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medicalbasics · an hour ago
"The mystery of government is not how Washington works but how to make it stop."
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meddcohealthcare · an hour ago
Best orthopedic surgery hospitals in Delhi provide complete treatment for bone and joint surgery. compare multiple hospitals' prices near your location. Book your online Appointment
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themedicalstate · 4 hours ago
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Nothing Could Make Her Body Stop Itching. Would It Ever End?
It felt like the itch was coming from somehow under her skin. The cause ended up being even deeper.
It was dark by the time the 41-year-old woman was able to start the long drive from her father’s apartment in Washington, D.C., to her home in Westchester County, N.Y. She was eager to get back to her husband and three children. Somewhere after she crossed the border into Maryland, the woman suddenly developed a terrible itch all over her body. She’d been a little itchy for the past couple of weeks but attributed that to dry skin from her now-faded summertime tan. This seemed very different: much stronger, much deeper. And absolutely everywhere, all at the same time.
The sensation was so intense it was hard for the woman to pay attention to the road. She found herself driving with one hand on the steering wheel and the other working to respond to her skin’s new need. There was no rash — or at least nothing she could feel — just the terrible itch, so deep inside her skin that she felt as if she couldn’t scratch hard enough to really get to it. By the light of the Baltimore Harbor Tunnel she saw that her nails and fingers were dark with blood. That scared her, and she tried to stop scratching, but she couldn’t. It felt as if a million ants were crawling all over her body. Not on her skin, but somehow under it.
The woman had gone to Washington to help her elderly father move. His place was a mess. Many of his belongings hadn’t been touched in years. She figured that she was having a reaction to all the dust and dirt and who knows what else she encountered while cleaning. As soon as she got home, she took a long shower; the cool water soothed her excoriated skin. She lathered herself with moisturizer and sank gratefully into her bed. But the reprieve didn’t last, and from that night on she was tormented by an itch that no scratching could satisfy.
A Year of Unrelenting Agony
After two weeks, she went to an urgent-care center. There didn’t seem to be a rash or bites, the doctor told her, but her skin was so red and scratched up that he might not be able to see if there was an allergic reaction or bites from bedbugs or fleas beneath it all. He started her on a two-week course of prednisone; that should calm your itch, he told her, no matter the cause. She took it faithfully. It didn’t help.
She cleaned every inch of her house and hired an exterminator to search for bedbugs. She took her dog and two cats to the vet to have them treated for fleas. She bought new mattresses. None of it helped.
She saw a dermatologist, who thought it was eczema and recommended a moisturizer. Useless. She went to her internist, who wondered if this could be a symptom of a disease beyond her skin. He asked her if she had noticed any other symptoms. No, she felt fine — except for this itch. He ordered some blood tests, but the only abnormality found, he told her when he called with the results, was a mild iron-deficiency anemia. That can cause pruritus — the medical term for itch — though not usually this severe. She was prescribed an iron supplement and waited for a relief that never came.
An allergist found a reaction to dust mites and a chemical preservative used in some cosmetics and cleaning products called methylisothiazolinone (MIT). The patient bought an air purifier, put allergy covers on her (new) mattresses and pillows and searched labels for any MIT-containing products and replaced them. She took antihistamines. The itch continued.
A second dermatologist took biopsies from the skin on her thigh and arm. They were unrevealing. He started her on a steroid cream to treat what he thought might be eczema. It had no effect. When a third dermatologist, recommended by a close friend, also suggested that she had eczema, the patient burst into tears. She’d been suffering for over a year. Was she going to feel like this for the rest of her life? That doctor prescribed gabapentin, which can be used to treat pain and itching caused by injured nerves. The drug helped — she was able to get to sleep at night, when the itch was its worst. And it helped a little during the day. But even so, she was still horribly itchy.
