Cardiology
Cardiology
28/09/2016
Introduction
Throughout history, the most important has been the division into surgical and
internal medicine specialties. The surgical specialties are the specialties in which
an important part of diagnosis and treatment is achieved through major surgical
techniques. The internal medicine specialties are the specialties in which the main
diagnosis and treatment is never major surgery. In some countries Anesthesiology
is classified as a surgical discipline, since it is vital in the surgical process, though
anesthesiologists never perform major surgery themselves.
Many specialties are organ-based. Many symptoms and diseases come from a
particular organ. Others are based mainly around a set of techniques, such as
radiology, which was originally based around X-rays.
The age range of patients seen by any given specialist can be quite variable.
Paediatricians handle most complaints and diseases in children that do not require
surgery, and there are several subspecialties in paediatrics that mimic the organ-
based specialties in adults. Paediatric surgery may or may not be a separate
specialty that handles some kinds of surgical complaints in children.
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Cardiology
Definition
Cardiology is the study and treatment of disorders of the heart; it is a medical
specialty which is involved in the care of all things associated with the heart and
the arteries.
Diseases
Atrial fibrillation. A heart rhythm disorder in which the upper chambers of the
heart (atria) contract rapidly and in a disorganized manner. Atrial fibrillation
increases the risk of blood clots that can block the flow of blood to the brain, lungs,
or other organs.
Chest pain. Discomfort or pain along the front of the body between the neck
and upper abdomen. Chest pain may be a symptom of a heart attack or coronary
artery disease, but it may also occur due to asthma, pneumonia, muscle strain,
anxiety, or digestive problems (e.g., heartburn, ulcers, or gallstones).
Claudication. Claudication is pain in the calf or thigh muscle that occurs with
exercise and is relieved by rest. The pain is caused by poor blood flow due to
narrowing or blockages affecting the arteries that carry blood to the legs.
Claudication is the most common symptom in people who have peripheral artery
disease.
Congestive heart failure. A condition in which the heart is weak and has lost
some ability to pump blood. Symptoms include shortness of breath, persistent
coughing or wheezing, fatigue, and swelling in the feet, ankles, legs, or abdomen.
Treatment
Alcohol septal ablation
A procedure in which ethanol (alcohol) is injected into an artery to shrink the
thickened heart muscle that obstructs the outflow of blood from the heart.
Atrial septal defect (ASD) closure
A surgical procedure to close a hole in the wall between the right and left atria (the
two upper chambers of the heart).
Balloon aortic valvuloplasty
A method used to temporarily relieve aortic stenosis (narrowing of the aortic valve)
by inflating a balloon within the narrowed valve.
Balloon mitral valvuloplasty
A procedure to thread a balloon into the heart through the femoral vein in the groin
to improve blood flow across the mitral valve.
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Coronary artery bypass graft (CABG) surgery
A surgical procedure used in which the blocked portion of the coronary artery is
bypassed with another piece of blood vessel.
Left ventricular assist device (LVAD)
A mechanical device which aids in the pumping function of the blood.
Patent foramen ovale (PFO) closure
A procedure in which a specialized device is used to close a common small tunnel
in the heart called a PFO, which has been linked to strokes.
Percutaneous coronary revascularization
Procedures in which blood flow to the heart is restored by removing or bypassing
blockages in the coronary artiers.
Percutaneous transluminal coronary angioplasty
A procedure in which a catheter is used to open blocked coronary arteries and
restore arterial blood flow to the heart tissue.
Transcatheter aortic valve implantation (TAVI)
A minimally invasive surgical procedure in which a damaged valve is repaired with
a replacement valve without removing the old, damaged valve.
Transcatheter aortic valve replacement (TAVR)
A less invasive procedure for patients with severe aortic stenosis, using an artificial
aortic valve.
Oncology
Oncology is a branch of medicine that deals with the prevention, diagnosis and
treatment of cancer. A medical professional who practices oncology is
an oncologist. The name's etymological origin is the Greek word (nkos),
meaning "tumor", "volume" or "mass".
Diseases
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Acute Lymphocytic Leukemia
Acute lymphocytic leukemia, a blood and bone marrow cancer, involves a
combination of radiation therapy to destroy cancer cells and chemotherapy which
our medical team expertly provides.
