ePromos has a huge selection of promotional products that can help you promote Psoriasis Awareness Month and dispel the stereotypes associated with carriers of Psoriasis. Awareness bracelets imprinted with your company name and corporate logo are great products to help raise awareness of this disease among staff and to promote unity within the office. However, promotional tote bags and imprinted t-shirts can have a more significant impact as recipients of your gift will share your company’s message wherever they travel. Spread the word of the National Psoriasis Foundation with one of ePromos’ promotional products!

Source : http://www.epromos.com/calendar/psoriasis-awareness-month.html

Breast cancer is a cancer that starts in the tissues of the breast.

There are two main types of breast cancer:

* Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
* Lobular carcinoma starts in parts of the breast, called lobules, that produce milk.

In rare cases, breast cancer can start in other areas of the breast.

Many breast cancers are sensitive to the hormone estrogen. This means that estrogen causes the breast cancer tumor to grow. Such cancer is called estrogen receptor positive cancer or ER positive cancer.

Some women have what’s called HER2-positive breast cancer. HER2 refers to a gene that helps cells grow, divide, and repair themselves. When cells have too many copies of this gene, cells — including cancer cells — grow faster. Experts think that women with HER2-positive breast cancer have a more aggressive disease and a higher risk of recurrence than those who do not have this type.
Symptoms

Early breast cancer usually does not cause symptoms. This is why regular breast exams are important. As the cancer grows, symptoms may include:

* Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt
* Change in the size, shape, or feel of the breast or nipple — for example, you may have redness, dimpling, or puckering that looks like the skin of an orange
* Fluid coming from the nipple — may be bloody, clear to yellow, green, and look like pus

Men get breast cancer, too. Symptoms include breast lump and breast pain and tenderness.

Symptoms of advanced breast cancer may include:

* Bone pain
* Breast pain or discomfort
* Skin ulcers
* Swelling of one arm (next to breast with cancer)
* Weight loss

Treatment

Treatment is based on many factors, including type and stage of the cancer, whether the cancer is sensitive to certain hormones, and whether or not the cancer overproduces (overexpresses) a gene called HER2/neu.

In general, cancer treatments may include:

* Chemotherapy medicines to kill cancer cells
* Radiation therapy to destroy cancerous tissue
* Surgery to remove cancerous tissue — a lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possible nearby structures

Other treatments:

* Hormonal therapy to block certain hormones that fuel cancer growth
* Targeted therapy to interfere with cancer cell growth and function

An example of hormonal therapy is the drug tamoxifen. This drug blocks the effects of estrogen, which can help breast cancer cells survive and grow. Most women with estrogen-sensitive breast cancer benefit from this drug. A newer class of medicines called aromatase inhibitors, such as exemestane (Aromasin), have been shown to work just as well or even better than tamoxifen in postmenopausal women with breast cancer.

Targeted therapy, also called biologic therapy, is a newer type of cancer treatment. This therapy uses special anticancer drugs that identify certain changes in a cell that can lead to cancer. One such drug is trastuzumab (Herceptin). For women with stage IV HER2-positive breast cancer, Herceptin plus chemotherapy has been shown to be work better than chemotherapy alone. Studies have also shown that in women with early stage HER2-positive breast cancer, this medicine plus chemotherapy cuts the risk of the cancer coming back by 50%.

Cancer treatment may be local or systemic.

* Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment.
* Systemic treatments affect the entire body. Chemotherapy is a type of systemic treatment.

Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning. For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.

* Stage 0 and DCIS — Lumpectomy plus radiation or mastectomy is the standard treatment. There is some controversy on how best to treat DCIS.
* Stage I and II — Lumpectomy plus radiation or mastectomy with some sort of lymph node removal is standard treatment. Hormone therapy, chemotherapy, and biologic therapy may also be recommended following surgery.
* Stage III — Treatment involves surgery possibly followed by chemotherapy, hormone therapy, and biologic therapy.
* Stage IV — Treatment may involve surgery, radiation, chemotherapy, hormonal therapy, or a combination of such treatments.

After treatment, some women will continue to take medications such as tamoxifen for a period of time. All women will continue to have blood tests, mammograms, and other tests following treatment.
Causes

Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer.

Risk factors you cannot change include:

* Age and gender — Your risk of developing breast cancer increases as you get older. The majority of advanced breast cancer cases are found in women over age 50. Women are 100 times more likely to get breast cancer then men.
* Family history of breast cancer — You may also have a higher risk for breast cancer if you have a close relative who has had breast, uterine, ovarian, or colon cancer. About 20 – 30% of women with breast cancer have a family history of the disease.
* Genes — Some people have genes that make them more prone to developing breast cancer. The most common gene defects are found in the BRCA1 and BRCA2 genes. These genes normally produce proteins that protect you from cancer. But if a parent passes you a defective gene, you have an increased risk for breast cancer. Women with one of these defects have up to an 80% chance of getting breast cancer sometime during their life.
* Menstrual cycle — Women who get their periods early (before age 12) or went through menopause late (after age 55) have an increased risk for breast cancer.

