Thursday, January 25, 2007

$1 billion in cancer research

A sister's promise led to $1 billion in cancer research



In the 25 years since, the foundation has grown from a small gathering of women in Brinker's living room to a world-renowned operation that will have invested roughly $1 billion in community outreach and research by year's end.

The Dallas-based organization has 200 employees, more than 100,000 active volunteers and 125 affiliates. Its annual Race for the Cure has grown from 800 women who ran for charity in Dallas to about 1.5 million participants in 120 races worldwide. The foundation has funded work in more than 47 countries.

The nonprofit is celebrating its 25th year with a new name -- Susan G. Komen for the Cure, an edgy new advertising campaign that includes T-shirts reading: "If you're going to stare at my breasts, you could at least donate a dollar to save them," sales of pink promise rings and a pledge to raise another $1 billion in the next 10 years.

With the help of organizations such as Komen and prominent figures including first lady Betty Ford, who spoke openly of about her experience with breast cancer in the mid-1970s, the culture slowly began to change from breast cancer being a taboo subject, said Dr. Gabriel Hortobagyi, president of the American Society of Clinical Oncology.

"I grew up at a time when most families didn't talk about either sex or cancer," said Hortobagyi, chairman of the department of breast medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston. "Those were sort of taboos. It was sort of shameful if anyone in the family had cancer. And people didn't talk about breasts, either healthy or sick."

The numbers tell the story
Today, the Komen Foundation reports: Nearly 75 percent of women over 40 get regular mammograms compared with fewer than a third who got breast exams in their doctor's offices in 1982; the five-year survival rate for breast cancer when caught before it spreads is 98 percent compared with 74 percent back then; the federal government devotes more than $900 million each year to breast cancer research, treatment and prevention compared with $30 million in 1982.

"I truly believe if Nancy hadn't started this thing, that that would not be the case, it just needed that special focus," said Hala Moddelmog, Komen's president and chief executive officer.

The Komen organization says it is second only to the U.S. government as a source of funding for breast cancer research and community outreach programs, which include education, screening and treatment. It says about 84 cents of every dollar it raises is spent in those areas, totaling about $157 million this year.

"Every advance in breast cancer has been touched by a Komen grant," said Komen spokeswoman Emily Callahan.

This year the organization is refocusing its research money to concentrate on more focused areas, such as finding biological signs that can help predict cancer before symptoms appear. (Interactive: Breast cancer warning signs. )

Moddelmog says the goal is to support research that is "transformational and that definitely ties back to the cure."

Funding both research and community programs is important, said Moddelmog, herself a five-year breast cancer survivor.

"We're helping to discover the cures by funding the research. And we're helping to deliver the cures by providing access," Moddelmog said. "What we want to wake up and see one day is a world without breast cancer."

There will be an international emphasis this year including a September summit in Budapest, Hungary, where Brinker served as U.S. ambassador from 2001 to 2003. The event will pair 25 U.S. activists with 25 people from around the world to look at the social, cultural and financial circumstances that prevent women from getting quality breast health care and treatment.

By getting the subject of breast cancer out into the public, Komen led women to becoming advocates, said Jean Sachs, executive director of Living Beyond Breast Cancer, a nonprofit provides breast cancer education. Komen is one of the sponsors of the group's annual conference for those diagnosed with breast cancer under the age of 45.

"If you look at where we are today, it's so different. Women have so many choices," said Sachs, who added that her 15-year-old organization could be viewed as "one of the grandchildren of Komen."

While the advances made in the 25 years since Komen was formed are reason to celebrate, the organization's ultimate goal remains unachieved: the eradication of breast cancer.

About one in eight women will get breast cancer, and the disease is the second most lethal kind of cancer after lung cancers in women. About 41,000 U.S. women died of breast cancer last year. Worldwide, it kills about 370,000 women each year.

"When you look at where we are, we're still not where our mission is, and that's a world without breast cancer," Moddelmog said.

Copyright 2007 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed. ........................

Tuesday, January 23, 2007

ASTHMA

ASTHMA - a patient's guide
Dr Adrian Harrison - Chest Specialist, Mercy Hospital

What is asthma?

Asthma is an inflammatory condition of the breathing tubes (or bronchi). The inflammation causes airway irritability and results in airway narrowing (called bronchospasm).

Now, to explain that in a little more detail, let's go back a few steps.

How the lungs work

Our breathing "equipment" is made up of two parts: a set of breathing tubes - similar to the trunk and branches of a tree, except that our breathing tubes, of course, are hollow. At the end of the finest branches of a tree there are leaves. In our bodies, instead of leaves, our lungs are made up of a sponge tissue.

Inhaled air travels down the breathing tubes, out to the finest branches, which are in close communication with blood vessels containing blood. The blood takes the oxygen from the air and carbon dioxide travels in the other direction, from the blood stream back into the airways, where it is breathed out.

The process of gas exchange occurs in the sponge tissue of the lung. The job of the breathing tubes is to get the air in and the carbon dioxide out.

What is different about the lungs in asthma?

In asthma, the sponge tissue works well. The problem lies in the breathing tubes.

The breathing tubes (bronchi) have an inner lining, which is similar to the lining of your mouth. In the middle of the airway wall is a layer of muscle. In asthma, this muscle layer is very irritable or "twitchy" so that a wide variety of trigger factors cause it to tighten. This causes narrowing of the breathing tubes, making it harder to breathe, and also causing chest tightness, wheezing and coughing.