Acute Myelogenous Leukemia
Acute myelogenous leukemia, a blood and bone marrow cancer, involves a
combination of radiation therapy to destroy cancer cells and chemotherapy which
our medical team expertly provides.
Aplastic Anemia
If you or someone you love has severe aplastic anemia, the unexplained failure of
the bone marrow to produce blood cells, you should seek immediate medical
treatment.
Basal Cell Carcinoma
Our renowned experts in skin cancer and dermatologic surgery will develop a
personalized treatment plan for patients with basal cell carcinoma.
Basal Cell Nevus Syndrome (Gorlin Syndrome)
Basal cell nevus syndrome, also known as Gorlin syndrome, is a genetic disorder
that increases the chance a person will develop cancer.
Bladder Cancer
Our multidisciplinary approach to bladder cancer provides patients with the
expertise of specially trained physicians.
Bone Cancer
Our specialists provide personal care for patients diagnosed with bone cancer such
as chondrosarcoma, Ewing's sarcoma, myeloma bone disease, multiple myeloma
or osteosarcoma.
Brain Tumor
More than 1,000 brain tumor surgeries are performed each year including, gliomas
and meningiomas, the most common types of brain tumors.
Breast Cancer
If you have been diagnosed with breast cancer, you can feel confident that our
renowned breast cancer specialists will carefully guide you through the available
treatment options and provide personalized care that takes into account all your
medical and emotional needs.
Breast Cancer (Men)
If you are diagnosed with breast cancer, our renowned experts will carefully guide
you through the available treatment options and provide personalized care that
takes into account all your medical and emotional needs.
Central Nervous System Lymphoma (CNS)
Our multidisciplinary team is dedicated to primary brain tumors including central
nervous system (CNS) lymphoma.
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Cervical Cancer
Our multidisciplinary team of specialists has expertise in treating women with both
premalignant and malignant conditions of the reproductive organs, including
cervical cancer.
Cholangiocarcinoma (Bile Duct Cancer)
Cholangiocarcinoma, also known as bile duct cancer, is often treated the same
way as hepatocellular carcinoma, the most common form of primary liver cancer
that develops in the main type of liver cell.
Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia, a blood and bone marrow cancer, involves a
combination of radiation therapy to destroy cancer cells and chemotherapy which
our medical team expertly provides.
Chronic Myelogenous Leukemia
Chronic myelogenous leukemia, a blood and bone marrow cancer, involves a
combination of radiation therapy to destroy cancer cells and chemotherapy which
our medical team expertly provides.
Colorectal Cancer
Colorectal cancer has been found to be one of the most common internal cancers
affecting both men and women, through early detection, this type of cancer is
highly curable.
Cutaneous T-Cell Lymphoma
Cutaneous T-cell lymphoma is the most common type of cutaneous lymphoma that
typically presents with red, scaly patches or thickened plaques of skin.
Endometrial Cancer
Endometrial cancer is the most common cancer of the female reproductive organs
and has a high cure rate with early detection.
Ewing Sarcoma
Ewing sarcoma is the second most common malignant bone tumor in children and
adolescents.
Glioma
Our multidisciplinary clinical team is among the most experienced in the nation for
treating gliomas, which is a type of brain tumor.
Head and Neck Cancers
Our specialists are experts in diagnosing and treating symptoms of head and neck
cancer which include ear pain, a growing neck mass, shortness of breath, weight
loss and a hoarse voice.
Hematologic Cancers
Hematologic cancers affect the blood cells and are more commonly known as
leukemias and Hodgkins and non-Hodgkins lymphoma.
Hereditary Breast Ovarian Cancer Syndrome
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We offer risk assessment, genetic counseling and gene testing for hereditary
breast and ovarian cancer syndrome.
Hodgkin's Lymphoma
Our team of specialists provides personalized care and treatment for patients with
Hodgkin's lymphoma. a type of blood and bone marrow cancer.
Inflammatory Breast Cancer
Inflammatory breast cancer (IBC) is a rare form of breast cancer that is treated by
experts at our Breast Care Center.
Kaposi's Sarcoma
Jefferson's renowned experts in skin cancer and dermatologic surgery will check
your skin and lymph nodes for signs of Kaposi's sarcoma.
Kidney Cancer
If you or someone important to you has been diagnosed with kidney cancer, turn to
our experienced team of urologists, medical oncologists, radiation oncologists and
radiologists.
