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Tests

Procedure, Risk Factors, and Benefits of Biopsy | Neurology

What is a biopsy?

A biopsy is a more detailed examination of a sample of tissue taken from the body. The doctor should recommend a biopsy when the initial examination indicates that the area of body tissue is not normal. Doctors call an area of abnormal tissue a lesion, tumor, or mass.

Types of biopsy

Needle biopsy: Most biopsies are needle biopsies, which means that the needle is used to access suspicious tissue.

CT-guided biopsy: The CT scan images can help doctors determine the exact location of the needle in the target tissue.

Ultrasound-guided biopsy: An ultrasound scanner can help the doctor redirect a needle to an ulcer.

Bone biopsy: Bone biopsy is used for bone cancer. This can be done using a CT scan technique or by an orthopedic surgeon.

Bone marrow biopsy: A large needle is used to insert the bone marrow into the pelvic bone. It detects blood diseases such as leukemia or lymphoma.

Liver biopsy: A needle is inserted into the liver through the skin of the abdomen and captures the liver tissue.

Kidney biopsy: Similar to a liver biopsy, a needle is inserted into the kidney through the skin on the back.

Aspiration biopsy: A needle extracts material from the dough. This simple method is also known as fine-needle aspiration.

Prostate biopsy: Several needle biopsies are taken simultaneously from the prostate gland. To reach the prostate, a tube is inserted into the rectum.

Surgical biopsy: Open or laparoscopic surgery may be required to obtain a biopsy of the tissue. A piece of tissue or an entire lump of tissue may be removed.

Risks factors of biopsy

This procedure is generally safe and causes fewer injuries.

  • Bleeding
  • Infection
  • Accidental injury to adjacent structures such as the lung parenchyma during intestinal or kidney during an abdominal biopsy

Purpose of biopsy

If you have symptoms that are generally associated with cancer and your doctor finds an area of concern, you may need a test to determine if the area is cancerous. It is the only way to diagnose most cancers. Imaging tests, such as CT scans and X-rays, can help identify areas of concern, but they cannot differentiate between cancer and non-cancer cells.

Biopsies are often associated with cancer, but just because your doctor ordered this procedure, it does not mean you have cancer. Doctors use biopsies to check if abnormalities in your body are due to cancer or other conditions.

Preparing for a biopsy

How to prepare for the procedure depends on the type of disease you have. For example, there are no large preparations for a fine needle biopsy in the doctor’s office. In some cases, you may need to take your clothes off and put on a dress.

Before biopsy

Ask your doctor or nurse if you can eat or drink before the test. Also, take clarification on the regular usage of medicines. For some biopsies, your doctor may want to know if you are thinning your blood or taking aspirin. The doctor should be informed about the history and current use of medicines.

Tell your doctor about any drug allergies or other medical conditions you may have. A member of your healthcare team will explain the procedure to you. You will be asked to sign a consent form stating that you understand the advantages and disadvantages of it and that you agree to perform the test. Visit the doctor if any problem is faced.

During biopsy

The doctor will perform a biopsy based on the part of your body where you may be lying on your stomach or on your back or sitting during the procedure. For some types of biopsies, you may need to hold your breath while the needle is inserted. Your healthcare team will let you know in advance what to expect in the process.

Before the procedure, you will usually receive a form of anesthesia to prevent the perception of pain. The anesthesia procedure used by the doctor depends on the type of procedure.

The following types can be used:

Local anesthesia: Local anesthesia is an injection that numbs the area where the procedure is done. You may feel a sting when your doctor injects a local anesthetic through a needle.

Conscious anesthesia: Conscious anesthesia care Medicines are used to relax you. It is usually given through an intravenous (IV) tube and is often combined with local or regional anesthesia.

General anesthesia: General anesthesia during a major procedure, such as surgery, will knock you out. If you are under regular anesthesia, you may not be aware of this procedure.

After biopsy

After taking a tissue sample, your doctor will need to evaluate it. In some cases, this can be done during the diagnostic process. However, in most cases, the sample must be sent to a laboratory for analysis. Results can take anywhere from a few days to a few weeks.

