Factors that increase the risk of developing DVT include:

Factors that increase the risk of developing DVT include:

Major surgery

Immobility, such as being in the hospital and long travel

Recent injury

Increased estrogen, from birth control pills, pregnancy, and certain medications

Certain chronic medical illnesses, such as heart disease and cancer

Previous DVT

Age (risk increases as age increases)

Obesity

Smoking

Know the symptoms of DVT and PE:

Deep Vein Thrombosis (DVT)

About half of people with DVT have no symptoms at all. For those who do have symptoms, the following are the most common and occur in the affected part of the body (usually the leg):

Swelling

Pain

Tenderness

Redness of the skin

Pulmonary Embolism (PE)

If you have a PE, you might:

Find it hard to breathe

Have a faster than normal heart beat

Have chest pain or discomfort, which usually worse with a deep breath or coughing

Cough up blood

Have very low blood pressure or lightheadedness, or black out

If you have any of these symptoms, you should seek medical help immediately.

Five steps you can take to protect yourself:

When sitting for long periods of time, such as when traveling for more than four hours:

Get up and walk around every 2 to 3 hours.

Exercise your legs while you're sitting by:

Raising and lowering your heels while keeping your toes on the floor.

Raising and lowering your toes while keeping your heels on the floor.

Tightening and releasing your leg muscles.

Drink plenty of water, and avoid drinking anything with alcohol or caffeine in it.

Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.

If you are at increased risk, talk to your doctor about wearing graduated compression stockings (sometimes called "support hose" or "medical compression stockings").

If you are at increased risk, talk to your doctor about medication (anticoagulants) to prevent or treat DVT.

Exercise regularly, maintain a healthy weight, and don't smoke.

CDC Activities

CDC is conducting research to learn more about risk factors for DVT and the effects of thrombophilia (inherited risks for DVT) on pregnancy. In addition, CDC funds a research network of specialized thrombosis and hemostasis centers, as well as a health promotion and wellness initiative to provide people with information about how to prevent DVT and its complications.

CDC Division of Blood Disorders

Deep Vein Thrombosis/Pulmonary Embolism, CDC Health Information for International Travel 2008

Travelers' Health

March is Deep Vein Thrombosis Awareness Month

Deep vein thrombosis (also called DVT or blood clots) occurs when a blood clot forms in a large vein. Part of a clot may break off and travel through the bloodstream to the lungs, causing a pulmonary embolism (PE) and, possibly, death. Take simple steps to protect yourself.

March is Deep Vein Thrombosis Awareness Month. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) are a major public health problem in the United States. Estimates suggest that 350,000 to 600,000 Americans have a DVT or PE each year, and that at least 100,000 people die as a result. Many of those who have a DVT or PE also have complications that can greatly impact their quality of life.

Everybody should know the risk factors, symptoms, and steps they can take to protect themselves.

Factors that increase the risk of developing DVT include:

Major surgery

Immobility, such as being in the hospital and long travel

Recent injury

Increased estrogen, from birth control pills, pregnancy, and certain medications

Certain chronic medical illnesses, such as heart disease and cancer

Previous DVT

Age (risk increases as age increases)

Obesity

Smoking

Know the symptoms of DVT and PE:

Deep Vein Thrombosis (DVT)

About half of people with DVT have no symptoms at all. For those who do have symptoms, the following are the most common and occur in the affected part of the body (usually the leg):

Swelling

Pain

Tenderness

Redness of the skin

Pulmonary Embolism (PE)

If you have a PE, you might:

Find it hard to breathe

Have a faster than normal heart beat

Have chest pain or discomfort, which usually worse with a deep breath or coughing

Cough up blood

Have very low blood pressure or lightheadedness, or black out

If you have any of these symptoms, you should seek medical help immediately.

cdc

DVT Awareness

Are You At Risk for Deep Vein Thrombosis?

