BREAST DISEASES symptoms causes treatment medicines preventive care

BREAST DISEASES 

The breast is an important part of the female reproductive system. And, like internal reproductive organs, it is dependent to an extent on the level of hormone activity. This is exemplified by changes in size and consistency of breast tissue during the menstrual cycle and during pregnancy as hormonal levels change. The breast is made up of glandulartissue arranged in a complicated pattern of lobes. The milk ducts lead into the nipple at the approximate center of the lobes. The breast is subject to a number of disorders that are difficult to differentiate by physical examination alone, since they most commonly take the form of a lump or mass. 

The lump may be a benign growth, a cyst, or a cancer.

Since primary prevention for any of these conditions is limited, early detection of a lump and identification of its nature are an important preventive measure. Self-examination of' the breasts at least once a month, at the end of the menstrual cycle (after the monthly flow) when the breasts are normally soft, is an excellent means of early detection. Women who feel that they cannot adequately perform self-examination can make arrangements with their doctor for a brief monthly examination. The technique of self-examination is described. Of course, examination of the breast is an important part of a regular physical examination. In many cases, when a mass is found, the physician can determine if it is benign through history and examination.

Among other things, he will consider the age of the patient; breast cancer is rare below age 20 and quite uncommon until the 40'S. Any painand fluctuation in size of the lump usually indicate that the cause is benign cystic change of glandular tissue. Some women are prone to recurrent breast cysts, a condition referred to as chronic cystic mastitis or benign cystic disease (see below). Nipple discharge, with or without a lump, is almost always indicative of a benign growth. 

The physician also will consider the consistency of the mass, whether it is well demarcated, and whether there are skin changes over the area. In most cases, when there is any doubt as to the nature of the suspicious mass, the physician will remove it for microscopic examination. This will resolve doubts and fears of both doctor and patient. The surgery is minor even though it is usually done under general anesthesia. 

Chronic Bone Infection - Scoliosis - symptoms causes treatment preventive care

When bone has been severely weakened by chronic infection, it may be necessary to provide support for it with plates and pins or bone grafts in order to avoid repeated fractures and to allow normal function. Scoliosis mean abnormal curvature of the spine. A minor degree of it is present in a large proportion of all people, in whom it is usually barely noticeable and does not interfere with posture and function.

 Two important causes of severe scoliosis in the past-polio and tuberculosis-have been minimized in recent years. Polio may lead to scoliosis if muscles on one side of the body are weakened to a greater extent than on the other side. When this occurs, the stronger muscles pull harder on the spine than the weaker ones, leading to curvature. Tuberculosis may affect the spine, leading to an imbalance of the bony spinal column. Scoliosis may be the result of a congenital defect, such as absence of half of a vertebra. It may develop for unknown reasons, usually between the ages of 5 and 15, and most often in girls. Sometimes, unequal leg length or faulty function of a hip joint can unbalance the spine, leading to curvature. 

Scoliosis can progress rapidly, particularly the type that affects young girls. Therefore, it should be brought to a physician's attention as soon as possible. The physician is most concerned about whether the curvature is progressing, and if so how fast. If the cause of the scoliosis is unequal leg length, treatment may require nothing more than use of a shoe lift for the shorter leg. Most cases of scoliosis are minor and require little if any treatment.

But when treatment is needed, it should be supervised by a specialist in bone problems, an orthopedist. X-ray studies of the spine with careful measurement of the degree of curvature is an important step in evaluation of the scoliosis. If the scoliosis is of the type which, if unchecked, may progress to become a serious deformity, it may not only interfere with normal posture and gait but also lead eventually to compromising of lung function, since the chest wall on one side may be compressed. Treatment should be begun without delay.

 The further the spine is deformed, the longer corrective measure will be needed. Recent advances have made treatment of scoliosis more effective and less inconvenient as well. The Milwaukee brace, a device designed to gradually reposition the curved spine, is particularly effective. It is essential that an experienced technician measure and fit the brace and an orthopedist supervise the wearing. Another method of treatment is to cast the spine so as to gently nudge it into normal position. Most children adapt readily to several months of treatment with brace or cast. Surgery may be avoided in this way. 

With age, the spinal column becomes less pliable and bracing or casting may be insufficient to correct a deformity. Several surgical procedures are of value. One of the most outstanding is the insertion of special rods, called Harrington rods, in the back muscles, one on either side of and connected to the spinal column. One rod pushes up on the shortened side of the spine while the other pulls the longer side.

