SoManyThingz

Life is 10% what happens to you and 90% how you react to it -Charles R. Swindoll

Tuesday 29 March 2016

Guy Drives By New Home And Notices Something Surprising. Do You Notice It?

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Reddit can be a hub of laughs, information, surprise, and more. Take, for example, reddit user's liquidthc picture titled, "They had one job." Do you notice what the problem is?
via reddit / liquidthc
Can't figure it out? It's okay. The top comment puts it eloquently: "It took me an embarrassing amount of time to see the problem." 
The problem is simple: The driveway leads to the side of the home and not to the garage. That means it's completely inaccessible from the streets. For a lot of people, this seems absolutely baffling. Why would anyone do this? 

Redditors hit the comments and starting providing reasons. The predominant reason seems to be is because it's a model home. According to redditor f0gax:
This is a model home and sales office for the builder.
The road in front is still dirt. This house is close to being done, but it's unlikely anyone would want to live in this neighborhood until that road is done.
There's an obvious walk way from that slab to the front door.
There's no "cut" in the curb that would accommodate a different driveway. I'm sure they'll add it later when they eventually sell this house to someone. But for now it's not necessary.
But this leads to even more question, like why wouldn't they just configure it the right way? This could be because:
  1. A driveway in front can potentially block a clear view of the property with cars. Remember, it's a model home: they're trying to show it off.
  2. The ability to add more landscaping to make the home look better.
  3. The ability to add more parking. 
  4. Bolognahead: "Home builders also like to 'trap' clients and will sometimes build doors into the garage where
    the sales office is as the only entrance accessible to clients and then building fences around the walkways to force people to go through the sales office before going through the front door to tour the home."
There you have it. What was perceived to be an unbelievable error is just simply a design for model homes. Some might find it wasteful, but, in the end, it's meant to be pretty enough to sell. Sales, am I right?

Women Need More Sleep Than Men Because Their Brains Work Harder, According To Science

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Women Need More Sleep Than Men

Couples will sometimes fight over who sleeps in more. And according to a study, it turns out your wife should be the one sleeping in, not you. The study examined 210 middle aged men and women, and found that women suffered greater health issues from lack of sleep than men.
"We found that for women, poor sleep is strongly associated with high levels of psychological distress and greater feelings of hostility, depression, and anger. In contrast, these feelings were not associated with the same degree of sleep disruption in men."
"One of the major functions of sleep is to allow the brain to recover and repair itself," says Professor Jim Horne, director of the Sleep Research Center at Loughborough University and author of Sleepfaring: A Journey Through The Science of Sleep. "During deep sleep, the cortex — the part of the brain responsible for thought memory, language, and so on — disengages from the senses and goes into recovery mode."
He continues, "The more of your brain you use during the day, the more of it that needs to recover and, consequently, the more sleep you need. Women tend to multi-task ... and so, they use more of their actual brain than men do. Because of that, their sleep need is greater."
But why do women need more sleep than men?
"This is because women's brains are wired differently from men's and are more complex, so their sleep need will be slightly greater. The average is 20 minutes more, but some women may need slightly more or less than this."
So in every sense, yes, women's brains are more complex, and need more time to relax and recover overnight.
In other words: Let her sleep in, gentleman. It's important.

Monday 28 March 2016

More trees than there were 100 years ago? It's true!

