krokodil A flesh eating drug

In the vast pharmacopeia of illegal street drugs, few have as heinous a reputation as desomorphine, popularly known as crocodile or "krokodil." An opiate that's chemically related to morphine and heroin, krokodil earned its name in two ways: Addicts develop dark, scaly lesions on their skin, and the drug tends to eat its victims alive, like a crocodile.

Krokodil first surfaced in Russia several years ago, where users discovered the drug was much cheaper than heroin and could easily be cooked in a kitchen by combining codeine with gasoline, oil, alcohol or paint thinner, Fox News reports.

And now, krokodil has arrived in the United States: Two cases of people addicted to the drug have been reported in Arizona. "As far as I know, these are the first cases in the United States," said Dr. Frank LoVecchio, director at Banner Good Samaritan Poison and Drug Information Center in Arizona, as quoted by Fox News. "So we're extremely frightened." [Trippy Tales: The History of 8 Hallucinogens]

Krokodil is injected with a hypodermic needle, and necrosis — the death and decay of living tissue — can quickly set in. Gangrene and amputations are common among addicts, who often die within two or three years after they start using the drug, according to the Daily Mail.
Like other opiates, krokodil is powerfully addictive, and even those users who kick the habit often walk away severely disfigured: severe scarring, bone damage, amputated limbs, speech impediments, poor motor skills and varying degrees of brain damage — for life.

And it doesn't take much lab equipment to make: The illegal production of krokodil in Russia and the Ukraine is similar to the chemical processes used to home-produce methamphetamine, according to an article published online June 3 in the International Journal of Drug Policy. To make krokodil, producers transform codeine into its opiate analog called desomorphine, whose analgesic effect is about 10 times greater than that of morphine — it's also about three times more toxic than morphine, the authors wrote.

Krokodil users may avoid seeking help partly due to the stigma attached to drug use. "In countries where public campaigns or media position drug use as social evil and where health providers are viewed as closely aligned with law enforcement or other systems of social control (e.g. child protection agencies), PWID [people who inject drugs] are likely to postpone seeking treatment for medical problems that need urgent professional care," the authors wrote in their journal article.

"This is really frightening," Dr. Aaron Skolnik, a toxicologist at Banner Good Samaritan Poison and Drug Information Center in Phoenix, told Fox News. "This is something we hoped would never make it to the U.S. because it's so detrimental to the people who use it."

secrets of longevity

Blood Of Oldest Woman In The World Reveals Secrets Of Longevity, Suggests We Can Live Longer

A study on the blood of the world's oldest woman has revealed that the secret to longevity is in our white blood cells. Photo courtesy of Shutterstock
It seems that 500 years after the death of Juan Ponce de Leon, science may have just discovered the mysterious fountain of youth. Only it’s not a fountain, and it’s definitely not in Florida. He actually had it all along — we all do. The secret to our longevity lies in our white blood cells. A study of blood and tissue samples from Hendrikje van Andel-Schipper, once the oldest woman in the world, revealed that death from old age is specifically caused by exhaustion of blood stem cells. Now that scientists have discovered what causes death, it automatically raises the question of what to do with this information. Some believe that manually replenishing these stem cells will result in the ability to fool Mother Nature and perhaps make death no longer inevitable.

Secrets in Blood

Born in 1890, van Andel-Schipper was known for her remarkable health in old age. She had a clear mind and disease-free body until her death in 2005. As she wished, upon her death van Andel-Schipper’s body was donated to science, and her blood and tissue samples helped scientists understand how the body is affected by old age. What scientists found is that our lifespan is limited by the capacity for stem cells to replenish, New Scientist reported. When stem cells are eventually no longer able to self-replenish, they gradually die off. The individual will no longer be able to replace tissue, and cells will soon succumb to a natural death of old age.

