“Some Facts about Psoriasis:

• 33% of psoriasis patients report social interactions are impacted
• 59% report the condition is a problem in their everyday lives
• 52% are dissatisfied with treatment
• 72% are overweight or obese, increasing the risk of other chronic conditions“

National Psoriasis Foundation  (https://www.psoriasis.org/wellness).

“Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp. Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission.”

MAYO CLINIC

“Autism spectrum disorder (ASD) is a complex developmental disability, typically appearing during childhood and affecting a person’s ability to communicate and interact with others.”.

Autism Society (https://www.autism-society.org)”.

What is autism spectrum disorder?

Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect daily functioning.

The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013) includes Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. A diagnosis of ASD includes an assessment of intellectual disability and language impairment.

ASD occurs in every racial and ethnic group, and across all socioeconomic levels. However, boys are significantly more likely to develop ASD than girls. The latest analysis from the Centers for Disease Control and Prevention estimates that 1 in 68 children has ASD.

What are some common signs of ASD?

Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.

The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.

Social impairment and communication difficulties Many people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other people’s feelings or talk about their own feelings.

People with ASD may have very different verbal abilities ranging from no speech at all to speech that is fluent, but awkward and inappropriate. Some children with ASD may have delayed speech and language skills, may repeat phrases, and give unrelated answers to questions. In addition, people with ASD can have a hard time using and understanding non-verbal cues such as gestures, body language, or tone of voice. For example, young children with ASD might not understand what it means to wave goodbye. People with ASD may also speak in flat, robot-like or a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Repetitive and characteristic behaviors Many children with ASD engage in repetitive movements or unusual behaviors such as flapping their arms, rocking from side to side, or twirling. They may become preoccupied with parts of objects like the wheels on a toy truck. Children may also become obsessively interested in a particular topic such as airplanes or memorizing train schedules. Many people with ASD seem to thrive so much on routine that changes to the daily patterns of life — like an unexpected stop on the way home from school — can be very challenging. Some children may even get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.

What disorders are related to ASD?

Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome (which causes intellectual disability) and tuberous sclerosis (which causes benign tumors to grow in the brain and other vital organs) — each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases.

People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life — before age 3 — appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder.

How is ASD diagnosed?

ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps. Very early indicators that require evaluation by an expert include:

• no babbling or pointing by age 1
• no single words by age 16 months or two-word phrases by age 2
• no response to name
• loss of language or social skills previously acquired
• poor eye contact
• excessive lining up of toys or objects
• no smiling or social responsiveness

Later indicators include:

• impaired ability to make friends with peers
• impaired ability to initiate or sustain a conversation with others
• absence or impairment of imaginative and social play
• repetitive or unusual use of language
• abnormally intense or focused interest
• preoccupation with certain objects or subjects
• inflexible adherence to specific routines or rituals

Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of ASD, a more comprehensive evaluation is usually indicated.

A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose and treat children with ASD. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for ASD, children with delayed speech development should also have their hearing tested.

“August is National and World Breastfeeding Awareness Month, and experts and mothers from more than 170 countries agree: Breast milk is best when it comes to feeding a baby in the first year of life. Like trees, teeth contain growth rings that can be counted to estimate age. Teeth rings also incorporate dietary minerals as they grow. Breast milk contains barium, which accumulates steadily in an infant’s teeth and then drops off after weaning.”

NIH – National Institute of Health

“It it estimated for lung cancer in the United States for 2020 are: About 228,820 new cases of lung cancer (116,300 in men and 112,520 in women) About 135,720 deaths from lung cancer (72,500 in men and 63,220 in women). Jan 8, 2020″

American Cancer Society

For many people, the first sign that they may have lung cancer is the appearance of a suspicious spot on a chest x-ray or a CT scan. But an image alone is not enough to tell you whether you have cancer and, if so, what type of cancer it is.

Most people who come to us for a lung cancer diagnosis first meet with a surgeon. He or she will work with pathologists, radiologists, and other lung cancer specialists to determine the specific type of lung cancer you have and how advanced it is. These findings help your disease management team develop the most successful treatment plan for you.

The first step is for your doctor to get a tissue sample using one of several biopsy methods. Then a pathologist — a type of doctor who specializes in diagnosing disease —who focuses on lung cancer studies the tissue under a microscope to determine whether you have lung cancer and, if so, what type. He or she will be able to tell this by looking closely at the cancer cells’ shape and other features.

Knowing which type of lung cancer you have will help your doctors to stage the tumor accurately and to begin identifying the best treatment approach. Understanding what type of cancer you have is also important because each type responds differently to certain chemotherapy drugs.

Testing healthy people for lung cancer

Several organizations recommend people with an increased risk of lung cancer consider annual computerized tomography (CT) scans to look for lung cancer. If you’re 55 or older and smoke or used to smoke, talk with your doctor about the benefits and risks of lung cancer screening.

Tests to diagnose lung cancer

If there’s reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend:

• Imaging tests. An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.
• Sputum cytology. If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.
• Tissue sample (biopsy). A sample of abnormal cells may be removed in a procedure called a biopsy.Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that’s passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest wall and into the lung tissue to collect suspicious cells.A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.

“Lung cancer staging is way of describing where the lung cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Treatment options are available for all stages of lung cancer, and knowing the stage helps your healthcare team:

• Understand how advanced your lung cancer is
• Recommend those treatment options that are likely to be most effective for you
• Evaluate your response to treatment”.

LUNGEVITY (Lungevity.org)

Understanding if and where lung cancer has spread (the stage) is important to determining what options are available for treatment. Imaging tests, biopsies and laboratory tests help to determine staging.

Non-small cell lung cancer is one of several cancers staged using the TNM system. The cancer is staged according to the size of the tumor (T), the extent to which the cancer has spread to the lymph nodes (N), and the extent to which the cancer has spread beyond the lymph nodes, or metastasis (M).

The TNM staging system:

• Was created by merging the staging systems of the American Joint Committee on Cancer (AJCC) http://www.cancerstaging.org/ and the International Union Against Cancer (UICC) http://www.uicc.org/ in 1987
• Is one of the most commonly used cancer staging systems
• Standardizes cancer staging internationally

How big is the tumor? Where is it located? Has it spread to nearby tissue?

Has the cancer spread to the lymph nodes in and around the lungs? For more information on the lymph system and lymph nodes, see Lymph System

Has the cancer spread to other parts of the body?

After the Tumor (T), Lymph Nodes (N) and Metastasis (M) have been determined, the cancer is then staged accordingly:

Small cell lung cancer is most often staged as either limited-stage or extensive-stage.

Limited-Stage

Indicates that the cancer has not spread beyond one lung and the lymph nodes near that lung.

Extensive-Stage

The cancer is in both lungs or has spread to other areas of the body.

International Association for the Study of Lung Cancer. Goldstraw P, ed. Staging Handbook in Thoracic Oncology. Orange Park: Editorial Rx Press; 2009.

“Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale.  Lung cancer is the leading cause of cancer deaths worldwide. People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked.”

MAYO CLINIC