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trees in forest

The numbers are in.
In the United States, which contains 8 percent of the world's forests, there are more trees than there were 100 years ago. According to the Food and Agriculture Organization (FAO), "Forest growth nationally has exceeded harvest since the 1940s. By 1997, forest growth exceeded harvest by 42 percent and the volume of forest growth was 380 percent greater than it had been in 1920." The greatest gains have been seen on the East Coast (with average volumes of wood per acre almost doubling since the '50s) which was the area most heavily logged by European settlers beginning in the 1600s, soon after their arrival.
This is great news for those who care about the environment because trees store CO2, produce oxygen — which is necessary for all life on Earth — remove toxins from the air, and create habitat for animals, insects and more basic forms of life. Well-managed forest plantations like those overseen by the Forest Stewardship Council also furnish us with wood, a renewable material that can be used for building, furniture, paper products and more, and all of which are biodegradable at the end of their lifecycle.
AMAZING PHOTOS: The world's 10 oldest living trees
The increase in trees is due to a number of factors, including conservation and preservation of national parks, responsible tree growing within plantations — which have been planting more trees than they harvest — and the movement of the majority of the population from rural areas to more densely populated areas, such as cities and suburbs. Tree planting efforts begun in the 1950s are paying off and there is more public awareness about the importance of trees and forests. Finally, 63 percent of the forest land in the United States is privately owned, and many landowners are leaving their land intact instead of using it for agriculture or logging (at least partially because many of these activities have shifted overseas).
Quantity over quality?
The average age of forests in the United States is younger than it was before European settlement. The greatest diversity is found in the oldest forests, so there may be more forest now, but because it is so young, it is home for fewer animals, plants, insects and other organisms than a fully developed, mature forest ecosystem. It also means that protecting old growth forests is imperative.
As a society, we are likely in the middle of our cultural (and scientific understanding) of the value of forests. The history of conservation in this country is still young, after all. According to Chuck Leavell, director of Environmental Affairs at MNN and a tree farmer, "It was during the Theodore Roosevelt administration that conservation began to take hold, and along with Roosevelt, figures like Gifford Pinchot, John Muir and others began to warn Americans about overuse of our natural resources. Eventually, programs were put into place that encouraged landowners to plant trees ... in some cases encouraging farmers to convert some of their farm lands into forests."
We can't go back and reverse what we've done to the forests, but we can support current conservation efforts. While our forests are recovering, their protection will only encourage what Leavell calls, " ... a remarkable restoration of American forests."
spotted owlSpotted owls are key indicators of the health of old-growth forests in Oregon. (Photo: Oregon Fish & Wildlife)
Sustainable forestry initiatives
One of the main reasons forests are recovering is the role of government, which now agrees that responsible management practices are important for future forest ecosystem health. In 1992, the United Nations adopted the "Forest Principles" which kicked off the latest round of modern sustainable forest management initiatives in the U.S. and abroad.
The definition of sustainable forest management, as understood by the FAO is: The stewardship and use of forests and forest lands in a way, and at a rate, that maintains their biodiversity, productivity, regeneration capacity, vitality and their potential to fulfill, now and in the future, relevant ecological, economic and social functions, at local, national, and global levels, and that does not cause damage to other ecosystems. These rules now govern how forests are managed.
Carbon dioxide, global warming and trees
Trees do more than protect water resources and produce oxygen, they are also good carbon sinks, which is more and more important in a warming world (carbon dioxide is one of the main global warming gases). As they grow, trees use and store CO2, making them popular bulwarks against climate change. In fact, quite a few carbon offsetting companies include tree planting as part of their portfolio.
Basically, the more trees, the more oxygen, and less carbon dioxide, (though there may be exceptions to this rule in Northern latitudes, according to climate models). "At present, the U.S. does not have any type of carbon tax or cap-and-trade system," says Leavell. "Europe does, with mixed reviews and mixed success. But there is not a doubt that the forests of the world sequester more carbon than anything else."
The future of American forests
Leavell points out that many of America's national parks were originally set aside as a "wood resource" though they are largely unlogged today, though there are still some controversial moves in old-growth areas. Only about 7 percent of U.S. forests are part of national or state parks, but many of those now encompass what we consider to be "environmentally sensitive" areas, or unique ecosystems. (Think California's redwoods or small patches of old growth forests on the East Coast.)
Moving forward, we will continue to have more trees, and more forests than in years past. It's important that we encourage foresters and governments in Third World countries, where deforestation is still occurring at an alarming rate, to do the same.

Can Blue-Colored Light Prevent Suicide?