At the end of her life, two thirds of van Andel-Schipper’s remaining white blood cells had originated from just two stem cells. This suggests that most or all of the blood stem cells she had started with in life had burned out and died. Also, the telomeres on van Andel-Schipper’s white blood cells were drastically worn down. Telomeres are the protective tips on chromosomes that burn down like a candle wick each time a cell divides. During life, the number of active stem cells shrinks, and their telomeres shorten to the point at which they die. This point is called stem-cell exhaustion.

'Fountain of Youth'?

Does understanding the cause of death mean that we will be able to one day control death? Some scientists believe it may be possible to rejuvenate aging bodies with re-injections of stem cells saved from birth or early life. “If I took a sample now and gave it back to myself when I’m older, I would have long telomeres again—although it might only be possible with blood, not other tissue,” Henne Holstege, lead researcher of the study on van Andel-Schipper’s blood, told New Scientist. Rather than using this information to create a theoretical "fountain of youth," scientists hope that the results can be used in correlation with studies on Alzheimer’s disease to reveal why some people are more susceptible to the disease at an early age.

Van Andel-Schipper’s blood also gave some important insight into our bodies’ natural defenses against cancer. Researchers found that although there were many mutations in van Andel-Schipper’s blood, they were all harmless. These mutations were the result of mistaken replication of DNA, but due to their absence of cancer, researchers concluded that van Andel-Schipper had an advanced system for repairing or aborting cells with dangerous mutations. “When there is a mutation, there’s an opportunity for selection and some somatic mutations lead to cancer. Now we see the range of somatic mutations in normal, non-cancerous tissues like blood, so we can start to think about health consequences,” said Chris Tyler-Smith of the Wellcome Trust Sanger Institute in Hixton, Texas.

1.4 Million People Might Contract Ebola By February why think for a while

Why The CDC Thinks 1.4 Million People Might Contract Ebola By February
A crash course in modeling the outbreak of a deadly disease


Last June, the Kenema Government Hospital in Sierra Leone built a temporary ward in anticipation of an influx of Ebola patients. The makeshift building was covered with thin, tin metal sheets, haphazardly held to the walls by wire twist-ties. Robert Garry says that when the structure fell, it seemed inevitable.

But finding physical space for patients wasn’t the only problem at the hospital. Even after the ward was rebuilt, Garry and his staff have been overworked, and many have contracted the disease. Another doctor at the Kenema Hospital, Sheik Humarr Khan, was often left as the only person caring for 80 people. But he told his sister: “If I refuse to treat them, who would treat me?”

Western Africa is struggling to prevent collapse during the worst Ebola outbreak ever. This week the CDC released a study predicting that by January of 2015, 1.4 million people may have contracted the virus. With new studies suggesting that the virus's mortality rate may be close to 70 percent, in the next six months 980,000 more people might die from the disease. Thomas Gift, one of the people who worked on the CDC report, explained that their model was based on daily case counts from the current outbreak, as well as estimates of previous ones.

To develop these types of predictive models, epidemiologists break individuals up into four groups: people who are at risk, people who are infected but not contagious, people who are infected and contagious, and people who have recovered. Ultimately, researchers try to determine how those groups interact with each other and predict movements between the groups. These movements comprise what is known as the “effective reproductive rate,” or the number of people each infected person will give the disease to. This number is called R. When R is less than 1, the outbreak is declining; if it’s more than 1, the disease is spreading.

Reports vs. Predicitions Graphs show how model predictions and actual case reports match up.
Gift says the parameters in the CDC study were set to minimize the differences between the model and what is being reported on the ground in Sierra Leone and Liberia. But he says, “Like all models, they are simplifications of reality.” Any model is only as good as the data that is fed into it, and it's possible that as many as 75 percent of all Ebola cases are going unreported.

For this reason, the model uses a correction factor to account for underreporting. The CDC study decided that factor should be based on the number of beds in use, since counting physical objects is somewhat more reliable than depending on case reporting. So researchers compared the number of patients in beds predicted by the model on August 28th to the number of actual patients in beds. But the authors only had access to the bed counts in Liberia, so it’s still just an estimate.