Laryngeal Cancer
A cancer of the voice box, laryngeal cancer is usually treated with radiation therapy
or surgery.
Liver Cancer
Our experts are leading the field in research for liver cancer and provide thorough
analysis and treatment personalized for each patient.
Lung Cancer
If you are at high risk of lung cancer, our specialists offer state-of-the-art screening
methods to detect a lump, a mass or a nodule.
Melanoma
As the most dangerous of skin cancers, melanoma personalized treatment is
provided by our experienced multidisciplinary team of specialists.
Merkel Cell Cancer
Our team of specialists provides a personalized care for patients diagnosed with
merkel cell cancer, a rare disease that develops on or just beneath the skin.
Multiple Myeloma
Our multidisciplinary team of specialists provides expert care and advanced
technologies for patients with multiple myeloma.
Non-Hodgkin's Lymphoma
Our experienced team provides personalized treatment for patients with non-
Hodgkin's lymphoma.
Ocular Melanoma
If you have been diagnosed with ocular melanoma, the most common malignant
eye tumor, our specialists can provide personalized treatment options.
Oral Cancer
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Oral cancer is found in the mouth area and the oropharynx (the throat area at the
back of the mouth) and is treated with personalized care by our doctors.
Osteosarcoma
Here at Jefferson, you and your child will have access to the best physicians, the
latest treatment and state-of-the-art technology for osteosarcoma.
Pancreatic Cancer
Treatment
Surgery
Describes how surgery is used to treat cancer. Includes information about what
you can expect before, during, and after surgery.
Radiation Therapy
Describes how radiation therapy is used to treat cancer. Includes information
about the types of radiation, side effects, and what you can expect from
treatment.
Chemotherapy
Describes how chemotherapy is used to treat cancer. Includes information about
what to expect during treatment and tips for managing diet needs and working
during treatment.
Immunotherapy
Describes how immunotherapy helps your immune system fight cancer.
Includes information about the types of immunotherapy and what you can
expect during treatment.
Targeted Therapy
Information about the role that targeted therapies play in cancer treatment.
Includes how targeted therapies work against cancer, who receives targeted
therapies, common side effects, and what to expect when having targeted
therapies.
Hormone Therapy
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Describes how hormone therapy slows or stops the growth of breast and
prostate cancers that use hormones to grow. Includes information about the
types of hormone therapy and side effects that may happen.
Precision Medicine
Information about the role that precision medicine plays in cancer treatment.
Includes how genetic changes in a person's cancer are identified and may be
used to select treatments that are most likely to help them.
Some people with cancer will have only one treatment. But most people have a
combination of treatments, such as surgery with chemotherapy and/or radiation
therapy.
Dermatology
Dermatology is the science that is concerned with the diagnosis and treatment of
diseases of the skin, hair and nails. Dermatology involves but is not limited to
study, research, and diagnosis of normal and disorders, diseases, cancers,
cosmetic and ageing conditions of the skin, fat, hair, nails and oral and genital
membranes, and the management of these by different investigations and
therapies, including but not limited to dermatohistopathology.
Diseases
There are a variety of sexually transmitted diseases (STDs) that may affect the
appearance of skin and could lead to more serious health problems. The Human
Papillomavirus (HPV) is known to be associated with genital warts and can be
spread very easily, which necessitates its effective treatment. Molluscum, another
viral infection often spread through sexual contact, is also highly contagious and
results in unsightly physical changes to the skin. Both can be treated by excision
and a variety of topical treatments.
With age, natural wear, and constant sun exposure, the skin is subject to
developing areas of discoloration. While generally harmless and mostly treated for
cosmetic purposes, certain patches of discoloration may point toward possible
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development of skin cancer. Actinic keratosis, the most common condition treated
by dermatologists in the adult population, a precancerous skin condition. Mount
Sinai Dermatology specializes in helping patients deal with and take preemptive
measures to prevent serious complications associated with solar damage.
Acne is a problem that afflicts almost everyone at some point of their lives,
with some people being more severely affected than others. Acne can be
reasonably treated by targeting the bacteria responsible as well as targeting
and weakening the sweat glands near the surface of the skin. More severe
cases of acne may require more aggressive approaches, including
minimally-invasive surgical excision or steroid injections directly into cysts.
