ophthalmologist are very important. This way you can gain control upon vision problems and receive advice related to sun protection and the health of our eyes.