Dermatomycosis is a fungal skin disease. This ailment, also known as trichophytosis, causes fungal bacteria Microsporum or Trichophyton. A person can get infected both from another person, and from an animal. It is important to conduct timely treatment of the disease in order to prevent the development of complications.

Usually pathology develops on:

• smooth skin;
• head in the area of ​​hair growth
• external genitals
• skin of the feet.

The majority of patients with trichophytosis are children, and inguinal dermatomycosis is a disease most often affected by adults. It is characterized by the appearance of erythematous-type plaques and severe itching.

Ways of infection

Dermatomycosis can be purchased if:

1.  contacting the patient
2.  touch objects that the patient uses;
3.  contact with stray animals
4.  touch the seat backs in public transport

Trichophytosis of smooth skin is a more rare phenomenon and occurs with close contact with the diseased. The chronic appearance of the disease develops in patients with weakened immunity, and also usually manifests itself in childhood. He does not heal to the end, but proceeds in a latent form. Such patients have flaky areas on the skin, which are usually localized in the region of the temples or occiput.

Classification of ailment

Dermatomycosis can be of the following types:

• Mycosis on the feet
• smooth skin dermatomycosis. It is shown by peeling spots from white to brown, which are usually localized on the shoulders, back or neck. They can grow over time;
• dermatomycosis of feet and hands. Dermatomycosis of the foot is characterized by the appearance of spots and itchy cracks on the legs. This type of disease is characterized by the appearance of sores and blisters
• inguinal dermatomycosis. The spots are localized on the lower part of the abdomen, hips (especially on the inner surface), buttocks or perineum. Inguinal dermatomycosis involves the presence of spots that have inflammatory areas and are colored in different shades — from pink to brown
• Mycosis of the scalp. It usually occurs in children and is manifested by the presence of round spots, which are shelled. At the site of their localization the patient’s hair falls out or thinens. When breaking the hair in its place, there remains a stump, which looks like a black dot;
• onychomycosis. Affects nails. They change their color and become thicker. Affected nails often crumble;
• face dermatomycosis. It affects the upper or lower lip, as well as the skin on the chin. Characterized by the appearance of nodes that have a bluish tint, which contain a turbid liquid. After the merging of such nodes, the skin becomes rough.

Symptoms:

Symptoms of trichophytosis usually begin to appear one week after contact with a sick person, animal or objects that the infected person used. Symptoms vary depending on the site of the skin lesion

1.  The superficial lesion is characteristic of the head and smooth skin. In this case, the skin forms circular plaques, which can easily be seen with the naked eye. If the plaque is formed on the site of the hair follicle, then the hair in this place begins to break down or falls out. On the remaining hair there is a plaque of gray color, which is a fungal spore (a characteristic symptom). Smooth plaques are formed on the smooth skin, which itch, and have a rim painted in red;
2.  inguinal skin lesions are characterized by the appearance of symptoms of inflammation in the groin, buttocks or thighs. It arises because of neglect of the rules of personal hygiene, the wearing of linen from synthetic materials, as well as high sweating
3.  Onychomycosis promotes the appearance of white or yellow spots on the nail plate.

If you do not notice the symptoms of dermatomycosis of the feet or other part of the body in time, it leads to complications of an infectious nature. On the affected areas, pus can form, which will contribute to worsening of well-being. There are headaches, general weakness and enlarged lymph nodes.

Treatments:

Treatment of pathology involves antifungal therapy. If therapy is started at the first symptoms of the disease, it will be highly effective and will help to completely cure the patient of dermatomycosis. The doctor prescribes ointments, creams or shampoos that contain antifungal agents to treat the patient. These include Exoderyl, Lamisil and other means. Another method of treatment is rubbing the affected areas with iodine.

To get rid of inflammation, the patient should take anti-inflammatory and hormonal drugs.

When the first signs of skin damage appear, the patient should immediately consult a doctor so that he is given the right treatment, because self-medication can lead to various complications that worsen the appearance of the skin and the general condition of a person. During the prescribed course of treatment, the patient should be isolated from contact with others.

Treatment with folk remedies is also effective. There are such popular recipes:

• grease the cabbage leaf with sour cream and apply to the affected skin
• mix mustard with vinegar and make a medical compress

Tonsillitis is inflammation of the tonsils caused by bacterial or viral infection. Typical symptoms are sore throat, swollen tonsils, difficulty swallowing, fever, and swollen glands in the neck.Treatment will differ depending on whether the cause is bacterial or viral.

