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Diagnonistic Test

Chest X-Ray

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Definition:The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Doctors have used x-rays for over a century to see inside the body in order to diagnose a variety of problems, including cancer, fractures, and pneumonia. During this test, you usually stand in front of a photographic plate while a machine sends x-rays, a type of radiation, through your body. Originally, a photograph of internal structures was produced on film; nowadays, the image created by the x-rays goes directly into a computer. Dense structures, such as bone, appear white on the x-ray films because they absorb many of the x-ray beams and block them from reaching the plate (see Figure 16). Hollow body parts, such as lungs, appear dark because x-rays pass through them. (In some other countries, like the United Kingdom, the colors are reversed, and dense structures are black.)

Back x-rays and chest x-rays are among the most common conventional x-ray tests. You should not have an x-ray if you’re pregnant, because radiation can be harmful to a developing fetus.

A chest x-ray provides black-and-white images of your lungs, ribs, heart, and diaphragm.

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Some common uses:
The chest x-ray is performed to evaluate the lungs, heart and chest wall.

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:

*shortness of breath
*a bad or persistent cough
*chest pain or injury
*fever.
Physicians use the examination to help diagnose or monitor treatment for conditions such as:

*pneumonia
*heart failure and other heart problems
*emphysema
*lung cancer
*other medical conditions.


How should you prepare for the test?

A chest x-ray requires no special preparation.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

You are usually asked to remove all clothing, undergarments, and jewelry above your waist, and to wear a hospital gown.

What does the equipment look like?
The equipment typically used for chest x-rays consists of a wall-mounted, box-like apparatus containing the x-ray film or a special plate that records the image digitally and an x-ray producing tube, that is usually positioned about six feet away.
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The equipment may also be arranged with the x-ray tube suspended over a table on which the patient lies. A drawer under the table holds the x-ray film or digital recording plate.

A portable x-ray machine is a compact apparatus that can be taken to the patient in a hospital bed or the emergency room. The x-ray tube is connected to a flexible arm that is extended over the patient while an x-ray film holder or image recording plate is placed beneath the patient.

What happens when the test is performed?
Chest x-rays usually are taken while you are standing. A technician positions you against the photographic plate (which looks like a large board) to obtain the clearest pictures. He or she takes pictures from the front and from one side while asking you to take in a deep breath just before each picture. The technician leaves the room or stands behind a screen while the x-rays are taken.

How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.

Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black.

On a chest x-ray, the ribs and spine will absorb much of the radiation and appear white or light gray on the image. Lung tissue absorbs little radiation and will appear dark on the image.

Until recently, x-ray images were maintained as hard film copy (much like a photographic negative). Today, most images are digital files that are stored electronically. These stored images are easily accessible and are sometimes compared to current x-ray images for diagnosis and disease management.

How is the procedure performed?

Typically, two views of the chest are taken, one from the back and the other from the side of the body as the patient stands against the image recording plate. The technologist, an individual specially trained to perform radiology examinations, will position the patient with hands on hips and chest pressed the image plate. For the second view, the patient’s side is against the image plate with arms elevated.

 

Patients who cannot stand may be positioned lying down on a table for chest x-rays.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

The chest x-ray examination is usually completed within 15 minutes.

Additional views may be required within hours, days or months to evaluate any changes in the chest.

What will you experience during and after the procedure?
A chest x-ray examination itself is a painless procedure.

You may experience discomfort from the cool temperature in the examination room and the coldness of the recording plate. Individuals with arthritis or injuries to the chest wall, shoulders or arms may have discomfort trying to stay still during the examination. The technologist will assist you in finding the most comfortable position possible that still ensures diagnostic image quality.
Who interprets the results and how do you get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

In an emergency, the results of a chest x-ray can be available almost immediately for review by your physician.
What are the benefits vs. risks?
Benefits:

*No radiation remains in a patient’s body after an x-ray examination.
*X-rays usually have no side effects in the diagnostic range.
*X-ray equipment is relatively inexpensive and widely available in emergency rooms, physician offices, ambulatory care *centers, nursing homes and other locations, making it convenient for both patients and physicians.
*Because x-ray imaging is fast and easy, it is particularly useful in emergency diagnosis and treatment.

Risks:

*There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

*The chest x-ray is one of the lowest radiation exposure medical examinations performed today. The effective radiation dose from this procedure is about 0.1 mSv, which is about the same as the average person receives from background radiation in 10 days. See the Safety page for more information about radiation dose.

*Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

How long is it before the result of the test is known?
Although digital images may be available immediately, it will take additional time for a doctor to examine and interpret them. You’ll probably get the results later in the day.

A Word About Minimizing Radiation Exposure:
Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection councils continually review and update the technique standards used by radiology professionals.

