Crossing the mind-body divide: when philosophy meets psychiatry.
WITH its battered desks, fluorescent lights and interactive
whiteboard showing an odd creature that, depending on how you look at
it, could be either a duck or a rabbit, this could be a class in any
university philosophy department.
But this is a class with a difference. It is the Maudsley Philosophy
Group, a seminar that meets regularly on the grounds of the Maudsley
Hospital, Britain’s largest mental health teaching hospital, which is
affiliated with the Institute of Psychiatry at King’s College London.
Participants at the last session included psychiatrists,
psychologists, philosophers and an actor who had just finished working
as a chaplain in a locked men’s ward at the hospital and who was about
to organise a storytelling group there.
“We started out as a reading group for trainee psychiatrists,” said
Dr Gareth S. Owen, a researcher at the Institute of Psychiatry who
co-founded the group in 2002. “Then, gradually, we developed and started
inviting philosophers – at first it was quite low key. We would talk
about our clinical experiences and then they would relate those
experiences to their way of thinking.”
Dr Robert Harland, another co-founder of the group, said he had
known Dr Owen since they “cut up a corpse together at medical school”.
“The analytic philosophers brought a real clarity to our
discussions,” Dr Harland said. “We were looking at various models to
help us understand what we were doing as psychiatrists.
“There is lots of applied science now in psychiatry: neuroimaging,
genetics, epidemiology. But they don’t have much to say about sitting
with a patient and trying to understand that person’s experiences.”
Tania L. Gergel, a philosopher whose work stretches from Ancient
Greek ideas about ethics to dilemmas in contemporary medicine, was drawn
to the Maudsley seminar out of intellectual curiosity. She also
relished the chance to “come into contact with people who have actual
clinical experience”.
“You can only learn so much from reading journal articles,” Gergel
said. “The problem is that, as you move towards abstraction, it’s easy
to lose sight of the fact that people are dealing with real suffering
and real dysfunctions. We need to remember that those dysfunctions –
whether of the brain or of the mind – are linked to a real individual
who is going through a devastating crisis.”
The question of whether a mental illness has a bodily, physical
cause is one aspect of what philosophers call the mind-body problem.
For Plato, the mental world was the real world, while Descartes argued that mind and matter were distinct.
More recently, some scientists have tried to locate consciousness in
different parts of the brain. But the dispute over its location and
origins is not just confined to philosophy or neurology departments.
A longtime member of the Maudsley seminar, Richard Sykes, a social
worker who has studied both the physical and mental sides of chronic
fatigue syndrome, or CFS, said there was a “terrific animosity between
psychiatrists and patient groups”.
“There is an immense hostility to psychiatrists because they have
got CFS wrong for such a long time,” he said. “At first, they thought it
was hysteria. Then they said it was depression. But the absence of a
medical explanation is not a good reason for saying it’s a psychiatric
illness.”
For Sykes, the Maudsley group “is a chance to make use of my own philosophical background”.
The mind-body problem also preoccupied Dr Jacqueline P. Owen, a
clinical lecturer in child and adolescent psychiatry who is married to
Dr Owen of the Institute of Psychiatry. Her own doctorate on functional
neuroimaging charted which networks in the brain lit up while performing
certain tasks.
When she graduated, she discovered that “psychology in its pure form didn’t help very much when you are seeing patients”.
“A lot of what I studied was based on subjects who had damage to
specific parts of the brain,” she said. “But in psychiatry, your
patients often have no discernible brain damage.”
The Maudsley seminar offered “a different way of seeing things”. she said.
How different? Dr Iain McGilchrist, the group’s most recent visiting
lecturer, started on familiar ground, describing recent research
showing how differences in the structure of the two halves of the human
brain are reflected in the way the brain functions. But Dr McGilchrist,
who taught English literature at the University of Oxford before
training as a psychiatrist, soon left the strict confines of
neuroscience to touch on poetry, politics, painting and anthropology.
He eventually circled back to his announced topic: “What the
reciprocal organisation of the cerebral hemispheres could tell us about
some problems in philosophy.”