CDC scientists aren't the only ones trying to develop models of Ebola transmission. Christian Althaus, an epidemiologist at the University of Bern, has also developed an estimate of the outbreak. He says that the CDC’s estimate of 1.4 million is based on an assumption that the real number of cases is 2.5 times higher than reported. However, Althaus says that way before Ebola patients number in the millions, "we will see a dramatic change in behavior and probably a collapse of the countries. That might limit the spread to some extent, but it will be very important to maintain social order.”

He says it’s hard to quantify the impact of international aid, but Caitlin Rivers, a PhD student of computational epidemiology at Virigina Tech,  says her modeling results suggest that contact tracing and improving infection control can help but not halt the progress of the epidemic. “But there's no question it needs to be a top priority for the global public health community,” Rivers says.

Despite the uncertainty involved in developing these models -- including the chronic underreporting, which has made solid data about the outbreak difficult to come by -- even conservative estimates put the number of people infected by Ebola in the tens of thousands by the end of the year.

As of September 24th, WHO has reported 6,263 cases of infection, with 2,917 deaths. “The number of lives already lost is staggering, and grows every day,” Rivers says.

Aminocentesis tests problems

Amniocentesis

Your family / personal medical history or perhaps an ultrasound result may suggest to your doctor that you have a slightly greater chance of giving birth to an infant with a birth defect. Therefore your doctor may suggest that you undergo an amniocentesis, a test used to detect some foetal abnormalities.

What Is An Amniocentesis?

An amniocentesis is a test in which a small sample of liquor (water) is taken from around the developing baby. A needle is passed through the abdomen, the wall of the uterus (womb) and into the water (liquor) surrounding the baby without touching the baby or the placenta. Approximately 15mls of fluid is taken, this amount being small compared with the total amount of fluid present (at least 150mls) at the time of the test at 16 weeks.

Who Is Offered One?

Women of 37 years and over at the projected time of birth
Women who have already had a child with a problem such as Down’s Syndrome or Spina Bifida
Occasionally amniocentesis is done for other reasons. These include parents who are known to have a chromosomal abnormality or who are known to be at risk of having a baby with one of a number of rare abnormalities of their metabolism.

Why Are Women Over The Age Of 37 Offered An Amniocentesis?

As the age of the mother increases the chances of her having a baby with a chromosomal abnormality also increases. The most common chromosome abnormality is Downs Syndrome. Between 37 and 40 years of age the chance of having a baby with an abnormality is approximately 1 in 100. Beyond the age of 40 years this chance increases even further. The incidence of Spina Bifida does not seem to be correlated with age.

When Is Amniocentesis Performed?

An amniocentesis is usually performed from 14 weeks gestation.
What Are The Potential Complications?
There is a risk of miscarriage following this test, which is quoted at approximately 1 in 200 tests performed.

What Will Happen On The Day?

It is important that the mother’s bladder is full; this lifts the uterus up out of the pelvis making it easier to see the baby with ultrasound. The ultrasound scan is performed prior to the amniocentesis so that the pregnancy and the placenta can be checked and to determine whether there is a singleton or twin pregnancy. The ultrasound scan is quite painless and merely involves spreading a little warm gel over the lower abdomen and then moving an ultrasound probe gently over the skin surface.
After the ultrasound scan has been performed, the abdomen is cleaned and the needle is inserted into the uterus. The needle is watched all the time on the ultrasound screen. It then only takes about one minute to draw up 15-20mls of fluid into a syringe. After removing the needle and again checking the baby, the mother is able to get dressed and go home.
Almost without exception, patients experience far less discomfort from the test than they had expected. Any discomfort felt is usually similar to that felt for a simple blood test. It is recommended that for the rest of the day things are taken quietly, but after this to return to a usual routine.


Could There Be Any Problems Afterwards?

