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Archive for December, 2008

Discount Diabetic Supplies Insulin Pouch Diabetics idabetes Buy Discount Diabetic Supplies insulated portable Insulin Pouch & get Desserts for Diabetics with idabetes

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Pleural thickening

Pleural thickening And Mesothelioma Chest Xray Tech


Pleural thickening may follow organization of a variety of inflammatory processes involving the pleura. These include infective pleural effusions, empyema, haemothorax, occupational exposure to asbestos or talc (see asbestosis, talcosis), rheumatoid lung disease, radiation therapy and drugs. Pleural thickening may also occur as a result of infiltration of the pleura by various malignant tumours, especially mesothelioma and metastatic adenocarcinoma. It may be uni- or bilateral, diffuse or localized and may be calcified.

On the chest radiograph the changes predominantly affect the dependent areas with blunting of the costophrenic angle. Extensive pleural thickening produces volume loss and a veil-like reduction in transradiancy of the hemithorax. There is a soft tissue density medial to and paralleling the chest wall with a well-defined inner margin. There may be extension into the fissures which appear thickened. In contradistinction to pleural fluid the appearance remains constant on a decubitus radiograph.

Chest ultrasonography can be used to detect pleural thickening and distinguish it from pleural fluid but is only reliable if the pleura is more than 1 cm thick. The appearances are usually of a homogeneous echogenic layer between the chest wall and underlying lung.

CT is much more sensitive in detecting pleural thickening which is seen as a layer of soft tissue density between the chest wall and lungs (Fig.1). Thickening of as little as 1 – 2 mm can be detected with HRCT.

Pleural thickening is best assessed immediately internal to the ribs where there is normally no detectable soft tissue. Between the ribs the normal pleura and innermost intercostal muscle produce a thin line which should not be mistaken for pleural thickening. In the paravertebral region, any thickening of the pleural line is abnormal. In many diseases causing pleural thickening the layer of extrapleural fat between parietal pleura and chest wall is increased, allowing a subtle degree of thickening to be detected, especially with HRCT.
The distribution and shape of pleural thickening as determined by CT are useful for differentiating between benign and malignant causes of pleural thickening. The most useful signs in predicting the presence of malignancy are circumferential thickening, nodularity, thickening of greater than 1 cm and involvement of the mediastinal pleura.

Localized pleural thickening often occurs at the lung apices with increasing age, forming an apical cap. This may be uni- or bilateral and is usually of homogeneous, soft tissue density, usually less than 5 mm thick, with a well-defined inferior margin. It should be distinguished from a superior sulcus neoplasm. …


Mesothelioma Demographic Statistics

Mesothelioma Demographic Statistics ANDSTRING Frequency

Author: http://www.PainsAway.Info

The number of individuals affected by asbestos-related disease is slowly increasing. However, whether this is secondary to a true increase in incidence or due to increased recognition is debated.

The prevalence of benign pleural plaques in the non�asbestos-exposed general population is extremely low. The prevalence in environmentally exposed general populations in industrial societies is approximately 0.5-8%. Frequencies in exposed individuals are 3-58%, depending on occupation. The development of plaques depends on the length of exposure or the amount of time that has passed since the first exposure, as opposed to being dependent on a threshold dose, which is the case for asbestosis. The prevalence of pleural plaques is 10% in exposed individuals 20 years after exposure, rising to 50% after 40 years.

The prevalence of diffuse pleural thickening is not known, although it is reported to occur with frequency equal to that of pleural plaques. Thickening is a common concomitant finding to asbestosis, with a reported associated incidence of 10%.

The frequency of benign, asbestos-related pleural effusions in exposed individuals is reported to be 3-7%. However, this number may be an underestimate, because most patients are asymptomatic; therefore, effusions are subclinical and undetected. The incidence rises with increasing levels of asbestos exposure.

Asbestosis is reported to develop in 49-52% of adults with industrial asbestos exposure, after a latency period of 40-45 years.

Approximately 2000-3000 cases of malignant mesothelioma, or 7-13 cases per million general population, are diagnosed annually in the United States.

Epidemiologic studies predicted a decline in incidence in the United States after the year 2000, with a peak incidence in the United Kingdom in 2020. The prediction is probably applicable to benign pleural plaques also, because the latency period is similar. Lung cancer develops in as many as 25% of asbestos workers. In asbestos-exposed nonsmokers, the incidence of lung cancer is 5 times that of the general population. In exposed individuals, smoking further increases the risk of bronchogenic carcinoma by 80-90 fold.