In his book, The Master and His Emissary, published in
2009, Dr McGilchrist argues that each half of the brain generates a
fundamentally different way of experiencing the world. The left
“constructs a virtual world, a self-enclosed world” whose
representations we can manipulate and analyse, while the right sees
“things as they are” in a more fluid way.
He compares the “gestalt” perception of the right hemisphere to a
master who relies on the emissary of the left hemisphere for information
to make sense of his experiences. He also argues that, since the
Renaissance, the emissary has become more and more assertive.
At the Maudsley seminar, he invited his listeners to consider what
it might be like to live in “a world where knowledge has been replaced
by information, where skill and judgment has been displaced by
abstraction”.
“Our lives would be governed by bureaucracy, losing any sense that
each of us is unique,” he said. “It would be a world where quality no
longer matters and quantity is the only criterion of success,” he added,
suggesting provocatively that the condition he had just described was
the world in which we all now live.
Not everyone in the group seemed convinced by some of the more
sweeping historical claims, which set off a vigorous debate that
continued through dinner.
Dr Jacqueline Owen said that the talk offered a new way to think
about a problem she often encountered in her work. “I’m on a ward with
teenagers – boys and girls – who complain of hearing voices,” she said.
“So how do I discriminate between the ones who are really having
hallucinations and those who are just listening to their own thoughts?
“Perhaps what we need to do is step back and think about what they
are experiencing in the first place. Philosophy can provide a way into
that – something that isn’t a gene, or a drug, but that can still be
useful.”
“Psychiatry crosses domains,” Dr Gareth Owen said. “So it is
important that the people who do it can cross domains as well. Our aim
with the seminar is to provide a kind of third space – outside academic
psychiatry or clinical practice or academic philosophy.” – IHT
Friday, 30 August 2013
Malaysia Independence Day (Merdeka Day)
Independence Day (Hari Merdeka)
31 Aug 2013
Hari Merdeka (Independence Day) commemorates the independence of the Federation of Malaya from British colonial rule in 1957. It is celebrated on August 31 each year.
Venue:
Nationwide
Sunday, 25 August 2013
Saturday, 24 August 2013
Early Symptoms and Common Signs of Breast Cancer
Every person should know the symptoms and signs of breast cancer, and
any time an abnormality is discovered, it should be investigated by a
healthcare professional.
Most people who have breast cancer symptoms and signs will initially notice only one or two, and the presence of these symptoms and signs do not automatically mean that you have breast cancer.
By performing monthly breast self-exams, you will be able to more easily identify any changes in your breast. Be sure to talk to your healthcare professional if you notice anything unusual.
Most people who have breast cancer symptoms and signs will initially notice only one or two, and the presence of these symptoms and signs do not automatically mean that you have breast cancer.
By performing monthly breast self-exams, you will be able to more easily identify any changes in your breast. Be sure to talk to your healthcare professional if you notice anything unusual.
A change in how the breast or nipple feels
- Nipple tenderness or a lump or thickening in or near the breast or underarm area
- A change in the skin texture or an enlargement of pores in the skin of the breast (some describe this as similar to an orange peel’s texture)
- A lump in the breast (It’s important to remember that all lumps should be investigated by a healthcare professional, but not all lumps are cancerous.)
A change in the breast or nipple appearance
- Any unexplained change in the size or shape of the breast
- Dimpling anywhere on the breast
- Unexplained swelling of the breast (especially if on one side only)
- Unexplained shrinkage of the breast (especially if on one side only)
- Recent asymmetry of the breasts (Although it is common for women to have one breast that is slightly larger than the other, if the onset of asymmetry is recent, it should be checked.)
- Nipple that is turned slightly inward or inverted
- Skin of the breast, areola, or nipple that becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange
Any nipple discharge—particularly clear discharge or bloody discharge
It is also important to note that a milky discharge that is present when a woman is not breastfeeding should be checked by her doctor, although it is not linked with breast cancer.
If I have some symptoms, is it likely to be cancer?
Most often, these symptoms are not due to cancer, but any breast cancer symptom you notice should be investigated as soon as it is discovered. If you have any of these symptoms, you should tell your healthcare provider so that the problem can be diagnosed and treated.
