Health

2023-07-13 16:59:36

Carotid artery disease in the neck

* Is surgery necessary to treat cervical artery stenosis?

– This is a summary of your questions regarding the doctor’s diagnosis of severe stenosis in one of the main neck arteries, and your previous stroke a few months ago, and its effects have gone away from you. However, the doctor suggested surgery to address this problem.

Note the following points in sequence:

• A diagnosis of carotid artery disease means that there are fatty deposits narrowing or blocking this important artery that carries blood to the head and brain. Having this narrowing increases the odds of having a stroke (symptoms lasting more than 24 hours) or a transient ischemic attack (symptoms that go away in less than 24 hours). A stroke means that all or most of the blood supply stops reaching the brain or parts of it. Thus, the brain will not get oxygen, and brain cells will begin to die within minutes. A transient ischemic attack is a temporary decrease in blood flow to the brain. This is why knowing and treating the causes of stroke is so important.

• Carotid artery disease often occurs gradually. The early stages of carotid artery disease usually have no symptoms, and the condition often progresses to a point where the narrowing is severe enough to block blood supply to the brain, causing symptoms of a stroke or transient ischemic attack.

Their symptoms include sudden numbness or weakness in the face or one part of the body, on one side of the body, or a sudden disturbance in the ability to speak and understand speech, or a sudden problem with vision in one eye or both eyes, or dizziness and loss of balance. Or a severe and sudden attack of headache. And if the person feels, or those around him notice that on him, it is worth going to the ambulance department urgently.

• The main pathogenetic mechanism of carotid artery disease is the buildup of fatty deposits – called plaques – in the arteries that carry blood from the heart to the brain. These deposits contain a mixture of clumps of cholesterol, fat and types of blood cells. This process is called “atherosclerosis”. What motivates the occurrence of these pathological changes in the components of the walls of the arteries of the neck is either the presence of high blood pressure, or diabetes, or smoking, or high levels of light cholesterol and triglycerides, in addition to obesity, advanced age, or sleep apnea. or lack of physical exercise.

• Clinical examination using a stethoscope, may show a murmur or noise over the site of the carotid artery in the neck. And the occurrence of this sound is due to blood flow through the narrowed area in the artery. Then the doctor resorts to ultrasound imaging, to assess the extent of blood flow, the amount of pressure in the carotid arteries, the degree of narrowing in them (percentage of the amount of narrowing), and other information. Sometimes a CT or MRI scan of the brain and arteries (often with dye) is done to assess whether the brain has any previous strokes (even if the person has not felt them before), or other problems in the brain or blood vessels within the brain. These scans also provide more information regarding blood flow in the carotid arteries and other nearby arteries.

• The presence of these narrowings (according to the percentage of their severity) in the carotid arteries in the neck, making it difficult for oxygen and nutrients to reach the brain. This may be evident in stroke. Specifically, between 10 and 15 percent of patients with these severe stenosis may have a stroke.

This occurs according to 3 possible scenarios: the first is the result of the development of severe carotid artery stenosis that prevents sufficient blood from reaching parts of the brain. The second is the fragmentation of part of those masses that are deposited in the walls of the arteries in the neck, and they are thrown into the cerebral arteries, and they get trapped in one of the arteries, which prevents blood flow from those smaller arteries inside the brain, and thus stops the blood from reaching one of the parts of the brain. And third, that the blood fluid itself may coagulate locally (coagulate to turn into a cohesive mass) on the surface of those wall accumulations inside the neck arteries, then that blood clot travels from that area to one of the brain arteries itself, which may cause it to be blocked, and thus a stroke occurs. Therefore, the increase in the size of these fatty accumulations, and the narrowing of the neck arteries, causes stroke through several possible mechanisms.

• In addition to following prevention steps (stopping smoking, controlling blood pressure levels, controlling cholesterol levels, controlling blood sugar, exercising, reducing weight, etc.), and in addition to the possibility that the doctor suggests taking medications that prevent blood clot formation, he may see The doctor states that it is necessary to conduct a radical treatment of these narrowings in the arteries of the neck, in order to expand the blood flow through them first, and to prevent the possibility of repercussions secondly, especially if there is severe narrowing in the carotid artery (i.e. it reaches between 70 and 90 percent), or You have already had a stroke or transient ischemic attack.

• One of the possible radical treatment methods is surgery to remove the carotid endarter, ie in which there are those large fatty accumulations (carotid endarterectomy). The other method is to perform a carotid angioplasty, to widen the narrowing through a catheter and by inserting a balloon, then installing a stent in the place of the expansion. That is, similar to what is done to treat narrowing of the coronary heart arteries. And medical advice depends on using one of the two methods, but each of them has reasons that you prefer over the other. That is, in some cases, surgery may be recommended as a first line of treatment, while in other cases dilatation and stent placement may be recommended as a first line of treatment.

• According to a review of many medical sources, the preference for any of the two methods of treatment depends on several factors, in the case of the arteries, the brain, the general health condition of the patient, and other factors he has, as well as the availability of treatment capabilities and medical experience in providing treatment.

To be clear, carotid endarterectomy is the most common treatment for severe cases of carotid artery disease that have caused cerebral symptoms (stroke). It is performed either under local or general anesthesia. During this procedure, the surgeon makes an incision across the front of the neck, opening the carotid artery and removing the masses blocking the artery. The surgeon then repairs the artery with stitches or a graft made from a vein or synthetic material. Surgery is often recommended.

