Lumbar Metastatic Disease Diagnosis

Lumbar Metastatic Disease Diagnosis Arlena Davis What additional historical information do you want to collect from the patient? Healthcare professionals are supposed to gather historical information from the patient when diagnosing lumbar pain. Gathering historical information ensures proper diagnosis of lumbar pain and treatment. The following historical information would be obtained from the patient. The doctor will determine whether the patient has had any spinal problems since birth. Also, the doctor will determine whether the patient has had lumbar pain before and any treatment. In addition, the physician will determine whether the lumbar pain was sudden or gradual. This is by asking the patient to describe how the pain began. Further, the patient will be required to state what increases or decreases the pain including rest or activity. Additionally, understanding the family history is vital in diagnosing lumbar pain. The health professional should determine if there is family history of lumbar pain. The doctor determines whether the patient is suffering from any disease that might cause the lumbar pain. Injuries and accidents can cause lumbar pain and the health professional should determine if the patient had an accident or injury. Wong,  D.A., Transfeldt, E., Macnab, I. (2007).  Macnab’s backache. Philadephia: Lippincott Williams and Wilkins What additional physical examination should you complete immediately and why? Physical examination is vital when diagnosing lumbar pain. Additional physical examinations are required to determine whether the patient has lumbar pain or not. The patient will do several movements while sitting, lying down and standing. This will make it easy to assess muscular and sensory problems causing the pain. Palpation is critical in identifying the affected area. Palpation helps the doctor feel tenderness and alignment of joints. This helps identify the inflamed lumbar area. Also, examining the leg pulse as pain increases the pulse. General examination of legs and trunk is done to identify the causes of the lumbar pain. Straight leg testing and nerve tests are done to determine whether the patient symptoms are due to pressure on the nerves or nerve compression. Tollison, C.D., Satterthwaite, J.R., Tollison, J.W. (2002).  Practical pain management. Philadephia: Lippincott Williams and Wilkins What differentials should you consider? A differential diagnosis is important when diagnosing lumbar pain as different diseases cause pain. Various diseases affecting the bladder, colon, abdomen aorta and kidney can cause pain. Therefore, different tests should be performed to rule out the diseases. Abdominal and pelvic ultrasounds are critical in ruling out the diseases. Clinical and neurological observations should be done to eliminate the diseases. CT, MRI, blood tests, urine tests, and complete blood tests are needed to differentiate different diagnoses. Beirman, R., Bull, P., Eaton, S.(2011). Cases in differential diagnosis for the physical and manipulative therapies. Australia: Elsiever Australia The clinical scenario suggests what diagnosis? The diagnosis shows that the patient has lumbar metastatic disease. The in house lumbar x-ray showed that lumbar vertebrae had lesions which are a sign for metastatic disease. The metastatic disease causes pain in the lumbar area. Metastatic disease occurs when cancer cells break away from a cancerous tumor and travel though the blood and lymph vessels to other regions including the lumbar vertebrae. The cancer cells settle in the lumbar vertebrae and start to grow and produce new tumors. The metastatic disease compresses or damages nerves and causes pain. Rabbani, S.A., Singh, G. (2007).  Bone metastasis: Experimental and clinical therapeutics. New York City: Springer Why does he have an elevated calcium and alkaline phosphatase? The patient has high levels of alkaline phosphate and calcium. He has alkaline phosphates of 850 and calcium of 11. The high levels of calcium and alkaline phosphates are due to the metastatic disease. Cancer cells affect the bones including lumbar vertebrae and damage them. Calcium is released into the blood as the cancer cells damage the bones. The level of calcium in the blood increases as more bones are damaged. The high levels of calcium in the blood lead to loss of appetite. The levels of alkaline phosphates increase as the damaged bones dissolve. Therefore, the high levels of alkali phosphates and calcium show that the lumbar vertebrae are damaged and have dissolved. The elevated levels of alkali phosphates can also be due to liver damage as the patient has hepatomegaly. Lipton, A et