Trichomoniasis treatment

Trichomoniasis treatment, until recently, metronidazole was the only efficacious antibiotic available in the United States for the treatment of trichomoniasis. The recommended dose is 2 g orally in a single dose, and the reported cure rate is 97%. Sexual partners should also be treated. Metronidazole intravaginal gel has limited efficacy and should not be used.

Although there continues to be some controversy about the safety of metronidazole in pregnancy, there has never been a documented case of fetal malformation attributed to its use, even when it is used in the first trimester. Recently, controversy has also developed concerning the treatment of trichomoniasis in pregnancy and its relationship to preterm birth.

Trichomoniasis treatment on pregnant women. Two studies have recently been published which suggest that treatment of trichomoniasis in pregnancy may actually increase the risk of preterm birth rather than decrease the risk as predicted. However, there are limitations to both of these studies. One of the studies used much higher doses of metronidazole than are recommended. In addition, the study was stopped prematurely because of the trend toward preterm birth that was seen, and so the number of women enrolled fell short of the number needed for a definitive analysis. The second study was a subanalysis of a study designed to answer questions relating to STD (sexual transmition diseases) and HIV risk, therefore, it was not designed primarily to answer questions regarding the risks of preterm birth associated with treatment of trichomoniasis in pregnancy.

Since the publication of these papers, the Centers for Disease Control and Prevention has not revised recommendations for treatment during pregnancy. Pregnant women may be treated with the 2-g single dose of metronidazole. Occasionally patients are allergic to metronidazole. Since there is no effective alternative, desensitization is the only option. Another therapeutic dilemma involves metronidazole resistance in Trichomoniasis vaginalis. The mechanism of development of anaerobic resistance to metronidazole also is controlled by hydrogenosomes, in that metronidazole competes for H
as an electron acceptor. In metronidazole-resistant trichomoniasis vaginalis, the expression levels of the hydrogenosomal enzymes pyruvateferredoxin oxidoreductase, ferridoxin, malic enzyme, and hydrogenase are reduced dramatically, which probably eliminates the ability of the parasite to activate metronidazole.

Early warning signs for breast cancer

 Early warning signs for breast cancer

Breast cancer affects millions of women across the globe every year. According to the World Health Organization, breast cancer is the most frequent cancer among women, affecting 2.1 million women each year. As daunting as that may seem, the WHO also notes that early diagnosis can greatly reduce a woman’s risk of dying from breast cancer.

Women can be proactive in the fight against breast cancer by learning to identify early warning signs of the disease. The nonprofit breast cancer advocacy organization Susan G. Komen® notes that the warning signs for breast cancer are not the same for all women, but the most common signs include a change in the look or feel of the breast or a change in the look or feel of the nipple. A discharge from the nipple is another common warning sign of breast cancer.

Physical changes in the breast can vary, but Susan G. Komen® advises women who notice these changes to bring them to the attention of their physicians immediately:

♦ Lump, hard knot or thickening inside of the breast or underarm area

♦ Change in the size or shape of the breast

♦ Swelling, warmth, redness or darkening of the breast

♦ Dimpling or puckering of the skin

Breast cancer in men

Breast cancer in men, The male breast is a rudimentary organ that is limited to ducts in the retro-aerolar area, expressing oestrogen receptor (ER), progesterone receptor (PR) and androgen receptor (AR). Benign and malignant lesions presenting as retro-aerolar lumps can occur, although male breast cancer is rare: less than 1% of all breast cancers occur in men and less than 0.5% of deaths in men can be attributed to breast cancer.

The lifetime risk for breast cancer in men is 1 in 833 compared with 1 in 10 for a woman. Of affected men, 20% have a first- degree family history of cancer; 4–14% of cases in males are attributed to germline BRCA2 mutations and there is a 60–76% chance of a BRCA2 mutation in families with at least one affected male. Klinefelter syndrome engenders a relative risk of 30–50 for male breast cancer (owing to elevated circulating oestrogens); 5% of men with breast cancers have this syndrome.

Other risk factors for breast cancer development in men include elevated oestrogens (imbalance of oestrogen and testosterone), liver cirrhosis, prostate cancer, age, obesity and smoking. In individuals who undergo male-to-female gender reassignment, hormonal stimulation may promote breast cancer development.

Clinically, men with breast cancer present at older age (60–70 years) and with higher stage than women with breast cancer. Invasive ductal carcinoma is the most frequent subtype, whereas invasive lobular carcinoma is extremely rare compared with female breast cancer; papillary carcinoma is the second most frequent histological type.

