The results, abstract number 0326-OR, are based on the Allegheny County Type 1 Diabetes Registry, one of the largest population-based registries of the disease, which includes nearly 1,100 people diagnosed between 1965 and 1979 in Allegheny County, Pa.
As of January 2008, 26 percent of registry participants had died - a rate seven times higher than age-and sex-matched people in the general population. Participants who were diagnosed most recently (1975 to 1979) were only 5.5 times more likely to have died.
The researchers also found that women with type 1 diabetes were 13 times more likely to have died than women in the general population, compared to men whose death rate was five times higher than their healthy counterparts. When the researchers explored differences in survival by race, they found that after 30 years of diabetes only 52 percent of African-Americans were alive compared to 82 percent of Caucasians.
"The more recent a person was diagnosed with type 1 diabetes, the less likely they were to die, suggesting the positive impact of advances made during the last few decades," said Aaron M. Secrest, lead author of the study and a doctoral student at the University of Pittsburgh Graduate School of Public Health. "Even so, significant disparities in mortality remain and reveal a need for continuing improvements in diabetes treatment and care."
Researchers also found that people diagnosed in the late 1970s have an even lower mortality rate compared with those diagnosed in the 1960s.
"The encouraging thing is that, given good [diabetes] control, you can have a near-normal life expectancy," said the study's senior author, Dr. Trevor J. Orchard, a professor of epidemiology, medicine and pediatrics in the Graduate School of Public Health at the University of Pittsburgh, Penn.
But, the research also found that mortality rates for people with type 1 still remain significantly higher than for the general population -- seven times higher, in fact. And some groups, such as women, continue to have disproportionately higher mortality rates: women with type 1 diabetes are 13 times more likely to die than are their female counterparts without the disease.
Results of the study are published in the December issue of Diabetes Care.
Type 1 diabetes is an autoimmune disease that causes the body's immune system to mistakenly attack the body's insulin-producing cells. As a result, people with type 1 diabetes make little or no insulin, and must rely on lifelong insulin replacement either through injections or tiny catheter attached to an insulin pump. Insulin is a hormone that allows the body to use blood sugar.
Insulin replacement therapy isn't as effective as naturally-produced insulin, however. People with type 1 diabetes often have blood sugar levels that are too high or too low, because it's difficult to predict exactly how much insulin you'll need. When blood sugar levels are too high due to too little insulin, it causes damage that can lead to long term complications, such as an increased risk of kidney failure and heart disease. On the other hand, if you have too much insulin, blood sugar levels can drop dangerously low, potentially leading to coma or death.
These factors are why type 1 diabetes has long been associated with a significantly increased risk of death, and a shortened life expectancy.
However, numerous improvements have been made in type 1 diabetes management during the past 30 years, including the advent of blood glucose monitors, insulin pumps, newer insulins, better medications to prevent complications and most recently continuous glucose monitors.
To assess whether or not these advances have had any effect on life expectancy, Orchard, along with his student, Aaron Secrest, and their colleagues, reviewed data from a type 1 diabetes registry from Allegheny County, Pennsylvania. The registry contained information on almost 1,100 people under the age of 18 at the time they were diagnosed with type 1 diabetes.
The children were sorted into three groups based on the year of their diagnosis: 1965 to 1969, 1970 to 1974 and 1975 to 1979. As of January 2008, 279 of the study participants had died, a death rate that is 7 times higher than would be expected in the general population.
When the researchers broke the mortality rate down by the time of diagnosis, they found that those diagnosed later had a much improved mortality rate. The group diagnosed in the 1960s had a 9.3 times higher mortality rate than the general population, while the early 1970s group had a 7.5 times higher mortality than the general population. For the late 1970s group, mortality had dropped to 5.6 times higher than the general population.
The mortality rate in women with type 1 diabetes remained significantly higher, however, at 13 times the rate expected in women in the general population.
In addition, blacks with diabetes had a significantly lower 30-year survival rate than their white counterparts -- 57 percent versus 83 percent, according to the study.
Although Orchard said it isn't clear why women and blacks have higher-than-expected mortality, Barbara Araneo, director of complications therapies at the Juvenile Diabetes Research Foundation, said that both discrepancies have been found in other research, and that one theory is that blacks may have a greater genetic susceptibility to heart disease or high blood pressure. And, for women, she said previous research has shown that, "women with diabetes lose their innate protection against [heart disease], similar to the loss sustained in postmenopausal phases of life." But, she said, it's not clear how diabetes causes this loss.
