Tag Archives: Medicine

Dr. C "Comments", Medicine, Videos

Medicine: The ABCs Of Hepatitis (Mayo Clinic)

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Approximately 5.3 million people in the US have hepatitis. Listen as Dr. Stacey Rizza breaks down the ABCs of hepatitis. Vaccines protect against hepatitis A, and are especially important for children and travelers. Hepatitis C is transmitted from person to person through bodily fluids. The virus can cause liver damage and death.

COMMENTS:

For the past three months, hundreds of cases of severe hepatitis cases among children have been noticed, especially in England and America, but present in more than 50 countries. These cases of Hepatitis were not caused by any of the usual suspects.

This puzzling increase in pediatric hepatitis apparently is due to Adenovirus 41, plus infection with adeno-associated virus 2. The double requirement is probably why it took a while to crack the causation mechanism. Genetic factors and the Covid lockdown may also have contributed.

—Dr. C.

Medicine, Videos

Mayo Clinic: Bladder Cancer Explained

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Learning about bladder cancer can be intimidating. Mark Tyson, M.D., a urologist at Mayo Clinic, walks you through the facts, the questions, and the answers to help you better understand this condition.

Video timeline: 0:00 Introduction 0:37 What is bladder cancer? 0:53 Who gets bladder cancer? / Risk factors 1:32 Symptoms of bladder cancer 1:59 How is bladder cancer diagnosed? 2:39 Treatment options 3:25 Coping methods/ What now? 4:04 Ending

For more reading visit: https://mayocl.in/3vcSF5u.

Infographics, Medicine

Infographics: Chronic Wounds In Older Adults

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  • •Chronic wounds are common, costly, and are more likely to affect older adults.
  • •Venous ulcers, neuropathic ulcers, ischemic ulcers, and pressure injuries each necessitate unique prevention and treatment strategies.
  • •With the evidence and pragmatic guidance provided herein, providers will have the working knowledge to successfully manage chronic wounds.

Appropriate prevention, diagnosis, and treatment of chronic wounds is important for providers across specialties. Wounds affect patients in all care settings and result in significant cost and morbidity. The burden of this condition falls largely on older adults, for whom the incidence of chronic wounds far exceeds that of younger populations.

 Medicare costs for wound care in 2014 were estimated at greater than $28 billion, and the prevalence for most wound types was greatest in patients aged 75 or older.

 Venous ulcers are the most common lower extremity wound type, comprising 45% to 60% of all wounds, followed by neuropathic ulcers (15% to 25%), ischemic ulcers (10% to 20%), and mixed ulcers (10% to 15%).

 Fortunately, new wound-treatment modalities continue to emerge. This review summarizes the latest information regarding prevention, identification, classification, and treatment of chronic wounds. Guidance on management of major wound types and pearls regarding dressing selection are provided.

Dr. C's Journal, Infographics, Medicine

Dr. C’s Journal: Sexually Transmitted Disease (STDs)

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Sexually transmitted diseases are so common they deserve their own acronym, STDs. Down through the ages, Sexual activity with multiple partners has been so popular that the ever-resourceful bacteria, fungi, and viruses all compete for this ever present ecosystem. It is not uncommon to have multiple STDs at the same time.

Since STDs have many symptoms and physical findings in common, it is essential to go to the doctor for a diagnosis; certainly the treatments very widely.

Until the mid 20th century, treatments were very unsatisfactory, and the infection of the vagina would often lead to deeper infections of the uterus and abdominal cavity; pelvic inflammatory disease (PID)was fairly common then, and still occurs in people foolish enough to postpone getting their problem treated properly.

The common STDs include bacterial vaginosis, chlamydia, gonorrhea, genital herpes, human papilloma virus infection(HPV), Syphillis  and Trichomoniasis. These are sufficiently different in their symptoms and treatment as to deserve their own discussion among the 101 common disorders. Now we have a new kid on the block, Monkeypox, that is helping out AIDS as a plague to the homosexual community.

I have a dear friend who is a physician for a student health department at a major university. STDs, depression, and other psychiatric problems are among the more common things that she sees in her practice.

—Dr. C.

