Day: July 4, 2024

Jul 04

On ultrasonographic features of MUMPC

Introduction Mucinous breast carcinoma (MBC) is a comparatively rare specific carcinoma of breast featuring much extracellular mucus and favorable prognosis.1,2 Moreover, MBC takes a proportion of 1–4% in all primary breast cancers approximately. Several factors can influence the prognosis of MBC, including age, stage of the disease, and specific histological features. Although MBC is generally associated with a favorable prognosis, older age at diagnosis can be a negative prognostic factor. Elderly patients may have comorbidities or age-related physiological changes that can impact treatment decisions and overall outcomes. In the existing literature, MBC morbidity is rather high among the elderly, that is about 6–7%.3 Pathologically, there are two subtypes of MBC according to the content of intratumoral mucus. One is pure mucinous breast carcinoma (PMBC); and the other is mixed mucinous breast carcinoma (MMBC). While PMBC is merely constituted by tumor cells producing mucus and the proportion taken by mucus components in the tumor is at least 90%, mucus in MMBC takes a proportion of 50–90% and is also mixed with infiltrating ductal epithelium.4,5 As demonstrated in many studies, PMBC is an indolent tumor characterized by good prognosis and low axillary lymph node metastasis rate;6,7 and by contrast, MMBC exhibits distinct biological behavior from PMBC.8 In recent years, it is clarified in some research that some PMBC is as invasive as MMBC.6,9 For example, Ranade et al point out10 that micropapillary structures can be observed in 60% PMBCs with axillary node positive and 14% PMBCs with axillary node negative. This manifests that the micropapillary structure plays a critical role in progression of axillary node metabasis. As early as 2002, a novel subtype of PMBC was reported by Ng11 for the first time; and it was named mucinous carcinoma with micropapillary pattern, or MUMPC for short. However, MUMPC alignment is believed in some literature to be similar to that of invasive micropapillary carcinoma; and MUMPC is more inclined to be associated with biological behavior of infiltrating tumors, such as lymphatic metastasis and lymphovascular invasion. According to Barbashina et al.12 MUMPC is an invasive subtype in clinics of mucinous breast cancers and should be differentiated from conventional pure mucinous breast carcinoma without micropapillary architecture (cPMBC). Micropapillary patterns consist of small, finger-like projections of tumor cells floating within mucus pools. Micropapillary structures have been associated with increased invasiveness, lymphatic metastasis, and poorer clinical outcomes in various types of breast carcinoma. Understanding the significance of micropapillary patterns is essential for accurate diagnosis and management of these tumors. Therefore, further investigation into the role and implications of micropapillary patterns in mucinous breast carcinoma, particularly in MUMPC, is warranted for better characterization and treatment strategies. To our knowledge, MUMPC is seldom explored at present, especially relevant literature describing its ultrasound findings. Therefore, the Breast Imaging Reporting and Data System (BI-RADS) was utilized in this paper to carry out ultrasound examinations on MUMPC, analyze ultrasound features of MUMPC, and then compare MUMPC with cPMBC or MMBC. Methods Participants We retrospectively analyzed 872 patients with breast cancer who received relevant therapies at Suzhou Municipal Hospital from January 2015 to June 2019. Based on the classification of breast neoplasms by the World Health Organization (WHO), content of mucus in PMBC exceeds 90%, while that of MMBC is below 90%.13 As for the lower limit of mucus content in MMBC, it remains unsolved. The corresponding inclusion criteria are as follows: (1) the performance status of Eastern Cooperative Oncology Group (ECOG) is 0 or 1; (2) the patients are histopathologically diagnosed with MBC; (3) the patients should experience breast ultrasound and surgical excision; and (4) clinical pathological and ultrasonic data of the patients should be complete. Regarding the exclusion criteria, they are: (1) combined with distant metastasis; (2) being combined with other malignant tumors or a history of tumors; (3) bilateral breast cancers; and (4) male. In strict accordance with the above inclusion and exclusion criteria, 49 patients were incorporated at last, taking a proportion of 5.62% in the total number of patients with breast cancer, showing 49 lesions in total. All of them are females aged 28~84 (mean: 57; and median: 56), including 9 cases with MUMPC and 21 cases with MMBC. This study has been approved by the Ethics Committee of Suzhou Municipal Hospital; and the informed consent has been gained from all patients. Ultrasound Examinations Forty-nine patients were all subjected to ultrasonography of breast cancer by using a linear array probe (5–15 MHz). Ultrasound images were judged by a physician-in-charge uninformed of the corresponding pathological outcomes. More particularly, results of ultrasound examinations were also retrospectively analyzed by a sonographer with at least 6 years of experience based on standards specified in BI-RADS categories of image features. Sizes, shapes (regular/irregular), edges (smooth and complete or not), halo signs (yes or no), posterior echo (no alterations, enhancement or attenuation), internal echo (solid and cystic mixed echo, or solid hypoecho/isoecho), malignant halo (yes or no) and lymph node metastasis were all recorded. Besides, vascularity (being present or not) of breast lesions was retrospectively analyzed. By means of Adler’s semi-quantitative grading, blood flow conditions of lesions were classified into 4 grades: (1) Grade 0: No blood flow signals; (2) Grade 1: A few blood flow signals (characterized by 1 or 2 dotted/short rod-like color blood flow signals); (3) Grade 2: Medium blood flows (characterized by 3 or 4 dotted color blood flow signals, or by longer blood flows, probably half of the corresponding lump in length); and (4) Grade 3: Abundant blood flows (characterized by over 4 dotted color blood flow signals, or by two long blood flows). Tissue Pathology Breast lesions of all patients were surgically removed. For surgical pathological reports verified by well-experienced pathologists of Suzhou Municipal Hospital, they were all reviewed together with pathological results of ipsilateral lymph node metastasis (LNM). Statistical Analysis All outcomes are analyzed by SPSS 20.0 applicable to Windows (Microsoft). Both x2 and Fisher’s precise tests were performed to analyze shapes, edges, halo signs, posterior echo, internal echo, malignant halo, lymph node metastasis and grades

