Adenomyosis causes pain, heavy periods and infertility but you’ve probably never heard of it

Adenomyosis is a condition of the uterus (womb), where the tissue that grows on the lining of the uterus (also known as the endometrium) is also present on the inside muscular wall of the uterus. Adenomyosis can cause symptoms such as heavy bleeding during your period, bleeding when you are not due for your period, period pain (dysmenorrhea), pain during or after sex (dyspareunia) and infertility.

Although women with adenomyosis often also have endometriosis, they are different conditions. With endometriosis, cells similar to those that line the uterus are found in other parts of the body such as the fallopian tubes, the ovaries or the tissue lining the pelvis (the peritoneum).

The area of the uterus affected by adenomyosis is known as the endometrial-myometrial junction, which is where the endometrium and the myometrium (the muscular part of the uterus) meet.

Disruption in the endometrial-myometrial junction is now considered an important contributor to reproductive problems such as recurrent implantation failure, a condition that can prevent women falling pregnant. Adenomyosis can either be quite spread out, known as generalised adenomyosis or localised in one place, also known as an adenomyoma.

Adenomyosis can have a number of causes though none have been definitively identified. There is an association between the presence of adenomyosis and the number of times a women has given birth: the more pregnancies, the more likely you are to have adenomyosis. Women with adenomyosis have also often had a trauma to the uterus such as surgery in the uterus, like during a caesarean section.

How common is adenomyosis?

Like endometriosis, we don’t know exactly how many women may be affected by the condition. What makes the impact of adenomyosis so tricky to determine is that it is quite commonly found during regular screening tests, even when women are not complaining of any symptoms, which means many women may have it and not know about it.

Because it’s often found in women with other conditions like endometriosis, it’s difficult to determine which condition caused the symptoms. We don’t currently know why some women with adenomyosis have symptoms and others don’t.

There are also a number of different criteria for diagnosing adenomyosis, which can differ in important factors. For instance, the number of sections of adenomyosis that need to be affected for a diagosis when looking at tissue samples under a microscope. This makes it a problem when we try to work out how common adenomyosis is.

There can also be differences of opinion among the experts who look at these tissue samples. Experts can look at the same slides and come to very different conclusions.

How is it diagnosed?

Unlike endometriosis, which can only be definitively diagnosed through a key-hole surgery, a diagnosis of adenomyosis can be done through both invasive and non-invasive methods. The most common invasive method is a uterine biopsy (tissue sampling). A biopsy of the uterus can also be performed to make the diagnosis by an abdominal key-hole surgical procedure (laparoscopy) but this remains limited to clinical trials.

Biopsies going through the vagina up to the uterus may have a role in the diagnosis of adenomyosis, but can potentially damage the uterus and therefore are avoided in women wishing to fall pregnant. The ultimate biopsy is a hysterectomy (the removal of the uterus). This is the most accurate method but is obviously a significant surgical procedure and will prevent women having children. A diagnosis of adenomyosis has been made in between 10-88% of hysterectomy specimens showing how common this condition is.

Non-invasive diagnosis can be made by different types of imaging. Ultrasound is commonly available and can be done either using the probe on the abdomen or, preferably, placing the probe in the vagina.

However, ultrasound isn’t always the best choice as it only detects adenomyosis about 50-87% of the time. Magnetic resonance imaging (MRI) is a better choice as there are a number of typical features seen during MRI. These vary throughout the cycle and in response to hormonal therapy but can reliably predict adenomyosis.

What are the treatments?

Management options for adenomyosis include hormonal therapy and surgery. These are mainly targeted at reducing symptoms such as pain. There isn’t much research into whether these increase the chance of getting pregnant.

Hormonal treatments focus on suppressing menstruation. This can be achieved by combined oestrogen and progesterone therapy (such as the combined oral contraceptive pill), progestogen-only treatment (such as a Mirena) or placing women into an “induced” menopause (through GnRH analogs).

Surgical treatment is most effective when the adenomyosis is localised to a smaller area and can be removed, and this type of surgery doesn’t prevent women falling pregnant in the future. If the adenomyosis is spread throughout a larger area then treatments include destroying the lining of the uterus (endometrial ablation) provided adenomyosis is not too deep, and hysterectomy, both of which will prevent further pregnancy.

