Angioplasty

Angioplasty is one potential treatment for vascular disease and blocked or narrow arteries.It may be recommended to treat blockages within your arteries. An angioplasty is performed when a very thin wire and a small balloon are passed across the blockage in your artery. The balloon is inflated to push the plaque apart. An angioplasty is using a balloon to expand and dilate a narrowed or blocked vessel. Not all vessel bloackages are best treated with an angioplasty. The JVI is committed to having the latest in technology that can allow endovascular techniques such as angioplsty to be available to patients.It may be recommended to treat blockages within your arteries. An angioplasty is performed when a very thin wire and a small balloon are passed across the blockage in your artery. The balloon is inflated to push the plaque apart.

While the balloon is inflated, you may feel some cramping pain. This is only temporary and will go away once the balloon is deflated. After the balloon is deflated, the blockages will be smaller, allowing blood to flow.

How Angioplasty performed

Your body isn’t cut open except for a very small incision in the skin over a blood vessel in the leg, arm or wrist through which a small, thin tube (catheter) is threaded and the procedure performed. Angioplasty can take 30 minutes to several hours, depending on the difficulty and number of blockages and whether any complications arise.

What Is a Stent?

A stent is a small mesh tube that’s used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body.

In the late 1970s, doctors began using balloon angioplasty to treat narrowed coronary arteries. During this procedure, a very thin, long, balloon-tipped tube, called a catheter, is inserted into an artery in either the groin or arm and is moved to the site of the blockage with help from an X-ray. The balloon at the tip of the catheter is then inflated to compress the blockage and restore blood flow, and then it’s deflated to allow the catheter and balloon to be removed.

How Angiplasty works

Angioplasties may be done to expand a partially blocked artery or during or after a heart attack when the need to open blocked vessels is critical.

During an angioplasty, a small balloon at the end of the catheter is inflated, sometimes several times, to widen the artery. This typically reduces blockage from 70-90% to about 20-30%. When the artery is widened, a stent, a tiny coil of wire mesh, only about three quarters of an inch long, is often inserted into the artery to keep it from narrowing again. The balloon is again inflated and the stent springs open. The balloon catheter is removed and the stent remains permanently in place. Drug-eluting stents are coated with medication and may be used to prevent clot formation and restenosis (renarrowing of the artery).

Most angioplasty patients stay in the hospital overnight. Typically, aspirin or another medication is prescribed to keep the blood from clotting. If a stent has been implanted, clopidrel will usually be prescribed to keep clots from forming inside the stent.

A successful angioplasty will immediately relieve chest pain, increase blood flow to your heart and throughout your body, and give you more energy. But angioplasty is only one alternative for treating blocked arteries. Other options are drug therapy to dissolve clots, or coronary artery bypass graft surgery, especially for patients with small arteries or with multiple or severe blockages.

Frequently Asked Questions:

1. How does an angioplasty work?
Answer: Angioplasty uses a high pressure ballon of a diameter close to that of the intended target vessel. By expandning the balloon, the atherosclerotic plaque is disrupted and remodeled into a larger lumen. This is done via a catheter and guidewire placed into your vessels. Typical patients can go home the same day if an angioplasty is all that is required.
2. Where does an angioplasty work the best?
Answer: Angioplasty works best in large vessels with short, even narrowings. As a vessel becomes smaller (as in the smaller vessels in the leg), completely blocked (or occluded), unevenly narrowed, or the lesions become longer, an angioplasty has less benefit.
3. How can an angioplasty not work? 
Answer: An angioplasty can fail immediately by causing a vessel to ‘dissect’, or split on the inside. It also can not break the hardened artery in a way that does not recoil. Over time, an angioplasty can narrow down from scarring on the inside, or from progression of your hardening of the arteries from continued Atherosclerosis. This is especially so if you are a smoker of tobacco and continue to smoke!
4. What can be done if an angioplasty is not successful? 
Answer: Some vessel angioplasties can be salvaged for a good outcome with the placement of a Stent. A Stent is a mettalic mesh frame in the shape of a tube that is of similar size to your actual vessel. This can correct for the dissections that occur. Stents also decrease elastic recoil of the vessel. Stents as a primary mode for angioplasty have not been shown to increase long term patency however. The stented vessel is still subject to internal scarring and progressive hardening of your arteries. Many times a patient who cannot get a satisfactory result from an angioplasty can be treated by a bypass operation

5. How come my heart vessels can get an angioplasty, but my leg vessel cannot?
Answer: A patient who has a coronary angioplsty is receiving treatment for a different problem – Coronary Artery Disease. Every vessel in your body is a little different. It may be bigger, smaller, in an area with a lot of movement, or more involved with hardeining of the arteries. At the JVI, our caridologists can and do perform coronary vessel angioplasties for many patients. There are also many times where a patient is better served with a heart bypass rather than balloon angioplasty. This can also be the case in treating your legs or carotid arteries.

