Essential tips to choose the right inpatient drug rehab center

If any of your dear ones have been a victim of substance abuse, then you would be keen on finding a good place to help them. In doing so, you would want to get them the best treatment from the best rehab centers available across the country. However, what should be the criteria to help you find and zero in on a good rehab center? Read on to get some tips to find the best inpatient drug rehab centers in the country.

Whether you are looking for inpatient rehab centers in California or an inpatient rehab center in New York, ensure the facility is closer to your home. Even if the inpatient drug rehab center in Florida offers ample of features and benefits, it is useless if you cannot reach it when you need to. If you are in Chicago, it will be essential and advisable to find an inpatient drug rehab center in Chicago. This not only ensures continued care but also helps you reach your dear ones when required within no time.

The faculty at the inpatient drug rehab centers should be one of the main deciding factors when picking a facility. They need to be full of empathy, both to identify with the affected person’s issue and to support during therapy.

Comprehensiveness of therapy
It is not just the substance abuse, but the person’s needs and history have to be considered totally and a treatment must be planned accordingly at the inpatient drug rehab center you choose. Quitting once and resuming old habits will not be difficult for the sufferer if not cared for properly. Hence, one should ensure that a holistic approach to treatment is adopted by the selected rehab center for the affected individuals.

When choosing an inpatient drug rehab center, consider whether inpatient treatment is absolutely necessary, as it does not come cheap. Wherever possible, for instance, if the inpatient drug rehab center is within 50 miles of your residence in Havesue, Arizona, it makes sense to make regular visits than stay there.

Matching beliefs and values
While most inpatient drug rehab centers promise effective treatments, very few live up to it. Each person has a different set of beliefs and reasons for getting into and wanting to get out of substance abuse. It is extremely important that the inpatient drug rehab centers are able to identify and align with this so that the treatment is successful.



Top 3 outpatient drug rehab centers

It is advisable to visit outpatient drug rehab centers if one is suffering from a substance abuse problem that is not severe, but mild, to work towards ensuring a life of sobriety. It is helpful if any patient with a history of substance abuse enrolls in these rehab centers as early detection and treatment will increase their chances of recovering completely from it. With outpatient drug rehab centers that are present across the country, you can also continue being employed at your workplace while undergoing treatment for managing the withdrawal symptoms and recovering from substance abuse; however, this depends on the severity of your condition. Outpatient drug rehab centers help you carry on with your regular routine as they allocate specific times for the therapy sessions during the week.

Outpatient drug rehab centers conduct a variety of programs that have varying formats and levels of intensity. They treat patients through education, counseling, and support networks.

The different types of outpatient rehab programs are mainly grouped into three categories namely—Day Programs, Intensive Outpatient Programs (IOP), and Continuing Care Networks such as Narcotics Anonymous and Alcoholics Anonymous.

In the following, you can find information on some of the best outpatient drug rehab centers in the country.

Ocean Breeze Recovery Treatment Center
Based in South Florida, the Ocean Breeze Recovery Treatment Center is known to impart treatment on an individual basis to the program attendees. Here, they believe in a holistic approach to help substance abusers wean off their addiction. Some programs at the center include yoga sessions, gender-specific caring groups, etc.

Boca Recovery Center
At the Boca Recovery Center situated in Boca Raton, Florida, the condition of the patients is carefully assessed after which an appropriate treatment plan is charted out whilst keeping in mind their present condition which is similar to the procedures of several other outpatient drug rehab centers.

The outpatient treatment program at this center is designed to assist people in coping with the given situations, without resorting to substances for escaping their distress albeit for a temporary period. The staff at this treatment center are dedicated to helping the patients recuperate from their substance abuse problems and helping them lead a normal life.

Northeast Addiction Treatment Center
Northeast Addiction Treatment Center is located in Quincy, Massachusetts. The staff at this drug rehab center do not subscribe to a single treatment module but a range of curative methods. Like other outpatient drug rehab centers, some activities that patients can engage in during their stay here include meditation techniques, yoga therapy, outdoor activities and several other healing therapies for getting their lives back on track.