Other risk factors include:

* Alcohol use — Drinking more than 1 – 2 glasses of alcohol a day may increase your risk for breast cancer.
* Childbirth — Women who have never had children or who had them only after age 30 have an increased risk for breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.
* DES — Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer after age 40. This drug was given to the women in the 1940s – 1960s.
* Hormone replacement therapy (HRT) — You have a higher risk for breast cancer if you have received hormone replacement therapy for several years or more. Many women take HRT to reduce the symptoms of menopause.
* Obesity — Obesity has been linked to breast cancer, although this link is controversial. The theory is that obese women produce more estrogen, which can fuel the development of breast cancer.
* Radiation — If you received radiation therapy as a child or young adult to treat cancer of the chest area, you have a significantly higher risk for developing breast cancer. The younger you started such radiation, the higher your risk — especially if the radiation was given when a female was developing breasts.

Breast implants, using antiperspirants, and wearing underwire bras do not raise your risk for breast cancer. There is no evidence of a direct link between breast cancer and pesticides.

The National Cancer Institute provides an online tool to help you figure out your risk of breast cancer. See: www.cancer.gov/bcrisktool
Tests & diagnosis

The doctor will ask you about your symptoms and risk factors, and then perform a physical exam, which includes both breasts, armpits, and the neck and chest area. Additional tests may include:

* Mammography to help identify the breast lump
* Breast MRI to help better identify the breast lump
* Breast ultrasound to show whether the lump is solid or fluid-filled
* Breast biopsy, needle aspiration, or breast lump removal to remove all or part of the breast lump for closer examination by a laboratory specialist
* CT scan
* Sentinal lymph node biopsy
* PET scan

If your doctor learns that you do have breast cancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.

Breast cancer stages range from 0 to IV. Breast cancer that has not spread is called ductal carcinoma in situ (DCIS), or noninvasive breast cancer. If it spreads, the cancer is called invasive breast cancer. The higher the number, the more advanced the cancer.
Prognosis

How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome.

The 5-year survival rate refers to the number of patients who live at least 5 years after their cancer is found. According to the American Cancer Society (ACS), the 5-year survival rates for persons with breast cancer who are appropriately treated are as follows:

* 100% for stage 0
* 100% for stage I
* 92% for stage IIA
* 81% for stage IIB
* 67% for stage IIIA
* 54% for stage IIIB
* 20% for stage IV

Prevention

Many risk factors — such as your genes and family history — cannot be controlled. However, a healthy diet and a few lifestyle changes may reduce your overall chance of cancer in general.

Breast cancer is more easily treated and often curable if it is found early.

Early detection involves:

* Breast self-exams (BSE)
* Clinical breast exams by a medical professional
* Screening mammography

Most experts recommend that women age 20 and older examine their breasts once a month during the week following the menstrual period.

Women between the ages 20 and 39 should have a doctor examine their breasts at least once every 3 years.

After age 40:

* Women 40 and older should have a mammogram every 1 – 2 years, depending on their risk factors. Women should call their doctor immediately if they notice in change in their breasts whether or not they do routine breast self-exams.
* Women 40 and older should have a complete breast exam by a health care provider every year.

Mammography is the most effective way of detecting breast cancer early.

Certain women at high risk for breast cancer may have a breast MRI along with their yearly mammogram. Ask your doctor if you need an MRI.

Screening for breast cancer is a topic filled with controversy. A woman needs to have an informed and balanced discussion with her doctor, along with doing additional reading and researching on her own, to determine if mammography is right for her.

Tamoxifen is approved for breast cancer prevention in women aged 35 and older who are at high risk.

Women at very high risk for breast cancer may consider preventive (prophylactic) mastectomy, which is the surgical removal of the breasts. Possible candidates for this procedure may include those who have already had one breast removed due to cancer, women with a strong family history of breast cancer, and persons with genes or genetic mutations that raise their risk of breast cancer.
Complications

New, improved treatments are helping persons with breast cancer live longer than ever before. However, even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns even after the entire tumor is removed and nearby lymph nodes are found to be cancer-free.