Powerful oral medications have been approved for use for patients with
extremely severe acne.
Acne scars may develop at sites where acne lesions have resolved and the
severity of acne correlates with the severity of scarring. "Picking" can
predispose to the development of acne scars, which are typically depressed.
Deeper skin tones generally develop darkening within the scars, while
lighter skin tones usually scar with redness. Treating acne lesions by seeing
a dermatologist early may prevent potentially permanent scarring.
Therapeutic options for acne scars include vitamin A derivatives, chemical
peels, fillers, and laser skin resurfacing. The pulse dye laser may be used
for redness within scars, and topical bleaching agents may mitigate
hyperpigmentation.
Bullous diseases are a heterogeneous group of disorders that result in
detachment of the skin and/or mucous membranes. We treat a broad
spectrum of these diseases, such as pemphigus vulgaris, bullous
pemphigoid, dermatitis herpetiformis, among many others. We offer the
latest in biologic therapy, including Rituxan (rituximab) and intravenous
immune globulins (IVIg), as well as a gamut of other options, such as
mycophenolate mofetil, azathioprine, methotrexate, prednisone, and
Dapsone.
Eczema (also known as atopic dermatitis) generally starts in childhood, but
it can also present later in life. Eczema presents as an itchy red rash, most
often on the arms, legs, and trunk. There is no definitive cause of eczema,
but we know that it is most likely a due to a disruption in the skin's ability to
hold moisture and maintain a healthy skin barrier. There are many targeted
treatment for eczema, including topical anti-inflammatories, medical-grade
ultraviolet therapy, and oral medications. We are fortunate to have a special
program dedicated to eczema care and research in our Department, so you
can be assured that you are getting the most advanced treatment.
Hyperhidrosis (excessive perspiration) is a condition in which patients
experience excessive sweating. It can be generalized or localized to
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armpits, hands, and/or feet. Generalized hyperhidrosis is usually associated
with a medical condition that can be diagnosed and treated appropriately by
your primary care doctor. However, the majority of cases are localized, and
it is not usually associated with a medical disease. In this case, your
dermatologist may consider several treatments, including topical or oral
medications, BOTOX injections, an innovative new medical device called
miraDry, or surgical procedures.
Moles (or nevi) are dark bumps or flat areas on the skin. These are made of
a collection of melanocytes, or pigment-producing cells, underneath the
skin. Sometimes, you might be born with a mole, but it is also common to
have them occur in childhood or beyond. Although there are certain criteria
to look for in moles to determine if they are abnormal or not, it is best to
have any suspicious mole examined by a board certified dermatologist.
Mycosis fungoides is a rare form of T-cell lymphoma of the skin, which is
typically slowly progressive and chronic. In individuals with mycosis
fungoides, the skin becomes infiltrated with patches or lumps composed of
white cells called lymphocytes. In advanced cases, the disease can cause
ulcerated tumors and infiltration of lymph nodes and spread to other parts of
the body. The cause is unknown, and the diagnosis is often delayed for
months or years and may require several biopsies, as early mycosis
fungoides can be difficult to differentiate from other skin conditions,
especially eczema. Treatment of individual patients varies and depends on
the stage. Topical treatments including corticosteroids are frequently used
as well as light therapy called phototherapy, which is available at The Mount
Sinai Hospital.
Psoriasis is an autoimmune, genetic condition caused by inflammation of
the skin, as well as other organs. Most commonly, psoriasis presents as
thick, silvery, scaly plaques on the elbow, knees, scalp, and trunk although
the condition can affect any area of the skin. Psoriasis is associated with
arthritis, known as psoriatic arthritis, in approximately 30 percent of patients.
Other associated conditions include heart disease, diabetes and insulin
resistance, obesity, metabolic syndrome, depression, and alcoholism.
Treatment of psoriasis includes topical agents (e.g., creams, ointments,
lotions, foams, and sprays), light therapy, and oral and biologic injectable
(shots) medications. Biologics are the latest class of medication available to
treat psoriasis. These medications not only treat the skin, but these also
help with joint pain and in some studies have been shown to decrease the
risk of cardiovascular (heart and vessel) disease in psoriasis patients. Since
there are so many options available for treatment, it's important for the
patients to work with a doctor they know and trust. Since no approach is
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right for all the patients, our doctors will choose a personalized treatment
regimen for you.
