skip to main |
skip to sidebar
DEFINITIONS
Benign tumors of the stomach seems to not cause symptoms or medical problems. But sometimes, some bleeding or develop into cancer.
Approximately 99% of gastric cancer is adenocarcinoma.
Other gastric cancer is leiomiosarkoma (cancer of smooth muscle) and lymphomas.
Kankler stomach is more common in the elderly.
Less than 25% of certain cancers occur in people under the age of 50 years.
In China, Japan, Chile and Iceland, so often found in gastric cancer.
In the U.S., more common in poor, black people and people living in the north. And is the No. 7 cause of death, which occurred at approximately 8 of every 100,000 people.
CAUSE
Gastric cancer often begins on the side where the inflamed stomach lining. But many experts believe that inflammation is a result of gastric cancer, not as a cause of cancer.
Some experts argue, gastric ulcers can cause cancer. But most people with ulcers and gastric cancer, the possibility is that cancer is not detected before tukaknya formed.
Helicobacter pylori, bacteria that play an important role in duodenal ulcer, could also play a role in the occurrence of gastric cancer.
Gastric polyp, a benign growth of the round, which grew into the cavity of the stomach, allegedly a sign of cancer and therefore always polyps removed.
Cancer may occur in conjunction with certain types of polyps, the polyps larger than 1.8 cm or polyps of more than one.
Specific dietary factors is estimated to play a role in gastric cancer growth.
These factors include:
- High salt intake
- High carbohydrate intake
- Intake of preservatives (nitrates) high
- Intake of green vegetables and fruits are lacking.
But none of those factors that have been proven to cause cancer.
SYMPTOMS
In early-stage gastric cancer, its symptoms are vague and often ignored.
If symptoms develop, can help determine where the location of gastric cancer. For example, full or uncomfortable feeling after eating can show the existence of cancer in the lower stomach.
Weight loss or fatigue usually caused by eating difficulties or inability to absorb some vitamins and minerals.
Anemia can be caused by bleeding in stages that do not cause other symptoms.
Sometimes patients may also experience a lot of vomiting blood (haematemesis) or issue a blackish stools (melena).
When gastric cancer grew, the mass may be palpable in the abdominal wall.
In the early stages, the small gastric tumors can spread (metastasize) to distant places.
The spread of tumors can cause liver enlargement, jaundice (jaundice), fluid collection in the abdomen (ascites) and skin nodules that are malignant.
The spread of cancer can also cause bone loss, resulting in broken bones.
DIAGNOSIS
Stomach cancer symptoms can be confused with peptic ulcers.
If symptoms do not disappear after patients taking medicine for ulcers or when symptoms include weight loss, then the suspicion of a gastric cancer.
X-ray examination using barium to mark a change in the surface of the stomach is often done, but rarely find a small gastric cancer in early stages.
Endoscopy is a diagnostic procedure is best because:
- Allows doctors to see directly the stomach
- Could find the existence of Helicobacter pylori, bacteria that play a role in gastric cancer
- Can take a sample of tissue for microscopic examination.
TREATMENT
Benign gastric polyps removed using endoscopy.
When carcinoma is found in the stomach, surgery is usually performed to try to cure him.
Most or all of the stomach and nearby lymph nodes involved was appointed.
If the carcinoma has spread to the outside of the hull, the goal of treatment is to reduce symptoms and prolong life expectancy.
Chemotherapy and radiation therapy can relieve symptoms.
Results of chemotherapy and radiation therapy in lymphoma better than carcinoma. Perhaps patients will survive longer can even cured.
DEFINITIONS
Tuberculosis is a contagious infection and can be fatal, caused by Mycobacterium tuberculosis, Mycobacterium bovis or Mycobacterium africanum.
Tuberculosis showed that the disease most often caused by Mycobacterium tuberculosis, but sometimes caused by M.bovis or M.africanum.
Other bacteria that cause diseases like tuberculosis, but not contagious and most provide a poor response to drugs very effective treatment for tuberculosis.
Tuberculosis is spread through contaminated air by the bacterium M. tuberculosis.
Udar contaminated by bacteria due to active tuberculosis bacteria through coughing and release the bacteria can survive in air for several hours.