You may experience side effects or complications from cancer treatment. For example, radiation therapy may cause temporary swelling of the breast, and aches and pains around the area. Ask your doctor about the side effects you may have during treatment.
When to contact a doctor

Contact your health care provider for an appointment if:

* You have a breast or armpit lump
* You are a woman age 40 or older and have not had a mammogram in the last year
* You are a woman age 35 or older and have a mother or sister with breast cancer, or have already had cancer of the breast, uterus, ovary, or colon.
* You do not know how or need help learning how to perform a breast self-examination

Illustrations
Female Breast

Female Breast
Needle biopsy of the breast

Needle biopsy of the breast
Open biopsy of the breast

Open biopsy of the breast
Breast self-exam

Breast self-exam
Breast self-exam

Breast self-exam
Breast self-exam

Breast self-exam
Mammary gland

Mammary gland
Sentinel node biopsy

Sentinel node biopsy
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Google Scholar More »
Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene
D Slamon,G Clark,S Wong,W Levin,A Ullrich,W McGuir… – Science, 1987 – www.sciencemag.org
Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up
C Elston,I Ellis – Histopathology, 2007 – www3.interscience.wiley.com
Identification of the breast cancer susceptibility gene BRCA2
R Wooster,G Bignell,J Lancaster,S Swift,S Seal,J M… – , 1995 – www.nature.com
Search Trends
People who searched for Breast cancer also searched for:
Conditions

1. tumor
2. prostate cancer
3. lung cancer
4. pregnancy
5. breast lump
6. ovarian cancer
7. diabetes mellitus
8. metastases

Symptoms

1. breast pain
2. back pain
3. fatigue
4. weight loss
5. chest pain
6. headache
7. cough
8. fever

Drugs

1. tamoxifen
2. herceptin
3. paclitaxel
4. doxorubicin
5. cyclophosphamide
6. arimidex
7. avastin
8. progesterone

The information provided on this page should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only – they do not constitute endorsements of those other sites.

A.D.A.M. creates health content for consumers that is physician-reviewed by experts in their field. © 1997-2010 A.D.A.M., Inc. Any unauthorized duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC’s accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.’s editorial process. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

Source : Google.com

• 38.9 million. The number of people 65 and older in the United States on July 1, 2008.  This age group accounted for 13 percent of the total population. Between 2007 and 2008, this age group increased by 927,305 people.

• 88.5 million. Projected population of people 65 and older in 2050. People in this age group would comprise 20 percent of the total population at that time.
• 520 million. Projected 2009 midyear world population 65 and older. Projections indicate the number will increase to 1.53 billion by 2050. The percentage of the world’s population 65 and older would increase from less than 8 percent to 17 percent over the period. By 2050, Europe’s rate would be 29 percent.
• 4. Number of countries with 20 percent or more of their population 65 and older in 2009: Germany, Italy, Japan and Monaco.
• More than 100. Number of countries that could have 20 percent or more of their population 65 and older in 2050.
• 112 million. The number of people 65 and older in China in 2009, which led the world.  China’s older population is expected to reach 349 million in 2050.
• $29,744. Median 2008 income of households with householders 65 and older, statistically unchanged, in real terms, from the previous year. The corresponding median for all households was $50,303.
• 9.7%. Poverty rate for people 65 and older in 2008, statistically unchanged from 2007. There were 3.7 million seniors in poverty in 2008, statistically unchanged from the previous year. The corresponding rate for the population as a whole was 13.2 percent.
• $239,400. Median net worth for families in 2007 whose head was between 65 and 74. The corresponding median for all families was $120,300.
• 9.1 million. Estimated number of people 65 and older who were veterans of the armed
• forces in 2008.
• 6.2 million. Number of people 65 and older who were in the labor force in 2008. Projections indicate that by 2016, the number will reach 10.1 million.
• 16%. Percentage of people 65 and older in the labor force in 2008.
• 76%. Proportion of people 65 and older in 2008 with at least a high school diploma.
• 20%. Percentage of the population 65 and older in 2008 who had earned a bachelor’s
• 7.3 million. Number of people 66 and older taking adult education courses in 2004-05,
• comprising about 8 percent of these students.

• 56%. Percentage of people 65 and older who were married in 2009.
• 29%. Percentage of people 65 and older in 2009 who were widowed.
• 68%. Percentage of people 65 and older in households in 2008 who lived with relatives. Twenty-seven percent of all people this age lived alone, while 5 percent lived in group quarters and 2 percent in a household with nonrelatives.
• 1.6 million. Number of people 65 and older who lived in nursing/skilled nursing facilities in 2008. These residents comprised 4 percent of all people in this age group.
• 70%. Percentage of citizens 65 and older reporting casting a ballot in the 2008 presidential election. Along with those 45 to 64, people 65 and older had the highest turnout rate of any age group.
• 80%. Percentage of householders 65 and older in 2008 who owned their homes.
• 73. The number of men 65 and older on July 1, 2008, for every 100 women in this age
• 5.7 million. The number of people 85 and older in the United States on July 1, 2008.
• 104,754. Estimated number of centenarians in the United States on Nov. 1, 2009.
• 601,000. Projected number of centenarians in the United States in 2050.
• 4.1 million. Number of people 65 and older living in California on July 1, 2008, the highest total of any state. Florida, with 3.2 million, and New York,with 2.6 million, were the runners-up.
• 17%. Percentage of Florida’s population 65 and older in 2008, which led the nation. States with the next-highest percentages of older people included West Virginia (16 percent) and Pennsylvania (15 percent).

