Symptoms and prevention of Cirrhosis

Cirrhosis is the destruction of normal liver tissue that left scar tissue that does not work in the surrounding liver tissue that is still functioning.


CAUSE
Diseases that cause liver damage will result in cirrhosis. In the U.S., the most common cause is alcohol abuse. At USIS 45-65 years, cirrhosis is the third leading cause of death, after heart disease and cancer. In some countries of Asia and Africa, a major cause of cirrhosis is chronic hepatitis.

The cause of cirrhosis is:

Alcohol abuse
Use of certain drugs
Exposure to certain chemicals
Infection (including hepatitis B and hepatitis C)
Autoimmune diseases (including chronic autoimmune hepatitis)
Bile duct obstruction
Persistent blockage in blood flow from the liver (eg Budd-Chiari syndrome)
Disorders of the heart and blood vessels
Deficiency of alpha-1-antitrypsin
High levels of galactose in the blood
High tyrosine levels in the blood at birth (tirosinosis kongenitalis)
Diseases of glycogen accumulation
Diabetes (diabetes)
Malnutrition
Excessive accumulation of copper congenital (Wilson disease)
Excess iron (haemochromatosis).


SYMPTOMS
Some patients with mild cirrhosis have no symptoms and appear healthy for many years. Other patients experienced loss of appetite, weight loss and feeling sick. If bile flow is blocked for many years, there could be jaundice (jaundice), itching and small nodules arising in the skin is yellow, especially around the eyelids.

Malnutrition is common due to poor appetite and impaired absorption of fats and vitamins that are fat soluble, which is caused by reduced production of bile salts.

It sometimes happens coughing up blood or vomit blood because of bleeding from varicose veins in the lower end of the esophagus (esophageal varices). Dilation of blood vessels is a result of the high pressure in the venous blood from the intestines that leads to the liver. High blood pressure is called portal hypertension, which together with poor liver function, can also cause accumulation of fluid in the abdomen (ascites). Can also occur renal failure and hepatic encephalopathy.

The symptoms of other liver diseases can occur, such as:
- Muscle weakness
- Redness of the palms (palmar erythema)
- Fingers curved upward (palms Dupuytren contracture)
- Small veins that provide a picture like a spider
- Breast enlargement in men (gynecomastia)
- Salivary gland enlargement in cheeks
- Hair loss
- Shrink the testicles (testicular atrophy)
- Abnormal nerve function (peripheral neuropathy).


Diagnosis
Ultrasound may reveal enlarged liver. Scanning liver using radioactive isotopes show a still picture of the liver function and liver area that has become scar tissue. Definitive diagnosis is made based on microscopic examination of liver tissue (biopsy).


TREATMENT
Treatment for cirrhosis of the form:

eliminate sources of toxins (eg alcohol)
proper food intake, including vitamin supplements
treatment of complications.

Effective liver transplant performed in patients who have developed the Cirrhosis. But if people continue to consume alcohol or if the cause can not be resolved, then the hearts were transplanted in the end may also have cirrhosis.


Prognosis

Cirrhosis is growing very fast. If patients with alcoholic cirrhosis early immediately stop consuming alcohol, the formation of scar tissue in the liver will usually stop, but the scar tissue that forms will persist. In general, the prognosis is worse in case of serious complications, such as vomiting blood, ascites, or abnormal brain function.

Liver cancer (hepatocellular carcinoma) are more common in patients with cirrhosis caused by hepatitis B or hepatitis C, iron overload (haemochromatosis) and accumulation of glycogen disease of long standing. Liver cancer can also occur in patients with cirrhosis due to alcohol abuse.

Testicular cancer symptoms, causes and prevention

Testicular cancer is the growth of malignant cells in the testes (testicles), which can cause enlarged testicles or cause a lump in the scrotum .


