PTCA

Percutaneous transluminal coronary angioplasty (PTCA) is performed to open blocked coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue without open-heart surgery. A special catheter (long hollow tube) is inserted into the coronary artery to be treated. This catheter has a tiny balloon at its tip. The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery. The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow.

The use of fluoroscopy (a special type of x-ray, similar to an x-ray “movie”) assists the physician in the location of blockages in the coronary arteries as the contrast dye moves through the arteries. A small sample of heart tissue (called a biopsy) may be obtained during the procedure to be examined later under the microscope for abnormalities.

A technique called intravascular ultrasound (IVUS), a technique that uses a computer and a transducer that sends out ultrasonic sound waves to create images of the blood vessels, may be used during PTCA. The use of IVUS provides direct visualization and measurement of the inside of the blood vessels and may assist the physician in selecting the appropriate size of balloons and/or stents, to ensure that a stent, if used, is properly opened, or to evaluate the use of other angioplasty instruments.

The physician may determine that another type of procedure is necessary. This may include the use of atherectomy (removal of plaque) at the site of the narrowing of the artery. In atherectomy, there may be tiny blades on a balloon or a rotating tip at the end of the catheter. When the catheter reaches the narrowed spot in the artery, the plaque is broken up or cut away to open the artery. Atherectomy is used when the plaque is calcified, hardened, or if the vessel is completely closed. Another type of atherectomy procedure uses a laser, which opens the artery by "vaporizing" the plaque.

Osteomyelitis

Osteomyelitis is characterized as an acute or chronic inflammatory condition of bone due to secondary infection of bacterial organisms. There are basically two process of contracting osteomyelitis 1) hematogenous infection and 2) direct contiguous infection. Hematogenous osteomyelitis is a secondary bone infection caused by blood bacteriemia seeding infectious bacteria into the bone through the blood stream. This is a common cause of osteomyelitis in children. Over 85% of hematogenous osteomyelitis is reported in children. This infection is most commonly associated with vascular metaphyseal infection in the young, growing bone. Vessels can thrombose and bone will locally necrose from bacterial infection. Direct or contiguous osteomyelitis is the most common cause of bone infection caused by open ulceration in diabetes after a break in the skin barrier. The most common pathogen to cause this infection is staphylococcus aureus. However, ulcerative osteomyelitis is multibacterial in nature with common pathogens such as pseudomonas and streptococcus species as primary and secondary organisms.

Heart Attack Symptoms

Chest Pain. People with heart disease or risk factors should be concerned about any chest pain, usually precipitated by exercise or stress, that interrupts normal activities and does not clear up after resting or taking angina medications. Chest symptoms might be experienced as follows:

• Pain is typically felt as a crushing weight against the chest, accompanied by profuse sweating. The pain may radiate to the left shoulder and arm, the neck or jaw, and even infrequently to the right arm. The arm may be tingling or numb.
• Some people may have only a tingling sensation or a sense of fullness, squeezing, or pressure in the chest.
• In some patients with a history of heart disease, chest pain is mild. Such patients may have experienced unexplained fatigue, depression, and ill health within a month of a heart attack. Although chest pain is the classic symptom, it occurs in only about half of patients with a heart attack.

Other Common Symptoms.

• Nausea, vomiting, and cold sweats
• A feeling of indigestion or heartburn
• Fainting
• A great fear of impending death, a phenomena known as angor animi

Atypical Symptoms. Some studies suggest that nearly half of patients with heart attack do not have chest pain as the primary symptom. Common atypical symptoms of a heart attack include:

• Shortness of breath
• Cardiac arrest
• Dizziness, weakness, and fainting
• Abdominal pain

Patients most likely to have atypical symptoms are women and the very elderly (although they can certainly have classic heart attack symptoms as well).

• In one study, 52% of elderly people with acute coronary syndrome had atypical symptoms that included shortness of breath, nausea, profuse sweating, pain in the arms, and fainting. Such symptoms were more likely to occur in people with personal or family history of heart disease.
• Before a heart attack, women are more likely than men to be nauseous and experience pain high in the abdomen or chest. Their first symptom may be extreme fatigue after physical activity rather than chest pain. Chest pain in women is also more likely to be caused by non-heart problems than in men.

