Lilith is 42-yeаr-оld wоmаn whо undergoes routine cervicаl screening. Biopsy reveals atypical epithelial cells confined above the basement membrane. Her healthcare provider explains that the lesion has not invaded surrounding tissues and can potentially be cured through removal. The patient wants to understand her risk if the lesion is not treated. Which sequence best represents malignant transformation?
Minа is а 58-yeаr-оld wоman is diagnоsed with invasive ductal carcinoma of the breast. Imaging identifies a 3.5-cm primary tumor, and biopsy reveals cancer cells in two axillary lymph nodes. Bone scans demonstrate metastatic lesions in the femur. The oncology team uses staging information to guide treatment and discuss prognosis. Which TNM component is represented by the finding of cancer in the axillary lymph nodes?
Initiаl Pоst оn Type I Diаbetes Intrоduction Diаbetes is a disorder that happens in the body when there are “high levels of blood glucose resulting from the body’s inability to produce or utilize insulin.”(Capricotti, 2024, p. 612). This disease affects the human body from producing little or no insulin, which in turn affects their glucose levels. Diabetes can affect many different parts of the body, and has different classifications based on the severity of it. Type I diabetes specifically is the less common, but more severe form of diabetes. In type I there is a complete absence of insulin in the body, which makes it more severe than type II. Type I diabetes can be diagnosed and treated properly in order for someone to have a healthy life. Etiology Type I diabetes is considered a polygenic disorder. Polygenic disorders happen because of mutations in multiple different genes in the human body. Along with there being polygenic issues that cause diabetes, environmental factors can also affect and cause someone to develop this disease. Type I diabetes is considered the more severe type of diabetes because it is an autoimmune disorder. In type I the “immune system mistakenly attacks and destroys pancreatic cells that produce insulin, an essential hormone that directs cells to take up glucose from the blood.” (2023). The killer T cells in the human body attack the beta cells in the pancreas that secrete insulin. Due to this, people who have type I do not produce any insulin at all. There are two main risk factors of people developing type I diabetes: genetic and environmental factors. Type I can be transmitted by genetics at birth, or developed during adolescence because of different environmental factors like infections and different diet exposures at a young age. Assessments and Clinical Manifestations The signs and symptoms of type I diabetes are all a result of losing insulin and glucose rising. Some signs and symptoms include fatigue, weight loss, and what is considered the “classic triad (three “P’s”) : polydipsia (constant thirst), polyuria (excessive urination), and polyphagia (increased appetite).” (Capriocotti, 2024, p. 619). Both polydipsia and polyuria are a direct result of the blood glucose levels being too high. However, polyphagia happens because “there is not enough insulin, glucose cannot enter the cells in the body, so it cannot be used for energy. Therefore, the body sends hunger signals that trigger you to eat more, so the body can try to get more glucose.” (Bonn & Connell, 2024). These symptoms are vital in the diagnosis of type I diabetes. If type I diabetes is never found in the human body and remains untreated “too much sugar builds up in your blood, causing hyperglycemia (high blood sugar). This can lead to serious health problems or even death if it’s not treated.” (Cleveland Clinic, 2022). Whenever a patient gets to this level of type I diabetes, the outcome usually results in a coma or death. It is vital to see the doctor whenever these manifestations arise. Diagnosis All types of diabetes are generally diagnosed the same way because it all affects insulin levels. To primarily diagnose diabetes there are two main blood glucose tests that are taken: the oral glucose tolerance test and the glycated hemoglobin test. In the oral glucose tests patients are given a set amount of a glucose solution to orally ingest. After two hours their glucose levels are taken. The parameters are “140 to 199 mg/dL, prediabetes is diagnosed. If the measurement is greater than or equal to 200 mg/dL, diabetes is diagnosed.”(Capricotti, 2024 p. 621). The glycated hemoglobin test is a less common test due to the results not being as accurate because of other factors that a patent may have. This test is taken over a period of three months where the patient tracks their own glucose levels. The levels for this test are a “value of greater than 6.5% is diagnostic of diabetes and a value between 5.7% and 6.4% is considered prediabetes.” (Capricotti, 2024, p. 621). Along with these blood glucose tests, urine tests, islet cell autoantibody tests, and c-peptide tests can be taken. However the blood glucose tests are the more common, faster acting, more accurate, and less invasive tests that can be given for a diagnosis. Treatment Treatment for type I diabetes varies on the stage and severity of the patient, however the most common treatment is insulin replacement therapy. In type I diabetes there is a complete absence from insulin produced in the body, therefore insulin has to be fully replaced and given. Insulin replacement therapy is given through different devices that the patient uses daily. The delivery for insulin are called AID’s or automated insulin delivery systems. These systems can be used by insulin pumps, daily shots, or insulin pens. Omnipods are the most common devices that are given today. Along with that, patients have glucose monitors either attached to them or portable monitors that can be used by pricking their finger for blood, that track their blood sugar levels throughout the day. A good diet should also be maintained while on these insulin pumps to help maintain patients' blood sugar levels. Some less common treatment options include an artificial pancreas replacement, immune therapies, and sodium-glucose co-transporter 2 therapies (SGLT2). Each of these alternative therapies are more invasive and have more side effects than the regular insulin therapy replacement therapies. Each of these therapies are vital for the success of maintaining a healthy life. However a good diet and daily exercise should also be maintained in order to have a normal healthy life. Conclusion In conclusion, type I diabetes is the less common but more fatal type of diabetes that can happen to patients. The complete lack of insulin in the body can be life threatening, therefore treatment is necessary. The diagnosis of this disease is vital for survival, and the treatment should be managed as well. Type I diabetes can be treated and maintained in order for a patient to live life as normal as possible. References Bonn, T., & Connell, C. (2024, May 20). The Three Ps of Diabetes - Alabama Cooperative Extension System %. Alabama Cooperative Extension System. https://www.aces.edu/blog/topics/health/the-three-ps-of-diabetes/ Capriotti, T. & Frizzell, J. (2024). Pathophysiology: Introductory concepts and clinical perspectives. F.A. Davis. https://fhubookshelf.vitalsource.com/reader/books/9781719650533/epubcfi/6/40[%3Bvnd.vst.idref%3Dc07]!/4/2/2/258[box7-4]/22/1:0[%2C%E2%80%A2%C2%A0%C2%A0 Cleveland Clinic. (2022, March 9). Type 1 diabetes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes Kahanovitz, L., Sluss, P. M., & Russell, S. J. (2017). Type 1 diabetes: A clinical perspective. Point of Care, 16(1), 37–40. https://doi.org/10.1097/POC.0000000000000125 (2023). Overweight and Obesity in People With Type 1 Diabetes Nearly Same as General Population | Johns Hopkins | Bloomberg School of Public Health. Publichealth.jhu.edu. https://publichealth.jhu.edu/2023/overweight-and-obesity-in-people-with-type-1-diabetes-nearly-same-as-general-population