Carotid angioplasty and stenting are preferred for blockages that are difficult to reach with carotid endarterectomy, or for people who have other conditions that make surgery too risky. However, several other factors remain with the patient, others with the doctor, and the availability of capabilities, which make the doctor who follows directly the patient’s condition the best in providing a proposal for the method of treatment, without another, to treat the condition of the patient himself.

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2023-07-14 13:02:31

The first study of its kind conducted in Quebec has detected traces of the presence of the hepatitis E virus in pork liver and in certain products that contain it.

Researchers at Laval University have thus found the RNA of the hepatitis E virus in raw pork livers and in nearly a third of the liver pâtés and country pâtés tested during the study. “We suspected that the virus was circulating in these animals, so especially in the pig which is one of the reservoirs of this virus, but we really wanted to confirm if it was the same thing as what was happening elsewhere ( in the world),” explained study leader Julie Jean, who is a professor in the Department of Food Sciences and a researcher at the Institute of Nutrition and Functional Foods at Laval University. “We wanted to have a better picture of what was going on (in Quebec). So we weren’t totally surprised to find the RNA of the virus. »

The researchers purchased, in the summer of 2022 and in Quebec grocery stores, 83 pâtés in which pork liver was one of the three main ingredients. They also obtained 79 samples of raw pork liver from slaughterhouses in different regions of Quebec. Twenty-nine percent of the pâtés and 4% of the raw pork liver samples contained virus RNA. The discrepancy is possibly due to the fact that manufacturers mix several pork livers to make a pâté. The researchers do not know at this time if the RNA comes from active viruses or if it is released by viruses destroyed during the heat treatment used to prepare the pâtés.

“We do not currently have a reliable enough method to be able to really determine if the infectious virus is inside the product, confided Ms. Jean. When we detect the RNA, we suspect very well that the virus was there at some point, but that does not guarantee us (…) that the virus can really cause illness. The next work by Ms. Jean and her team will also examine whether the processes for preparing pâtés and whether cooking pork liver are enough to render the virus harmless if ever it is present. Less known to the public than its cousins ​​A, B, C and D, hepatitis E is an inflammation of the liver caused by HEV, can we read on the site of the World Health Organization. The virus is transmitted by the faecal-oral route, mainly through contaminated water. Around 20 million people are believed to be infected with HEV each year, mainly in East Asia and South Asia.

Symptoms of hepatitis E – such as fever, yellowing of the skin, decreased appetite and vomiting – may be indistinguishable from those that accompany other hepatitis. No outbreak of hepatitis E attributable to the consumption of food containing pork infected with this virus has yet been reported in Quebec. These foods therefore appear to pose little risk to healthy individuals. In rare cases, however, warns the WHO, acute hepatitis E can be severe and progress to a life-threatening form of the disease. Pregnant women with hepatitis E, especially during the second and third trimesters, are at increased risk of acute liver failure, fetal loss and death, says the UN health agency, which specifies that up to “20-25% of pregnant women may die if they contract hepatitis E during the third trimester”.

Given current knowledge, the consumption of these products may therefore represent an unnecessary risk for some, warned Ms. Jean. “It remains a potential risk and which should be better assessed in order to ensure that pregnant women who wish to consume these products do not find themselves in a situation which can lead to quite serious complications”, she said. in conclusion. The study was published by the journal Frontiers in Sustainable Food Systems.

Photo credit: Pixabay.

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#Hepatitis #RNA #pork #liver #products

2023-07-14 13:13:00

After a long wait, right-back Kyle Walker has now apparently agreed to Bayern Munich. This is reported by several media unanimously.

After FC Bayern had been associated with Kyle Walker for weeks, the right-back is said to have now promised the Munich team.

According to a report by sky, a contract has already been agreed until 2025 plus an option for another season. An agreement between Bayern and Manchester City has not yet been reached. A transfer fee in the range of 15 million euros plus bonus payments is speculated.

Walker’s contract with Manchester City runs until 2024. If both clubs agree, Walker would probably be coach Thomas Tuchel’s first choice at right-back. Benjamin Pavard, who is yet to be sold, would rather play inside anyway and Noussair Mazraoui is seen more as a backup in Munich.

Walker joined the Skyblues from Tottenham in 2017 for 52.7 million euros and since then has mostly been a regular player, occupying all positions in the back four under Pep Guardiola and even playing in right midfield. Last season he played 39 competitive games and provided one assist.

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2023-07-14 09:46:00

Mahmoud Ragheb wrote on Friday, July 14, 2023 12:46 PM

The activities of a camp for case managers at the Women’s Complaints Office have been launched to raise awareness regarding mental health and the management of cases of violence once morest women, which it is organizing The National Council for Women In partnership with the United States Agency for International Development, which will last for 4 days, from July 13-16, 2023.

The camp aims to support the capabilities of workers in the complaints line of the National Council for Women “No. 15115”, psychologically and technically, through activities that help them relieve stress, prevent job burnout, and protect them from re-traumatization. It also provides them with technical skills in dealing with calls received by the hotline and managing cases of violence once morest women. They receive it daily.

The camp includes a discussion of many topics such as responsibility, roles and their impact on mental health, and how to deal with different types of callers.

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