Rosacea is a common chronic skin condition characterized by many
symptoms that may include facial redness/swelling, skin bumps, visible tiny
blood vessels, and eye redness. Some common triggers that may cause
flare-ups of rosacea include, but are not limited to, eating hot/spicy foods,
drinking hot drinks, drinking alcohol, extremes of temperature, sun
exposure, and stress. Depending on the severity of this condition, treatment
is composed of gels, creams, lotions, and oral medications. To avoid flares
and control symptoms, patients should use daily sunscreen and sun
protection, avoid triggers, refrain from using irritating products on your face,
and wash skin with a gentle cleanser.
Treatments
Laser treatments
Chemical peel
Injectable fillers
Lip augmentation
Non-surgical facelift
Acne treatment
Microdermabrasion
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Dermabrasion
Vein treatment
Scar removal
Skin tightening
Mole removal
Hair transplant
Liposuction
Facelift
Eyelid surgery
Endocrinology
Endocrinology is the study of medicine that relates to the endocrine system, which
is the system that controls hormones. An endocrinologist will deal with diseases
that are caused by problems with hormones.
Endocrine Diseases
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Endocrinology is focused on the care and treatment of endocrine diseases. These
fall into three categories, which are:
Tumors: Tumors in the glands, whether cancerous or benign, can cause
hormone balance problems.
Gland hypersecretion: Occurs when a gland secretes too much of the
hormone it is designed to create.
Gland hyposecretion: Diseases caused when the body has a deficiency of a
certain hormone due to the glands secreting too little of it.
In each of these situations, the result is a disease that impacts the body and its
overall function and well-being.
Treatments
Gynecology
Gynecology is the medical practice dealing with the health of the female
reproductive systems (vagina, uterus, and ovaries and the breasts. Literally,
outside medicine, the term means "the science of women.
Diseases
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Pregnancy
Ectopic Pregnancy
Cervical Cerclage
Miscarriage
o General information
Menstruation
Abnormal bleeding
Endometriosis
Menopause
Cystocele
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Pelvic floor dysfunction
Rectocele
Urinary incontinence
Urine leakage
Uterine prolapse
Contraception
Contraception options
o Cervical Biopsy
Reproductive Surgeries
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Cystectomy
Endometrial Ablations
Hysteroscopy
Laparoscopy
Laparoscopic oophorectomy
Robotic Hysterectomy
Urology
Diseases
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Simple Prostatectomy
Bacillus Calmette-Gu
Bladder Cancer
Partial Cystectomy
Penile Cancer
Radical Cystectomy
Urethral Cancer
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Cancer, Prostate
Prostate Cancer
Cancer, Testicle
Partial Orchiectomy
Radical Orchiectomy
Testicular Cancer
Testicular Choriocarcinoma
Testicular Seminoma
Neuroblastoma
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Common Problems of the Penis
Balanitis
Balanoposthitis
Paraphimosis
Peyronie Disease
Priapism
Cryptorchidism
Epididymitis
Hydrocele
Spermatocele
Testicular Torsion
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Torsion of the Appendices and Epididymis
Varicocele
Urethral Caruncle
Urethral Diverticula
Urethral Prolapse
Urethral Syndrome
Urethral Warts
Urethritis
Horseshoe Kidney
Dermatological Disorders
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UROLOGY PROCEDURES:
Laparoscopic/Robotic Surgery
Template Guided Transperineal 3-D Mapping of the Prostate
Cryosurgery
Prostate Biopsy
High-Powered Microscopic Vasectomy Reversal
Radiofrequency Ablation of Kidney Cancer
Microwave Therapy of the Prostate
Greenlight Laser of the Prostate
Interstim
Gastroenterology
Diseases
Oral disease
Even though anatomically part of the GI tract, diseases of the mouth are often not
considered alongside other gastrointestinal diseases. By far the most common oral
conditions are plaque-induced diseases (e.g. gingivitis, periodontitis, dental caries).
Some diseases which involve other parts of the GI tract can manifest in the mouth,
alone or in combination, including:
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Gardner's syndrome can be associated with failure of tooth
eruption, supernumerary teeth, and dentigerous cysts.
Oesophageal disease
Oesophageal diseases include a spectrum of disorders affecting the oesophagus.
