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Minimally Conscious State: Causes, symptoms & Treatments

A minimally conscious state is severe but not complete impairment of awareness that results from widespread damage to the cerebrum (the part of the brain that controls thought and behavior).

A minimally conscious state may result directly from brain damage, or it may follow a vegetative state as people recover some function.

People in a minimally conscious state, unlike those in a vegetative state, do some things that indicate some awareness of self and of their environment. They may do the following:

  • Make eye contact

 

  • Follow objects with their eyes
  • Reach for objects
  • Respond to questions (although often with the same word whether it is appropriate or not)
  • React to all commands in a usual but usually inappropriate way (for example, by blinking).

 

Most people in a minimally conscious state tend to improve continuously, but improvement is limited. A few people regain the ability to communicate and understand, sometimes after many years. However, very few recover enough to live and function independently. The longer a minimally conscious state lasts, the less function people are likely to regain. However, with skilled nursing care, people can live for years. Recovery may be better when the cause is a head injury.

There have been reports of people awakening after spending years in what appears to be a coma. These reports often involve people who had been in a minimally conscious state after a head injury.

Diagnosis

  • A doctor’s evaluation

  • Imaging tests such as magnetic resonance imaging

Doctors suspect the diagnosis based on symptoms. But before a minimally conscious state can be diagnosed, people should be observed for a period of time and on more than one occasion.

An imaging test, such as magnetic resonance imaging (MRI) or computed tomography (CT), is done to check for disorders that may be causing the problem, especially those that can be treated.

Treatment

  •  Preventive measures for problems due to immobilization
  •  Good nutrition
  •  Possibly certain drugs

Long-term care

Like people in a coma, people in a minimally conscious state require comprehensive care.

Providing good nutrition ( nutritional support) is important. People are fed through a tube inserted through the nose and into the stomach. Sometimes they are fed through a tube (called a percutaneous endoscopic gastrostomy tube, or PEG tube) inserted directly into the stomach through an incision in the abdomen. Drugs may also be given through this tube.

Many problems result from being unable to move, and measures to prevent them are essential (see Problems Due to Bed Rest). For example, the following can happen:

  • Pressures sores: Lying in one position can cut off the blood supply to some areas of the body, causing skin to break down and pressure sores to form. Caregivers must turn people very frequently.
  • Contractures: Lack of movement can also lead to permanent stiffening of muscles (contractures) causing joints to become permanently bent.
  • Blood clots: Lack of movement makes blood clots more likely to form in leg veins.

To prevent these problems, physical therapists gently move the person’s joints in all directions (passive range-of-motion exercises). Therapists may splint joints in certain positions to help prevent contractures. People are also given drugs to prevent blood clots from developing.

If people are incontinent, care should be taken to keep the skin clean and dry. If the bladder is not functioning and urine is being retained, a tube (catheter) may be placed in the bladder to drain urine.

Other treatments

A very few people have improved after treatments such as zolpidem (a sleep aid) or amantadine (a drug used to treat viral infections). However, no treatment has been proved effective.

Sebaceous Cysts : Causes, Symptoms & Treatments

Sebaceous cysts form out of your sebaceous gland. The sebaceous gland produces the oil called sebum that coats your hair and skin. Cysts can develop if the gland or its duct, the passage where oil is able to leave, becomes damaged or blocked. This usually occurs due to a trauma to the area.

The trauma may be a scratch, a surgical wound, or a skin condition, such as acne. Sebaceous cysts grow slowly, so the trauma may have occurred months or weeks before you notice the cyst.

Other causes of a sebaceous cyst may include:

  • a misshapen or deformed duct
  • damage to the cells during a surgery
  • genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome

Symptoms of sebaceous cyst :

Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.

This type of cyst is typically filled with white flakes of keratin, which is also a key element that makes up your skin and nails. Most cysts are soft to the touch.

Areas on the body where cysts are usually found include:

  • scalp
  • face
  • neck
  • back

A sebaceous cyst is considered unusual — and possibly cancerous — if it has the following characteristics:

  • a diameter that is larger than five centimeters
  • a fast rate of reoccurrence after being removed
  • signs of infection, such as redness, pain, or pus drainage

Diagnosis of a sebaceous cyst

Doctors often diagnose a sebaceous cyst after a simple physical examination. If your cyst is unusual, your doctor may order additional tests to rule out possible cancers. You may also need these tests if you wish to have the cyst surgically removed.

