Archive for April, 2009

April 16th 2009

Kaposi’s Sarcoma- Lets find out the causes, symptoms and way of treatment

What is this condition?

Kaposi’s sarcoma is a type of cancer affecting the walls of certain lymphatic cells. Until the 1980s, doctors viewed it as a rare sarcoma (soft­tissue cancer) of the blood vessels, occurring mostly in elderly Italian and Jewish men. But the incidence of Kaposi’s sarcoma has risen dramatically along with the incidence of AIDS. Currently, it’s the most common AIDS-related cancer.

Kaposi’s sarcoma causes both structural and functional damage. When associated with AIDS, it has an aggressive course, involving the lymph nodes, internal organs, and possibly the digestive tract.

What causes Kaposi’s Sarcoma?

The exact cause of Kaposi’s sarcoma is unknown, but the disease may be related to suppression of the immune system. Genetic or hereditary predisposition is also suspected.

What are its symptoms?

The first sign of Kaposi’s sarcoma is one or more obvious skin lesions. These lesions vary in shape and size, and their color may range from red-brown to dark purple. They are most common on the skin, inside of the cheek or mouth, lips, gums, tongue, tonsils, eyes, and eyelids. Besides the skin, Kaposi’s sarcoma may affect the lungs, gastrointestinal tract, and other areas.

When the disease advances, the lesions may join, becoming one large plaque, or patch. Untreated lesions may look like large, craterlike masses. Other signs and symptoms include:

  • pain (if the sarcoma advances beyond the early stages or if a lesion breaks down or presses on nerves or organs)
  • swelling caused by clogged lymphatic channels
  • shortness of breath or difficulty breathing (if the disease affects respiratory structures), wheezing, slow and shallow breathing, and respiratory distress
  • digestive problems.

How is it diagnosed?

The doctor performs a tissue biopsy (removal and analysis of tissue from the lesion) to identity the type and stage of the lesion. Then the person may undergo a computed tomography scan (commonly called a CAT scan) to detect and evaluate possible disease spread.

How is it treated?

Treatment isn’t indicated for all cases of Kaposi’s sarcoma. But if the disease is progressing quickly and the lesions are cosmetically offensive or painful or if they’re blocking vital functions, the person should get treatment.

Treatment options include radiation therapy, chemotherapy, and biotherapy (administration of drugs called biological response modifiers). Radiation therapy eases symptoms, including pain from obstructing lesions in the mouth, throat, arms, or legs and swelling caused by lymphatic blockage. It may also be used to improve the person’s appearance.

Chemotherapy includes combinations of the drugs doxorubicin, vinblastine, vincristine, and etoposide (VP-16).

Biotherapy with interferon alfa-2b may be prescribed for AIDS­related Kaposi’s sarcoma. This treatment reduces the number of skin lesions but isn’t effective in advanced disease.


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April 10th 2009

Metabolic Acidosis - are you aware of the causes, symptoms and treatment

What is this condition?

Metabolic acidosis is a combination of excess acid accumulation and insufficient base compounds in the person’s system. This acid-base imbalance is usually brought on by a medical disorder.

This imbalance of body chemicals depresses the central nervous system. Left untreated, metabolic acidosis can lead to dangerous changes in heart rate and rhythm, cardiac arrest, and coma. The prognosis improves if the underlying cause is identified quickly and the body’s normal acid-base balance is promptly restored.

Metabolic acidosis is more common in children than in adults.
What causes it?

Metabolic acidosis is commonly caused by excessive burning of fats in the absence of usable carbohydrates. This can be caused by diabetes, chronic alcoholism, malnutrition, or a low-carbohydrate, high­fat diet - all of which produce more acids than the body can handle. Other causes include:

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too little oxygen to burn carbohydrates (as occurs after a heart attack) and a corresponding rise in lactic acid level
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kidney insufficiency and failure (the kidneys may fail to secrete sufficient acid)
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diarrhoea and intestinal malabsorption, which cause loss of sodium bicarbonate
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aspirin overdose (less frequently) or some other poisoning
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Addison’s disease.

What are the symptoms of Metabolic Acidosis?

Metabolic acidosis typically causes a headache and lethargy, progressing to drowsiness, central nervous system depression, and rapid breathing (as the lungs try to compensate by “blowing off” carbon dioxide), and stupor. If the condition is severe and goes untreated, the person may suffer a coma and die.

The person usually has stomach problems that produce appetite loss, as well as nausea, vomiting, and diarrhea, which may lead to dehydration. If the person has diabetes, he or she may have fruity­smelling breath.
How is it diagnosed?

After he asks about symptoms, the doctor will order blood tests to confirm metabolic acidosis and determine its severity. The key test for detecting metabolic acidosis is called arterial blood gas analysis.
How is it treated?

If severe metabolic acidosis is diagnosed, treatment begins with intravenous sodium bicarbonate, which helps to neutralize body acids. The doctor evaluates and corrects other electrolyte imbalances - for example, a person with metabolic acidosis may also need treatment for excessive potassium.

Other treatments may include mechanical ventilation to ensure adequate breathing, replacement of fluids, and antibiotics to treat infection. Ultimately, the doctor must correct the underlying cause. For example, in diabetic ketoacidosis, a low-dose continuous, intravenous infusion of insulin is recommended.


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