symptoms

contribute to the overall feeling of pain, discomfort and limited function of the joints.
It is understood that in a number of forms of arthritis, because they are rheumatic diseases other areas and organs of the body can be affected that aren’t related directly to the infected joint.
Patients suffering from arthritis may present symptoms such as weight loss, fatigue, a general feeling of illness, gland swelling particularly in the lymph node and fever. In some cases organs such as the kidneys, lungs or heart may show signs of abnormalities.
Source: Health Guidance

For nurses, networking can provide a lifeline of support and professional growth. Networking can help nurses improve their nursing career, personal and social skills. It provides opportunities for nurses to develop their knowledge and skills, including educational and business opportunities. Networking could help boost nurses’ reputation and provide new leads in their career. Donna Fisher and Sandy Vilas of Power Networking described networking as “making links from people we know to people they know, in an organized way, for a specific purpose, while remaining committed to doing our part, expecting nothing in return.” It involves building relationships over time and expanding one’s professional contacts for assistance, support of ideas and guidance. Professional organizations (for example, the Nigerian Nurses Association of USA) provide opportunity for nurses to expand their network of professional colleagues, providing access to contacts, referrals, information, support, and professional mentorship. Thus, networks serve a number of useful purposes.


Why network?

Networking provides excellent opportunity for contacts that may one day lead to new opportunities. Nurses may tap into their networks when looking for job and recruiters tap into professional organizations for candidates, making joining a professional organization a worth while effort. A referral generates 80% more results than a cold call. 75% of people get their jobs through networking. Also, many positions are filled before they are even posted! Another reason for nurses to network is because of the effect of the law of 250. The law of 250 explain that for every person you know, knows at least 250 other people. That is each of your contacts knows at least 250 people.  So that’s 62,500 at your 2nd level. Each of your 2nd level contacts knows 250 people – and that’s over 15,000,000 and so on. Go figure!

Networking Tips & Techniques

• Develop Good People Skills
• Get involve in your professional organizations (for example, the Nigerian Nurses Association of USA)
• Assert yourself positively
• Be a good listener
• Present yourself attractively
• Be viewed as knowledgeable or skillful in a particular area
• Show interest in empowering others
• Keep in regular contact with your contacts.
• Keep a log of all contact interactions

Above all, get involve. Be visible in your professional organizations. Remember, part of networking is giving to other people and can be a life-changing experience, producing personal as well as professional growth.

It is not new any more. Results from various researchers have consistently shown that about 64 percent of adults and 13 percent of children are either overweight or obese. The epidemic is covered on TV and in the newspapers. The question is what are YOU doing about it? Have you taken the first step towards achieving a healthy weight?  – Do you know why it is important to maintain a healthy weight and what steps you can take to achieve it?

Research has shown that excess weight is a serious health problem, increasing your risk of developing a number of serious illnesses, including heart disease, stroke, Diabetes, cancer, respiratory problems, complications in pregnancy, high blood pressure and psychological disorders, such as depression and low self esteem. The list of health consequences from overweight and obesity may seem endless, but the good news is that healthy eating and regular physical activity can help reduce your risk of these diseases. The key is to make changes in your habits/daily routine – including what you eat and the amount of physical activity you do. Your goal should be to- achieve long-term health and life long weight management; not a quick fix (Remember: your excess weight did not occur overnight. You cannot expect to lose it overnight, despite some manufacturer’s claims).

Where to start

First, find out from your Health Care Provider if you are within a healthy weight range. Your healthy weight is likely to be different from anyone else’s. A variety of factors influence your weight, including your genes (which play a role in determining your body size and shape), your physical activity, age, behavior, environment, culture and the foods you eat. Whether your weight is healthy depends on where your body fat is located, how much of your weight is fat, and whether you have weight-related health problems, such as diabetes or high blood pressure.

If your Health Care Provider advises you to lose weight, don’t panic. Ask for help from your Doctor, you’re Nurse or a Registered Dietitian. These professionals can help you set a reasonable weight goal and recommend an approach that is right for you.

