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- Preoperative staging [determination of precise extent of tumor growth] of rectal cancer tumors

is important. Dr. Anton Titov MD

Because correct staging allows the surgeon to select the right patient for the right

type of surgery and correct combination of radiotherapy or chemotherapy.

How do you stage patients with rectal cancer before you take them to the operating room?

We also have to think about the history.

because there were times, maybe 10 or 15 years ago, when there was no preoperative staging

for rectal cancer.

The surgeon just palpated the tumor, maybe took a biopsy, and then brought the patient

for surgery directly.

Surgeons had no idea of how colorectal tumor was growing outside the bowel.

Then people started to do ultrasonography.

Ultrasound is good for the superficial tumors, but rectal cancer very difficult to detect

by ultrasound if cancer is more extensive, if tumor is growing outside the bowel wall

into the mesorectum and maybe even into other body organs.

We were the first in the world at the Karolinska Institute, with Professor Lennart Blomquist,

to start doing MRI, first, for locally recurrent rectal cancer treatment planning, and then

to stage all colorectal cancer patients before surgical operation.

I remember still the first lecture we had at the first rectal cancer surgical treatment

course with Professor Heald.

We showed him MRI of the rectal cancer patient he was going to operate on.

He was completely enthusiastic about MRI, he had never seen anything like that.

Since then MRI use for rectal cancer staging has spread around the world.

So today the golden standard for preoperative staging of rectal cancer is an MRI.

No patient with rectal cancer should have an operation unless they have had an MRI.

Because MRI allows local staging of rectal cancer, it is the road map for the surgeon

how to do the rectal cancer operation.

You can see on the MRI if the tumor is extending somewhere, you see if there are lymph nodes

that you have to remove during surgery.

MRI is very crucial, but also, of course, for staging you need a good CT scan of the

chest and the abdomen to see if there are any metastases.

So a combination of MRI and CT scans is the preoperative staging method of choice for

rectal cancer.

So MRI is the primary method of assessing rectal cancer tumor...

- Yes.

For more infomation >> Rectal Cancer: Preoperative Staging Principles to Select Best Treatment (5) - Duration: 2:55.

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Heather Locklear to undergo long-term treatment for substance abuse - Duration: 3:49.

Heather Locklear will soon leave the psychiatric ward at UCLA to undergo long-term treatment for substance abuse and mental health issues

The troubled actress was placed under a 5250 hold - where a clinician can involuntarily admit a patient for up to 14 days - earlier this week

 A source linked to Locklear's family told TMZ during her time at the hospital, doctors performed a number of tests to try and understand her recent behavior

 They concluded the Melrose Place star was suffering not just from substance abuse issues, but also from mental health issues

Locklear has agreed to voluntarily check herself in to a long-term treatment program, though some close to her are concerned this means she could check out at any time

 Those close to the actress believe they would be unable to get a conservatorship, allowing someone to take control of Locklear's decisions until she is more stable, and say they will not be applying to the court for one

Locklear was arrested on Sunday night after downing a bottle of tequila and crashing her Porsche into a pylon on the grounds of her California mansion, DailyMail revealed last week

The troubled actress, 56, then attacked the cops when they arrived to calm her down and was arrested and booked into Ventura County Jail on police battery charges

RELATED ARTICLES Previous 1 Next EXCLUSIVE: Heather Locklear has been placed on a 5250 psych

Tommy Lee slams Howard Stern for 'suggesting he is to blame. Share this article Share She was released on Monday morning but was rushed to hospital a little over six hours later after allegedly taking an overdose

Sunday's arrest comes exactly a week after Locklear was cuffed and taken to hospital after choking her mother Diane, 85, and threatening to shoot herself

After being released from hospital on Tuesday June 19, the troubled Melrose Place star allegedly checked into a detox center but checked herself out again after completing just two days of a five-day program

On the way home from the detox center on Sunday morning, she purchased a bottle of tequila which she drank before later attempting to drive off in her Porsche

For more infomation >> Heather Locklear to undergo long-term treatment for substance abuse - Duration: 3:49.

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Heather Locklear to undergo long-term treatment for substance abuse - Duration: 3:49.