Causes and Symptoms of Tonsillitis

Bacterial and viral infections can cause tonsillitis. A common cause is Streptococcus (strep) bacteria. Other common causes include:

• Adenoviruses
• Influenza virus
• Epstein-Barr virus
• Parainfluenza viruses
• Enteroviruses
• Herpes simplex virus

The main symptoms of tonsillitis are inflammation and swelling of the tonsils, sometimes severe enough to block the airways. Other symptoms include:

• Throat pain or tenderness
• Redness of the tonsils
• A white or yellow coating on the tonsils
• Painful blisters or ulcers on the throat
• Headache
• Loss of appetite
• Ear pain
• Difficulty swallowing or breathing through the mouth
• Swollen glands in the neck or jaw area
• Fever, chills
• Bad breath

In children, symptoms may also include:

• Nausea
• Vomiting
• Abdominal pain

Treatments for Tonsillitis

Treatment for tonsillitis will depend in part on the cause. To determine the cause, your doctor may perform a rapid strep test or throat swab culture. Both tests involve gently swabbing the back of the throat close to the tonsils with a cotton swab. A lab test can detect a bacterial infection. A viral infection will not show on the test, but may be assumed if the test for bacteria is negative. In some cases, the physical findings are convincing enough to diagnose a probable bacterial infection. In these cases, antibiotics may be prescribed without performing a rapid strep test

If tests reveal bacteria, treatment will consist of antibiotics to cure the infection. Antibiotics may be given as a single shot or taken 10 days by mouth. Although symptoms will likely improve within two or three days after starting the antibiotic, it’s important to take all of the medication your doctor prescribes to make sure the bacteria are gone. Some people need to take a second course of antibiotics to cure the infection.

What causes bone loss?

Bone loss is a common consequence of loss of teeth and chronic periodontitis. In the case of periodontitis, the bacteria gradually eats away at the underlying jawbone and at the periodontal ligaments that connect the tooth to the bone.

The most common cause of bone loss is tooth loss left unreplaced, especially multiple teeth. Jawbone is preserved through the pressure and stimulus of chewing. When that is removed through tooth loss, the bone “resorbs” (reabsorbs) into the body. In the first year after tooth extraction 25% of bone is lost, and this bone loss continues on.

Bone loss

This bone loss occurs in the bone surrounding and supporting the tooth, known as alveolar bone. Alveolar bone forms the ridges in which the teeth are embedded. These ridges atrophy both vertically and horizontally.

Replacing teeth with full or partial dentures doesn’t solve the problem as the dentures exert a very small amount of chewing pressure on the bone compared to natural teeth, as low as 10% or less.

Removal of the molars in the upper jaw can cause additional resorption of the bone due to expansion of the sinus cavity. With no teeth in place, the air pressure in the sinus cavity can cause resorption of the bone lining the sinuses.

Other causes of bone loss

• Bone loss can also be caused by misaligned teeth, creating a situation where normal chewing doesn’t occur, causing loss of the needed stimulus to the bone.
• Bone can be lost through infection that damages the bone.
• A large tumor in the face may require removal of the tumor and some of the jaw.

Bone loss and dentures

Dentures can accelerate bone loss by wearing away at the ridges of bone they are placed on. Every time you bite down or clench your teeth you are placing pressure on the ridge, resulting in its resorption. This is a primary cause of continual problems on getting dentures to fit, of sore spots and difficult or painful chewing.

People who wear dentures can experience another severe consequence of bone loss: collapse of the lower third of their face.

Bone loss and dentures

Dentures can accelerate bone loss by wearing away at the ridges of bone they are placed on. Every time you bite down or clench your teeth you are placing pressure on the ridge, resulting in its resorption. This is a primary cause of continual problems on getting dentures to fit, of sore spots and difficult or painful chewing.

People who wear dentures can experience another severe consequence of bone loss: collapse of the lower third of their face.

The loss of the ridge bone brings your chin closer to the nose, causing your jaw to jut out and your nose appears to stick out further because your upper lip has puckered in. Deep wrinkles appear around the mouth and the cheeks develop “jowls”— sagging skin. This facial collapse can appear to age you by many years!

Preventing bone loss

Bone loss can be prevented by giving the jawbone a replacement tooth with a root that can exert the same or similar pressure as natural teeth. This is done immediately after extraction by replacing single teeth with dental implants, or by using a fixed implant-supported bridge or denture.