al. (2011). The Science and Practice of Bone Health in Oncology: Managing Bone Loss and Metastasis in Patients With Solid Tumors. J Natl Compr Canc Netw, s1-s30 Why does he have hepatomegaly and elevated ALT/AST? The patient has hepatomegaly which is the swelling of the liver. Cancer metastases cause the liver to swell. The patient has a swollen liver because of the metastatic disease. Cancer cells have spread to the liver and caused inflammation or swelling of the liver. Liver function tests are used to determine liver functioning or the condition of a patient’s liver. The tests include AST and ALT. The AST and ALT tests were done to determine whether the patient had liver damage. AST and ALT levels are raised if the patient has liver damage. The patient’s AST and ALT levels are 600 and 700 respectively. The AST and ATL levels can increase suddenly showing a sudden liver injury or gradually depicting continuing liver damage. Thus, the patient AST and ALT levels are high because he has liver injury caused by the metastatic disease. Wallach, J.B.(2007).  Interpretation of diagnostic tests. Philadephia: Lippincott Williams and Wilkins What additional screening blood test can help you confirm your diagnosis? Why is it used? There are different blood tests that can be used to confirm metastatic disease diagnosis. Blood chemistries can be done. A blood test is done to determine the amount of calcium in the blood. Calcium dissolves in the blood after bones are damages and this increases calcium levels. The patient is said to have metastatic disease if he has abnormal levels of calcium(high levels).A blood test is done to determine the level of alkaline phosphates in the blood as high levels show metastatic disease. A complete blood count can also be done as patients with metastatic bone diseases have no enough red blood cells. Schwab, M. (2008).  Encyclopedia of cancer. New York City: Springer References Beirman, R., Bull, P., Eaton, S. (2011). Cases in differential diagnosis for the physical and manipulative therapies. Australia: Elsiever Australia Lipton, A et al. (2011). The Science and Practice of Bone Health in Oncology: Managing Bone Loss and Metastasis in Patients With Solid Tumors. J Natl Compr Canc Netw, s1-s30 Rabbani, S.A., Singh, G. (2007).  Bone metastasis: Experimental and clinical therapeutics. New York City: Springer Schwab, M. (2008).  Encyclopedia of cancer. New York City: Springer Tollison, C.D., Satterthwaite, J.R., Tollison, J.W. (2002).  Practical pain management. Philadephia: Lippincott Williams and Wilkins Wallach, J.B. (2007).  Interpretation of diagnostic tests. Philadephia: Lippincott Williams and Wilkins Wong, D.A., Transfeldt, E., Macnab, I. (2007).  Macnab’s backache. Philadephia: Lippincott Williams and Wilkins

Poetry :: Poem to a friend

To a Friend Whose Work Has Come to Triumph In the poem "To a Friend Whose Work Has Come to Triumph", Anne Sexton alludes to the flight of Icarus and Daedalus and to "To a Friend Whose Work Has Come to Nothing" to convey a message to a friend. I think this poem was written to reassure a friend that what she did was the right thing. Perhaps a father figure of the friend advised her to do something and she defied him, making herself feel worried that she did the wrong thing. William Butler Yeats once wrote a poem titled "To a Friend Whose Work has Come to Nothing". It was a poem believed to be written to reassure a friend that what she ended up doing was a noble thing even though in reality she failed her original task. The title of Sexton's poem is an obvious allusion to Yeats' poem. Sexton changed "Nothing" to "Triumph" in her title. Sexton's friend must have been a fellow poet to be able to catch the allusion to Yeats' poem. I believe she wanted her friend to know that what she did was the right thing. Perhaps she compared her friend to Yeats' friend. Sexton wrote "Think of the difference it made!" referring to Icarus' flight. She might have wanted her friend to realize a difference her defying her father made. The final line of the poem has a comparably different tone than the first 13 lines. The last line, "See him acclaiming the sun and come plunging down while his sensible daddy goes straight into town.", seems more mocking of Daedalus' flight. It seems that Sexton feels that Daedalus' flight was a wasted chance and was in no way adventurous. She might also be comparing her friend to Icarus, seeing as he too failed his initial task but accomplished something greater on a global scale. I believe Sexton thought that Icarus' flight was not foolish or a failure, but adventurous and a great personal success, even though his satisfaction and personal glory was short-lived.

