Burkitt Lymphoma

Burkitt’s lymphoma (or Burkitt Lymphoma) is an uncommon type of Non-Hodgkin Lymphoma (NHL). Burkitt’s lymphoma commonly affects children. It is a highly aggressive type of B-cell lymphoma that often starts and involves body parts other than lymph nodes. In spite of its fast-growing nature, Burkitt’s lymphoma is often curable with modern intensive therapies.

Two types of Burkitt's lymphoma:

There are two broad types of Burkitt’s lymphoma – the sporadic and the endemic varieties. There is a very high incidence of this disease in equatorial Africa, and disease in this region is called endemic Burkitt’s lymphoma. Disease in other regions of the world is much less common, and is called sporadic Burkitt’s lymphoma. Though they are the same disease, the two forms are different in many ways.

Endemic Burkitt’s lymphoma:

In equatorial Africa, about half of all childhood cancers are Burkitt’s lymphoma. The disease involves children much more than adults, and is related to Epstein Barr Virus (EBV) infection in 95% cases. It characteristically has a high chance of involving the jawbone, a rather distinctive feature that is rare in sporadic Burkitt’s. It also commonly involves the abdomen.

Sporadic Burkitt’s lymphoma :

The type of Burkitt’s lymphoma that affects the rest of the world, including Europe and the Americas is the sporadic type. Here too, it's mainly a disease in children. The link between Epstein Barr Virus (EBV) is not as strong as with the endemic variety, though direct evidence of EBV infection is present in one out of five patients. More than the involvement of lymph nodes, it is the abdomen that is notably affected in more than 90% of the children. Bone marrow involvement is more common than in the sporadic variety. Jaw involvement is extremely rare.

Treatment of Burkitt’s lymphoma:

Burkitt lymphoma is a highly aggressive tumor, and often life threatening. But it is also one of the more curable forms of lymphoma. With current aggressive forms of chemotherapy that uses drugs in high doses, and with the availability of new measures to support individuals during intensive treatment, this lymphoma is curable in many patients. Nearly 80% of those with localized disease and more than half the children with more widespread disease are cured. Late relapses are hardly seen.

See Also

The types of Non-Hodgkin Lymphoma (NHL)

Tests for Lymphoma

How does Chemotherapy work?

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Anemia

Anemia is a condition at which in blood the content of functionally adequate red cells (erythrocytes) is lowered. The anemia develops owing to the varied reasons, accompanies set of diseases and frequently is only their symptom. Quantitatively it is expressed by a degree of reduction of concentration of hemoglobin – a ferriferous pigment erythrocyte, giving to blood red color. At diagnostics of an anemia it is necessary to consider normal fluctuations of concentration of hemoglobin depending on a sex and age.

The anemia arises in all the periods of human life not only at various diseases. Progress of an anemia can be connected with the climacteric period, hormonal infringements, character of a feed, diseases of a digestive path, a liver, kidneys, infringement resorption, autoimmune conditions, operative intervention and other factors. Quite often the anemia is an independent or accompanying symptom of many internal diseases, infectious and oncological illnesses.

Hematolytic anemia. Erythrocatalysis occurs under influence of antibodies. It can be the antibodies of mother directed against erythrocytes of the child at incompatibility of the child and mother on a Rhesus factor-antigene and much less often on antigenes of system AVO. Antibodies against own erythrocytes can be active at usual temperature or only at cooling. They can appear for no apparent reason or in connection with fixing on erythrocytes incomplete antigenes-hapten alien for an organism.

Aplastic anemia. Disease described by pancytopenia circumferential blood and reduction of a content of cells of a bone brain. It is connected basically with a cytopenia syndrome and depends on its depth.

Treatment of anemia

Therapy depends factors which have by nature caused an anemia. The best results are observed at introduction of separate missing substances, for example iron at iron-deficient anemias, vitamin B12 at pernicious anemias and a folic acid at aphthous cachexia (the disease, described by infringement of processes resorption in intestines and accompanied an refractory megaloblastic anemia).