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Blue Streetlight by Travis Nicholson
An intriguing, anecdotal finding was recently reported by some news outlets that the implementation of blue-colored streetlights has reduced both crime and suicides:
Glasgow, Scotland, introduced blue street lighting to improve the city’s landscape in 2000. Afterward, the number of crimes in areas illuminated in blue noticeably decreased.
The Nara, Japan, prefectural police set up blue street lights in the prefecture in 2005, and found the number of crimes decreased by about 9 percent in blue-illuminated neighborhoods. Many other areas nationwide have followed suit.
Keihin Electric Express Railway Co. changed the color of eight lights on the ends of platforms at Gumyoji Station in Yokohama, Japan, in February.
Since the railway company introduced the new blue lights, they’ve had no new suicide attempts.
This effect may be attributed to a few possible reasons (some of which are mentioned in the comments section of the article):
  • The light color is new and unusual, causing people to act more cautiously in the area (as a person is unsure what to expect in the unusually-lit area).
  • Blue is a light color almost universally associated with a police presence, suggesting it is an area of stricter law enforcement.
  • Blue may be a more pleasant illuminating color to most people, as opposed to yellow, orange or red (according to some research, such as Lewinski, 1938).
In fact, the article quotes from a professor at the end, noting it may just be an “unusualness effect:”
Prof. Tsuneo Suzuki at Keio University said: “There are a number of pieces of data to prove blue has a calming effect upon people. However, it’s an unusual color for lighting, so people may just feel like avoiding standing out by committing crimes or suicide under such unusual illumination. It’s a little risky to believe that the color of lighting can prevent anything.”
There is a lot of research into the psychology of color, but not as much has looked into the color of blue illumination itself (as opposed to the color of an object or wall). But some research looking into short wavelength light (blue) has demonstrated that it is a potentially effective treatment for seasonal affective disorder (a seasonal type of depression; see for instance, Glickman, et al., 2006), and helps to reduce the stress response in fish (it hasn’t been yet tested on humans).
If this finding is robust and the behavior change associated with it is still prevalent a few years from now (when everyone has become accustomed to the new light color), it would be an interesting finding. A simple, inexpensive change might be effective in helping reduce at least one method of suicide (and reduce crime to boot).

Sunday 27 March 2016

Acute stress reaction

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"Acute stress response" was first described by Walter Cannon in the 1920s as a theory that animals react to threats with a general discharge of the sympathetic nervous system. The response was later recognized as the first stage of a general adaptation syndrome that regulates stress responses among vertebrates and other organisms.

Signs and symptoms

Common symptoms that sufferers of acute stress disorder experience are: numbing; emotional detachment; muteness; derealization; depersonalization; psychogenic amnesia; continued re-experiencing of the event via thoughts, dreams, and flashbacks; and avoidance of any stimulation that reminds them of the event. During this time, they must have symptoms of anxiety, and significant impairment in at least one essential area of functioning. Symptoms last for a minimum of 2 days, and a maximum of 4 weeks, and occur within 4 weeks of the event.

Causes

Acute stress disorder (abbreviated ASD, and not to be confused with autism spectrum disorder) is the result of a traumatic event in which the person experiences or witnesses an event that causes the victim/witness to experience extreme, disturbing, or unexpected fear, stress, or pain, and that involves or threatens serious injury, perceived serious injury, or death to themselves or someone else. A study of rescue personnel after exposure to a traumatic event showed no gender difference in acute stress reaction. [1] Acute stress reaction is a variation of post-traumatic stress disorder (PTSD).
The onset of a stress response is associated with specific physiological actions in the sympathetic nervous system, both directly and indirectly through the release of adrenaline and to a lesser extent noradrenaline from the medulla of the adrenal glands. These catecholamine hormones facilitate immediate physical reactions by triggering increases in heart rate and breathing, constricting blood vessels. An abundance of catecholamines at neuroreceptor sites facilitates reliance on spontaneous or intuitive behaviors often related to combat or escape.
Normally, when a person is in a serene, unstimulated state, the "firing" of neurons in the locus ceruleus is minimal. A novel stimulus, once perceived, is relayed from the sensory cortex of the brain through the thalamus to the brain stem. That route of signaling increases the rate of noradrenergic activity in the locus ceruleus, and the person becomes alert and attentive to the environment.
If a stimulus is perceived as a threat, a more intense and prolonged discharge of the locus ceruleus activates the sympathetic division of the autonomic nervous system (Thase & Howland, 1995). The activation of the sympathetic nervous system leads to the release of norepinephrine from nerve endings acting on the heart, blood vessels, respiratory centers, and other sites. The ensuing physiological changes constitute a major part of the acute stress response. The other major player in the acute stress response is the hypothalamic-pituitary-adrenal axis.

Diagnosis

There must be a clear temporal connection between the impact of an exceptional stressor and the onset of symptoms; onset is usually within a few minutes or days but may occur up to one month after the stressor. In addition, the symptoms show a mixed and usually changing picture; in addition to the initial state of "daze," depression, anxiety, anger, despair, overactivity, and withdrawal may all be seen, but no one type of symptom predominates for long; the symptoms usually resolve rapidly in those cases where removal from the stressful environment is possible; in cases where the stress continues or cannot by its nature be reversed, the symptoms usually begin to diminish after 24–48 hours and are usually minimal after about 3 days.[2]
If symptoms last for more than a month, then the patient might be instead diagnosed with PTSD.