Deep vein thrombosis (also called DVT or blood clots) occurs when a blood clot forms in a large vein. Part of a clot may break off and travel through the bloodstream to the lungs, causing a pulmonary embolism (PE) and, possibly, death. Take simple steps to protect yourself.

 March is Deep Vein Thrombosis Awareness Month. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) are a major public health problem in the United States. Estimates suggest that 350,000 to 600,000 Americans have a DVT or PE each year, and that at least 100,000 people die as a result. Many of those who have a DVT or PE also have complications that can greatly impact their quality of life.

Everybody should know the risk factors, symptoms, and steps they can take to protect themselves.

Factors that increase the risk of developing DVT include:

• Major surgery
• Immobility, such as being in the hospital and long travel
• Recent injury
• Increased estrogen, from birth control pills, pregnancy, and certain medications
• Certain chronic medical illnesses, such as heart disease and cancer
• Previous DVT
• Age (risk increases as age increases)
• Obesity
• Smoking

Know the symptoms of DVT and PE:

Deep Vein Thrombosis (DVT)

About half of people with DVT have no symptoms at all. For those who do have symptoms, the following are the most common and occur in the affected part of the body (usually the leg):

• Swelling
• Pain
• Tenderness
• Redness of the skin

Pulmonary Embolism (PE)

If you have a PE, you might:

• Find it hard to breathe
• Have a faster than normal heart beat
• Have chest pain or discomfort, which usually worse with a deep breath or coughing
• Cough up blood
• Have very low blood pressure or lightheadedness, or black out

If you have any of these symptoms, you should seek medical help immediately.

Five steps you can take to protect yourself:

1. When sitting for long periods of time, such as when traveling for more than four hours:

• Get up and walk around every 2 to 3 hours.
• Exercise your legs while you're sitting by:
  • Raising and lowering your heels while keeping your toes on the floor.
  • Raising and lowering your toes while keeping your heels on the floor.
  • Tightening and releasing your leg muscles.
  • Drink plenty of water, and avoid drinking anything with alcohol or caffeine in it.

1. Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.
2. If you are at increased risk, talk to your doctor about wearing graduated compression stockings (sometimes called "support hose" or "medical compression stockings").
3. If you are at increased risk, talk to your doctor about medication (anticoagulants) to prevent or treat DVT.
4. Exercise regularly, maintain a healthy weight, and don't smoke.

CDC

Vein Problems

Vein Problems Related to Varicose Veins

A number of vein problems are related to varicose veins, such as telangiectasias (tel-AN-juh-ek-TA-ze-uhs), spider veins, varicoceles (VAR-i-ko-seals), and other vein problems.

Telangiectasias

Telangiectasias are small clusters of blood vessels. They’re usually found on the upper body, including the face.

These blood vessels appear red. They may form during pregnancy and often are found in people who have certain genetic disorders, viral infections, or other medical conditions, such as liver disease.

Because telangiectasias can be a sign of a more serious condition, see your doctor if you think you have them.

Spider Veins

Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body.

Spider veins often show up on the legs and face. They usually look like a spider web or tree branch and can be red or blue. They usually aren’t a medical concern.

Varicoceles

Varicoceles are varicose veins in the scrotum (the skin over the testicles). Varicoceles may be linked to male infertility. If you think you have varicoceles, see your doctor.

Other Related Vein Problems
< Other types of varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on the face and neck.

Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus.

NIH

Lordosis

Spinal Diseases

Skeletal spine

Lordosis Lordosis is an increased curving of the spine.

Considerations

The spine has three types of curves:

Kyphotic curves refer to the outward curve of the thoracic spine (at the level of the ribs).

Lordotic curves refer to the inward curve of the lumbar spine (just above the buttocks).

Scoliotic curving is a sideways curvature of the spine and is always abnormal.

A small degree of both kyphotic and lordotic curvature is normal. Too much kyphotic curving causes round shoulders or hunched shoulders (Scheuermann's disease).

Too much lordotic curving is called swayback (lordosis). Lordosis tends to make the buttocks appear more prominent. Children with significant lordosis will have a significant space beneath their lower back when lying on their back on a hard surface.