Symptoms That Are Less Likely to Indicate a Heart Attack. The following symptoms are less likely to be due to a heart attack:

• Sharp pain brought on by lung movements or coughing
• Pain that is mainly or only in the middle or lower abdomen
• Pain that can be pinpointed with the top of one finger
• Pain that can be reproduced by moving or pressing on the chest wall or arms
• Pain that is constant and lasts for hours (although no one should wait hours if they suspect they are having a heart attack)
• Pain that is very brief and lasts for a few seconds
• Pain that spreads to the legs

However, the presence of these symptoms does not always rule out a serious heart event (health.nytimes.com).

Breats Cancer

Symptoms of Breast Cancer

Symptoms of breast cancer include:

• enlarged lymph nodes in the armpit ("axillary")
• nipple discharge
• lumps, dimples or swelling in the breast
• suddenly inverted nipple or nipple pain
• persistent breast tenderness
• sudden prominent veins at the surface of the breast.

These are cancer warning signs and should not be ignored.

Lumps are typically firm structures that may or may not be painful. Any armpit lump, enlarged lymph nodes, or breast swelling should be reported to your doctor. Skin discoloration or texture change should be similarly shared.

Borobudur Yogyakarta

Borobudur temple (at two seasons of the year) — one of the most magnificent Buddhist shrines in the world — was built at the end of the 9th century by the Hindu kings of the Sailendra dynasty. Borobudur is located 42 kms west of Yogyakarta, on the island of Java in Indonesia. The plan for this stupa is a schematized representation of the cosmos, a mandala. After visiting its lower terraces decorated with bas-relief, pilgrims attain the shrine's crowning stupa, which symbolizes the Absolute.Yogyakarta, Indonesian have many unique situs, e.c prambanan temples, kalasan temple, mendut temple, beautiful beach i.e parangtritis, samas, and depok beach with sun set.

Attorney Malpractice

There are three main types of attorney malpractice:

• Negligence – If your attorney did not treat your case as well as an average attorney should, then your attorney was probably negligent in handling your case. Your attorney may have committed malpractice, and can be held liable for any damages you suffered as a result.
• Breach of Fiduciary Duty – If an attorney acts in his own best interest instead of yours and your case is adversely affected because of it, your attorney has probably committed malpractice by breaching his fiduciary duty. You can sue your attorney for the damages you suffered.
• Breach of Contract – When you hire an attorney, you sign a contract with him. If he fails to do what the contract obligates him to do, then he has committed malpractice and you may be able to recover damages.
  

There are many ways an attorney can commit malpractice. Here are a few common examples of lawyer malpractice:

• Blunders – If your attorney makes outrageous mistakes, such as missing court dates and deadlines, failing to properly submit documents to the court, or otherwise being irresponsible, your attorney may have committed malpractice.
• Bad Checks – If your attorney sends you a check from his own account for damages you've won, and the check bounces, your attorney may have committed malpractice.
• Settling Without Your Permission – If your attorney settles a case without your permission, your attorney may be liable for malpractice.
• Failing to Contact You – If your attorney has not returned your phone calls or responded to your letters for a long period of time, he may have committed malpractice
  (legalmatch.com).

Lung Cancer to Asbestos Exposure

A smoker has a risk of lung cancer because of smoking that is much greater than that of individuals who have never smoked, but, even so, that person has a fairly good chance of not developing a lung cancer based on the risk seen in the population of all smokers. If that smoker does develop lung cancer, the lung cancer will be caused by the tobacco smoke and could have been avoided if the person had never smoked. If we look closer at the population of smokers with a risk of lung cancer, we can identify criteria that select those with the most risk of developing lung cancer based on the cumulative dose of tobacco smoke that they are exposed to and to factors of individual susceptibility. However, the causal association between tobacco smoke and lung cancer is so strong that we seldom do more than obtain a smoking history and do not require a detailed analysis of corroborating evidence to link a smokers lung cancer to tobacco smoke in the vast majority of cases.

Many studies examine only the risk of lung cancer for asbestos-exposed populations and do not investigate the criteria for ascribing an individuals lung cancer to asbestos exposure. Studies have demonstrated that certain occupations and populations of workers commonly have higher asbestos exposures and greater risks of asbestos-related diseases than others. For compensation, however, a worker must substantiate the individual claim (Philip T. Cagle, 2008).

Mesothelioma - Pathophysiology

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is thepleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.

Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.

Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet derived growth factor transforming growth factor -β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres. (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres (en.wikipedia.org, 2008).