Fetus can be infected from their mothers before or during the delivery process by inhaling or swallowing of contaminated amniotic fluid. Babies can be infected by inhaling air containing the bacteria.
In developing countries, children infected by other mikobakterium that causes tuberculosis. This organism called M. bovis, which can be spread through milk is not sterilized.
Immune system of someone who is infected by tuberculosis bacteria are usually destroyed or held at the site of infection. Sometimes the bacteria are not destroyed but remains in the form of inactive (dormant) inside macrophages (a type of white blood cells) for many years.
Approximately 80% of tuberculosis infections caused by bacteria that dormant back. Bacteria that live in the scar tissue caused by previous infection (usually on top of one or both of the lungs) begin breeding. Pengaktivan these dormant bacteria can occur if the patient's immune system is declining (eg because of AIDS, use of corticosteroids or elderly).
Usually someone who is infected with tuberculosis has a 5% chance to experience an active infection within 1-2 years.
-The development of tuberculosis in each person varies, depending on various factors: Ethnic: tuberculosis developed more rapidly in blacks and Native Americans
- The immune system: an active infection more often and more quickly occur in people with AIDS. People with AIDS have a 50% chance of suffering utnuk active infection within 2 months. If bacteria become resistant to antibiotics, the possibility of death in patients with AIDS and tuberculosis within two months amounted to 50%.
Active tuberculosis usually begins in the lungs (pulmonary tuberculosis).
Tuberculosis which attacks parts of the body (extrapulmonary TB) usually originates from pulmonary tuberculosis that has spread through blood. Infection may not cause disease, but the bacteria remain dormant life in the small scar tissue.
Tuberculosis milier
Tuberculosis can be fatal can happen if a large number of bacteria spreads throughout the body via the bloodstream. This is called TB infection milier, because it causes the formation of millions of small-sized wounds millet (bird food).
Milier tuberculosis symptoms can be very vague and difficult to recognize, namely in the form of weight loss, fever, chills, weak, unwell and respiratory disorders.
If the attack bone marrow, severe anemia can occur and other blood disorders, resembling leukemia.
The release of bacteria at any time into the bloodstream from a hidden injury can cause fever, loss arose, accompanied by a gradual weight loss.
CAUSE
Mycobacterium tuberculosis, Mycobacterium bovis or Mycobacterium africanum.
SYMPTOMS
Initially only patients feeling unwell or coughing.
In the morning, cough can be accompanied by a little green or yellow sputum. Number of sputum usually be increased, in line with the development of disease. In the end, will be colored red with sputum containing blood.
One of the most common symptom is night sweats. Patients are often awakened at night because his body drenched in sweat so that clothing or even sepreinya must be replaced.
Shortness of breath is a sign of air (pneumothorax or fluid (pleural effusion) in the pleural cavity.
About a third of infections found in the form of pleural effusion.
In a new tuberculosis infection, bacteria move from the wound in the lungs to the lymph nodes originating from the lungs. If the body's natural defense system can control the infection, the infection will not continue and the bacteria become dormant.
In children, the lymph nodes become large and pressing the bronchial tubes and cause coughing or even may cause lung contraction. Sometimes the bacteria got into the channel and formed a group of lymph nodes in the neck. Infection in the lymph nodes can penetrate skin and produce pus.
Tuberculosis can attack organs besides the lungs and a condition termed extrapulmonary tuberculosis.
Parts of the body most often affected are the kidneys and bones.
Renal tuberculosis can only produce few symptoms, but the infection can destroy part of the kidney. Then tuberculosis can spread to the bladder.
In men, infection can also spread to the prostate, seminal vesicles and epididymis, causing the formation of lumps in the penis sac.
In women, tuberculosis can attack the ovaries and the channels, resulting in sterility. From the ovary, the infection can spread to the lining of the abdominal cavity and cause peritonitis, tuberculosis, with symptoms such as fatigue, abdominal pain, tenderness accompanied by mild to severe pain resembling appendicitis.
Infection can spread to joints, causing arthritis, tuberculosis.
Inflamed and painful joints. The most commonly affected are the hip and knee joints, but can also attack the wrist bones, hands and elbows.
Tuberculosis can infect the skin, intestines and adrenal glands.
Infection of the aortic wall (main artery) caused aortic rupture.