Once the results come in, your doctor may call you to share the results or ask you to come to the next appointment to discuss the next steps. If the results show signs of cancer, your doctor can determine the type of cancer and the level of aggression from your biopsy. If your biopsy is done for a cause other than cancer, the lab report should be able to guide your doctor in the diagnosis and treatment of the condition.

Even if the results are negative, if the doctor’s suspicion of cancer or other conditions remains high, you may need another biopsy or a different type of biopsy. Your doctor will be able to guide you on the best course to follow. If you have any questions about it or the results before the procedure, do not hesitate to speak with your doctor. You may want to write down your questions and bring them to your next office visit.

Analysis and biopsy results

Once your doctor obtains a tissue sample, it is sent to a laboratory for analysis. It can be chemically treated or frozen and bisected into thin sections. Sections are placed on glass slides, stained to increase contrast, and studied under a microscope. The results can help your doctor determine if the cells are cancerous. If the cells are cancerous, results can tell your doctor where the cancer is – the type of cancer.

It can also help your doctor determine how aggressive your cancer is – cancer grade. The grade is sometimes expressed as a number on a scale of 1 to 4 and is determined by how the cancer cells look under a microscope.

Low-grade (grade 1) cancers are generally less aggressive, and high-grade (grade 4) cancers are generally more aggressive. This information can help guide treatment options. Other specialized tests on cancer cells can help guide treatment options.

In some cases, such as during surgery, a pathologist will immediately examine the sample and deliver the results to your surgeon within minutes. But in most cases, the results of it will be available in a few days. Some samples take longer to analyze. Ask your doctor how long to wait for your biopsy results.

Recovery

Most biopsies only require local anesthesia, which means you don’t have to stay in the hospital overnight. However, an overnight stay is sometimes required when performing a biopsy under general anesthesia. Most types of biopsies are painless once the anesthesia begins to work, although it depends on where the sample was taken.

You may experience a dull ache, which can be treated with pain relievers as recommended by your doctor or surgeon. For some types, it takes a few hours in the hospital. You will need to put on stitches or get dressed before you go.

Benefits

Needle biopsy is a reliable method of obtaining tissue samples to help determine whether the nodule is benign (not cancerous) or malignant.

  • It is less aggressive than open or closed surgical biopsies, and both involve a large incision in the skin.
  • In general, the procedure is not painful and the results are accurate when the tissue sample is surgically removed.
  • Recovery time is short and patients can resume normal activities soon.
  • Any procedure that involves cutting of the skin carries a risk of infection. The risk of infection that requires antibiotic treatment is less than one in 1,000.
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Disease

Prevention of Enlarged Heart (Cardiomegaly) | Cardiology

What is an enlarged heart (cardiomegaly)?

An enlarged heart (cardiomegaly) means that your heart is larger than normal. Your heart expands if the muscles work too hard or the chambers expand. An enlarged heart is not a disease. It is a symptom of a heart defect or condition that causes the heart to become harder, such as cardiomyopathy, heart valve problems, or high blood pressure.

An enlarged heart does not pump blood as efficiently as an enlarged heart. This can lead to problems like stroke and heart failure. Certain conditions can cause the heart muscle to thicken, leaving one of the heart’s chambers larger. Depending on the condition, the enlarged heart can be temporary or permanent. An enlarged heart can be treated by correcting the cause. Treatment for an enlarged heart may include medications, medical procedures, or surgery.

Types of an enlarged heart

The heart enlarges because of damage to the heart muscle. Up to a point, an enlarged heart can still pump blood normally. As the condition progresses, though, the heart’s pumping ability declines. Dilated cardiomyopathy is the main type of enlarged heart. The walls of both sides (also known as ventricles) become thin and stretched. This enlarges your heart.

In the other types, the muscular left ventricle becomes very thick. High blood pressure may cause your left ventricle to enlarge (a type known as hypertrophy). The thickening (which doctors call hypertrophic cardiomyopathy) can also be inherited. An enlarged heart keeps more of its pumping ability when it’s “thick” rather than “thin.”

What are the symptoms of an enlarged heart?