Treatment

This disorder may resolve itself with time or may develop into a more severe disorder such as PTSD. However, results of Creamer, O'Donnell, and Pattison's (2004) study of 363 patients suggests that a diagnoses of acute stress disorder had only limited predictive validity for PTSD. Creamer et al. did find that re-experiences of the traumatic event and arousal were better predictors of PTSD.[3] Medication can be used for a short duration (up to four weeks).[citation needed]
Studies have been conducted to assess the efficacy of counselling and psychotherapy for people with ASD. Cognitive behavioral therapy which included exposure and cognitive restructuring was found to be effective in preventing PTSD in patients diagnosed with ASD with clinically significant results at 6 months follow-up. A combination of relaxation, cognitive restructuring, imaginal exposure, and in vivo exposure was superior to supportive counseling.[4] Mindfulness based stress reduction programs also appear to be effective for stress management.[5]

Alzheimer's disease

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Alzheimer's disease (AD), also known as Alzheimer disease, or just Alzheimer's, accounts for 60% to 70% of cases of dementia.[1][2] It is a chronic neurodegenerative disease that usually starts slowly and gets worse over time.[1][2] The most common early symptom is difficulty in remembering recent events (short-term memory loss).[1] As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self care, and behavioural issues.[1][2] As a person's condition declines, they often withdraw from family and society.[1] Gradually, bodily functions are lost, ultimately leading to death.[3] Although the speed of progression can vary, the average life expectancy following diagnosis is three to nine years.[4][5]
The cause of Alzheimer's disease is poorly understood.[1] About 70% of the risk is believed to be genetic with many genes usually involved.[6] Other risk factors include a history of head injuries, depression, or hypertension.[1] The disease process is associated with plaques and tangles in the brain.[6] A probable diagnosis is based on the history of the illness and cognitive testing with medical imaging and blood tests to rule out other possible causes.[7] Initial symptoms are often mistaken for normal ageing.[1] Examination of brain tissue is needed for a definite diagnosis.[6] Mental and physical exercise, and avoiding obesity may decrease the risk of AD.[6] There are no medications or supplements that decrease risk.[8]
No treatments stop or reverse its progression, though some may temporarily improve symptoms.[2] Affected people increasingly rely on others for assistance, often placing a burden on the caregiver; the pressures can include social, psychological, physical, and economic elements.[9] Exercise programmes are beneficial with respect to activities of daily living and can potentially improve outcomes.[10] Treatment of behavioural problems or psychosis due to dementia with antipsychotics is common but not usually recommended due to there often being little benefit and an increased risk of early death.[11][12]
In 2015, there were approximately 48 million people worldwide with AD.[2] It most often begins in people over 65 years of age, although 4% to 5% of cases are early-onset Alzheimer's which begin before this.[13] It affects about 6% of people 65 years and older.[1] In 2010, dementia resulted in about 486,000 deaths.[14] It was first described by, and later named after, German psychiatrist and pathologist Alois Alzheimer in 1906.[15] In developed countries, AD is one of the most financially costly diseases.[16][17]

Prevention

Intellectual activities such as playing chess or regular social interaction have been linked to a reduced risk of AD in epidemiological studies, although no causal relationship has been found.
At present, there is no definitive evidence to support that any particular measure is effective in preventing AD.[117] Global studies of measures to prevent or delay the onset of AD have often produced inconsistent results. Epidemiological studies have proposed relationships between certain modifiable factors, such as diet, cardiovascular risk, pharmaceutical products, or intellectual activities among others, and a population's likelihood of developing AD. Only further research, including clinical trials, will reveal whether these factors can help to prevent AD.[118]

Medication

Although cardiovascular risk factors, such as hypercholesterolaemia, hypertension, diabetes, and smoking, are associated with a higher risk of onset and course of AD,[119][120] statins, which are cholesterol lowering drugs, have not been effective in preventing or improving the course of the disease.[121][122][123]
Long-term usage of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced likelihood of developing AD.[124] Evidence also support the notion that NSAIDs can reduce inflammation related to amyloid plaques.[124] No prevention trial has been completed.[124] They do not appear to be useful as a treatment.[125] Hormone replacement therapy, although previously used, may increase the risk of dementia.[126]