State-of-the-art x-ray systems have tightly controlled x-ray beams with significant filtration and dose control methods to minimize stray or scatter radiation. This ensures that those parts of a patient’s body not being imaged receive minimal radiation exposure.

What are the limitations of Chest Radiography?
The chest x-ray is a very useful examination, but it has limitations. Because some conditions of the chest cannot be detected on an x-ray image, this examination cannot necessarily rule out all problems in the chest. For example, very small cancers may not show up on a chest x-ray. A blood clot in the lungs, a condition called a pulmonary embolism, cannot be seen on chest x-rays.

Further imaging studies may be necessary to clarify the results of a chest x-ray or to look for abnormalities not visible on the chest x-ray.

Click for More Additional Information and Resources: ->
*RadiologyInfo: Radiation Therapy for Lung Cancer

*RTAnswers.org: Radiation Therapy for Lung Cancer

Resources:
https://www.health.harvard.edu/diagnostic-tests/chest-x-ray.htm
http://www.radiologyinfo.org/en/info.cfm?PG=chestrad

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Is Red Meat’s Bad Name Justified?

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The news for red meat seems to be getting worse and worse.

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In December, a survey of more than 494,000 people by the National Institutes of Health found that men who ate more than 5 ounces of red meat each day and women who ate more than 3 ounces had a 51% greater risk of esophageal cancer, 61% of liver cancer and 24% of colorectal cancer than those who ate less than an ounce of red meat daily

In October 2007, the World Cancer Research Fund and the American Institute for Cancer Research, two charities that fund research on the effects of diet and activity on cancer risk, declared that the evidence linking red meat consumption and colorectal cancer was “convincing.”

And though previous reports for breast cancer have been contradictory overall, findings published in July from a Harvard study of more than 39,000 young nurses suggested that the risk of getting breast cancer before menopause goes up for every extra daily serving of red meat a woman ate as a teenager, a time period that had not been studied before.

Add the numerous studies linking red meat to other cancers, cardiovascular disease, Type 2 diabetes and even Alzheimer’s disease, and it sounds like the hamburger you had for lunch might as well have been laced with rat poison.

In fact, there is a place for red meat in a healthful diet, scientists say, but they recommend choosing smaller portions of lean cuts and cooking them well but not at high temperatures.

The question is which meat components are responsible for the observed health risks. Scientists have several theories, though none seems to tell the whole story.

Red meat can contain a lot of saturated fats and cholesterol, known contributors to cardiovascular disease. “We know that dementia is strongly related to vascular disease, so it’s likely we’ll find a relationship there as well,” says Dr. Walter Willett, chair of the department of nutrition at the Harvard School of Public Health.

Contributing factors
Meat from commercially raised livestock also contains a high amount of omega-6 fats, which have been associated with poor cardiovascular health, but a low amount of omega-3 fats, which may be protective.

Another potential culprit is the iron in meat. Iron is essential for health, but iron from meat comes in a different form than that from vegetables and legumes, one that is absorbed whether the body needs it or not. “This type of iron can cause oxidative damage to all the components of the cell — the protein, lipid, DNA, RNA,” says Al Tappel, professor emeritus of food science at UC Davis.

Many of the studies that found an association between meat consumption and health risks did not differentiate between unprocessed meat, such as a steak, and processed or cured meats such as salami, bacon, pepperoni, bologna and hot dogs. Chemicals in processed meats may account for some of the cancer risk.

Finally, high-temperature cooking methods, such as grilling over charcoal, can cause the formation of known carcinogens such as heterocyclic amines, or HCAs, and polycyclic aromatic hydrocarbons, or PAHs.

Mary Young, a registered dietitian from the Centennial, Colo.-based National Cattlemen’s Beef Assn., says that a study it commissioned on the science of red meat reached a very different conclusion (the study has not yet been published). “Red meat does not cause cancer,” she says. “Beef is really one of the most underappreciated nutrient-rich foods out there” — rich in protein and eight other nutrients, including B vitamins and zinc.

Some scientists, too, think that the risk of red meat has been overplayed. “The proof is not as strong as some people would like to think,” says Iowa State University animal science professor Don Beitz. “Cancer is such a multifactorial [problem]. I don’t see how one can just pin it on certain pollutants or nutrients.”

Rock-hard conclusions require carefully controlled, long-term, well-defined studies of many people. Each one of these requirements can be difficult to meet, so scientists rely heavily on epidemiological studies in which the normal habits of large numbers of people are tracked, often pooling the results of multiple studies.