Jul 04

Early clinical trial highlights cancer vaccines as potential affordable, safe and effective breast cancer treatment

Before they were able to develop the promising HER2 DNA vaccine highlighted in this study, figuring out how to make an effective vaccine against cancer took some trial and error. Dhillon explained that “the real breakthrough came about eight years ago when we developed an understanding of how the same protein, or antigen, could have different responses from the immune system.” For instance, one part of the protein may elicit a strong tissue destructive response that kills off cancer cells, while another part may promote disadvantageous immune suppression. Excitingly, Dhillon exclaimed “we’ve figured out this system and now we’ve got a hammer to combat cancer.” Knowing that each cancer comes with unique treatment challenges, the CVI researchers designed vaccines to work at three stages of cancer therapy: cancer prevention, treatment, and recurrence. While these vaccines aren’t designed to work quite like our yearly flu shot, they’re aimed to either help prevent cancer in high-risk patients (prevention or interception), work in conjunction with current chemotherapies to boost their effectiveness (treatment) or help keep cancers from coming back after they’re initially treated (recurrence). Cancer vaccines all generally work by “training the immune system to recognize cancer cells expressing specific proteins as dangerous, setting off alarms and signaling to attack those cells,” Dhillon explained. These trained T cells survey the body including the brain, which is a common site of breast cancer metastasis and difficult to target since many drugs cannot cross the blood-brain barrier. Thus, this approach can overcome one of the current challenges of drug-based therapeutic regimens. To focus on treating this aggressive breast cancer, with hammer in hand, Disis and the CVI research team developed a DNA vaccine encoding the HER2 protein intracellular domain (thus training the immune system to attack HER2-expressing cancer cells) to treat 66 patients with stage III or IV HER2-positive breast cancer. Prior to vaccination, all patients had been effectively cured of cancer through treatment with chemotherapy drugs like Trastuzumab. Although patients were technically cancer-free at this pre-vaccine stage, HER2-positive breast cancers are aggressive with a high probability of recurrence and metastasis. But this is where the vaccine steps in! The patients were given one of three monthly doses of this DNA vaccine over a 3-month period. Vaccines were found to be very safe with extremely mild adverse effects, similar to the aches and chills one might experience from COVID-19 or flu vaccines- a walk in the park compared to current, more toxic, cancer treatments. Disis and colleagues then assessed the patients’ immune responses to the vaccines by analyzing blood samples taken at various post-vaccination timepoints. Teaming up with Dr. Katherine Guthrie, a Professor in the Cancer Prevention Program at Fred Hutch, to analyze the patient data, the researchers observed a strong immune response to all doses of vaccines administered. However, the middle dose seemed to be the most effective with a sustained immune response over time. This immune response was accompanied by an increase in central memory T cells, which are important for long-term immunity. Furthermore, at this dose, the mean survival after a 10-year period for these late stage breast cancer patients was ~85% among stage III and IV patients, remarkably with all of the stage III women still alive today. Comparatively, the survival rate for stage III/IV breast cancer patients receiving currently available chemotherapies is only 50% at just 4.5 years post-treatment. The remarkable increased survival rates for this phase I clinical trial emphasize the effectiveness of vaccines for this aggressive breast cancer and bring hope that effective, affordable and accessible vaccine-based cancer treatments might be a future reality for other cancers. Partnering with Aston Sci., the vaccine developed at CVI is headed into phase II randomized clinical trials which will be expanded to include patients with other types of difficult-to-treat breast cancers who might benefit from a HER2-targeted therapeutic approach. It is important to note that final approval by the FDA for use outside of clinical trials will require even larger phase III randomized trials that rigorously test efficacy. As an off the shelf cancer therapy, vaccines are emerging as a promising new treatment that could be broadly available, affordable, safe, and effective, with adverse effects being no worse than a COVID-19 shot. In addition to the research teams at CVI, these exciting breakthroughs would not have been possible without the work of several key players, including the UW/Fred Hutch/Seattle Children’s Cancer Consortium Women’s Cancer Program, which helped recruit patients for clinical trials, and Fred Hutch’s GMP facility which manufactured the vaccines for this work. While Dhillon is excited about the scientific results of this study, she emphasized how integral the patients are in this. Dhillon stressed how grateful CVI is for the patients, “as nothing we do would be possible without them. We keep the patients at the center of everything we do.” Living this value, the CVI team gives back to patients through hosting patient reunion and educational events to teach people about cancer vaccines and clinical trials, with a focus on holding these events for diverse communities that are not well represented in clinical trials. Underscoring the strong relationship CVI builds with their patients, Dhillon shared that more than 10 years after the HER2 vaccine clinical trial, one patient recently called her to say: “I’m still here!” This simple phone call may not have been possible without this breast cancer vaccine. For those interested in learning more clinical trials, please check out the resources below! -To learn more about current UW CVI clinical trials and the contact information for these studies for those interested in enrolling, see here. -To learn more about how to participate in clinical trials and the risks and benefits involved, see here.