Lifestyle

People who engage in intellectual activities such as reading, playing board games, completing crossword puzzles, playing musical instruments, or regular social interaction show a reduced risk for Alzheimer's disease.[127] This is compatible with the cognitive reserve theory, which states that some life experiences result in more efficient neural functioning providing the individual a cognitive reserve that delays the onset of dementia manifestations.[127] Education delays the onset of AD syndrome, but is not related to earlier death after diagnosis.[128] Learning a second language even later in life seems to delay getting Alzheimer disease.[129] Physical activity is also associated with a reduced risk of AD.[128]

Diet

People who eat a healthy, Japanese, or Mediterranean diet have a lower risk of AD.[130] A Mediterranean diet may improve outcomes in those with the disease.[131] Those who eat a diet high in saturated fats and simple carbohydrates (mono- and disaccharide) have a higher risk.[132] The mediterranean diet's beneficial cardiovascular effect has been proposed as the mechanism of action.[133]
Conclusions on dietary components have at times been difficult to ascertain as results have differed between population-based studies and randomised controlled trials.[130] There is limited evidence that light to moderate use of alcohol, particularly red wine, is associated with lower risk of AD.[134] There is tentative evidence that caffeine may be protective.[135] A number of foods high in flavonoids such as cocoa, red wine, and tea may decrease the risk of AD.[136][137]
Reviews on the use of vitamins and minerals have not found enough consistent evidence to recommend them. This includes vitamin A,[138][139] C,[140][141] E,[141][142] selenium,[143] zinc,[144] and folic acid with or without vitamin B12.[145] Additionally vitamin E is associated with health risks.[141] Trials examining folic acid (B9) and other B vitamins failed to show any significant association with cognitive decline.[146] In those already affected with AD adding docosahexaenoic acid, an omega-3 fatty acid, to the diet has not been found to slow decline.[147]
Curcumin as of 2010 has not shown benefit in people even though there is tentative evidence in animals.[148] There is inconsistent and unconvincing evidence that ginkgo has any positive effect on cognitive impairment and dementia.[149] As of 2008 there is no concrete evidence that cannabinoids are effective in improving the symptoms of AD or dementia.[150] Some research in its early stages however looks promising.[151]

Friday 25 March 2016

Heart cancer

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Heart cancer is an extremely rare form of cancer that is divided into primary tumors of the heart and secondary tumors of the heart.

Primary

Most heart tumors begin with myxomas, fibromas, rhabdomyomas, and hamartomas, although malignant sarcomas (such as angiosarcoma or cardiac sarcoma) have been known to occur. In a study of 12,487 autopsies performed in Hong Kong seven cardiac tumors were found, most of which were benign.[1] According to Mayo Clinic: "At Mayo Clinic, on average only one case of heart cancer is seen each year."[1] In a study conducted in the Hospital of the Medical University of Vienna 113 primary cardiac tumour cases were identified in a time period of 15 years with 11 being malignant. The mean survival in the latter group of patients was found to be 26.2 ± 9.8 months.[2]
Primary malignant cardiac tumors (PMCTs) are even more rare. A study using the Surveillance, Epidemiology and End-Results (SEER) Cancer Registry from 1973-2011 found 551 case of PMCTs, with an incidence of 34 cases per million persons. The study also found that the incidence has doubled over the past 4 decades. The associated mortality was very high, with only 46% of patients are alive by 1 year. Sarcomas and Mesotheliomas had the worst survival, while lymphomas had better survival. When compared with extracardiac tumors, PMCTs had worse survival. [3]

Atrial myxoma

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An atrial myxoma is a benign tumor of the heart, commonly found within the left and right atria on the interatrial septum.

Causes

Myxomas are the most common type of primary heart tumor.[1]
The tumor is derived from multipotential mesenchymal cells and may cause a ball valve-type obstruction.
About 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are sometimes associated with tricuspid stenosis and atrial fibrillation.
Myxomas are more common in women. About 10% of myxomas are passed down through families (inherited). Such tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age than other myxomas.

Symptoms

Symptoms may occur at any time, but most often they accompany a change of body position. Symptoms may include:
The symptoms and signs of left atrial myxomas often mimic mitral stenosis. General symptoms may also be present, such as:
These general symptoms may also mimic those of infective endocarditis.