Research Project: Margaret Bourke-White Essay

Margaret Bourke – White, an American journalist photographer, was born in New York City on June 14, 1904. She was raised in a strict household. During her time in high school she became the yearbook editor and that is when she started showing her writing talent. Raised in a strict household, Bourke-White attended local public schools in Bound Brook, New Jersey, after her family moved there. In high school Bourke-White served as the yearbook editor and showed promise in her writing talents. After High school she kept on moving back and forth from the East to the Midwest, that was the reason why she attended several different universities. After tried out several different fields of studies, she discovered photography and decided to continue her education in this field. She received her bachelor’s degree in 1927. After her graduation she opened a studio in Cleveland, Ohio. At first she specialized in architectural photography, that was when she started taking pictures of the Otis Steel factory. Her work resulted to be some of the best steel factory pictures of that era, and these earned her national attention, by the publisher Henry Luce in Time magazine. Bourke-White became the associate editor and staff photographer of Fortune magazine, from 1929 till 1935. During that time she became the first western photographer who was allowed to document the Soviet Industry through photographs. That was a trigger to make her think about her work, from taking photographs for advertising, which was very profitable. She changed her perception on photography; she discovered how it is more of a powerful tool used to inform and influence the people, than an artistic medium. In 1937 she started working on a photo essay with Erskine Caldwell, whom she later on married in 1936, on revealing the social conditions in South America. Together they published a book, ‘You Have Seen Their Faces’ with their work from the photo essay, which became her best-known book. Never the less, this photo essay was one of the reasons why she was hired in Life magazine. During her time in Life magazine she composed her most famous single photograph, while covering the Louisville flood. Being a photographer doesn’t only mean taking photographs, but it’s to live and experience what you as a photographer are trying to show the world. It could be very dangerous and you will face a lot of obstacles. Bourke-White had no fear, all she cared about is to document and show the world what was happening. She was the first female photographer to document what was happening during the World War 2, and who was allowed  to work in the combat zones. She went was in Russia during the time Germany boomed Moscow for the first time, and that was when she decided to become a war correspondent. Of course this made her see horrors, which she could have never dreamt of seeing. At first she kept on going back and forth between the US Army Forces on the front lines of North Africa and Italy. During that time She experienced a torpedo attack on a ship she was taking to North Africa. This did not make her change her mind on covering the war, even after the fire she repeatedly came under in Italy in areas of fierce fighting. Her photos showed emotions and revealed the horrors to the war. There we two photographs she took during the war that had a great effect on the American population. The first one was a photo she took in Buchenwald camp, which was published in TIME magazine in 1945. Buchenwald camp was a concentration camp, where thousands of Jews were taken hostage and killed. Margaret was able to take a picture of the Jewish corpses that were piled on top of each other. It was a shocking picture that showed the suffering of the Jews and the cruelty of Nazi German. The second picture showed a Nazi mother who is covering both of her children with a white cloth. The story behind this picture is more shocking that what we saw. This mother killed her children after her husband was killed during the war, and then she ended up committing suicide. After the war was over Bourke White went back to documenting about humanitarian issues, which lead her to India. Two years after the Second World War, partition problems occurred between India and Pakistan that ended to be very violent. She was very keen to record all these horror to show to the world. She took photographs of dead victims with open eyes, streets filled with corpses and refugees with vacant eyes. These pictures touched a lot of people, some of them were displayed at â€Å"the posh shopping center Khan Market† in Delhi, India, and sixty-six of them were added in 2006 in a republished book called, ‘Train to Pakistan’. During her time in India, Bourke White took this chance to go photograph and interview Mohandas K. Gandhi. A lot of people regard her as being very lucky to have taken this interview, because a couple of hours after she left him he was assassinated. Her next destination was South Africa; she spent five month there documenting the unfair social and political treatment of black people and the cruelty of apartheid. After that she decided to fly to South Korea  to document the war that was going on during that time. Unfortunately that was her last trip, she discovered that she had the Parkinson’s disease, in 1956. She didn’t give up and fought back. She started working on her autobiography, Portrait of Myself that was published in 1963. She then died in 1971, due to her illness. Margaret was a strong and determined woman. She didn’t only play a big role in changing the people’s perspectives on the sufferings and problems that were around the world and the reality of things, but also how a woman can do a mans job. This wasn’t something common at that time. She has proved to the world that women can do everything, no matter how hard it is and her work reflected that. She crossed all barriers to make history and became well known around the world.