The overall message of the study, however, is a positive one.
"The outcome of this study shows that diabetes care has improved in many ways over the last couple of decades, and as a result people with diabetes are living longer now," said Araneo, adding, "Managing and taking good care of your diabetes is the surest way to reduce the risk of developing complications later in life."
"What we're seeing now is incredibly encouraging, but it's not necessarily the full story yet," said Orchard, who noted that improvements in diabetes care should continue to lower mortality rates in people with type 1 diabetes.
Monday, November 29, 2010
Thursday, November 25, 2010
What to Do for a Stuffy Nose
Clear your stuffy nose.
A stuffy nose, otherwise known as a nasal congestion, sinus infection, or simply the sniffles, is caused by inflamed blood vessels in the membranes lining the inside of your nostrils, usually due to the flu, cold, or allergies. When the tissues become swollen, it blocks the normal passage of fluid through your nasal pathways. While this can be life-threatening to newborns, for most adults, the condition is simply discomforting. However, there are many home and alternative remedies that might do the trick in clearing a stuffy nose.
It's the season of stuffy noses and achy heads, a time when many people dash to their local drugstores in search of relief. But Step No. 1, before taking any over-the-counter decongestant, is to evaluate the likely cause of your stuffiness, advises Richard Rosenfeld, professor and chairman of otolaryngology at Long Island College Hospital in Brooklyn, N.Y.
Your nose "doesn't just swell up [inside] for no reason," Rosenfeld says. "It's important to understand why your nose" is stuffy. Sinusitis, for instance, may require an antibiotic, which means getting a prescription. Allergies may respond to an antihistamine. And structural problems, like a deviated septum, may require surgery. For persistent congestion, it's usually best to see your doctor, he says.
Once you've determined the cause of your stuffiness, here are some options for unclogging your nose:
• Consider nasal washings. A 2007 study published in the Archives of Otolaryngology—Head & Neck Surgery found that saline irrigation was more effective than saline spray for a group of patients with chronic nasal and sinus symptoms. "But many people who have colds [also] find it soothing," Rosenfeld says. "The basic principle is you need to irrigate, not just moisturize." Several nasal rinse kits are available on store shelves, or you can create a homemade kit: Squeeze about 4 to 8 ounces of saltwater into your nose "until there is no more mucous or cloudy material coming out," Rosenfeld suggests.
• Seek out pseudoephedrine. Some people say the oral decongestant phenylephrine—which replaced pseudoephedrine in many over-the-counter products in 2006—doesn't do a good job of unclogging their noses at the current 10-milligram dose. Pramod Kelkar, a Minneapolis allergist in private practice, says that some of his patients contend that it's less effective than pseudoephedrine, no longer residing on store shelves because it can be used to make methamphetamines. "Some patients feel like [phenylephrine] doesn't work at all," he says. While the Food and Drug Administration hasn't sanctioned a higher dose out of concern that too much can raise blood pressure, there are other options if phenylephrine (now a main ingredient in Sudafed PE, Robitussin cough syrup, and Benadryl Allergy & Sinus) doesn't work for you. Drugs containing pseudoephedrine are still available in limited amounts behind some pharmacy counters to those who show ID; no more than 9 grams per month or 3.6 grams per day can be purchased.
• Try a nasal spray, but don't use an over-the-counter decongestant spray for longer than 3 days. Overuse can create a rebound effect of narrowing and constricting the blood vessels of your nose, according to the Mayo Clinic. Prescription nasal sprays are also an option, if your doctor thinks they'll ease your congestion. Steroid sprays, such as Flonase and Nasonex, work by reducing swelling in the nose.
• Ask your doctor for a prescription oral decongestant. If your congestion is due to more than a simple cold—perhaps you're experiencing a nasty bout of sinusitis—it's reasonable to ask for a prescription oral decongestant, particularly if phenylephrine doesn't work for you and you're having trouble finding over-the-counter pseudoephedrine. "If a patient's condition warrants it...I would be happy to prescribe it," says Kelkar.
• Inhale steam. Sitting in front of a cool mist humidifier or using personal steam inhalation devices may loosen up congestion, Rosenfeld says.