Tips for Achieving Healthy Weight

• Set a realistic weight goal; accept changes in eating as a way of life, not a short-term hurdle to overcome.
• Identify your eating attitudes and behavior (keeping a record for a week of what you eat and when you eat may help you understand your eating habits and areas of improvement).
• Practice behavior modification techniques to control factors that contribute to your over eating. You may wait 10 minutes after feeling the urge to eat before you actually eat, never skip meals, trim recipes of extra fat and sugar, use a small plate (how much you eat counts – cut down on your portion), chew food thoroughly, eat slowly and leave some food on your plate.
• Modify your shopping habits: never shop while hungry, always shop from a list, buy only as much food as needed, don’t buy items that you know are your “weakness”
• Don’t weigh yourself too frequently. Once a week is enough
• Incorporate life-style changes: Keep busy with projects and hobbies
• Incorporate some type of physical activity into your daily routine, gradually increasing the intensity and duration of activity (e.g., start with a 10-minute walk three times a week and work your way up to 30 minutes of brisk walking or other form of moderate activity five times a week), select activities that you enjoy and can fit into your daily life. Get off the bus or train one stop before your usual one and walk; walk up/down one flight up stairs.
• Accept set backs or infrequent cheating without giving up on your plan – they are inevitable (remember, it is not how many times a man falls that matters but rather how many times he got up after he fell). COMMIT to Maintaining Healthy Weight.
• Enlist the support of family, and friends, and attend group weight loss sessions, if possible. There are also Internet support groups.

Overweight in Children

According to Surgeon General Fact sheet, about 14 percent of children and adolescents are overweight or obese. Overweight or obese children are also at risk of health problems. The most important consequence of overweight and obesity in children and adolescents is social discrimination. This could lead to your child’s poor self-esteem, avoiding school and depression. Consult with your child’s Health Care Provider to determine if your child is overweight or obese. Don’t start weight management program for your child unless you are told to do so by your child’s Health Care Provider. Many overweight children who are still growing may not need to lose weight, but may need to reduce their rate of weight gain (Surgeon General).

Teach your child healthy eating habits incorporate healthy foods to your family menu and plan family activities that provide everyone with exercise and enjoyments.

Remember, your family must consider achieving and maintaining a healthy weight a lifelong effort

Above information is to raise your awareness about your health. For your medical management, Contact your Health Care Provider. For more information about Overweight and Obesity, visit www.health.gov/dietaryguildelines, www.nih.org, www.cdc.org

It struck when you least expected and when you are not paying attention. When you are having fun, full of life, thinking all is well. After all, you look healthy with no signs of illness/sickness. Unfortunately, by the time you realize what has happened, it is too late, six feet under. You are lucky to be reading this paper. I bet you must have escaped this silent killer with major injuries/damages – stroke, heart attack, heart failure or kidney failure. This “Silent Killer” is known as High Blood Pressure and the medical name for it, is Hypertension. It is called the silent killer because many people have high blood pressure for years without knowing that they have it; and there are no symptoms.
I am sure you don’t know either and you look well and don’t feel any thing. My dear reader, the only way you can tell if you have high blood pressure, is to have your blood pressure checked. So, do that today. For time wasted is life wasted. Your health is your wealth and your life. Maintain it! According to American Heart Association (AHA), high blood pressure killed 44,619 Americans in 2000 and contributed to the death of about 118,000. About 50 million Americans age 6 and older have high blood pressure. Of those people with high blood pressure, 31.6 percent don’t know they have it (AHA).

What is High Blood Pressure?

Your heart pumps blood rich in oxygen and nutrients to all parts of your body 24 hours a day. The blood passes through arteries (passageway) to get to those parts of the body. As the heart pushes blood through the arteries, it exerts some pressure/force on the walls of the arteries. Blood pressure therefore refers to the force of the blood against arterial walls. Blood pressure is measured in millimeters of mercury and recorded as a fraction; for example120/80, 120 is the systolic pressure, 80 is the diastolic pressure. A person whose blood pressure is above normal for a sustained period is in a state of hypertension. According to AHA, high blood pressure is defined in an adult as a blood pressure greater than or equal to 140mm Hg systolic pressure or greater than or equal to 90 mm Hg diastolic pressure. Persistent high blood pressure is a major cause of early death and serious disability in millions of people.

Who Can Develop High Blood Pressure?

Regardless of your race, age, or gender, anyone can develop high blood pressure. It can occur in children or adults, but it is more common in people over age 35.  According to AHA, High Blood Pressure is very common. More than 50 million American adults –1 in 4- have high blood pressure. High blood pressure occurs more often among African Americans who may get it earlier in life than whites – one out of every three African Americans have high blood pressure. Are you in that number? Remember, you will not know without having your blood pressure checked. So, make appointment with your health care provider today; the earlier, the better. High blood pressure is easily detected and usually controllable. Early detection saves lives.