Stress Effects On Your Body…!!!

How does stress affect health?

The human body is designed to experience stress and react to it. Stress can be positive, keeping you alert and ready to avoid danger. Stress becomes negative when a person faces continuous challenges without relief or relaxation between challenges. As a result, the person becomes overworked, and stress-related tension builds.

Stress that continues without relief can lead to a condition called distress, a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain and problems with sleeping. Research suggests that stress can also bring on or worsen certain symptoms or diseases.

Stress also becomes harmful when people turn to alcohol, tobacco, or drugs to try to relieve their stress. Unfortunately, instead of relieving the stress and returning the body to a relaxed state, these substances tend to keep the body in a stressed state and cause more problems. Consider the following:

The Health and Safety Executive says around 10.4 million working days are lost each year to stress, depression or anxiety.
Occupations with the highest rates of work-related stress are social work, teaching and public administration.
The NHS says psychological problems, including stress, anxiety and depression, are behind one in five visits to a GP.
Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma and arthritis.

Common effects of stress

 Indeed, stress symptoms can affect your body, your thoughts and feelings, and your behavior. Being able to recognize common stress symptoms can give you a jump on managing them. Stress that’s left unchecked can contribute to health problems, such as high blood pressure, heart disease, obesity and diabetes.

Common effects of stress …
… On your body	… On your mood	… On your behavior
Headache Muscle tension or pain Chest pain Fatigue Change in sex drive Stomach upset Sleep problems	Anxiety Restlessness Lack of motivation or focus Irritability or anger Sadness or depression	Overeating or undereating Angry outbursts Drug or alcohol abuse Tobacco use Social withdrawal

Stress also becomes harmful when people use alcohol, tobacco, or drugs to try to relieve their stress. Unfortunately, instead of relieving the stress and returning the body to a relaxed state, these substances tend to keep the body in a stressed state and cause more problems. Consider the following:

Forty-three percent of all adults suffer adverse health effects from stress.
Seventy-five percent to 90% of all doctor’s office visits are for stress-related ailments and complaints.
Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety.
The Occupational Safety and Health Administration (OSHA) declared stress a hazard of the workplace. Stress costs American industry more than $300 billion annually.
The lifetime prevalence of an emotional disorder is more than 50%, often due to chronic, untreated stress reactions.

Gastrointestinal
Esophagus
When you’re stressed, you may eat much more or much less than you usually do. If you eat more or different foods, or increase your use of alcohol or tobacco, you can experience heartburn or acid reflux. Stress or exhaustion can also increase the severity of heartburn pain.
Stomach
When you’re stressed, your brain becomes more alert to sensations in your stomach. Your stomach can react with “butterflies” or even nausea or pain. You may vomit if the stress is severe enough. And, if the stress becomes chronic, you may develop ulcers or severe stomach pain even without ulcers.
Bowel
Stress can affect digestion, and what nutrients your intestines absorb. It can also affect how fast food moves through your body. You may find that you have either diarrhea or constipation.

Stress & Mental Health

Studies have shown a link between stress and mental health problems, the reason behind this connection has remained unclear. Recent research from the University of California, Berkeley, has discovered new insight into why stress can be so detrimental to a person’s psyche.

Previous research has found physical differences in the brains of people with stress disorders, such as post-traumatic stress disorder (PTSD), and those without. One of the main distinctions is that the ratio of the brain’s white matter to gray matter is higher in those with stress-related mental disorders compared to those without.

Shrinks The Brain
Even for healthy people, stressful moments can take a toll on the brain, a new study from Yale University suggests.

Researchers reported in the journal Biological Psychiatry that stressful occasions — like going through a divorce or being laid off — can actually shrink the brain by reducing gray matter in regions tied to emotion and physiological functions. This is important because these

Raises Stroke Risk
Stressed-out people may have a higher stroke risk than their more mellowed-out peers, according to an observational study published in the Journal of Neurology, Neurosurgery and Psychiatry.