Sometimes an enlarged heart doesn’t cause any symptoms. When symptoms do occur, they include:

  • Difficulty breathing
  • Irregular heartbeat (arrhythmia)
  • Swelling of the legs and ankles due to increased fluid (edema)
  • Fatigue
  • Dizziness

Symptoms that indicate a medical emergency:

  • Chest pain
  • Difficulty holding your breath
  • Pain in the arms, back, neck, or jaw.
  • Epilepsy

Causes of an enlarged heart

An enlarged heart is caused by conditions that cause your heart to pump harder than normal or damage your heart muscle. Sometimes the heart becomes enlarged and weak for unknown reasons. This is called idiopathic cardiomegaly. Damage from a congenital (congenital) heart condition, a heart attack, or an abnormal heartbeat (arrhythmia) can cause your heart to dilate. Other conditions associated with an enlarged heart include:

  • Hypertension: Your heart needs to pump hard to supply blood to the rest of your body, to stretch and tighten your muscles.
  • High blood pressure: Causes the left ventricle to dilate, eventually weakening the heart muscle. High blood pressure also expands the chambers above the heart.
  • Heart valve disease: The four valves in your heart allow blood to flow in the right direction. If the valves are damaged due to conditions such as rheumatic fever, heart defects, infections (infective endocarditis), irregular heartbeats (atrial fibrillation), connective tissue disorders, certain medications, or radiation treatments for cancer, your heart may enlarge.
  • Cardiomyopathy: This heart disease makes it difficult for your heart to pump blood throughout your body. As it develops, you can try to pump more blood into the vagina.
  • High blood pressure in the artery connecting the heart and lungs (pulmonary hypertension). Your heart needs to be pumped hard to move blood between your lungs and your heart. As a result, it can expand to the right side of your heart.
  • Fluid around your heart (pericardial effusion): Fluid buildup in the sac that contains your heart makes your heart appear enlarged on a chest X-ray.
  • Blocked arteries in your heart (coronary artery disease): With this condition, fatty plaque in the coronary arteries blocks blood flow through the coronary arteries, leading to a heart attack. When a section of the heart muscle dies, your heart must pump hard to get enough blood to the rest of your body, causing it to expand.
  • Low red blood cell count (anemia): Anemia is a condition in which there are not enough healthy red blood cells to carry enough oxygen to the tissues. Untreated chronic anemia can cause a fast or irregular heartbeat. Your heart needs to pump more blood so there is no oxygen in the blood.
  • Thyroid disorders: Both a dysfunctional thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
  • Excess iron in the body (hemochromatosis): Hemochromatosis is a disorder in which your body does not metabolize iron properly, which occurs in various organs, including the heart. It causes enlargement of the left ventricle due to the weakening of the heart muscle.
  • Rare diseases that affect your heart, such as amyloidosis: Amyloidosis is an abnormal protein that circulates in the blood and can build up in the heart, disrupting the heart’s function and causing it to expand.

Diagnosis of an enlarged heart

An early diagnosis of an enlarged heart is very necessary to control or improve the condition. On a physical exam, the doctor may hear abnormal heart sounds or fluid in the lungs or swelling in the legs, ankles, or abdomen. Advanced tests to carefully diagnose, treat, and monitor the condition effectively include:

  • Blood tests: Blood tests measure the levels of certain fats, cholesterol, sugar, and proteins in the blood, which indicate heart conditions.
  • Cardiac catheterization: A long, thin flexible tube is inserted through a blood vessel in the arm or groin and into the heart. The contrast material is injected through a tube and a kind of X-ray video is taken to show how the heart is working and to see the heart block. A small piece of the heart tissue may be taken for laboratory analysis.
  • Chest X-ray: A simple imaging test of the lungs, lungs, heart, and aorta.
  • Computed tomography (CT) angiography: This non-invasive exam shows the arteries in the abdomen, pelvis, and legs. This test is especially useful in patients with pacemakers or stents.
  • Echocardiogram: This ultrasound test uses sound waves to take moving images of the heart’s chambers and valves.
  • Electrocardiogram (EKG): An EKG measures the electrical activity of the heart and can detect an enlarged heart and determine whether the heart is overactive or damaged. The electrical currents of the heart are detected by 12 to 15 electrodes through the adhesive tape on the arms, legs, and chest.
  • Magnetic Resonance Imaging (MRI): A large magnet, radio waves, and a computer are used to create images of the heart and blood vessels.
  • Stress test: This test is done while you exercise. If a person is unable to exercise, medications are given to increase the heart rate. In addition to the ECG, the test shows changes in blood pressure along with heart rate, rhythm, or electrical activity. Exercise-The heart works harder and beats faster when heart tests are done.