Common tests used for a sebaceous cyst include:

  • CT scans, which help your doctor find the best route for surgery and spot abnormalities
  • ultrasounds, which identify the contents inside the cyst
  • punch biopsy, which involves removal of a small amount of tissue from the cyst to be examined in a laboratory for signs of cancer

Treatment of sebaceous cyst:

Your doctor can treat a cyst by draining it or by surgically removing it. Normally, cysts are removed. This is not because they are dangerous but rather for cosmetic reasons. Since most cysts are not harmful to your health, your doctor will allow you to pick the treatment option that works for you.

It is important to remember that without surgical removal, your cyst will usually come back. The best treatment is to ensure complete removal through surgery. Some people do decide against surgery, however, because it can cause scarring.

Your doctor may use one of the following methods to remove your cyst:

  • conventional wide excision: completely removes a cyst but can leave a long scar
  • minimal excision: causes minimal scarring but carries a risk that the cyst will return
  • laser with punch biopsy excision: the laser is used to make a small hole to drain cyst contents and the outer walls of the cyst are removed about a month later

After your cyst is removed, your doctor may give you an antibiotic ointment to prevent infection. You should use this until the healing process is complete. You may also be given a scar cream to reduce the appearance of any surgical scars.

BAHA Devices: Causes and uses

Conductive and mixed conductive/sensory hearing loss

A bone conduction implant (BCI) is used to treat 2 basic problems: conductive and/or mixed hearing loss and deafness in one ear (single-sided deafness). These devices are considered when use of a conventional (air-conduction hearing aid) is not possible. For the case of conductive or mixed hearing loss, they are used most commonly in patients with chronic ear infections, cholesteatoma, and chronic otorrhea in which the diseased eardrum and/or middle ear ossicles are not able to conduct sound to the cochlea and use of a conventional hearing device often is not possible. The other common situation is congenital aural atresia in which absence of the ear canal and eardrum causes conductive hearing loss and a conventional hearing aid cannot be used.

Before Baha, the only device available to treat these situations was a conventional bone conduction hearing aid. This device consists of a bone conduction hearing aid (vibrator) attached to a headband (see the image below). These devices, while very helpful over the years, have several inherent disadvantages that limit their benefit and their acceptance, including the following:

  • Discomfort caused by the constant pressure of the vibrator against the scalp
  • Poor sound quality and volume caused by the indirect and variable coupling of the vibrator to the skull due to intervening hair and scalp tissues
  • Variable and unstable positioning affecting the quality of transduction
  • Bilateral use is not possible
  • Poor aesthetics

Audiometric Testing

Basic audiometry including pure-tone audiogram and speech audiometry should be performed. A trial of the Baha using an external headband is useful. Several questionnaires are also available in order to obtain the participating patient’s subjective view of different aspects of Baha fitting, and these include the study-specific questionnaire, the International Outcome Inventory for Hearing Aids, the Meaningful Auditory Integration Scale, the Meaningful Use of Speech Scale, and the H70.

Polycystic Ovary Syndrome: Causes, Symptoms & Treatments

Polycystic Ovary Syndrome :

13321768_sWhat is Polycystic Ovary Syndrome?

Polycystic ovary syndrome, or PCOS, is a complex hormone disorder that causes such symptoms as irregular menstrual cycles, infertility, excessive body hair, acne, and obesity.  The syndrome is named for the cysts that may form in the ovaries when the hormone imbalance interrupts the ovulation process.  The term polycystic means “composed of many cysts”.  If the hormone imbalance is left untreated, the syndrome may lead to life-threatening illnesses such as diabetes, heart disease, stroke, and uterine and endometrial cancers.