The anemia caused by decrease of production erythrocytes and arising at such chronic diseases as a cancer, infections, an arthritis, to illness of kidneys and hypothyroidism, it is frequently poorly expressed and does not demand special treatment. Treatment of the basic disease should affect salutarily and an anemia. In some cases happens the cancelling of the preparations overwhelming hematosis, – antibiotics or other chemotherapeutic means is necessary.

Blood transfusions, as a rule, are shown only in the urgent cases requiring restoration of volume of circulating blood and quantity of hemoglobin, as well as at aggravations of a chronic anemia for the lack of other medical means. At heavy forms hematolytic illnesses of newborns for prevention of the jaundice, capable to lead to defeat of a brain (bilirubinic encephalopathies), apply exchange transfusion (replacement of blood of the child by the blood which is not containing the factor of destruction of erythrocytes). Blood transfusions are interfaced to a number of severe hazards, such, as sharp the hematolytic reactions of incompatibility leading nephritic insufficiency, virus infection of a liver (hepatites) and illness of adjournment of iron (bronzed diabetes).

At the some people with hematolytic conditions surgical removal of a spleen is needed; it is especially effective at congenital annulocyte anemias as leads to disappearance of all clinical symptoms though does not influence hereditary infringement of structure erythrocytes.

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Aphasia and Apraxia

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Aneurysm

Definition

An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.

See also:

• Abdominal aortic aneurysm
• Cerebral aneurysm
• Thoracic aortic aneurysm

Causes

It is not clear exactly what causes aneurysms. Some aneurysms are present at birth (congenital). Defects in some of the parts of the artery wall may be responsible.

Common locations for aneurysms include:

• The major artery from the heart (the aorta)
• The brain (cerebral aneurysm)
• In the leg behind the knee popliteal artery aneurysm)
• Intestine (mesenteric artery aneurysm)
• An artery in the spleen (Splenic artery aneurysm)

High blood pressure and high cholesterol may raise your risk of certain types of aneurysms. High blood pressure is thought to play a role in abdominal aortic aneurysms. Atherosclerotic disease (cholesterol buildup in arteries) may also lead to the formation of some aneurysms.

Pregnancy is often linked to the formation and rupture of splenic artery aneurysms.

Symptoms

The symptoms depend on the location of the aneurysm. If the aneurysm occurs near the body's surface, pain and swelling with a throbbing mass is often seen.

Aneurysms within the body or brain often cause no symptoms.

If an aneurysm ruptures, low blood pressure, high heart rate, and lightheadedness may occur. The risk of death after a rupture is high.

Exams and Tests

The health care provider will perform a physical exam.

Tests used to diagnose an aneurysm include:

• CT scan
• Ultrasound

Treatment

Surgery is generally recommended. The type of surgery and when you need it depends on your symptoms and the size and type of aneurysm.

Some patients may have endovascular stent repair. A stent is a tiny tube used to prop open a vessel or reinforce it's wall. . This procedure can be done without a major cut, so you recover faster than you would with open surgery. Not all patients with aneurysms are candidates for stenting, however. See: Endovascular embolization

Outlook (Prognosis)

With successful surgical repair, the outlook is often excellent.

Possible Complications

The main complications of aneurysm include:

• Compression of nearby structures such as nerves, which may lead to weakness and numbness (most common with aneurysms that occur in the artery behind the knee)
• Infection, can lead to body-wide illness and rupture
• Rupture, which can cause massive bleeding that may lead to death

Massive bleeding is commonly seen with abdominal aortic aneurysms, mesenteric artery aneurysms, and splenic artery aneurysms.

Rupture of brain aneurysms can cause stroke, disability, and death. For more information, see: Cerebral aneurysm

When to Contact a Medical Professional

Call your health care provider for if you develop a lump on your body, whether or not it is painful and throbbing.