A New Round of Questions
The patient’s husband started doing some research of his own. He found a couple of specialists he thought might help. One was in London, but another, Dr. Melissa Iammatteo, a specialist in allergy and immunology, was quite close. By the time he made this discovery, though, Covid-19 was rampaging through Westchester. His wife scheduled an appointment for the early summer, crossing her fingers that by then it would be safe for her to see the doctor.
It was a bright, cool day when the woman finally met Iammatteo. On exam, the patient’s arms and legs were covered with blotches of inflamed red skin, shiny in places and covered with marks from scratching. The patient repeated the story she’d already told a half dozen times: She felt fine except for this terrible itch that drove her nuts.
Iammatteo pressed: Did she really feel fine? Like the patient’s internist the year before, she was worried about problems that went beyond the skin. Iammatteo asked her specific questions, which helped the patient realize that she did not actually feel healthy. Yes, the patient acknowledged, she was tired. Yes, she had recently lost a little weight. And, come to think of it, yes, she did sometimes feel feverish, though, no, she didn’t have night sweats.
When dealing with patients who have already had an extensive work-up and seen many providers, it’s important to focus on the less likely causes of a symptom. Iammatteo forced herself to think broadly through all the different types of diseases that can cause itching. Diseases of the kidneys and liver are common causes of pruritus — but repeated testing was normal. Infection with parasites or viruses can cause itching; she would order tests for some of the more common of these, including toxocara, a type of parasite carried by cats and dogs, and for H.I.V. It was also important to check for cancer: Nearly 10 percent of patients with persistent unexplained pruritus are found to have cancer. She would order a chest X-ray to look for enlarged lymph nodes. And she would refer the patient to a cancer specialist just in case she’d missed anything.
She reviewed the plan with the patient, who needed to go to the lab and the radiology department before she left the building. Iammatteo would call her with the results, she said; it would probably take a few days.
A Flurry of Tests, Scans and Biopsies
The patient hadn’t been home for long when Iammatteo called. She had some results. It wasn’t an answer, but a clue. The X-ray revealed a mass the size of a softball in her chest. Iammatteo wasn’t sure exactly what it was but had sent the image to the cancer specialist. And she had moved up the patient’s appointment with the specialist to that week. Iammatteo was sure he would be able to tell them exactly what was going on.
The next few days were a flurry of blood tests, scans and biopsies. Although this was scary, the patient was eager to finally have an answer — even if it meant she had cancer. And that is what it meant. She had Hodgkin lymphoma, an unusual cancer of a type of white blood cell known as lymphocytes. This cancer usually starts in the chest or neck and spreads through the lymph nodes. H.L. is often diagnosed when patients develop enlarged lymph nodes in the neck or under the arms. This patient never had that. Up to 30 percent of patients with H.L. report having pruritus for months or occasionally years before a diagnosis is made. Why this occurs is not well understood.
Treatment for this disease can be tough, but the prognosis is good. The patient would need months of chemotherapy. She was eager to start. “I would have done anything to get rid of this itch,” she told me. The itch subsided significantly after the first round of chemo. After six weeks it was gone completely. And it hasn’t come back.
As the patient neared the end of her treatment, she tracked down Iammatteo, who now only sees patients with severe drug allergies, to thank her for helping to beat that all-consuming itch.
by Lisa Sanders, M.D. (The New York Times).
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babybearreblobs · 6 hours ago
hey!!! other wittles!!! dont forget to take your meds today!!!! ive been struggling to take mine, but ima take them right now!! so you take yours too, okay?
get your meds and we'll do it on the count of three, okay?
Good job!! I'm so pwoud of you!!!! Give your stuffy a big huggle fwom me!!!! wuv you fwiends!!!!
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heardatmedschool · 7 hours ago
Student 1: They are so gonna fail us all.
Student 2: Anything we can do?
Student 3: Faith, trust and pixie dust.