Symptoms of Polycystic Ovary Syndrome

Because it is a syndrome, PCOS includes a set of symptoms.  Women with PCOS can suffer from any combination of the symptoms listed here.  Some women experience only one of these symptoms, while other women experience all of them.  The severity of PCOS symptoms can vary widely from woman to woman.  Talk to your physician if you suffer from one or more of these symptoms.•

  • Chronically irregular menstrual cycles or absent periods
  • Infertility or difficulty conceiving (due to not ovulating)
  • Obesity (greater than 20 percent over “ideal” weight)
  • Sudden, unexplained weight gain (even if you are still of “normal” weight)
  • Adult acne
  • Excessive hair growth (especially dark hair on the face, chest, or abdomen)
  • Male-pattern hair loss or thinning hair
  • Type II diabetes or insulin resistance

It is possible to have the above symptoms and not have PCOS.  However, most women with these symptoms, especially irregular menstrual cycles, do have PCOS.  In fact, 80 percent of women with six or fewer periods per year have PCOS.

Researchers have found some variations in the symptoms among different races.  For example, while excessive body hair is found among 70 percent of American women with PCOS, it only occurs in about 10 to 20 percent of Asian women.  Unfortunately, there is not enough evidence to explain why these variations in symptoms occur.

Because the symptoms of PCOS can vary widely, it can be difficult to exclude or include symptoms as a part of the diagnosis.  In face, the World Health Organization tried to determine a comprehensive list of symptoms and couldn’t agree on more than four of them.  Further research is being done at a dozen facilities in the United States alone.  There may be more common symptoms discovered as new studies are completed and women continue reporting their experiences.

Who Is Affected by Polycystic Ovary Syndrome, PCOS?

The most common endocrine disorder, PCOS is estimated to affect anywhere from 5 to 10 percent of all women. That means at least 5 million and as many as 10 million women in the United States suffer from PCOS. The syndrome does not discriminate and can be found in women of all races and ethnic groups throughout the world, although it tends to be more common in women of Mediterranean descent.  PCOS affects women of all ages, from adolescence to menopause.  Once a woman is diagnosed, she will need to manage the symptoms for the rest of her life.

What is the Cementless Total Hip Replacement

What is Uncemented / Cementless Total Hip Replacement

Total hip replacement is a surgical procedure for replacing the hip joint. This joint is composed of two parts – the hip socket (acetabulum, a cup-shaped bone in the pelvis) and the “ball” or head of the thighbone (femur). During the surgical procedure, these two parts of the hip joint are removed and replaced with smooth artificial surfaces. The artificial socket is made of high-density plastic, while the artificial ball with its stem is made of a strong stainless metal. These artificial pieces are implanted into healthy portions of the pelvis and thighbones and affixed with a bone cement (methyl methacrylate).

An alternative hip prosthesis called a “cementless” total hip replacement has the potential to allow bone to grow into it, and therefore may last longer than the cemented hip. This is an important consideration for the younger patient. In some cases, only one of the two components (socket or stem) may be fixed with cement and the other is cementless and would be called a “hybrid” hip prosthesis.

When is total hip replacement considered ?

Total hip replacements are usually performed for severe arthritic conditions. The operation is sometimes performed for other problems such as hip fractures or avascular necrosis (a condition in which the bone of the hip ball dies). Most patients who have artificial hips are over 55 years of age, but the operation is occasionally performed on younger persons.

Circumstances vary, but generally, patients are considered for total hip replacements if : –

Your pain is severe enough to restrict work, recreation, and the ordinary activities of daily living.
Your pain is not relieved by anti-inflammatory medicine, the use of a cane or walker and restricting activities.
You have significant stiffness of the hip.
Your x-rays show advanced arthritis, or other problems.

The orthopaedic surgeon must be very precise in preparing the femur for a cementless impact. The implant channel must match the shape of the implant itself very closely. New bone growth cannot bridge gaps larger than 1 mm to 2 mm. Your surgeon may recommend a period of protected weight-bearing (using crutches or a walker) to give the bone time to attach itself to the implant. This protected weight bearing helps to ensure there is no movement between the implant and bone so a durable connection can be established.

Cementless femoral components tend to be much larger at the top, with more of a wedge shape. This design enables the strong surface (cortex) of the bone and the dense, hard spongy (cancellous) bone just below it to provide support.

The acetabular component of a cementless total hip replacement also has a coated or textured surface to encourage bone growth into the surface. Depending on the design, these components may also use screws through the cup or spikes, pegs, or fins around the rim to help hold the implant in place until the new bone forms. Usually these components have a metal outer shell and a polyethylene liner.