Quick Tips1Salt water can help ease sinuses and reduce the need for pain medication. [1] Breathe in salt water to clear your sinuses (helpful if you live by the ocean), use a nasal saline spray (unmedicated salt water) [2], or use a neti pot (see below).Ads by Google
ZYRTEC® Home MakeoverEnter For A Chance To Win ZYRTEC® Sweepstakes. See Official Rules.allergy.promo.eprize.com/zyrtec2Use a humidifier at home to avoid living in an environment with dry air, which can irritate your sinuses.[3]3Eat spicy, peppery or pungent foods, which are natural decongestants. Try an Indian, Thai or Sichuan (Chinese) cuisine.[4] Chewing a minty gum could also help.4Drink lots of water to keep your sinus membranes well-hydrated. It can also thin your mucus.5Bathe your pets, clean your carpet and dust your furniture regularly to prevent allergens from clogging your sinuses.6Exercise more, not less. Running up and down stairs can change the pressure in your body and help clear your nose. [5]Over-the-Counter (OTC) Drugs1Determine the cause of nasal congestion. Are you experiencing congestion because of sickness and colds, or because of allergies?2Choose an OTC drug. Consult with your pharmacist as to the best OTC product to relieve your congestion, and the proper way to use it. Pick according to the cause, according to what has worked for you in the past, and according to side effects you want to minimize, such as drowsiness. #*Another consideration is the amount of active ingredient in a dose, what it is, how often you take it. You could actually save yourself money by buying a drug that treats only nasal congestion instead of a multi-symptom cold relief drug, and by purchasing a 12 hour relief formula instead of doses that need to be taken every 4 hours. Some active ingredients serve in both allergy and cold relief applications.
Neti Pot1 The neti pot is an ancient remedy that is filled with a saline solution and then used to irrigate your nose. It washes out all of the pollution, infection and allergens that may be troubling you. [6] Video: Truth About Neti Pots on WebMD2Acclimate yourself to voluntarily breathing through your mouth and not your nose.3Prepare a saline solution with water and non-iodized salt. Use a 1/4 tsp. of salt for about every 8 oz. of water. [7]4You can add an herbal wash to your saline solution, but read the label carefully. Zinc can temporarily taper your sense of smell, so you may want to use one that is zinc-free.Herbal washes are not recommended in pregnant women.5Tilt your head to the side and stick the end of the neti pot down the higher nostril to irrigate your nose. Water will flow from your other nostril and clean out your nasal pathways in the process.6Feel free to use the neti pot as long as your symptoms occur -- from once a week to multiple times a day.Steam1Get a bowl of steaming or hot water.2Inhale the steam slowly.3 Try mixing in essential oils such as menthol, eucalyptus, or tea tree oil for improved results.4Alternatively, try slowly sipping hot water or tea with a bit of lemon in it, keeping your nose close to the cup.5Try taking a warm shower as well, to let the steam help clear your nose
A stuffy nose, otherwise known as a nasal congestion, sinus infection, or simply the sniffles, is caused by inflamed blood vessels in the membranes lining the inside of your nostrils, usually due to the flu, cold, or allergies. When the tissues become swollen, it blocks the normal passage of fluid through your nasal pathways. While this can be life-threatening to newborns, for most adults, the condition is simply discomforting. However, there are many home and alternative remedies that might do the trick in clearing a stuffy nose.
It's the season of stuffy noses and achy heads, a time when many people dash to their local drugstores in search of relief. But Step No. 1, before taking any over-the-counter decongestant, is to evaluate the likely cause of your stuffiness, advises Richard Rosenfeld, professor and chairman of otolaryngology at Long Island College Hospital in Brooklyn, N.Y.
Your nose "doesn't just swell up [inside] for no reason," Rosenfeld says. "It's important to understand why your nose" is stuffy. Sinusitis, for instance, may require an antibiotic, which means getting a prescription. Allergies may respond to an antihistamine. And structural problems, like a deviated septum, may require surgery. For persistent congestion, it's usually best to see your doctor, he says.
Once you've determined the cause of your stuffiness, here are some options for unclogging your nose:
• Consider nasal washings. A 2007 study published in the Archives of Otolaryngology—Head & Neck Surgery found that saline irrigation was more effective than saline spray for a group of patients with chronic nasal and sinus symptoms. "But many people who have colds [also] find it soothing," Rosenfeld says. "The basic principle is you need to irrigate, not just moisturize." Several nasal rinse kits are available on store shelves, or you can create a homemade kit: Squeeze about 4 to 8 ounces of saltwater into your nose "until there is no more mucous or cloudy material coming out," Rosenfeld suggests.
