Shoulder Bursitis

What is shoulder bursitis?

A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. The plural of bursa is bursae. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.

Bursitis is inflammation of a bursa. Injury or inflammation of a bursa around the shoulder joint occurs causes shoulder bursitis.

How does a bursa become inflamed?

A bursa can become inflamed from injury, infection (rare in the shoulder), or an underlying rheumatic condition. Examples include infection of the bursa in front of the knee from a knee scraping on asphalt (septic prepatellar bursitis), inflammation of the elbow bursa from gout crystals (gouty olecranon bursitis), or injury as subtle as lifting a bag of groceries into the car, which could inflame the shoulder bursa (shoulder bursitis).

What are shoulder bursitis symptoms and signs? How is shoulder bursitis diagnosed

Bursitis is typically identified by localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area. X-ray testing can sometimes detect calcifications in the bursa when bursitis has been chronic or recurrent. MRI scanning (magnetic resonance imaging) can also define bursitis. Shoulder bursitis is often accompanied by tendinitis of tendons adjacent to the affected bursa in the shoulder. Shoulder bursitis causes focal tenderness of the inflamed tissues. It can also cause a "pinching" pain when the elbow is moved away from the body, referred to as an "impingement" sign.

How is shoulder bursitis treated?

The treatment of any form of bursitis depends on whether or not it involves infection. Infection of a shoulder bursa is uncommon, and bursitis that develops there is usually from injury. Bursitis that is not infected (as from injury or an underlying rheumatic disease) can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions and can be performed in the doctor's office. Sometimes the fluid is sent to the laboratory for further analysis. Noninfectious shoulder bursitis can also be treated with an injection of cortisone medication into the swollen bursa. This is sometimes done at the same time as the aspiration procedure. Physical therapy can sometimes be used to aid the recovery from bursitis, especially when it is accompanied by a frozen shoulder.

Infectious (septic) bursitis, again which is uncommon in the shoulder, requires even further evaluation and aggressive treatment. The bursal fluid can be examined in the laboratory to identify the microbes causing the infection. Septic bursitis requires antibiotic therapy, sometimes intravenously. Repeated aspiration of the inflamed fluid may be required. Surgical drainage and removal of the infected bursa sac (bursectomy) may also be necessary. Generally, the adjacent joint functions normally after the surgical wound heals.

What is the prognosis (outlook) for shoulder bursitis?

The outlook is generally excellent for a full recovery with shoulder bursitis. If the bursitis is accompanied by scarring around the shoulder joint (adhesive capsulitis or "frozen shoulder"), it can require long-term physical therapy

Can shoulder bursitis be prevented?

By avoiding overuse of the shoulder by excessive straining the shoulder and gradual exercise training, shoulder bursitis can be prevented.
source:medicinenet.com

Too Much Sitting Tied to Risks for Certain Cancers

Too Much Sitting Tied to Risks for Certain Cancers

Those with the most chair time had worse odds for colon, endometrial cancers, researchers suggest

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WebMD News from HealthDay

By Brenda Goodman

HealthDay Reporter

MONDAY, June 16, 2014 (HealthDay News) -- You may want to stand up to read this.

A new study suggests that people who spend the bulk of their day sitting -- whether behind the wheel, in front of the TV or working at a computer -- appear to have an increased risk for certain kinds of cancers.

Previous studies have tied too much time spent sedentary to a variety of health problems, including heart disease, blood clots, a large waistline, higher blood sugar and insulin, generally poor physical functioning, and even early death.

For the new study, researchers zeroed in on 43 studies that specifically looked at the link between sitting and nearly 70,000 cases of cancer.

After combining the results from individual studies -- a statistical tool that helps to reveal trends in research -- there was good news and bad news.

The good news? Being sedentary did not appear to be linked to every kind of cancer. Scientists found no relationship between sitting and breast, ovarian, testicular or prostate cancers, or cancers of the stomach, esophagus and kidneys, or non-Hodgkin lymphoma.

The bad news was that there did seem to be a consistent relationship between hours spent sitting and an increased risk for colon and endometrial cancers.