What Causes High Blood Pressure?

Unfortunately, most causes of high blood pressure are unknown. However, it has been documented that several factors do contribute to high blood pressure. Some risk factors you cannot change but changing most controllable risk factors through lifestyle modification will help reduce your risk of developing high blood pressure.

Uncontrollable risk factors:

• Race: African Americans develop high blood pressure more often than whites, and it tends to occur earlier and more severe.
• Age: Although high blood pressure can occur in children, but it is more common among people over age 35. The older you get, the greater your risk of developing high blood pressure. Please note here that high blood pressure is not part of the normal aging process. It is a serious condition that needs to be treated. Get your blood pressure checked today.
• Heredity: High blood pressure tends to run in some families. You are more likely to develop high blood pressure if your close blood relatives have developed it. So, learn more about your family medical history. Because, high blood pressure is so serious but early detection and treatment are very important.

If you are over 35 years, with a blood relative with high blood pressure, and black, then you have three strikes against you. Therefore, you must have a regular blood pressure check.

Controllable risk factors;

It has been documented that healthy lifestyle can help prevent and control high blood pressure. If you have not started healthy lifestyle habits, learn more about it and start now. For your Health is your Wealth and your Life, you got to maintain it! There is no Wealth without Health and there is no Life without Health.

• Overweight/Obesity: Overweight or obesity increases your risk of developing high blood pressure. Maintain a healthy weight
• Drinking too much alcohol: heavy and regular use of alcohol can increase blood pressure dramatically (AHA). Limit alcohol intake and seek help if you drink heavily.
• Lack of physical activity:
• Stress: Emotions, such as anger, fear, excitement, and pain, generally cause the blood pressure to rise, but the pressure falls to normal when the situation passes. Don’t forget that if your blood pressure remains persistently high, it will increase the risk of coronary heart disease and stroke.

• Quit smoking
• Healthy Eating Pattern: Research has shown that healthy eating plan – food can reduce your risk of developing high blood pressure or help lower it.
• Reducing Salt and sodium in your diet. Choose and prepare foods with less salt and sodium.

Above information is to raise your awareness about your health. For your medical management, Contact your Health Care Provider. For more information about High blood pressure, visit www.aha.org, www.nih.org, www.cdc.org.

Definition: DM is a group of metabolic diseases characterized by an abnormal increase in the concentration of blood glucose (hyperglycemia).  DM occurs when the human body does not produce insulin or use insulin properly (insulin resistance),

DM affects the body ability to use sugars, starches, fats, and protein.  Our bodies normally change sugars and starches into soluble form called glucose, which is carried into skeletal muscle and liver by insulin (a hormone produced by the pancreas), to be broken down and used for energy or stored for later use.

DM is the fourth leading cause of death in United States killing more than 180,000 American each year (Barker, et al, 1999).  Nearly 1 in 12 New Yorkers have DM, and thousands have long-term diabetes related complications.  Throughout the past decade, a 30% increase in the prevalence of DM has been recorded in the United States, with the increases in younger individual.  Ethnic populations at higher risks are Hispanic American, African-American, Native Americans, Asian American, and Pacific Islander.

DM is a serous life-long disease, associated with a significant health & economic burdens, and it’s too serious to ignore!  Only a doctor can determine if you have DM.  See a doctor and find out for sure.

Causes/Classification and Clinical Presentation of DM

The classification of DM is based on the cause (etiology). The following are the types:

Type 1: formerly called Insulin Dependent Diabetes Mellitus (IDDM), accounts for approximately 10 to 12% of cases in the United States generally has it’s onset in childhood (with the highest incidence between ages 10 to14), once called juvenile onset diabetes, can also develop in adulthood.

Causes (etiology): It may be an autoimmune disease, where the body’s immune (defense)

system attacks the body cells.  The B cell in the pancreas (organ that make insulin) is

destroyed, thereby, the body does not produce insulin at all, so, the person must have

daily insulin injections (for life) to stay alive and prevent Ketosis-Acidosis.

Only 2% of siblings of type1 diabetic patients develop diabetes (Barker, et el, 1999).  Other causes are idiopathic (unknown).  Type 1 DM can be successfully managed but not prevented.  The goal is to keep the blood sugar at near normal levels.

Treatment: Insulin, individualized healthy diet planned with a registered dietitian (low in saturated fat & cholesterol, no trans fats, foods in fiber) and exercise (at least 30 minutes of moderate physical activity –such as brisk walk, at least 5 days/week.  Quit smoking.