If I have no symptoms, should I assume I do not have cancer?
Although there’s no need to worry, regular screenings are always important. Your doctor can check for breast cancer before you have any noticeable symptoms. During your office visit, your doctor will ask about your personal and family medical history and perform a physical examination. In addition, your doctor may order one or more imaging tests, such as a mammogram.
Most often, these symptoms are not due to cancer, but any breast cancer symptom you notice should be investigated as soon as it is discovered. If you have any of these symptoms, you should tell your healthcare provider so that the problem can be diagnosed and treated.
If I have no symptoms, should I assume I do not have cancer?
Although there’s no need to worry, regular screenings are always important. Your doctor can check for breast cancer before you have any noticeable symptoms. During your office visit, your doctor will ask about your personal and family medical history and perform a physical examination. In addition, your doctor may order one or more imaging tests, such as a mammogram.
25 Cancer Symptoms Men Are Most Likely to Ignore
By Melanie Haiken, Caring.com senior editor
Here, some signs of cancer that are commonly overlooked:
1. Upset stomach or stomachache: One of the first signs colon cancer patients remember experiencing when they look back is unexplained stomach aches. Those with pancreatic cancer describe a dull ache that feels like it's pressing inward. Many liver cancer patients say they went in complaining of stomach cramps and upset stomachs so frequently that their doctors thought they had ulcers. Liver cancer patients and those with leukemia can experience abdominal pain resulting from an enlarged spleen, which may feel like an ache on the lower left side.
If you have a stomachache that you can't attribute to a digestive problem or that doesn't go away, ask your doctor to order an ultrasound. Finding a liver or pancreatic tumor early can make all the difference in treatment.
2. Chronic "acid stomach" or feeling full after a small meal: The most common early sign of stomach cancer is pain in the upper or middle abdomen that feels like gas or heartburn. It may be aggravated by eating, so that you feel full when you haven't actually eaten much. What's particularly confusing is that the pain can be relieved by antacids, confirming your conclusion that it was caused by acid in the stomach, when it's more than that. An unexplained pain or ache in the lower right side can be the first sign of liver cancer, known as one of the "silent killers." Feeling full after a small meal is a common sign of liver cancer as well.
If you have frequent bouts of acid stomach, an unexplained abdominal ache, or a full feeling after meals even when you're eating less than normal, call your doctor.
3. Unexplained weight loss: If you notice the pounds coming off and you haven't made changes to your diet or exercise regime, it's important to find out why. Unexplained weight loss can be an early sign of colon and other digestive cancers; it can also be a sign of cancer that's spread to the liver, affecting your appetite and the ability of your body to rid itself of waste.
4. Jaundice: Pancreatic cancer, another one of the "silent killers," is often discovered when someone notices jaundice and asks the doctor to do a battery of tests. Jaundice is most commonly thought of as a yellowing of the skin or whites of the eyes, but darker-than-normal urine that's not the result of dehydration is also a sign. Clay-colored stools are another little-known sign of jaundice. Oddly, jaundice can also cause itching, because the bile salts in the bloodstream cause the skin to itch. Some people with pancreatic cancer say they noticed the itching before they noticed the jaundice itself.
5. Wheezing or shortness of breath: One of the first signs lung cancer patients remember noticing when they look back is the inability to catch their breath. "I couldn't even walk to my car without wheezing; I thought I had asthma, but how come I didn't have it before?" is how one man described it. Shortness of breath, chest pain, or spitting blood are also signs of testicular cancer that's spread to the lungs.
6. Chronic cough or chest pain: Several types of cancer, including leukemia and lung tumors, can cause symptoms that mimic a bad cough or bronchitis. One way to tell the difference: The problems persist, or go away and come back again in a repeating cycle. Some lung cancer patients report chest pain that extends up into the shoulder or down the arm.
7. Frequent fevers or infections: These can be signs of leukemia, a cancer of the blood cells that starts in the bone marrow. Leukemia causes the marrow to produce abnormal white blood cells, which crowd out healthy white cells, sapping the body's infection-fighting capabilities. Doctors sometimes catch leukemia in older adults only after the patient has been in a number of times complaining of fever, achiness, and flu-like symptoms over an extended period of time.
