Saturday, December 30, 2006

Types of Mesothelioma

Mesothelioma is a cancer that normally presents in malignant form and results in tumours around vital organs of the body. The mesotelium is a sac that lines and protects vital organs such as the heart and the lungs. And Mesothelioma diseases causes the cell of the lining to become abnormal and malignant.

Mesothelioma comes in three forms including of pleural mesothelioma, perioteneal mesothelioma, and pericardial mesothelioma.

Pleural Mesothelioma :
This is the most commont of mesothelioma where the cancer affects the lungs and the protective lining and cavity of the lungs.
Symptoms :
  • Difficulty in breathing;
  • Difficulty in swallowing;
  • Shortness of breath;
  • Persistent coughing;
  • Weight loss;
  • Fever;
  • Coughing up of blood; and
  • Rasping.

Peritoneal Mesothelioma :
This is rarer of mesothelioma where the cancer affects the stomach and abdomen. It can start in the abdominal area and spreads to other part of the body.
  • Abdominal pain;
  • Abdominal swelling;
  • Nause and loss of appetite;
  • Vomiting;
  • Breathing problem;
  • Chest pain;
  • Bowel obstruction;
  • Anemia;
  • Fever; and
  • Blood clotting abnormalities.

Pericardial Mesothelioma:
This is the rarest of mesothelioma where the cancer affects to the heart and the cavity surrounds the heart.
  • Chest pain;
  • Shortness of breath;
  • Trouble breathing;
  • Persistent coughing; and
  • Palpitations.

The symptoms for all three types of mesothelioma are non specific. It means that they could be the result of a number of more commont diseases associated with the same symptoms. Keep on your eyes and be aware of any mesothelioma symptoms that can be present.

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Sunday, December 17, 2006

How to Stage Pleural Mesothelioma

Mesothelioma is one of diseases that almaost 100% preventable. The only known cause is through exposure of asbestos. Mesothelioma can be staged by three staging systems : Brutchart system, TNM system and Brighan system. Brutchart system is the oldest one to stage mesothelioma by extent of primary tumor mass. TNM system stages mesothelioma by considering of tumor in mass and spread, lymph node involvement, and metastasis. The latest one is Brigham system, stages mesothelioma by resectability and lymph node involvement, whether the mesothelioma can be surgically removed or not and whether the lymph nodes are affected or not.

Burchart System
Stage I: Presence of mesothelioma in the lining of the right lung and may involve the diaphragm on the same side.
Stage II: Mesothelioma spreads to the chest wall or esophagus, heart, or lung lining on both side.
Stage III: Mesothelioma penetrates throguh the diaphragm into the lining of the abdominal cavity or peritoneum.
Stage IV: Mesothelioma spreads to other organ (metastasis).

TNM System
Stage I: Mesothelioma involves the lining of the right or left lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
Stage II: Mesothelioma spreads to the lining of the lung on one side and a lumpht node on the same side.
Stage III: Mesothelioma exists in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side as the primary tumor.
Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends into the lung opposite the primary tumor, or directly into organs in abdominal cavity or nex (metastasis).

Brigham System
Stage I: The tumor is resectable (can be surgically removed) and lymph nodes are unaffected.
Stage II: The tumor remains respectable but the mesothelioma affects the lymph node.
Stage III: The tumor is not resectable and extends into the chest wall, heart, or through diaphragma, and pertoneum.
Stage IV: Mesothelioma becomes metastatic into distant organs.

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Friday, December 15, 2006

Nurse and Personal Digital Assistant

PDA or Personal Digital Assistant is a handheld device that is designed as personal organizer to store many informations such as calender, games, address book, accesing the internet, sending and receiving e-mail, video recording, use as radio or stereo, and other database.

Nurses can use PDA to support their profesional job. Nurses can put a variety of searchabel databases on PDA that can be accessed when they need as quick as possible. They can store many nursing / medical database on PDA such as : assessment skill and tool, laboratory values, drug list, IV drug and infusion information, emergency algorithms, reference books, and any nuring information.

It is legal for nurses to keep PDA on their pocket during their duty. Of course it is not used for playing game or other unuseful things.

When using a PDA, consider to choose what types of software nurses might wanto to use with it. There are a lot of softwares availabe now on market. Many sites that I have found selling so many medical/nursing software especially for PDA such as HERE or HERE. Search any sites on internet just to guide you as nurses to buy mdical/nursing software for your PDA.

So, if you are a nurse and you got PDA, install any medical/nursing software that you need and keep your PDA in your pocket as quick reference.

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Thursday, December 14, 2006

Differences CPR for Lay Rescuers and Healthcare Providers

CPR is a lifesaving procedure that is performed when someone's breathing or heartbeat has stopped, as in cases of electric shock, drowning, or heart attack. It is a combination of recue breathing and chest compressions. And of course it is best performed by trained person in and accredited CPR course.

When you find an unconscious person who is not breathing in the field, you should deal with him as soon as possible not more than 4 minutes. The reason is permanent brain damage begins after only 4 minutes. It is a golden periode. Wether you are lay person or healthcare person, you shoud deal with him. Part of Basic and Advanced Life Support is CPR. I don't explain algorythm of Basic and Advanced Life Support here.

