Back Pain

Back pain (also known "dorsalgia") is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.

The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain. It may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may be felt in the neck (and might radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling.

Back pain is one of humanity's most frequent complaints. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities.

Treatment
The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible; to restore the individual's ability to function in everyday activities; to help the patient cope with residual pain; to assess for side-effects of therapy; and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain to a manageable level to progress with rehabilitation, which then can lead to long term pain relief. Also, for some people the goal is to use non-surgical therapies to manage the pain and avoid major surgery, while for others surgery may be the quickest way to feel better.

Not all treatments work for all conditions or for all individuals with the same condition, and many find that they need to try several treatment options to determine what works best for them. The present stage of the condition (acute or chronic) is also a determining factor in the choice of treatment. Only a minority of back pain patients (most estimates are 1% - 10%) require surgery.

Symptom

Symptoms may be chronic, relapsing or remitting. They also may progressively worsen or progressively become better (convalescence). Conditions may also be classified as symptomatic (present and demonstrating symptoms) or asymptomatic (present but without symptoms). Asymptomatic conditions exist for years undiagnosed and may only be found upon medical testing (such as high blood pressure).Constitutional or general symptoms are those that are related to the systemic effects of a disease (e.g., fever, malaise, anorexia, weight loss). They affect the entire body rather than a specific organ or location.

The terms "chief complaint", "presenting symptom", or "presenting complaint" are used to describe the initial concern which brings a patient to a doctor. The symptom that ultimately leads to a diagnosis is called a "cardinal symptom".

Symptom versus signA symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.

A feature might be sign or a symptom, or both, depending on the observer(s). For example, a skin rash may be noticed by either a healthcare professional as a sign, or by the patient as a symptom. When it is noticed by both, then the feature is both a sign and a symptom.

Some features, such as pain, can only be symptoms, because they cannot be directly observed by other people. Other features can only be signs, such as a blood cell count measured in a medical laboratory.

Symptomatic treatment

is any medical therapy of a disease that only affects its symptoms, not its cause, i.e., its etiology. It is usually aimed at reducing the signs and symptoms for the comfort and well-being of the patient, but it also may be useful in reducing organic consequences and sequelae of these signs and symptoms of the disease. In many diseases, even in those whose etiologies are known (e.g., most viral diseases, such as influenza), symptomatic treatment is the only one available so far.

Examples of symptomatic treatments:

• Analgesics, for pain
• Anti-inflammatory agents, for inflammation caused by arthritis
• Antitussives, for cough
• Antihistaminics, for allergy
• Brain shunts, to alleviate hydrocephalus

When the etiology for the disease is known, then specific treatment may be instituted, but it is generally associated to symptomatic treatment, as well.

Symptomatic treatment is not always recommended, and in fact it may be outright dangerous, because it may mask the presence of an underlying etiology which will then be forgotten or treated with great delay. Examples:

• Low-grade fever for 15 days or more sometimes is the only symptom of bacteremia by staphylococcus bacteria. Suppressing it by symptomatic treatment will hide the disease from effective diagnosis and treatment with antibiotics. The consequence may be severe (rheumatic fever, nephritis, endocarditis, etc.)
• Chronic headache may be caused simply by a constitutional disposition or be the result of a brain tumor or a brain aneurysm.

Finally, symptomatic treatment is not exempt of adverse effects, and may be a cause of iatrogenic consequences (i.e., ill effects caused by the treatment itself), such as allergic reactions, stomach bleeding, central nervous system effects (nausea, dizziness, etc.).

Brain tumor

A brain tumor (brain tumour in the UK and Canada; see spelling differences) is any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors). Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain. In the United States in the year 2005, it was estimated that there were 43,800 new cases of brain tumors (Central Brain Tumor Registry of the United States, Primary Brain Tumors in the United States, Statistical Report, 2005–2006), which accounted for 1.4 percent of all cancers, 2.4 percent of all cancer deaths, and 20–25 percent of pediatric cancers. Ultimately, it is estimated that there are 13,000 deaths per year in the United States alone as a result of brain tumors.

Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as gamma knife radiosurgery, remains a viable option.
Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.
Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with a chemical (5-aminolevulinic acid) that causes them to fluoresce . Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors.
UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. They also show a listing of chemotherapy agents used to treat high grade glioma tumors.
Patients with benign gliomas may survive for many years, while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored.
The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.
A shunt operation is used not as a cure but to relieve the symptoms. The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation.

Cancer

Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.
Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Cancer causes about 13% of all deaths. According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007. Cancers can affect all animals.
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells[citation needed]. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.
Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.

Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy or other methods. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient (performance status). A number of experimental cancer treatments are also under development.
Complete removal of the cancer without damage to the rest of the body is the goal of treatment. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness. The effectiveness of chemotherapy is often limited by toxicity to other tissues in the body. Radiation can also cause damage to normal tissue.
Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases.