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nuadox · 7 hours ago
Proof of concept: Ion pump to deliver chemotherapy agents to the brain
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- By Anders Ryttarson Törneholm , Linköping University -
Despite surgery and subsequent treatment with chemotherapy and radiation, the majority of patients experience recurrence of malignant brain tumours. Researchers at Linköping University, Sweden, and the Medical University of Graz, Austria, have shown in cells in culture that an ion pump can deliver drugs more accurately, which gives less severe adverse effects in chemotherapy.
The results have been published in Advanced Materials Technologies.
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Image: In the future, an implanted ion pump can be used to get around the blood-brain barrier and supply gemcitabine directly into the brain with high precision. Credit: Thor Balkhed.
“This is the first time an ion pump has been tested as a possible method to treat malignant brain tumours. We used cancer cells in the lab, and the results are extremely promising. However, it will probably take five to ten years before we see this new technology used in treatments for brain tumours”, says Daniel Simon, associate professor at the Laboratory of Organic Electronics at the Department of Science and Technology at Linköping University.
The scientists have used cells from glioblastoma, which is the most common and most aggressive type of cancer that can arise in the brain. When a brain tumour is surgically removed, small parts of the tumour are often left behind, embedded between the brain cells. Even high-precision surgery cannot remove these cells without damaging the surrounding healthy brain tissue. This means that radiation treatment and chemotherapy are used to stop the recurrence of the tumour.
Circumvent the blood-brain barrier
In Sweden, around 30 cytostatics are available to treat different types of cancer. These chemotherapy agents are most often given either intravenously or as a tablet. But in order to reach the brain, they must first spread through the circulatory system and then pass through the blood-brain barrier. The walls of the small blood vessels in the brain are much less permeable than blood vessels in the rest of the body, and can prevent many substances in the blood entering the brain. Thus, only a few drugs that work against cancer can pass through.
Scientists at Linköping University and at the Medical University of Graz have now developed a method in which an implanted ion pump can be used to get around the blood-brain barrier and supply gemcitabine - an extremely effective chemotherapy agent that cannot normally pass the blood-brain barrier - directly into the brain with high precision. Gemcitabine is currently used to treat cancers in the pancreas, bladder and breast, where it acts by disrupting the cell division process in rapidly growing tumours. This means that gemcitabine does not affect brain cells, since these do not, in general, undergo cell division.
"The traditional glioblastoma treatment currently used in the clinics harms both cancer and neuronal cells to the same extent. However, with the gemcitabine ion pump, we tackle only the cancerous cells, while neurons stay healthy. In addition, our experiments on cultured glioblastoma cells show that more cancer cells are killed when we use the ion pump than when we use manual treatment", says Linda Waldherr, postdoctoral fellow at the Medical University of Graz. She has conducted the study together with researchers at Linköping University.
When the ion pump is to transport gemcitabine from an electrolyte reservoir into cells or a tumour, a low current is used to "pump" the positively charged drug through an ion transport channel. The method is known as electrophoresis. The ion pump needs only a low current to pump the gemcitabine, which is an advantage since it avoids the risk that brain cells are activated and transmit unintended nerve signals. The low current and voltage also mean that eventual therapeutic technology will not require large power supplies or batteries to operate.
Rainer Schindl, associate professor at the Medical University of Graz, describes other advantages.
"The pressure inside the brain is extremely sensitive, and using an ion pump to transport the drug instead of a fluid-driven device means that the pressure is not affected. Also, the dosage is controlled by electrical charging, which makes the supply of the chemotherapy agent extremely precise. The next step will be to use the ion pump to evaluate different chemotherapy agents that have previously given adverse effects that are too serious or that are unable to pass the blood-brain barrier", he says.
Principal funding bodies for the research have been The Austrian Science Fund, the Knut and Alice Wallenberg Foundation, and the Swedish Foundation for Strategic Research.
Source: Linköping University
Full study: “Targeted Chemotherapy of Glioblastoma Spheroids with an Iontronic Pump”, Advanced Materials Technologies.