Once the spine is correctly aligned, surgical fusion ofbones of the spine secures the alignment.   Sometimes, however, as in many fractures of hip, forearm, and upper arm, extra support may be needed to insure that the bone knits together. Such support may be provided by operative placement of plates and screws or nails, or occasionally by bone grafts. Simple fractures can often be treated by a general practitioner. But most fractures should be evaluated and treated by an orthopedist, who will decide on the need for operative or non-operative measures.

Bone requires six or more weeks to heal, and during this time proper alignment is maintained by a plaster cast. Although the fractured bone must be immobilized if it is to heal properly, muscles that normally move the immobilized part must be kept limber and strong. Special exercises achieve this. Doctors also pay close attention to the cast itself, making certain it is neither too snug nor too loose. Too tight a fit can lead to compression of theblood supply to the extremity. 

Fingertips and toes are left uncovered by a cast so the physician can judge the status of blood supply from skin color. Too loose a fit of the cast can allow movement of the fractured bone and misalignment. X-rays after application of the cast can be used to check proper alignment. As mentioned earlier, prolonged immobilization weakens bone andmuscle. Therefore, return to normal functioning as soon as possible is encouraged. 

BONE DISEASES-Osteoporosis and Osteomalacia Causes symptoms treatment remedies

BONE DISEASES 

Osteoporosis and Osteomalacia Beginning at about age 50, it is not unusual for people to note a slight diminution of height every few years. It is well known, too, that bones tend to become more brittle and to be more prone to fracture as we pass from the middle years to the later years. Both the slight height reduction and tendency to bone brittleness result from a process called osteoporosis (literally, softening of the bones) which occurs with aging. 

Bones that are osteoporotic contain the same individual minerals and proteins but they are less dense than younger bones.

Hence, they are more likely to be compressed (resulting in height loss) or broken. While x-rays do not invariably reveal the presence of osteoporosis, it is not uncommon for the condition to be first identified on a routine x-ray film. One rather common x-ray finding in osteoporosis is compression and fracture of a vertebra which may cause mild back pain but does not endanger the spinal cord. Osteoporosis is not limited to the later years. Other causes which a physician must consider include:

1. Steroid medications which may produce osteoporosis changes even in very young patients when administered for prolonged periods.

2. Lack of stress. Bones begin to weaken when they are not subjected to normal stresses such as those exerted by muscles and by the pull of gravity. Astronauts, as the result of exposure to gravity- free environment, have shown early changes of osteoporosis. More commonly, such changes may stem from immobilization because of illness or the casting of a fractured bone. Osteoporosis also may be- come apparent after a stroke when muscles in a limb fall into disuse.

3. A diet low in calcium and protein.

These are the basic building blocks of bone, and a dietdeficient in them will eventually lead to weakening of bones.

Cancer, when it spreads to bone, weakens the intrinsic structure.

Menopause apparently hastens the development of osteoporosis, and many women past the menopause exhibit bone changes (see page 618). What can be done to prevent osteoporosis and to treat it should it occur? Prolonged immobilization should be avoided. If it cannot be, exercises to maintain muscle tone and stress on bone are of value. Almost every hospital today has a physical therapist to administer such exercises as a precaution.

Bone diseases poor blood supply, natural body defenses against infection, which are circulated by the blood, have a more difficult time reaching a trouble area. Bone infection may result from in- jury to a bone, such as a compound fracture, or the entrance of a foreign body, or from spread of infection from elsewhere in the body. If acute bone infection is not treated effectively, the infection may become chronic. 

With chronic osteomyelitis, the bone is weakened and made more subject to fracture, pus may be discharged chronically through the skin, the body's reserves are drained by the constant need to fight the infection, and there may be considerable pain and discomfort.

For these reasons, any attack of severe bone pain and fever-usually it occurs in a child or young adult- needs quick evaluation and therapy. An effort will be made to identify the causative organisms and select an anti- biotic suitable for combating them. In addition, surgery to drain the infected area may be required. Surgery is often an indispensable adjunct to antibiotic treatment in cases of chronic bone infection. 

Dead and dying tissuewhich serves as the nest, for continuing infection must be removed. Occasionally it is difficult to remove all the infected or dead tissue located in and around the bone, and repeated surgery may be required. In some instances, chronic osteomyelitis may be present for years, with alternating periods of quiescence and activity, and intensive therapy is needed to affect a cure. 

Chronic Backache causes and treatment home exercise remedies

The hospital's specialist in backache- an orthopedist- will usually arrange for traction apparatus. After an attack has ended, it may still be necessary for the patient to wear a supportive corset or brace which should be prescribed by the doctor. Its fit also should be checked by him. After a time, it will usually be found that the brace may be needed only when traveling or during periods of extra stress. If complete healing does not occur, the doctor will need to investigate the back in the same way as described below for chronic backache. 