How enlarged heart is treated?

Your doctor will prescribe a treatment plan for the condition that is causing your heart. For example:

  • Hypertension: ACE inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers
  • Irregular heart rhythm: Antiarrhythmic drugs, pacemakers, and implanted automatic defibrillator (ICD)
  • Heart valve problems: Surgery to repair or replace a damaged valve
  • Narrow coronary arteries: Percutaneous coronary intervention, coronary artery bypass graft (CABG), and nitrates
  • Heart failure: Diuretics, beta-blockers, inotropes, and, in some minorities, the left ventricular assist device (LVAD)
  • Other approaches can address congenital heart defects. If you try some treatments and they don’t work, you may need a heart transplant.

Changes in lifestyle

With lifestyle changes like these, you can maintain an enlarged heart:

  • Exercise: Exercise most days of the week. Ask your doctor what types of exercises are safe for you.
  • Give up smoking: Techniques like nicotine restoration products and treatment can help stop it.
  • Lose weight: Weight loss will be followed by constant fatigue and tiredness.
  • Limit certain foods: Limit salt, cholesterol, and saturated and trans fats in your diet.
  • Avoid certain things: Drugs such as alcohol, caffeine, and cocaine should be avoided.
  • Chill out: Follow relaxation techniques like meditation or yoga to reduce stress.

Enlarged heart complications

The risk of complications from an enlarged heart depends on the enlarged part of the heart and the cause.

Problems with an enlarged heart include:

  • Heart failure: An enlarged left ventricle, one of the most serious types of enlarged heart, increases the risk of heart failure. In heart failure, the heart muscle weakens and the ventricles dilate (dissociate) until the heart can efficiently pump blood throughout the body.
  • Blood clots: Having an enlarged heart is more likely to cause blood clots in the lining of the heart. If clots enter the bloodstream, they can block blood flow to vital organs and even cause a heart attack or stroke. A clot on the right side of your heart can travel to your lungs, a dangerous condition called a pulmonary embolism.
  • Heart murmur: For people whose hearts are enlarged, two of the four heart valves, the mitral and tricuspid valves, do not close properly because they rupture, causing backflow of blood. This flow creates sounds called heart murmurs. Although it is not necessarily harmful, your doctor should monitor your heart murmurs.
  • Cardiac arrest and sudden death: Sometimes an enlarged heart can lead to heart rhythm interruptions. Heart rhythms that allow the heart to beat too slow or too fast to move blood can lead to epilepsy or, in some cases, cardiac arrest or sudden death.

Prevention of enlarged heart

  • Tell your doctor if you have a family history of conditions that can cause an enlarged heart, such as cardiomyopathy. If cardiomyopathy or other heart conditions are diagnosed early, treatments can prevent the disease from getting worse.
  • Controlling risk factors for coronary artery disease (smoking, high blood pressure, high cholesterol, and diabetes) can help reduce the risk of heart enlargement and heart failure by reducing the risk of a heart attack.
  • Eating a healthy diet and avoiding alcohol abuse or illicit drug use can help lower your chances of heart failure. Controlling high blood pressure with diet, exercise, and possibly medication can prevent many people with an enlarged heart from stopping.

Recovery after dilated heart surgery

The length of your hospital stay depends on the process.

