The question the reader will ask at this point is ‘Given all this epidemiological study, do we know the causes of cancer?’ Broadly the answer is ‘yes’ in many circumstances and for many cancers, and the opportunities for prevention that this understanding generates are there to be taken. We do not always know how the factors that have been identified by the epidemiological studies discussed in this chapter link up to what is being learned in the laboratories of the molecular biologists. This connection is being made rapidly and will be increasingly clear by the end of the century. Epidemiology has been very successful in discovering or confirming which features of our lives in the Western world can be now identified as causes of cancer.
Sexual activity has been extensively investigated as a factor in the cause of certain cancers, particularly cancer of the neck of uterus. Certainly, the number of sexual partners appears to be
an association. In a woman with only a single lifelong sexual partner, the number of partners that her one sexual partner has had also seems to affect her risk. How this leads to a cancer, and particularly whether the cancer is caused by transfer of a virus, is the subject of current research focusing particularly on the human papilloma virus. The transfer of infectious agents which give rise to AIDS must also be considered under this heading because people with AIDS can get unusual types of cancer.
*31\194\4*
-
-
What are the elements of a good rehabilitation program? What should I look for?
First, the goals should be realistic. The rehab specialist should carefully explain exactly what the plan of action is and what should be accomplished with this plan. Your program should be based on you and you alone. Everybody is different. Second, the period to achieve these goals of rehabilitation should be realistic. If it is going to take two years, you need to know that. Third, the rehabilitation specialist should consult with your arthritis specialist to make sure your program will not cause you further pain and deterioration. Fourth, you should be able to report your progress accurately and not overdo it. The doctor and you have to come to some agreement on your progress.What is deconditioning?
Deconditioning is the effect that disuse has on your body. Often those affected with RA stop using affected body parts due to pain or depression. As a result, muscles become weaker and bones begin to deteriorate. Rehabilitation medicine is directed to prevent you from deconditioning.What kind of team is involved in my rehabilitation?
Your rehabilitation team will consist of a rehabilitation physician; your rheumatologist, of course; a rehabilitation nurse; an occupational therapist (ОТ) to help you with your activities of daily living; and a physical therapist (PT). A social worker, a psychologist, and even a speech therapist can be brought in if needed. All of these people may work with you to help improve your quality of life.What are some of the pain-relieving modalities that might be used?
Both heat and cold can decrease joint pain. Heat can be given by way of paraffin baths, application of moist hot packs, or even immersion in warm water. Cold therapy can be given via ice packs or immersion in cold water. This helps reduce swelling, raise the pain threshold, and decrease muscle spasm.
Topical creams and liniments can be applied to relieve pain. One example is a cream containing capsaicin (an extract of paprika), which is very helpful in relieving the pain of RA.
Electrical nerve stimulation is another method used to relieve pain. This method, called transcutaneous electrical nerve stimulation (TENS), is good for bone pain and even nerve pain in certain sites. Electrodes that transmit mild electrical impulses are attached to the skin. These electrical impulses are thought to relieve pain by interrupting the pain pathway, by increasing the production of endorphins, or by increasing the blood supply to the affected area. Though this procedure is relatively painless, a mild tingling or massaging sensation is felt as the electrical impulses are emitted.Are there specific treatments for different parts of the body?
Absolutely. Rehabilitation therapy can strengthen each area with specific exercises and assist devices. One such device to aid function is the splint. There are resting splints, which basically immobilize a part of the body like the hand or the wrist, and functional splints, which are designed to support a limb during activities, such as the hands during exercises or the knees while walking.
*42/141/5* -
Acute varicella (chickenpox) may be severe, particularly in adults, and can complicate travel and delay return home. Travelers may be exposed to this highly communicable virus (varicella-zoster virus) while traveling to their destination or through exposure to local populations after arrival. The status of varicella immunity should be reviewed in long-term travelers as well as in those whose activities bring them into contact with children in schools, day care centers, refugee camps, or health care settings. Adults who give no history of varicella or prior immunization should be tested for the presence of antibodies, since 71% to 93% of adults without a reliable history are actually immune. Adults who grew up in tropical or subtropical countries are more likely to be at risk, since varicella infection is rare in childhood in these locations. Children 1 to 12 years of age should receive a single dose of vaccine (Varivax, Merck), and those 13 years of age or older should receive two doses of vaccine 4 to 8 weeks apart. Varicella vaccine may be administered concurrently (but at different sites) with any other vaccine. Pregnant and immunocompromised individuals should not receive this live attenuated vaccine. Immunization should occur prior to the initiation of anti-malarial chemoprophylaxis, since these drugs will interfere the effectiveness of the vaccine.
*180/348/5*
Recent Comments