Other treatment options are interventional radiology such as uterine artery embolisation, where the blood supply to the uterus is cut off and magnetic resonance-guided focused ultrasound where the adenomyosis is destroyed with ultrasound energy.

Does it affect fertility?

There is some evidence adenomyosis can reduce fertility, but this is still controversial. Clinical studies are limited by difficulties and differences in diagnosis and their study designs have problems.

Some MRI studies show changes consistent with infertility, but because patients presenting with infertility in their 30s and 40s are more likely to be diagnosed with adenomyosis, it’s difficult to say if adenomyosis is the cause of their fertility issues.

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Obesity both feeds tumors and helps immunotherapy kill cancer

A groundbreaking new study by UC Davis researchers has uncovered why obesity both fuels cancer growth and allows blockbuster new immunotherapies to work better against those same tumors.

The paradoxical findings, published today in Nature Medicine, give cancer doctors important new information when choosing drugs and other treatments for cancer patients.

“It’s counter-intuitive because up to this point all of our studies showed that obesity resulted in more toxicities associated with immunotherapy treatments,” said William Murphy, a co-last author of the study and vice chair of research in the UC Davis Department of Dermatology. “This is a game-changer because when we personalize medicine and look at body mass index, in some situations it can be bad, and in some situations it can be helpful.”

Obesity, which is reaching pandemic levels and a major risk factor for many kinds of cancer, also is known to hasten cancer growth, promote cancer recurrence and worsen chances of survival. Obesity also is associated with impairment of the immune system. Previous studies of the use of immune-stimulatory immunotherapies have demonstrated that in obese animal models and in humans, these drugs overstimulate the immune system and cause serious side effects.

The research, which involved studies using animal models and human patients, analyzed the effect of a different class of immunotherapies called checkpoint inhibitors. These drugs work by blocking pathways called immune checkpoints that cancers use to escape the immune system. They include drugs like Keytruda (pembrolizumab), which have dramatically improved survival in many lung cancer and melanoma patients. In the current study checkpoint inhibitors had a different effect than other immunotherapies, and in fact, resulted in better survival in those who are obese than in those who are not.

Why this happens, they discovered, relates both to the effect that obesity has on the immune system and to the way that checkpoint inhibitors do their jobs.

Cancers can cause increased expression of checkpoint proteins that keep T cells in check, preventing them from attacking cancer cells. Checkpoint inhibitors block those proteins, in effect releasing the immune system’s brakes so that the T cells can go after cancer cells.

The research team discovered that because obesity also causes suppression of the immune system and increased expression of checkpoint proteins, the action of checkpoint inhibitors is enhanced in animal models and humans who are obese.

https://youtube.com/watch?v=o_Dw09YXvBs%3Fcolor%3Dwhite

They first studied the differences in T-cell function in obese and non-obese mice and found that T-cell function was diminished and the expression of the PD-1 protein on the T-cells was higher than in the non-obese control mice. They saw a very similar pattern when the same studies were done in both macaque monkeys and in human volunteers.

Additional studies also found that tumors grew more aggressively in obese mice, regardless of tumor type.

“In obese animals cancer grows faster because there are more nutrients for tumors and because the immune system is more suppressed,” said Murphy.

Drilling down, Murphy and his colleagues also found that the T-cell dysfunction was driven in part by leptin, a weight-regulating hormone produced by the body’s fat cells. The research showed that increased leptin levels in obese mice and humans also correlated with increased expression of PD-1 checkpoint protein.

When obese mice with tumors were given checkpoint inhibitors designed to block the action of PD-1, they survived significantly longer than the non-obese control mice in the study. A study involving 251 patients with melanoma who were treated with checkpoint inhibitors also found marked improvements in the clinical outcomes of obese patients that were not observed in non-obese patients.

“Overall these findings suggest that obesity may be a very important biomarker for response to checkpoint inhibitor immunotherapy,” said Arta Monjazeb, associate professor in the UC Davis Department of Radiation Oncology and co-last author on the study. “We are not advocating for obesity as improving prognosis for cancer patients. But obesity appears to induce immune suppression and accelerated tumor growth through mechanisms that can be successfully reversed by checkpoint inhibitor immunotherapy.”