Jul 04

Nearly 8,000 blood tests recalled over risk of missed heart attack diagnosis

QuidelOrtho has recalled nearly 8,000 potentially faulty blood tests meant to help doctors quickly determine whether a patient is having a heart attack. The tests inaccurately showed low levels of troponin, a protein that indicates damage to the heart. A false negative could lead doctors to mistakenly conclude their patient is not having a heart attack, delaying diagnosis or treatment when time is of the essence. advertisement The device maker, which also sells products like the QuickVue Covid-19 antigen test, sent letters to health systems in May telling them to immediately stop using the test. The Food and Drug Administration classified the recall as serious, because problems with the product could result in serious injury or death. QuidelOrtho has reported 41 complaints, but no injuries or deaths so far. The tests, which use either a blood or plasma sample, promise to return results in under half an hour. They are used in emergency rooms to triage patients suspected of having a heart attack. The FDA said the patients most at risk are those with zero or abnormal heart attack symptoms, for whom a diagnosis would be easy to miss without an accurate lab test. advertisement The company advised using a different testing method to detect heart attacks. If none are available, doctors should be extra wary of the blood panel’s readings, perform multiple tests to confirm low troponin levels, and also reference data from EKGs and other imaging. San Diego-based QuidelOrtho said the error is due to a “raw material issue” in its recall record. The issue caused the test to falsely pick up 30% less troponin than is present. The company did not respond to STAT’s request for more information on the error. The test maker’s last serious recall was in 2021 for reports of false negatives from its Lyra PCR Covid-19 test when used with certain lab equipment. The notice impacted more than 18,000 test kits.

Jul 04

What Is Palliative Care?

What Is Palliative Care? Palliative care is a specialized form of healthcare that focuses on providing treatment and comfort to individuals with serious illnesses. It involves a team of specially trained healthcare providers who work together to address the physical, emotional, and psychological needs of patients. The primary objective of palliative care is to enhance the quality of life for patients while also providing support to their family members. It aims to alleviate symptoms and reduce stress associated with the illness. Despite the significant need for palliative care, only a small percentage of those who require it actually receive it. Out of the estimated 56.8 million individuals in need, only 14% have access to palliative care services. It is important to note that palliative care is not determined by prognosis but rather by a person’s needs. It is suitable for individuals of any age and at any stage of a serious illness, and can be provided in conjunction with curative treatments aimed at addressing the underlying disease. By prioritizing the holistic well-being of patients and their families, palliative care offers comprehensive support to improve their overall experience and promote a better quality of life. What Is Included in Palliative Care? Palliative care is highly individualized, with each person’s care plan tailored to address their specific needs. A comprehensive palliative care plan encompasses a wide range of issues and considerations, aiming to provide holistic support to the patient. The following elements are typically taken into account when developing a palliative care plan: 1. Emotional Needs: Coping with a serious illness can evoke a spectrum of emotions. Palliative care can address psychological aspects such as depression, anxiety, fear, and stress, providing emotional support and counseling. 2. Physical Needs: Palliative care specialists address physical symptoms associated with the illness, including pain, fatigue, shortness of breath, nausea, vomiting, and insomnia. They work to ensure the patient’s comfort and alleviate physical distress. 3. Spiritual Needs: Serious illness can prompt individuals to reevaluate their beliefs and find meaning in their situation. Palliative care teams assist patients in exploring their spiritual concerns, helping them find peace, acceptance, and reconciliation with their beliefs. 4. Practical Needs: Palliative care extends support to practical matters, such as addressing financial concerns, legal issues, insurance questions, and employment challenges. The care team can guide patients and their families in making decisions and completing necessary documents, such as advance directives. 5. Caregiver Needs: Caregivers play a crucial role in supporting their seriously ill loved ones, but they can face their own challenges and burdens. Palliative care recognizes the needs of caregivers and provides resources, education, and guidance on caregiving strategies, helping them cope with their responsibilities and strike a balance between caring for their loved one and attending to their own well-being. By considering and addressing these various aspects, palliative care aims to provide comprehensive support that goes beyond medical treatment, fostering overall well-being for both patients and their families. Who Needs Palliative Care? Palliative care is not limited to a specific stage of a serious illness and can be provided at any point in the disease trajectory. Some experts even advocate for early integration of palliative care upon diagnosis. By engaging in palliative care early on, individuals can benefit from improved quality of life, symptom management, and a better understanding of their treatment options. Palliative care is inclusive and available to individuals with any serious illness that impacts their daily functioning, quality of life, or carries an increased risk of mortality. The range of illnesses appropriate for palliative care is vast, and some common examples include heart failure, chronic obstructive pulmonary disease (COPD), cancer, dementia, COVID-19, Parkinson’s disease, kidney failure, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis, and stroke. In fact, the American Society of Clinical Oncology recommends that all individuals with advanced cancer receive palliative care alongside their cancer treatments. They also suggest that patients be offered palliative care no later than eight weeks after their cancer diagnosis. This highlights the importance of early integration of palliative care in managing a serious illness and optimizing the overall care experience for patients and their families. Where to Receive Palliative Care Palliative care can be delivered in diverse settings to accommodate the individual’s needs and preferences. These settings may include hospitals, long-term care facilities, cancer centers, outpatient palliative care clinics, specialized clinics, or even in the comfort of one’s home. A comprehensive palliative care team is typically composed of various healthcare professionals who specialize in this field. These professionals work collaboratively to address the multifaceted needs of the individual. Some common members of a palliative care team include: – Doctors and physicians: They provide medical expertise, manage symptoms, and coordinate the overall care plan. – Physician assistants: They work closely with doctors to provide medical care, perform assessments, and assist with treatment plans. – Nurses and nurse practitioners: They provide hands-on care, monitor symptoms, administer medications, and offer support and education. – Registered dietitians: They provide nutritional guidance and ensure the individual’s dietary needs are met. – Psychologists: They offer emotional and psychological support, counseling, and strategies for coping with distress and anxiety. – Social workers: They provide support, counseling, and assistance with practical matters such as advance care planning, financial concerns, and navigating healthcare systems. – Massage therapists: They provide therapeutic touch and massage techniques to help alleviate physical discomfort and promote relaxation. – Chaplains or spiritual counselors: They offer spiritual and emotional support, guidance, and comfort according to the individual’s belief system. By involving a diverse team of professionals, palliative care aims to address the physical, emotional, social, and spiritual aspects of care, providing a holistic approach to support individuals and their families. What Are The Benefits of Palliative Care? The implementation of a palliative care plan can have significant positive impacts on patients and their loved ones. Here are some ways in which palliative care can benefit individuals and their families: 1. Improved quality of life: Palliative care focuses on enhancing the patient’s quality of life by addressing