If the lordotic curve is flexible (when the child bends forward the curve reverses itself), it is generally not a concern. If the curve does not move, medical evaluation and treatment are needed.

Causes

Achondroplasia

Benign juvenile lordosis (not medically significant)

Spondylolisthesis

Home Care

If the back is flexible, lordosis is usually not treated and will not progress or cause problems.

When to Contact a Medical Professional

Call your health care provider if you notice that your child has an exaggerated posture or a curve in the back. The condition should be evaluated to determine if there is a medical problem.

nih

Ingredient in Botanicals Tied to Urinary Cancer

New research links a carcinogen known as aristolochic acid, which is found in some Chinese herbal products, including guan mu-tong, to a higher risk of urinary tract cancer.

The findings were reported online Dec. 21 in the Journal of the National Cancer Institute.

The study involved 4,594 people in Taiwan who had just been diagnosed with urinary tract cancer, as well as a random sample of 174,701 people from the country.

The cancer rate was higher among those who had been prescribed more than 60 grams of mu-tong (which the researchers said might have had guan mu-tong in it) and among people who had consumed an estimated 150 milligrams or more of aristolochic acid.

"In addition to a ban on products that contain any amount of aristolochic acid, we also recommend continued surveillance of herbs or Chinese herbal products that might be adulterated with aristolochic-acid-containing herbs," the researchers wrote. "Finally, patients with a history of aristolochic acid nephropathy or consumption of mu-tong or fangchi before they were banned should be monitored regularly for urinary cancer."

Many countries, including Taiwan, have banned products, including botanicals, that contain aristolochic acid, according to a news release from the journal's publisher.

The researchers acknowledged that their finding came with caveats — including that participants in the study might have taken other herbs that were not prescribed and that the analysis did not take smoking into account.

Women's Health

Winter Weather Safety

Be Prepared: Staying Safe and Healthy in Winter Weather

Winter storms and cold temperatures can be hazardous, but if you plan ahead, you can stay safe and healthy. Prepare your home and cars. Keep emergency kits stocked. Be ready for power outages. Wear appropriate clothing. Check on children, the elderly and pets.

Although winter comes as no surprise, many of us are not ready for its arrival. If you are prepared for the hazards of winter, you will be more likely to stay safe and healthy when temperatures start to fall.

Many people prefer to remain indoors in the winter, but staying inside is no guarantee of safety. Take these steps to keep your home safe and warm during the winter months:

• Winterize your home.

• • Install weather stripping, insulation, and storm windows.
  • Insulate water lines that run along exterior walls.
  • Clean out gutters and repair roof leaks.

• Check your heating systems.

• • Make sure that your heating system is clean, working properly, and ventilated to the outside.
  • Inspect and clean fireplaces and chimneys.
  • Install a smoke detector. Test batteries monthly.
  • Have a safe alternate heating source and alternate fuels available.
  • Prevent carbon monoxide (CO) emergencies.
    • Install a CO detector to alert you of the presence of the deadly, odorless, colorless gas.
    • Learn symptoms of CO poisoning: headaches, nausea, and disorientation.
    • Keep grills and generators out of the house and garage. Position generators at least 25 feet from the house.

• Be prepared for weather-related emergencies, including power outages.

• • Stock food that needs no cooking or refrigeration and water stored in clean containers.
  • Keep an up-to-date emergency kit, including:
    • battery-operated devices, such as a flashlight, a National Oceanic and Atmospheric Administration (NOAA) Weather Radio, and lamps;
    • extra batteries;
    • first-aid kit and extra medicine;
    • baby items; and
    • cat litter or sand for icy walkways.

Many people spend time outdoors in the winter working, traveling, or enjoying winter sports. Outdoor activities can expose you to several safety hazards, but you can take these steps to prepare for them:

• Wear appropriate outdoor clothing: layers of light, warm clothing; mittens; hats; scarves; and waterproof boots.
• Sprinkle cat litter or sand on icy patches.
• Learn safety precautions to follow when outdoors.