The pelvis is prepared for a cementless acetabular component using a process similar to that used in a cemented total hip replacement procedure. The intimate contact between the component and bone is crucial to permit bone ingrowth.

Initially, it was hoped that cementless total hip replacement would eliminate the problem of bone resorption or stem loosening caused by cement failure. Although certain cementless stem designs have excellent long-term outcomes, cementless stems can loosen if a strong bond between bone and stem is not achieved.

Patients with large cementless stems may also experience a higher incidence of mild thigh pain. Likewise, polyethylene wear, particulate debris, and the resulting osteolysis (dissolution of bone) remain problems in both cemented and uncemented designs. Improvements in the wear characteristics of newer polyethylene and the advent of hard bearings (metal-on-metal or ceramic) may help resolve some of these problems in the future.

Although some orthopaedic surgeons are now using cementless devices for all patients, cementless total hip replacement is most often recommended for younger, more active patients and patients with good bone quality where bone ingrowth into the components can be predictably achieved. Individuals with juvenile inflammatory arthritis may also be candidates, even though the disease may restrict their activities.

Esophageal Cancer : Causes, Symptoms & Treatments

What Is Esophageal Cancer?

The esophagus is a muscular tube that’s responsible for moving food from the throat to the stomach. Esophageal cancer can occur when a malignant tumor forms in the lining of the esophagus. As the tumor grows, it can affect the deep tissues and muscle of the esophagus. A tumor can appear anywhere along the length of the esophagus, including the junction of the esophagus and stomach, or where the two meet.

What Are the Common Types of Esophageal Cancer?
 There are two common types of esophageal cancer.

Squamous cell carcinoma occurs when cancer starts in the flat, thin cells that make up the lining of the esophagus. This form most often appears in the top or middle of the esophagus, but it can appear anywhere.

Adenocarcinoma occurs when cancer starts in the glandular cells of the esophagus that are responsible for the production of fluids such as mucus. Adenocarcinomas are most common in the lower portion of the esophagus.

 What Are the Symptoms of Esophageal Cancer?

During the early stages of esophageal cancer, you probably won’t experience any symptoms. As your cancer progresses, you may experience:

  • unintentional weight loss
  • indigestion
  • heartburn
  • difficulty or painful swallowing
  • frequent choking while eating
  • vomiting
  • food coming back up the esophagus
  • chest pain
  • fatigue

What Causes Esophageal Cancer?

As with most cancers, the cause of esophageal cancer isn’t yet known. It’s believed to be related to abnormalities, or mutations, in the DNA of the cells related to the esophagus. These mutations signal the cells to multiply more rapidly than normal cells. These mutations also disrupt the signal for these cells to die when they should. This causes them to accumulate and become tumors.

Who Is at Risk for Developing Esophageal Cancer?

Experts believe that the irritation of esophagus cells contributes to the development of cancer. Some habits and conditions that can cause irritation include:
  • consuming alcohol
  • smoking
  • having a reflux disorder, such as gastroesophageal reflux disease (GERD)
  • being overweight
  • not eating enough fruits and vegetables
  • having Barrett’s esophagus, which is a condition characterized by damaged esophageal lining due to GERD

People at increased risk of esophageal cancer include the following:

  • Men are three times as likely to develop esophageal cancer as women.
  • Esophageal cancer is more common in African-Americans than in other races.
  • Your chances of developing esophageal cancer increase with age. If you’re over the age of 45, your risk may be higher.

Treating Esophageal Cancer

Your doctor may recommend surgery if the cancer hasn’t spread to other parts of your body. Your doctor may instead recommend chemotherapy or radiation therapy as the best course of action. These treatments are also sometimes done to shrink tumors in the esophagus so that they can be removed more easily with surgery.

Surgery

If the cancer hasn’t grown past the superficial layers of the esophagus, your doctor can remove the tumor using an endoscope. In more serious cases, a portion of the esophagus and sometimes the lymph nodes around it are removed. The tube is reconstructed with tissue from the stomach or large intestine. In severe cases, a portion of the top of the stomach may be removed as well.

The risks of surgery can include bleeding, leaking in the area where the rebuilt esophagus was attached to the stomach, and infection.

Chemotherapy

Chemotherapy involves the use of drugs to attack cancer cells. Chemotherapy may be used before or after surgery. It sometimes accompanies the use of radiation therapy.