Jul 04

What Is Sciatica?

What Is Sciatica? Painful and debilitating, sciatica results from the sciatic nerve becoming inflamed, compressed, or damaged.1 When it comes to nerves, the sciatic nerve takes the cake. It begins with the lumbar region and spreads to the back of both legs and the soles of the feet. With the aid of the sciatic nerve, you can move your muscles and experience feeling in your legs.2 Pain, burning, or paresthesias (sometimes known as "pins and needles") that originate in the buttocks and go down the leg are all possible outcomes of nerve injury or disruption. In extremely rare cases, the afflicted leg(s) may also become weak.1 Sciatic pain can be debilitating, but it often goes away within four to six weeks. When conventional treatments fail, there are a number of alternative and integrative methods available to help. Sciatica Symptoms Sciatica refers to pain or other symptoms that arise when the sciatic nerve, which runs from the lower back down through the hips and buttocks to each leg, becomes compressed or irritated. It is important to note that sciatica specifically pertains to the symptoms resulting from this nerve issue, rather than general low back pain or leg pain. The most common symptom associated with sciatica is one-sided low back pain that radiates down the leg on the affected side. Some individuals may also experience pain or a burning sensation in the buttock on the affected side. Certain movements such as sneezing, coughing, or physical activity may exacerbate the discomfort. In addition to pain, individuals with sciatica often report sensory changes in the leg, including the foot. These sensations can be challenging to describe but may include feelings of pins and needles, numbness and tingling, abnormal temperature sensations (such as coldness or heat), or a shooting pain or discomfort that travels down the leg. In rare cases, individuals may also experience weakness in the affected leg or a sensation of heaviness. What Causes Sciatica? Sciatica can occur when the sciatic nerve at the spine is irritated or compressed. In older adults, common causes of sciatica include bone spurs and arthritis in the spine. Younger adults may experience sciatica due to herniated discs. Other conditions that can cause sciatica symptoms include bulging discs, lumbar spinal stenosis, spondylolisthesis, lumbar epidural hematoma, tumors, and injuries. Certain factors can increase the risk of developing sciatica, such as being in your 40s, having occupations that involve prolonged unusual positions, and a history of previous sciatica episodes. Interestingly, regular physical activity may both increase the likelihood of recurrent sciatica in those who have had it before and decrease the likelihood of developing it for those who have never experienced it. If you suspect you may have sciatica or are at risk of developing it, it is important to consult a healthcare professional for an accurate diagnosis and appropriate management. They can assess your specific condition, provide guidance on pain relief, and recommend treatments to alleviate the underlying cause of sciatica. Diagnosis When you consult a healthcare provider for suspected sciatica, they will likely start by asking about your symptoms and medical history. This information helps them in forming a diagnosis. They may also conduct a physical examination to assess your mobility and pain levels, which may involve exercises like squatting, walking on your heels and toes, and a straight-leg test. The straight-leg test involves lying on your back while your provider slowly raises your leg. You inform them when you start to experience pain, and the height at which the pain occurs can provide insights into the origin of the pain. In many cases, imaging such as X-rays or MRIs is not initially necessary as it does not typically change the course of treatment. Structural changes in the spine are common as people age, and these changes may not be directly related to the sciatica symptoms. However, imaging may be recommended if the symptoms persist or if there is a need to identify any underlying causes that require more targeted intervention. Treatments for Sciatica Most cases of sciatica resolve on their own within four to six months without medical intervention. However, if pain persists or is severe, medical treatment may be necessary. Healthcare providers typically begin with conservative management approaches and progress to more invasive treatments if needed. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen are not recommended for treating sciatica. Instead, using hot and cold packs on the affected area and staying moderately active may help alleviate symptoms. If conservative measures are not sufficient, healthcare providers may prescribe medications such as corticosteroid shots to reduce inflammation, anticonvulsants to alleviate nerve pain, muscle relaxants, or opioid pain medications. However, the effectiveness of some of these medications for sciatica is still under debate. Studies have suggested that acupuncture can provide pain relief for sciatica, and other complementary therapies like spinal manipulation and deep tissue massage may also help alleviate pain depending on the underlying cause of the sciatica. It’s important to consult with your healthcare provider to discuss these options and determine their suitability for your specific case. In some cases, surgery may be considered, although studies have shown that surgical and non-surgical treatments for sciatica can yield similar improvements in symptoms after two years. The decision to undergo surgery is typically made after careful consideration of individual factors and consultation with a healthcare provider. Prevention Research suggests that certain individuals may have a genetic predisposition to developing sciatica. However, there are also lifestyle factors that can influence the likelihood of experiencing sciatica. Here are some lifestyle changes that may help reduce the risk of developing sciatica: 1. Stay physically active: Engaging in regular physical activities such as walking, cycling, and exercises that promote core strength and flexibility can help maintain spinal health and reduce the risk of sciatica. 2. Quit smoking: Smoking has been associated with an increased risk of developing sciatica. Quitting smoking can not only improve overall health but also decrease the likelihood of developing sciatic nerve-related pain. 3. Maintain a healthy weight:

Jul 04

What Is Kyphosis?

What Is Kyphosis? Kyphosis is a condition characterized by an abnormal curvature of the spine. It typically involves a forward curve in the vertebrae at the upper part of the back. This natural curve is present in most individuals to some extent and does not usually cause any pain or postural issues. However, when the curvature exceeds 50 degrees, it is considered excessive kyphosis or hyperkyphosis, which can lead to discomfort and noticeable postural changes. Excessive kyphosis is often referred to as kyphosis, hunchback, or roundback. While excessive kyphosis can occur at any age, it is more commonly observed in individuals over the age of 40 due to the natural aging process. Some forms of kyphosis may be identified in infancy or during adolescence, although they are relatively rare. Types of Kyphosis There are a few different kinds of kyphosis, primarily defined by the cause of the condition. Postural Kyphosis Postural kyphosis develops when the muscles supporting the back and spine are stretched and subsequently weaken over time. It is more commonly observed in younger individuals who frequently slouch or carry heavy bags, putting strain on the muscles and leading to postural imbalances. In older individuals, postural kyphosis is often associated with age-related muscle weakness, which contributes to poor posture and increases the risk of developing the condition. The weakening of the muscles can further exacerbate the curvature of the spine, leading to an increased likelihood of postural kyphosis. Scheuermann Disease Scheuermann disease, also referred to as Scheuermann’s kyphosis or juvenile kyphosis, is characterized by the presence of abnormally shaped vertebrae. This condition typically emerges during the growth phase in adolescence. Diagnosis of Scheuermann disease commonly occurs during the teenage years, and it is observed more frequently in males than females. The prevalence of Scheuermann disease in the United States is estimated to range from 1% to 8% of the population. Congenital Kyphosis Congenital kyphosis is a type of kyphosis that arises from abnormalities in the development of the spine during fetal development. It is characterized by the presence of missing or fused vertebrae. Typically, children with congenital kyphosis are diagnosed once they begin walking and exhibit noticeable symptoms. Although congenital kyphosis is relatively rare, it can be significantly debilitating and impact a child’s mobility and overall function. Kyphosis Symptoms Kyphosis primarily manifests as the abnormal curvature of the spine, resulting in a rounded hump on the back and rounded shoulders. This physical characteristic is the main symptom associated with kyphosis. However, individuals with kyphosis may also experience other symptoms, which can vary in severity and include: Back pain: Some individuals may experience pain in the lower or middle back, which can range from mild discomfort to more severe and persistent pain. Neck pain: In some cases, kyphosis can contribute to neck pain and stiffness, particularly if the abnormal spinal curvature affects the upper back and neck region. Stiffness: The presence of kyphosis can lead to stiffness and reduced flexibility around the back and spine, making it challenging to perform certain movements comfortably. Tenderness: The affected area of the spine may be tender to touch, particularly in the region of the abnormal curvature. Fatigue: Some individuals with kyphosis may experience fatigue or a sense of increased physical effort due to the altered alignment and strain on the back muscles. What Causes Kyphosis? Kyphosis can have various causes depending on the type of kyphosis. Here are the main factors associated with each type: Postural kyphosis: Age: Kyphosis is more prevalent in older adults, especially those aged 60 and above. It often progresses more rapidly during menopause. Age-related osteoporosis, which weakens the bones, is a common underlying condition associated with kyphosis in older individuals. Poor posture: Prolonged slouching, habitual leaning back, and carrying heavy bags can strain and stretch the muscles and ligaments in the back, leading to postural kyphosis. Spinal injury or disease: Trauma to the spine, as well as various conditions such as arthritis, disc degeneration, tuberculosis, and hormone-related diseases, can contribute to the development of kyphosis. Other conditions: Kyphosis can arise from conditions affecting spinal growth, muscles around the spine, and overall posture. These may include scoliosis, Paget’s disease, Gibbus deformity (vertebral collapse), muscular dystrophy, cerebral palsy, and spinal tumors, among others. Scheuermann disease: The exact cause of Scheuermann disease is not fully understood, but it is believed to involve genetic factors. In this condition, at least three consecutive vertebrae in the spine wedge together, typically before puberty. The underlying mechanisms and triggers of this abnormal vertebral wedging are still being investigated. Congenital kyphosis: Congenital kyphosis is attributed to abnormal development during fetal growth. It can result from either the absence of one or more vertebrae or the fusion of two or more vertebrae in the spine. These structural abnormalities can lead to progressive kyphosis as the child grows. Risk Factors Certain factors can increase the likelihood of developing postural kyphosis or Scheuermann disease. Here are some key risk factors associated with each condition: Postural kyphosis: Age: The risk of developing postural kyphosis tends to increase with age, particularly in individuals over the age of 40. Gender: Women, especially after menopause, have a higher risk of developing postural kyphosis. Osteoporosis or degenerative diseases: Conditions that weaken the bones, such as osteoporosis, can contribute to the development of postural kyphosis. Other degenerative diseases affecting the spine may also increase the risk. Spinal injury: Any past injury to the spine can be a risk factor for developing postural kyphosis. Persistent poor posture: Maintaining poor posture over an extended period, such as slouching or adopting an imbalanced stance, can contribute to the development of postural kyphosis. Scheuermann disease: Gender: Males have a higher likelihood of developing Scheuermann disease compared to females, with a male-to-female ratio of approximately 2:1. Age: Scheuermann disease typically manifests during adolescence, and the risk is highest during this period. How is Kyphosis Diagnosed? When evaluating a suspected case of kyphosis, healthcare providers may employ various diagnostic techniques to confirm the condition and determine its underlying causes. These