In terms of the intrinsic subtypes, >90% of male breast cancers are luminal A or luminal B; human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancer are extremely rare in men. AR is often overexpressed in male breast cancer. Expression pathways of luminal genes are also predominant; activation of fibroblast growth factor receptor 2 (FGFR2) and phosphatidylinositol 3-kinase (PI3KCA) pathways are potential therapeutic targets to be explored in the future. Prognosis is similar to stage-matched women with breast cancer, although overall survival is worse because male patients with breast cancer are often older, have more comorbidities and have lower life expectancy. Treatments are largely extrapolated from female breast cancer, due to a paucity of available data.

As the vast majority of breast cancers in men are luminal cancers, the most important therapy is endocrine therapy. In the adjuvant setting, tamoxifen (which binds to and inhibits the ER) is the standard of care and aromatase inhibitors should not be used alone (as these are associated with worse survival). In cases of absolute contra-indication for tamoxifen use, a combination of an aromatase inhibitor and a luteinizing hormone-releasing hormone agonist can be considered, although this approach is associated with higher toxicity. Recommendations for adjuvant chemotherapy and radiation therapy are similar to those in women with luminal early breast cancer, as are recommendations for management of advanced breast cancer.

Vitamins for kids

Vitamins are a powerful weapon that is always used by almost all parents in order to maintain and increase the child's immune system. Especially if the weather is not friendly, which makes children vulnerable to contracting diseases. The supplements or vitamins chosen also have various forms, ranging from capsules, syrups, or tablets with a sweet taste that are very popular with children. 

 Immunomodulators, how this supplement is often called by health experts, works by improving the function of immunity in the body by stimulating the work of this immunity. The stimulation is given from the ingredients contained in the supplement. 

The dangers of giving supplements to children arbitrarily

 Unlike ordinary vitamins, immunomodulators are not recommended for long-term consumption. The impact of this children's supplement will respond to excessive body immunity, which can cause allergies and hypersensitivity in children. This is why parents are advised to only provide supplements if the child has immune problems, such as long-term coughing, frequent colds and flu, so that they are prone to infection. This does not mean that supplements should not be given to healthy children. It's okay, as long as it's not for a long or prolonged period.

Also read: Why does your little one need to take a nap?

Instead of giving vitamins or supplements for a long time, a nutritionist who is also a herbalist, Jennifer Crain said, providing nutritious food and meeting children's daily nutritional intake is much better and recommended. We recommend that you avoid giving supplements when the child is in good health.

Also in a study published in the journal Pediatric and Adolescent Medicine wrote that the majority of children and adolescents in the United States who take supplements every day actually do not need this intake. On the other hand, children who need supplement intake cannot get it for various reasons, one of which is the low economy.

Immune involvement in breast cancer

Breast cancer develops in a complex microenvironment comprising several benign cell types and the extracellular matrix (which provides mechanical support for the tumour and enables cellular interaction in a paracrine fashion). The most abundant cell type is cancer-associated fibroblasts, but the breast cancer microenvironment also contains cells of leukocyte lineage (including lymphocytes, macrophages and myeloid-derived stromal cells), most of which are involved in the immune response.

Immunogenicity of breast cancer varies between the molecular subtypes, being highest in TNBC and HER2-positive tumours and lower in luminal A and luminal B subtypes. Moreover, the response to neoadjuvant treatment and the prognosis of breast cancer are positively influenced by the amount of tumour-infiltrating lymphocytes, which reflects the intensity of the immune response within the tumour bed.

The immune microenvironment influences the development and progression of breast cancer according to immune surveillance and immune editing principles. In the early phase of carcinogenesis, the immune microenvironment exerts mostly anti-tumour action, via the cytokine milieu derived from activated CD8+ and CD4+ T cells. By contrast, once a tumour becomes invasive, the microenvironment cell composition, including cancer-associated fibroblasts and cytokine content, are tumour-promoting, ‘hacked’ by breast cancer cells.

Management of early breast cancer

Management of early breast cancer is based on tumour burden and subtype. All patients with oestrogen receptor (ER)-positive disease receive adjuvant endocrine therapy after surgery. If patients are at high risk of recurrence (for example, owing to high-risk gene expression signature results with 0–3 involved lymph nodes, involvement of ≥4 lymph nodes or a >10% risk of breast cancer-specific mortality at 10 years), chemotherapy needs to be recommended as well.

Management of early breast cancer In triple-negative and human epidermal growth factor receptor 2 (HER2)-positive early breast cancer, neoadjuvant subtype-specific systemic therapy is standard, followed by surgery. In the case that pathological complete response (pCR) is not achieved, systemic therapy can be escalated. Bisphosphonates are an additional adjuvant therapy option for all postmenopausal patients and premenopausal patients receiving ovarian suppression; they also conserve bone density. If indicated, radiation therapy can be administered after surgery.