Infection of the pericardium causes tuberculosis pericarditis, where perikardiuim stretched by the fluid. This fluid can interfere with the ability of the heart in pumping blood. Symptoms include fever, neck vein dilation and shortness of breath.
Infection at the base of the brain called tuberculosis meningitis.
Symptoms include fever, persistent headache, nausea and decreased awareness. Very stiff neck so your chin can not be brought closer to the chest.
Sometimes after meningitisnya improved, will form a mass in the brain, called tuberkuloma. Tuberkuloma can cause muscle weakness (as happens in a stroke) and must be removed surgically.
In children, the bacteria can infect the spine and the tip of the long bones of the arm and leg.
If these conditions are not addressed, could have happened to collapse at one or two back bones that can lead to paralysis.
In developing countries, tuberculosis bacteria can be spread through contaminated milk and live in the lymph nodes in the neck or in the small intestine.
Mucous membranes of the digestive tract are resistant to bacteria, because it was new infections occur when bacteria are in a very large quantity or if there is disruption of the immune system.
Intestinal tuberculosis may not cause symptoms, but causes abnormal tissue growth in the infected area, which could be misinterpreted as cancer.
DIAGNOSIS
Which is often a preliminary indication of tuberculosis is the chest x-rays. This disease appears as white areas of irregular shape with a black background.
X-rays can also show pleural effusion or enlargement of the heart (pericarditis).
Diagnostic tests for tuberculosis are:
1. Tuberculin skin test, injecting small amounts of protein derived from TB bacteria into the
layers of skin (usually in the arm). 2 days later were observed in the injection area, if there's
redness pembengkakand, then the result is positive.
2. Examination of sputum, body fluids or infected tissue. With a needle, a liquid sample taken
from the chest, abdomen, joints or about the heart. Biopsy may be necessary to obtain
samples of infected tissue.
To confirm the diagnosis of tuberculosis meningitis, polymerase chain reaction examination (PCR) to liquid serebrospinalis.
To ensure renal tuberculosis, PCR can be performed on urine, x-ray examination of the patient or with a special dye to describe any abnormal masses or cavities caused by tuberculosis. Sometimes it is necessary that the mass sampling to differentiate between cancer and tuberculosis.
To confirm the diagnosis of tuberculosis in the female reproductive organs, pelvic examination was performed through laparoscopy.
In certain cases the necessary examination of liver tissue samples, lymph nodes or bone marrow.
TREATMENT
There are five types that can be used antibotik.
An active pulmonary tuberculosis infections often contain a billion or more bacteria, thus providing a kind of drugs would leave thousands of organisms that really resistant to the drug. Therefore, at least, given two different drugs having different mechanism of action and both drugs together this will destroy all bacteria.
Once patients completely recovered, treatment should be continued, because it takes a long time to destroy all bacteria and to reduce the possibility of recurrence.
Antibiotics are most often used are isoniazid, rifampicin, pyrazinamide, streptomycin and ethambutol.
Isoniazid, rifampicin and pyrazinamide can be combined in one capsule, thus reducing the number of pills that must be swallowed by the patient.
All three of these drugs can cause nausea and vomiting due to its effect on the liver. If nausea and vomiting occur, hence the use of drugs should be discontinued until liver function tests.
If the liver function tests showed a reaction to one of the three drugs, the drugs in question are usually replaced with another drug.
Ethambutol giving begins with a relatively high dose to help reduce the number of bacteria immediately. After two months, the dose is decreased to avoid side effects harmful to the eyes.
Streptomycin is the first drug effective against tuberculosis, but must be given in the form of injections. If given in high doses or continued use until more than three months, streptomycin can cause loss of hearing and balance.
If people actually follow the treatment regularly, so no need for surgery to remove part of lung.
Sometimes surgery to remove pus or correct spinal deformity due to tuberculosis.
PREVENTION
-There are several ways to prevent tuberculosis: eradication of bacteria ultraviolet rays, can be used in places where a group of people with various diseases have to sit together for several hours (eg in hospital, the emergency waiting room). This light can kill bacteria present in the air.
- Isoniazid is very effective when given to people with high risk of tuberculosis, such as health care workers with positive tuberculin test results, but the X rays did not show any disease. Isoniazid taken daily for 6-9 months.