  • After a coronary artery bypass graft, you spend a day or two in the intensive care unit and another three to five days in another unit before returning home. Full recovery can take 6 to 12 weeks. Your doctor will tell you when you are physically active again, return to work, or resume sexual activity.
  • Recovery after ventricular assist device surgery depends on your condition before surgery. You spend a day or two in the intensive care unit and another three to five days in another unit before going home. You make a slow transition from the hospital to the home, which may be the first day you are home, but you return to the hospital that night. Your doctor will advise you on activities you can participate in until you fully recover.
  • After heart valve surgery, you will spend one to two days in the intensive care unit and three to five days in another unit before going home. Full recovery can take 6 to 12 weeks. Your doctor will tell you when to be active again.
  • After heart transplant surgery, you spend several days in the intensive care unit before going home and several weeks in another unit. After discharge, you must be very close to the hospital for the first six weeks for frequent subsequent visits and lab tests. Your doctor will advise you on activities you can participate in until you fully recover.
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Disease

Overview of Encephalitis | Treatment Options | Neurology

What is Encephalitis?

Encephalitis is an inflammation of the brain. There are several causes, but the most common one is a viral infection. Encephalitis frequently inceptions mild, flu-like signs and symptoms – such as a fever or headache – or no evidence at all. Sometimes the flu-like symptoms are more severe.

Encephalitis can also cause confusion in thinking, seizures, or problems with movement or with sensory organs such as vision or hearing. In some cases, encephalitis can be life-threatening. Timely identification and treatment are crucial because it is challenging to pretend how encephalitis will impact everyone.

Types of encephalitis

Different types of encephalitis have different causes.

  • Japanese encephalitis is spread by mosquitoes
  • Tick-borne encephalitis is spread by ticks
  • Rabies can be spread through a chomp from a vertebrate

There is also primary or secondary encephalitis.

  • Primary or infectious encephalitis can occur if fungi, viruses, or bacteria infect the brain.
  • Secondary or postinfectious encephalitis happens when the immune system reacts to a former infection and erroneously affliction the brain.

Symptoms of encephalitis

The patient normally has a fever, headache, and photophobia (unreasonable sensitivity to light). There may also be general weakness and seizures.

Less common symptoms

An individual may also experience stiffness of the nucleus (stiff neck), which can lead to a misdiagnosis of meningitis. There may be stiffness in the limbs, slow movements, and clumsiness. The patient may also feel sleepy and cough.

More serious cases

In more thoughtful cases, a respective may encounter terrible headache, nausea, vomiting, confusion, disorientation, memory loss, speech problems, hearing problems, hallucinations, just as seizures, and possibly coma. In some cases, the patient can become aggressive.

Signs and symptoms in infants

At first, encephalitis is difficult to detect in young children and infants. Parents or guardians should look for vomiting, bulging fontanel (the soft area at the top of the middle of the head), constant crying that does not improve when the baby is carried, rested, and stiff.

What causes encephalitis?

Many different viruses can cause encephalitis. It is helpful to classify the possible causes into three groups: common viruses, pseudoviruses, and arboviruses.

Common viruses

The most individual virus that justification encephalitis in formulated countries is herpes simplex. The herpes virus is usually transmitted through a nerve to the skin, where it causes a cold sore. In rare proceedings, all the same, the virus traveling to the brain.

This form of this disease unremarkably affects the temporal lobe, which is the part of the brain that standard memory and speech. It can also impact the frontal lobe, the part that standard emotions and behavior. Encephalitis origination by herpes is harmful and can track to severe brain damage and death.

Other common viruses that can cause this disease that may include:

  • Mumps
  • HIV
  • Cytomegalovirus
  • Epstein-Barr virus

Childhood viruses

Vaccines can forbid the immaturity viruses that used to inception inflammation of the brain. Therefore, these types of inflammation of the brain are rare today. It includes some childhood viruses that can cause inflammation of the brain:

  • Chickenpox (very rare)
  • Rubella
  • Measles

Arboviruses

Arboviruses are viruses that are carried by insects. The type of virus transmitted by arthropods depends on the insect. Here are the different types of arboviruses:

  • California encephalitis (additionally called la crosse encephalitis) is sent by mosquito chomps and chiefly influences children. It causes not many or no symptoms.
  • Louis encephalitis occurs in rural areas of the Midwest and Southern states. It is generally a mild virus and causes few symptoms.
  • West Nile virus is regularly found in Africa and the Middle East. However, it can occur in the United States. It is usually relatively mild, causing flu-like symptoms. However, it can be fatal among the elderly and people with weak immune systems.
  • Colorado encephalitis (additionally called Colorado tick fever) is communicated by the female wood tick. It is usually a mild illness, and most people will recover quickly.
  • Eastern equine encephalitis is spread by mosquitoes. It affects both humans and horses. Albeit uncommon, it has a 33 percent death rate.
  • Kayasanur forest disease is transmitted by tick bites. People can also get it by drinking raw goat, sheep, or cow’s milk. Hunters, campers, and farmers are most vulnerable to this disease.