The incidence of asbestos-related lung and pleural disease in the remainder of the industrialized world remains similar to that of the United States. In the United Kingdom, asbestos use was highest in the 1970s, later than in the United States; therefore, the peak incidence of disease lags as well. Legislation regarding asbestos varies from country to country, and although crocidolite is rarely used internationally, other forms of asbestos remain in use.

After the onset of symptoms, severe asbestosis may lead to respiratory failure and death over 12-24 years. Respiratory failure may be accelerated by the development of Caplan syndrome; pulmonary hypertension; or malignancy, including lung cancer or mesothelioma.

No treatment for asbestosis is effective. The primary strategy is prevention, through the worldwide elimination of asbestos use and the replacement of asbestos with safe synthetic products.

Mesothelioma tends to appear late and is usually associated with an extremely poor prognosis. The median survival is 10 months or less, and most patients die within 2 years.20

See also the following related Medscape topics:
CME Advances in the Systemic Therapy of Malignant Pleural Mesothelioma
CME/CE Interstitial Lung Disease and Pulmonary Hypertension

No race predilection exists for asbestos-related disease.

Mesothelioma has a male-to-female ratio of approximately 4:1. Asbestos-related disease in women is uncommon and is usually confined to spouses of industrial workers, as well as to secretarial and domestic staff working in asbestos industries.

A minimum latency period of 8-10 years is required for an asbestos-related pleural effusion to develop; this is usually the earliest manifestation of asbestos-related disease. Similarly, a latency period of more than 20 years is required for the development of asbestosis. As a result, most patients with asbestos-related disease are older than 40 years.

Mesothelioma usually is seen after a longer latency period, with most patients in the sixth-to-eighth decades of life.

* Pleural plaques are not reported to cause symptoms.
* Diffuse pleural thickening may be associated with symptoms and signs comparable to those arising from other causes of fibrothorax, such as dyspnea. The restriction of lung function rarely may be severe enough to warrant decortication of the lung.
* The clinical picture in benign, asbestos-related pleural effusion varies from asymptomatic patients to patients with an acute episode of pleuritic chest pain and pyrexia.
* Asbestosis may cause an insidious onset of progressive dyspnea in addition to a dry cough. Clinical findings of basal inspiratory crackles associated with reduction in vital capacity and diffusion capacity are also seen.
* Asbestosis is usually diagnosed on the basis of certain clinical, functional, and radiographic findings outlined by the American Thoracic Society (ATS).21 However, these guidelines have not been updated since the routine clinical use of high-resolution computed tomography (HRCT) scanning began in the early 1990s.22, 23 Findings based on the ATS criteria include the following:
o Reliable history of nontrivial asbestos exposure
o Appropriate interval between exposure and detection (usually >10 y)
o Abnormal chest radiographic findings
o Restrictive lung disease as indicated by pulmonary function test results
o Abnormal diffusing capacity
o Bilateral crackles at the lung bases that are not cleared by coughing
* Clinical symptoms in malignant mesothelioma are frequently present 6-8 months prior to diagnosis. Symptoms include localized chest wall pain and weight loss. Cough and dyspnea may also be present.

The international staging system for malignant mesothelioma is as follows:

* Tumor
o T1a – Tumor limited to ipsilateral parietal pleura
o T1b – Additional scattered foci of visceral pleural involvement
o T2 – T1 plus involvement of diaphragmatic muscle and/or confluent visceral tumor (including fissures) or direct extension to the pulmonary parenchyma
o T3 – Locally advanced (but potentially resectable) tumor encasing the lung with at least 1 of the following features:
Involvement of endothoracic fascia
Extension into mediastinal fat
Solitary focus of chest wall invasion
Nontransmural involvement of pericardium
o T4 – Locally advanced, unresectable tumor encasing the lung, with at least 1 of the following features:
Multifocal or diffuse chest wall involvement
Transdiaphragmatic peritoneal spread
Direct extension to contralateral pleura
Involvement of vital mediastinal structures
Direct extension to the spine
Transpericardial disease, with or without pericardial effusion or myocardial involvement
* Node
o N0 – No regional nodal metastases
o N1 – Ipsilateral bronchopulmonary or hilar nodal enlargement
o N2 – Ipsilateral mediastinal (including internal mammary) or subcarinal nodal enlargement
o N3 – Contralateral mediastinal, contralateral internal mammary, or supraclavicular nodal enlargement
* Metastasis
o M0 – No distant metastases
o M1 – Distant metastases present
* Staging
o Stage Ia – T1a, N0, M0
o Stage Ib – T1b, N0, M0
o Stage II – T2, N0, M0
o Stage III – Any T3, M0; any N1, M0; any N2, M0
o Stage IV – Any T4, any N3, any M1

