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Meta-analysis is a concept that is used mainly in statistics. It involves combining and contrasting multiple types of studies to find visible patterns.
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How does chlamydia go away?
Chlamydia can clear up on its own. A metaanalysis undertaken by the CDC suggests that chlamydia may clear on its own within a year in some cases (see related link). It is bacterial, and the body can remove bacterial infections. Certainly, you should seek antibiotic treatment if you test positive. Even without symptoms, untreated chlamydia can cause damage.
Adenomyosis?
DefinitionAdenomyosis is uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.Alternative NamesEndometriosis interna; AdenomyomaCauses, incidence, and risk factorsThe cause is unknown. Sometimes adenomyosis may cause a mass or growth within the uterus, which is called an adenomyoma.The disease usually occurs in women older than 30 who have had children. It is more likely in women with previous cesarean section or other uterine surgery.SymptomsLong-term or heavy menstrual bleedingPainful menstruation , which gets increasing worsePelvic pain during intercourseNote: In many cases, the woman may not have any symptoms.Signs and testsDuring a pelvic exam, the doctor may find an soft and slightly enlarged uterus. The exam may also reveal a uterine mass or uterine tenderness.An ultrasound of the uterus may help tell the difference between adenomyosis and other uterine tumors. MRI can be helpful when ultrasound does not give definite results.TreatmentMost women have some adenomyosis as they near menopause but few women have symptoms, and most women don't require any treatment.In some cases, pain medicine may be needed. Birth control pills and a progesterone-containing intrauterine device (IUD) can help decrease heavy bleeding.A hysterectomymay be necessary in younger women with severe symptoms.Expectations (prognosis)Symptoms usually go away after menopause. A hysterectomy completely relieves symptoms.Calling your health care providerCall for an appointment with your health care provider if you develop symptoms of adenomyosis.ReferencesKatz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 18.Speroff L, Fritz MA. Dysfunction uterine bleeding. In. Speroff L, Fritz MA, eds. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 2005:chap 15.
Lung cancer - non-small cell?
Alternative NamesCancer - lung - non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma - lung; Squamous cell carcinoma - lungDefinitionNon-small cell lung cancer (NSCLC) is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer.There are three forms of NSCLC:Adenocarcinomas are often found in an outer area of the lung.Squamous cell carcinomas are usually found in the center of the lung by an air tube (bronchus).Large cell carcinomas can occur in any part of the lung. They tend to grow and spread faster than the other two types.Causes, incidence, and risk factorsSmoking causes most cases of lung cancer. The risk depends upon the number of cigarettes smoked every day and for how long someone has smoked. Being around the smoke from others (secondhand smoke) also raises your risk for lung cancer. However, people who do not smoke and have never smoked have become sick with lung cancer.A review of decades of research has recently shown that smoking marijuana may help cancer cells grow, but there is no direct link between the drug and developing lung cancer.High levels of air pollution and drinking water containing high levels of arsenic can increase your risk for lung cancer. Radiation therapy to the lungs can also increase the risk.Working with or near the following cancer-causing chemicals or materials can also increase your risk:AsbestosProducts using chloride and formaldehydeCertain alloys, paints, pigments, and preservativesSymptomsEarly lung cancer may not cause any symptoms. Symptoms you should watch for include:Cough that doesn't go awayCoughing up bloodShortness of breathWheezingChest painLoss of appetiteLosing weight without tryingFatigueOther symptoms that may be due to NSCLC:WeaknessSwallowing difficultyNail problemsJoint painHoarseness or changing voiceSwelling of the faceEyelid droopingBone pain or tendernessShoulder pain or weaknessNote: These symptoms can be due to other, less serious conditions. It is important to talk to your health care provider.Signs and testsThe health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.Tests that may be performed to diagnose lung cancer or see if it has spread include:Chest x-rayCBCSputum test to look for cancer cellsBone scanCT scan of the chestMRI of the chestPositron emission tomography (PET) scanThoracentesisIn some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:Bronchoscopycombined with biopsyPleural biopsyCT scan directed needle