Chemotherapy does have several side effects. Most are related to the fact that the drugs used also kill healthy cells. Your side effects will vary depending on the drugs your doctor uses. These side effects can include:

  • hair loss
  • nausea
  • vomiting
  • fatigue
  • pain
  • neuropathy

Radiation Therapy

Radiation therapy uses beams of radiation to kill cancer cells. Radiation may be administered externally with the use of a machine or internally with a device placed near the tumor, which is called brachytherapy. Radiation is commonly used along with chemotherapy and side effects are usually more severe when combined treatment is used. The side effects of radiation can include:

  • skin that looks sunburned
  • pain or difficulty when swallowing
  • fatigue
  • painful ulcers in the lining of the esophagus

It’s possible to experience some side effects of treatment long after treatment finishes. These can include esophageal stricture, where the tissue becomes less flexible and can cause the esophagus to narrow, making it painful or difficult to swallow.

Other Treatments

If your esophagus is obstructed as a result of cancer, your doctor may be able to implant a stent, or tube made of metal, into your esophagus to keep it open.

They may also be able to use photodynamic therapy, which involves injecting the tumor with a photosensitive drug that attacks the tumor when exposed to light.

 

Pancreatic Cancer : Causes, symptoms & Treatments

Signs and symptoms of pancreatic cancer:

The symptoms of exocrine pancreatic cancers and pancreatic neuroendocrine tumors (NETs) are often different, so they are described separately.

Having one or more of the symptoms below does not mean you have pancreatic cancer. In fact, many of these symptoms are more likely to be caused by other conditions. Still, if you have any of these symptoms, it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.

Signs and symptoms of exocrine pancreatic cancer:

Early pancreatic cancers often do not cause any signs or symptoms. By the time they do cause symptoms, they have often already spread outside the pancreas.

Jaundice and related symptoms

Jaundice is yellowing of the eyes and skin. Most people with pancreatic cancer (and virtually all people with ampullary cancer) will have jaundice as one of their first symptoms.

Jaundice is caused by the buildup of bilirubin, a dark yellow-brown substance made in the liver. Normally, the liver excretes bilirubin as part of a liquid called bile. Bile goes through the common bile duct into the intestines, where it helps break down fats. It eventually leaves the body in the stool. When the common bile duct becomes blocked, bile can’t reach the intestines, and the level of bilirubin in the body builds up.

Cancers that start in the head of the pancreas are near the common bile duct. These cancers can press on the duct and cause jaundice while they are still fairly small, which can sometimes lead to these tumors being found at an early stage. But cancers that start in the body or tail of the pancreas don’t press on the duct until they have spread through the pancreas. By this time, the cancer has often spread beyond the pancreas as well.

When pancreatic cancer spreads, it often goes to the liver. This can also lead to jaundice.

Dark urine: Sometimes, the first sign of jaundice is darker urine. As bilirubin levels in the blood increase, the urine becomes brown in color.

Light-colored or greasy stools: Bilirubin normally helps give stools their brown color. If the bile duct is blocked, stools might be pale or gray. Also, if bile and pancreatic enzymes can’t get through to the intestines to help break down fats, the stools can become greasy and might float in the toilet.

Itchy skin: When bilirubin builds up in the skin, it can start to itch as well as turning yellow.

Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis, and other liver and bile duct diseases, are much more common.

Belly or back pain

Pain in the abdomen (belly) or back is common in pancreatic cancer. Cancers that start in the body or tail of the pancreas can grow fairly large and start to press on other nearby organs, causing pain. The cancer may also spread to the nerves surrounding the pancreas, which often causes back pain. Of course, pain in the abdomen or back is fairly common and is most often caused by something other than pancreatic cancer.

Weight loss and poor appetite

Unintended weight loss is very common in people with pancreatic cancer. These people often have little or no appetite.

Nausea and vomiting

If the cancer presses on the far end of the stomach it can partly block it, making it hard for food to get through. This can cause nausea, vomiting, and pain that tend to be worse after eating.

Gallbladder or liver enlargement

If the cancer blocks the bile duct, bile can build up in the gallbladder, making it larger. Sometimes a doctor can feel this (as a large lump under the right ribcage) during a physical exam. It can also be seen on imaging tests.