How is encephalitis diagnosed?

Doctors use several tests to diagnose this disease, including:

  • Imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI), to check the brain for swelling, bleeding, or other problems
  • An electroencephalogram (EEG), which records electrical signals in the brain, to check for unusual brain waves
  • Blood tests to search for microscopic organisms or infections in the blood. These can also show whether the body is making antibodies (specific proteins that fight infection) in response to a germ.
  • A lumbar puncture, or spinal tap, which examines the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord) for signs of infection

Risk factors

Anyone can develop this disease. Include factors that may increase the risk:

  • Age: Some types of inflammation of the brain are more common or more severe in some age groups. In general, young children and the elderly are more likely to have most types of viral encephalitis.
  • Weak immune system: People with HIV / AIDS, who take immunosuppressive drugs or have another condition that causes a weakened immune system, are more likely to develop inflammation of the brain.
  • Geographical regions: Viruses transmitted by mosquitos or ticks are common in certain geographical areas.
  • Season this year: Diseases transmitted by mosquitoes and ticks tend to be more common in the summer in many areas of the United States.

Encephalitis treatment

The way to enduring encephalitis is the early discovery and powerful treatment of the fundamental reason. A group of masters cooperating is a significant factor in ideal consideration.

Patients may need to stay in the intensive care unit so that health care providers can monitor for seizures, brain swelling, respiratory failure, or heart rhythm changes.

Treatment for inflammation of the brain depends on the cause and the underlying symptoms, and may include:

  • Antivirals fight viral infections that affect the brain.
  • Antibiotics to treat bacterial infections that cause inflammation of the brain.
  • Immunotherapy, such as steroids, intravenous (IVIg) antibodies, or plasma exchange, to treat certain types of autoimmune encephalitis.
  • Medicines or other treatments to control seizures.
  • A breathing tube, urinary catheter, or feeding tube might be important if it makes an individual lose consciousness.

Patients with inflammation of the brain who have seizures that do not respond well to anti-seizure medications can benefit from a ketogenic diet, which is high in fat and low in carbohydrates. It has been effective in reducing seizures in drug-resistant epilepsy in children and adults, as well as in patients with autoimmune encephalitis such as NMDA receptor antagonist encephalitis.

Recovery

It can last from a few days to two or three months. After that, most people find they recover better from their symptoms within two or three months. It is common to feel fatigued after a serious illness, and most people find that they need a lot of rest during their recovery and that it is helpful to gradually return to daily activities.

Some people experience long-term effects of inflammation of the brain. Long haul indications can incorporate physical issues, memory issues, character changes, discourse issues, and epilepsy. Depending on your individual situation, you may benefit from physical therapy to help with physical problems or speech and language therapy to help with speech problems. Long haul indications can incorporate physical issues, memory issues, character changes, discourse issues, and epilepsy. Many people find these services an important part of long-term recovery and rehabilitation.

Complications of encephalitis

The majority of patients with inflammation of the brain have at least one complication, especially elderly patients, those who develop symptoms of coma, and individuals who did not receive treatment at an early stage.

Complications may include:

  • Memory loss – especially among people with HSV encephalitis
  • Behavioral or personality changes – such as mood swings, outbursts of frustration, anger, and anxiety
  • Epilepsy
  • Aphasia – language and speech problems

How can I prevent encephalitis?

Significant progress has already been made in preventing some causes of inflammation of the brain.

The elimination of smallpox and the use of vaccines against mumps, measles, and rubella reduced the incidence of inflammation of the brain, especially in children. Vaccines have been developed for people traveling to high-risk areas as well.

Other ways to prevent it are to avoid viruses that can lead to disease (such as herpes) and protect yourself from mosquito and tick bites.