Preferred Examination

HRCT scanning is playing an increasingly important role in the diagnosis of diffuse interstitial lung disease. However, chest radiography remains the initial modality for the detection and characterization of pleural and parenchymal disease. Ultrasonography has a role in characterizing pleural effusions and guiding pleural aspiration and biopsy. Nuclear medicine study has a limited role in the investigation of asbestos-related intrathoracic disease. Gallium-67 (67 Ga) citrate testing has been used to differentiate benign from malignant, asbestos-related pleural disease and to give a quantitative index of inflammatory activity.24
Limitations of Techniques

The limitations of chest radiography in the diagnosis and evaluation of asbestos-related disease are well recognized. The quality of the radiograph and the size, shape, position, and degree of calcification determine whether the radiologist can detect pleural plaques on the image. While the identification of bilateral, scattered, calcified, costal, and diaphragmatic pleural plaques is virtually diagnostic of asbestos exposure, studies have shown an 11% false-positive rate with chest radiographs. In particular, extrapleural fat mimics pleural thickening and is a significant cause of false-positive readings. Conversely, a high false-negative rate has also been reported.

Computed tomography (CT) scans have long been known to be more sensitive and specific than chest radiographs for the diagnosis of asbestos-related pleural disease.25, 26

Radiographic-pathologic studies have shown that chest radiographic findings are normal in as many as 20% of patients with asbestosis. HRCT scanning is more sensitive and specific than other studies, particularly when images are obtained with the patient in the prone position, which allows differentiation of mild parenchymal changes from dependent density (increased attenuation of the posterior, usually basal, lung, which is gravity induced and secondary to nonaeration of dependent alveoli).27

Nuclear medicine studies have been used in small series, but their exact role remains unclear. …


What is Asbestos?

What is Asbestos?

Author: http://www.PainsAway.Info

Asbestos is a naturally occurring, fibrous silicate that was widely used in the past for commercial applications because of its heat-resistance properties. Asbestos exists in several forms. The 2 primary groups of asbestos are made up of amphibole and serpentine fibers. Amphibole fibers, which are characteristically straight, rigid, and needlelike, can be subdivided into commercial amphiboles (crocidolite, blue asbestos, and amosite [brown asbestos]) and noncommercial amphiboles (actinolite, anthophyllite, and tremolite). Chrysotile (white asbestos) is the only form of serpentine asbestos that is used commercially, and it accounts for more than 90% of asbestos used in the United States.1

For the most part, asbestos exposure has been industrial or occupational; such exposure primarily affects workers involved in mining or processing asbestos or those involved in the use of asbestos in the shipbuilding, construction, and textile- and insulation-manufacturing industries.2, 3 Chrysotile is mined in Canada, and tremolite and anthophyllite are mined in Finland and North America. Crocidolite and amosite are mined in South Africa and Australia. About 2-6 million people in the United States are estimated to have had significant levels of exposure.3, 4

High exposures ceased in the United States in the late 1970s, and later in the United Kingdom, because of governmental legislation passed after the adverse effects became recognized. However, because the latency period between an initial exposure and the development of most asbestos-related disease is 20 years or longer, asbestos-related disease remains an important public health issue.5, 6

The spectrum of asbestos-related thoracic diseases includes benign pleural effusion, pleural plaques, diffuse pleural thickening, rounded atelectasis, asbestosis, mesothelioma, and lung cancer.7

Asbestosis is defined as diffuse lung fibrosis due to the inhalation of asbestos fibers, and it is one of the major causes of occupationally related lung damage. Mesothelioma is a malignant pleural or peritoneal tumor that rarely occurs in patients who have not been exposed to asbestos.8, 9, 10, 11, 12, 13

