CHRONICLES :HOT TOPICS SERIES

 WHAT YOU NEED TO KNOW

1.- PROSTATE DISEASE AT A GLANCE

Prostate cancer is the most common cancer in elderly men and the second most common cause of cancer-related death in men. Prostate cancer causes few if any symptoms in its early stages, but as it progresses it can lead to difficulties with urination and bleeding in the urinary tract, and the cancer can spread to other areas of the body. Prostate cancer may be detected by Digital Rectal Examination ( DRE). Testing for abnormally high blood levels of the protein known as prostate-specific antigen (PSA) is also used to diagnose the disease. Prostate cancer is treated using hormones, chemotherapy, radiation therapy, or surgical procedures.

Bacterial prostatitis is treated with antibiotics but sometimes all the infection cannot be eliminated from the prostate gland, and some men develop a chronically infected prostate.

 Prostate fluid also helps to keep sperm, which is found in semen, healthy and lively, thereby increasing the chances that fertilization will occur.

As the prostate grows, it constricts the urethra, possibly causing a partial obstruction of the bladder. Such obstruction may lead to bladder wall thickening and urination problems. Symptoms such as frequent urination, nighttime urination, a feeling of urgency to urinate, difficulty emptying the bladder, and a weak urinary stream are the most common problems men encounter from prostate enlargement.

The standard surgical procedure for removing the enlarged tissue in the prostate is called transurethral resection of the prostate (TURP). During this procedure, the surgeon uses an endoscope, a tube equipped with a small television camera and a sharp instrument, to cut away the excess prostate tissue.

INCIDENCE

A DISEASE OF AFRICAN AMERICAN

AA men have the highest prostate cancer incidence in the world. The are seven times more likely to be diagnosed with the disease than Asian men, who run the lowest risk. AA have positive prostate biopsies 70 per cent more often than do white American.  Other factors are high levels of dietary fat, low vitamin  D synthesis, and less access to medical care. Diet, sunshine, selenium are also mentioned.

Age and prostate caner appear to be bound together in some  fundamental biologic way that we don’t understand. The median age at diagnosis is 69 as opposed to age 63 for breast cancer. The median age for prostate cancer death is 77.

Factors that increase prostate ca risk are  a diet low in protective antioxidants( vitamin E and selenium) while a regime rich in fruits and vegetables might help ward off the disease.

CHRONICLES : INFECTIOUS DISEASES

1.- TRAVELER'S DIARRHEA

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lthough the cardiovascular diseases account for more than 60 % of deaths during travel, infection disease is not uncommon and is considered the most preventable part of travel medicine. 

Traveler’s diarrhea , the TDtd , remains a concern among peoples using drinking water in countries with poor hygiene.

Traveler’s Diarrhea, abbreviated TD, is the most common illness affecting travelers, according to Wikipedia.  Among causing pathogens, the most common  is enterotoxigenic Escherichia coli. Major symptoms consist of three or more loose stools, abdominal cramps, nausea and bloating. TD also is labeled :WD, the  acronym for wilderness diarrhea.

TD most often is self-limited. Patients can need rehydration therapy, disinfected water of carbonated water, antimotility agents, antibiotics such as norfloxacin, ciprofloxacin or trimethroprim/sulfamethoxazole.

Prevention seems however to be the best weapon against TD:  it is recommenced to use proper  water quality management systems and drink safe beverages. A traveler ‘s diarrhea vaccine is said to have reduced the risks  of getting diarrhea among some persons.

CHRONICLES :WOMEN CONCERN SERIES : :BREAST SELF EXAMINATION

YOUR BREAST AND YOU

BREAST SELF EXAMINATION

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irst of all, the woman has a big part to play, because it is her body. She knows more about it than everybody else.  She can perform the procedure as BSE.

Here are the main steps in this process.

Brest can be completed  using the mirror examination. Standing in front of a mirror, the woman can better evaluate the breast surroundings and any change in its shape. 

To do it, the woman examines her breast herself, in the days following her period. She touches her breast with the fingers pads rather than with fingertips, looking for some possible lump. To have a better grip, she benefits from squeezing her breasts against the chest bone while going to the armpit. Many doctors advise practicing this palpation in a prone position (lying down). The point  is to identify any change of size or texture, and notice any irregular mass. Furthermore, the woman can observe how this lump behaves, whether it grows larger or disappears between the menses.

 The woman will strive to note any deformity, shape change, asymmetry, and discoloration in each breast. As well, she has to observe whether there is any discharge in the nipples.

Some doctors want their patients to push against their breast, contracting the pectoral muscles. Fingers feel deeply set lumps this way. The same goes for the nipples which, when squeezed, can discharge fluids which can be pathologic. The mirror technique allows the woman to note any color changes or dermatologic details as happens in the case of Paget’s disease.