• • Be aware of the wind chill factor.
  • Work slowly when doing outside chores.
  • Take a buddy and an emergency kit when you are participating in outdoor recreation.
  • Avoid traveling when the weather service has issued advisories.
  • If you must travel, inform a friend or relative of your proposed route and expected time of arrival.
  • Carry a cell phone.

• Prepare your car for winter.

• • Service the radiator and maintain antifreeze level; check tire tread or, if necessary, replace tires with all-weather or snow tires
  • Keep gas tank full to avoid ice in the tank and fuel lines.
  • Use a wintertime formula in your windshield washer.
  • Keep a winter emergency kit in your car in case you become stranded. Include
    • blankets;
    • food and water;
    • booster cables, flares, tire pump, and a bag of sand or cat litter (for traction);
    • compass and maps;
    • flashlight, battery-powered radio, and extra batteries;
    • first-aid kit; and
    • plastic bags (for sanitation).
  • Learn safety rules to follow in case you become stranded in your car.
    • Stay with your car unless safety is no more than 100 yards away, but continue to move arms and legs.
    • Stay visible by putting bright cloth on the antenna, turning on the inside overhead light (when engine is running), and raising the hood when snow stops falling.
    • Run the engine and heater only 10 minutes every hour.
    • Keep a downwind window open.
    • Make sure the tailpipe is not blocked.

Above all, be prepared to check on family and neighbors who are especially at risk from cold weather hazards: young children, older adults, and the chronically ill. If you have pets, bring them inside. If you cannot bring them inside, provide adequate, warm shelter and unfrozen water to drink.

No one can stop the onset of winter. However, if you follow these suggestions, you will be ready for it when it comes.

CDC

Bone Cancer

1. What is bone cancer? Bone cancer is a malignant (cancerous) tumor of the bone that destroys normal bone tissue (1). Not all bone tumors are malignant. In fact, benign (noncancerous) bone tumors are more common than malignant ones. Both malignant and benign bone tumors may grow and compress healthy bone tissue, but benign tumors do not spread, do not destroy bone tissue, and are rarely a threat to life.

   Malignant tumors that begin in bone tissue are called primary bone cancer. Cancer that metastasizes (spreads) to the bones from other parts of the body, such as the breast, lung, or prostate, is called metastatic cancer, and is named for the organ or tissue in which it began. Primary bone cancer is far less common than cancer that spreads to the bones.

2. Are there different types of primary bone cancer? Yes. Cancer can begin in any type of bone tissue. Bones are made up of osteoid (hard or compact), cartilaginous (tough, flexible), and fibrous (threadlike) tissue, as well as elements of bone marrow (soft, spongy tissue in the center of most bones).

   Common types of primary bone cancer include:

   • Osteosarcoma, which arises from osteoid tissue in the bone. This tumor occurs most often in the knee and upper arm (1).

   • Chondrosarcoma, which begins in cartilaginous tissue. Cartilage pads the ends of bones and lines the joints. Chondrosarcoma occurs most often in the pelvis (located between the hip bones), upper leg, and shoulder. Sometimes a chondrosarcoma contains cancerous bone cells. In that case, doctors classify the tumor as an osteosarcoma.

   • The Ewing Sarcoma Family of Tumors (ESFTs), which usually occur in bone but may also arise in soft tissue (muscle, fat, fibrous tissue, blood vessels, or other supporting tissue). Scientists think that ESFTs arise from elements of primitive nerve tissue in the bone or soft tissue (2). ESFTs occur most commonly along the backbone and pelvis and in the legs and arms (3).

   Other types of cancer that arise in soft tissue are called soft tissue sarcomas. They are not bone cancer and are not described in this resource.