CAUSE
Most testicular cancers occur in under 40 years of age. The cause is not known for sure, but there are several factors that support the occurrence of testicular cancer:

* Undesensus testes (undescended testes into the scrotum)
* The development of abnormal testes
* Klinefelter's syndrome (a sex chromosome disorder characterized by low levels of male hormones, sterility, breast enlargement (gynecomastia) and small testes).


Another factor that may be the cause of testicular cancer but research is still in its early stages of exposure to certain chemicals and infection by HIV. If in any family history of testicular cancer, the risk will increase. 1% of all cancers in men is testicular cancer. Testicular cancer is the most common cancer found in men aged 15-40 Thun.

Testicular cancer is grouped into:

1. Seminoma: 30-40% of all testicular tumors.
Usually found in men aged 30-40 years and confined to the testis.
2. Non-seminoma: a 60% of all testicular tumors.
Subdivided into several subcategories:
- Embryonal carcinoma: about 20% of testicular cancer, occurs at age 20-30 years and very malignant. Growing very rapidly and spreads to the lungs and liver.
- Yolk sac tumor: approximately 60% of all testicular cancers in young men.
- Teratoma: about 7% of testicular cancers in adult men and 40% in boys. - Choriocarcinoma.
- Tumor stromal cells: a tumor composed of Leydig cells, Sertoli cells and granulosa cells. This tumor is 3-4% of all testicular tumors. Tumors can produce the hormone estradiol, which can cause one of the symptoms of testicular cancer, which is gynecomastia.


SYMPTOMS
Symptoms include:
- Testicle enlarged or palpable weird (not as usual)
- Lump or swelling in one or both testicles
- Dull pain in the back or lower abdomen - Gynecomastia
- Discomfort / pain in the testicle or scrotum feels heavy.
But it may also not found any symptoms at all.


Diagnosis
Diagnosis based on symptoms and physical examination. Other tests are commonly performed:

* Scrotal ultrasound
* Blood tests for tumor markers AFP (alpha fetoprotein), HCG (human chorionic gonadotrophin) and LDH (lactic dehydrogenase).
Nearly 85% of non-seminoma cancer showed elevated levels of AFP or beta HCG.
* Chest X-rays (to determine the spread of cancer to the lungs)
* CT scan of the abdomen (to determine the spread of cancer to the abdominal organs)
* Tissue biopsy.


TREATMENT
Treatment depends on the type, stage and severity of the disease. Once cancer is found, the first step is to determine the type of cancer cells. The next stage is determined:

* Stage I: The cancer has not spread beyond the testicle
* Stage II: Cancer has spread to lymph nodes in the abdomen
* Stage III: cancer has spread beyond the lymph nodes, get to the heart or lungs.

There are four kinds of treatment that can be used:

1. Surgery: removal of the testes (orkiektomi and removal of lymph nodes (lymphadenectomy
2. Radiation therapy: using high doses of X rays or other high energy rays, is often performed after lymphadenectomy in non-seminoma tumors.
Also used as a primary treatment in seminoma, especially in its early stages.
3. Chemotherapy: used drugs (eg cisplatin, bleomycin, and etoposide) to kill cancer cells. Chemotherapy has improved the life expectancy of patients with non-seminoma tumors.
4. Bone marrow transplantation: do if the chemotherapy has caused damage to the bone marrow of patients.

Tumors Seminoma:
- Stage I is treated with irradiation orkiektomi and abdominal lymph nodes
- Stage II treated with orkiektomi, lymph node irradiation and chemotherapy with sisplastin
- Stage III treated with orkiektomi and multi-drug chemotherapy.

Non-seminomas tumors:
- Stage I: treated with orkiektomi and abdominal lymphadenectomy may be performed
- Stage II: treated with lymphadenectomy orkiektomi and abdomen, possibly followed by chemotherapy
- Stage III: treated with chemotherapy and orkiektomi.

If the cancer is a recurrence of previous testicular cancer, some drugs are given chemotherapy (ifosfamide, cisplatin and etoposide or vinblastine).