• Seek out pseudoephedrine. Some people say the oral decongestant phenylephrine—which replaced pseudoephedrine in many over-the-counter products in 2006—doesn't do a good job of unclogging their noses at the current 10-milligram dose. Pramod Kelkar, a Minneapolis allergist in private practice, says that some of his patients contend that it's less effective than pseudoephedrine, no longer residing on store shelves because it can be used to make methamphetamines. "Some patients feel like [phenylephrine] doesn't work at all," he says. While the Food and Drug Administration hasn't sanctioned a higher dose out of concern that too much can raise blood pressure, there are other options if phenylephrine (now a main ingredient in Sudafed PE, Robitussin cough syrup, and Benadryl Allergy & Sinus) doesn't work for you. Drugs containing pseudoephedrine are still available in limited amounts behind some pharmacy counters to those who show ID; no more than 9 grams per month or 3.6 grams per day can be purchased.
• Try a nasal spray, but don't use an over-the-counter decongestant spray for longer than 3 days. Overuse can create a rebound effect of narrowing and constricting the blood vessels of your nose, according to the Mayo Clinic. Prescription nasal sprays are also an option, if your doctor thinks they'll ease your congestion. Steroid sprays, such as Flonase and Nasonex, work by reducing swelling in the nose.
• Ask your doctor for a prescription oral decongestant. If your congestion is due to more than a simple cold—perhaps you're experiencing a nasty bout of sinusitis—it's reasonable to ask for a prescription oral decongestant, particularly if phenylephrine doesn't work for you and you're having trouble finding over-the-counter pseudoephedrine. "If a patient's condition warrants it...I would be happy to prescribe it," says Kelkar.
• Inhale steam. Sitting in front of a cool mist humidifier or using personal steam inhalation devices may loosen up congestion, Rosenfeld says.
Quick Tips1Salt water can help ease sinuses and reduce the need for pain medication. [1] Breathe in salt water to clear your sinuses (helpful if you live by the ocean), use a nasal saline spray (unmedicated salt water) [2], or use a neti pot (see below).Ads by Google
ZYRTEC® Home MakeoverEnter For A Chance To Win ZYRTEC® Sweepstakes. See Official Rules.allergy.promo.eprize.com/zyrtec2Use a humidifier at home to avoid living in an environment with dry air, which can irritate your sinuses.[3]3Eat spicy, peppery or pungent foods, which are natural decongestants. Try an Indian, Thai or Sichuan (Chinese) cuisine.[4] Chewing a minty gum could also help.4Drink lots of water to keep your sinus membranes well-hydrated. It can also thin your mucus.5Bathe your pets, clean your carpet and dust your furniture regularly to prevent allergens from clogging your sinuses.6Exercise more, not less. Running up and down stairs can change the pressure in your body and help clear your nose. [5]Over-the-Counter (OTC) Drugs1Determine the cause of nasal congestion. Are you experiencing congestion because of sickness and colds, or because of allergies?2Choose an OTC drug. Consult with your pharmacist as to the best OTC product to relieve your congestion, and the proper way to use it. Pick according to the cause, according to what has worked for you in the past, and according to side effects you want to minimize, such as drowsiness. #*Another consideration is the amount of active ingredient in a dose, what it is, how often you take it. You could actually save yourself money by buying a drug that treats only nasal congestion instead of a multi-symptom cold relief drug, and by purchasing a 12 hour relief formula instead of doses that need to be taken every 4 hours. Some active ingredients serve in both allergy and cold relief applications.