A single-tooth implant or a dental bridge with three to four teeth supported by two implants provide a chewing power of 99% of natural bite force. A denture secured with dental implants, such as our Same Day Teeth procedure, provides about 70% to 80% of normal biting force and helps considerably in preventing bone loss.

What about loss of bone density?

When bones loses density it becomes more porous. Density loss is much less common than loss of bone volume, but is something we need to watch out for. Bone can lose density because of a variety of factors, including diet, hormonal imbalance, disease, lifestyle, and even tooth loss.

We can detect low density bone ahead of time using our 3D cone beam CT scanner to capture 3D images. The whiter the color of the bone in the X-ray, the denser it is. We can then avoid these areas of low density, or take precautions by using special implants with a surface that draws the bone to it, which creates denser bone around the implant.

Bone Grafting:

We also use bone grafting to repair damaged and lost bone around teeth that have suffered from severe gum disease.In cases where bone has already been lost, bone grafting might be needed to provide enough bone for dental implant placement. We need enough height of the ridge for any teeth replacement with implants, and when replacing the back teeth (molars), we also need enough width.

A bone graft not only replaces lost bone, it also stimulates the jawbone to regrow and eventually replaces the bone graft with the patient’s own, healthy bone. We use a variety of different types of bone graft material, depending on the patient, including new cutting-edge materials that require less healing time.

Minimally invasive dental implants

The implant unless the bone loss is severe, in which case it might need to be done as a separate procedure. They use minimally invasive methods, including a gentle laser.

Sinus Lifts

When your upper back teeth have been removed, the ridge bone resorbs and the sinus cavity expands, so that eventually the bone separating the sinus cavity and the oral cavity is very thin.

 

Dental implants can’t be placed in such thin bone and in these cases. The sinus is raised by gently pushing up the membrane lining the sinus away from your jaw and packing in bone graft material into the space where the sinus cavity was. Once the bone graft material has fully integrated with the jawbone, we can lace your implants.

 

When bone loss doesn’t need bone grafting or sinus lifts:

The good news is that we can help many patients get implants without any kind of bone grafting through the use of our 3D cone beam CT scanner. This breakthrough technology allows us to see the teeth, jaw and related structures in full 360º view. We can measure the exact width and height of your ridges and assess how much, if any, bone grafting is actually needed. In many cases we can find enough bone to use for implants.

The 3D scanner also permits us to perform procedures such as full-mouth teeth replacement, which can be done using just four implants per arch placed where we can take advantage of the bone available.

What is an ectopic pregnancy?

In a normal pregnancy, a fertilized egg travels through a fallopian tube to the uterus. The egg attaches in the uterus and starts to grow. But in an ectopic pregnancy , the fertilized egg attaches (or implants) someplace other than the uterus, most often in the fallopian tube. (This is why it is sometimes called a tubal pregnancy.) In rare cases, the egg implants in an ovary, the cervix, or the belly.

There is no way to save an ectopic pregnancy. It cannot turn into a normal pregnancy. If the egg keeps growing in the fallopian tube, it can damage or burst the tube and cause heavy bleeding that could be deadly. If you have an ectopic pregnancy, you will need quick treatment to end it before it causes dangerous problems.

What causes an ectopic pregnancy?

An ectopic pregnancy is often caused by damage to the fallopian tubes. A fertilized egg may have trouble passing through a damaged tube, causing the egg to implant and grow in the tube.

Things that make you more likely to have fallopian tube damage and an ectopic pregnancy include:

• Smoking. The more you smoke, the higher your risk of an ectopic pregnancy.
• Pelvic inflammatory disease (PID). This is often the result of an infection such as chlamydia or gonorrhea.
• Endometriosis, which can cause scar tissue in or around the fallopian tubes.
• Being exposed to the chemical DES before you were born.

Some medical treatments can increase your risk of ectopic pregnancy. These include:

• Surgery on the fallopian tubes or in the pelvic area.
• Fertility treatments such as in vitro fertilization.

What are the symptoms?

In the first few weeks, an ectopic pregnancy usually causes the same symptoms as a normal pregnancy, such as a missed menstrual period, fatigue, nausea, and sore breasts.

The key signs of an ectopic pregnancy are:

• Pelvic or belly pain. It may be sharp on one side at first and then spread through your belly. It may be worse when you move or strain.
• Vaginal bleeding.