Pulmonary tuberculosis patients who are undergoing treatment need not isolated more than a few days because the medicine works quickly so reduce the likelihood of transmission. But patients who experienced coughing and did not undergo treatment on a regular basis, need longer isolated because of contagious disease
Patients are usually no longer can transmit the disease After undergoing treatment for 10-14 days.
DEFINITIONS
Most feeding problems and digestive disorders in newborns is not a serious problem and often disappear spontaneously or can be mitigated by the changes in feeding patterns.
Regurgitation and vomiting
Babies often spit (spit, regurgitation) small amounts of milk when or after feeding, often accompanied by belching. This is normal.
Sometimes regurgitation caused by drinking too fast and swallow air.
Very much regurgitation can result from feeding too much.
If milk is given through a bottle, regurgitation can be reduced by using a dot that is harder and smaller holes.
More often menyendawakan baby during breastfeeding can also help, both in infants fed with breast milk or a milk bottle.
Spew large amounts of milk may reveal an abnormality.
Vomiting that occurs repeatedly radiating may reveal narrowing or blockage in the stomach hole (stenosis pilorika).
Blockage in the small intestine which causes vomiting greenish.
Galactosemia can also cause vomiting.
Vomiting accompanied by fever may be caused by infection.
Poor feeding
Babies who get enough food to eat normally after the administration will be quiet or asleep. If feeding less, then 1-2 hours after feeding, the baby will stay awake and restless, apparently still hungry.
In infants aged less than four months, weight gain of less than 200 grams / week were low / less, and may reveal a lack of feeding.
Excessive feeding
Obesity later in life sometimes starts from excessive feeding in infancy. Obesity also involve heredity. The chances of obesity in infants who his parents are also obese amounted to 80%.
If the weight gain too fast (based on standard growth charts), then it should be controlling the speed of weight gain.
Diarrhea
Newborns usually do defecate as much as 4-6 times / day. Infants who received breast milk tend to frequently issue frothy stool, especially if it did not get solid food.
That need attention is if the baby has a bad appetite, vomiting, weight decreased, not increased weight or stool containing blood.
Bacterial or viral infections can cause severe diarrhea. Acute Diarrhea most often byi disebakan by infection.
- Mild diarrhea that lasted for weeks or months may be caused by celiac disease: a hereditary disease, which gluten (protein in wheat) causes an allergic reaction occur in the lining of the intestine so that absorption of fat became ugly.
Celiac disease causes malnutrition, poor appetite and foul-smelling stools are pale.
To cope with this disease, patients should not consume any kind of wheat.
Cystic Fibrosis : a hereditary disease, which occurs several organ dysfunction, including the pancreas.
Pancreas does not produce a sufficient number of enzymes to digest proteins and fats. Without the appropriate digestive enzymes, the body will waste a lot of protein and fat in the stool, resulting in malnutrition and growth restriction. Stool is very large and smelly.
To treat pancreatic extracts given.
-Malabsorbsi sugar, occurs in infants who experience shortages of certain intestinal enzymes to digest certain sugars, such as the enzyme lactase to digest lactose.
Intestinal infection caused a temporary shortage of the enzyme, whereas the enzyme deficiency hereditary disease which causes permanent.
This situation can be overcome by not eating sugar.
- Allergies milk sometimes causes diarrhea, vomiting and blood in the stool. The symptoms will disappear if the milk formula was replaced by soy milk. But some babies are allergic to formula milk are also allergic to soya milk. Babies are almost never allergic to breastmilk.
Constipation
Anus in babies aged less than three months may be narrow, so that the baby must be straining and stool comes out very thin.
This can be overcome by expanding the anus with your fingers as much as 1-2 times / hair.
Stools that could tear the lining of the anus (anal fissures), so when defecation pain and the possibility will arise in the stool will have a small amount of bright red blood.
The existence of fissures can be seen on examination anoskopi. Without special treatment, fissures will be better soon. Can also be given a mild stool softener.
Severe constipation persist, particularly if it starts before the baby reaches the age of one month, could indicate a serious disorder. Eg Hirschsprung's disease (neurological disorders are accompanied by large intestine) or an underactive thyroid gland.
DEFINITIONS
Normal human reproduction involves interactions between various hormones and organs, which is regulated by the hypothalamus (a region in the brain).