Prevention

Control of high blood pressure may help prevent some aneurysms. Following a healthy diet, getting regular exercise, and keeping your cholesterol at a healthy level may also help prevent aneurysms or their complications.

References

Isselbacher EM. Diseases of the aorta. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 78.

Zivin JA. Hemorrhagic cerebrovascular disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 432.

Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 146.

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Congenital afibrinogenemia

Definition

Congenital afibrinogenemia is a rare, inherited blood disorder in which the blood does not clot normally. It occurs when you are missing or have a problem with a protein called fibrinogen, which is needed for the blood to clot.

Causes

This rare disease is caused by an abnormal gene that must be passed down from both parents. There may be either a lack of fibrinogen or a defect in the functioning of available fibrinogen. This condition can occur in both sexes. The main risk factor is a family history of bleeding disorders.

Symptoms

• Bruising
• Nosebleeds
• Excessive bleeding after injury or surgery
• Gastrointestinal bleeding
• Bleeding in joints
• Miscarriage

Exams and Tests

If the health care provider suspects a bleeding disorder, laboratory tests can determine the type and extent. This disorder usually shows up in childhood, often at birth.

Tests include:

• PTT
• Prothrombin time (PT)
• Clotting time
• Fibrinogen levels
• Thrombin time
• Reptilase time
• Bleeding time

All of these tests are abnormal in afibrinogenemia.

Treatment

Patients may receive the liquid portion of the blood (plasma) or a blood product containing concentrated fibrinogen (cryoprecipitate) through a vein (transfusion) to treat bleeding episodes or to prepare for surgery to treat other conditions. People with this condition should have the hepatitis B vaccine because transfusion increases the risk of hepatitis.

Outlook (Prognosis)

Excess bleeding is common with this condition. These episodes may be severe, or even fatal. Bleeding in the brain is a leading cause of death in patients with this disorder.

Possible Complications

• Bleeding from the umbilical cord
• Bleeding from the mucous membranes
• Gastrointestinal bleeding
• Intracranial bleeding
• Clotting with treatment
• Development of antibodies (inhibitors) to fibrinogen with treatment

When to Contact a Medical Professional

Call your health care provider or seek emergency care if you have excessive bleeding.

Tell your surgeon before you have surgery if you know or suspect you have a blood disorder.

Prevention

There is no known prevention. Couples who are thinking about having children may find genetic counseling helpful if at least one partner has this condition.

References

Hoffman R, Benz E, Shattil S, Furie B, Cohen H. Hematology: Basic Principles and Practice. 4th ed. Philadelphia, Pa: Churchill Livingstone, 2004.

Asselta R, Duga S, Tenchini ML. The molecular basis of quantitative fibrinogen disorders. J Thromb Haemost. October 2006;4:2115-2129.

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Adenoma

Adenoma (innocent hyperplasia of prostate gland, to be exact external glands of prostata) - hormonedependent disease at which there is a growth of a tela of prostate gland leading infringement of process urination.

Most often an adenoma diagnose for men older 50 years are more senior, therefore some experts consider the given disease by one of displays of a man's climax. Except for age changes there are some more the factors promoting occurrence of illness:
* hormonal infringements
* presence of other chronic diseases (an atherosclerosis etc.)
* a sedentary way of life
* the big increase in weight of a body
* the ecological factor

At an adenoma under action of testicular hormone (a man's sexual hormone) growth of cells of a ferruterous tela which adjacent direct to a wall of the urethra which are passing through prostate gland begins. Eventually proliferative the tela starts to press on urethra that leads to its narrowing. Than more time there is a disease, especially strong pressure appears on a urethra. Problems with urination begin:
* speeded up urination
* complicated and faltering urination
* a weak pressure of a uric jet
* incontience urine or a sharp delay wet
* erythrocyturia (blood in urine)

As the heaviest cases are considered a sharp delay wet and erythrocyturia. At long-standing current of illness prostate gland increases so, that ejecting a bladder becomes impossible. In such cases of patients urgent hospitalization is required. Occurrence of blood in urine specifies damage of veins of a bladder as a result of elevated pressure in it.
Depending on duration of current of disease and clinical displays allocate three stages of an adenoma. At initial stages symptoms of disease are expressed slightly, therefore the patient can not notice them at all. At the first initial stage the patient tests: frequent desires to urination, especially at night-time, time urination increases, a jet wet languid.