Now I am going to post the differences in CPR for lay rescuers and healthcare provider as follow here:

Lay rescuers should immediately begin cycles of chest compression and ventilation after delivering 2 rescue breaths for an unresponsive victim. They are not trained to assess for pulse or signs or circulation for an unresponsive victim.

Lay rescuer will not be trained how to provide rescue breathing without chest compression.

For sudden collapse in victims of all ages, the lone healthcare provider should telephone the emergency number and get an AED then return to the victim to begin CPR and use AED.

For unresponsive victims of all age the lone healthcare provider should deliver about 5 cycles (2 minues) of CPR before leaving the victim to call emergency number and get AED then return to the victim and begin CPR and use AED.

Healthcare providers should attempt to feel a pulse after delivery of 2 rescue breathing in the unresponsive and non breathing victim not more than 10 second. If the provider does not definitely feel a pulse within 10 seconds, provider should begins cycles of chest compression and ventilation.

Healthcare providers are trained to deliver rescue breaths without chest compression for the respiratory arrest victim. Rescue breaths without chest compressions should be delivered about 10-12 breaths per minute for adult and 12-20 per minute for infant and child.

Healthcare providers should deliver cycles of compression and ventilation during CPR even there is no advanced airway in place. When the advanced airway is in place for infant, child, or adult victims, 2 rescuers no longer deliver "cycles" of compression interrupted with pasuses for ventilation. Instead the compression should deliver 100 compression per minute continuously without pauses for ventilation. Ventilation shoud be given 8 - 10 breaths per minute and should be careful to avoid delivering an excessive number of ventilation. Two rescuers should change compressor and ventilator roles every 2 minues to prevent fatique and deterioratin of quality and rate of chest compression. Or when rescuers more than two rescuers, they should rotate the compressor role every 2 minutes. And the switch should be performed as quickly as possible to minimize interruption in chest compression.

source: American Heart Association journal or you can see here for detail.

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Saturday, December 09, 2006

Glasgow Coma Scale


The Glasgow Coma Scale GCS) was first published by Glasgow-based Teasdale & Jennett (1974) to assess head trauma and to help keep track of patients' progress over a period of time. The Scale will evaluates the patient's level of awareness, which indirectly indicates the extent of neurologic injury.The scale is comprised of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered.

The GCS is scored between 3 and 15, 3 being the worst, and 15 the best.


Eye Opening Response

  • Spontaneous--open with blinking at baseline 4 points
  • To verbal stimuli, command, speech 3 points
  • To pain only (not applied to face) 2 points
  • No response 1 point

Verbal Response

  • Oriented 5 points
  • Confused conversation, but able to answer questions 4 points
  • Inappropriate words 3 points
  • Incomprehensible speech 2 points
  • No response 1 point

Motor Response

  • Obeys commands for movement 6 points
  • Purposeful movement to painful stimulus 5 points
  • Withdraws in response to pain 4 points
  • Flexion in response to pain (decorticate posturing) 3 points
  • Extension response in response to pain (decerebrate posturing) 2 points
  • No response 1 point

The sum obtained in this scale is used to the assess Coma and Impaired consciousness

  • Mild: score 13 - 15 points
  • Moderate: score 9 - 12 points
  • Severe: score 3 - 8 points
  • Coma: score less than 8 points

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Friday, December 08, 2006

Stop Female Genital Mutilation

Press release from International Council of Nurses on 29 November 2006, commending Muslim Scholar's call to end Female Genital Mutilation (FGM).

Female genital mutilation (FGM), often referred to as 'female circumcision', comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons (WHO).

The most common type of female genital mutilation is excision of the clitoris and the labia minora, accounting for up to 80% of all cases; the most extreme form is infibulation, which constitutes about 15% of all procedures.

International Conference on FGM sponsored by German Human Groups on 24 Novermber 2006 in Cairo, Egypt was attended by muslim scholar from many nations. They declared FGM to be contrary to Islam and practice is criminalized.

"The conference appeals to all Muslims to stop practicing this habit, according to Islam's teachings which prohibit inflicting harm on any human being. ... The conference reminds all teaching and media institutions of their role to explain to the people the harmful effects of this habit in order to eliminate it. ... The conference calls on judicial institutions to issue laws that prohibit and criminalize this habit ... which appeared in several societies and was adopted by some Muslims although it is not sanctioned by the Qur'an or the Sunna."

We are in our position to oppose FGM and safe womans and girls from suffering FGM around the world and prevent them from the risk of practice.


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Wednesday, December 06, 2006

Who is a nurse?

A nurse is a health care professional who is engaged in the practice of nursing. Nurses are responsiblewith other health care professionals for the treatment, safety, and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research and perform a wide range of non-clinical functions necessary to the delivery of health care.

Nursing education, regulation, roles, and titles vary in different countries, but in general reflect an increasing level of responsibility and status.

Talk about nursing? What is the practice of nursing?
Nursing is a profession focused on assisting individuals, families and communities in attaining, re-attaining and maintaining optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life. (

This is the first of my post talk all about nurse, the special job and profession I have been doing since my graduate in 1996.

Let me talk about everything in nursing science and skills.

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