Jul 04

5 Signs You Might Be “Skinny Fat”

5 Signs You Might Be ‘Skinny Fat’ When considering health, it’s important to recognize that weight and body size alone do not provide a complete picture. The traditional emphasis on numbers like pounds on a scale or body-mass index (BMI) may not accurately reflect a person’s overall health status. Simply having a weight within the normal range for their height does not guarantee good health. Sometimes referred to as "skinny fat," normal-weight obesity is a phenomenon where individuals have a normal BMI (between 18.5 to 24.9 kg/m2) but a high percentage of body fat. According to a study published in PLoS One, this condition can affect a significant portion of the population, ranging from 9% to 34%. These individuals may outwardly appear healthy but can have elevated levels of body fat and inflammation. Consequently, they are at higher risk for conditions such as diabetes and cardiovascular problems, despite their seemingly normal weight. It is worth noting that weight alone is not always a definitive predictor of disease risk. Some individuals with obesity can still be metabolically healthy, meaning they do not exhibit risk factors commonly associated with conditions like insulin resistance or atherosclerosis (hardening of the arteries). Understanding these nuances of weight as a predictor of disease is a complex task for researchers. The only way to ascertain metabolic health is by undergoing tests to measure blood pressure, cholesterol levels, and blood sugar levels. Consulting with a healthcare provider and undergoing these assessments can provide a more accurate assessment of an individual’s overall health. There are certain warning signs that may indicate a risk for normal-weight obesity. If you identify with these characteristics, it is essential to discuss your concerns with a healthcare provider to ensure that you are physically fit and maintain well-being both internally and externally. Extra Weight Around Your Waist The distribution of weight in your body can significantly impact your risk of developing certain diseases. Specifically, carrying excess weight around your abdomen can be particularly concerning. However, it’s important to note that the way fat is stored differs between biological males and females. Typically, bodies with female anatomy tend to have a "pear" shape, with more fat distributed in the hip and thigh area, while bodies with male anatomy tend to have an "apple" shape, with more fat accumulated around the waist. A study conducted in 2015 revealed that individuals who do not meet the criteria for being overweight or obese but still have excess fat around their waist are at a higher risk of premature death compared to individuals with overweight or obesity. The researchers used a measurement called waist-to-hip ratio, which proved to be a more accurate predictor of cardiovascular disease-related mortality than BMI. "Fat around the middle" is particularly problematic as it is associated with insulin resistance and the production of inflammatory proteins, according to Dr. Jialal. Furthermore, this type of fat tends to accumulate gradually, making it easy to overlook the warning signs. Therefore, if you notice a gradual increase in belt size or tighter-fitting pants around the waist, it should serve as a red flag and prompt you to take action. Monitoring your waist circumference and being aware of changes in your body shape can be valuable indicators of potential health risks associated with abdominal fat. Seeking guidance from a healthcare provider can help you assess your risk factors, develop appropriate strategies for weight management, and adopt a healthy lifestyle to mitigate the adverse effects of excess abdominal fat. Low Lean Muscle Mass Even if you don’t have overweight or obesity, it’s still possible to have elevated levels of body fat, particularly if you lack sufficient lean muscle mass. This can be a concern, especially if you lead a sedentary lifestyle with minimal physical activity. Engaging in regular aerobic exercises such as brisk walking, cycling, or running is crucial for maintaining a healthy heart and lungs. However, incorporating regular strength training exercises is equally important. Strength training helps in building muscle, boosting metabolism, and facilitating fat burning. If you’re looking for a cost-effective way to increase lean muscle mass, consider incorporating push-ups into your exercise routine. A study involving male participants found that those who were able to perform more push-ups had a lower risk of developing cardiovascular conditions. However, regardless of your gender, building upper body and core strength through exercises like push-ups can be beneficial for overall fitness. Increasing lean muscle mass not only contributes to a healthier body composition but also provides various health benefits. It can enhance metabolic function, improve physical performance, and support overall well-being. It’s important to note that engaging in any exercise routine should be done in consultation with a healthcare professional, especially if you have any pre-existing health conditions or concerns. By combining regular aerobic activity with strength training exercises like push-ups, you can promote the development of lean muscle mass, boost your metabolism, and support a healthier body composition. Family History If you have a family history of conditions such as diabetes, heart disease, high blood pressure, or high cholesterol, regardless of your body size, you may have a genetic predisposition to these health issues. It is crucial to discuss this with your healthcare provider to explore preventive measures that can help you avoid developing these conditions. Your healthcare provider may recommend adopting a healthy lifestyle, which includes following a nutritious diet, engaging in regular physical activity, and refraining from smoking. These lifestyle changes can significantly lower your risk of developing the conditions that run in your family. Incorporating exercise and maintaining a balanced diet are effective ways to proactively manage your health. However, even with a healthy lifestyle, there might be instances where you still have risk factors, such as high blood pressure or elevated blood sugar. In such cases, your healthcare provider may prescribe medications to help you keep these risk factors under control and reduce the likelihood of developing associated health problems. It is important to work closely with your healthcare provider to develop a personalized plan that

Jul 04

What Causes Asthma?

