It was in the 1960s-1970s that modern orthopedics took birth, especially after the contributions of Hugh Owen Thomas. Finally, intramedullary fixations were being done without opening up the fracture. This technology was popularized by the Harborview Medical Center in the Seattle group in the late 1970s.
Modern hip and joint replacement
The next big step in the evolution of orthopedics was joints and hip replacement which took place in the year 1960 by Sir John Charnley, an expert in tribology at Wrightington Hospital in England. He was the one who pioneered this procedure by conceiving that joint surfaces could be replaced with inserts made of inert high quality acrylic plastics. These implants were stuck to the bone surfaces with appropriate cements. His design for the hip joint consisted of a stainless-steel ball on a long stem to be inserted into the femur and an acrylic acetabular implant stuck to the acetabulum.
This prosthesis design was so successful that this and its derivatives were used popularly for over two decades, and the procedure was such a celebrated success that it became the model for all later joint replacements. This procedure found continual improvement both in design and procedure with many making significant contributions.
Exeter hip replacement system evolved in the same period. In this method, the stem of the ball had slightly different geometry. A father son duo, Dr. R.I. Harris and W.H. Harris at Harvard, developed and popularized uncemented arthroplasty or joint replacement. The implants were bonded to the bones directly.
Knee replacement
The next development was the knee replacement. Dr. McIntosh used the same techniques to replace the knee joints of rheumatoid arthritis patients. Later, Doctors Gunston and Marmor in the 1970s started to replace the knee joint for osteoarthritis patients using a joint design developed by Dr. John Instal in New York using a fixed bearing. This evidently had limitation on the range of movement of the joint. This was overcome by using a mobile bearing system by Doctors Frederick Buechel and Michael Pappas.
Fractures
The next great innovation originated in Germany when Dr. Gerhard Kuntscher introduced the intramedullary rods to fix fractures of femur and tibia in the 1960s. This quickened the recovery of these fractures considerably. Again, it took World War II to push this innovation to the world stage. Traction, however, continued as the standard treatment for these were not used till the 1970s.
In the last 30-40 odd years, modern orthopedic research has sought to make orthopedic surgeries less invasive and to make the components implanted in the body durable and better.
Chronic migraine is a condition where the affected person experiences at least 15 headache days a month. It is observed that at least 8 out of these 15 days are migraine headaches with severe symptoms, and this pattern of discomfort remains consistent for 3 months. Initially, it may not be a frequently occurring episode, however, with time, the episodes may get regular with chronic headaches. If left untreated, this condition can affect a person’s life.
Causes
Several factors determine the onset of this kind of migraine. One of them includes a steady increase in the frequency of episodic headaches. Over-the-counter treatment options that are used to treat frequent headaches stop affecting over time, leading to side effects that develop into chronic headaches. Some other factors that can put an individual at a high risk of developing this condition include mood disorders like anxiety or depression, snoring, excessive caffeine intake, ongoing disturbed sleep patterns, and a history of stressful life events causing emotional or physical trauma. An unhealthy lifestyle leading to an increase in the body mass index (BMI) can also be a causal factor.
Symptoms
There is no difference between symptoms of chronic migraines and episodic migraines. However, the only thing to notice is the increased frequency of episodic headaches in a month. Some typical symptoms of this illness can be observed for timely diagnosis and treatment.
Transitioning symptoms (episodic to chronic migraines)
Diagnosis
A health professional will take a look at the affected person’s health history. If needed, the doctor may ask questions that help understand the migraine patterns. The questions include how and when the migraines begin, how long they last, are there any notable physical factors or triggers that worsen the condition, and where the location of the pain is.
The professional may also ask for a detailed history of other health conditions like anxiety, depression, lifestyle choices that may trigger these headaches, any treatment options used, and possible side effects that could be factored into the diagnosis. Based on the results, appropriate treatment methods will be advised and implemented.
Treatment options
Most of the treatment methods focus on managing the symptoms, the migraine attacks, and reducing the episodes and pain.
One of the treatment therapies includes focusing on lifestyle changes.
Some other treatment options for managing migraine attacks include:
Other techniques include:
Also, maintain a headache diary and note down the possible triggers and the number of migraine attacks in a month. If there’s a notable increase in the attacks, consult a doctor at the earliest. Knowing the triggers can help the doctor chalk out an effective treatment plan.
Preventive treatments and methods
Apart from treatment options that help manage the symptoms, there are preventive treatment methods that reduce the episodes of these headaches to a certain extent. These include using beta blockers and other therapies. One such treatment method also includes using an Allergan product named BOTOX®, which doctors recommend for those 18 years and older. The intravenous treatment method is administered around the neck or the head, where the migraine pain usually affects the person. This ten-minute procedure is not painful and can prevent headaches for three months. The procedure takes place in a doctor’s clinic under close supervision.
Chronic migraine can be painful and disrupt everyday life activities, so choosing the right treatment plan is crucial. Get all the information from a licensed health professional and seek the best possible treatment plan according to a detailed diagnosis.
Melanoma is a type of skin cancer that develops in the cells that produce melanin. The pigment melanin is responsible for giving the skin its color. Advanced melanoma can form inside one’s nose, throat, or digestive tract. Studies show that the risk of melanoma increases in people under 40, especially women. Knowing the early signs of the disease is crucial since melanoma can be treated successfully if detected early.
Stages
There are five stages of melanoma. The cancer cells of Stage 0 melanoma are restricted to the epidermis, the top layer of skin. The epidermis and dermis, the deeper layer of the skin, both contain cancer cells in Stage I melanoma. Stage II melanoma is marked by tumor thickness and ulceration, while Stage III is marked by melanoma deposits in the skin and cancer spreading to nearby lymph nodes. The advanced stage of melanoma, also called metastatic skin cancer, shows the further spread of cancer to distant areas of the body.
Causes of advanced melanoma
The exact cause of melanoma is unknown, although exposure to harsh ultraviolet (UV) radiation, tanning beds, or lamps has been shown to increase one’s risk of getting the disease. One can develop skin disease anywhere in one’s body. Those with a family history of the disease or exposure to radiation or vinyl chloride are also vulnerable to metastatic melanoma.
Signs of advanced melanoma
An early sign of melanoma is the development of an unusual mole. Normal moles are minor and uniform in size and color. But melanoma moles have irregular shapes or borders and can be larger than 6 millimeters. If a mole grows in size, color, and shape and causes itchiness, it’s best to get it checked. Advanced melanoma may lead to chronic fatigue, swollen lymph nodes or liver, loss of appetite, jaundice, skin itchiness, headaches, and even seizures. Depending on where the metastatic melanoma has spread, one may experience chest pain, breathing issues, aching bones, paralysis, sleepiness, and swelling in one’s legs or abdomen.
Melanoma treatment options
The American Cancer Society reports that the five-year survival rate for patients with melanoma that has spread to surrounding lymph nodes is 66%. Surgery is a common way to treat it. Targeted therapy is another method to eliminate the tumor and its metastases selectively. Alternatively, immunotherapy aids a person’s immune system in recognizing and shrinking cancer cells. Other treatments for metastatic skin cancer include chemotherapy and radiation therapy.
Conclusion
Opdulag is a standard treatment for advanced melanoma skin cancer. The therapy, given by intravenous (IV) infusions, works with one’s immune system and is used to fight cancer that has spread or cannot be surgically removed. If one experiences any early signs of melanoma skin cancer, it’s recommended to consult a doctor immediately.