Murphy cautioned that while the findings are an important step in better targeting immunotherapies, there are many other factors that likely influence how effective a certain drug will be for a given patient. Those may include gender, the type of diet consumed, their individual microbiome and the timing of their treatment.

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Witch hazel: Uses, benefits, and side effects

Witch hazel is a small tree native to the east coast of North America. Many people use it as a decorative outdoor plant.

In this article, learn about the possible benefits of witch hazel, as well as how to use it and whether there are any side effects.

Uses and benefits

Witch hazel is an astringent. People commonly use it topically, meaning they apply it directly to the skin.

Witch hazel may help treat the following conditions:

Hemorrhoids

Witch hazel may help heal hemorrhoids, which are dilated veins in the anus or rectum. Hemorrhoids can cause irritation, bleeding, and discomfort.

While there is not enough evidence to prove it is effective, some people get relief by adding witch hazel to a bath. This may be due to its anti-inflammatory properties.

Similarly to sunburn, bug bites and stings can cause swelling and inflammation. Applying witch hazel to the bite may reduce itching and discomfort.

Sunburn

Witch hazel has anti-inflammatory properties, which may help reduce discomfort from sunburn.

People can use a cloth or cotton ball to apply witch hazel directly to sunburn.

It may be especially soothing if a person mixes witch hazel with aloe vera, which is another plant and anti-inflammatory agent.

Stretch marks

Some people apply witch hazel to pregnancy stretch marks in an effort to lighten them and make them less noticeable. However, there is no research to support this use.

Bleeding

The astringent properties of witch hazel cause the skin to tighten and small blood vessels to constrict, which may help stop bleeding from minor cuts or nosebleeds.

Side effects

Witch hazel is safe for most people to use as an at-home treatment for some common skin issues.

Some people may have an allergic reaction to witch hazel, so it is best to test it first on a small patch of skin and monitor it for 24 hours. If there is no redness, itching, or irritation, it should be safe to apply to a larger area.

Takeaway

Witch hazel can be a great addition to an at-home medicine cabinet and is usually well-tolerated. It is safe for most people to use for certain skin conditions, even if the research has not yet proven its effectiveness scientifically.

However, using home remedies such as witch hazel cannot replace advice from a doctor or other healthcare provider.

If using witch hazel as a remedy does not work or the condition gets worse, it is vital that people consult their doctor for further advice.

Witch hazel is available in some pharmacies, health food stores, and online.

We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.

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24 hours in the emergency room: The difficulty of the everyday life of Doctors and nurses

In emergency rooms the patient numbers are increasing – an increasing burden for the staff. FOCUS-Online-editor Anika, Jonas accompanied the everyday life in a Munich emergency room. There showed, what is the real challenge for Doctors and nurses – and why it is a good sign, when a Patient has to wait longer.

Monday, 20.29 PM: At the reception of the emergency Department in Großhadern suddenly happens all at once: A 60-Year-old comes in hobbling, in the Wake of his wife and son. His leg was between two cars crushed. Another man rushes excitedly into the room: His girlfriend has become in front of the toilets passed out. At the same time a rescue comes in the back entrance of the emergency room cart. He brings a patient with a suspected stroke.

I sit together with an emergency nurse Nele Schmid* on the so-called Triage counter, where she takes new arrivals in reception, the Severity of their injuries, evaluates and acquires data. Schmid has the late shift. A few minutes has passed, your colleague from the next room, where the rescue will arrive the car, in the evening. Schmid is now responsible for both areas.

If she could, she would now probably three parts. But she remains calm. After more than five years in the emergency room she does not know to distinguish the urgent cases from the non-critical, will take care of everything at the same time, but each patient in the appropriate order.

The emergency room at Klinikum Großhadern

In the emergency room at the Klinikum Grosshadern (Munich) to be handled annually about 40,000 patients. More than 100 people a day. Round-the-clock Doctors from different subject areas in this interdisciplinary emergency Department, neurology, trauma surgery, Internal medicine and abdominal surgery. More Doctors are available on call in the house. Per shift, five to six nurses to come also.