What Causes Asthma? The airways become irritated and restricted due to asthma, a chronic lung condition. Exercise, exposure to allergens and irritants, and respiratory infections can all bring on asthma symptoms including shortness of breath, wheezing, and chest tightness. Genetics, allergies, exposure to lung irritants, and immune system malfunction have all been linked to an increased chance of developing asthma, while the actual origin of the condition remains unclear.1 This article will examine the various causes and triggers of asthma, as well as the biological processes that contribute to asthma symptoms. Theories The development of asthma is a complex process that varies from person to person. While the exact cause(s) remain elusive, asthma is commonly triggered by specific factors. Individuals with asthma have airways that are hyperresponsive, meaning they are more sensitive to certain triggers. When exposed to these triggers, the airways become inflamed, leading to swelling and narrowing. This inflammation causes the surrounding muscles to constrict, further obstructing the airway passages and resulting in symptoms like shortness of breath, wheezing, coughing, and chest tightness. Additionally, the inflammation can stimulate excess mucus production, worsening the symptoms. Extensive research is ongoing to unravel the precise causes of asthma. It is widely accepted that a combination of genetic and environmental factors contributes to the development of asthma. Genetic predisposition plays a role, as asthma often runs in families. Specific genes related to immune function, airway reactivity, and inflammation have been identified, but the interplay of multiple genes and their interaction with environmental influences is believed to be responsible for asthma susceptibility. Environmental factors also play a crucial role in triggering asthma. Exposure to allergens such as pollen, dust mites, and pet dander, as well as irritants like tobacco smoke, air pollution, and chemical fumes, can provoke asthma symptoms. Respiratory infections, physical activity, and changes in weather conditions can also act as triggers. Occupational exposure to certain substances can lead to the development of occupational asthma. Understanding the complex interplay between genetic predisposition, environmental triggers, and immune system responses is crucial in managing and preventing asthma. Personalized treatment plans, trigger avoidance strategies, and ongoing research efforts aim to improve the management and quality of life for individuals with asthma. Exposure to Allergens There is a strong association between allergies and asthma, and individuals with allergies are at a higher risk of developing asthma compared to those without allergies. When people with allergies come into contact with allergens like pollen, pet dander, mold, or dust, their immune system perceives these substances as harmful and triggers an exaggerated response. This immune response leads to inflammation in the airways, causing symptoms associated with asthma, such as shortness of breath and chest tightness. This specific type of asthma triggered by allergies is referred to as allergic asthma. The immune system’s overreaction to allergens in allergic asthma involves the release of chemicals, such as histamines, which further contribute to airway inflammation and constriction. Allergic asthma can be diagnosed through specific allergy tests that identify the specific allergens triggering the immune response. Viral Respiratory Infections Viral respiratory infections, including the common cold and influenza, have been identified as potential triggers for the development of asthma. When a viral infection occurs, the immune system activates a response to combat the virus, involving the production of immune cells and the release of chemicals. In certain individuals, this immune response can lead to inflammation and constriction of the airways, resulting in asthma symptoms. Studies have shown that some children who experience viral or bacterial respiratory infections during their early years may go on to develop chronic asthma. This could be attributed to the fact that the immune system and lungs are still in the developmental stage during infancy and early childhood, rendering them more vulnerable to damage and inflammation caused by respiratory viruses. While not all viral infections lead to asthma, it is important to recognize the potential link between respiratory infections and the development of asthma in susceptible individuals, especially in children. Early prevention and management of viral infections, along with appropriate asthma treatment strategies, can help reduce the risk and impact of asthma triggered by respiratory infections. Exposure to Lung Irritants Exposure to lung irritants is considered a potential factor in the development of asthma. The impact of exposure to these irritants can vary depending on the specific irritant, duration of exposure, and individual factors such as genetics and underlying health conditions. Prolonged exposure to certain irritants, particularly in occupational settings, has been associated with an increased risk of asthma due to chronic exposure. When inhaled, lung irritants can lead to inflammation and constriction of the airways, contributing to the development of asthma symptoms. Examples of lung irritants include air pollution, cigarette smoke, specific types of dust (such as industrial or wood dust), chemical fumes, and vapors. These irritants can trigger an immune response and result in airway inflammation and subsequent asthma symptoms. Is Asthma Hereditary? Asthma has a strong genetic component, and its occurrence within families indicates a significant genetic link. Individuals who have family members with asthma are more prone to developing the condition, and the risk is significantly higher if one of their parents has asthma. Extensive research has identified more than 100 genes associated with asthma, many of which are involved in the functioning of the immune system and lungs. These shared genetic factors explain why individuals with asthma often exhibit heightened sensitivity to allergens and environmental irritants compared to those without asthma. Additionally, these genetic risk factors overlap with other conditions related to immune system overactivity, such as allergic rhinitis and eczema. It is important to note that having a genetic predisposition to asthma does not guarantee its development. The interplay between various genes, as well as the interaction with environmental factors, plays a crucial role in asthma development. Further research is necessary to understand the complex mechanisms through which genetic and environmental factors contribute to the manifestation of asthma. Who Gets Asthma? Asthma can affect individuals of all ages, genders, and ethnicities, although

Jul 04

Can You “Outgrow” Asthma Symptoms?