It is very rare to have any problems at all after the test. Occasionally there may be some mild discomfort due to a little bruising under the skin. If there is any loss of blood or water from the vagina or any pain after the amniocentesis you should consult your obstetrician.

What Tests Are Performed On The Fluid Taken?

An estimate of the amount of a particular protein (alpha feto-protein). There are usually large amounts of this protein present in the fluid if a baby has a defect called Spina Bifida.
The second test is carried out on the cells which are present in the fluid. The chromosomes of these can be examined and in this way it is possible to detect whether the baby has Downs Syndrome or any other less common chromosome problems. The sex of the baby is also determined.

Clinical Research Institute | Clini India

Clinical Research Institute | Clini India

weekly injectable insulin by FDA

FDA approves weekly injectable diabetes drug

 

FREETOWN, Sierra Leone –  The Food and Drug Administration has approved a new injectable diabetes drug from Eli Lilly and Co. for adults with the most common form of the disease.

The agency on Thursday cleared the drug, Trulicity, as a weekly injection to improve blood sugar control in patients with type 2 diabetes, which affects more than 26 million Americans. The drug is part of a new class of medicines called GLP-1 agonists, which spur the pancreas to create extra insulin after meals.

Type 2 diabetes accounts for 90 percent of U.S. cases of the disease and occurs when the body doesn't properly produce or use the hormone insulin. Drugs to treat the disease represent a large slice of Lilly's product portfolio, which includes the insulins Humalog and Humulin.

Indianapolis-based Lilly is counting on new drugs like Trulicity to replace falling revenue from blockbusters like the antidepressant Cymbalta, which is facing cheaper generic competition after the expiration of its patent.

The FDA approved Trulicity based on six studies in 3,342 patients that showed improvements in blood sugar control. The drug was studied as a stand-alone therapy and in combination with other commonly used diabetes drugs, such as metformin.

The drug will bear a boxed warning - the most serious type - highlighting that rats tested with Trulicity had cases of thyroid cancer, though it's unclear whether they were caused by the drug.

Lilly will be required to conduct follow-up studies on cases of thyroid cancer, heart problems and other potential safety issues with the drug. The FDA is also requiring Lilly to educate doctors about the drug's various risks

 

 

 

Questions and answers about prostate cancer, metastases, Glossary and treatment _ related Osteoporosis

 

                               

1.     Q. What is prostate cancer?

 

A.    rostate cancer is an abnormal (malignant) growth of the prostate, a walnut-sized gland at the base of the urinary bladder in men.

 

2.     Q. How common is prostate cancer?

 

A.    Prostate cancer is the most common form of cancer in men (except for skin cancer) and a leading cause of cancer death worldwide. In 2007, close to 218,890 men will be diagnosed with prostate cancer and 27,050 men will die from prostate cancer in the U.S.

 

3.     Q. How is prostate cancer diagnosed?

 

A.    Prostate cancer is most often diagnosed by needle biopsy of the prostate gland. Biopsies are usually advised for men found to have either an abnormal digital rectal exam (DRE) or elevated PSA blood level. (The medical term for PSA is prostate-specific antigen.) Some, but not all men with an abnormal DRE or PSA have prostate cancer.

 

            Digital rectal exam (DRE) — is a procedure in which a gloved finger is put into the rectum to check the prostate gland.

 

            Prostate-specific antigen (PSA) — is a protein produced by the prostate gland. Its level goes up in the blood of some men who have prostate cancer. It can also go up with other conditions that affect the prostate. These include infections (prostatitis) and a non-cancerous growth that comes with aging, benign prostatic hyperplasia (BPH).

 

4. Q. What are the risk factors for prostate cancer?

           

A.     Risk for prostate cancer increases with age. More than 90% of men diagnosed with prostate cancer are older than 50 years. African-American men have a higher risk for prostate cancer than men of other races. A family history of prostate cancer increases prostate cancer risk. About 10% of prostate cancers appear to run in families although little is known about how or why this happens. Some environmental factors, including high intake of dietary fat, appear to increase prostate cancer risk.