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I feel like dying tonight. Again. I could have done so much more. But I didn't. & I feel like failure... As I always do. But this time it's worse. I know I'll fuck up my college exam so bad. & I don't understand why sometimes I can't get myself to study. Or better yet, why an I not capable to do that for the last 7 years or so. I don't understand. I used to have ability to do learn when I was younger, now I feel like I've lost it all. I want to start, sometimes when we start school, sometimes a month before exam, sometimes two weeks... But it always ends up me studying the last two days. Even if I study before, it's like I'm staring at the blank pages, anxiously searching for anything that would allow me too surpass this weight of failure I carry. I just wish I had the ability to study. I talk to my friend who's in medical school & I'm so proud of her, of how smart she is. & besides all that, she's super kind & deserving of everything good she's got. & then I seee her posting her friends, who are all in medical school, all so smart, all so diligent, succesful... And all I want to be, is to be like them. I have no wish to go to medical school, I have never had intention to go to a medical school but I long for a different scientific path - microbiology (that friend of mine does too, but she decided to study it through medical school). And the way I didn't get accepted to school I wanted to, the way that I am still failing & I don't know what to do about it. I feel like I've been in this loop for far too long. Sometinmes I just wish I didn't exist. I am afraid I feel to much - I think that makes me stupid. & sometimes I wish I didn't feel anything. That I'd know how to focus on things to do what I like, I know I'll never be one of those people who are just able to focus ion their work & still have time to do what they want. So I figured I'd give up all of my emotions, all that I am, so I could do what I so wholeheartedly wish to do. I like to imagine, what would it be like if that were possible. How better would I be, how I'd be able to tell people off, when they'd nag me, how I could not give them a second glance, when they'd show me their true colours, instead of forgiving, hiding and wondering why I'm not enough, to have to deal with this... How wonderful it'd be if I were born to not be a failiure. But I was brn to be me, a worthless, stupid, confused, lost creature. I was born to feel.
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suturesandcoffee · 9 hours ago
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15.04.2021 - 4/100 days of productivity challenge
This morning was actually amazing! I went to uni - I hadn't been in such a long time (the above photo is actually really old) - and I did my first ever pratical examination with a sthetoscope! It was amazinggg! We were split into small groups (the usual ones we have for small group activities) and we practiced a basic back and thorax examination (palpation, auscultation, percussion...)
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nuadox · 9 hours ago
FDA approves first immunotherapy for initial treatment of gastric cancer
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- By U.S. Food and Drug Administration (FDA) -
Today, the U.S. Food and Drug Administration approved Opdivo (nivolumab), in combination with certain types of chemotherapy, for the initial treatment of patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer and esophageal adenocarcinoma. This is the first FDA-approved immunotherapy for the first-line treatment of gastric cancer.
“Today’s approval is the first treatment in more than a decade to show a survival benefit for patients with advanced or metastatic gastric cancer who are being treated for the first time,” said Richard Pazdur, M.D., director of the FDA’s Oncology Center of Excellence and acting director of the Office of Oncologic Diseases in the FDA’s Center for Drug Evaluation and Research. “The FDA is committed to bringing new safe and effective treatment options like Opdivo to patients with advanced cancer.”
There are approximately 28,000 new diagnoses of gastric cancer each year in the U.S. With currently available therapy, overall survival is generally poor; the rate of cure with resection is very low and the survival rate for all stages is 32%. The 5-year survival rate for advanced or metastatic gastric cancer is 5%.
Opdivo is a monoclonal antibody that inhibits tumor growth by enhancing T-cell function. Its efficacy was evaluated in a randomized, multicenter, open-label trial of 1,581 patients with previously untreated advanced or metastatic gastric cancer, gastroesophageal junction cancer and esophageal adenocarcinoma. The 789 patients who received Opdivo in combination with chemotherapy, on average, lived longer than the 792 patients who received chemotherapy alone. Median survival was 13.8 months for patients who received Opdivo plus chemotherapy compared to 11.6 months for patients who received chemotherapy alone.