People who spent the most time sitting during the day had a 24 percent increased risk of getting colon cancer compared to those who logged the least number of hours in a chair, according to the study.

When the researchers looked just at time spent watching TV, the risk jumped even more. Those who clocked the most hours glued to the tube had a 54 percent increased risk of colon cancer compared to those who watched the least.

That may be because viewers tend to consume unhealthy snacks and drinks while watching TV, said study author Daniela Schmid, an epidemiologist at the University of Regensburg in Germany.

For endometrial -- or uterine -- cancer, the risks were even higher. There was a 32 percent increased risk for women who spent the most time seated compared to those who sat the least, and a 66 percent increased risk for those who watched the most TV, the study authors said.

Moreover, every two-hour increase in sitting time was linked to an 8 percent increased risk of colon cancer and a 10 percent increased risk of endometrial cancer.

The risks remained even for "active couch potatoes" -- folks who squeeze in some time at the gym but still spend most of their day off their feet. This suggests that regular exercise can't offset the risks of too much sitting, the study authors said.

The findings, published June 16 in the Journal of the National Cancer Institute, make sense to Dr. Graham Colditz. He's the associate director for prevention and control at Washington University's Siteman Cancer Center in St. Louis.

"High blood sugar and high insulin is a clear sort of pathway to colon cancer, and we know from intervention studies that walking lowers insulin and getting up after meals lowers blood sugar compared to sitting," said Colditz, who was not involved in the research.

As for endometrial cancer, "Obesity is a phenomenally strong cause. In fact, it is the main modifiable risk factor for endometrial cancer," he said.

"So for me, the likely scenario there is that the sitting, the weight gain and obesity really go together and exacerbate the risk of endometrial cancer," he added.

Because the studies included in the review only looked at broad relationships, they can't prove that sitting, by itself, causes cancer. But the findings appeared to be remarkably consistent across studies, so Colditz thinks they should be taken seriously.

The study authors agree.

"Cutting down on TV viewing and sedentary time is just as important as becoming more active," said Schmid. "For those whose jobs require them to sit at a desk most of the day, we recommend breaking up the time spent sitting by incorporating short bouts of light activity into the daily routine," she added.

SOURCE:Web MD

How Do I Know If I Have Leukemia?

How Do I Know If I Have Leukemia?

Because many types of leukemia show no obvious symptoms early in the disease, leukemia may be diagnosed incidentally during a physical exam or as a result of routine blood testing. If a person appears pale, has enlarged lymph nodes, swollen gums, an enlarged liver or spleen, significant bruising, bleeding, fever, persistent infections, fatigue, or a small pinpoint rash, the doctor should suspect leukemia. A blood test showing an abnormal white cell count may suggest the diagnosis. To confirm the diagnosis and identify the specific type of leukemia, a needle biopsy and aspiration of bone marrow from a pelvic bone will need to be done to test for leukemic cells, DNA markers, and chromosome changes in the bone marrow. 

Important factors in leukemia include the age of the patient, the type of leukemia, and the chromosomal abnormalities found in leukemia cells and bone marrow.

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What Are the Treatments for Leukemia?

While the reported incidence of leukemia has not changed much since the 1950s, more people are surviving longer thanks mainly to advances in chemotherapy. Childhood leukemia (3 out of 4 cases in children is ALL), for example, represents one of the most dramatic success stories of cancer treatment. The five-year survival rate for children with ALL has risen to about 85% today.

For acute leukemia, the immediate goal of treatment is remission. The patient undergoes chemotherapy in a hospital and stays in a private room to reduce the chance of infection. Since acute leukemia patients have extremely low counts of healthy blood cells, they are given blood and platelet transfusions to help prevent or stop bleeding. They receive antibiotics to prevent or treat infection. Medications to control treatment-related side effects are given as well.

People with acute leukemia are likely to attain remission when chemotherapy is used as the primary treatment. To keep the disease under control, they will then receive consolidation chemotherapy for 1-4 months to get rid of any remaining malignant cells.

