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Cervical Lymphadenitis

Cervical Lymphadenitis is inflammation in the lymph glands of the neck. This lymph gland enlargement is usually secondary to any viral or bacterial infections. This condition is often noticed with tonsillitis, pharyngitis or even dental infection. Cervical Lymphadenitis is commonly seen in children suffering from upper respiratory infection. Infections such as diphtheria, tuberculosis or wounds caused by cat-scratch disease or impetigo can bring on Cervical Lymphadenitis.


Symptoms of Cervical Lymphadenitis include pain and tenderness in the lymph glands of the neck. There might be cough, sore throat and fever. Often patients suffering from Cervical Lymphadenitis experience irritability and earache. In some cases, scalp infections or impetigo or dermatitis is noticed. Chest x-rays and skin tests are used to diagnose the cause for the swollen lymph nodes. The infected nodes are sometimes aspirated for further analysis. Biopsy might be done in some cases.


In most cases, Cervical Lymphadenitis does not need any treatment. Once the cause for the swollen lymph glands is identified, appropriate treatment is prescribed. Penicillin or dicloxacillin is often used.

Melanoma

Melanoma is a type of skin cancer that develops from abnormal moles, or the pigment skin present in the skin. Because of its nature to spread to other parts of the skin, melanoma is more serious that other forms of skin cancer. It can cause serious illness and death. Derived from Greek origin 'melas' which means 'dark', melanocytes are cells that produce dark pigment called melanin which is responsible for the color of the skin. Melanoma is a most common form of cancer and the risk can increase with age. However, melanoma affects people of all ages, races, and genders and ethnicity.


Signs and symptoms

As melanoma occurs in the skin and it can be seen, patients themselves are the first to detect many melanomas. If caught early, melanomas can be cured by relatively minor surgery. However, early diagnosis and detection are crucial as it may otherwise invade healthy tissues and spread to other parts of the body making it out of control. The ABCD of melanoma can be described as:

Asymmetry: that is the shape of one half does not match with the other half.
Border: the edges are blurred, irregular.
Color is uneven and includes shades of black, brown and tan.
Diameter: there is a change in size as it increases.


Causes of Melanoma

Researchers opine that a gene known as BRAF plays a lead role in causing melanoma. As BRAF is a switch gene, it allows other cells to divide and grow. Mutations in this gene can cause explosive growth and the resultant melanoma skin cancer.

  • Sunburns, especially slow daily sun exposure, even without burning.
  • White ancestry (Caucasian)
  • Fair skin, light hair and light colored eyes
  • Intense exposure to sun especially during childhood
  • Many moles in the body, to the tune of more than hundred
  • Large irregular funny looking moles
  • History of close relatives especially parents, siblings or children with melanoma- presence of close family melanoma is a high risk factor; although only 10% of cases run in families.

Melanoma can occur on any skin surface – it is common on the area between a man's shoulders and hips. For women, melanoma generally develops on the lower legs. People with darker skin develop melanoma on their palms and soles as well as under toe and fingernails.


Diagnosis of melanoma

Get the dermatologist to examine your body fully and find out whether the moles are odd. The medical term for such moles is 'atypical'. The dermatologist will perform a skin biopsy to evaluate if the mole is cancerous or not. The doctor will remove all or part of the skin under local anesthesia and send the specimen to a pathologist for analysis. The biopsy report will reveal:

  • A totally benign condition that requires no further treatment, as in the case of a regular mole.
  • An atypical mole which depends on the judgment of the pathologist to treat – either conservative removal by taking off a bit of the normal skin all around to make sure that the spot is completely out or
  • A melanoma requiring surgery
  • Some doctors may perform epiluminescence or dermatoscopy.

Melanoma treatment

Once melanoma is diagnosed as cancer and staged, then the doctor will discuss the treatment options with the patient. Treatment is based on the stage of cancer and other related factors. In case of normal moles, which are small brown spots or growths of skin that appear in the first few decades of life in almost everyone, no treatment is necessary.

People with classic atypical mole syndrome have more than 100 moles, with many moles over 8 mm diameter and one or more moles are atypical. Treatment options include Surgery, chemotherapy, and immunotherapy and radiation therapy. Sometime a combination of treatment is used. In general melanoma is treated by surgery alone. But surgery need not be extensive, as was some years ago. During early stages of melanoma, surgeons will remove only a centimeter or even less of normal tissue around the melanoma. Whereas, deeper and more advanced cancers would require extensive surgery. The removal of nearby lymph glands depend upon factors that include tumor thickness, body location, age etc. If the stage is pretty advanced, immunotherapy treatments are adopted.