 

4.     Q. How is early-stage prostate cancer treated?

 

A.     There are several treatment choices for men with early-stage prostate cancer (tumors that appear confined to the prostate gland):

 

            Prostatectomy: surgical removal of the prostate gland.

 

 

            External beam radiation therapy: the most frequently used form of radiotherapy involving delivery of radiation to a tumor from a source (machine) outside the body.

 

            Brachytherapy: placement of radioactive seeds in the prostate gland.  In some cases, hormone therapy is given along with other treatments (See Question # 10).

Not all prostate cancers need to be treated. Some men with favorable prostate cancers may undergo what is called watchful waiting or active surveillance, where the physician monitors the patients’ condition to determine whether treatment is needed.

 

 

                                  Bone Metastases

 

6. Q. Where in the body does prostate cancer spread?

 

     A. Cancers may spread or metastasize to other organs in the body. Some cancers have distinct patterns of metastases. Prostate cancer, for example, tends to spread to either lymph nodes or bone.

The spine, pelvis, ribs, and bones of the arm and thigh are the most common sites if cancer spreads to the bone. Prostate cancer that has spread to the bone is called metastatic prostate cancer – it is not bone cancer, which is treated differently.

 

7. Q. What are the symptoms of bone metastases?

 

A.   Pain is the most common symptom of metastatic prostate cancer. It may be caused by pinched nerves due to metastases in the bones. Less often, pain is caused by fractures. Cancer can cause bones to weaken and break. Not all bone metastases result in pain.

 

8. Q. How are bone metastases detected?

 

   A.Bone metastases from prostate cancer can be found by a number of tests. Bone scan is the standard method for detecting bone metastases from prostate cancer. It is highly sensitive. A bone scan often detects bone metastases before they cause symptoms or before they can be seen by plain x-rays. In some cases, more tests may be needed to diagnose bone metastases. These tests include computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, or bone biopsy.

 

Treatment of Men with Prostate Cancer and Bone Metastases

 

 

9. Q. What types of physicians and other health professionals treat patients with prostate cancer affecting the bone?

 

            A. Most often more than one health care specialist will take part in the care of men with bone metastases from prostate cancer. Urologists, radiation oncologists, and medical

oncologists may provide care depending on the medical condition. Orthopedic surgeons provide care for bone fractures or impending fractures. Treatment by a neurosurgeon may be needed for metastases that press on the spinal cord or nerves. Physical medicine physicians may help in prescribing physical therapy. Oncology nurses, orthopedic nurses, and physical therapists will often be called upon to assist with the use of medications and rehabilitation so that patients are able to return to their usual daily activities.  Because of the emotional and social impact of prostate cancer in bone, many patients may consult mental health professionals (e.g., psychologists, social workers, or psychiatrists). Psychotherapy, medication for depression, and/or support groups may help some patients.

 

 

10. Q. What treatments are available for men with metastastic prostate cancer?

 

            A. Hormone therapy is the cornerstone of treatment for men with metastatic prostate cancer. At first, prostate cancer cells need the male hormone testosterone in order to grow. In almost all men with metastatic prostate cancer, treatments to reduce testosterone levels are helpful but they are not cures. Testosterone levels can be lowered by surgical removal of both testes (bilateral orchiectomies) or treatment with medicines termed gonadotropin-releasing hormone (GnRH) agonists. The names of some of these GnRH drugs are leuprolide (Lupron®, Eligard®, Viadur®) or goserelin (Zoladex®). In some cases, men who had both testes removed or are receiving a GnRH agonist are also treated with antiandrogens such as bicalutamide (Casodex®) or flutamide (Eulexin®). Chemotherapy may provide extra help in men with metastatic prostate cancer that has grown despite hormone therapy. Docetaxel (Taxotere®) and mitoxantrone(Novantrone®), are the most commonly used chemotherapy drugs for prostate cancer. Because of potential side-effects, chemotherapy may not be suitable for all of these men.