Can You ‘Outgrow’ Asthma Symptoms? Numerous Americans are diagnosed with asthma each year. According to the Asthma and Allergy Foundation of America (AAFA), over 25 million Americans have asthma. That’s about one in every 13. Women have a higher risk of developing asthma than males do, and the AAFA reports that more children than any other chronic ailment are affected by asthma. But can you "outgrow" your asthma, and does it ever really go away? The answer is yes, sort of and occasionally. Although this is more common in children, some adults also experience remission of their asthma symptoms and go on to have normal, symptom-free lives. It’s not always possible to "outgrow" asthma, though. Symptoms may return on their own accord, sometimes even years later. Learn more about asthma, how symptoms improve, and who has the best chance of seeing remission in this informative article. What Is Asthma? Asthma is indeed a chronic lung condition characterized by inflammation and narrowing of the airways. This inflammation and constriction can lead to various symptoms, including wheezing, coughing (particularly during specific times of the day), chest tightness, and shortness of breath. The severity and frequency of these symptoms can determine the type of asthma a person has. The classifications of asthma include intermittent asthma, mild persistent asthma, moderate persistent asthma, and severe persistent asthma. Each type is characterized by different symptom patterns and their impact on daily life. While asthma cannot be cured, it can be effectively managed with appropriate treatments. Inhalers are the most commonly prescribed form of treatment. Reliever inhalers provide immediate relief by relaxing the airway muscles, while preventer inhalers are used regularly to control inflammation and prevent symptoms. Combination inhalers contain both a reliever and a preventer medication. In more severe cases of asthma, medications such as steroids may be prescribed to reduce inflammation. Certain surgeries or procedures may also be considered as treatment options. So Does Asthma Ever Go Away Completely? It is possible for children to outgrow asthma symptoms as they age. Some children, particularly those who started wheezing at a young age, may see their symptoms improve or completely resolve over time. However, it is not entirely clear why this happens in some children and not others. Similarly, in adults, asthma symptoms can become less frequent or transition from persistent to intermittent. The persistence of asthma in adults is influenced by various factors, and the individual nature of the condition makes it difficult to predict how it will progress in each person. While some individuals may experience remission or a decrease in symptoms, it’s important to note that asthma is a chronic condition, and for many people, it remains a lifelong condition that requires ongoing management. Regular monitoring, adherence to prescribed medications, and avoidance of triggers are still crucial for individuals with asthma, even if their symptoms have improved. What Is Asthma Remission? Remission in asthma refers to a period of time when symptoms decrease or disappear entirely for at least 12 months. There are two main types of remission: symptomatic remission and total or complete remission. Symptomatic remission occurs when asthma symptoms stop occurring, but it does not address the underlying cause of asthma. Therefore, there is still a possibility of symptoms returning in the future, known as relapse. Total or complete remission indicates that the underlying condition causing asthma is no longer causing a problem. This type of remission implies a more long-lasting resolution of symptoms, where the asthma is no longer actively present. It is indeed possible for asthma to naturally go away on its own, particularly for those who developed asthma during childhood. Studies have reported varying rates of spontaneous remission, ranging from 2% to 52% of individuals experiencing a resolution of asthma symptoms without treatment. However, it’s important to note that even individuals who have outgrown asthma may still experience relapse later in life. The exact reasons why some people experience remission while others do not are not fully understood. It could be influenced by various factors, including genetics, environmental exposures, and individual immune responses. It is essential for individuals who have experienced remission of their asthma symptoms to continue monitoring their respiratory health and maintain regular follow-ups with their healthcare provider. Asthma can be a complex and unpredictable condition, and proper management is crucial even during periods of remission to ensure the best possible long-term outcomes. Who Is Most Likely To Achieve Remission? Achieving remission in asthma is not guaranteed, but certain factors have been identified to increase the likelihood of being symptom-free, as highlighted in a 2022 European Respiratory Journal study: Mild asthma: Individuals with milder forms of asthma have a higher probability of experiencing remission compared to those with more severe asthma. Lung function: Better lung function, as assessed through pulmonary function tests, is associated with an increased chance of remission. Asthma control: Well-managed asthma with minimal symptoms and exacerbations is more likely to enter a state of remission. Young age: Asthma that develops during childhood has a higher potential for remission compared to asthma that appears later in life. Length of asthma: The duration of asthma can impact the chances of achieving remission, with shorter durations potentially being more favorable. Airway response: Individuals with a favorable airway response to treatment and a lower degree of airway hyperresponsiveness may have a higher likelihood of remission. Few or no other diseases: The absence or limited presence of additional medical conditions can contribute to a better chance of remission. Smoking cessation or never having smoked: Quitting smoking or never having been a smoker can positively influence the possibility of achieving remission. The study also reported that certain medications, such as biologics (monoclonal antibodies) and macrolide antibiotics like azithromycin, may aid in achieving remission. While these medications are known to be effective for other conditions like rheumatoid arthritis, their potential to control asthma symptoms and potentially slow down airway remodeling requires further research. Additionally, a treatable traits approach focusing on managing underlying conditions, including comorbidities, smoking, anxiety and depression,