biopsyMediastinoscopy with biopsyOpen lung biopsyEndoscopic esophageal ultrasound (EUS) with biopsyIf the biopsy reveals you do have lung cancer, more imaging tests will be done to determine the stage of the cancer. Stage means how big the tumor is and how far it's spread. Non-small cell lung cancer is divided into five stages:Stage 0 - the cancer has not spread beyond the inner lining of the lungStage I - the cancer is small and hasn't spread to the lymph nodesStage II - the cancer has spread to some lymph nodes near the original tumorStage III - the cancer has spread to nearby tissue or spread to far away lymph nodesStage IV - the cancer has spread to other organs of the body such as the other lung, brain, or liverTreatmentThere are many different types of treatment for non-small cell lung cancer. Treatment depends upon the stage of the cancer.Surgery is the often the first line of treatment for patients with non-small cell lung cancer that has not spread beyond nearby lymph nodes. The surgeon may remove:One of the lobes of the lung (lobectomy)Only a small part of the lung (wedge or segment removal)The entire lung (pneumonectomy)Some patients need chemotherapy. Chemotherapy uses drugs to kill cancer cells and stop new ones from growing.Chemotherapy alone is often used when the cancer has spread (stage IV).It may also be given before surgery or radiation to make those treatments more effective.It may be given after surgery (called adjuvant therapy) to kill any remaining microscopic areas of cancer.Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. Radiation therapy can be used with chemotherapy if surgery is not possible.The following treatments are mostly used to relieve symptoms caused by NSCLC:Laser therapy - a small beam of light burns and kills cancer cellsPhotodynamic therapy - uses a light to activate a drug in the body, which kills cancer cellsSupport GroupsFor additional information and resources, see cancer support group.Expectations (prognosis)The outlook varies widely. Most often, NSCLC develops slowly and causes few or no symptoms until very late stages. However, in some cases, it can be extremely agressive and cause rapid death. The cancer may spread to other parts of the body, including the bone, liver, small intestine, and brain.Chemotherapy has been shown to prolong the life and improve the quality of life in some patients with stage IV NSCLC.Cure rates are related to the stage of disease and whether you are able to have surgery.Stage I and II cancer can be cured with surgery, sometimes in more than 50% of cases.Stage III tumors can be cured in some cases, but cure rates are much lower than earlier stage NSCLCPatients with stage IV disease are almost never cured, and the goals of therapy are to extend and improve the quality of their life.ComplicationsSpread of disease beyond the lungSide effects of surgery, chemotherapy, or radiation therapyPreventionIf you smoke, stop smoking. It's never too early to quit. People who have smoked in the past can be at increased risk for lung cancer more than 20 years after quitting, although the risk drops significantly in the first year after quitting. There are benefits to quitting smoking, even for people who are well into middle age.Try to avoid secondhand smoke.Eat a diet rich in fruits and vegetables.Routine screening for lung cancer is not recommended. Many studies have been done to look at the idea, but scientists have concluded that, at this time, screening does not help improve a person's chance for a cure.ReferencesAlberg AJ, Ford JG, Samet JM; American College of Chest Physicians. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:29S-55S.American Cancer Society. Cancer Facts and Figures 2008.Atlanta, Ga: American Cancer Society; 2008.Bach PB, Silvestri GA, Hanger M, Jett JR. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:69S-77S.National Cancer Institute. Lung Cancer Home Page. Bethesda, MD: U.S. National Institutes of Health. Accessed August 3, 2008Jett JR, Schild SE, Keith RL, Kesler KA. Treatment of non-small cell lung cancer, stage IIIB: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:266S-276S.Johnson DH, Blot WJ, Carbone DP, et al. Cancer of the lung_ Non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 76.Fischer B, Lassen U, Mortensen J, Larsen S, Loft A, Bertelsen A, Ravn J, Clementsen P, Hogholm A, Larsen K, Rasmussen T, Keiding S, Dirksen A, Gerke O, Skov B, Steffensen I, Hansen H, Vilmann P, Jacobsen G, Backer V, Maltbaek N, Pedersen J, Madsen H, Nielsen H, Hojgaard L. Preoperative staging of lung cancer with combined PET-CT. N Engl J Med. 2009 Jul 2;361(1):32-9.Tassinari D, Scarpi E, Sartori S, Tamburini E, Santelmo C, Tombesi P, Lazzari-Agli L. Second-line treatments in non-small cell lung cancer. A systematic review of literature and metaanalysis of randomized clinical trials. Chest. 2009 Jun;135(6):1596-609.