Infographics, Medicine

Multimorbidity: Affects 95% Of Adults Over Age 65

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Multimorbidity (two or more coexisting conditions in an individual) is a growing global challenge with substantial effects on individuals, carers and society. Multimorbidity occurs a decade earlier in socioeconomically deprived communities and is associated with premature death, poorer function and quality of life and increased health-care utilization. Mechanisms underlying the development of multimorbidity are complex, interrelated and multilevel, but are related to ageing and underlying biological mechanisms and broader determinants of health such as socioeconomic deprivation. Little is known about prevention of multimorbidity, but focusing on psychosocial and behavioural factors, particularly population level interventions and structural changes, is likely to be beneficial. Most clinical practice guidelines and health-care training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Multimorbidity requires person-centred care, prioritizing what matters most to the individual and the individual’s carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient’s values. Interventions are likely to be complex and multifaceted. Although an increasing number of studies have examined multimorbidity interventions, there is still limited evidence to support any approach. Greater investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity is urgently needed.

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Dr. C's Journal, Medicine, Research

Cancer Treatments: CAR-T Cell “Smart” Therapy

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In war, we are familiar with “smart bombs” that home in on a laser-marked target, or a heat source. The same thing is happening in our battle with cancer. Everybody has had friends or relatives given chemotherapy, which affects all cells, but  cancer cells, since they are dividing more rapidly, suffer the most. However, the entire body is affected with weight loss, hair loss, anemia, leukopenia and other severe symptoms.

The two developments I would like to address here, are smart chemotherapy using ADCs, and smart immunotherapy using CAR-T cells.

In smart chemotherapy, a poisonous package is linked to an antibody which homes in on cancer cells having a specific membrane marker on their surface. For instance, many cancers, not just those of the breast, express HER-2 receptors. Antibodies specific for this receptor are attached to such drugs as doxorubicin, in a therapy called ADC. The coupled pair then home in on the cancer cell and kill it, sparing  the rest of the body most of the exposure to this toxic chemical. This is really a form of immunotherapy, since it uses antibodies.

Smart cell therapy with CAR-T cells, uses T lymphocytes which normally have surface ligands that attach to various cells marked for killing. These T-cells have their targets genetically modified, with antibody receptors, to be specific for such things as CD 19 and BCMA on the surface of cancer cells. When infused, the T-cells latch on to the specified cancer cells and punch holes in them. The treatment can have some side effects, but they are usually much less severe than  regular chemotherapy.

CAR-T cell therapy has been very successful for blood cancers like leukemia, Lymphoma, and multiple myeloma. It can produce flu-like symptoms from the recruitment of lymphokines, and occasionally neurologic symptoms. It is currently successful in about a third of the cases, used as a second line therapy, and is very expensive.

It used to be that a cancer was classified according to its anatomic location, e.g. breast cancer, colon cancer, skin cancer. With increased knowledge, it is now becoming more important to know the surface markers of the cancer than the organ of origin.

—Dr. C.

JAMA Oncology Article

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Medicine, Women's Health

Diagnosis: What Is Painful Bladder Syndrome? (Q&A)

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DEAR MAYO CLINIC: I am a 45-year-old woman with urinary challenges, including feeling the frequent urge to empty my bladder. My primary doctor said I might have interstitial cystitis and suggested I see a urogynecologist. Could you explain this condition? What are my treatment options, and will I recover?

ANSWER: Cystitis is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by an infection. But interstitial cystitis, also called painful bladder syndrome, is different. It is a disease that causes pressure or pain in the bladder and pelvis that is associated with trying to hold urine.

Symptoms can range from mild burning or discomfort to severe pain and a persistent, urgent need to urinate. Interstitial cystitis is a chronic condition that can be difficult to treat, which is why your primary care provider suggested a urogynecologist.

A urogynecologist is a specialist who cares for women with pelvic floor disorders. This includes bladder leakage, pelvic organ prolapse and pelvic pain.

Unlike other forms of cystitis, researchers don’t know the exact reason for interstitial cystitis. But many theories exist regarding its cause.

Some researchers believe that people with interstitial cystitis have a defect in the protective lining, or epithelium, of their bladder. A leak in the epithelium may allow substances in urine to irritate the bladder wall, causing pain.

It’s also possible that problems with the pelvic nerves cause people who have interstitial cystitis to feel the need to urinate more often and with smaller volumes of fluid than most people. Other theories about the cause of interstitial cystitis include an autoimmune, hereditary, infectious or allergic condition, but none of these has been proven.

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Infographics, Medicine

Infographic: Colonic Diverticular Disease

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Colonic Diverticular Diseaes is a condition in which small, bulging pouches develop in the digestive tract. It’s common in people over age 40.

Usually, no symptoms occur, unless the diverticula become inflamed or infected (diverticulitis) which can result in fever and abdominal pain.

Treatment generally isn’t needed unless there is inflammation (diverticulitis).