Chronic Low Back Pain This is the condition that makes life miserable part or all of the time for millions of people. Yet it is, in almost every instance, unnecessary and preventable.   If the preceding suggested investigation fails to turn up an obvious cause which, when corrected, relieves the pain, then the basis for the pain is most likely muscle weakness and or imbalance, or excess emotional tension, or a combination of the two.

However, before going in for a program of strengthening muscles that support the back or trying to reduce nervous tension, there should be a complete checkup of the back by your doctor or an orthopedist or other back specialist (some internists and general practitioners are skilled in examining and treating backs). It is possible that some organic problem is causing the back pain-e.g., arthritis, a spine infection, a muscle or nerve disease, a tumor.

Once it is established that there is no organic cause, and then attention can be focused on achieving good physical fitness. This means discussing with the doctor how to achieve optimum weight and good posture. Then a program of general exercise should be agreed upon, and also a set of exercises to strengthen the lower back. Usually, the doctor prescribes a few basic exercises which strengthen not only the back muscles but also the large muscles of the abdominal wall. He may also give instruction in how to relax certain muscles which may be too tense and are constantly pulling on the lower back. Such muscles may even be located in back of the thighs-for example, the hamstrings which you can feel behind the knees. 

If nervous tension is contributing to the backache, emotional problems should be freely ventilated with the doctor. If the problems warrant, a to a psychotherapist is surely worth the effort if it will prevent days, months, and even years of naggingback pain. During the period of reconditioning, the doctor will prescribe a pain reliever, relaxing warm applications or warm baths, and possibly a tranquilizer to help quiet nervous tensions. Use of a brace or corset may be helpful until muscles are strengthened sufficiently so they act again as nature's own brace and support.

Our chapters on exercise, diet, and mental health contain material that you may well find helpful in preventing backache

if you are reaching the susceptible age.  

MEntal Illness causes and treatemnt

 Marriage can help assure a healthy mental and emotional life if there is true love, acceptance of each other's good and weak points by the mates, and a happy, fulfilling sexual life. Marriage should continue to grow as a creative experience and not settle into "dullsville." Because marriage is so important in preventing emotional problems, at the first sign of significant marital trouble there should be a talk with a marriage counselor. Sometimes a single session will work wonders. (See page 327 for further discussion of marriage.)

Pregnancy and the arrival of children

 Pregnancy can set off emotional problems. We have a section on pregnancy. The coming of the first child and then of later children expectably changes the quality of marriage. It should deepen ties. But each partner needs to realize that the other, deep down, wants and needs reassurance that a child hasn't usurped all love. If pregnancies and the coming of children go well, what then can threaten the emotional stability of adults? Here are several situations that cause tension and sometimes serious emotional disturbances: Loss of job or business reverses.

We have known people who have lost fortunes and made them again. Nothing disturbs their inner conviction that they will succeed in their work. On the other hand, we have seen emotional disturbances develop at the threat of a change of job or a small temporary reverse in a man's business venture. Such disturbances call for a talk with your doctor or other counselor.

Menopause

 This is a dramatic, emotion-charged event for some women. See our special discussion about its emotional component.

Sex in the later years

More and more, medical science recognizes the need of older people, and their ability, to continue sexual activity into very old age. Even many individuals with heart disease and other ailments can enjoy sexual activity. Sex deprivation, especially in an older man, may cause depression. Here again, a talk with a sympathetic physician will prove helpful.

Security

 We live in a competitive society which really has little mercy for the person who doesn't provide for himself and his family. Social security benefits are inadequate. It is reassuring-and a good preventive of mental tension-to work out early in life a program of disability, retirement, and life insurance which will provide for the family. This doesn't mean that you have to become so worried that you become "insurance poor." There are low-cost, term insurance policies which young people can afford. And almost everyone belongs to at least one organization that offers inexpensive group insurance.

Retirement

 What happens at retirement will probably reflect the sum total of your personality growth during your lifetime. Some people enjoy retirement; others abhor it. Talk at length to your doctor about your emotional as well as physical needs in the retirement period. A change of location may be beneficial emotionally for some people, not for others. If you need part-time work to keep you cheerful, remember that you usually get this more readily in your home location where you are known.

