Prostate cancer is a slow growing cancer that develops in men’s prostate gland. Prostate gland is a gland located in the male reproductive system (Cookson,2001).Most cases of this kind of cancer are slow growing even though aggressive kinds have been reported (Baade, Youlden & Krnjacki,2009).The cancer cells may spread (metastasize) from the prostate gland to other parts of the patient’s body (especially to lymph nodes and bones). Prostate cancer may cause severe pain, difficulty in urinating, sexual intercourse problems as well as erectile dysfunction. During the later stages of the disease, other symptoms may be seen.

The rates of detection varies widely across the globe with fewer cases being detected in South and East Asian and more cases being detected in Europe and the United States. This type of cancer is most common in men over the age of fifty (Siegel,2011).Globally, prostate cancer is the 6th leading cause of cancer-related deaths (Baade, Youlden & Krnjacki,2009).This kind of cancer is most common in developed nations but its rates are increasing in the developing world. Unfortunately, most men with prostate cancer never experience any symptoms of the disease, never undergo therapy and are eventually taken ill and even die of other unrelated complications. Several factors like diet and genetics have been implicated in the development of prostate cancer. Prostate cancer is noted to remain a cery common kind of cancer in mean aged over 50 (with an exclusion of skin cancer) with an estimated new cases in 2000 of 180,400. This figure represents a sharp decline from 334,500 cases that were reported sometime in January of 1977. Early detection as a result of PSA testing is what is credited with the sharp decline (AMA,2000;Landis et al.,1998).As noted earlier failure to detect this disease early and employ interventions leads to severe pain, difficulty in urinating, sexual intercourse problems as well as erectile dysfunction and death.

References

American Cancer Society (2000).Cancer Facts and Figures. Atlanta, Ga: The Society; 2000:1-40.

Baade, PD; Youlden, DR; Krnjacki, LJ (2009). “International epidemiology of prostate cancer: geographical distribution and secular trends..” Molecular nutrition & food research 53 (2): 171-84. PMID 1910194

Cookson, MS (2001).Prostate Cancer: Screening and Early Detection. Cancer Control, Vol. 8,(2).

Landis SH, Murray T, Bolden S, et al.(1998) Cancer statistics.CA Cancer J. Clin. 1998;48:6-29

Siegel R, (2011). “Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths..” CA Cancer J. Clin 61: 212 — 36. doi:10.3322/caac.20121. PMID 21685461.

Module 8 (a)

Burn Injuries

Burn, a term that McCance and Huether (2010) noted to be a generic term that is used in referring to the cutaneous injury that is caused by thermal, electrical or chemical agents is a major source of extensive tissue injury as well as destruction. The injury and destruction has far reaching effects in multiple organs. The most common causes of burn injuries are thermal, electrical, chemical as well as radioactive elements/agents.

How burn degree and severity are determined

There are several types of burn injuries. These are classified in accordance with the depth of the burn injury. The classification includes 1st degree, 2nd degree and 3rd degree burns. First degree burn affects the epidermis only. The second degree bum affects both the dermis and epidermis while the third degree burn affects the epidermis, the dermis as well as the underlying subcutaneous tissue (McCance & Huether, 2010).

The potential complications associated with the burn injuries

There are several complications that are associated with burn injuries. Bacterial infections is one of the complications associated with burn injuries. The use of antibacterial agents has howver reduced the cases of post-burn infection. Acute gastrointestinal ulcers are the other complications that are caused by burn injuries.These are treated by means of antacids as well as other drugs for reducing the level of acidic secretion. Post-burn seizures (usually in children) are another complication which results due to electrolytic imbalance, infection, low level of blood oxygen as well as drugs. Deep dermal burns and skin grafts too are complications associated with burn among brown-skinned races. Respiratory complications are ranked as the most common cause of death in burn patients. Pulmonary complications have also been reported.

All patients who suffered from inhalation injuries must be given a compulsory bronchoscopic examination so as to reveal the extent of respiratory injury and also to help in planning of the most suitable treatment.

References

McCance, K.A. & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed). St. Louis: Mosby.

Module 8 (B)

Hypovolemic shock

Hypovolemic shock is noted by McCance and Huether (2010) to be an emergency condition in which severe fluid and blood loss makes the victim’s heart unable to sufficiently pump enough blood to the victim’s body. This kind of shock is noted by McCance and Huether (2010) to result in multiple organ failure.

Brief case scenario presenting a patient who has experienced this type of shock

Mrs. Robertson was presented to the hospital with pale skin, was slipping into unconsciousness and sweating very heavily. She had been involved in a motor accident and had suffered massive hemorrhage on her left thigh. Her systolic blood pressure was 92 mmHg, and matched that of aperson suffering from stage 3 hypovolemic shock. Her leg had no pulse and fell unconscious after hemorrhaging profusely from the left thing. Her Cardiac output could not be maintained by arterial constriction. She had increase respiratory rate and increase diastolic pressure. Her pulse rate was to narrow.Afer first aid; she gained consciousness but was restless.

Associated pathophysiology

The condition is characterized by a massive loss in an individual’s intravascular volume that subsequently results in a decreased level of preload. Due to the fact that preload is one of the main determinants of stroke volume, the cardiac output automatically falls. The very initial case of hemodynamic abnormality of fluid loss inadvertently activates the rather compulsory mechanism under the control of the neuroendocrine system which maintains an adequate level of central perfusion irrespective of reduced level of cardiac output. Systemic vasoconstriction can however lead to hypoxia, tissue ischemia and ultimately to alteration of cellular function as well as global organ dysfunction in the worst case scenario (Worthley,2000).

Treatment of hypovolemic shock

The management of hypovolemic shock is critical since the condition is considered a medical emergency.The work of Shires (1979,p.139) clearly indicated that hypovolemic shock demands prompt recognition as well as treatment in order to prevent the complications associated with it as well as mortality due to prolonged as well as inadequate tissue perfusion. The tremetment involves seeking medical help while in the meantime, keeping the patients as warm and comfortable as possible (in order to prevent hypothermia). The person should be placed to lai down in a flat position with his or her feet lifted about twelve inches (in order to increase circulation).However, should the individual suffer from a neck, head, leg or back injury, then their position should never be changed since they are in immediate danger. Fluids should never be given by mouth. If the patient has an allergic reaction, then the allergy must first be treated. Should there be a need to move or carry the patient, then they should be kept flat with their head pointed downwards and their feet lifted. Their head and neck should be stabilized prior to moving any patient with a suspected spinal injury. The main goal of any hospital treatment is to effectively replace the lost fluids and blood. An IV line will need to be placed on the victim’s arm to allow for blood and any other blood products to be infused.

Pharmacological interventions such as dobutamine, dopamine, norepinephrine as well as epinephrine will then have to be administered to the patient so as to increase their blood pressure as well as the cardiac output. Other techniques like Heart monitoring, Swan-Ganz catheterization as well as Urinary catheter for collecting and monitoring how much urine is produced are also employed in order to manage as well as monitor the patient’s response to treatment.

References

McCance, K.A. & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6th ed). St. Louis: Mosby.

Shires, GT (1979).Management of hypovolemic shock. Bull NY Acad Med. 1979 February; 55(2): 139 — 149.

Worthley, LIG (2000).Shock: A Review of Pathophysiology and Management. Part I. Critical Care and Resuscitation 2000; 2: 55-65