If you think you are pregnant and you have these symptoms, see your doctor right away.

How is it treated?

The most common treatments are medicine and surgery. In most cases, a doctor will treat an ectopic pregnancy right away to prevent harm to the woman.

Medicine can be used if the pregnancy is found early, before the tube is damaged. In most cases, one or more shots of a medicine called methotrexate will end the pregnancy. Taking the shot lets you avoid surgery, but it can cause side effects. You will need to see your doctor for follow-up blood tests to make sure the shot worked.

For a pregnancy that has gone beyond the first few weeks, surgery is safer and more likely to work than medicine. If possible, the surgery will be laparoscopy . This type of surgery is done through one or more small cuts (incisions) in your belly. If you need emergency surgery, you may have a larger incision.

Joint replacement involves surgery to replace the ends of bones in a damaged joint. This surgery creates new joint surfaces.

In shoulder replacement surgery, doctors replace the ends of the damaged upper arm bone (humerus) and usually the shoulder bone (scapula) or cap them with artificial surfaces lined with plastic or metal and plastic. Shoulder joint components may be held in place with cement. Or they may be made with material that allows new bone to grow into the joint component over time to hold it in place without cement.

The top end of your upper arm bone is shaped like a ball. Muscles and ligaments hold this ball against a cup-shaped part of the shoulder bone. Surgeons usually replace the top of the upper arm bone with a long metal piece, inserted into your upper arm bone, that has a rounded head. If the cup-shaped surface of your shoulder bone that cradles your upper arm bone is also damaged, doctors smooth it and then cap it with a plastic or metal and plastic piece.

Surgeons are now trying a newer procedure called a reverse total shoulder replacement for people who have painful arthritis in their shoulder and also have damage to the muscles around the shoulder. In this procedure, after the surgeon removes the damaged bone and smooths the ends, he or she attaches the rounded joint piece to the shoulder bone and uses the cup-shaped piece to replace the top of the upper arm bone. Early results are encouraging. This surgery is not right for everyone. And not all surgeons have done it. Success depends not only on careful evaluation to be sure it’s the right surgery for you but also on having a surgeon with experience in reverse shoulder replacement.

Doctors often use general anesthesia for joint replacement surgeries. This means you’ll be unconscious during surgery. But sometimes they use regional anesthesia, which means you can’t feel the area of the surgery and you are sleepy, but you are awake. The choice of anesthesia depends on your doctor, on your overall health, and, to some degree, on what you prefer.

Your doctor may recommend that you take antibiotics before and after the surgery to reduce the risk of infection. If you need any major dental work, your doctor may recommend that you have it done before the surgery. Infections can spread from other parts of the body, such as the mouth, to the artificial joint and cause a serious problem.

Right after surgery

You will have intravenous (IV) antibiotics for about a day after surgery. You will also receive medicines to control pain and perhaps medicines to prevent blood clots. It is not unusual to have an upset stomach or feel constipated after surgery. Talk with your doctor or nurse if you don’t feel well.

When you wake up from surgery, you will have a bandage on your shoulder and probably a drain to collect fluid and keep it from building up around your joint. You may have a catheter, which is a small tube connected to your bladder, so you don’t have to get out of bed to urinate. You may also have a compression sleeve on your arm. This sleeve squeezes your arm to keep the blood circulating and to help prevent blood clots.

A physical therapist may begin gentle exercises of your shoulder on the day of surgery or the day after. These exercises are just passive motion, which means you relax and let the therapist move your arm for you.

Most people who have shoulder replacement surgery are able to sit up and get out of bed with some help later on the day of surgery.

Your doctor may teach you to do simple breathing exercises to help prevent congestion in your lungs while your activity level is reduced.

The first few days

You will probably still be taking some medicine. You will gradually take less and less pain medicine. You may continue taking medicines to prevent blood clots for several weeks after surgery.

A physical therapist will move your arm for you to keep your shoulder loose as it heals. The therapist will also show you how to use a pulley device so you can move your arm when you go home from the hospital. Your therapist may also begin some simple exercises to keep the muscles of your other arm and your legs strong.

Rehabilitation (rehab) after a shoulder replacement starts right away. It is not too demanding early on, but it is very important that you do it. Most doctors will not allow you to use the shoulder muscles for several weeks after surgery. The main goal of rehab is to allow you to move your shoulder as far as possible so it’s easier for you to do daily activities, such as dressing, cooking, and driving. Most people eventually regain about two-thirds of normal shoulder motion after surgery. But other things that affect how much movement you get back after surgery are how much movement you had before surgery and whether the soft tissues around your shoulder were also damaged. It is very important that you take part in physical therapyboth while you are in the hospital and after you are released from the hospital to get the most benefit from your surgery.