Diagnosis

A doctor will listen to the heart with stethoscope. A "tumor plop" (a sound related to movement of the tumor), abnormal heart sounds, or a murmur similar to the mid-diastolic rumble of mitral stenosis may be heard. These sounds may change when the patient changes position.
Echocardiogram of Atrial myxoma
Right atrial myxomas rarely produce symptoms until they have grown to be at least 13 cm (about 5 inches) wide.
Tests may include:
Blood tests: A FBC may show anemia and increased WBCs (white blood cells). The erythrocyte sedimentation rate (ESR) is usually increased.

Treatment

The tumor must be surgically removed. Some patients will also need their mitral valve replaced. This can be done during the same surgery.
Myxomas may come back if surgery did not remove all of the tumor cells.

Prognosis

An embolized fragment of an atrial myxoma in the iliac bifurcation.
Although a myxoma is not cancer, complications are common. Untreated, a myxoma can lead to an embolism (tumor cells breaking off and traveling with the bloodstream), which can block blood flow. Myxoma fragments can move to the brain, eye, or limbs.
If the tumor grows inside the heart, it can block blood flow through the mitral valve and cause symptoms of mitral stenosis. This may require emergency surgery to prevent sudden death.

Mediastinal tumor

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The mediastinum is the cavity that separates the lungs from the rest of the chest. It contains the heart, esophagus, trachea, thymus, and aorta. The mediastinum has three main parts: the anterior mediastinum (front), the middle mediastinum, and the posterior mediastinum (back).
The most common mediastinal masses are neurogenic tumors (20% of mediastinal tumors), usually found in the posterior mediastinum, followed by thymoma (15-20%) located in the anterior mediastinum.[1]
Masses in the anterior portion of the mediastinum can include thymoma, lymphoma, pheochromocytoma, germ cell tumors including teratoma, thyroid tissue, and parathyroid lesions. Masses in this area are more likely to be malignant than those in other compartments.[2][3]
Masses in the posterior portion of the mediastinum tend to be neurogenic in origin, and in adults tend to be of neural sheath origin including neurilemomas and neurofibromas.[1]
Lung cancer typically spreads to the lymph nodes in the mediastinum.
In several editions of Physical Diagnosis,[4] concerning mediastinal tumors the author writes:

Diagnosis

According to Christian1 the mediastinal neoplasms which are neither so rare nor so obscure as to make diagnosis practically impossible are: (1) Sarcoma (including lymphosarcoma, leucaemic growths, and Hodgkins' disease; (2) Teratoma and cyst.
Many signs and symptoms of a mediastinal tumor do not distinguish between these two principal classes of mediastinal tumor. However, on a radiograph usually the former class will have an irregular shape and the latter class will have a smooth spherical or ovoid shape. A large minority of patients with a mediastinal teratoma (including dermoid cyst) will cough up hair.[4] For a differential diagnosis, the key is to exclude aneurism.

Thursday 24 March 2016

Borderline personality disorder

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Borderline personality disorder (BPD) is a pattern of abnormal behavior characterized by impulsivity, unstable affect, inconsistent interpersonal relationships, and poor self-image. Some individuals also display uncontrollable anger and depression. The pattern is typically present by early adulthood, and occurs across a variety of situations and contexts.[3] Other symptoms include intense fears of abandonment, sensitivity to feelings of rejection, and irritability of vague or uncertain origin.[3][4] People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment.[5] Self-harm, suicidal behavior, and substance abuse are commonly associated.[6]
The cause of BPD is unclear but believed to involve both genetic and environmental factors. A study done on twins suggested the illness could be inherited. Traits such as impulsiveness and aggression can be attributed to temperament.[7] There is evidence that abnormalities of the frontolimbic networks are associated with many of the symptoms.[8] The disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders. Since a personality disorder is a pervasive, enduring, and inflexible pattern of maladaptive inner experiences and pathological behavior, there is a general reluctance to diagnose personality disorders before adolescence or early adulthood.[9] However, some practitioners emphasize that without early treatment, the symptoms may worsen.[10]
There is an ongoing debate about the terminology of this disorder, especially the suitability of the word "borderline".[11][12] The ICD-10 manual refers to the disorder as emotionally unstable personality disorder and has similar diagnostic criteria. In the DSM-5, the name of the disorder remains the same as in the previous editions