The most common condition of the oesophagus in Western countries
is gastroesophageal reflux disease,[2] which in chronic forms is thought to result in
changes to the epithelium of the oesophagus, known as Barrett's oesophagus.
Gastric disease
Intestinal disease
The small and large intestines may be affected by infectious, autoimmune, and
physiological states. Inflammation of the intestines is called enterocolitis, which
may lead todiarrhoea.
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Accessory digestive gland disease
Hepatic diseases refers to those affecting the liver. Hepatitis refers to inflammation
of liver tissue, and may be acute or chronic. Infectious viral hepatitis, such
as hepatitis A, Band C, affect in excess of (X) million people worldwide. Liver
disease may also be a result of lifestyle factors, such as fatty
liver and NASH. Alcoholic liver disease may also develop as a result of chronic
alcohol use, which may also cause alcoholic hepatitis. Cirrhosis may develop as a
result of chronic hepatic fibrosis in a chronically inflamed liver, such as one affected
by alcohol or viral hepatitis.
Pancreatic
One of the most common conditions of the exocrine pancreas is acute pancreatitis,
which in the majority of cases relates to gallstones that have impacted in the
pancreatic part of the biliary tree, or due to acute or chronic alcohol abuse or as a
side-effect of ERCP.
Treatment
Procedures
Colonoscopy
Upper Endoscopy
Capsule Endoscopy
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Bravo 48 Hour pH Monitor
Percutaneous Gastrostomy
Flexible Sigmoidoscopy
Treatments
Polypectomy
Sphincterotomy
Biliary Stenting
Hemorrhoid Treatment
Percutaneous Gastrostomy
Neurology
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and disease involving the centraland peripheral nervous system (and its
subdivisions, the autonomic nervous system and the somatic nervous system);
including their coverings, blood vessels, and all effector tissue, such as muscle.
Neurological practice relies heavily on the field of neuroscience, which is the
scientific study of the nervous system.
Diseases
The brain, spinal cord, and nerves make up the nervous system. Together they
control all the workings of the body. When something goes wrong with a part of
your nervous system, you can have trouble moving, speaking, swallowing,
breathing, or learning. You can also have problems with your memory, senses, or
mood.
There are more than 600 neurologic diseases. Major types include
treatment
Therapies for Neurological Disorders
Apart from the issue of a cure, sometimes patients with neurological issues can be
placed in rehabilitation as part of an effort to restore some lost function. This is
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usually a hopeful sign, as its rare to find a patient assigned to therapy when theres
little to no hope of at least a partial recovery. Therapies for neurological disorders
may often consist of:
Rheumatology
Rheumatology is a sub-specialty in internal medicine, devoted
to diagnosis and therapy ofrheumatic diseases. Physicians who specialize in
rheumatology are called rheumatologists. Rheumatologists deal mainly with clinical
problems involving joints, soft tissues, autoimmune diseases, vasculitis, and
heritable connective tissue disorders.
Many of these diseases are now known to be disorders of the immune system.
Rheumatology is increasingly the study ofimmunology.
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Diseases
Diseases diagnosed or managed by the rheumatologist include:
Degenerative arthropathies[edit]
Osteoarthritis
Inflammatory arthropathies[edit]
Rheumatoid arthritis
Spondyloarthropathies
Ankylosing spondylitis
Psoriatic arthropathy
Enteropathic arthropathy
Septic arthritis
Systemic conditions and connective tissue diseases[edit]
Lupus
Sjgren's syndrome
Polymyositis
Dermatomyositis
Polymyalgia rheumatica
Sarcoidosis
Fibromyalgia
Vasculitis
Microscopic polyangiitis
Polyarteritis nodosa
HenochSchnlein purpura
Serum sickness
Takayasu's arteritis
Behet's syndrome
Golfer's elbow
Olecranon bursitis
Treatment
Most rheumatic diseases are treated with analgesics, NSAIDs (Non-Steroid Anti-
Inflammatory Drugs), steroids (in serious cases), DMARDs (Disease-Modifying
Anti-Rheumatic Drugs), monoclonal antibodies, such
as infliximab and adalimumab, and the soluble TNF
receptor etanercept and Methotrexate for moderate to severe Rheumatoid arthritis.