Surgery
In theory, non-hematological cancers can be cured if entirely removed by surgery, but this is not always possible. When the cancer has metastasized to other sites in the body prior to surgery, complete surgical excision is usually impossible. In the Halstedian model of cancer progression, tumors grow locally, then spread to the lymph nodes, then to the rest of the body. This has given rise to the popularity of local-only treatments such as surgery for small cancers. Even small localized tumors are increasingly recognized as possessing metastatic potential.
Examples of surgical procedures for cancer include mastectomy for breast cancer and prostatectomy for prostate cancer. The goal of the surgery can be either the removal of only the tumor, or the entire organ. A single cancer cell is invisible to the naked eye but can regrow into a new tumor, a process called recurrence. For this reason, the pathologist will examine the surgical specimen to determine if a margin of healthy tissue is present, thus decreasing the chance that microscopic cancer cells are left in the patient.
In addition to removal of the primary tumor, surgery is often necessary for staging, e.g. determining the extent of the disease and whether it has metastasized to regional lymph nodes. Staging is a major determinant of prognosis and of the need for adjuvant therapy.
Occasionally, surgery is necessary to control symptoms, such as spinal cord compression or bowel obstruction. This is referred to as palliative treatment.

Heart disease

There are many types of heart disease. About 25% of all Americans have one or more types of cardiovascular disease. The major types of heart disease are atherosclerosis, coronary, rheumatic, congenital, myocarditis, angina and arrhythmia. Heart disease can arise from congenital defects, infection, narrowing of the coronary arteries, high blood pressure, or disturbances.
The first stages of heart disease are lesions and cracks forming in the blood vessel walls normally at the points of highest pressure or stress (near the heart). The second stage is the body trying to repair itself by depositing fatty substances (cholesterol, lipoproteins) inside the blood vessels to fill the cracks. Over time, without the proper body nutrient, vitamin C, to help keep the blood vessel walls from cracking and requiring constant repair, these fatty substances can begin to build up and clog the blood vessels causing stroke and heart attack

Symptoms of heart disease varies according to the type of heart disease. Unfortunately, some heart diseases cause no symptoms early in its course. When symptoms occur, they vary from person to person. Symptoms may may include chest pain, shortness of breath, weakness and fatigue, palpitations (the sensation of the heart beating in the chest), lightheadedness, and fainting, or feeling about to faint.

Lungs

The Lungs are paired organs in the chest that perform respiration. Each human has two lungs. Each lung is between 10 and 12 inches long. The two lungs are separated by a structure called the mediastinum. The mediastinum contains the heart, trachea, esophagus, and blood vessels. The lungs are covered by a protective membrane called the pulmonary pleura

Mesothelioma and asbestosis are diseases that affect the lungs. They are caused inhalation of asbestos.
Common infectious diseases of the lung include pneumonia, tuberculosis, lung cancer, cystic fibrosis, and emphysema.
A pulmonary embolism is a sudden blockage in a lung artery.
Chronic Beryllium Disease is a serious and sometimes fatal lung disease.
Silicosis is very serious and sometime fatal lung disease.
Black Lung Disease is a disease that often affects coal miners.

Diabetes

Diabetes Mellitus, commonly referred to as "diabetes," means "sweet urine." Diabetes mellitus means "to flow, honey" in Greek
Diabetes that affects the body's ability to produce or respond to insulin. Insulin is a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.
Diabetes results from defects in insulin secretion, insulin action, or both. In diabetes, too much glucose stays in the blood. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine.
As a result of elevated levels of blood glucose, two problems occur: body cells become starved for energy, and, over time, the high glucose levels can damage the nerves, eyes, kidneys, heart and blood vessels.
Diabetes is not an infectious disease, like a cold or flu. You can’t "catch" it from someone else, and no one can catch it from you. Diabetes is a lifelong disease.
Men with diabetes often have erectile dysfunction which can begin before the diagnosis of diabetes is made. It is recommended that men with unexplained erectile dysfunction be screened for diabetes with a fasting blood glucose test.

There are 4 main types of diabetes
Insulin-Dependent Diabetes Mellitus (IDDM)
Non Insulin-Dependent Diabetes Mellitus (NIDDM)
Gestational Diabetes
Secondary Diabetes
Secondary diabetes mellitus refers to elevated blood sugar levels that develop as the result of another medical condition. Secondary diabetes mellitus also develops when the pancreatic tissue responsible for the production of insulin is absent because it is destroyed by disease, such as chronic pancreatitis, trauma, or surgical removal of the pancreas. Diabetes can also result from other hormonal disturbances, such as excessive growth hormone production (acromegaly) and Cushing's syndrome.

Some of the most common treatment options are: oral medicines (Diabetes pills), dietary changes, exercise, insulin and islet Cell Transplantation. The oral medicines may have negative side effects. The side effects of the oral medicines include: nausea, diarrhea, metallic taste in mouth, low blood glucose, skin rash or itching, and weight gain.
Rare side effects or oral medicines are Liver failure, Respiratory infection, Headache, and Pain.