 

11. Q. What other therapies are available to treat bone metastases?

         

           A. Along with hormone and chemotherapy treatments for prostate cancer, there are other therapies designed to treat or prevent the problems that are due to spread of prostate cancer to bone.

External Beam Radiation Therapy (similar to that used to treat early stage prostate cancer) can be aimed at sites of painful bone metastases. External beam radiation relieves pain in the majority of men and is most useful for treatment of one or two sites of pain.

Radiopharmaceuticals are drugs given by IV (intravenous infusion), such as strontium-89 (Metastron®) or samarium-153 (Quadramet®). These drugs target radiation to bone metastases. They relieve pain in most men. Because radiopharmaceuticals travel throughout the

skeleton, this therapy may be most helpful for men with a number of painful bone metastases.

 

Bisphosphonates are a class of drugs that keep bone from breaking down or becoming resorbed. Zoledronic acid (Zometa®) is a bisphosphonate given by intravenous infusion. It reduces the risk of bone complications, including pain and fractures, in men with metastatic prostate cancer. Surgery may be needed to treat bone fractures or to relieve pressure on the spinal cord by bone metastases.

 

Pain medications are an important part of care for most men with metastatic prostate cancer. They are used in combination with other treatments for prostate cancer.

 

Drugs Approved to Treat Prostate Cancer In The United States

 

 Hormone Therapy

 

Gonadotropin-releasing hormone (GnRH) agonists:

 

Zoladex® (goserelin acetate)

Lupron® (leuprolide acetate)

Eligard® (leuprolide acetate)

Viadur® (leuprolide acetate implant)

 

Antiandrogens:

 

Casodex® (bicalutamide)

Eulexin® (flutamide)

 

Chemotherapy:

 

Taxotere® (docetaxel)

Novantrone® (mitoxantrone)

 

Bisphosphonates:

 

Zometa® (zoledronic acid)

 

Radiopharmaceuticals:

 

Metastron® (strontium-89)

Quadramet® (samarium-153)

 

12. Q. Can bone metastases be prevented?

            A. The best ways to prevent the spread of prostate cancer to bone are early diagnosis and treatment. In men whose cancer comes back after treatment for early-stage prostate cancer, hormone therapy may delay or prevent the spread of cancer to the bone. Ongoing and future clinical trials will examine new ways to prevent bone metastases.

 

13. Q. What are the emerging therapies to prevent or treat bone metastases?

 

            A. Several drugs are in development for the prevention and treatment of bone metastases in men

 

with prostate cancer.

Denosumab, is a drug currently under evaluation as a treatment to help prevent bone complications, including pain and fractures in men with metastatic prostate cancer. It is also being evaluated in clinical trials to prevent bone metastases in men with high risk prostate cancer.

Alpharadin (Radium-223) is a new radiopharmaceutical (a drug that targets radiation to bone metastases) in development for the treatment of men with bone metastases.

    Osteoporosis in Men with Prostate Cancer

 

14. Q. What is osteoporosis?

           

            A. Osteoporosis is a condition of general loss of bone mass that can lead to fractures.

Although osteoporosis is usually thought of as a disease of older women, it is also common in men. About two million American men have osteoporosis. Another twelve million men are at risk. Hormone therapy increases risk of osteoporosis and fractures in men with prostate cancer.

 

15. Q. What are the symptoms of osteoporosis?

         

A.     Osteoporosis causes no symptoms until a fracture occurs. Fractures of the spine are the most common sign of osteoporosis. Spinal fractures may be caused by bending, lifting, or other minimal stress. Pain comes from the collapse of the small bones of the spine (vertebrae). It may be worsened by standing or sudden movements. A person with many spinal fractures may become shorter and have a curvature of the spine. Early diagnosis and treatment are the most effective ways to prevent fractures.