Most people go home 1 to 3 days after surgery. Some people who need more extensive rehab or those who don’t have someone who can help at home go to a specialized rehab center for more treatment.

Risks

The risks of shoulder replacement surgery include:

• Blood clots. People can develop a blood clot in a leg vein after shoulder joint replacement surgery but usually only if they are inactive. Bloodclots can be dangerous if they block blood flow from the leg back to the heart or move to the lungs. Blood clots occur more commonly in older people, people who are very overweight, people who have had blood clots before, and those who have cancer.
• Infection in the surgical wound or in the joint. Infection is rare in people who are otherwise healthy. People who have other health problems, such as diabetes, rheumatoid arthritis, or chronic liverdisease, or those who are taking corticosteroids are at higher risk of infection after any surgery. Infections in the wound usually are treated with antibiotics. Infections deep in the joint may require more surgery. And in some cases the artificial joint must be removed.
• Nerve injury. In rare cases, a nerve may be injured around the site of the surgery. It is more common (but still unusual) if the surgeon is also correcting deformities in the joint. A nerve injury may cause tingling, numbness, or difficulty moving a muscle. These injuries usually get better over time and in some cases may go away completely.
• Problems with wound healing. Wound healing problems are more common in people who take corticosteroids or who have diseases that affect the immune system, such as rheumatoid arthritis and diabetes.
• Lack of good range of motion. How far you can move your shoulder after surgery depends a lot on how far you could move your shoulder before surgery. Some people are not able to move their shoulder far enough to allow them to do their regular daily activities, even after several weeks of recovery. If this happens, the doctor may give you a medicine to relax your muscles and will gently force the shoulder to move farther. This may loosen tissues around the joint that are preventing you from bending it.
• Dislocation of the upper arm bone (humerus). This usually only happens if the soft tissues around the shoulder are stretched too soon after surgery. To help prevent dislocation, do not allow your elbow to move past your body toward your back.
• Fracture of the upper arm bone. This is an unusual complication, but it may happen either during or after surgery.
• Instability in the joint. This can be the result of either the soft tissues being stretched too soon after surgery, or the new joint pieces loosening.
• The usual risks of general anesthesiarisks of general anesthesia. Risks of any surgery are higher in people who have had a recent heart attackand those who have long-term (chronic) lung, liver, kidney, or heart disease.

Achilles tendinitis is a condition that causes pain on the back of your leg near your heel. The Achilles tendon is strong and can take huge amounts of stress, but it can also develop tendinitis if over used.

Symptoms

• Pain after exercising
• Thickening of the tendon
• Pain and stiffness in the tendon in the morning
• Pain at the back of the heel
• Swelling
• Bone spur

Risk Factors

You are more likely to develop Achilles tendinitis:

• If you are starting a sudden exercise regimen that puts too much stress on the tendon
• You have extra bone growth
• You do very intense work out sessions

Diagnosis

Based on the symptoms, your doctor will examine your foot and look for signs of pain and discomfort or immobility. He will also run the following tests to rule out any other possibilities:

• X-Ray
• MRI scan

Treatment

Minor to moderate Achilles tendon injuries should heal on their own. To speed the process, you can:

• Resting plenty
• Applying ice packs on inflamed areas
• Exercising in moderation
• Practice stretching and strengthening exercises as recommended by your doctor, physical therapist, or other health care provider.
• Use a heel lift. Your doctor may recommend that you wear an insert in your shoe while you recover. It will help protect your Achilles tendon from further stretching.
• Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen will help with pain and swelling. Follow the instructions on the label to help prevent side effects, such as bleeding and ulcers. Take them with food. Check with your doctor first if you have any allergies, medical problems or take any other medication. If you need them for longer than 7 to 10 days, call your doctor.
• Raise (elevate) your leg. Prop your leg up on a pillow when you’re sitting or lying down.
• Compress your leg. Use an elastic bandage around the lower leg and ankle to keep down swelling.
• Ice it. Ice your injury for up to 20 minutes at a time as needed.
• Rest your leg. Avoid putting weight on your leg as best you can. You may need crutches.
• Getting Physiotherapy

Medication and Surgery

Medication for Achilles tendinitis includes steroidal and non-steroidal drugs.