Wednesday 23 March 2016

anorexia

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Anorexia nervosa, often referred to simply as anorexia,[1] is an eating disorder characterized by a low weight, fear of gaining weight, a strong desire to be thin, and food restriction.[2] Many people with anorexia see themselves as overweight even though they are underweight.[2][3] If asked they usually deny they have a problem with low weight.[4] Often they weigh themselves frequently, eat only small amounts, and only eat certain foods. Some will exercise excessively, force themselves to vomit, or use laxatives to produce weight loss. Complications may include osteoporosis, infertility and heart damage, among others.[2] Women will often stop having menstrual periods.[4]
The cause is not known. There appear to be some genetic components with identical twins more often affected than non-identical twins.[3] Cultural factors also appear to play a role with societies that value thinness having higher rates of disease.[4] Additionally, it occurs more commonly among those involved in activities that value thinness such as high level athletics, modelling, and dancing.[4][5] Anorexia often begins following a major life change or stress inducing event. The diagnosis requires a significantly low weight. The severity of disease is based on body mass index (BMI) in adults with mild disease having a BMI of greater than 17, moderate a BMI of 16 to 17, severe a BMI of 15 to 16, and extreme a BMI less than 15. In children a BMI for age percentile of less than the 5th percentile is often used.[4]
Treatment of anorexia involves restoring a healthy weight, treating the underlying psychological problems, and addressing behaviors that promote the problem. While medications do not help with weight gain, they may be used to help with associated anxiety or depression.[2] A number of types of therapy may be useful including an approach where parents assume responsibility for feeding their child, known as Maudsley family therapy and cognitive behavioral therapy.[2][6] Sometimes people require admission to hospital to restore weight.[7] Evidence for benefit from nasogastric tube feeding; however, is unclear.[8] Some people will just have a single episode and recover while others may have many episodes over years.[7] Many complications improve or resolve with regaining of weight.[7]
Globally anorexia is estimated to affect two million people as of 2013.[9] It is estimated to occur in 0.9% to 4.3% of women and 0.2% to 0.3% of men in Western countries at some point in their life.[10] About 0.4% of young females are affected in a given year and it is estimated to occur ten times less commonly in males.[4][10] Rates in most of the developing world are unclear.[4] Often it begins during the teen years or young adulthood.[2] While anorexia became more commonly diagnosed during the 20th century it is unclear if this was due to an increase in its frequency or simply better diagnosis.[3] In 2013 it directly resulted in about 600 deaths globally up from 400 deaths in 1990.[11] Eating disorders also increase a person's risk of death from a wide range of other causes including suicide.[2][10] About 5% of people with anorexia die from complications over a ten-year period.[4] The term anorexia nervosa was first used in 1873 by William Gull to describe this condition

prostate cancer

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Early prostate cancer usually has no clear symptoms. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. These include frequent urination, nocturia (increased urination at night), difficulty starting and maintaining a steady stream of urine, hematuria (blood in the urine), and dysuria (painful urination). A study based on the 1998 Patient Care Evaluation in the US found that about a third of patients diagnosed with prostate cancer had one or more such symptoms, while two thirds had no symptoms.[13]
Prostate cancer is associated with urinary dysfunction as the prostate gland surrounds the prostatic urethra. Changes within the gland, therefore, directly affect urinary function. Because the vas deferens deposits seminal fluid into the prostatic urethra, and secretions from the prostate gland itself are included in semen content, prostate cancer may also cause problems with sexual function and performance, such as difficulty achieving erection or painful ejaculation.[13]
Advanced prostate cancer can spread to other parts of the body, possibly causing additional symptoms. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis, or ribs. Spread of cancer into other bones such as the femur is usually to the proximal or nearby part of the bone. Prostate cancer in the spine can also compress the spinal cord, causing tingling, leg weakness and urinary and fecal incontinence.[14]

Risk factors

A complete understanding of the causes of prostate cancer remains elusive.[15] The primary risk factors are obesity, age and family history. Prostate cancer is very uncommon in men younger than 45, but becomes more common with advancing age. The average age at the time of diagnosis is 70.[16] However, many men never know they have prostate cancer. Autopsy studies of Chinese, German, Israeli, Jamaican, Swedish, and Ugandan men who died of other causes have found prostate cancer in 30% of men in their 50s, and in 80% of men in their 70s.[17] Men who have first-degree family members with prostate cancer appear to have double the risk of getting the disease compared to men without prostate cancer in the family.[18] This risk appears to be greater for men with an affected brother than for men with an affected father. In the United States in 2005, there were an estimated 230,000 new cases of prostate cancer and 30,000 deaths due to prostate cancer.[19] Men with high blood pressure are more likely to develop prostate cancer.[20] There is a small increased risk of prostate cancer associated with lack of exercise.[21] A 2010 study found that prostate basal cells were the most common site of origin for prostate cancers.[22]