But unlike lab rats, humans don’t live in a perfectly controlled environment, which makes it difficult to determine if it’s meat or something else in the diet or environment that leads to an observed cancer risk. Also, some studies ask people to recall what they ate years ago, and many studies don’t even define red meat the same way.

Even when a correlation between meat consumption and illness is found, the effect can be significant but small. In the December 2007 study, for example, high meat consumption resulted in only a 50% increased risk of developing esophageal cancer — by way of comparison, smoking can increase a person’s risk of developing lung cancer by 1,000% or more.

But to dismiss all risks because of inconsistencies in the research is unreasonable, Willett says. “That’s exactly the same argument used by cigarette manufacturers to say that smoking is not harmful. . . . The perfect study will never be done. The next best thing will be epidemiology.”

Scientists generally agree that lean red meat has a place in a healthful diet — in moderation. Studies showing increased cancer risks have mostly focused on high meat intake; the greatest risk increases are for those eating far more than the USDA-recommended limit of 18 ounces per week.

“One approach is to treat red and processed meat as a treat and not a regular staple,” said Dr. Michael J. Thun, vice president of epidemiology and surveillance research at the American Cancer Society

Moderation, it appears, is not the American way. According to the U.S. Department of Agriculture, in 2006 the average American consumed 95 pounds of beef and 64 pounds of pork — about 7 ounces of red meat a day.

To sidestep some health concerns without giving up steak, some consumers have turned to grass-fed beef, which studies have shown to contain a heart-healthier ratio of omega-3 to omega-6 fatty acids.

Meanwhile, scientists are looking to make beef more healthful via selective breeding.

The amount of specific nutrients in steaks from two animals of the same breed can vary by a factor of two or three, Beitz says. He and others in a group of researchers known as the National Beef Cattle Evaluation Consortium hope to find genetic markers for a host of nutrients, including omega-3 and other beneficial fats, zinc and vitamins B6 and B12. The research, sponsored by Pfizer Animal Science, would help animal breeders look at animals’ genetic profiles to select ones with the best nutritional composition.

“In a way, we’re trying to allow people to indulge themselves to a greater extent than to moderate,” said James Reecy, an Iowa State geneticist also involved in the project.

The same technique could be used to limit the unhealthy components of meat as well, such as specific saturated fats. Cattle breeders have already begun doing this, Reecy says.

Willett isn’t convinced that these efforts will eradicate the health risks that come from consuming red meat. “You may make it healthier in one way, but you’re unlikely to fix all the problems at the same time,” he says.

Click to see:->Red Meat Does and Doesnot

Sources:Los Angles Times

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Healthy Lifestyle Slows Aging

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Sweeping lifestyle changes including a better diet and more exercise can raise the body’s levels of an enzyme closely involved in controlling the aging process, US researchers reported. .

The small study involved 30 men with low-risk prostate cancer who underwent three months of lifestyle changes. They had blood levels of the enzyme telomerase 29% higher after these three months than when they began.
Telomerase fixes and lengthens parts of chromosomes known as telomeres that control longevity and are also important for maintenance of immune-system cells.

The research in the journal Lancet Oncology was led by Dr Dean Ornish, head of the Preventive Medicine Research Institute in Sausalito, California, and a well-known author advocating lifestyle changes to improve health.

The lifestyle changes included a diet rich in fruits, vegetables, whole grains, legumes and soy products, moderate exercise such as walking for half an hour a day, and an hour of daily stress management methods such as meditation.

“This is the first study showing that anything can increase telomerase. If it were a new drug that had been shown to do this, it would be a billion-dollar drug. But this is something that people can do for free,” Ornish said.

Shortening of telomeres indicates disease risk and premature death in some types of cancer, including breast, colon and lung cancer.

Sources: The Times Of India

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The Quiet Cancers

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Three big dangers your doctor may not talk about and how to stay safe:

Your doctor has given you the lowdown on how to protect yourself against breast, colon, and lung cancer: Get yearly mammograms (check) and regular colonoscopies (check), and don’t smoke (double check).

But when was the last time she asked if you had any persistent mouth sores, unexplained fevers or joint pain, or discomfort during sex? These can be symptoms of three cancers—oral, leukemia, and endometrial—that don’t get the attention they deserve. Even though they are among the most common cancers affecting women over age 55, these diseases can fall through the cracks as doctors focus on the biggest killers hogging the health headlines, says Elmer Huerta, M.D., president of the American Cancer Society.

Oral Cancer

Your Risk:
1 in 98, with diagnoses peaking between the ages of 55 and 65. Oral cancer is lethal more often than it needs to be because people tend to ignore symptoms (it’s typically caught in late stages).

Stay healthy: Watch your mouth—see a dentist or doctor about any sore in your mouth or on your lips that doesn’t clear up in two weeks. A change in color or persistent pain, tenderness, or numbness anywhere in your mouth or on your lips should also prompt a fast visit.