[3]
Biologic agent Rituximab (Anti-B-Cell Therapy) is now licensed for use in
refractory Rheumatoid Arthritis.[4] Physiotherapy is vital in the treatment of many
rheumatological disorders. Occupational therapy can help patients finding
alternative ways for common movements which would otherwise be restricted by
their disease. Patients with rheumatoid arthritis often need a long term, coordinated
and a multidisciplinary team approach towards management of individual patients.
Treatment is often tailored according to the individual needs of each patient which
is also dependent on the response and the tolerability of
medications. Rheumasurgery has also played an integral part in the treatment of
rheumatic disorders.
Nephrology
Nephrology is a branch of medical science that deals with diseases of the kidneys.
The kidneys are vital for life with their complex network of blood vessels and
intricate network of tubes and tubules that filter blood of its waste products and
excess water.
The kidneys maintain the fluid, electrolyte, and acid-base regulation that are
altered by several disease conditions as well as drugs and toxins.
Diseases
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Nephrology deals with study of the normal working of the kidneys as well as its
diseases. The diseases that come under the scope of nephrology include:
Glomerular disorders that affect the tiny filtering systems of the kidneys
called the glomerulus
Renal vascular diseases affecting the blood vessel networks within the
kidneys
Kidney infections
Polycystic kidneys diseases where large cysts or fluid filled sacs are formed
within the kidney impairing its functions - this is a congenital and inherited or
genetic condition
Hydronephrosis
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Treatment
Autoimmune kidneys diseases
Other immune suppressing drugs like cyclosporine, azathoprine etc. are useful in
autoimmune kidney diseases as well as in prevention of graft rejection after kidney
transplants.
High blood pressure caused due to kidney diseases respond to several classes of
drugs that are useful in hypertension.
The commonest type of blood pressure medicines used in renal disease include
angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers
(ARBs), beta blockers, diuretics and calcium channel blockers.ACE inhibitors
(including Enalapril, Captopril etc.) and ARBs (including Losartan, Candesartan
etc.) have additional protective effects on the kidney and are thus most commonly
prescribed. They are used with maximum benefits in diabetic as well as
hypertensive nephropathy.Diuretics, also known as water pills, help in excretion
of excess fluid in the body.
Vitamin D deficiency is common in persons with long term kidney diseases and its
replacement is necessary in chronic kidney disease patients.Erythropoietin is an
important hormone that is secreted from the kidneys and helps in manufacture of
blood cells. This also needs to be replaced in chronic kidney disease
patients.Electrolyte supplements and fluid supplements are often needed for
electrolyte imbalances caused by kidney disease.
As kidney disease progresses, the patient may reach renal failure and end stage
renal disease, where the kidneys are unable to clear the blood of waste products.
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These patients require dialysis or artificial filtering of the bloodstream.Hemodialysis
uses an external device or artificial kidney through which the blood is passed to
clear it from metabolic waste products. Hemodialysis may sustain life for years in
both acute and chronic kidney failure.Another form of dialysis is peritoneal dialysis.
Like hemodialysis, peritoneal dialysis also removes metabolic wastes from blood
via a catheter placed in their abdomen or peritoneal cavity. This may useful for both
acute and chronic kidney failure.
Kidney transplant
Patients with end stage renal disease may need a donor kidney to replace their
own. The donor kidney needs to be matched to the recipient in order to reduce the
risk of the body failing to recognize it as a foreign organ and attacking it.This
damage to the donor organ caused by the bodys immune system is called graft
rejection.
Conclusion
Before the discovery of modern medicine, life was fleeting for humans. The
environment was replete with unseen dangers in the form of disease and medical
conditions. Then medical practice changed into an organized profession, and
humans experienced a significant improvement in the quality of life. Aided by
modern scientific innovation, the boundaries of medical technology extended to
unimaginable limits.
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Medicine is often perceived as a profession for the altruists and is interpreted from
the perspective of social mission. In collective consciousness, medical profession
is associated primarily with the public service.
Medicine bridges the gap between science and society. Indeed, the application of
scientific knowledge to human health is a crucial aspect of clinical practice. But
medicine is more than the sum of our knowledge about disease. Medicine
concerns the experiences, feelings, and interpretations of human beings in often
extraordinary moments of fear, anxiety, and doubt. In this extremely vulnerable
position, it is medical professionalism that underpins the trust the public has in
doctors.
References
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