At transition of disease to the second stage it is observed: formation of residual urine, difficulty of outflow of urine from a bladder, faltering urination, sensation incomplete ejecting.
The further progress of illness leads to a delay or incontience of urine, internal constrictor loses the tone, can appear nethritic insufficiency.
Quite often the adenoma meshs with other diseases of urinogenital system (a cystitis, an urethritis, a pyelonephritis, urolithic illness, etc.), that is connected with infringement of process urination.
Treatment can be conservative and surgical. Selection of this or that method depends on weight of illness, availability of accompanying diseases, specific features of the patient.

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Prostatitis. Symptoms of a prostatitis. Treatment of a chronic prostatitis

The prostatitis - disease so complex and artful, that its treatment represents a greater problem for doctors of all world. However it at all does not mean, that the doctor anything helps sick of a prostatitis cannot, and to go to it it be no point. Not always there is a possibility completely to cure the patient of a prostatitis, but to eliminate symptoms of disease and to cause resistant long-term remission modern medicine in forces. And there duration of this period will already depend on the patient.

The prostatitis can suddenly develop, as sharp inflammatory disease with all corresponding semiology. In this case at the patient heat, a fever, a body temperature 38-39 With, sharp pains in perineum, a groin, for pubis, areas of back pass, painful urination and defecation will be marked.

Unfortunately, the medicine in general and urology in particular cannot boast of achievements in treatment of a syndrome which we name "prostatitis". The cancer of a prostata gland and innocent hyperplasia of prostate gland was intercepted with attention of the scientific, research centers and the pharmaceutical companies. And a prostatitis as " the poor relative " these diseases, remained long time outside of sphere of interests of the advanced medicine. Though all knew, that the echo the "dark horse" amazing prostate gland, and accordingly the attitude to a prostatitis as to "dark horse" was superficial, and sometimes - deformed.

The reasons for it was a little. Was considered, that the prostatitis does not bear direct threat for a life of the patient and, means, with this disease it is possible to adapt to live. Now the situation has cardinally changed, when to one of priorities of modern medicine became quality of a life. Last researches have shown, that the chronic prostatitis is one of frequent clinically and socially significant diseases. And mental health at a chronic prostatitis suffers not less, than at other heavy somatic diseases, that sharply reduces quality of a life of men. And it has served as serious stimulus for studying this problem.

Another very the cardinal error consist that many doctors have been convinced, and the some people till now consider, that the reason of all cases of a prostatitis is the chronic infection which is necessary for treating antibacterial preparations. Already absolutely the fact in evidence considers, that the chronic bacterial prostatitis is rather rare disease and makes only 10 % among all cases of a prostatitis.

One more serious problem are complexities in diagnostics of some forms of a prostatitis, and it is the reason of inadequate and ineffective treatment of such patients, that finally leads frustration both the patient, and the attending physician.

For example, men with urological masks of depression (urethral hypochondriacs) quite often became patients of urologists and many years were treated for a nonexistent prostatitis. It only aggravated opinion on complexity and hopelessness of treatment of a prostatitis. Other typical mistake was the far-fetched interrelation of a chronic prostatitis and erectile dysfunctions. Until recently, the mechanism fo erection has not been studied yet and methods of diagnostics and treatment of infringements erection are not standardized, the majority of the patients addressing to the urologist with AD, there passed inspection and treatment of a chronic prostatitis. In occasion of nonexistent disease of the patient accepted set of antibiotics, to it on a regular basis massed prostate gland and appointed various physiotherapeutic procedures. Thus the erection was not restored, and to the patient the label of "prostatics" that caused serious damage to mental health was attached.

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