“Compared with healthy age-matched individuals, stressful habits and type A behavior are associated with high risk of stroke.

Nervous System

The autonomic nervous system (ANS) is a vast network of nerves reaching out from the spinal cord, directly affecting every organ in the body. It has two branches, the sympathetic and the parasympathetic, which have opposite effects.

The sympathetic ANS helps us deal with stressful situations by initiating a ‘fight or flight’ reaction. After the danger has passed, the parasympathetic ANS takes over, decreasing heartbeat and relaxing blood vessels.

In healthy people, the two branches of the ANS maintain a balance — action followed by relaxation. Unfortunately many people’s sympathetic ANS stays on guard, making them unable to relax and let the parasympathetic system take over. If this situation becomes chronic, a whole variety of stress-related symptoms and illnesses can follow.

Mind and body are inextricably linked and the interaction between them can produce physical changes. Our brain notices a stressor, a physical reaction is triggered, and the reaction can lead to further emotional reactions and mental and physical damage. Some problems such as headaches and muscle tension are often directly caused by the bodily responses that accompany stress. Many other disorders, some say most, are aggravated by stress.

The human body is designed to withstand occasional extreme stress, so can survive quite a lot of pressure. It’s important to remember that most negative symptoms can be corrected if you take action. And there’s a lot of help available. If you are at all worried, do not delay in getting expert advice — your peace of mind is worth the effort. The problem will most likely not go away and the worst thing you can do is ignore it.

If you do develop a stress-related illness, at least you will have become familiar with your individual ‘weak point’, and will be able to keep a close eye on it. If similar symptoms creep back, take them very seriously as a warning. Take a close look at your current situation and ease off the pressure wherever possible. Most of the problems below aren’t life-threatening, and controlling your stress levels will help keep them at bay.

Sexual Desire

Women juggle personal, family, professional, financial and a broad range of other demands across their life span. Stress, distraction, fatigue, etc., may reduce sexual desire — especially when women are simultaneously caring for young children or other ill family members, coping with chronic medical problems, feeling depressed, experiencing relationship difficulties or abuse, dealing with work problems, etc.

Fat storage

“You can clearly correlate stress to weight gain,” says Philip Hagen, MD, an assistant professor of medicine at the Mayo Clinic in Rochester, Minn.

Part of that link is due to poor eating during stress, but the stress hormone cortisol may also increase the amount of fat tissue your body hangs onto and enlarge the size of fat cells. Higher levels of cortisol have been linked to more deep-abdominal fat—yes, belly fat. 

Heart Problems

Over the long term, people who react more to stress have a higher risk of cardiovascular disease. This risk particularly is linked to people who tend to be excessively competitive, impatient, hostile, and move and talk quickly. Of these characteristics, hostility is often pinpointed as the most significant.

The common stress response of eating comfort foods, with their accompanying fat and salt, is not beneficial to the heart either.

Skin Problems

Stress is known to aggravate skin problems such as acne, psoriasis and eczema. It also has been linked to unexplained itchy skin rashes. These skin problems are themselves intensely stressful.

Diabetes

There is some evidence that chronic stress may lead to insulin-dependent diabetes in people who are predisposed to the disease. It could be that stress causes the immune system to destroy insulin-producing cells.

Infertility

Stress does not normally cause infertility, but the two have been linked many times. People who are trying for a baby are more likely to conceive when on holiday or when facing little stress, and fertility treatment is more successful at these times too.

Pain

Continued stimulation of muscles through prolonged stress can lead to muscular pain such as backache. Together with our sedentary lifestyles and bad posture, this makes back, shoulder and neck ache extremely widespread.

Insomnia
Stress can cause hyperarousal, a biological state in which people just don’t feel sleepy.

While major stressful events can cause insomnia that passes once the stress is over, long-term exposure to chronic stress can also disrupt sleep and contribute to sleep disorders.

What to do? Focus on sleep hygiene (making your surroundings conducive to a good night’s rest) and try yoga or another stress-busting activity during the day.

Difficult to Control Your Emotions
It’s no secret that stressed people can fly off the handle. But new research tells us that how little stress is actually required for you to lose your cool.