Heather Locklear will soon leave the psychiatric ward at UCLA to undergo long-term treatment for substance abuse and mental health issues

The troubled actress was placed under a 5250 hold - where a clinician can involuntarily admit a patient for up to 14 days - earlier this week

 A source linked to Locklear's family told TMZ during her time at the hospital, doctors performed a number of tests to try and understand her recent behavior

 They concluded the Melrose Place star was suffering not just from substance abuse issues, but also from mental health issues

Locklear has agreed to voluntarily check herself in to a long-term treatment program, though some close to her are concerned this means she could check out at any time

 Those close to the actress believe they would be unable to get a conservatorship, allowing someone to take control of Locklear's decisions until she is more stable, and say they will not be applying to the court for one

Locklear was arrested on Sunday night after downing a bottle of tequila and crashing her Porsche into a pylon on the grounds of her California mansion, DailyMail revealed last week

The troubled actress, 56, then attacked the cops when they arrived to calm her down and was arrested and booked into Ventura County Jail on police battery charges

RELATED ARTICLES Previous 1 Next EXCLUSIVE: Heather Locklear has been placed on a 5250 psych

Tommy Lee slams Howard Stern for 'suggesting he is to blame. Share this article Share She was released on Monday morning but was rushed to hospital a little over six hours later after allegedly taking an overdose

Sunday's arrest comes exactly a week after Locklear was cuffed and taken to hospital after choking her mother Diane, 85, and threatening to shoot herself

After being released from hospital on Tuesday June 19, the troubled Melrose Place star allegedly checked into a detox center but checked herself out again after completing just two days of a five-day program

On the way home from the detox center on Sunday morning, she purchased a bottle of tequila which she drank before later attempting to drive off in her Porsche

For more infomation >> Heather Locklear to undergo long-term treatment for substance abuse - Duration: 3:49.

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Drugs to Treat Bipolar Disorder, Treatments for bipolar disorde - Duration: 7:10.

Drugs to treat bipolar disorder bipolar

Medications if you have bipolar disorder, you'll need to be treated on an ongoing basis

In fact, you should be seeing a mental health professional

Regularly, even if you feel fine

Treatment usually includes a combination of medication and talk therapy

Psychiatrists typically recommend medications as initial treatment to control symptoms as quickly as possible

Once symptoms are under control, you'll receive maintenance treatment to reduce the risk of relapse

Maintenance treatment also reduces the chance of minor mood swings developing into mania or depression

Several types of medications are used to treat bipolar disorder these include mood stabilizers

antidepressants and drugs that relieve anxiety

Your doctor may prescribe one or a combination of medications for maximum effect

Finding the right medication or combination of medications will take some trial and error

You may need to change medications due to side effects

It can take up to eight weeks to see the full effects of each medication

Usually only one medication is changed at a time

This helps your doctor to better monitor and identify which one isn't working

The following types of medications are used to treat bipolar disorder lithium lithium

such as lava bed is a mood stabilizing drug that has been used since the

1970s it helps control symptoms of acute mania

It's also effective at preventing the recurrence of periods of mania and depression

Common side effects include weight gain and digestive issues the drug can also affect your thyroid and kidneys

Periodic blood tests are needed to monitor thyroid and kidney health

Lithium is a category D drug that should be avoided in pregnancy if possible

However, in some instances the benefits may outweigh the potential risks

anticonvulsants

anticonvulsants our mood stabilizers used to treat bipolar disorder

Have been used since the mid 1990s in

2009 the drug AIC Nepean was approved for treatment of bipolar disorder

It's also used to treat people with mixed episodes mania and depression at the same time

anticonvulsant drugs include divalproex sodium dipper coat lamotrigine

lamictal

valproic acid

depakene common side effects of anticonvulsants include weight gain

drowsiness and an inability to sit still

Anticonvulsants are also associated with increased risk of suicidal thoughts and behavior

Valproic acid is known to cause birth defects

Lamech Liz known to cause a rash that can be dangerous

Alert your doctor to any new rash that develops while on lamech Blandy psychotics

