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Zuza, sciskam <uscisk>

Dostalas oslonowy antybiotyk?

Bad girl

Zuza, a co z Royal Marsden (ze sie tak niedyskretnie zapytam)?

Zuza,
Moze wyslij te wyniki mailem do Turpina?
On kiedys uprzejmie podal swoj prywatny adres w watku Ani (tam gdzie Kangur podawal namiary na Royal Marsden) zaznaczaja, ze na miesakach sie nie zna ale moze bedzie mogl Ci pomoc w zrozumieniu wynikow badan trepanobiopsji?
usciski
Zosia

Zuza,
Czytaj tu:
http://bjr.birjournals.or...ract/24661539v1

i tu:

Cytat:

In their report, Cypess and his colleagues reviewed 3,640 PET-CT scans performed on 1,972 patients at Beth Israel Deaconess Medical Center in Boston for various diagnostic reasons. Among women, 7.5 percent had patches of brown fat that were more than 4 millimeters in diameter, while 3.1 percent of men had similar patches.

"The people who had brown fat were, in fact, different from the people who didn't," Cypess explained: They were younger and leaner. People who were older, those who were obese, and those using heart drugs called beta blockers were less likely to have brown fat.

Cypess and his team also found that people whose scans were done in the winter had the most brown fat, while those scanned in the summer had the least; people who underwent the tests in the spring or fall fell in the middle.

Researchers from the Maastricht University Medical Center in the Netherlands, in the second study, looked at how temperature affected brown fat activity in 24 healthy men, also using PET-CT. When the volunteers sat in a room kept at 72° F (=22,2 stopni C) for two hours, none of their scans showed brown fat activity. But when they were exposed to slightly chillier conditions -- about 61° F (=16,1 stopni C) -- 23 showed brown fat activity. The 10 men who were lean (with body mass indexes of less than 25) had more brown fat than the 14 who were overweight or obese, and their brown fat was also more active.

http://www.cnn.com/2009/H...sity/index.html

Zuza,
Jestes kobitka i raczej "slender" wiec masz zapewne wiecej tego brazowego tluszczu niz reszta populacji.
Brazowy tluszcz ma tendencje do wylapywania znacznika. Okryli Cie - to dobrze. Ale czy bylo Ci rzeczywiscie cieplo?
Pilas kawe przed badaniem? Kawa i aktywnosc fizyczna przed badaniem sa a NO-NO!

Cytat:

zosia, czyli, że jak zrozumiałam, ten tłuszczyk może albo udawać nowotwór albo go maskować?kocem byłam przykryta

Tak dokladnie pisza.
Moze albo udawac nowotwor (false positive) albo maskowac przerzuty do wezlow chlonnych (false negative).

Poszukam jeszcze czegos na ten temat.
trzymaj sie cieplo - chetnie Ci odstapie nieco naszej kanikuly

zosia

Lektura dla Zuzy:

Warm Blanket Lessens Chances Of False-Positives In Cancer Scans

ScienceDaily (June 20, 2006) — Placing a warm blanket on patients undergoing PET/CT scans to detect cancer makes the test more accurate, new Saint Louis University research finds.