Genetic

Genetic background may contribute to prostate cancer risk, as suggested by associations with race, family, and specific gene variants. Men who have a first-degree relative (father or brother) with prostate cancer have twice the risk of developing prostate cancer, and those with two first-degree relatives affected have a fivefold greater risk compared with men with no family history.[23] In the United States, prostate cancer more commonly affects black men than white or Hispanic men, and is also more deadly in black men.[24][25] In contrast, the incidence and mortality rates for Hispanic men are one third lower than for non-Hispanic whites. Studies of twins in Scandinavia suggest that 40% of prostate cancer risk can be explained by inherited factors.[26]
No single gene is responsible for prostate cancer; many different genes have been implicated. Mutations in BRCA1 and BRCA2, important risk factors for ovarian cancer and breast cancer in women, have also been implicated in prostate cancer.[27] Other linked genes include the Hereditary Prostate cancer gene 1 (HPC1), the androgen receptor, and the vitamin D receptor.[24] TMPRSS2-ETS gene family fusion, specifically TMPRSS2-ERG or TMPRSS2-ETV1/4 promotes cancer cell growth.[28]
Two large genome-wide association studies linking single nucleotide polymorphisms (SNPs) to prostate cancer were published in 2008.[29][30] These studies identified several SNPs which substantially affect the risk of prostate cancer. For example, individuals with TT allele pair at SNP rs10993994 were reported to be at 1.6 times higher risk of prostate cancer than those with the CC allele pair. This SNP explains part of the increased prostate cancer risk of African American men as compared to American men of European descent, since the C allele is much more prevalent in the latter; this SNP is located in the promoter region of the MSMB gene, thus affects the amount of MSMB protein synthesized and secreted by epithelial cells of the prostate.[31]

Dietary

While some dietary factors have been associated with prostate cancer the evidence is still tentative.[32] Evidence supports little role for dietary fruits and vegetables in prostate cancer occurrence.[33] Red meat and processed meat also appear to have little effect in human studies.[34] Higher meat consumption has been associated with a higher risk in some studies.[35]
Lower blood levels of vitamin D may increase the risk of developing prostate cancer.[36]
Folic acid supplements have no effect on the risk of developing prostate cancer.[37]

Medication exposure

There are also some links between prostate cancer and medications, medical procedures, and medical conditions.[38] Use of the cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk.[39]
Infection or inflammation of the prostate (prostatitis) may increase the chance for prostate cancer while another study shows infection may help prevent prostate cancer by increasing blood to the area. In particular, infection with the sexually transmitted infections chlamydia, gonorrhea, or syphilis seems to increase risk.[40] Finally, obesity[41] and elevated blood levels of testosterone[42] may increase the risk for prostate cancer. There is an association between vasectomy and prostate cancer; however, more research is needed to determine if this is a causative relationship.[43]
Research released in May 2007, found that US war veterans who had been exposed to Agent Orange had a 48% increased risk of prostate cancer recurrence following surgery.[44]

Infectious disease

An association with gonorrhea has been found, but a mechanism for this relationship has not been identified.[6]
In 2006, a previously unknown retrovirus, Xenotropic MuLV-related virus or XMRV, was associated with human prostate tumors,[45] but subsequent reports on the virus were contradictory,[46][47] and the original 2006 finding was instead due to a previously undetected contamination.[48] The journals Science and PlosONE both retracted XMRV related articles.[49][50]

Sexual factors

Several case-control studies have shown that having many lifetime sexual partners or starting sexual activity early in life substantially increases the risk of prostate cancer.[51][52][53]
While the available evidence is weak,[54] tentative results suggest that frequent ejaculation may decrease the risk of prostate cancer.[55] A study, over eight years, showed that those that ejaculated most frequently (over 21 times per month on average) were less likely to get prostate cancer.[56] The results were broadly similar to the findings of a smaller Australian study.[57]