In men and women, the hypothalamus produces hormones called releasing factors (RH).
RH walked into the pituitary (a gland located below the hypothalamus) and stimulates the pituitary to release other hormones. Eg gonadotropin-releasing hormones (produced by the hypothalamus) stimulates the pituitary to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
- LH and FSH stimulates the maturation of the reproductive glands and release of sex hormones: the woman's ovaries to release estrogen
- The testes in the male to release androgens (eg testosterone).
Sexual hormones are also released by the adrenal glands, located above the kidneys.
The pattern of release of hormones and hormone levels in the blood is an indication of the stimulation or inhibition in the release of LH and FSH by the pituitary. For example, decreased levels of sex hormones stimulate the pituitary to release more LH and FSH.
Hormones are released every 1-3 hours, because that hormone levels in the blood is usually spotty.
Puberty
Puberty is early sexual maturation, which is a period in which a child suffered physical changes, hormonal and sexual abuse and able to conduct the process of reproduction.
Puberty associated with rapid growth and emergence of secondary sexual characteristics.
At birth, levels of LH and FSH are high, but several months later declined and remained low until puberty.
At the beginning of puberty, both hormones are increased, thus stimulating the formation of sexual hormones. Elevated levels of the hormone causes:
- Maturation of the breast, ovary, uterus and vagina
- Commencement of the menstrual cycle
- The appearance of secondary sexual characteristics (such as pubic hair and underarm hair).
These changes occur sequentially during puberty to sexual maturity occurs.
In girls, the first change occurs at puberty is usually a protrusion of the breast, which was soon followed by the growth of pubic hair and armpit hair. The distance between the protrusion of the breast with the first menstrual cycle, usually about two years.
Changing body shape and body fat percentage increases. The rapid growth of the body (especially the addition of height) usually begins before the breasts enlarged. Besides, from the vagina out clear or whitish fluid and the addition of wide pelvic bone.
The most rapid growth relative body occurs in early puberty (before the start of the menstrual cycle). Then the growth slows and typically stops at the age of 14-16 years. In the boys are on the contrary, the body's most rapid growth occurred at 13-17 years of age and continue until the beginning of 20 years.
In girls, puberty usually occurs at age 9-16 years. Average daughter undergoes puberty two years earlier than boys.
Age of puberty appears to be influenced by child health and nutrition, as well as socio-economic factors and heredity.
Slightly chubby girls who tend to experience first cycle early, while girls are skinny and malnourished tend to have slower first cycle. The first cycle also occurs earlier in girls who live in the city.
MENSTRUAL CYCLE
Menstruation is the release of the uterine lining (endometrium), accompanied by bleeding and occur repeatedly every month except during pregnancy.
First menstruation (called menarche) most often occurs at the age of 11 years, but can also occur at the age of 8 years or 16 years.
Menstruation is a sign of the reproductive years in the life of a woman, who started from menarche to menopause.
The first day of bleeding is calculated as the beginning of each menstrual cycle (day 1). Cycle ends right before the next menstrual cycle.
Menstrual cycles ranging from 21-40 days. Only 10-15% of women who have 28 day cycles.
The distance between the longest cycle usually occurs shortly after menarche and immediately before menopause.
Initially, the cycle may be irregular. The distance between the two cycles can last for two months or within one month may be two cycles. This is normal, after a long cycle will become more regular.
And duration of the menstrual cycle can be known by making notes on kalender.Dengan use the calendar, mark your cycle each month. After several months, you can know your cycle pattern and this will help you in predicting future cycles.
Mark each day of the first with a cross, then count to the next cross. Thus you can find out your cycle.
Each month, after day 5 of the menstrual cycle, the endometrium begins to grow and thicken in preparation for the possibility of pregnancy.
Around day 14, there was the release of eggs from the ovaries (ovulation). Tues telulr this into one of the fallopian tubes. Can occur in the fallopian fertilization by sperm.
If fertilization occurs, the egg will go into the womb and begin to grow into a fetus.
At about day-to-28, if no fertilization occurs, the endometrium is released and bleeding (menstrual cycle). The cycle may last for 3-5 days, sometimes up to seven days.
The process of growth and thickening of the endometrium and then started again on the next cycle.