Patients with ALL will receive intermittent treatment usually for up to two years. After obtaining a complete remission, some patients with acute myeloid leukemia (AML) may require an allogeneic stem cell transplant. This requires a willing donor with compatible tissue type and genetic characteristics -- preferably a family member. Other donor sources could include a matched unrelated donor or umbilical blood.

A stem cell transplant has three stages: induction, conditioning, and transplantation. First, the individual’s white blood cell count is brought under control by chemotherapy. Then a single dose of chemotherapy may be given followed by a conditioning regimen of high dose chemotherapy. This will destroy the individual’s bone marrow and any residual leukemia cells that may be present. Then the donor cells will be infused.

source:Web MD

Stem Cell Transplants for Blood Cancers

Stem cell transplants have become important weapons in the fight against certain blood cancers, such as multiple myeloma, non-Hodgkin's lymphoma, Hodgkin lymphoma, and leukemia. A stem cell transplant may help you live longer. In some cases, it can even cure blood cancers.

About 50,000 transplantations are performed yearly, with the number increasing 10% to 20% each year. More than 20,000 people have now lived five years or longer after having a stem cell transplant.

Here's how it works: The stem cells in healthy bone marrow produce blood cells, including the white blood cells that are crucial to your immune system. Blood cancers themselves damage your bone marrow, and so do chemotherapy and radiation treatments for the cancers. A stem cell transplant lets new stem cells take over from your damaged marrow so your body can produce healthy, cancer-free blood cells.

Your doctor may want to use stem cells taken from your own blood, or stem cells from a donor. If you use your own stem cells, your blood will be drawn when your cancer is not active. If you use a donor's cells, your doctor will first need to find a matching donor. Either way, you will have chemotherapy and/or radiation beforehand. This will kill the cancer cells and destroy your damaged stem cells so the transplanted stem cells can take over.

If you use your own cells, you may be able to have an outpatient stem cell transplant. You need to have no other serious medical conditions, have a caregiver who can monitor you at home, and live within an hour of the hospital. Your home environment must be carefully prepared, and you must wear a mask when going out.

Here's what to expect from the transplant process.

Before the Stem Cell Transplant

1. You or the donor will get injections of special medicines four or five days before the blood draw. These medicines move blood-forming stem cells from your bone marrow into your bloodstream.
2. Your blood or the donor's will be drawn. The stem cells from your or the donor's bloodstream will be separated from the rest of the blood and frozen.
3. You will have "conditioning treatment." This will be either high- or low-dose chemotherapy and/or radiation. Its purpose is to kill the cancer cells and destroy your own stem cells -- destroying your immune system in the process -- so the transplanted stem cells can take over.

During the Stem Cell Transplant

1. You will have an infusion of the stem cells. You'll sit in a comfortable chair for several hours as the infusion is given through a central line (a surgical port in your neck).
2. Nurses will monitor you. They will check to be sure you are not developing fever, chills, hives, or a drop in blood pressure.
3. You might have mild side effects, including headache, nausea, flushing, or shortness of breath.

After the Stem Cell Transplant

1. Your new immune system starts to work.After two to four weeks, the new stem cells graft to your bone marrow and start to make new white blood cells. Next, your body starts making platelets, then red blood cells.
2. If you received donor cells, you will get antibiotics and anti-rejection drugs to help your body accept the transplanted cells. You may also need transfusions of red blood cells and platelets as well as intravenous nutrition.
3. You must stay in a germ-free environment for the first few weeks. If you have a transplant with donor cells, you will probably stay in the hospital for about a month until your new immune system starts working. You will need filtered air and your visitors must wear masks.
4. You will make regular visits to the outpatient clinic for six months. The transplant staff will test your blood or bone marrow for levels of healthy blood cells and check for any complications. After that, your own doctor will continue to care for you.

During Recovery From Your Stem Cell Transplant

You'll feel tired for the first few weeks. It may be several months before you can resume your normal schedule. About two months after the transplant, your doctor will draw blood and may take a sample of bone marrow from your hip to see that you are producing all types of blood cells. The bone marrow will also show which cells are being formed, yours or, preferably, the donor's. This is known as chimerism. Your doctor will also want to see that you have no major complications.