The most common side effects of Opdivo in combination with chemotherapy include peripheral neuropathy (damage to the nerves outside of the brain and spinal cord), nausea, fatigue, diarrhea, vomiting, decreased appetite, abdominal pain, constipation and musculoskeletal pain. Opdivo can cause serious conditions known as immune-mediated side effects, including inflammation of healthy organs such as the lungs (pneumonitis), colon (colitis), liver (hepatitis), endocrine glands (endocrinopathies) and kidneys (nephritis). Patients should tell their healthcare providers if they have immune system problems, lung or breathing problems, liver problems, have had an organ transplant, or are pregnant or plan to become pregnant before starting treatment.
Opdivo received Priority Review and Orphan Drug designations for this indication. Priority Review designation directs overall attention and resources to the evaluation of applications for drugs that, if approved, would be significant improvements in the safety or effectiveness of the treatment, diagnosis or prevention of serious conditions when compared to standard applications. Breakthrough Therapy designation is a process designed to expedite the development and review of drugs that are intended to treat a serious condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy on a clinically significant endpoint(s).
The FDA granted approval to Bristol-Myers Squibb Company.
This review was conducted under Project Orbis, an initiative of the FDA Oncology Center of Excellence. Project Orbis provides a framework for concurrent submission and review of oncology drugs among international partners. For this review, the FDA collaborated with the Australian Therapeutic Goods Administration, the Brazilian Health Regulatory Agency, Health Canada and Switzerland’s Swissmedic. The application reviews are ongoing at the other regulatory agencies.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Source: U.S. Food and Drug Administration (FDA)
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godlovesyoualwayz · 9 hours ago
Text DR.Tenpenny, A devout Christian that is warning others not to take the Vax which is MARK OF THE BEAST. Inform yourself and spread this like crazy.
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medicosis · 9 hours ago
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Can you answer today’s question?
Q: Which electrolytes are more prevalent in the ICF than in the ECF? 🤔...
#medicine #anatomy #physiology #biology #premed #doctor #nurse #usmle #nclex
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Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.
John F Kennedy
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medicosis · 10 hours ago
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Can you answer today’s question? Q: What are 2 mechanisms that contribute to the resting membrane potential (RMP) 🧠 ? 🧐...#physiology #anatomy #biology #neuro #medicine #medical #medschool #nurse #doctor #premed
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java9lives-blog · 10 hours ago
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i was irresponsible and put this off weeks too long, but today i finally transplanted the tobacco and sage seedlings into their proper containers 🌱 they still look alike, so i labeled the sage 😁 i was well supervised by @mitsoumonday 🐈‍⬛ #picoftheday #picaday2021 #nofilfer #planting #tobacco #čhaŋlí #whitesage #pȟežíȟota #sage #medicine #pȟežúta #lakȟótawiŋyaŋ #brownthumbturninggreen #farming #maȟkhíčhaŋwaye (at Touchstone Gallery)
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past-lives-today · 11 hours ago
I will say this once and with absolute clarity.
There is no such thing as an asymptomatic transmission of COVID. None.
My attempts to help make it easier and kinder for people with really high risk for infectious diseases does in no shape or form change the fact that forcing masks on people is morally wrong, ethically despicable and medically unjustifiable.
We are healthy, we do not need any masks, we do not need any lockdowns, fear mongering politicians, doctors and any person who follows their dogma will get what is coming for them. Those who find their completion and relishing fusing in the absolute submission to the authorities are the worst part of this whole age of suffering. Without you, without your self-righteous judgement of yourself being "the good people", the powers that be would have no way of inflicting that much destruction and terror upon innocent people. I hope you all rot in Hell for your disgusting framework of a self-concept that is costing millions of lives and is traumatizing generations to come.
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