The Management of early breast cancer takes evidence-based registered therapy options into account. Availability and reimbursement of individual diagnostic or therapeutic options may differ regionally and require adjustments of the treatment concepts outlined here. −, negative; +, positive; GnRH, gonadotropin-releasing hormone; HR, hormone receptor; p, pathological; PR, progesterone receptor; N, node status; T, tumour grade; T-DM1, ado-trastuzumab emtansine. a One study showed a benefit with 15 years of adjuvant endocrine therapy.

The management of early breast cancer typically involves a combination of treatments aimed at removing or destroying the cancer while preserving as much of the breast as possible. The specific treatment plan may vary based on factors such as the stage of cancer, the type of breast cancer, the patient's overall health, and personal preferences. Here is an overview of the key components of the management of early breast cancer:

1. **Surgery:**

   - **Breast-Conserving Surgery (Lumpectomy):** This involves the removal of the tumor and a small amount of surrounding healthy tissue. It is often followed by radiation therapy.

   - **Mastectomy:** This procedure removes the entire breast. In some cases, a double mastectomy (removal of both breasts) may be recommended, depending on the patient's risk factors.

   - **Sentinel Lymph Node Biopsy:** To determine if cancer has spread to nearby lymph nodes, the surgeon may remove one or a few sentinel lymph nodes for examination.

2. **Radiation Therapy:**

   - Radiation therapy is often recommended after breast-conserving surgery to target any remaining cancer cells in the breast.

   - In some cases, radiation therapy may be recommended after mastectomy, especially if there is a high risk of cancer recurrence.

3. **Chemotherapy:**

   - Chemotherapy may be recommended depending on the tumor size, stage, hormone receptor status, and other factors.

   - It can be administered before surgery (neoadjuvant chemotherapy) to shrink tumors, making surgery more effective, or after surgery (adjuvant chemotherapy) to reduce the risk of cancer recurrence.

4. **Hormone Therapy:**

   - Hormone therapy is used to treat hormone receptor-positive breast cancers.

   - Medications like tamoxifen or aromatase inhibitors are often prescribed to block the effects of estrogen on breast cancer cells.

5. **Targeted Therapy:**

   - Targeted therapies, such as Herceptin (trastuzumab), are used for HER2-positive breast cancers. These drugs target specific molecules involved in cancer growth.

6. **Immunotherapy:**

   - Some early breast cancer patients may be eligible for immunotherapy as part of clinical trials or based on specific molecular characteristics of the tumor.

7. **Lifestyle and Supportive Care:**

   - A healthy lifestyle, including regular exercise, a balanced diet, and stress management, can help support overall well-being during treatment.

   - Psychological support, such as counseling or support groups, can help patients cope with the emotional and psychological challenges of a cancer diagnosis and treatment.

8. **Follow-Up and Monitoring:**

   - After treatment, patients are typically monitored closely with regular check-ups, mammograms, and other imaging tests to detect any signs of recurrence.

   - Long-term hormone therapy or other medications may be prescribed based on the patient's risk profile.

9. **Breast Reconstruction:**

   - For patients who undergo mastectomy, breast reconstruction surgery may be an option to restore the appearance of the breast.

It's important to note that the treatment plan for early breast cancer is highly individualized. Patients should have detailed discussions with their healthcare team to understand their specific diagnosis, treatment options, potential side effects, and expected outcomes. Second opinions can also be valuable in making informed decisions about treatment.

Early detection through regular breast self-exams, clinical breast exams, and mammograms is essential for increasing the chances of successful treatment and improving long-term survival rates for breast cancer.

Alcohol and heart health

Just like smoking, consuming alcoholic drinks will have a negative impact on your health. This drink will change the performance of the brain and reflexes in the body, as well as trigger obesity and addiction.

However, in relation to the heart, alcohol can be bad if consumed in excess. So, how does alcohol affect the heart and liver? Here is the review.

Effect of Alcohol on Heart Health

Steven Nissen, MD, chairman of the Cleveland Clinic Ohio cardiovascular section, said there is actually no accurate data that shows the effect of alcohol on the heart specifically. This is because studies conducted are often observational, not specifically looking at the relationship between alcohol and the heart.

Also Read: Alcohol Consumption Increases Breast Cancer Risk

Even so, excessive alcohol consumption can lead to alcoholic cardiomyopathy, which is often referred to as a weakened heart. In addition, alcohol triggers ventricular tachycardia or an irregular heartbeat. The American Heart Association states, alcohol also triggers an increase in atrial fibrillation or disturbances in heart rhythm.

Alcohol is a compound with very strong properties, so it can do various things in your body. This compound also turns out to have good properties, of course, if consumed in reasonable amounts. Some of the good benefits of alcohol for the body are increasing good cholesterol or LDL, reducing the risk of blood clots by acting as a coagulant, also minimizing inflammation that triggers strokes and heart attacks.