Terrorism Is Caused By Multiple Factors - Free Essay Example

Sample details Pages: 4 Words: 1220 Downloads: 8 Date added: 2019/07/30 Category Society Essay Level High school Tags: Terrorism Essay Did you like this example? From 1970 to 2017, 2014 had the greatest number of fatalities of 44,490 deaths worldwide (Roser et al.). Terrorism is an issue known as a worldwide threat of violence motivated by political and religious views. There are numerous contributions to this issue, and the main causes terrorism are the internet and social media. This issue can also be caused by cultural, religious, and political beliefs and individual reasons. Due to these causes, there are consequences that follow which create damaging negative effects. These effects include an extreme number of deaths and injuries, an increasing raise in financial costs, and tons of property are destroyed, leaving people homeless and traumatized. Terrorism is an extremely dangerous problem that happens worldwide, caused by terrorist organizations who are motivated by different beliefs or individual views. This leads to negative effects that cause long-term damages to everyone in affected countries. Don’t waste time! Our writers will create an original "Terrorism Is Caused By Multiple Factors" essay for you Create order Terrorism is caused by multiple factors, such as the internet and religion and political beliefs, which motivate terrorist organizations to cause massive destruction. Terrorism is not considered a local issue but is also a worldwide issue that could happen anywhere. Some factors include . Terrorism occurs worldwide, however there are many countries, such as Iraq, Afghanistan, and Nigeria, that are more affected compared to others. In 2014, there were 44,490 fatalities worldwide (Roser et al.). 2014 had the greatest number of fatalities from terrorist attacks compared to all other years up to 2017. While 2014 had 44,490 fatalities, the most recent year, 2017, on the other hand, had 26,445 fatalities worldwide (Roser et al.). There is a visible decrease between the two years, showing that the amount of deaths have lessened. However, among of all the countries, Iraq has the deaths. Iraq does not only have the most deaths, but they also have the greatest number of injuries, striking at 16,804 injuries in 2014 and 4,916 injuries in 2017 (Roser et al.). Compared to 2014, Iraq seems to have three to four times less injuries in 2017. While Iraq had 16,804 injuries in 2014, other countries had far less injuries: Afghanistan had 5,111, Nigeria had 2,283, Pakistan had 3,388, India had 776, China had 478, the United States had 19, and the United Kingdom had 4 (Roser et al.). In 2017, Iraq had 4,916 injuries, meanwhile Afghanistan had 6,027 injuries: Nigeria had 1,031, Pakistan had 3,388 injuries, China had 76, the United States had 932, and the United Kingdom had 301 (Roser et al.). Afghanistan was the only country in 2017 to have more injuries than Iraq, while the other countries listed had less. The number of injuries from 2014 and 2017 decreased in Nigeria and China, remained the same in Pakistan, and increased in the United States and the United Kingdom. According to the map in 2017, the top three regions with the greatest number of terrorist incidents are Iraq with 2,466, Afghanistan with 1,414, and Pakistan with 719 (Roser et al.). However, of all countries, Iraq still remains to be the top nation most affected by terrorism. Iraq is more affected contrasted to other nations because Iraq is a small, poor, developing country that lacks special resources in their economy (Bandyopadhyay et al.). This means that Iraq is not as advanced in technology and equipment, so it is easier for terrorist groups to attack this nation, while it is harder for terrorist groups to attack a larger and richer economy. The effects of terrorism are excruciatingly devastating, leading to associated costs which include deaths, financial costs, and loss of property. In a terrorist attack, thousands of people are either kidnapped or killed. Terrorist attacks can also cause serious indirect harm to neighboring countries and their economies, and there are even worse effects in smaller countries with developing economies, such as Israel and Colombia (Bandyopadhyay et al.). When there is an attack, economic