Type 2 DM: formerly called Non-insulin Dependent Diabetes (NIDM) or Non-Ketosis DM, is also called Adult onset diabetes, because onset generally occurs in adult over age 40.  It is the most common form of DM, and accounts for approximately 80-90% of diabetes cases in the United States (Barker et, el, 1999).  It has gradual onset and slow progression of symptoms.  Frequently, patients have complications before they are diagnosed!  People with type 2 DM usually produce insulin but cannot use the insulin effectively.  Initially not insulin dependent (use antidiabetic medications, diet & exercise), but may need insulin for the control of persistent high blood sugar.  The biggest risk factor for type 2 DM is overweight (>20% over ideal body weight), and obesity.  Other risk factors include family history of DM, race (African American, Hispanic, American Indian), age >45 years, hypertension, hyperlipidemia, and women with a history of gestational diabetes.

Gestational DM (GDM): refers only to women who become diabetic during pregnancy (does not include diabetic who becomes pregnant).  Most patients return to a state of normal glucose tolerance after delivery (postpartum).  GDM occurs in 1-14% of all pregnancies.  Such patients are at increased risk of perinal complications and future diabetes (approximately 30%) within 5-10 years after parturition (Barker, et, el, 1999).

Other Types of DM: (also called secondary diabetes) they are associated with other diseases or drug/chemical ingestion (steroids, antidepressants, etc).  Diagnosis demands usual abnormalities of glucose handling and documentation of associated condition.

Impaired Glucose Tolerance (IGT): This is another type of DM where plasma glucose levels are higher than normal but not diagnostic of DM.  This is intermediate stage between glucose homeostasis and diabetes (borderline).

Signs and Symptoms of DM

Most diabetic patients at the time of diagnosis usually complain of increased frequency of urination (polyuria), excessive thirst with increased fluid intake (polydipsia), increased appetite and food consumption (polyphagia), associated with weight loss.  Other symptoms include fatigue, blurred vision, dehydration, nausea, vomiting, vaginitis, candidiasis, glucosuria (sugar in urine), and urinary tract infections.

Diagnosis of DM

A routine blood test that reveals elevation of blood sugar concentration is the hallmark of DM.  A positive blood result should be repeated the next day.  Any of the following blood sugar tests can be done-Plasma Glucose (PG), Fasting Plasma Glucose (FPG), or oral glucose tolerance test (OGTT).  A single elevation of FPG or OGTT does not establish the diagnosis.  Portable devices for monitoring blood glucose (at home) are not sufficiently accurate to be used in diagnosis.

Management of DM

Lifestyle modifications that address the underlying risk factors such as obesity, physical inactivity, smoking, and atherogenic diet must be implemented.  DM patients must know and control their ABCs (A1c, BP, cholesterol, and smoking).

. A1c (Glycosylated hemoglobin-HbA1 or HbA1c): a blood test that reflects average glucose levels for preceding 2-3 months and determines the degree of the sugar control must be done every 3 or 6 months.  Level <7.5% (target) indicates good diabetes control.

. Blood Pressure should be treated aggressively with the goal to below 130/85 mm Hg.

. Cholesterol: The LDL (bad) cholesterol must be less than 100.

. Smoking: If you smoke, quit.  Smoking or second-hand smoking contributes to early development or worsening DM.  (For free help to quit call smoker quit line at 311).

Complications of DM

Most of deaths related to DM are caused by the complications of the disease especially arteriosclerosis (caused by hyperlipidemia, can lead to heart attack, hypertension, stoke) and chronic Renal (Kidney) Failure (life-threatening).  Others are nerve dysfunction with loss of sensation to pain, hot/cold, numbness, foot ulcers (that can lead to amputation), blindness, impotence, neurogenic bladder, and Alzheimer’s disease.

Advise: Remember to stick to your diet & exercise program, take your medications (also get pneumonia & flu vaccines), and keep your appointments.

Heightening attention to male breast cancer is an issue of great importance.

Many people are still unaware that men can develop breast cancer. Many doctors are unaware of male breast cancer. The campaign’s slogan of the National Breast Cancer Awareness Month is “Pass the word that early detection saves lives”.   As a health care provider and as one monitoring the trend, There is a great deal to be done to launch this message into the community. Every opportunity must be taken to make the public aware that the incidence of male breast cancer is increasing.

It is true that far fewer men develop breast cancer. The American Cancer Society (ACS) estimates that in 2006 some 1690 new cases of invasive breast cancer in men will be diagnosed in the United States. Of those, around 460 are likely to die.

Men have breast tissue and like women can develop breast cancer. What is alarming is male breast cancer has increased 50 % in the last five years according to the National Cancer Institute (2006). A family history of breast cancer is the most common risk factor.