Those who have to wait may be lucky

So you can be the man with the trapped leg, despite the pain, his face twisted in time to sit and search for a free treatment room for the patient in the ambulance. How the victim feels, I can well understand. I remember my first visit to an emergency room. That was eight years ago. I had cut the little Finger on a tin can. He got three stitches. At the time, I was shocked to some extent, that upon my arrival in the emergency room, not at once all life support measures were taken. Instead, I should put me in the waiting area – with a blood Finger?!

Today I know: That was a good sign. If it takes a little longer, that means in an emergency room, you will survive the day. Worse it would be if Doctors and nurses are provided with a deck, slips, syringes. As it is in the patient of the case that has probably suffered a stroke. With him, every Minute can make the difference between life and death.

20.39 PM: Nele Schmid is back at the Triage counter. It takes a short time to fill up water bottle. This is their second break since the start of the Shift four hours ago. Meanwhile, the Stroke Team takes the patient from the ambulance, the blood. Thereafter, in the computer tomography images of the brain are created.

“The true face of the company”

21.33 clock: All treatment rooms are occupied. In one of the rooms, a 40-year-old woman with systemic scleroderma, a connective tissue disease is seated. At the time of their arrival in the emergency room they prayed continuously to God, he was barely responsive.

In the waiting area of ten patients were able to talk to any doctor, sit. Including a mathematics student who is feeling burned out, a woman with stomach pain, a cancer patient who has lost the car, the orientation to short-term, a woman who cut herself while cooking in the Finger.

“In the emergency room, you will see the true face of the society, the entire range, starting from people needs, about asylum-seekers to the Upper Class with their own set of problems,” tells me emergency nurse Sandra’s reputation*. You experience dramatic stories, as a result, the work was very stressful, she says.

The work takes energy

Tuesday, 7.22 PM: Outside it’s cold, over night it snowed. In such weather, the emergency room is often visited in the morning. A man fell down in the snow slide. A woman is caught with your car on the slippery road and hit the collision with another car the Arm. These are the most typical accidents in this weather, explains Matthias Klein, senior physician and head of the emergency room Großhadern.

12.38 PM: The lunch break falls short today. Because a colleague moves to another Department, there is the farewell to sandwiches and pastries. Most of the employees take just ten minutes to refuel shortly. A 59-year-old woman with a suspected brain haemorrhage is the arrival of the wagon at any Moment with the rescue. As time to enjoy lunch.

In the meantime, I’ve found: The biggest challenge in a emergency room, the serious illnesses and injuries with which patients arrive. The violence is not the willingness of some patients under the influence of alcohol or drugs. For Doctors and nurses to be trained in their training, learning certain operations and handles, applying them routinely in their everyday work.

What is the training not prepared for the many: The work robs immense energy that is missing in your private life. Doctors and nurses to sacrifice their own quality of life, so that other people get a better quality of life.

“The work is exhausting, and you often feel exhausted”, tells me Sandra’s reputation. It is every second weekend on duty, Early, Late and night shifts. So it is with people in many Professions – but not everyone is in his Job for the lives of other people. “If we miss something, is the life in the worst case, a threat to the patient,” says the sister. At night around three o’clock, she often leaves the force. Your shift lasts five hours.

12.47 PM: The 59-year-old patient has arrived. She is barely responsive. Your sister-in-law has not elected to the emergency, because they responded to calls and messages. The emergency doctor and his assistant found the woman unconscious in her living room, she had slipped from the Sofa.

Now the 59-Year-old surrounded by a ten-member Team of Doctors in the so-called shock room. Because it is not able itself to take off, cut nurses her pink T-Shirt and grey Jogging pants. The patient is connected to monitors to observe your heart rate and the oxygen saturation in the blood. A blood sample comes to the evaluation to the laboratory.

13.07 PM: The patient is in the computer tomograph pushed. It is still unclear exactly what is wrong with her. Senior physician Matthias Klein comes to me now a little like Sherlock Holmes. Together with a neurosurgeon, neurologist and radiologist, he is puzzled on the basis of the previous findings, what the woman might be sick.

13.22 PM: Small lays: The patient probably has an infection of the sinuses taken. The infection had eaten through the skull plate and now they are attacking the brain. She comes back in the shock room. A doctor picks her brain fluid from the back to secure the diagnosis.