Surgery should be considered a last resort, only if there are no signs of the pain reducing. Types of surgery include:

• Debridement and repair – This is recommended only if the tendon is less than 50% damaged
• Gastrocnemius recession (surgical lengthening of the calf muscle)
• Debridement with tend on transfer – This is recommended if the tendon is over 50% damaged

Prevention:

• Cut down on uphill running.
• Wear shoes with good support that fit well.
• Stop exercising if you feel pain or tightness in the back of your calf or heel.

While many people are familiar with the names of these conditions, there is less widespread understanding about how they differ. Both tennis elbow, or lateral epicondylitis, and golfer’s elbow, or medial epicondylitis, are injuries to the tendons attaching your forearm muscles to the bone at your elbow. The “epicondyle” part of epicondylitis refers to the bony bumps or protrusions at your elbow.

Lateral epicondylitis affects the tendons attached to the outer (lateral) side of your elbow, which are connected in turn to the muscles that extend your wrist backward and straighten your fingers. Medial epicondylitis affects tendons connected to the inner (medial) side of your elbow, which are attached to the muscles that flex your wrist and contract your fingers when you grip something.

Both injuries are usually the result of repetitive strain on the tendons, and although you don’t have to be a golfer or tennis player to experience them, the repeated forceful motions involved in both sports make them very common.

Symptoms

The anatomical structures involved in tennis elbow and golfer’s elbow are very similar and the symptoms are also similar, but they appear on opposite sides of the elbow and arm.

Common symptoms of tennis elbow include:

• Pain that radiates from the outside of your elbow and down your forearm
• Tenderness on the outside of your elbow
• Weakness in your forearm or a weak grip
• Pain when you grip things, twist something or, if you play tennis, especially with backhand strokes

Golfer’s elbow symptoms are similar, but occur on the inside of your arm and include:

• Pain and tenderness on the inside of your elbow
• Pain that radiates down your arm from the inside of your elbow
• Weakness in your hand or wrist
• Numbness or tingling in your ring and little fingers
• Pain when you grip or twist things
• Pain when you flex your wrist

Both tennis elbow and golfer’s elbow symptoms usually start gradually and get worse over time.

Causes

Both conditions are types of tendonitis, or inflammation of a tendon, and both are commonly caused by overuse. This may be due to excessive force on a regular basis (like hitting a tennis or golf ball) or due to other repetitive activities that involve the forearm muscles. The tendons over time can progress from inflammation, to partial thickness tears, and finally full thickness tears. Painters, plumbers, and carpenters or anyone performing repetitive gripping and lifting activities are also prone to both tennis and golfer’s elbow.

Treatment

Fortunately, most cases of tennis elbow and golfer’s elbow respond well to conservative treatments. Surgery is usually not necessary, although complete recovery can take weeks or even months, depending on the severity of the condition. As with other forms of tendonitis, the most important aspect of treatment is to reduce the amount of strain on the affected tendons. This may include resting the arm, using a brace or athletic taping, wrist splints, and once healed, correcting improper technique/form to prevent the recurrence of the injury.

Other treatments may include:

• Ice – depending on the severity, icing the affected area may be helpful for reducing pain and inflammation
• Anti-inflammatory medications – medications such as ibuprofen or naproxen are commonly recommended
• Stretching exercises – exercises which stretch the involved forearm muscles can help reduce strain on the inflamed tendons
• Physical therapy – stretches and strengthening exercises through physical therapy can aid and accelerate the recovery process
• Platelet Rich Plasma (PRP) – “blood spinning” therapy is another option you may have heard of; this is done for many professional athletes
• Cortisone injections – in severe cases, your doctor may recommend cortisone injections for pain relief and to reduce inflammation
• Surgery – if all else fails, surgery yields high success rates.

What is HIV? What is AIDS?

HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body’s natural defense system. Without a strong immune system, the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.

White blood cells are an important part of the immune system. HIV infects and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.

The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.

But having HIV doesn’t mean you have AIDS. Even without treatment, it takes a long time for HIV to progress to AIDS-usually 10 to 12 years.

When HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. If AIDS does develop, medicines can often help the immune system return to a healthier state.

The kidneys are part of the urinary system, which eliminates waste and excess fluid and electrolytes from the blood. They also control the production of red blood cells and regulate blood pressure.