Anti-psychotic drugs are another treatment option

some commonly prescribed

Antipsychotics include olanzapine. Zyprexa

risperidone

risperdal

kishi 18 sarah co ac Nepean safra's

common side effects include weight gain

drowsiness dry mouth decreased libido and blurred vision

Antipsychotics may also affect memory and attention. They are also known to cause involuntary facial or body movements

antidepressants these include serotonin reuptake inhibitors SSRIs

serotonin norepinephrine reuptake inhibitors SNRIs

monoamine oxidase inhibitors

mice and tricyclic

Antidepressants can sometimes trigger manic episodes. They are often prescribed along with a mood stabilizer to control manic symptoms

Here are some of the more commonly prescribed

Antidepressants SNR is dismal effects seen Christic. Jülich Sedin

Cymbalta Yantra venlafaxine

effexor

SSRIs citalopram

celexa SLO prom lexapro fluoxetine

prozac prozac weekly

paroxetine paxil paxil CR Pizza sertraline

zoloft tricyclics

ametropia line

decipher men nor perman mi Perman door Anil Dharan LPM

nortriptyline

Pam ler mais final son nard l

Tranny Alsip Ramin par Nate in general mais are rarely prescribed unless a patient has a poor response to

snr eyes or SSRIs

Common side effects include reduced sexual desire sleep disturbance increased appetite dry mouth

Gastrointestinal troubles and menstrual problems when taking and may it's important to avoid other

Medications and foods, like wine and cheese which can cause a rare but dangerous condition known as serotonin syndrome

Benzodiazepines, these are a group of medications with anxiety relieving properties

Finn's ODA subpoenas include alprazolam

xanax, Claudia Spock side librarian clonazepam klonopin

diazepam Valium Laura spam ativan side effects can include drowsiness

reduced muscle coordination and problems with balance and memory

These medications should be used with caution due to the risk of dependence

simpie acts this medication combines fluoxetine and the

antipsychotic olanzapine

Simpie acts has properties of both an antidepressant and a mood stabilizer

side effects can include increased appetite sexual problems

drowsiness fatigue and dry mouth if your doctor prescribes

This medicine ask if separate prescriptions for the two components are less expensive

There is nothing different about the combination pill. It is simply a new formulation of two existing drugs

Medications and pregnancy some medications such as lithium and valproic acid

Can increase your unborn baby's risk for birth defects?

Certain medications may also lower the effectiveness of birth control drugs

If you're using birth control to prevent pregnancy, make sure to discuss this with your doctor

You should also talk to your doctor about your medication if you're breastfeeding

Some medications may not be safe for your child

For more infomation >> Drugs to Treat Bipolar Disorder, Treatments for bipolar disorde - Duration: 7:10.

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Coxsackie Virus Prevention and Treatment - Duration: 8:15.

Coxsackie Virus Prevention and Treatment

The Coxsackie Virus has been on the rise for many years.

Unfortunately, this virus affects children and adults alike.

Its name comes from New York Citym where it was first isolated and officially investigated.

The Coxsackie virus is found on all the continents of the world.

In places with a more tropical climate, the Coxsackie Virus can show up at virtually anytime of the year.

And, in places with the normal four seasons of the year, the virus is most likely to appear during Spring and Autumn.

What is the Coxsackie Virus?.

The Coxsackie Virus is also known as the hand-foot-mouth disease.

The main symptoms of the virus usually oocur in the extremities and throat of those it affects.

The nasty virus belongs to the enterovirus gene.

This gene infects humans and causes a wide variety of diseases such as poliomyelitis, or Hepatitis A and many more.

Even though it exists among demographics of all ages, the hand-foot-mouth disease mainly affects children younger than twelve.

Two different types of the virus exist.

The first is virus type A, and the second, virus type B.

These two types exhibit symptoms that are practically identical to the symptoms of the other.

What are the main symptoms of the Coxsackie Virus?.

Many of the children infected with this virus do not show any kinds of superficial or outward symptoms.

The following is a list of the general symptoms or problems that a child may be dealing with due to the virus:.

Head aches. Throat pain and irritation.

Fevers higher than 100.