Neti Pot1 The neti pot is an ancient remedy that is filled with a saline solution and then used to irrigate your nose. It washes out all of the pollution, infection and allergens that may be troubling you. [6] Video: Truth About Neti Pots on WebMD2Acclimate yourself to voluntarily breathing through your mouth and not your nose.3Prepare a saline solution with water and non-iodized salt. Use a 1/4 tsp. of salt for about every 8 oz. of water. [7]4You can add an herbal wash to your saline solution, but read the label carefully. Zinc can temporarily taper your sense of smell, so you may want to use one that is zinc-free.Herbal washes are not recommended in pregnant women.5Tilt your head to the side and stick the end of the neti pot down the higher nostril to irrigate your nose. Water will flow from your other nostril and clean out your nasal pathways in the process.6Feel free to use the neti pot as long as your symptoms occur -- from once a week to multiple times a day.Steam1Get a bowl of steaming or hot water.2Inhale the steam slowly.3 Try mixing in essential oils such as menthol, eucalyptus, or tea tree oil for improved results.4Alternatively, try slowly sipping hot water or tea with a bit of lemon in it, keeping your nose close to the cup.5Try taking a warm shower as well, to let the steam help clear your nose
Saturday, November 20, 2010
At the scene of a road accident
The first person on the scene of a collision will almost certainly be another road user. So as a driver your knowledge of first aid could make a real difference to someone in the event of a road accident Stop. Apply handbrake. Turn off engineTopAssess conditionsRemain calm. Assess the scene and seriousness of the collision. Determine what happened, how many people and vehicles are involved and the exact locationTopMake safeMake sure you stay safe: keep off the road. If you need to stop or warn approaching cars, signal to them from the pavement. Wear fluorescent reflective clothing use warning triangles, flashing lights and hazard warning lights. Don’t smoke If you are in a car and you come across an accident, first park safely and turn off the engine before you get out to help. Use a hazard triangle if necessary. Consider the safety of others. Immobilize the vehicle/s, look out for hazards - leaking fuel, chemicals, broken glass or shed loads – guide uninjured passengers to a place of safety TopAssess casualtiesHow many casualties are there? What is the severity of the injuries? Is anyone trapped? Is there a danger of fire?TopCall for helpDial 999 (or 112) for the emergency services. If there is no phone nearby, recruit help and send two people in opposite directions Do not use mobile phones if there is a danger from petrol-spillage or fumesTopApply emergency first aidRemain calm. Reassure the victims. Do not allow smoking or offer food or drink to casualties as this could hamper urgent medical treatmentTopCalling 999 (112)Do this as soon as you can or get someone else to do it while you deal with an injured person. You will need to tell the emergency services: where you are what has happened (describe the accident) how many people are injured whether they are breathing or bleeding.
Wednesday, November 17, 2010
Treatment for Stage IV and Recurrent Colon Cancer
Treatment of patients with recurrent or advanced colon cancer depends on the location of the disease. For patients with locally recurrent and/or liver-only and/or lung-only metastatic disease, resection surgery, if feasible, is the only treatment with the potential to cure the disease. Patients with cancer that cannot be treated surgically are treated with systemic chemotherapy. Treatment of stage IV and recurrent colon cancer may include the following:
Resection/anastomosis (surgery to remove the cancer or bypass the tumor and join the cut ends of the colon)
Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread. Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life. Special treatments of cancer that has spread to or recurred in the liver may include the following:
Radiofrequency ablation (a technique that uses a special probe with tiny electrodes that kill cancer cells)
Cryosurgery (using an instrument to freeze and destroy abnormal tissues).
The goal of surgery for Stage IV colorectal cancer is to prevent or stop the tumor from blocking the colon and rectum and to prevent other complications. This surgery may involve:
Resection -Your doctor will remove the cancer and a small amount of the healthy tissue surrounding the cancer. The doctor will usually sew the healthy parts of the colon together so that your bowel can continue to function normally. This procedure is known as anastomosis. In anastomosis, the doctor often removes lymph nodes near the colon and examines them under a microscope to find out if they have any cancer cells.
If the tumor is large and has created a hole in your colon, you might need a temporary colostomy. In a colostomy, an opening is made in the abdomen and one end of the large intestine is attached to this opening. Stool comes through the intestine, out the opening, and into a replaceable plastic bag. You will wear this bag outside your body. Often, you will only need the colostomy for a short time. As soon as your colon heals, the doctor can sew the two ends of the colon back together. In very rare cases, when the cancer cannot be completely removed, the two ends of the colon are not sewn back together and the colostomy becomes permanent.
About half of all patients with colorectal cancer have liver metastases, or cancer cells that have spread from the colon or rectum to the liver. Metastases in the liver and other organs are sometimes removed surgically by resection. If resection is not possible, the surgeon might use one of these techniques:
Radiofrequency ablation- In some cases, the physician uses a special probe with tiny electrodes that kill cancer cells. This probe is sometimes inserted directly through the skin. In other cases, the doctor cuts into the abdomen to insert the probe.
Cryosurgery- In cryosurgery, the surgeon uses an instrument to freeze and destroy the tumor. This is especially useful for metastases in the liver.
If you have rectal cancer, you might be treated with radiation therapy and chemotherapy before surgery. This reduces the chance that the cancer will come back and can make the surgery more effective.