A cancer that starts outside the kidney and metastasizes to the kidney is not normally called kidney cancer.

Kidney cancers mainly originate in two parts of the kidney, the renal tubule and the renal pelvis.

Types:

• Urothelial cell carcinoma of the renal pelvis
• Renal cell Carcinoma
• Squamous cell carcinoma
• Juxtaglomerular cell tumor, or reninoma
• Angiomyolipoma
• Renal oncocytoma
• Bellini duct carcinoma
• Clear-cell sarcoma of the kidney
• Mesoblastic nephroma
• Wilms’ tumor, usually diagnosed in children under 5 years of age
• Mixed epithelial stromal tumor

Rarely, potentially cancerous tumors that usually originate in other parts of the body can start off in the kidneys. These include clear cell adenocarcinoma, transitional cell carcinoma, inverted papilloma, renal lymphoma, teratoma, carcinosarcoma, and carcinoid tumor of the renal pelvis.

Most cancers that originate in the renal tubule are renal cell carcinoma and clear cell adenocarcinoma. Those that originate in the renal pelvis are transitional cell carcinoma.

This article focuses mainly on renal cell carcinoma.

Signs and symptoms

Symptoms do not usually appear in the early stages of kidney cancer.

In the later stages, the person may experience:

• Blood in the urine
• A lump or mass in the back, near the kidneys

Less often, there may be:

• A continuous pain in the side, near the kidneys
• A lump in the abdomen
• Anemia
• Constant fever and night sweats
• Tiredness or fatigue
• Weight loss and loss of appetite

Other conditions can lead to similar symptoms, so it is important to see a physician if any of these occur.

Causes and risk factors

Cancer starts when there is a change in the structure of DNA in cells. A genetic mutation causes cells to grow uncontrollably eventually producing tumor cells.

Untreated, cancer grows and spreads, usually through the lymphatic system, a series of nodes or glands that exist throughout the body.

Renal cell carcinoma typically starts in the cells that line the tiny tubes of the nephron. Tumors normally grow as a single mass, but sometimes, more than one tumor can grow in one kidney, and sometimes in both kidneys.

Transitional cell carcinoma develops in the tissue that forms the tubes that connect the kidneys to the bladder. This type of cancer can begin in the ureters and also in the bladder itself.

Wilms’ tumor is a childhood kidney cancer caused by the loss or inactivation of a tumor suppressor gene called QT1 on chromosome 11. Tumor suppressor genes generally suppress tumor growth and control cell growth.

Risk factors for common kidney cancers

Risk factors for renal cell carcinoma, the most common type of kidney cancers, include:

• Age: The risk increases significantly after the age of 60 years
• Sex: For every two women who get kidney cancer, 3 men will do so
• Obesity: People with obesity have a significantly higher risk
• Smoking: Regular tobacco smokers have a much higher risk, but the risk drops when the person quits
• Hypertension, or high blood pressure: The higher risk may be due to the hypertension itself, or it may be due to anti-hypertensive medications
• Smoking, obesity, and hypertension account for around 50 percent of all renal cell carcinomas
• Workers who are exposed to chemicals, such as asbestos, trichloroethylene, and cadmium, are more likely to develop renal cell carcinoma

Asbestos was widely used in the past in construction. Cadmium is a metal used in batteries. Trichloroethylene is an industrial solvent used to strip paint from metals.

Patients receiving long-term dialysis for chronic kidney failure are more likely to develop renal cell carcinoma. This may be due to kidney disease rather than the dialysis itself.

Patients who have received a kidney transplant and are taking immunosuppressant medications have a higher risk of developing renal cell carcinoma. The use of medications such as phenacetin, a pain reliever, has been linked to a higher risk of kidney cancer, and the use of diuretics may contribute.

Von Hippel-Lindau disease is a genetic condition that increases the risk of several kinds of tumors, including renal cell carcinoma. In hereditary papillary renal cell carcinoma, multiple papillary tumors develop in both kidneys. Other diseases that increase the risk include Birt-Hogg-Dube syndrome and hereditary leiomyoma-renal cell carcinoma.

Kidney cancer stages:

One way of staging kidney cancer is a four-stage system:

Stage I: The tumor is under 2.8 inches, or 7 centimeters in diameter and it is limited to the kidney.

Stage II: The tumor is greater than 2.8 inches, or 7 centimeters, in diameter, and it is still limited to the kidney.