Pancreatic cancer can also sometimes enlarge the liver, especially if the cancer has spread to the liver. The doctor might be able to feel this below the right ribcage as well on an exam, or it might be seen on imaging tests.

Blood clots

Sometimes, the first clue that someone has pancreatic cancer is a blood clot in a large vein, often in the leg. This is called a deep vein thrombosis or DVT. Symptoms can include pain, swelling, redness, and warmth in the affected leg. Sometimes a piece of the clot can break off and travel to the lungs, which might make it hard to breathe or cause chest pain. A blood clot in the lungs is called a pulmonary embolism or PE.

Still, having a blood clot does not usually mean that you have cancer. Most blood clots are caused by other things.

Fatty tissue abnormalities

Some people with pancreatic cancer develop an uneven texture of the fatty tissue underneath the skin. This is caused by the release of the pancreatic enzymes that digest fat.

Diabetes

Rarely, pancreatic cancers cause diabetes (high blood sugar) because they destroy the insulin-making cells. Symptoms can include feeling thirsty and hungry, and having to urinate often. More often, cancer can lead to small changes in blood sugar levels that don’t cause symptoms of diabetes but can still be detected with blood tests.

Signs and symptoms of pancreatic neuroendocrine tumors:

Pancreatic neuroendocrine tumors (NETs) often release excess hormones into the bloodstream. Different types of tumors make different hormones, which can lead to different symptoms.

Gastrinomas

These tumors make gastrin, a hormone that tells the stomach to make more acid. Too much gastrin causes a condition known as Zollinger-Ellison syndrome, in which the stomach makes too much acid. This leads to stomach ulcers, which can cause pain, nausea, and loss of appetite. Severe ulcers can start bleeding. If the bleeding is mild, it can lead to anemia (too few red blood cells), which can cause symptoms like feeling tired and being short of breath. If the bleeding is more severe, it can make stool black and tarry. Severe bleeding can itself be life-threatening.

If the stomach acid reaches the small intestine, it can damage the cells of the intestinal lining and break down digestive enzymes before they have a chance to digest food. This can cause diarrhea and weight loss.

Glucagonomas

These tumors make glucagon, a hormone that increases glucose (sugar) levels in the blood. Most of the symptoms that can be caused by a glucagonoma are mild and are more often caused by something else.

Excess glucagon can raise blood sugar, sometimes leading to diabetes. This can cause symptoms such as feeling thirsty and hungry, and having to urinate often.

People with these tumors can also have problems with diarrhea, weight loss, and malnutrition. The nutrition problems can lead to symptoms like irritation of the tongue (glossitis) and the corners of the mouth (angular cheilitis).

The symptom that brings most people with glucagonomas to their doctor is a rash called necrolytic migratory erythema. This is a red rash with swelling and blisters that often travels from place to place on the skin.

Insulinomas

These tumors make insulin, which lowers blood glucose levels. Too much insulin leads to low blood sugar (hypoglycemia), which can cause symptoms like weakness, confusion, sweating, and rapid heartbeat. When blood sugar gets very low, it can lead to a person passing out or even going into a coma and having seizures.

Somatostatinomas

These tumors make somatostatin, which helps regulate other hormones. Symptoms of this type of tumor can include belly pain, nausea, poor appetite, weight loss, diarrhea, symptoms of diabetes (feeling thirsty and hungry, and having to urinate often), and jaundice (yellowing of the skin and eyes).

The early symptoms of a somatostatinoma tend to be mild and are more often caused by other things, so these tumors tend to be diagnosed at an advanced stage. Often, they are not found until they spread to the liver, when they cause problems like jaundice and pain.

Which treatments are used for pancreatic cancer?

Depending on the type and stage of the cancer and other factors, treatment options for people with pancreatic cancer can include:

  • Surgery
  • Ablation or embolization treatments
  • Radiation therapy
  • Chemotherapy and other drugs

Pain control is also an important part of treatment for many patients.

Sometimes, the best option might include more than one type of treatment. To learn about the most common approaches to treating these cancers, see Treating pancreatic cancer, based on the extent of the cancer.

For pancreatic neuroendocrine tumors (NETs), treatment options might include surgery, ablation or embolization treatments, radiation therapy, or different types of medicines. For more on how these tumors are treated, see Treating pancreatic neuroendocrine tumors, based on the extent of the tumor.