A recent study by neuroscientists at New York University found that even mild levels of stress can impair our ability to keep a grip on our emotions. In their study, researchers taught subjects stress-control techniques. But after participants were put under mild stress by having their hands dunked in icy water, they couldn’t easily calm themselves down when shown pictures of snakes or spiders.

You Look Older
Chronic stress is a major contributor to premature aging.

Researchers from the University of California, San Francisco discovered that stress shortens telomeres—structures on the end of chromosomes—so that new cells can’t grow as quickly. This leads to the inevitable signs of aging: wrinkles, weak muscles, poor eyesight, and more.

Weakens Your Immune System
The connection between mind and body are often underestimated, but everyone’s experienced a cold when they can least afford to. That’s because stress is so demanding on the body that the immune system suffers, making you more vulnerable to colds and infection.

Respiratory System
Stress can make you breathe harder. That’s not a problem for most people, but for those with asthma or a lung disease such as emphysema, getting the oxygen you need to breathe easier can be difficult.
And some studies show that an acute stress — such as the death of a loved one — can actually trigger asthma attacks, in which the airway between the nose and the lungs constricts.
In addition, stress can cause the rapid breathing — or hyperventilation — that can bring on a panic attack in someone prone to panic attacks.
Working with a psychologist to develop relaxation and breathing strategies can help.

It’s no secret that stressed people can fly off the handle. But new research tells us that how little stress is actually required for you to lose your cool.

Mammography

Mastography called Mammography is the process to detect breast cancer by using low-energy X-rays (usually around 30 kVp) to examine the human breast, this method is used as a diagnostic and screening tool. typically through detection of characteristic masses and/or microcalcifications.

Types of Mammogrphy

There are two types of Mammography

1-Film Screen Mammography

2-Digital Mammography (FFDM)

Techniques for perfoming Film screen Mammography and digigtal mammography is same , the only difference is that whether the images take the form of photographic films or of digital files recorded directly onto a computer.

Film-screen vs. digital

Diagnostic mammography is performed in women who present with breast symptoms such as nipple discharge or focal pain, who have abnormal clinical findings such as palpable lump, or who have mammographic abnormalities detected on a screening study. It is performed under the direct supervision of a radiologist who chooses different additional views to further demonstrate the morphology of the lesion and decides whether ultrasound also needs to be used. Additional views include cleavage view, tangential view, and rolled view.

If you’ve had a film-screen mammogram, the images will be in black and white on large sheets of film. With digital mammography, the images are recorded directly into a computer. The image can then be viewed on a computer screen and specific areas can be enlarged or highlighted. If there is a suspicious area, your doctors can use the computer to take a closer look. The images also can be transmitted electronically from one location to another.

Many studies have shown that film-screen and digital mammography are equally accurate in screening for breast cancer. One 2005 study of nearly 50,000 women, the Digital Mammographic Imaging Screening Trial (DMIST), found that digital mammography was a better screening tool than film-screen mammography only for women who either:

• are under age 50
• have very dense or extremely dense breast tissue
• are still menstruating or are perimenopausal (starting menopause), but have had a period within the previous 12 months

If you fall into any one of these three categories, talk to your doctor about having digital mammography. If you’re not sure whether or not you have dense breast tissue, your doctor can help — usually by looking at previous mammograms you may have had.

The other advantages of digital mammography versus film-screen are that

(1) digital images can be manipulated for better views and they can be stored more easily, and

(2) digital mammograms deliver about three-fourths of the radiation that film-screen mammograms do (although film-screen mammograms deliver a safe and very small amount of radiation).

The disadvantages of digital mammography are that it is more expensive and not as widely available as film-screen mammography.

In the future, it’s expected that digital mammography will become more common. In the meantime, you can speak with your doctor about which type of mammography is best for your individual situation. If your doctor recommends digital mammography, or you want to have it, you can work together to determine where it is available in your area.

Many imaging centers are now in the process of switching over from traditional film mammography to digital mammography. According to an April 2008 article in the New York Times, this is causing a temporary increase in the number of women who are getting called back for additional testing. As radiologists get used to reading the digital images — especially for a woman who has always had films done — they may be more likely to call a woman back to take more views of potentially suspicious areas. Be aware of this if you make the switch from film mammography to digital mammography, and try not to worry prematurely if you get called back.

If you do not have access to digital mammography, you should still have film-screen mammography as you normally would.

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السلام علیکم 

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ایک گلاس پانی

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نمک ایک چٹکی

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