Stage III: The cancer is any size but has spread beyond the kidney to at least one other location. It may have reached the adrenal gland, nearby blood vessels, a lymph node, or the fat that surrounds the kidney.

Stage IV: The cancer has spread beyond the fatty tissue around the kidney, it affects at least one lymph node, or it has spread to other organs.

Treatment options

Treatment options depend on several factors, including the patient’s general health, the type and stage of kidney cancer, and the patient’s own preferences.

Nephrectomy involves removing the kidney, the nearby adrenal gland, a border of healthy tissue, and the adjacent lymph nodes. The surgery can be done laparoscopically, through small incisions.

If the tumor is less than 1.5 inches, or 4 centimeters across, the surgeon may remove only part of the kidney in a partial nephrectomy.

If the cancer has spread outside the kidney, surgery may not cure it, but it can ease pain and make other non-surgical treatments more effective.

In nephron-sparing surgery, the tumor, but not the kidney, is surgically removed. This may be an option during the early stage of kidney cancer, or if the patient has only one kidney.

A patient who is unwell or frail may not be able to undergo surgery. In this case, a number of nonsurgical treatment options are possible.

Embolization aims to block the flow of blood to the tumor. The surgeon inserts a small tube known as a catheter into the groin. X-ray images guide the catheter into the blood supply for the kidney. A special material passes through the catheter into the blood vessel, blocking the blood supply to the kidney and starving the tumor of oxygen and nutrients. This causes the tumor to shrink.

Cryoablation involves inserting one or more special needles, known as cryoprobes, through small incisions into the tumor. An imaging scan guides the process. A gas in the needles freezes the cells around the tip of each needle. Another gas warms thaws the tissue, and then the cells are refrozen. This freeze-thaw cycle kills the cancer cells.

Some pain may occur after the procedure, and, rarely, some bleeding, infection, and damage to the tissue close to the tumor.

Advanced or recurrent kidney cancer treatment is for kidney cancer that comes back, or kidney cancer that has spread out of the kidney.

Surgery aims to remove as much of the tumor as possible.

In biological therapy, or immunotherapy, drugs use the body’s own immune system to fight cancer. Examples are interferon and interleukin-2. Both are synthetic versions of chemicals that our bodies make. Side effects include nausea, vomiting, chills, elevated body temperature, and loss of appetite.

In targeted therapy, medicines interrupt the functions that cancer needs to survive, such as the blood supply.

Targeted therapies include:

• Sunitinib, or Sutent
• Sorafenib, or Nexavar
• Bevacizumab
• Temsirolimus

Radiation therapy cannot usually cure kidney cancer, but it may help reduce the spread and the severity of symptoms. Patients typically undergo a few minutes of treatment daily for a number of days. Radiation therapy that is used to control rather than to cure a cancer tends to have less severe side effects.

Side effects can include fatigue, nausea, and vomiting.

Complementary treatments may include taking certain vitamins alongside regular treatment. This should first be discussed with a physician. Some people have found that alternative treatments can relieve symptoms, but these can be unhelpful or hazardous, and should first be discussed with the medical team.

Living with kidney cancer

When a person finds out they have cancer or another serious illness, they may experience feelings of grief, stress, anxiety and depression.

Talking to a well-qualified counselor may help.

It is important to get as much information as possible. Members of the medical team will provide details about the diagnosis, available options, and their effectiveness.

The patient should eat a healthy diet with plenty of fruits and vegetables, sleep at least 7.5 hours each day, and get enough exercise, within the limits set by the physician. This will maximize the benefits of any treatment.

Allow friends and family to help. They can provide practical assistance and support the patient’s mental, emotional, spiritual, and, ultimately, physical health.

Prevention and life expectancy

Measures to reduce the risk of developing kidney and other cancers include:

• Not smoking
• Eating plenty of fruit and vegetables
• Exercising regularly
• Keeping the body weight within normal limits for your height, sex, and age
• Getting at least 7 hours good quality continuous sleep every 24 hours
• Maintaining a healthy blood pressure
• Avoiding toxic chemicals

Getting an early diagnosis for kidney cancer improves the outlook for patients. A patient who receives a diagnosis at Stage I has an 81 percent chance of living for at least another 5 years.

At Stage II, there is a 74 percent chance of surviving for another 5 years, at Stage III, there is a 53 percent chance, and if the disease is diagnosed at Stage IV, the likelihood of surviving 5 years or longer is around 8 percent.