Curb your vices: About 75 percent of oral cancers are caused by smoking and drinking alcohol. When such habits were considered unladylike, men with oral cancer outnumbered women 6 to 1, says Sol Silverman Jr., D.D.S., a professor of oral medicine at the University of California, San Francisco, School of Dentistry. “But in the last 50 years, the incidence in women has soared—now the ratio is two men to every woman.” Limit your intake to one drink per day.

Guard your lips: They need protection, too. Sunscreen isn’t exactly tasty, so choose a balm with SPF and then apply your favorite gloss or lipstick.

…………….

The good news: Researchers at Ohio State University recently found that phytochemicals extracted from Hass avocados could kill or stop the growth of oral cancer cells. The study was done in test tubes, but there’s no need to wait for confirmation—bring on the guacamole!

Leukemia

Your Risk: Many think of it as a children’s disease, but the biggest jump in cases occurs between ages 55 and 74.

Stay healthy: Note any symptoms If you find yourself extremely pale or bruising easily, or if your gums bleed (more than is normal if you neglect to floss), it’s time to get checked out. Extreme fatigue, unexplained fevers, and bone or joint pain are other common symptoms.

Avoid unnecessary scans: CT scans are a great diagnostic tool, but they deliver much more radiation than X-rays and may be overused, says Barton Kamen, M.D., Ph.D., chief medical officer for theLeukemia & Lymphoma Societyociety. In fact, researchers suggest that one-third of CT scans could be unnecessary. High doses of radiation can trigger leukemia, so make sure scans are not repeated if you see multiple doctors, and ask if another test, such as an ultrasound or MRI, could substitute.

The good news: The five-year survival rate for all people with leukemia has more than tripled in recent decades, from about 14 percent in the 1960s to about 65 percent today. “New advancements now help us determine who is a good candidate for a bone marrow transplant and who might respond better to other therapies,” says Kamen. “The result is more targeted treatment and better outcomes.”

Endometrial (Uterine) Cancer

Your Risk: 1 in 40. This is the fourth most common type of cancer in women—90 percent of cases occur in women over age 50. You’re more vulnerable if you’re toting extra weight: Obese women are two to three times as likely to develop the disease. “Fat acts like another gland, which increases the levels of estrogen and other hormones in your system. That stimulates the growth of abnormal tissues,” says Huerta.

Stay healthy: Mention any unusual bleeding. More than 80 percent of endometrial cancers are found in the earliest, most treatable stages because this symptom tends to send women promptly to their doctors. If you notice any vaginal bleeding after menopause or bleeding between your periods, or if you experience pelvic pain, especially during intercourse, tell your doctor immediately.

Know your family history: “The same genetic mutation that puts people at increased risk of colon cancer also ups their odds of getting endometrial cancer,” says Edward L. Trimble, MD, MPH, head of Gynecologic Cancer Therapeutics at the National Cancer Institute. If you have a parent or sibling with that disease, get screened yearly for endometrial cancer starting at 30.

Move more all day: In a recent report on more than 250,000 women, those who exercised several hours daily reduced their risk of endometrial cancer by up to 52 percent, probably because staying active reduces estrogen levels while helping you maintain a healthy weight. Exercise frequency mattered more than intensity—light housework, gardening, and walking are enough. Avoid iron: A Swedish study has found that taking iron supplements after menopause raises the risk of endometrial cancer by 70 percent. After age 50, the daily recommendation for iron drops from 18 mg per day to 8 mg, an amount easily obtained from food.

The good news: In the same study, calcium supplements halved endometrial cancer risk. (Researchers aren’t sure why, but eating high-calcium dairy products didn’t provide the same benefit.) Experts recommend that postmenopausal women consume up to 1,000 mg of calcium a day, and 1,200 mg after age 70.

Click to see Your Anti-Cancer Guide: -> prevention.com/cancer.

Sources: msn health & fitness

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How Broccoli Fights Cancer

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Just a few additional portions of broccoli each week could protect men from prostate cancer. Researchers believe a substance called isothiocyanate in the broccoli sparks hundreds of genetic changes, activating some genes that fight cancer and switching off others that fuel tumors.

Prostate cancer kills more men than any other kind except for lung cancer. Each year, 680,000 men worldwide are diagnosed with the disease and about 220,000 will die from it.

The benefit derived from broccoli would likely also be available from other cruciferous vegetables that contain isothiocyanate, including Brussels sprouts, cauliflower, cabbage, arugula, watercress and horseradish.

Sources:

* Reuters July 1, 2008

* PLoS ONE July 2, 2008; 3(7):e2568

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