In up to 9 percent of patients, doctors have difficulty interpreting scans because of the presence of brown adipose tissue, also known as brown fat, which may lead to a cancer misdiagnosis.
"This is a significant finding," says Medhat Osman, M.D., Ph.D., assistant professor of nuclear medicine and PET director at Saint Louis University School of Medicine. "It is a solution that not only is effective but low-cost and extremely easy for any PET facility to implement."
Osman says brown fat serves an important physiological role – it keeps the body warm in cold temperatures. But accumulations of the tracer that is used to identify malignancies during PET/CT scans that appear in brown fat can mimic cancer – or even mask the appearance of cancer in areas such as the lymph nodes.
New research presented by Osman, co-author Scott Huston and other Saint Louis University Hospital scientists at the 2006 Society of Nuclear Medicine in San Diego this month suggests that covering patients with a heated blanket before the scan can reduce the brown fat uptake by 62 percent.
Researchers currently suggest fighting the problem of brown fat uptake with drugs such as valium and beta blockers, which studies show only reduce the uptake by up to 30 percent.
"A warm blanket is more than twice as effective, and patients don't have to worry about negative drug interactions – or how they’re going to get home after their scan," he says.
While everyone has brown fat, it is more common in women, especially those who are slender, Osman says.
Osman's previous research suggests strenuous activity and consuming caffeinated beverages before undergoing PET/CT scans can also increase the chance for false-positives.
"We always call our patients 24 hours before their appointment as a reminder," Osman says. "Now we can give them a checklist: Don’t drink coffee, take it easy and try to stay warm to ensure the most accurate scan."
In addition to Osman and Huston, Saint Louis University Hospital technologists Crystal Botkin and Penny Yost were authors of the research, which placed third in the technologists section of the meeting.

http://www.sciencedaily.c...60620170520.htm

Zuza,

Tak sie zastanawiam, gdzie jest w tym wszystkim Twoja rodzina. Czy Twoi bliscy zdaja sobie sprawe z tego co sie dzieje? Czy tylko Twoi przyjaciele z forum sa tacy upierdliwi i usiluja Cie popchnac do dzialan?

Zuza,

Zpewniam Cie, ze nikt z nas nie uwaza, ze jestes infantylna.
Zdajac sobie sprawe (w mniejszym lub wiekszym stopniu) z zaawansowania Twojej choroby probujemy namowic Cie do podjecia dzialan w Twoim dobrze pojetym interesie.

Czy znasz angielskie pojecie "to be in denial"?

Denial is a mechanism of defense that usually helps the patient to cope with painful, threatening, overwhelming, or awkward thoughts. When it turns out to be ineffective and pathological, it can cause either delay or avoidance in seeking treatment for symptoms relevant for a true malignancy and will lead inexorably to death if not cured.
http://journals.cambridge...ine&aid=5867776

Mysle, ze powinas rowniez przeczytac ponizszy artykul.

"Denial among cancer patients. Tips and traps."
http://www.ncbi.nlm.nih.g...2379955/?page=2

Sciskam Cie,
Zosia

Zuza, ja wprawdzie do Krakowa nie dojade by zjednoczyc sily z Goncha (16tys km to nie w kij dmuchal) ale robie marsowa mine i palcem Ci groze

A poza tym starszych sie slucha (podobno)...

Za obrone dyplomu trzymam kciuki - to zadna sztuka, wszak groze palcem wskazujacym :mrgreen:

zosia

Zuza,
Skoro znasz angielski to poczytaj sobie o tym jak powinno wygladac leczenie sarcomy. To sa zalecenia NCN oraz NICE a cytat pochodzi ze strony Australian Sarcoma Group.
http://www.australiansarc...inary-care.html

Why multi-disciplinary care is important in sarcomas

The National Cancer Control Network (NCCN) in the US and the National Institute for Health and Clinical Excellence (NICE) have issued detailed recommendations for the management of patients with sarcoma. These are accessible at www.nccn.org and www.nice.org.uk respectively.

A critical component of these recommendations is that all patients with sarcoma should be treated at centres with appropriate expertise and relevant multidisciplinary teams (MDT). The evidence for these recommendations is available from NICE, and is attached as a PDF to this page. As these recommendations are based on the different populations and health care systems in the US and UK, the Australasian Sarcoma Study Group has slightly modified these for the Australian setting.