The patient needs to be on this day in surgery and is in need of a bed on the intensive care unit of neurology. However, the is full. No bed during the day, you need to deal with the nurses on the ward to a patient’s more – an additional, unplanned burden for the staff.

More and more patients come to the emergency room

Around 1600 euros net a care worthy of power. In a city like Munich, where rents are rising steadily, is for many too little to live on. Consequently, there is a lack of hospitals to care staff. If at the same time, the number of patients increases, attributed to the more pressure and responsibility on the shoulders of the existing forces. Some drag themselves to work sick, so that colleagues do not need to fill in.

The growth in patient numbers, not necessarily the fact that people get hurt more often, or more often become ill. “Patients nowadays are demanding a fast diagnostic classification,” says Matthias Klein. A violation of the patient take today is not easy. You want round-the-clock best possible care.

21.13 PM: In one of the treatment rooms sits a 22-year-old woman for a few days, a strange feeling in the chest. As if she had swallowed an object, she says. In the room next door, an elderly lady accompanied by her husband. Your foot is numb. Now she is afraid to plunge.

Many patients in the emergency room are not “true emergencies,” says a senior physician Matthias Klein. “You feel but all as an emergency. Of the patients, we can’t expect that you consider yourself to be.“ So the emergency room treated both patients with epileptic seizures or a stroke, as well as the retiree who decides after twenty years of back pain one Night, to come to the emergency room, because he has the time.

“I am looking forward to the slowness”

Performance pressure and Stress, the loads on the personnel, are not felt in the emergency room. Everyone is working quietly and patiently. Nele Schmid kids counter with the new patient at Triage, to take you to the fear. However, one learns of the immense pressure in conversations: “When I retire, will I get back my life”, tells me Sandra’s reputation. She has no husband, no children.

After so many years in the service, you will be happy to work on the little things. On a relaxing Sunday on the couch, take a walk, to a concert that you missed, because she has a late service, and the colleagues not to change. “I’m most looking forward to the slowness,” she says. Many of your colleagues will not even consider it until retirement in your profession. You switch after a few years in other hospital areas, or a completely different Job.

*Name changed by the editors

Aseptic technique: Purpose, benefits, and types

Aseptic technique is a standard healthcare practice that helps prevent the transfer of germs to or from an open wound and other susceptible areas on a patient’s body.

This article will explain different types of aseptic technique, how it differs from clean technique, and how to use it at home.

Purpose and benefits of aseptic technique

The skin is the body’s first line of defense against germs. A person is vulnerable to infection as soon as there is a break in their skin, regardless of whether it occurs as a result of an accidental injury or a surgical incision.

Aseptic technique helps prevent healthcare-associated infections (HCAIs). An HCAI is an infection that a person acquires as a result of treatment from a healthcare professional.

According to the Centers for Disease Control and Prevention (CDC), one in every 31 hospital patients will have at least one HCAI.

Common HCAIs include:

  • catheter-associated urinary tract infection
  • central line-associated bloodstream infection
  • Clostridium difficile infection
  • surgical site infection
  • ventilator-associated pneumonia

These types of infection are a significant concern in the healthcare community. HCAIs can lead to severe health complications for affected individuals and disciplinary consequences for medical facilities.

Additionally, HCAIs have a significant economic impact. According to the Center for Disease Dynamics, Economics & Policy, the five most common HCAIs cost the United States approximately $9.8 billion a year.

Aseptic techniques range from simple practices, such as using alcohol to sterilize the skin, to full surgical asepsis, which involves the use of sterile gowns, gloves, and masks.

Healthcare professionals use aseptic technique practices in hospitals, surgery rooms, outpatient care clinics, and other healthcare settings.

Using aseptic technique prevents the spread of infection by harmful germs. Healthcare professionals use aseptic technique when they are:

  • performing surgical procedures
  • performing biopsies
  • dressing surgical wounds or burns
  • suturing wounds
  • inserting a urinary catheter, wound drain, intravenous line, or chest tube
  • administering injections
  • using instruments to conduct a vaginal examination
  • delivering babies

People working in a variety of healthcare settings use aseptic technique. Aseptic technique is not the same as surgical asepsis, also known as sterile technique, which refers to a set of infection control practices that it is necessary to use in operating rooms.