Making the Decision: Next Steps

• Arrange an appointment with your doctor to talk about possibilities.
• Meet the staff at your hospital and check out its statistics on stem cell transplants.
• Consider the impact that transplantation and recovery might have on your job, if you work, and your home life.
• Ask family members if they could help during recovery.

source:webMD

1.  

Healthy Eating When You're Sick

Eating healthy meals isn't easy when you don't feel well, especially if you have a serious or chronic illness. You may be too tired to prepare food for yourself. Medicines may make food taste strange or unpleasant. Mouth sores or swallowing problems can make eating difficult. Or nausea, which is a common symptom and a common side effect of some medications, may make food the last thing you want to think about.  

"Fortunately, there's a lot you can do, even when you're not feeling well, to get the nutrition you need," says Veronica McLymont, PhD, RD, director of food and nutrition services at Memorial Sloan-Kettering Cancer Center.

Lack of Appetite

Eat smaller meals more frequently through the day than you do when you're healthy. "We tend to eat with our eyes," says Sarah Rafat, RD, senior dietitian at MD Anderson Cancer Center. "Sitting down to too big a meal can seem overwhelming if you don't have much of an appetite." Make a list of comfort foods that you love and have one or two on hand for when you feel like eating. Also keep nutritious snacks handy, such as nuts, carrot sticks, or yogurt.

Mouth Sores, Dry Mouth, or Trouble Swallowing

Avoid foods that require a lot of chewing. Puree or grind foods like meat and vegetables to make them easier to eat. Liquid foods such as soups and smoothies are also good options. "Real foods are always the best choice," says Kim Jordan, RD, director of nutrition at Seattle Cancer Care Alliance, part of the Fred Hutchinson Cancer Research Center. "But if you’re having serious problems eating and swallowing, talk to your doctor about liquid meal replacements." For dry mouth, try chewing gum or sucking on hard candies like lemon drops, which stimulates saliva production.

Nausea

Choose bland foods. Eat smaller meals more often during the day than you would when you are healthy. Eat slowly. Hard candy, peppermint, and ginger may ease nausea. If nausea persists, talk to your doctor. An anti-nausea medicine may help.

Fatigue

When you're sick, you may feel too tired to make a meal. Stock up on prepared foods that you can easily pop in the microwave, such as frozen lasagna or pot pies. Keep nutritious snacks on hand such as nuts, sliced vegetables, hardboiled eggs, whole grain breakfast cereal, or yogurt. Eat your biggest meal at a time when you have the most energy.

Diarrhea

Diarrhea is a common symptom and a side effect of some medicines. Eating soft, bland foods and avoiding greasy foods can help. Drink plenty of water or other fluids, since diarrhea can quickly dehydrate you. One way to replace electrolytes is to drink a sports beverage diluted with water.

Constipation

Opioid pain medicines and certain other treatments often cause constipation. To help prevent and treat constipation, eat foods high in fiber, such as apricots, prunes, applesauce, and whole grain breakfast cereals. Getting up and walking can also help get your digestive tract moving.

Unwanted Weight Loss

"If you're losing weight when you shouldn't, your top priority is taking in more calories," says McLymont. Help yourself to foods you love, including high-calorie foods like milkshakes and desserts. Eat as often as you can throughout the day. Snack on high-energy foods such as nuts, seeds, cheese slices, and hardboiled eggs.

Unwanted Weight Gain

Some commonly used medicines can also make you gain unwanted weight. These include:

• Alpha-blockers and Beta blockers for regulation of blood pressure
• Anticonvulsants for epilepsy or other neurologic symptoms
• Antidepressants, certain ones such as Elavil, Endep, (amitriptyline), Eskalith, Lithobid (lithium carbonate), and Zyprexa (olanzapine)
• Insulin
• Steroids like prednisone for arthritis and similar conditions

Falling Short on Nutrients

If you're having real trouble eating a balanced diet, you may benefit from taking a vitamin and mineral supplement. Talk to your doctor or a dietitian before taking dietary supplements, especially if you take medicines for a serious health condition. Some supplements can impact the effectiveness of medicines.

source:webMD

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