Why is the muscle layer in the breathing tubes so irritable? By far the main reason for this is inflammation. An example of inflammation elsewhere in the body is sunburn. Inflamed tissues are red and swollen. In asthma the lining of the breathing tubes are inflamed.

a) Inflamed tissue contains a large number of white blood cells and these are like tiny chemical factories. The substances they release have a number of harmful effects. They cause blood vessels to become leaky so that fluid seeps out into the tissues - the tissues then become swollen.

b) Other chemicals or substances from the white blood cells attack the inner lining layer of the breathing tubes, causing it to become so damaged that, under the microscope, it looks as though the lining layer has been attacked with sandpaper. Because of this damage, infections and irritating substances we breathe in can affect the breathing tubes more easily and cause problems.
devamı...

GUATR

ZEHİRLİ GUATR (HİPERTİROİDİZM)
Tiroid bezesinin gereğinden daha fazla hormon salgıladığı guatr türüne “zehirli guatr denir. Zehirli guatr, nodüllü veya nodülsüz olabilir. Nodülsüz zehirli guatr’a Basedow Graves Hastalığı da denilebilir. Nodüllü zehirli guatr, sıcak nodüllü zehirli guatr, sıcak otonom nodüllü zehirli guatr veya diğer nodül çeşitleri ile birlikte olabilir.Zehirli guatr’da çarpıntı, ellerde titreme, vücutta titreme, ani kilo kaybı, saçlarda dökülme, kaşıntı, boğazda dolgunluk hissi, aşırı iştah dolayısıyla çok yemek yeme ve çok su içme, aşırı terleme, çabuk yorulma, aşırı sinirlilik sık görülen şikayetlerdir.

Bazı hastalar, bulantı, ishal, kusma ve çok sık dışkılamadan yakınır.Bunların hepsi birlikte olmak zorunda değildir. Bu şikayetlerin bazıları ön plandadır, diğer şikayetler ancak doktorun sorgulaması ile ifade edilebilir. Bazı hastalarda göğüs ve boyunda devamlı bir kızarıklık söz konusu olabilir. Nodülsüz guatrlı hastaların bazılarında gözlerde büyüme ve gözlerin ileriye doğru çıkması mümkündür.Hastaların muayenesinde; kalp atımının çok arttığı, solunumun hızlandığı, ellerin titrediği, avuçiçlerinin nemli olduğu görülür.Bu hissedilen belirtiler, aslında zehirli guatrın vücut içinde yaptığı hasar ve etkilerden daha önemsizdir. Zira zehirli guatr başta kalp ve damar sistemi olmak üzere vücudumuzda bir çok organ ve dokuya kalıcı olabilen hasarlar verebilmektedir. Örneğin, kalbin büyümesi ve takiben kalp yetmezliği, yüksek tansiyon, şeker hastalığı, kemik erimesi bu hasarların bir kısmıdır. Kısaca söylemek gerekirse, zehirli guatr, EN YIKICI VE TAHRİP EDİCİ guatr türüdür.

TİROİD KRİZİ

Zehirli guatrda, yüksek hormonların kontrolden çıkması ile seyreden çok ağır bir durumdur. Yaşlı hastalarda ölüm oranı %25’e kadar yükselebilir. Acil tedavi gerektiren bir hastalıktır. Böyle bir durumda hasta, hastaneye yatırılıp tedavi edilir. 40 derece ve üstünde ateş, kalp çarpıntısının çok şiddetli olması, ishal ve kusma, ateş basması hissi, algılama bozuklukları bu krizin haberci ve belirtileri arasındadır.Bu tür hastalarda acil müdahele muhakkak tiroid konusunda deneyimli hekimlerce yapılmalıdır.

ZEHİRLİ GUATR’DA GÖZ BULGULARI

Gözlerin ileriye doğru çıkması zehirli guatr’da hastaları ilk ele veren görüntüdür. Bu ileriye çıkış genellikle çift taraflı iken bazen tek taraflı olabilir. Ancak her zehirli guatr hastasında göz bulgusu olmaz. Özellikle nodüllü zehirli guatr hastalarında göz bulgusu sık değildir. Göz bulgusunun şiddetine göre hastada şikayetler olur: uyurken gözlerin kapanmaması, gözlerde kızarıklık, yanma, gözyaşı akıntısı, hatta cerhatli göz iltihapları görülebilir. Göz bulguları, zehirli guatrın kalıcı olarak tedavisinden (örneğin kapsül tedavisi ile) sonra önemli ölçüde düzelir. Ancak, hangi yöntemle olursa olsun, zehirli guatrın tedavisinden sonra (örneğin ameliyattan sonra dahi) sıklıkla ortaya çıkan tiroid hormon yetmezliği (hipotiroidizm) yeterli düzeyde tedavi edilmezse göz bulgular düzelmez ve hatta ilerleyebilir. Eski bilgilere dayalı ve hatta kasıtlı bazı iddiaların aksine, zehirli guatr tedavisinden sonra hastanın tiroid hormonları normalize edildikten sonra göz bulguları "daha kötü" olmaz. Göz bulguları olan zehirli guatrlı hastalarda oto-antikorlar genellikle yüksektir.