According to the U.S. Joint Commission, there are several different aspects of aseptic technique practices:

  • barriers
  • patient and equipment preparation
  • environmental controls
  • contact guidelines

We discuss each of these below.

Barriers

Barriers prevent the transfer of germs between healthcare professionals, patients, and the environment. Aseptic barriers include:

  • sterile gloves
  • sterile gowns
  • sterile masks
  • sterile drapes
  • protective wrappers on sterilized instruments

Patient and equipment preparation

Healthcare professionals must thoroughly prepare both the patient and the equipment before a medical procedure takes place.

Aseptic preparation may involve:

  • disinfecting a patient’s skin using antiseptic wipes
  • sterilizing equipment and instruments before a procedure
  • keeping sterilized instruments inside plastic wrappers to prevent contamination before use

Environmental controls

Healthcare professionals also have to consider the patient’s immediate surroundings. It is essential to maintain an aseptic environment before and during procedures. The designated procedural area is also called an aseptic field.

Maintaining an aseptic field involves:

  • keeping doors closed
  • minimizing movement in and out of the aseptic field
  • limiting entry to necessary personnel only
  • permitting only one patient per aseptic field

Contact guidelines

Once a healthcare professional has washed their hands and donned their sterile barriers, they must follow sterile-to-sterile contact guidelines. These guidelines prohibit any contact between sterile and nonsterile items.

At this point, healthcare professionals can only touch sterile objects and surfaces, and they must avoid touching nonsterile items and surfaces at all costs.

The same guidelines apply to sterile devices. If a sterile instrument falls on the ground and the wrapper sustains damage, a healthcare professional must remove the instrument and re-sterilize it before use.

The proper execution of aseptic technique requires training. If a person needs to use aseptic technique in their home, a trained healthcare professional can demonstrate the proper practices to them.

Anyone performing aseptic techniques at home will need to have sterile gloves and special dressing kits at hand.

While aseptic technique requires proper training and the use of specialist equipment, clean technique is much easier to achieve at home. Clean technique involves thoroughly washing the hands, wearing gloves, and maintaining a clean environment.

Takeaway

Aseptic technique is a standard set of healthcare practices that aim to eliminate the transfer of germs. The proper use of aseptic technique should prevent HCAIs, which are a significant healthcare concern that can lead to consequences for both patients and healthcare facilities.

Healthcare professionals receive specialized training in aseptic technique practices. However, a person can also receive aseptic technique training if they need to use these practices at home.

Clean technique is much easier for untrained individuals to achieve, and it involves limiting the number of germs in a patient’s vicinity. Clean technique does not require the use of sterile instruments and equipment. Instead, the aim of using this technique is to avoid directly contaminating instruments and materials that will come into contact with the patient.

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Timely care key to improving survival rates and racial disparities

Delayed care is a crtically important factor in the survival of patients with head and neck cancer, and the patients who most often experience these delays are African American, according to two new studies at the Medical University of South Carolina (MUSC) and Hollings Cancer Center.

These findings are reported in an article published online October 18 and by a systemic review published online October 11—both in JAMA Otolarynology—Head & Neck Surgery.

MUSC Hollings Cancer Center researcher, MUSC Health otolaryngologist-head and neck surgeon and lead author Evan Graboyes, M.D., said this is a critical area of research.

“Just as some scientists work to understand cancer genetics or tumor biology in the hope of finding targets that can be modified with a new drug, we see care delivery pathways in the same light,” said Graboyes. “Even just changing a few things can result in a higher survival rate of patients and decreased racial disparities in care around the country.”

Head and neck squamous cell carcinoma (HNSCC) affects the areas around the throat, voice box, nose, sinuses and mouth. The disease begins when healthy cells in the head and neck start to grow rapidly and out of control to form a tumor, according to the American Society of Clinical Oncology. Squamous cell carcinoma refers to the origin of the tumor: flat cells that form the lining of both the mouth and the throat.

While HNSCC is considered rare, consisting of only 4 percent of all cancer cases each year, it has a high mortality rate. The American Cancer Society estimates that almost 14,000 patients will die from this disease in the U.S. in 2018, and African Americans are even more likely to die from it.