3. What are the possible causes of bone cancer? Although bone cancer does not have a clearly defined cause, researchers have identified several factors that increase the likelihood of developing these tumors. Osteosarcoma occurs more frequently in people who have had high-dose external radiation therapy or treatment with certain anticancer drugs; children seem to be particularly susceptible. A small number of bone cancers are due to heredity. For example, children who have had hereditary retinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma, particularly if they are treated with radiation. Additionally, people who have hereditary defects of bones and people with metal implants, which doctors sometimes use to repair fractures, are more likely to develop osteosarcoma (4). Ewing sarcoma is not strongly associated with any heredity cancer syndromes, congenital childhood diseases, or previous radiation exposure (2).
4. How often does bone cancer occur? Primary bone cancer is rare. It accounts for much less than 1 percent of all cancers. About 2,300 new cases of primary bone cancer are diagnosed in the United States each year (5). Different types of bone cancer are more likely to occur in certain populations:

   • Osteosarcoma occurs most commonly between ages 10 and 19. However, people over age 40 who have other conditions, such as Paget disease (a benign condition characterized by abnormal development of new bone cells), are at increased risk of developing this cancer.

   • Chondrosarcoma occurs mainly in older adults (over age 40). The risk increases with advancing age. This disease rarely occurs in children and adolescents.

   • ESFTs occur most often in children and adolescents under 19 years of age. Boys are affected more often than girls. These tumors are extremely rare in African American children.

5. What are the symptoms of bone cancer? Pain is the most common symptom of bone cancer, but not all bone cancers cause pain (1). Persistent or unusual pain or swelling in or near a bone can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause.
6. How is bone cancer diagnosed? To help diagnose bone cancer, the doctor asks about the patient’s personal and family medical history. The doctor also performs a physical examination and may order laboratory and other diagnostic tests. These tests may include (1):

   • X-rays, which can show the location, size, and shape of a bone tumor. If x-rays suggest that an abnormal area may be cancer, the doctor is likely to recommend special imaging tests. Even if x-rays suggest that an abnormal area is benign, the doctor may want to do further tests, especially if the patient is experiencing unusual or persistent pain.

   o A bone scan, which is a test in which a small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it then collects in the bones and is detected by a scanner.

   o A computed tomography (CT or CAT) scan, which is a series of detailed pictures of areas inside the body, taken from different angles, that are created by a computer linked to an x-ray machine.

   o A magnetic resonance imaging (MRI) procedure, which uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body without using x-rays.

   o A positron emission tomography (PET) scan, in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.

   o An angiogram, which is an x-ray of blood vessels.

   • Biopsy (removal of a tissue sample from the bone tumor) to determine whether cancer is present. The surgeon may perform a needle biopsy or an incisional biopsy. During a needle biopsy, the surgeon makes a small hole in the bone and removes a sample of tissue from the tumor with a needle-like instrument. In an incisional biopsy, the surgeon cuts into the tumor and removes a sample of tissue. Biopsies are best done by an orthopedic oncologist (a doctor experienced in the treatment of bone cancer) (1). A pathologist (a doctor who identifies disease by studying cells and tissues under a microscope) examines the tissue to determine whether it is cancerous.

   • Blood tests to determine the level of an enzyme called alkaline phosphatase. A large amount of this enzyme is present in the blood when the cells that form bone tissue are very active—when children are growing, when a broken bone is mending, or when a disease or tumor causes production of abnormal bone tissue. Because high levels of alkaline phosphatase are normal in growing children and adolescents, this test is not a completely reliable indicator of bone cancer (1, 6) .

7. What are the treatment options for bone cancer? Treatment options depend on the type, size, location, and stage of the cancer, as well as the person’s age and general health. Treatment options for bone cancer include surgery, chemotherapy, radiation therapy, and cryosurgery.

   • Surgery is the usual treatment for bone cancer. The surgeon removes the entire tumor with negative margins (no cancer cells are found at the edge or border of the tissue removed during surgery). The surgeon may also use special surgical techniques to minimize the amount of healthy tissue removed with the tumor.

   Dramatic improvements in surgical techniques and preoperative tumor treatment have made it possible for most patients with bone cancer in an arm or leg to avoid radical surgical procedures (removal of the entire limb). However, most patients who undergo limb-sparing surgery need reconstructive surgery to maximize limb function (1).