Smoking Causes - Cautions - problems

In the seventeenth century, there was even a book authored by a London physician on smoking, Panacea, or the Universal Medicine. The book dedicated a drop of tobacco juice in each ear to cure deafness, a leaf on the head to cure headache, a leaf on a tooth for toothache. And, in the form of ointments, powders, leaves or concoctions, tobacco was suggested as a cure for burns, wounds, cancers, sciatica, diseases of the liver, spleen and womb, worms, colic, warts, corns, and mad dog bites.

The smoking of tobacco in paper wrappers as small cigars or cigarettes began in Spain in the seventeenth century and gradually spread. But the really tremendous spurt in cigarette smoking came during World War 1 with free distribution of cigarettes to soldiers, followed not long after-ward by acceptance of cigarette smoking by women. Even a century ago, Dr.Oliver Wendell Holmes, author, poet, and distinguished physician and Harvard Medical School professor, was writing: "I think tobacco often does a great deal of harm to health.

 I myself gave it up many years ago. I think self-narcotization is a rather ignoble substitute for undisturbed self." Early in this century some reports began to appear in medical journals suggesting an apparent relationship between smoking and specific diseases. In 1927, Dr. F. E. Tylecote in England reported that in virtually every case of lung cancer he had seen or known about, the patient was a regular smoker. But striking evidence of the effects of smoking was yet to come.

THE MODERN INDICTMENT In 1938, Dr. Raymond Pearl of Johns Hopkins University published a study on smoking and length of life based on findings in 2,094 men who did not use tobacco, 2,814 moderate smokers, and 1,905 heavy smokers, Dr. Pearl concluded that smoking is unquestionably associated with a reduction in length of life. For example, between the years of 30 and 50, the chances of dying are 15 percent greater for a moderate and 98 percent greater for a heavy smoker than for a nonsmoker. 

By 1965, studies of mortality rates of smokers and nonsmokers had extensive enough for Dr. Luther Terry, then Surgeon General, to report that 240,000 men would die that year prematurely from diseases associated with cigarette smoking. About 138,000 of the premature deaths would be from diseases clearly associated with smoking, such as cancer of the lung, larynx, oral cavity, esophagus and bladder, as well as bronchitis, emphysema, and coronary heart disease. Another 102,000 deaths would result from diseases in which the relationship to cigarette smoking, while not so obvious, is nevertheless well indicated. These figures did not include women. 

ACTIVITY AND MANY KEY PHYSICAL HEALTH PROBLEMS And Treatment

Excercise, Activities and health problems

There is increasing evidence that exercise is of value in preventing many key diseases such as heart disease, stroke, and peripheral vascular dis- orders which affect circulation in the extremities. It is good for most ACTIVITY AND THE HEART lung diseases; an aid in the prevention of backaches and foot problems; a help too in the prevention of hernias; and a means of maintaining good skin tone. . For many years, vigorous physical activity was considered a hazard for the healthy heart, let alone the diseased. Today, there is mounting evidence that regular activity not only is essential for optimal maintenance of heart health but also, with certain precautions, can be of great value in heart patients formerly doomed to inactive existence.

In one of the pioneering studies concerned with exercise and the heart, British investigators found that the frequency of coronary heart disease in London bus conductors was about 30 percent lower than in the less active bus drivers. Since then, an inverse relationship between physical activity and coronary heart disease-the more of the former, the less of the latter-has been found by many other investigators in this country and elsewhere in the world. In a study carried out by Harvard scientists, 700 Bostonians of Irish descent were compared with their brothers who stayed in Ireland.

Coronary heart disease deaths in the Boston group (ages 30 to 60) were two times those in the Ireland group. The men in Ireland ate more eggs, more butter, and more of other saturated fats-yet had lower serum cholesterol levels. They consumed 400 calories more per day on the average than their Boston counterparts but weighed 10 percent less. They were getting more exercise and their lower cholesterol levels showed that physical activity does more than just burn off calories. Somewhat to their amazement, American scientists who recently made a special trip to study Masai tribesmen in Africa found that these people, despite a diet containing enough cholesterol to send the ordinary worried American fleeing in panic from the dinner table, never seem to get heart trouble.

 They live almost exclusively on meat and on milk with a butter- fat content that soars to 6.5 percent. Yet they have lower blood cholesterol levels on the average than do Americans. It is possible that it is exercise which protects Masai hearts, keeping cholesterol levels in their blood low despite the high dietary intake. The Masai are known to walk as much as 50 to 60 miles a day-and to do it without strain. In a study covering 120,000 American railroad employees, the heart attack incidence among sedentary office workers was found to be almost twice that of men working in the yards. Investigators have noted that activity trains the heart to beat slowly, to function more economically, to require less oxygen for a given amount