Treatment for HNSCC varies depending on the stage at which the patient is diagnosed, but best practices have been tested and agreed upon by a team of doctors from across the United States. These findings, which form the basis for the National Comprehensive Cancer Network (NCCN) guidelines for treating this form of cancer, shaped the parameters of these two studies.

According to the NCCN treatment guidelines, patients undergoing surgery for HNSCC need to receive postoperative radiotherapy (PORT) within six weeks of their surgical procedure to maximize their chances of remission.

Graboyes’ study found that delays starting PORT are common and occurred in 45 percent of the patients involved in his research. While examining these findings, the team also determined that 56 percent of African American patients received delayed care while only 43 percent of white patients did.

Graboyes and his team investigated the processes of care that caused delays and found many factors contribute. Patients who received their pathology report within seven days of surgery were four times more likely to follow treatment guidelines by starting PORT within six weeks.

Patients who had care in two different hospitals rather than continuous care at one hospital or academic medical center were more likely to experience delays as well. Those who met with radiation oncology before surgery had an 8.9-fold increase in timely PORT.

“We know that African Americans with this disease have a significantly higher rate of mortality than white patients, but we aren’t sure why,” said Graboyes. “This research showed us that delays in treatment disproportionately affected African Americans, which could be one of the factors contributing to their lower survival rates.”

More research is still needed to determine the specific barriers to timely and equitable HNSCC care, and racial differences as well as treatment delays in other aspects of cancer care continue.

Barriers to cancer treatment in general often relate to a patient’s insurance status, the cost of the procedure, fear or distrust of the medical system, lack of knowledge of the disease and a lack of perceived importance.

Graboyes aims to enact real change that will benefit future patients in South Carolina and across the country. “We hope that these data will be helpful for head neck cancer providers and healthcare policy makers to understand the magnitude of the problem and spur coordinated action to address its root causes,” he said.

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Home remedies: Relieve and reduce itchy eczema

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.

To help reduce itching and soothe inflamed skin, try these self-care measures:

– Take an oral allergy or anti-itch medication.

Options include nonprescription allergy medicines (antihistamines) – such as cetirizine (Zyrtec) or fexofenadine (Allegra). Also, diphenhydramine (Benadryl, others) may be helpful if itching is severe. But it can make you drowsy, so it’s better for bedtime.

– Take a bleach bath.

A diluted-bleach bath decreases bacteria on the skin and related infections. Add { cup (118 milliliters) of household bleach, not concentrated bleach, to a 40-gallon (151-liter) bathtub filled with warm water—measures are for a U.S.-standard-sized tub filled to the overflow drainage holes. Soak from the neck down or just the affected areas of skin for about 10 minutes. Do not submerge the head. Rinse, pat dry and moisturize. Take a bleach bath no more than two or three times a week. – Apply an anti-itch cream or calamine lotion to the affected area.

A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch. Apply it to the affected area before you moisturize. Once your reaction has improved, you may use this type of cream less often to prevent flare-ups.

– Moisturize your skin at least twice a day.

Use a moisturizer all over while your skin is still damp from a bath or shower. Pay special attention to your legs, arms, back and the sides of your body. If your skin is already dry, consider using oil or lubricating cream.

– Avoid scratching.

Cover the itchy area if you can’t keep from scratching it. Trim nails and wear gloves at night.

– Apply cool, wet compresses.

Covering the affected area with bandages and dressings helps protect the skin and prevent scratching.

– Take a warm bath.

Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal—a finely ground oatmeal that is made for the bathtub (Aveeno, others). Soak for 10 to 15 minutes, then pat dry and apply medicated lotions, moisturizers or both (use the medicated form first).

– Choose mild soaps without dyes or perfumes.

Be sure to rinse the soap completely off your body.

– Use a humidifier.

Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Keep your humidifier clean to prevent the growth of bacteria and fungi.

– Wear cool, smooth-textured cotton clothing.

Reduce irritation by avoiding clothing that’s rough, tight, scratchy or made from wool. Also, wear appropriate clothing in hot weather or during exercise to prevent excessive sweating.

– Treat stress and anxiety.

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