Secondly, the next step consists of palpation. Going to the right breast and lifting the left arm above of her head, the woman would look for some mass, swelling or nay unusual lump in her breast. It is recommended to push the mass of the breast against the chest in order to feel any modification in consistency of form.

Repeat the same process for the left breast.

The next step is performed  with the woman in supine or lying down position. The breast and muscles below are relaxed. There is less effect of gravity. Masses and any irregular modification can be identified in this laying down position.

Women who menstruate no longer are advised to perform this examination each month at the same time.

Whatever their age, women who note some change in their breast have to check with their physician.

CHRONICLES :HEART ATTACK

HEART ATTACK

DEFINITION

        A heart attack occurs when blood flow  is interrupted causing some part of the heart to become ischemic and resulting in death. Put simply, it is a circulation accident followed by tissue death.  The medical term for this is myocardial infarction.

• INCIDENCE
• RIKS
• CLINIC SIGNS
• TRICKY HEART ATTACK
• PARACLINIC SIGNS
• HOW TO IDENTIFY
• HOW TO PREVENT
• WHAT TO DO IN CASE
• PATIENTS TESTIMONY
• HA STORIES

HOW TO IDENTIFY A HEART ATTTACK

HEART ATTACK SIGNS

·         SHORTNESS OF BREATH

·         DIFFICULTY OF BREATHING

·         FEELING COLD AND CLAMMY

·         SWEATING

·         EXTREME WEAKNESS, FATIGUE, EXHAUSTION

·         NAUSEA, VOMITING, PALPITATIONS

·         DIZZINESS

·         LIGHT-HEADNESS

FIGHTING HEART DISEASE IMPLIES

·         SALT RESTRICTION

·         WEIGHT REDUCTION

·         EXERCICE

·         ALCOHOL RESTRICTION

·         RELAXATION

SIX-LIFE SAVING STEPS IN CASE OF HEART ATTACK

·         STOP WHAT YOU ARE DOING

·         DON’T PANIC

·         CALL 911 & SAY YOU HAVE A HEART ATTACK

·         TAKE A BABY  A.S.A.

·         TAKE A NITROGLYCERINE

·         ASK IF AN AUTOMATIC EXTERNAL DEFRIBRILLATOR IS AVAILABLE

·         CPR IN CASE

RISK FACTORS IN HEART ATTACK

1.-MODIFIABLE RISK FACTORS

·         CIGARETTE SMOKING

·         HYPERLIPIDEMIA

·         HTA

·         DIABETES MELLITUS

·         INACTIVITY –OBESITY

2.- NON MODIFIABLE RISK FACTORS

·         FAMILY HISTORY

·         GENDER

·         AGE

BREAST CANCER PREVENTION

How can women reduce their risks of getting breast cancer?

DRINKING. 

In reducing their drinking, women can lover these risks. France and Italy known for their large drinking habits, have a high incidence of breast cancer. However some authors think that taking a glass of wine daily protects against the malignancy.

DIET. 

A fat diet is associated with an increases rate of breast cancer. Lowering their fat consumption can spare women from being targeted by breast cancer. This observation has been noted comparing the rate of the disease among Japanese women living in rural Japan and others who migrated to California. The later show more cases than the natives still at home , due to the westernized fat consumption habits.

OBESITY.

 Obese women are prone to develop breast ca more than slim ones. It is said that the fat in their food generates some genetic mutation, hence the increase incidence to being affected by the malignancy

SMOKING as well is blamed as a risk factor.

ENVIRONMENT.

Such  as like x-rays and notably the time exposure to radiation, the agricultural organ chorines, are held responsible in causing breast cancer.

AGE OF THE FIRST PREGNANCY.

Late first pregnancy alter the 30s favors breast cancer. So. many authors encourage women to have their first child around the mid 20s

HORMONES.

 Estrogen, the female hormone, plays a key role in launching he disease.  Researchers and clinicians think  that time exposure is capital, for, they said, the more  . women menstruates in her life time, the more she is at risk of getting breast cancer. Early menarche and late menopause are  positive factors.

AGE OF THE PATIENT .

Breast cancer is a disease of women turning their 50s. But, beyond their 30s, women are growing more vulnerable. Breast ca is rare in the 20s.

SCREENING .

Take the family history in order to identify whether there exists some genetic transmission. If this turns out to be true, consider the possibility for the gene responsible for  breast cancer.   BCRA1 and BCRA 2  may be involved

PREVENTIVE MASTECTOMIES.

This is a rare and dreadful step that most of the doctors are reluctant to.

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