Cervical Polyps: Causes, symptoms and treatments

The cervix is a tubelike channel that connects the uterus to the vagina. Cervical polyps are growths that usually appear on the cervix where it opens into the vagina. Polyps are usually cherry-red to reddish-purple or grayish-white. They vary in size and often look like bulbs on thin stems. Cervical polyps are usually not cancerous (benign) and can occur alone or in groups. Most polyps are small, about 1 centimeter to 2 centimeters long. Because rare types of cancerous conditions can look like polyps, all polyps should be removed and examined for signs of cancer.

The cause of cervical polyps is not well understood, but they are associated with inflammation of the cervix. They also may result from an abnormal response to the female hormone estrogen.

Cervical polyps are relatively common, especially in women older than 20 who have had at least one child. They are rare in girls who have not started menstruating. There are two types of cervical polyps:

  • Ectocervical polyps can develop from the outer surface layer cells of the cervix. They are more common in postmenopausal women.
  • Endocervical polyps develop from cervical glands inside the cervical canal. Most cervical polyps are endocervical polyps, and are more common in premenopausal women.

Symptoms

Cervical polyps may not cause any symptoms. However, you may experience:

  • Discharge, which can be foul-smelling if there is an infection
  • Bleeding between periods
  • Heavier bleeding during periods
  • Bleeding after intercourse

Diagnosis

If you have a cervical polyp, you probably won’t be able to feel it or see it. Cervical polyps are discovered during routine pelvic exams or evaluations for bleeding or while getting a Pap test.

Expected Duration

Sometimes a polyp will come off on its own during sexual intercourse or menstruation. However, most polyps need to be removed to treat any symptoms and to evaluate the tissue for signs of cancer, which is rare.

 

Cervical Polyps

 

Prevention

Visit your doctor for an annual Pap test and for regular pelvic exams. A direct examination is the best way to identify cervical polyps.

Treatment

Cervical polyps are removed surgically, usually in a doctor’s office. The doctor will use a special instrument, called a polyp forceps, to grasp the base of the polyp stem and then gently pluck the polyp with a gentle, twisting motion. Bleeding is usually brief and limited. Nonprescription, mild pain medication such as acetaminophen (Tylenol and others) or ibuprofen (Advil, Motrin and others) can help to relieve discomfort or cramping during or after the procedure.

The polyp or polyps are sent to a laboratory for examination. You may receive antibiotics if the polyp shows signs of infection. If the polyp is cancerous, treatment will depend on the extent and type of cancer.

Large polyps and polyp stems that are very broad usually need to be removed in an operating room using local, regional or general anesthesia. You will not need to stay in the hospital overnight. Cervical polyps may grow in the future from different areas of the cervix, usually not from the original site. Regular pelvic examination will help to identify and treat polyps before they cause symptoms.

When To Call a Professional

If you experience vaginal discharge, bleeding after intercourse, or bleeding between periods, make an appointment to see your doctor as soon as possible for a pelvic exam.

Prognosis

The outlook is excellent. The vast majority of cervical polyps are not cancerous. Once removed, polyps usually don’t come back.

 

Stem cells and Procedures

Humans are the most advanced in the order of creation, they have been gifted with the intellect which they have been using in different fields and helping mankind make his life easier and simpler. With the advance in technology medicine was not far behind. The so called “incurable diseases” started finding a cure, psychiatric patients were unshackled after the discovery of neurotransmitters responsible for psychiatric illnesses. Antibiotics and vaccines started curing and preventing serious infectious diseases.

However the neuro-degenerative diseases such as dementia, MNDs, spinal cord injury, parkinsonism, cerebral palsy etc., still are in search of that elusive drug. But with the discovery of stem cell therapy the hitherto “elusive drug” the magic remedy has been found which has come to salvage scores of patients suffering from these debilitating illnesses.

What is stem cell?
Stem cells can be called as the ‘mother cells’. They originate from the developing embryo and differentiate into different types of cells for example the heart muscle, the liver, brain, skin, bone etc. Etc., They are known as progenitors cells since they lead to creation of new cells.

When these stem cells are transplanted into the body they migrate to the injured areas in the body , get attached there and transform themselves into the tissue desired and replace the damaged one.
This is the theory behind the use of stem cells in most of the neuro-degenerative and autoimmune disorders.