Prevent melanoma

Reduce sun exposure. Perhaps avoidance of sun exposure is the best means to prevent melanoma. Wear hats and tightly woven clothing and apply sunscreens liberally when going out. Although there is a controversy among dermatologists about sunscreen protecting against melanoma, it is certainly preferred to unprotected sun exposure.

Early detection is the key to prevention. Get your skin checked at least once every few years. In the US, the American Academy of Dermatology sponsors free skin cancer screening clinics every year all over the country. Special pigmented lesion clinics have also been established in many medical centers to allow close clinical and photographic follow ups of patient with high risk. But a reference from a concerned dermatologist is essential to undergo the screening.

Any person with high risk and having a close relative who has/had melanoma should be screened by a doctor for cancer of the skin. As with any other cancer, early diagnosis and proper evaluation and treatment is the essence.



Cat Behavior

Cats are solitary predators unlike dogs which are pack or herd animals.In consequence, Cats don't treat humans as authority figures in the same manner the dogs do. A cat's visual cortex contains more neurons than the equivalent area of a human brain. Typically a cat's brain weighs about 30 gm which is just under 1 percent of its total body weight. Compare this to a human brain which is 2 % of the body weight or to a dog which is 1.2 %. However, the cortex of the cat's brain has high Cortical folding which significantly increases the amount of the cerebral cortex. As a result, a cat has a well developed area of the brain responsible for interpreting sensory information. It can use its paws almost like humans. Cat's night vision is exceptional and their binocular vision is attuned to see in depth and to judge distances accurately. Their night vision is further enhanced by a layer behind the retina called as tapetum lucidum which is the reason why a cat's eyes shine bright golden or green disk when struck by a light. Their eyes detect motion better than actual sharp details. With large eyes it takes more time to focus sharp.

Most cat bites occur because of fear on the cat’s part or a phenomenon known as petting-induced aggression. Petting induced aggression is a behavior in which a cat - usually younger cats that has been apparently enjoying contact with a human suddenly turns on the human and bites. In elderly cats, the aggression may have been induced by pain due to pressure on arthritic joints.

Inflammation is probably the most common sign of infection from an animal bite. The skin around the wound may turn red and warm and over a period of time the wound may exude pus. Nearby lymph glands may become swollen. If not treated in time, complications may arise when the infection spreads deep or to the blood stream. Live disease causing bacteria within the bloodstream or in the tissues may cause major complications further away from the wound site. Such complications include meningitis, brain abscesses, pneumonia, lung abscesses and heart infections which can be fatal at times.

Cat scratch disease is caused by Bartonella Henselae), previously known as Rochalimaeaquintana, a type of bacteria in cat saliva. Infection may occur with a bite or a scratch. As per CDC, in USA alone there are 22000 reported cases. The Cat scratch disease is not normally severe in people with healthy immune systems. However, it can become sever in immunocompromised individuals - acquired immune deficiency syndrome (AIDS) or those undergoing chemotherapy.

Prevention: Cat bites can easily be avoided by learning about a cat’s body language and recognizing the signs of impending aggression. Look out for signs such as:

  • dilating pupils
  • a low growl
  • stiffening of the body
  • wagging/flicking tail - increasing frequency denotes increasing anger
  • twitching of the tail
  • flattening the ears backward against the head
Cat scratch disease

Warning Stance: When a cat stands with his rump raised or back arched, it feels threatened and it is a warning that it is about to strike/attack. Sometimes the hair on its body may also be raised. A cat's tail is probably the most significant signal:

Tail SignalInterpretation
Flicking from side to sideIrritated
Curved like an “N” or low to the ground and flickingFeeling aggressive
Strong lashing movementsDon't mess with me! Will attack at the first chance
Arched over the backAll right! I am going to attack now. You asked for it
Hair fluffed out and standing on end OH ! I am anxious and threatened now
Horizontal or slightly low to the floor All is well
Erect or with a curl at the tipI feel friendly now. How are you doing ?
Pointing straight up and vibrating Quivering with joy and excitement
Tucked between the legsI am submissive now. Please don't hurt me

A healthy cat tends to be friendly. An ailing cat can be aggressive or scratch you unintentionally.
Vital signs of Cats

  • body temperature : 100.5 - 102.5°F (38 - 39°C).
  • Pulse rate: 110 - 180 beats per minute
  • Respirations : 20 - 30 per minute
  • Time for gum to regain pink color after being blanched by gentle pressure with finger(Capillary refill time): < 2 seconds
Tags: #Cervical Lymphadenitis #Melanoma #Cat Behavior
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Bibliography / Reference

Collection of Pages - Last revised Date: September 19, 2020