Many patients with stage IV colorectal cancer are treated with chemotherapy after their surgery, typically with one or more of the following drugs, either alone or in combination:
Camptosar® (irinotecan) -Irinotecan can be used in combination with other chemotherapy drugs, especially fluorouracil (5-FU) and leucovorin, as the first treatment for metastatic colorectal cancer (cancer that has spread to other parts of the body). This combination is known as FOLFIRI for folinic acid, 5-FU, and irinotecan.
Some people have an inherited genetic variation that makes it hard for them to tolerate irinotecan. Luckily, a test is available to find out if you have this genetic variation. If you do, your doctor will prescribe a different chemotherapy drug or drugs for you.
Eloxatin® (oxaliplatin)- This drug can be very effective when it is combined with 5-FU and leucovorin. Sometimes oxaliplatin is combined with both 5-FU and folinic acid. This combination is known as FOLFOX (for folinic acid, 5-FU, and oxaliplatin). FOLFOX seems to be the most effective treatment for colorectal cancer that has returned (recurred) after it was originally treated.
Fluorouracil (5-FU)- This is the drug used most often to treat colorectal cancer. 5-FU is often given with another drug, leucovorin, to make it more effective. Patients usually receive injections of 5-FU over a few days or weeks and then take a few weeks off from chemotherapy. These cycles are repeated over 6 months to a year.
Xeloda® (capecitabine)- Capecitabine is usually taken by mouth. It actually turns into 5-FU when it gets to the tumor. This drug can be used instead of 5-FU and it acts as if the 5-FU were being given continuously.
If you have liver metastases, you might receive chemotherapy directly into the artery that goes to the liver. This shrinks cancers in the liver more effectively than giving the chemotherapy intravenously (through a vein).
Patients with Stage IV colorectal cancer are sometimes treated with targeted treatments. These are new therapies that affect cancer cells but do little damage to noncancer cells. These drugs are becoming more important in the treatment of colorectal cancer. These treatments are sometimes known as immunotherapies because they help the patient’s immune system fight cancer more effectively.
Antiangiogenesis therapy -Tumors need the nutrients in blood vessels to grow and spread. Antiangiogenesis therapies stop the process of making new blood vessels, known as angiogenesis, by “starving” the tumor. Avastin® (bevacizumab) is one of these therapies, and it works by blocking the growth factors that stimulate the development of new blood vessels. Bevacuzimab is given with chemotherapy to improve survival in people with advanced colorectal cancer.
Epidermal growth factor receptor (EGFR) inhibitors -The EGFR protein seems to help many colorectal cancers grow. Erbitux® (cetuximab) is a monoclonal antibody, or protein used by the immune system, that can find and attach itself to cancer cells and can block the EGFR protein. Cetuximab can sometimes shrink tumors in patients whose cancers continue to grow after other treatments. Cetuximab can be used with or without irinotecan. VectibixTM (panitumumab), another monoclonal antibody, is a newer EGFR inhibitor that can shrink tumors in some people whose cancer has not responded to other treatments. Vectibix is used to treat certain colorectal cancers that have metastasized (spread to other parts of the body) and continue to grow after treatment with combinations of chemotherapy drugs that include 5-FU, oxaliplatin, or irinotecan.
Radiation therapy is another treatment that is used for people with Stage IV colorectal cancer.It can help reduce certain symptoms, such as pain.
External beam radiation therapy (EBRT) - This is the most common type of radiation treatment for people with colorectal cancer. A machine called a linear accelerator directs the radiation at the tumor from outside your body. The treatments last just a few minutes and are given 5 days a week for several weeks.
read more:http://www.thethank.com/health/coloncancer/201011/Treatment-for-Stage-IV-and-Recurrent-Colon-Cancer_1420.html
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Resection/anastomosis (surgery to remove the cancer or bypass the tumor and join the cut ends of the colon)
Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread. Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life. Special treatments of cancer that has spread to or recurred in the liver may include the following:
Radiofrequency ablation (a technique that uses a special probe with tiny electrodes that kill cancer cells)
Cryosurgery (using an instrument to freeze and destroy abnormal tissues).
The goal of surgery for Stage IV colorectal cancer is to prevent or stop the tumor from blocking the colon and rectum and to prevent other complications. This surgery may involve:
Resection -Your doctor will remove the cancer and a small amount of the healthy tissue surrounding the cancer. The doctor will usually sew the healthy parts of the colon together so that your bowel can continue to function normally. This procedure is known as anastomosis. In anastomosis, the doctor often removes lymph nodes near the colon and examines them under a microscope to find out if they have any cancer cells.