 

16. Q. How is osteoporosis diagnosed?

 

A.     Osteoporosis is diagnosed by testing the density of the bone called bone mineral density (BMD). There are several ways to measure BMD; all are convenient, safe and painless. The most common method is a DXA (dual energy x-ray absorptiometry) scan.

 

17. Q. How can osteoporosis be treated or prevented?

         

           A. There are several approaches most men with prostate cancer can take to treat and prevent osteoporosis:

Change unhealthy habits including smoking and excessive use of alcohol.

 

Take adequate calcium and vitamin D. Daily calcium (1000-1500 mg daily) and vitamin D (800-1200 IU) from diet and supplements are advised for most men who receive hormone therapy.

 

Exercise regularly.

 

Prescription medications including bisphosphonates may be suitable for some men.

 

Denosumab, the drug discussed in Question 13, has been shown in clinical trials to increase bone density and prevent fractures in men who develop osteoporosis as a result of androgen deprivation therapy.

 

Glossary

Anemia Having too few red blood cells. Symptoms include tiredness, weakness, and

shortness of breath.

Anus Opening at the lower end of the rectum through which solid waste leaves the body.

Benign prostatic hypertrophy (BPH) Enlargement of the prostate, blocking urine flow. BPH is not cancer, but can cause some of the symptoms. Also called benign prostatic

hyperplasia.

Biopsy Removal of a sample of tissue, examined under a microscope to check for cancer cells.

Bisphosphonate Drug used to prevent breakdown of bone.

Brachytherapy Implanting radioactive material into the tumor or close to it. Also called internal radiation therapy, interstitial radiation therapy, or seed implant therapy.

Calcium Major mineral component of bone, important for normal function of nerves and other organs.

Clinical trial Research study involving volunteers, designed to answer medical questions and find better ways to prevent or treat disease.

CT scan (computerized tomography or CAT scan) Series of detailed pictures of areas inside the body, created by a computer linked to an x-ray machine.

Digital rectal examination (DRE) Procedure in which the doctor inserts a gloved finger into the rectum to examine the rectum and prostate.

External beam radiation therapy Use of a machine to aim high-energy rays at cancer.

Hormones Body chemicals secreted by glands. Male hormones include androgen and

testosterone (produced mainly by the testes) plays important role in a man’s sexuality and fuels the growth of prostate cancer). Estrogen is a female sex hormone. These hormones circulate in the blood-stream, and control the actions of certain cells or organs.

Hormone therapy Use of medications or surgical removal of the testes to prevent male hormones from stimulating further growth of prostate cancer.

Intravenous Into a vein.

Lymph nodes Small, bean-shaped organs that are part of the body’s immune system. They are located throughout the body along the channels of the lymphatic system. Also called lymph glands.

Medical oncologist Doctor trained in the diagnosis and treatment of cancer.

Metastasis (pl., metastases; v. metastasize) Spread of cancer cells throughout the body. Cells that have metastasized are the same as those in the original tumor.

Monoclonal antibodies A type of protein made in the laboratory that targets and attaches to a specific substance in the body, such as a tumor cell. Each monoclonal antibody is made to find only one substance. Monoclonal antibodies are currently being used to treat some types of cancer, and are being investigated as a treatment in several others.

MRI (magnetic resonance imaging) Imaging technique that produces detailed pictures of areas inside the body by linking a computer with a powerful magnet.

Multiple myeloma Disease of the bone marrow in which certain cells grow out of control and break down bone.

Oncology Branch of medicine dealing with cancer.

Pituitary gland Master gland in the brain that makes hormones that control hormone production in other glands such as the testes.

Prostate A walnut-sized gland at the base of the bladder in men. The prostate produces fluid that forms part of the semen.

Prostate-specific antigen (PSA) Protein produced by the prostate gland. PSA circulates in the blood and can be measured with a blood test. PSA levels go up in some men who have prostate enlargement, inflammation, infection, or prostate cancer.