8. Difficulty swallowing: Most commonly associated with esophageal or throat cancer, having trouble swallowing is sometimes one of the first signs of lung cancer, too. Men diagnosed with esophageal cancer look back and remember a feeling of pressure and soreness when swallowing that didn't go away the way a cold or flu would have. Consult your doctor also if you have a frequent feeling of needing to clear your throat or that food is stuck in your chest; either of these can signal a narrowing of the esophagus that could mean the presence of a tumor.
9. Chronic heartburn: If you just ate half a pizza, heartburn is expected. But if you have frequent episodes of heartburn or a constant low-level feeling of pain in the chest after eating, call your doctor and ask to be screened for esophageal cancer. Gastroesophageal reflux disease (GERD)—a condition in which stomach acid rises into the esophagus, causing heartburn and an acidic taste in the throat—can trigger a condition called Barrett's esophagus, which can be a precursor of esophageal cancer.
10. Swelling of facial features: Some patients with lung cancer report that they noticed puffiness, swelling, or redness in the face. The explanation for this is that small-cell lung tumors commonly block blood vessels in the chest, preventing blood from flowing freely from the head and face.
Early Symptoms of Liver Cancer
Liver cancer symptoms
are very diverse. However, as a rule, there are common symptoms of
«malignant disease», manifestation of which depends on the variations of
clinical course of the neoplasm.
In a typical aspect of disease leading symptoms are noted such ones as progressive weakness, adynamia, appetite loss, cachexia, often nausea and vomiting. There is a carebaria and the constant pain in the right subcostal area, anemia develops. Liver quite rapidly increases in size, with its lower edge often determined on the level of the navel and below; with palpation it is moderately painful, stiff, hilly; sometimes is determined an isolated tumor node.
With the liver cancer development against the background of cirrhosis, symptoms of malignant neoplasms are prevalent in the clinical presentation of the disease; deterioration of the patient makes progress rapidly, increases pain in the liver, appears ascites, jaundice, fever, arises frequent nasal bleeding, often found skin telangiectasis.
In some cases of the primary liver cancer is a high non-treatment fever; symptoms of liver lesion appear later in these cases.
Asymptomatic form of primary liver cancer often goes like a chronic hepatitis B, without constant and typical clinical signs of cancer. In some cases, the clinical presentation of primary liver cancer may include symptoms of complications or signs of dissemination of tumor.
In the clinical symptomatology of complications are typical: obstructive jaundice (compression of main bile duct tumor or its metastases), splenomegaly, ascites, enlargement of subcutaneous veins of the front abdominal wall, gastrointestinal bleeding (compression of portal vein), and signs of rupture of the tumor, spontaneous or under the influence of minor injuries with intraperitoneal bleeding and subsequent peritonitis.
Metastatic liver cancer is mostly detected in the liver (intraorganic metastasis), in lymph nodes of the porta and omentulum, in splanchnic as well as other organs (lungs, pleura, peritoneum, kidneys, pancreas, bones).
Of the epithelial tissue in the liver may arise: hepatocellular (liver cell) cancer, cholangiocellular (bile duct cancer),
hepato-cholangiocellular (mixed) cancer, and undifferentiated
carcinoma. Of non-epithelial tissue - hemangioendothelioma. Mixed
malignant tumors include embryonal liver carcinoma and carcinosarcoma.
From a clinical point of view and by liver cancer symptoms, there are primary and secondary (metastatic, sprouting from an adjacent organ) liver cancers.
Primary liver cancer looks like a single or multiple dense formation, with whitish color without clear boundaries. Tumor quickly extends to the blood vessels and spreads over the liver, where forms metastases. With cancer, which develops against the background of liver cirrhosis, malignant tumor takes diffuse form without nodes formation. Metastatic liver cancer appears like a tumor metastasis with a primary localization in other organs.
Treatment of primary liver cancer is currently being conducted by combined methods. The main method is a radical surgical intervention (typical lobectomy or hemihepatectomy, atypical resections of the liver) in combination with chemotherapy (methotrexate, thio-TEF, 5-fluorouracil) with the introduction of drugs through of umbilical vein or hepatic artery. However, the possibility of a radical operation is only available for one of five patients (depends on liver cancer symptoms and diagnosis).