In many ways the disease appears similar in both sexes. The reason we do not hear about the disease in men is simply because it occurs less frequently in men. Male breast cancer is rare. Researchers have had a hard time studying the disease and the effect it has on the larger community.

The most common kind of cancer in men is found in the breast ducts.

During the last decade, regular breast cancer screening has gained wide acceptance by women and physicians, data supporting the efficacy of screening like mammography have undergone intensive re-examination, and the benefits of regular mammography havebeen affirmed.  Although the use of screening mammography has increased the number of male breast cancer found before they cause any symptoms, some are still missed.  Themost common sign of breast cancer is a painless, hard lump or mass, some rare cancers are tender and soft. So it is very important to have anything unusual checked by a health care provider. Early detection of breast cancer saves lives.

Other signs of breast cancer are:

-A swelling of part of the breast

-Skin irritation or dimpling

-Nipple pain or the nipple turning inward

-Redness or scaliness of the nipple or breast skin

-A nipple discharge other than breast milk

-A lump in the underarm (armpit) area

Prevention is better than cure. Particularly because men are not routinely screened for the disease and don’t think about the possibility that they’ll get it. As a result, breast cancer tends to be more advanced in men than in women when it is first detected, treatment option is then limited. The earlier breast cancer is diagnosed, the better, so it is important to understand the risk factors for male breast cancer. It was frustrating to find that most information available on breast cancer research is specific to women. Male and female breast cancers do share many common features.

Although the cause of breast cancer remains unknown, but many studies have identified

several risk factors: -

Growing older: The median age of men diagnosed with breast cancer is about 67.

The chance of getting breast cancer goes up, as you get older, about 8 out of 10 breast cancers are found in women/men over age 50 (ACS).

Klinefelter Syndrome: This is a rare genetic condition where a man is born with an extra female chromosome. Klinefelter Syndrome is a condition present at birth that affects about 1 in 1,000 men. Normally men have a single X and single Y chromosome.

Men with Klinefelter syndrome have more than one X-chromosome (sometimes as many as four).  For men who have this syndrome the risk of breast cancer is more than 20 times greater than average.

Family History: Sometimes breast cancer runs in families. This is called familial or hereditary breast cancer. The vast majority of breast cancers occur by chance and only a small number occurs as a result of a family history. However, familial breast cancer is more common in men, and it is thought that approximately 15 per cent of all breast cancers in men have a genetic link, compared to about 7 per cent in women.

A relative with positive genetic test for BRCA1 or BRCA2. (BR stands for Breast, and CA stands for Cancer), have an increased risk for male breast cancer. Men who carry a BRCA1 or BRCA2 mutation has an elevated risk of breast cancer

Radiation exposure: Having radiation therapy to the chest before age 30, and during adolescence may increase the risk of developing breast cancer. This has been seen in young people receiving radiation to treat Hodgkin’s disease. This increased risk is because of the known long-term effects of radiation on normal healthy tissue

High Estrogen Levels: Breast cell is stimulated by the presence of estrogen. Men can have high estrogen levels as a result of taking hormonal medicines

Obesity: Being overweight increases the production of estrogen.

Diseases of the liver: put men at risk for developing breast cancer because the liver plays an important role in sex hormone metabolism. Alcohol limits the liver’s ability to regulate blood estrogen levels.

Unfortunately, men are often diagnosed at a later-stage of the disease when the cancer has already spread to other part of the body-because men do not think that they are at risk and are less likely to report any symptoms to their health care provider.  As discussed earlier, the causes of most breast cancer are not yet known; therefore, the focus now is early detection. Early detection of male breast cancer saves lives. The earlier breast cancer is found the better the chances that treatment will work. Breast awareness and breast self-examination is very important. Data supporting the efficacy of regular screenings have undergone intensive debate during the past decade. The treatment options for male breast cancer have evolved in a way that mirrors female breast cancer treatment.  In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop.  The National institutes of Health, the National Cancer Institute, and the United Sates Preventive Services Task Force (USPSTF) has all published guideline

for screening women for breast cancer. Right now there is limited information present for screening male patients at high risk. Memorial Sloan-Kettering physicians have treated large numbers of male breast cancer patients over several decades, and are now planning a national registry for men who have undergone treatment for breast cancer.

There is no sure way to prevent breast cancer. Prevention is better than cure. Utilizing evidence based studies shows that a new treatment is better than the one currently being used. Hopefully, this awareness will encourage men to seek timely medical intervention, thus providing evidence for future research and recommendation.

References

American Cancer Society.

www.cancer.org.

The National Cancer Institutes. (2006).