The diagnostic approach to asbestos-related intrathoracic disease is different from that of other diffuse lung diseases because of the medicolegal implications.14 The likelihood of asbestos-related disease should be determined, and other possible causes should be eliminated. An assessment of the extent of disease is used to calculate compensation. Therefore, imaging plays a pivotal role in the diagnosis and management of asbestos-related disease. …


Electric Scooters For Seniors Are A Terrific Gift Idea

For years, handicapped seniors have been begging for the newest bicycle on the market. The holiday season is always the prime time for kids to begin a clamor for a great gift. The image of a bicycle topped with a big bow sitting next to a Christmas tree has also been used by advertisers for years. In the near future the popular image to portray holiday happiness may very well be a scooter with a big red bow. The kids electric scooters like the Razor e200 is one of the most desired items that kids are requesting this year. If you ask almost any youngster who is between 8 and 15, they can tell you about brands, colors and specs for every scooter model.

Kids are thrilled by the though that they own a form of transportation no matter if it is skates, a bike, or a skateboard. Children often dream about futuristic cars and motorcycles. Kids can have the thrill of having their own “real wheels” with these sporty electric scooters. While parents can’t give an actual automobile, at last , there is this kids electric scooter.

When selecting a kids electric scooter,there are a few things to consider. Full sized decks are included with most high quality kid’s scooters, maximizing your child’s safety. The deck size of a scooter can make the riding experience very different especially when it comes to the deck size.

Before you buy a scooter, you should investigate its top speed. Older children will not find much fun in a scooter that barely putts downhill at 5 miles per hour! Select one capable of going at least 10 miles per hour even if your child won’t be traveling that fast right now. A quality scooter will be with the family for years and will be able to go faster as the child ages.

The weight requirements are more important than the age limit when it comes to kids electric scooters. Select one that can handle your child’s weight now and in the next couple of years. Many of the best electric scooters can accomodate 200-220 pounds.

Electric scooters as a gift are perfect for children not only because kids love them, but also because scooters are involved in fewer accidents than bicycles.

To get a full description and product summary on one of the most popular electric scooters on the market, CLICK HERE ===>> RazorE200

Diabetic Supply Companies new talking diabetic meters

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New Bed Bath Shower tray system for Handicapped in Wheelchairs

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Powder Free Latex And Vinyl Gloves, Incontinence Products And Disposable Aprons

Help Loved Ones Maintain Independent Living

When a beloved family member or elderly parent can no longer take care of themselves then it can be tough. There are often a number of issues that can lead to a person needing to be placed into care or that make them eligible to receive home care.

Old age affects motor skill.  Once simple tasks become daunting, they are no longer simple tasks, and they struggle with personal hygiene chores like going to the toilet.

Sometimes the problem can be that the motor skills are fine but the mind is starting to fail, this can be down to diseases like dementia and Alzheimer’s, which often lead to confusion and moments of anger and aggression. If you want to give someone the sort of care they require then you either have the option of trying to raise money for it by selling anything of value that you may have or by applying for help.

Caring for the old whether in a care home or your own house requires a large amount of different sorts of medical supplies. These tend to be sold in bulk form, from a wholesale health supplier. These places will be able to supply you with much of the equipment that you need such as wholesale latex gloves, Incontinence Pads and disposable plastic aprons. These are the sort of health products that you will be buying frequently to clean up as well as limit mess and to help stop the spread of diseases.

Plastic Aprons are found to be incredibly useful when taking care of the old. They are a must for people that struggle with motor skills or have difficulty feeding themselves. There are wide ranges of plastic aprons available from disposable aprons to reusable plastic aprons. They also come packaged in a number of ways from cardboard dispensers to flat packs and rolls.

There are different types of glove available for various tasks and they come in a wide range of resistant fabrics as people can often have allergies to materials like latex. There are also two different styles of glove some that contain powder where as others do not and are called powder free gloves. Powder is often put into gloves to make them easier to don if the task you are performing means that your hands are damp. There have been issues in the medical industry with regards to powdered gloves as the powder can sometimes cause problems when performing tasks like surgery. This has meant that more medical institutions have now switched to Powder Free Vinyl Gloves in most cases as they are a lot safer to use when you are working with open wounds.

Drive’s Akkulift Bath Lift for Disabled Handicap Bathroom Bathtubs

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