resources, markets, transportation, restaurants, and owned property are striked and destroyed by bombers (Bandyopadhyay et al.). This outcome causes an extreme loss of property, causing a tremendous raise in financial costs. The raise causes a decline in production and advancement and trade reduction. This result affects the neighboring countries as well because the neighboring countries would have to help the affected country by providing money to pay off the raise in insurance. For example, in the 911 Attack, the Twin Towers of New York collapsed, killing approximately 2,996 people, estimating $80 billion in losses (Bandyopadhyay et al. ; Sawe). This highlights the amount of damage a terrorist attack is capable of doing. To prevent the threat of terrorism, strong and lasting solutions are required to ensure the safety of citizens. Governments of different nations and international groups can help raise awareness or create strategies to tackle terrorism. Many countries are working on different solutions to help contribute to decreasing terrorism. One country includes Turkey, involving the Turkish government and the Prime Ministers Chief Adviser Akdogan. When the Turkish government stresses on developing a lasting solution to lessen terrorism, Akdogan states the goal is not simply to manage the problem on a temporary basis, but to bring it to a final and permanent solution (Turkish Adviser Outlines Plan for Tackling Terrorism). Akdogan indicates how terrorism should not be taken as a trivial problem and should instead be thoroughly looked into to solve this problem. Despite terrorism being a problem in the last thirty years, Akdogan remains determined to create better solutions. This leads to Akdogans six steps to achieve goal: being determined, not taking any shortcuts, getting more involvement and support from citizens, maintaining common sense, and staying hopeful but being realistic about the outcomes (Turkish Adviser Outlines Plan for Tackling Terrorism). These fundamental steps can be used to put an effect into Akdogans goal. As each step is completed, the issue of terrorism will gradually decrease. International authorities are also involved with minimizing the extreme amount of terrorist attacks. One international group is the Federal Bureau of Investigation, the FBI, a national security organization which ensures to help protect and support the country by clarifying threats and ways for protection. The FBI lists three ways for people to protect themselves: 1. Remain aware of surroundings; 2. Refrain from oversharing personal info; and 3. Say something if you see something (Terrorism). It is essential for the people to fulfill these steps to stay safe in their environment. Since the FBIs number one priority is protecting the United States from terrorist attacks, the FBI devises different methods for protection that people from all over the world can follow. Overall, terrorism is an extremely dangerous threat that causes many negative effects toward thousands of people in affected countries. This issue is caused by political or religious beliefs, the internet involving social media, and individual reasons or emotions. Although terrorism is increasing in some parts of the world, there are solutions to reduce this problem, including being aware of the environment, getting more involvement and ideas from citizens, and gaining support from international or government groups. Works Cited Bandyopadhyay, Subhayu et al. The Toll of Terrorism. Finance Development, vol. 52, no. 2, June 2015, pp. 26-28, elibrary, explore.proquest.com/document/1685875351? accountid=164834. HLS 101 Terrorism. Definition, History, and Types of Terrorism, Eastern Kentucky University, [circa 2018], hlsonline.eku.edu/hls-101-terrorism. Roser, Max et al. Terrorism. Our World in Data, Jan. 2018, ourworldindata.org/terrorism. Sawe, Benjamin Elisha. Worst Terrorist Attacks In World History. World Atlas, 21 Nov. 2016, www.worldatlas.com/articles/worst-terrorist-attacks-in-history.html. Terrorism. FBI, FBI, 3 May 2016, www.fbi.gov/investigate/terrorism. Turkish Adviser Outlines Plan for Tackling Terrorism. BBC Monitoring European, 21 Feb. 2013, elibrary, explore.proquest.com/document/1291068536?accountid=164834. Understanding Terrorism. ReachOut Australia, [circa 2018], au.reachout.com/articles/ understanding-terrorism.