4 degrees Fahrenheit. Nausea.

Abdominal pain. Loss of apetite.

Other symptoms exist that are due entirely to the Coxsackie Virus such as:.

The formation of small blisters on the feet, and hands that in general are very sensitive to touch.

The formation of blisters in the throat, the roof of the mouth, and inside of the cheeks.

There will also be a redness that spreads just around the blisters.

How can you get the Coxsackie Virus?.

We can come into contact with the virus in almost any environment.

We can contract it through inhalation into anyone of our respiratory airways.

However, there are also other ways we can contract the virus:.

Touching our mucous membranes (eyes, nose, or mouth), after being in contact with a contaminated surface.

Having direct contact with the mucous membranes of an infected person.

Having direct contact with the feces of an infected person.

Direct contact with the secreted fluids of the blisters of an infected person.

This virus is capable of remaining in the form of blisters on the skin for up to three days.

A child is more likely to be exposed to the virus in a daycare or in school.

Furthermore, the incubation period of the virus in our bodies can take anywhere from 3-7 days.

We will not know if we are infected with the virus until after a sufficient amount of incubation time.

Treatment of the virus to counteract its symptoms.

There is no cure, or specific treatment for the sickness.

With time, our bodies will naturally defend themselves and fight it off.

Even though all of the symptoms should disappear within 7 days, there are some medicines and homemade remedies that we can use to reduce their potency.

Pharmaceutical treatments for the Coxsackie Virus.

To reduce the fever we can use pharmaceutics like paracetamol or ibuprofen.

We can freely obtain any of these medications at our nearest pharmacy.

We should only administer aspirin as a form of treatment if the patient is an adult.

This method of treatment will help to combat the symptoms.

Homemade treatments for the Coxsackie Virus.

To bring down the fever, we can use can soak a towel in lukewarm water and lay it over the head, hands, and/or feet.

Refreshing the body with alcohol is an excellent idea.

However, be careful to avoid contact of the alcohol with cuts, or skin injuries.

Taking chamomile baths will help to diminish hives and blisters on the skin.

Drinking alcoholic drinks can help the body to stay hydrated and effectively fight the virus.

Basil is a great supplement we can use in infusions.

Ingredients:. 6 basil leaves.

1 cup of water (250 ml). Preparation:.

Heat up the water until boiling, and the add the basil leaves.

Let the basil leaves dissolve into the water for about 15 minutes, and then turn off the heat completely.

Filter the water, and drink it.

How to protect yourself from the Coxsackie Virus.

Really, there is no extremely effective manner of preventing the contraction of the virus.

We can unfortunately come into contact with the virus anytime, anywhere.

Despite this fact, the best way to reduce the risk of contracting the virus is hygiene.

We must teach our children the basic rules and appropriate form of hygiene.

For more infomation >> Coxsackie Virus Prevention and Treatment - Duration: 8:15.

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Spain sweating over Pique who has treatment on ankle knock in training - Duration: 2:50.

Gerard Pique is at risk of missing 's tie with on Sunday after a collision with goalkeeper Pepe Reina

were going through the motions as they completed their final training session before they face the hosts at the Luzhniki Stadium

However, concern has arisen over the fitness of Barcelona centre-back Pique as he was forced to receive treatment midway through the session

that the 31-year-old, who has played all 270 minutes of 's campaign thus far, collided with Reina and suffered a knock to his ankle

He was pulled aside to receive treatment on the injury and was able to rejoin the session, but he must now prove his fitness ahead of the crucial match on Sunday

Fernando Hierro led the session but refused to comment on Pique or the side he will field against

Only confirming the David de Gea will start in goal, while Koke and Diego Costa are expected to feature in the starting line-up

 Cesar Azpilicueta and Nacho Fernandez will be on standby, awaiting to see if either of them will be required to take Pique's place should he not be able to feature against the hosts

The Spanish are potential semi-final opponents for England - should both nations make it that far - but will need to beat either Croatia or Denmark in the quarter-finals

England face Colombia on Tuesday in their last-16 fixture, and will need to beat either Sweden or Switzerland in the following round to make the final four