In a specially equipped medical centers performed a liver transplant. Radiation therapy is usually not effective and can be used only in the postoperative period. There are currently carried out extensive researches to determine the effectiveness of immunization against hepatitis B as a way to prevent hepatocellular carcinoma.
The forecast for operated on the primary liver cancer, unfortunately, is not optimistic, no more than 9-19% of patients who experienced surgery are living up to 5 years after surgery. The transplantation of the liver is the best perspective for today.
If there are symptoms similar to liver cancer symptoms, then differential diagnosing of primary liver cancer is made with secondary (metastatic) tumors of the body, cirrhosis, and nonneoplastic liver diseases. Diagnosis of secondary tumors of the liver becomes evident when the primary focus identified.
By the differential diagnosis of primary liver cancer with cirrhosis helps reaction to alpha-fetoprotein, which is negative with cirrhosis, and liver scan clearly identifies nidal or diffuse its lesion.
Liver cyst of nonparasitic nature is round, with elastic consistency, and a clear roentgenological picture and the typical manifestations by radioisotope scanning of the liver. In the differential diagnosis of liver echinococcosis, anamnestic data is relevant, as well as eosinophilia and positive serological reactions. If there are suspicions about nephroblastoma or neuroblastoma, which located in the upper abdomen, then excretory urography and angiography are applied.
Recognition of liver cancer, especially in the initial stage, is difficult, since there are no specific liver cancer symptoms. Therefore, liver cancer is often diagnosed in the far-called stages. History data (fever, pain in the right side of the stomach, increasing of the liver) is important, as well as clinical examination (strain or increase of abdomen, expressed subcutaneous vasculature in the upper half of the abdomen, changing of the shape and size of the liver).
Laboratory researches show hypochromic anemia, leukocytosis, ESR acceleration, increase of transaminase and alkaline phosphatase.
Other techniques are widely used: diagnostic radioisotope and ultrasonic scanning of the liver, CT, MRI, laparoscopy with the sighting of liver biopsy, splenoportography, aortography, selective celiacography.
Primary liver cancer separated into main and diffuse forms. According to the cell type - in hepatocellular (hepatoma), emanating from the hepatocytes (liver cells), cholangiocellular (holangioma) emanating from the bile duct epithelium, mixed (holangiogepatoma) emanating from the cells of both types, and mesodermal tumors (mesenchymoma, angiosarcoma and lymphosarcoma). Hepatomas occur much more frequently than other forms of liver cancer.
The most common classification is on the basis of international standard TNM, taking into account the peculiarities of the anatomic structure of the organ, size of the primary focus, spread of intrahepatic metastasis (T element - the incidence of tumors, N element - the status of lymph nodes, M element - distant metastases) and liver cancer symptoms.
The etiology and mechanism of liver cancer development, as well as other cancers, are not sufficient determined. The influence of climate and geography, the nature of food, medical treatment are the factors of risk. The presence of aflatoxin in food products (carcinogenic mitoksin) sometimes affects the occurrence of primary liver cancer. Angiosarcoma of the liver is sometimes associated with endogenous anabolic hormones. Parasitic (amoebiasis, schistosomiasis, Opisthorchiasis, etc.) and viral diseases (viral hepatitis B, which is considered to be caused at least 80% of all cases of hepatocellular carcinoma), liver cirrhosis irrelatively of its reason may favour the occurrence of primary liver cancer.
There is a family predisposition to the liver cancer development, as well as a clear link between alcoholic cirrhosis and primary liver cancer. In present-day world, primary liver cancer in patients with alcoholism, in 80-90% of the cases develops against the background of gin-drinker’s liver.
Every year in the world with liver cancer become sick at least 250 000 people. Primary liver cancer is found in the 30-40 times less than metastatic. A particularly high frequency of primary liver cancer observed in Senegal, South Africa, China, India and the Philippines. In Russia, a primary liver cancer is found from 0.25 to 1% of deaths. Men sick liver cancer 4 times more likely than women. The disease may occur at any age, but more often after 40 years.