If the tumor is large and has created a hole in your colon, you might need a temporary colostomy. In a colostomy, an opening is made in the abdomen and one end of the large intestine is attached to this opening. Stool comes through the intestine, out the opening, and into a replaceable plastic bag. You will wear this bag outside your body. Often, you will only need the colostomy for a short time. As soon as your colon heals, the doctor can sew the two ends of the colon back together. In very rare cases, when the cancer cannot be completely removed, the two ends of the colon are not sewn back together and the colostomy becomes permanent.
About half of all patients with colorectal cancer have liver metastases, or cancer cells that have spread from the colon or rectum to the liver. Metastases in the liver and other organs are sometimes removed surgically by resection. If resection is not possible, the surgeon might use one of these techniques:
Radiofrequency ablation- In some cases, the physician uses a special probe with tiny electrodes that kill cancer cells. This probe is sometimes inserted directly through the skin. In other cases, the doctor cuts into the abdomen to insert the probe.
Cryosurgery- In cryosurgery, the surgeon uses an instrument to freeze and destroy the tumor. This is especially useful for metastases in the liver.
If you have rectal cancer, you might be treated with radiation therapy and chemotherapy before surgery. This reduces the chance that the cancer will come back and can make the surgery more effective.
Many patients with stage IV colorectal cancer are treated with chemotherapy after their surgery, typically with one or more of the following drugs, either alone or in combination:
Camptosar® (irinotecan) -Irinotecan can be used in combination with other chemotherapy drugs, especially fluorouracil (5-FU) and leucovorin, as the first treatment for metastatic colorectal cancer (cancer that has spread to other parts of the body). This combination is known as FOLFIRI for folinic acid, 5-FU, and irinotecan.
Some people have an inherited genetic variation that makes it hard for them to tolerate irinotecan. Luckily, a test is available to find out if you have this genetic variation. If you do, your doctor will prescribe a different chemotherapy drug or drugs for you.
Eloxatin® (oxaliplatin)- This drug can be very effective when it is combined with 5-FU and leucovorin. Sometimes oxaliplatin is combined with both 5-FU and folinic acid. This combination is known as FOLFOX (for folinic acid, 5-FU, and oxaliplatin). FOLFOX seems to be the most effective treatment for colorectal cancer that has returned (recurred) after it was originally treated.
Fluorouracil (5-FU)- This is the drug used most often to treat colorectal cancer. 5-FU is often given with another drug, leucovorin, to make it more effective. Patients usually receive injections of 5-FU over a few days or weeks and then take a few weeks off from chemotherapy. These cycles are repeated over 6 months to a year.
Xeloda® (capecitabine)- Capecitabine is usually taken by mouth. It actually turns into 5-FU when it gets to the tumor. This drug can be used instead of 5-FU and it acts as if the 5-FU were being given continuously.
If you have liver metastases, you might receive chemotherapy directly into the artery that goes to the liver. This shrinks cancers in the liver more effectively than giving the chemotherapy intravenously (through a vein).
Patients with Stage IV colorectal cancer are sometimes treated with targeted treatments. These are new therapies that affect cancer cells but do little damage to noncancer cells. These drugs are becoming more important in the treatment of colorectal cancer. These treatments are sometimes known as immunotherapies because they help the patient’s immune system fight cancer more effectively.
Antiangiogenesis therapy -Tumors need the nutrients in blood vessels to grow and spread. Antiangiogenesis therapies stop the process of making new blood vessels, known as angiogenesis, by “starving” the tumor. Avastin® (bevacizumab) is one of these therapies, and it works by blocking the growth factors that stimulate the development of new blood vessels. Bevacuzimab is given with chemotherapy to improve survival in people with advanced colorectal cancer.
Epidermal growth factor receptor (EGFR) inhibitors -The EGFR protein seems to help many colorectal cancers grow. Erbitux® (cetuximab) is a monoclonal antibody, or protein used by the immune system, that can find and attach itself to cancer cells and can block the EGFR protein. Cetuximab can sometimes shrink tumors in patients whose cancers continue to grow after other treatments. Cetuximab can be used with or without irinotecan. VectibixTM (panitumumab), another monoclonal antibody, is a newer EGFR inhibitor that can shrink tumors in some people whose cancer has not responded to other treatments. Vectibix is used to treat certain colorectal cancers that have metastasized (spread to other parts of the body) and continue to grow after treatment with combinations of chemotherapy drugs that include 5-FU, oxaliplatin, or irinotecan.