Procedures:

Essentially there are two types of stem cell therapy:

  • Autologous therapy where the patient is given stem cells derived from his own bone marrow, or adipose (fat) tissue.
  • Allogenic therapy where the donor cells are used ( not the patient himself but some other persons cells are transplanted)

 

What are Keloids: Symptoms, Treatment & Prevention

Keloids are raised overgrowths of scar tissue that occur at the site of a skin injury. They occur where trauma, surgery, blisters, vaccinations, acne or body piercing have injured the skin. Less commonly, keloids may form in places where the skin has not had a visible injury. Keloids differ from normal mature scars in composition and size. Some people are prone to keloid formation and may develop them in several places.

Keloids

Keloids are more common in African-Americans. They are seen most commonly on the shoulders, upper back and chest, but they can occur anywhere. When a keloid is associated with a skin incision or injury, the keloid scar tissue continues to grow for a time after the original wound has closed, becoming larger and more visible until it reaches a final size. They generally occur between 10 and 30 years of age and affect both sexes equally, although they may be more common among young women with pierced ears. Keloids may form over the breastbone in people who have had open heart surgery.

Symptoms:

Keloids usually appear in areas of previous trauma but may extend beyond the injured area. They are shiny, smooth and rounded skin elevations that may be pink, purple, or brown. They can be doughy or firm and rubbery to the touch, and they often feel itchy, tender or uncomfortable. They may be unsightly. A large keloid in the skin over a joint may interfere with joint function.

Expected Duration:

Keloids may continue to grow slowly for weeks, months or years. They eventually stop growing but do not disappear on their own. Once a keloid develops, it is permanent unless removed or treated successfully. It is common for keloids that have been removed or treated to return.

Prevention

People who are prone to keloids should avoid cosmetic surgery. When surgery is necessary in such people, doctors can take special precautions to minimize the formation of keloids at the site of the incision. Examples of techniques that might be used to minimize keloid formation include covering the healing wound with hypoallergenic paper tape for several weeks after surgery, covering the wound with small sheets made of a silicone gel after the surgery, or using corticosteroid injections or radiation treatments at the site of the surgical wound at the beginning of the healing period.

Treatment

There is no single treatment for keloids, and most treatments do not give completely satisfying results. Two or more treatments may be combined. If you decide to pursue treatment for a keloid scar, you will have the best results if you start treatment soon after the keloid appears. Available treatments include:

  • Removal with conventional surgery — This unreliable technique requires great care, and keloids that return after being removed may be larger than the original. Keloids return in more than 45% of people when they are removed surgically. Keloids are less likely to return if surgical removal is combined with other treatments.
  • Dressings — Moist wound coverings made of silicone gel sheets have been shown in studies to sometimes reduce the size of keloids over time. This treatment is safe and painless.
  • Corticosteroid injections — Injections with triamcinolone acetonide or another corticosteroid medicine typically are repeated at intervals of four to six weeks. This treatment can often reduce keloid size and irritation, but injections are uncomfortable.
  • Compression — This involves using a bandage or tape to apply continuous pressure 24 hours a day for a period of six to 12 months. Such compression can cause a keloid to become smaller. For keloids that form at the site of an ear piercing, a clip known as a “Zimmer splint” usually reduces keloid size by at least 50% after one year of compression. Zimmer splints that resemble earrings are available.
  • Cryosurgery — This freezing treatment with liquid nitrogen is repeated every 20 to 30 days. It can cause a side effect of lightening the skin color, which limits this treatment’s usefulness.
  • Radiation therapy — This therapy is controversial because radiation increases the risk of cancer. Radiation treatments may reduce scar formation if they are used soon after a surgery, during the time a surgical wound is healing.
  • Laser therapy — This is an alternative to conventional surgery for keloid removal. There is no good evidence that keloids are less likely to return after laser therapy than after regular surgery.
  • Experimental treatments — One treatment showing promise is injecting keloid scars with medicines that were developed to treat autoimmune illnesses or cancers. Treatments with these medicines (various types of interferon and the chemotherapy agents 5-fluorouracil and bleomycin) will need to be evaluated further before they are appropriate for use outside of research studies.

 

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