In a typical aspect of disease leading symptoms are noted such ones as progressive weakness, adynamia, appetite loss, cachexia, often nausea and vomiting. There is a carebaria and the constant pain in the right subcostal area, anemia develops. Liver quite rapidly increases in size, with its lower edge often determined on the level of the navel and below; with palpation it is moderately painful, stiff, hilly; sometimes is determined an isolated tumor node.
With the liver cancer development against the background of cirrhosis, symptoms of malignant neoplasms are prevalent in the clinical presentation of the disease; deterioration of the patient makes progress rapidly, increases pain in the liver, appears ascites, jaundice, fever, arises frequent nasal bleeding, often found skin telangiectasis.
In some cases of the primary liver cancer is a high non-treatment fever; symptoms of liver lesion appear later in these cases.
Asymptomatic form of primary liver cancer often goes like a chronic hepatitis B, without constant and typical clinical signs of cancer. In some cases, the clinical presentation of primary liver cancer may include symptoms of complications or signs of dissemination of tumor.
In the clinical symptomatology of complications are typical: obstructive jaundice (compression of main bile duct tumor or its metastases), splenomegaly, ascites, enlargement of subcutaneous veins of the front abdominal wall, gastrointestinal bleeding (compression of portal vein), and signs of rupture of the tumor, spontaneous or under the influence of minor injuries with intraperitoneal bleeding and subsequent peritonitis.
Metastatic liver cancer is mostly detected in the liver (intraorganic metastasis), in lymph nodes of the porta and omentulum, in splanchnic as well as other organs (lungs, pleura, peritoneum, kidneys, pancreas, bones).
From a clinical point of view and by liver cancer symptoms, there are primary and secondary (metastatic, sprouting from an adjacent organ) liver cancers.
Primary liver cancer looks like a single or multiple dense formation, with whitish color without clear boundaries. Tumor quickly extends to the blood vessels and spreads over the liver, where forms metastases. With cancer, which develops against the background of liver cirrhosis, malignant tumor takes diffuse form without nodes formation. Metastatic liver cancer appears like a tumor metastasis with a primary localization in other organs.
Treatment of primary liver cancer is currently being conducted by combined methods. The main method is a radical surgical intervention (typical lobectomy or hemihepatectomy, atypical resections of the liver) in combination with chemotherapy (methotrexate, thio-TEF, 5-fluorouracil) with the introduction of drugs through of umbilical vein or hepatic artery. However, the possibility of a radical operation is only available for one of five patients (depends on liver cancer symptoms and diagnosis).
In a specially equipped medical centers performed a liver transplant. Radiation therapy is usually not effective and can be used only in the postoperative period. There are currently carried out extensive researches to determine the effectiveness of immunization against hepatitis B as a way to prevent hepatocellular carcinoma.
The forecast for operated on the primary liver cancer, unfortunately, is not optimistic, no more than 9-19% of patients who experienced surgery are living up to 5 years after surgery. The transplantation of the liver is the best perspective for today.
If there are symptoms similar to liver cancer symptoms, then differential diagnosing of primary liver cancer is made with secondary (metastatic) tumors of the body, cirrhosis, and nonneoplastic liver diseases. Diagnosis of secondary tumors of the liver becomes evident when the primary focus identified.
By the differential diagnosis of primary liver cancer with cirrhosis helps reaction to alpha-fetoprotein, which is negative with cirrhosis, and liver scan clearly identifies nidal or diffuse its lesion.
Liver cyst of nonparasitic nature is round, with elastic consistency, and a clear roentgenological picture and the typical manifestations by radioisotope scanning of the liver. In the differential diagnosis of liver echinococcosis, anamnestic data is relevant, as well as eosinophilia and positive serological reactions. If there are suspicions about nephroblastoma or neuroblastoma, which located in the upper abdomen, then excretory urography and angiography are applied.
Recognition of liver cancer, especially in the initial stage, is difficult, since there are no specific liver cancer symptoms. Therefore, liver cancer is often diagnosed in the far-called stages. History data (fever, pain in the right side of the stomach, increasing of the liver) is important, as well as clinical examination (strain or increase of abdomen, expressed subcutaneous vasculature in the upper half of the abdomen, changing of the shape and size of the liver).