Mesothelioma - Pain Management

Mesothelioma patients often suffer from a great deal of pain as a result of their illness. There are many sources of pain for those suffering from various forms of cancer, including Mesothelioma. These tumors can press on nerves, organs or bones and cause pain ranging from mild to severe. There can be pain associated with the mesothelioma treatment itself - whether treatment is from surgery, chemotherapy or radiation. There is psychological pain associated with the knowledge that you have cancer, the burden that you believe that cancer places on your family and related issues. You can also have other pains not related to your cancer that can add to the burden. Patients are often afraid to speak up for themselves and let doctors know that they are in pain.

The medical community is working to improve the management of the mesothelioma patient's pain. Many patients are unaware of the numerous resources available that can help them feel better - some of them at no cost. Your doctor will explain that there is no benefit to enduring this pain - it can cause problems sleeping, problems with activity and movement, make you less likely to eat, increase depression, and interfere with how you interact with family and friends. Untreated, pain can diminish your quality of life. And keeping a positive outlook will be key as you move ahead. With the numerous resources and methods available for treating pain, no one should suffer from unmanageable pain. Many hospitals monitor pain closely. The Sloan-Kettering Cancer Center refers to it as the "5th Vital Sign" - believing it should be monitored and addressed.

If you want to better understand what your doctors and health care workers are doing to help you manage your condition, understanding tools available for pain management may help. The three most common types of pain are chronic, acute and breakthrough. Chronic pain can be varying in degree from mild to severe, and persists over a long time. Acute pain is short in duration, quite sudden and can be severe. Someone who experiences pain, when his or her chronic pain is normally controlled by medication is said to have "Breakthrough" pain.

There are several things that can be done to control pain, but you must first help your doctor assess your pain. You can keep a record or journal of your pain to share with your doctor. You are the only one who knows where your pain is located, how intense it is, how often it occurs, and what helps you feel better. Once you have determined how much pain you are having, you can inform your doctor. He cannot help you unless you let him know that you are experiencing pain. You should also let him know if you are experiencing any new pain or any changes in pain that you have had. Together, you can develop a plan to effectively minimize your pain. [Note: Your doctor will manage your care. This information may help you as you move ahead.]

Your particular mesothelioma treatment, whether it is from surgery, chemotherapy, radiation therapy or immune therapy, may provide some relief as they rid your body of the underlying cancer. Your doctor may want you to consider other pain management tools. These methods include the use of medications/anesthesia. There are several ways that medications are administered - orally, intravenously, suppositories, patches, and shots. Medications are divided into groups: Non-Opioids, Opioids, and Rapid-Onset Opioids. Non-Opioids are non-narcotic drugs that are used for mild to moderate pain. This can include over the counter medications, such as Tylenol. Opioids are narcotics that are prescribed for moderate to severe pain. Rapid-Onset Opioids are narcotics used to treat breakthrough pain. Epidurals, nerve blocks, or implanted pain pumps can also help. Some medications will cause side effects, but these can usually be managed by your doctor if you advise him of your problems.

Neurosurgery is another option to help reduce your pain. Basically, this method alters or interrupts nerve pathways to reduce pain. It can also be used to implant drug-delivery devices. Some mesothelioma patients have been helped with neurosurgery.

Psychological and Social Approaches are vital to helping you and your family deal with anxiety and depression that you may be experiencing. It can also help you to devise coping skills for handling your pain, and teaching your loved ones how to step in and help you when you are experiencing pain. It can also provide support to help you and your family manage your illness. By learning how to cope with your pain and asking for help, you are improving your own quality of life (mesoinfo.com, 2008)

Personal Injury Claim

To determine what your claim is worth, you must first know the things for which you are entitled to compensation. Usually, a person who is liable for an accident -- and therefore his or her liability insurance company -- must pay an injured person for:

• medical care and related expenses
• income lost because of the accident, because of time spent unable to work or undergoing treatment for injuries
• permanent physical disability or disfigurement
• loss of family, social, and educational experiences, including missed school or training, vacation or recreation, or a special event
• emotional damages, such as stress, embarrassment, depression, or strains on family relationships -- for example, the inability to take care of children, anxiety over the effects of an accident on an unborn child, or interference with sexual relations, and
• damaged property.

Determining fault for an accident is not an exact science. But, in most claims, both you and the insurance adjuster will at least have a good idea whether the insured person was entirely at fault, or if you were a little at fault, or if you were a lot at fault. Whatever that rough percentage of your comparative fault might be -- 10%, 50%, 75% -- is the amount by which the damages formula total will be reduced to arrive at a final figure (Nolo.com, 2008)