Radiation oncologist Doctor who specializes in using radiation to treat cancer.

Radiation therapy Treatment with high-energy rays to kill cancer cells.

Radiopharmaceuticals Drugs given by intravenous infusion to target radiation to bone metastases

Prostatectomy Surgery to remove the prostate gland.

Scrotum External skin pouch containing the testes.

Testes Pair of egg-shaped glands contained in the scrotum that produce sperm and male hormones. Also called testicles.

Total androgen blockade Complete blockage of androgen production. Also called combination hormone therapy.

Tumor Abnormal growth of tissue. A tumor can be malignant (cancerous) or benign (noncancerous).

Urologist Doctor who specializes in disorders of the urinary and male reproductive systems.

Watchful waiting Following the patient closely, postponing aggressive therapy unless signs of disease progress.

 

MEDICATION EXPOSURES DURING PREGNANCY AND LACTATION

MEDICATION EXPOSURES DURING PREGNANCY  AND LACTATION

 

            Every woman in the general population has a 3–5% risk of having a child with a birth defect or mental retardation. Birth defects are the leading cause of infant mortality in the United States. Two important factors to consider when assessing the teratogenic potential of a medication are the stage of pregnancy at which the exposure occurred and the amount of medication taken. It is critical to evaluate each exposure on a case-by-case basis in order to give an accurate risk assessment. Some of the known, possible, and unlikely human teratogens are listed below.

            If you have a pregnant or breast feeding patient who is currently taking, or considering taking, a medication, the patient needs to be counselled about potential adverse effects the medication could have on her fetus or infant.

 

Some Known Teratogens

 

• Radiation

Atomic weapons

Radioiodine

Therapeutic radiation

 

• Infections

Cytomegalovirus

Herpes simplex virus I and II

Parvovirus B-19 (Erythema

infectiosum)

Rubella virus

Syphilis

Toxoplasmosis

Varicella virus

Venezuelan equine encephalitis virus

 

• Maternal & Metabolic Imbalance

Alcoholism

Amniocentesis, early

(before day 70 post conception)

Chorionic villus sampling

(before day 60 post conception)

Cretinism, endemic

Diabetes

Folic acid deficiency

Hyperthermia

Myasthenia gravis

Phenylketonuria

Rheumatic disease

Sjögren’s syndrome

Virilizing tumors

-----------

Drugs and Environmental Chemicals

ACE inhibitors (benazepril,

captopril, enalapril, fosinopril,

lisinopril, moexipril, quinapril,

ramipril, trandolapril)

Aminopterin

Androgenic hormones

Busulfan

Chlorobiphenyls

Cigarette Smoking

Cocaine

Coumarin anticoagulants

Cyclophosphamide

Diethylstilbestrol

Etretinate

Fluconazole (high doses)

Iodides

Isotretinoin (Accutane®)

Lithium

Mercury, organic

Methimazole

Methotrexate (methylaminopterin)

Methylene blue (via intraamniotic

injection)

Misoprostol

Penicillamine

Phenytoin

Tetracyclines

Thalidomide

Toluene (abuse)

Trimethadione

Valproic acid

 

Possible Teratogens

Binge drinking

Carbamazepine

Colchicine

Disulfiram

Ergotamine

Glucocorticoids

Lead

Primidone

Quinine (suicidal doses)

Streptomycin

Vitamin A (high doses)

Zidovudine (AZT)

Zinc deficiency

 

Unlikely Teratogens

Agent Orange

Anesthetics

Aspartame

Aspirin (but aspirin in the 2nd half of

pregnancy may increase cerebral

hemorrhage during delivery)

Bendectin® (antinauseant)

Electromagnetic waves

Hydroxyprogesterone

LSD

Marijuana

Medroxyprogesterone

Metronidazole

Oral contraceptives

Progesterone

Rubella vaccine

Spermicides

Video display terminals

Ultr