   • Chemotherapy is the use of anticancer drugs to kill cancer cells. Patients who have bone cancer usually receive a combination of anticancer drugs. However, chemotherapy is not currently used to treat chondrosarcoma (1).

   • Radiation therapy, also called radiotherapy, involves the use of high-energy x-rays to kill cancer cells. This treatment may be used in combination with surgery. It is often used to treat chondrosarcoma, which cannot be treated with chemotherapy, as well as ESFTs (1). It may also be used for patients who refuse surgery.

   • Cryosurgery is the use of liquid nitrogen to freeze and kill cancer cells. This technique can sometimes be used instead of conventional surgery to destroy the tumor (1).

8. Is follow-up treatment necessary? What does it involve? Yes. Bone cancer sometimes metastasizes, particularly to the lungs, or can recur (come back), either at the same location or in other bones in the body (1). People who have had bone cancer should see their doctor regularly and should report any unusual symptoms right away. Follow-up varies for different types and stages of bone cancer. Generally, patients are checked frequently by their doctor and have regular blood tests and x-rays. People who have had bone cancer, particularly children and adolescents, have an increased likelihood of developing another type of cancer, such as leukemia, later in life. Regular follow-up care ensures that changes in health are discussed and that problems are treated as soon as possible.

Selected References

1. Malawer MM, Helman LJ, O’Sullivan B. Sarcomas of bone. In: DeVita VT, Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. Vol. 2. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2004.
2. Pizzo P, Poplack DG, editors. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincott Williams and Wilkins, 2002.
3. Ries LAG, Smith MA, Gurney JG, et al., editors. Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975-1999. Bethesda, MD: National Cancer Institute, 1999.
4. Miller RW, Boice JD, Curtis RE. Bone cancer. In: Schottenfeld D, Fraumeni JF, editors. Cancer Epidemiology and Prevention. 2nd ed. New York: Oxford University Press, 1996.
5. American Cancer Society (2008). Cancer Facts and Figures 2008. Atlanta, GA: American Cancer Society. Retrieved March 13, 2008, from http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf.
6. Fischbach FT, Dunning MB. A Manual of Laboratory and Diagnostic Tests. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2004.

National Cancer Institute

Bladder Cancer

Bladder cancer is extremely rare in children. The most common carcinoma to involve the bladder is transitional cell carcinoma, which generally presents with blood in the urine. The diagnosis and treatment of bladder cancer are the same for children, adolescents, and adults. Adolescents who develop this tumor are often prone to the development of other cancers. Bladder cancer in adolescents may develop as a late effect of certain chemotherapy Bladder Cancer Treatment drugs given for other childhood tumors or leukemia.

National Cancer Institute

Pleuropulmonary Blastoma

Pleuropulmonary blastomas are rare tumors that usually occur under the tissue covering the lungs. Changes in a specific chromosome may be found in pleuropulmonary blastoma. Every cell in the body contains DNA (genetic material stored inside chromosomes) that determines how the cell looks and acts. Part of the DNA in chromosome 8 is often abnormal in these tumors. Early-stage pleuropulmonary blastoma develops as a cyst -like tumor in the lung. It usually appears in the first 2 years of life and has a good prognosis. Late-stage tumors are solid and can spread to the brain. When the tumor can be completely removed by surgery at any time during treatment, the chance of recovery is improved. The tumor may recur or spread, in spite of surgical removal. There are no standard treatment options for pleuropulmonary blastoma. Early-stage tumors may be treated with surgery alone, or surgery with adjuvant chemotherapy to help prevent the tumor from coming back. Late-stage tumors may be treated with surgery followed by chemotherapy. Radiation may be used when the tumor cannot be surgically removed. A family history of cancer in close relatives has been noted for many young patients affected by this tumor. Pleuropulmonary blastoma may also occur in siblings of patients.

National Cancer Institute

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