Radiation therapy is another treatment that is used for people with Stage IV colorectal cancer.It can help reduce certain symptoms, such as pain.
External beam radiation therapy (EBRT) - This is the most common type of radiation treatment for people with colorectal cancer. A machine called a linear accelerator directs the radiation at the tumor from outside your body. The treatments last just a few minutes and are given 5 days a week for several weeks.
read more:http://www.thethank.com/health/coloncancer/201011/Treatment-for-Stage-IV-and-Recurrent-Colon-Cancer_1420.html
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Monday, November 1, 2010
沙宝亮个人档案资料简介,沙宝亮年龄身高(沙宝亮图片)
音乐可以不是利益，可以只是坚持！16日晚，蓉城的歌迷就享受到了一场高品质的廉价演唱会。“1沙1世界”2010沙宝亮全国走唱会启动仪式暨成都·金沙演唱会盛大唱响。无数歌迷在昨夜彻底满足了一回安抚心灵的音乐保卫战。歌者沙宝亮，此次的措举不仅完成了自己的音乐历程上的一次奋进，背后蕴藏的更是众多的责任和荣誉。 荣誉；堪称中国内地第一人站在有着厚重历史文化的博物馆上开唱！大家都知道，金沙遗址博物馆是中国文物界的重大发现，他的出现不仅推翻了成都“不晓文字，未有礼乐”的恒久之道，不仅彰显出成都这所城市的悠久文化历史，如今更是一张属于成都的城市文化名片。作为歌手，能有幸站在这个聚宝盆之地上歌唱，是何等荣耀光鲜！ 此次沙宝亮成都演唱会的票价订为180 280 380 580，足以显示出用意所在。而他的个人属性绝不是这个价钱。此次只为能让大家更多的感受音乐，能回点本钱而已，但事实上是赔钱的。正如他北京发布会上所说，走唱会，不应该是为了赚钱，更多的是边走边唱，带着音乐去旅行，为更多的人带去一种音乐心情。也是自己为以后创作音乐而走，希望在每一站能感受更多的人杰地灵从而获得更多的创作灵感。 姓名：沙宝亮 性别：男 出生年： 生日：1月1日 地区：中国大陆 星座：摩羯座 血型：B型 身高：180cm 三围： 嗜好：骑马、游泳、登山 职业：歌手 个人简介 沙宝亮于1986年毕业于北京艺校，1993年步入歌坛和现代人乐队合作开始创作、演唱。沙宝亮写歌已经很多年，创作一般比较随意的，96年时与其好友段目然成立沙漠工作室，沙宝亮负责作曲，他负责作词，期间为戴娆写了《期待》和叶蓓的《我是谁》。 其它 1986年毕业于北京艺校 1987年在法国世界未来杂技节比赛中获金奖 1993年步入歌坛和现代人乐队合作开始创作、演唱 1995年成立沙漠音乐工作室，推出单曲及MTV《扫落叶的人》 为正大国际音乐中心签约歌手潘劲东第二张专辑创作《好想你》、《落泪的玫瑰》(因故未发行)。 1996年任现代人乐队主唱 为香港三栖明星钟镇涛专辑创作主打歌《简简单单的生活》 1997年为北京国安足球队演唱《国安永远争第一》受到广泛的认可和赞许 1998年为天星娱乐公司签约歌手戴娆专辑创作《期待》、《落泪的玫瑰》 1999年为麦田音乐公司签约歌手叶蓓专辑创作《我是谁》 2000年参加《公益歌曲大擂台》获擂主称号 2001年为中唱领先音乐和强磊音乐的合辑《校园Feeling》录唱《青春日记》。从众多歌手中脱颖而出，《青春日记》在全国各大排行榜上名列首位，并在央视、北京卫视、山东卫视等综艺晚会演出，《中国广播影视》、《中国大学生》、《广播歌选》、《东方》、《音乐生活报》等报刊均作过专刊，在北京各大高校巡演中深受欢迎被誉为“新一代校园歌曲代言人”。 签约北京现代力量文化发展有限公司，推出单曲《我的秋天谁来过》，位居中央人民广播电台《中国流行歌曲榜》第二名，并在全国各地电台几十家排行榜上榜。 2002年推出单曲CD《被遗忘的人》，拍摄MTV《爱上一条鱼》、《青春日记》
http://www.ent199.com/Article/manhua/201011/4821.html
http://www.ent199.com/Article/manhua/201011/4821.html
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