There is sound evidence to support the following conclusions 1:

Radiology: That specialist review of the imaging in people with suspected sarcoma reduces clinical error rates and delay in diagnosis (p 43).
Pathology: That the histopathological diagnosis of sarcoma is often changed on review by an expert pathologist. Tthis includes the diagnosis of sarcoma, sarcoma sub-type and tumour grade. (p 50).
MDT: That being treated at a sarcoma MDT centre results in better overall survival, increased disease-free survival, reduced risk of amputation, better conformity to clinical practise guidelines and greater use of preoperative imaging and biopsy (p 58-59 ).
Supportive care:That coordinated supportive care is associated with improved patient quality of life, fewer days in hospital, fewer home visits required and better physical, social and emotional outcomes (p 82).
Participation in clinical trials correlates with survival rates for patients with sarcoma (Bleyer et al.2).
Please note that the recommendations for centralisation of care for paediatric sarcomas (osteosarcoma, Ewing sarcoma/Primitive neuroectodermal tumor, rhabdomyosarcoma) is particularly important, owing to: the rarity of these cancers; the lack of a large evidence base for treatment; the complexity and intensity of the treatment regimens; and the high mortality from these cancer types. As a consequence, the ASSG strongly recommends that all patients with paediatric sarcomas under the age of 16 years be treated at a paediatric cancer centre, and that older patients be treated at a specialist sarcoma centre. For other sarcoma types, the recommendation is that a specialist sarcoma multidisciplinary team assesses patients even if subsequent treatment is carried out elsewhere.

Modified key recommendations are based on the National Institute for Health and Clinical Excellence Guidance on Cancer Services 3

All patients with a confirmed diagnosis of bone or soft tissue sarcoma (except children with certain soft tissue sarcomas) should have their care supervised by or in conjunction with, a sarcoma multidisciplinary team.
A soft tissue sarcoma MDT should meet minimum criteria for caseload. In the UK this is specified as at least 100 new patients with soft tissue sarcoma per year, or at least 25 new patients with bone sarcoma per year (p 54). Given the difference in population and the size of the landscape, these figures must me modified for the Australian setting.

The sarcoma MDT should include
* A specialist sarcoma pathologist and/or radiologist who is able to review each patientĂ˘ÂÂs pathology and radiology
* A surgeon who is a member of a sarcoma MDT or a surgeon with tumour site-specific or age-appropriate skills, in consultation with the sarcoma MDT
* Medical and radiation oncology expertise. Chemotherapy and radiotherapy should be carried out by appropriate specialists as recommended by a sarcoma MDT
* Dedicated ancillary supportive care, which includes nursing, physio- and occupational therapy, age-appropriate psychosocial support and palliative care
* Access to relevant clinical trials.
* sarcoma MDTs should participate in national audit, data collection and training.
*Patients with functional disabilities as a consequence of their sarcoma should have timely access to appropriate support and rehabilitation services.

1National Institute for Health and Clinical Excellence, 2006. Improving outcomes for people with sarcoma.NICE guidance on cancer services.

2Bleyer, A., Montello, M., Budd, T., and Saxman, S. 2005. National survival trends of young adults with sarcoma: lack of progress is associated with lack of clinical trial participation. Cancer 103:1891-1897

3National Institute for Health and Clinical Excellence, 2006. Improving outcomes for people with sarcoma. NICE guidance on cancer services."[/i]

Tutaj jest link do MDT (Multidisciplinary Teams) w poszczegolnych stanach Australii.
Skierowany prze swojego GP pacjent trafia do zespolu rzeczywistych specjalistow w dziedzinie sarcomy (patolog, radiolog, chirurg, rehabilitant, psycholog, etc)
http://www.australiansarc...specialist.html
Jak widac, kazdy osrodek podaje rowniez liste wszystkich badan klinicznych, w ktorych moga wziac udzial pacjenci chorzy na sarcome

A tutaj informacja dla pacjentow, ich rodzin i przyjaciol na temat soft tissue sarcoma - ulotka wydana przez Cancer Council stanu Victoria
http://www.australiansarc.../donwloads/Soft tissue sarcoma_Info Sheet.pdf

usciski,

zosia