Laboratory researches show hypochromic anemia, leukocytosis, ESR acceleration, increase of transaminase and alkaline phosphatase.
Other techniques are widely used: diagnostic radioisotope and ultrasonic scanning of the liver, CT, MRI, laparoscopy with the sighting of liver biopsy, splenoportography, aortography, selective celiacography.
Primary liver cancer separated into main and diffuse forms. According to the cell type - in hepatocellular (hepatoma), emanating from the hepatocytes (liver cells), cholangiocellular (holangioma) emanating from the bile duct epithelium, mixed (holangiogepatoma) emanating from the cells of both types, and mesodermal tumors (mesenchymoma, angiosarcoma and lymphosarcoma). Hepatomas occur much more frequently than other forms of liver cancer.
The most common classification is on the basis of international standard TNM, taking into account the peculiarities of the anatomic structure of the organ, size of the primary focus, spread of intrahepatic metastasis (T element - the incidence of tumors, N element - the status of lymph nodes, M element - distant metastases) and liver cancer symptoms.
The etiology and mechanism of liver cancer development, as well as other cancers, are not sufficient determined. The influence of climate and geography, the nature of food, medical treatment are the factors of risk. The presence of aflatoxin in food products (carcinogenic mitoksin) sometimes affects the occurrence of primary liver cancer. Angiosarcoma of the liver is sometimes associated with endogenous anabolic hormones. Parasitic (amoebiasis, schistosomiasis, Opisthorchiasis, etc.) and viral diseases (viral hepatitis B, which is considered to be caused at least 80% of all cases of hepatocellular carcinoma), liver cirrhosis irrelatively of its reason may favour the occurrence of primary liver cancer.
There is a family predisposition to the liver cancer development, as well as a clear link between alcoholic cirrhosis and primary liver cancer. In present-day world, primary liver cancer in patients with alcoholism, in 80-90% of the cases develops against the background of gin-drinker’s liver.
Every year in the world with liver cancer become sick at least 250 000 people. Primary liver cancer is found in the 30-40 times less than metastatic. A particularly high frequency of primary liver cancer observed in Senegal, South Africa, China, India and the Philippines. In Russia, a primary liver cancer is found from 0.25 to 1% of deaths. Men sick liver cancer 4 times more likely than women. The disease may occur at any age, but more often after 40 years.
Ohhira Nutrition
Choose Probiotics, Choose OMX ! For more details, contact Ms.Dinah Tan +60178798755 or Mr.DKTan +6012 3159527 or dktan57@gmail.com http://dktan.blogspot.com/ — with Pak David Tan and 2 others at Setia Walk, Pusat Bandar Puchong, 47160 Puchong, Selangor Malaysia.
Wednesday, 21 August 2013
Today, Lay people observe the Eight Precepts on Uposatha days, as a support for meditation practice and as a way to re-energize commitment to the Dhamma. Whenever possible, lay people use these days as an opportunity to visit the local monastery, in order to make special offerings to the Sangha, to listen to Dhamma, and to practice meditation with Dhamma companions late into the night. For those not closely affiliated with a local monastery, it can simply be an opportunity to step up one's efforts in meditation, while drawing on the invisible support of millions of other practicing Buddhists around the world.
The calendar of Uposatha days is calculated using a complex traditional formula that is loosely based on the lunar calendar, with the result that the dates do not always coincide with the actual astronomical dates. To further complicate matters, each sect within Theravada Buddhism tends to follow a slightly different calendar. * Thus, Uposatha days are times of renewed dedication to Dhamma practice, observed by lay followers and monastics throughout the world of Theravada Buddhism.
For monastics, these are often days of more intensive reflection and meditation. In many monasteries physical labor (construction projects, repairs, etc.) is curtailed. On New Moon and Full Moon days the fortnightly confession and recitation of the Bhikkhu Patimokkha (monastic rules of conduct) takes place. http://www.accesstoinsight.org/ptf/dhamma/sila/uposatha.html
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