5 things to know about immunotherapy and lung cancer

Advanced lung cancer is difficult to treat since it engulfs other lobes of the lungs and even other organs of the body. Surgical resection does not work in such situations. Doctors usually go with chemotherapy and radiotherapy to treat such patients. However, there are many patients who can’t go through chemotherapy; the side effects are too many. A new treatment for lung cancer is taking shape, and it is called immunotherapy lung cancer. The aim of this kind of treatment is to strengthen the immune system and release it from the devious cancer cells. This bolsters the immune system to fight the cancer cells.

Immunotherapy lung cancer
Immune checkpoints
The most important aspect of immunotherapy is the immune checkpoint. In this therapy, certain checkpoints in the immune system can be selectively disabled to work to the benefit of the cancer cells.

PD-1 checkpoint
The cancer cells take over the immune checkpoints so that the immune system is not able to target them. There are many such checkpoints in the immune system. The PD-1 checkpoint is one of these. With the help of lung cancer treatment immunotherapy, these checkpoints can be blocked. As the checkpoints are blocked, the immune system regains its insight, identifies the cancer cells and attacks them. The drugs to this effect are administered intravenously and do not necessitate hospitalization.

Only for non-small cell lung cancer
However, it must be said that this therapy is suitable only for non-small cell carcinoma lung cancer patients. It is not yet being used on patients suffering from small cell carcinoma.

Side effects
There are certain side effects of immunotherapy lung cancer, but those are fewer compared to chemotherapy. Most of the side effects involve allergic skin reactions. However, there may be other side effects too, such as inflammation of the lungs or the gut or even abnormalities with the endocrine system.

It does not work for everybody
However, immunotherapy does not work for everybody. It works in about 30% of patients suffering from advanced non-small cell lung cancer. Some patients with a lung tumor respond better to targeted therapy. It has been seen that targeted therapy in some patients with lung cancer can reduce the size of the tumor better than immunotherapy.



Popular treatment options for metastatic lung cancer

Accounting for 27% of cancer deaths, lung cancer is deadlier than colorectal, breast, and pancreatic cancer. To be safer and increase the chances of a cure, detecting lung cancer in its early stages is important. When lung cancer is not detected early and is left untreated, lung cancer metastasizes to other body parts such as the liver, the other lung, the brain, the adrenal gland, or the bones. This widespread cancer is then considered as metastatic lung cancer.

Several metastatic lung cancer treatments are available that can help you deal with the condition. Read on to know about them.

Radiation and chemotherapy
Both radiation and chemotherapy are considered to be a very effective treatment option for non-small cell lung cancer, as they play crucial roles in preventing the non-small cell lung cancer from recurring once it is surgically removed. Though chemotherapy is the primary treatment for cancer-affected cells, it is often used in combination with radiation for better results.

Surgery is one of the primary treatment options for non-small cell lung cancer when the patient is diagnosed with metastatic lung cancer in Stage I or Stage II. Here, the surgeon usually removes the section or the lobe of the lung that contains the tumor.

Immunotherapy has recently emerged as a new lung cancer treatment. It focuses on strengthening the immune system, and its mechanism of action is considered to be greatly effective as a metastatic lung cancer treatment. This non-small cell lung cancer treatment can be broken down into four categories that are based on the type of immunotherapy the patient who has metastatic cancer may require, which are as follows:

  • Monoclonal antibodies
  • Therapeutic vaccines
  • Checkpoint inhibitors
  • Adoptive t-cell transferring

Targeted therapies
Among all the metastatic lung cancer treatment options, targeted therapies are often considered to be the most effective ones as they, unlike chemotherapy and radiation that fail to differentiate between a normal and cancer cell, specifically attack the cancer cells only. This type of metastatic lung cancer treatment is ideal for patients who are in the advanced stage of lung cancer.

Metastatic lung cancer is a life-threatening condition; however, with proper metastatic lung cancer treatment at the right time, further spreading of the cancer cells can be prevented, and as a result, the condition of the lungs can be improved as well.

These are some of the most preferred treatment options for metastatic lung cancer.



Stage-wise treatment options for non-small cell lung cancer

Non-small cell lung cancer, also known as NSCLC, is a type of epithelial lung cancer other than small cell lung cancer. About 80–85% of all lung cancers usually are non-small cell lung cancer. It is a group of lung cancers that behave similarly, such as squamous cell carcinoma or adenocarcinoma. Non-small cell lung cancer therapy as a class is relatively insensitive to chemotherapy when compared with small cell lung cancer therapies.

Treatment options for non-small cell lung cancer
The treatment for non-small cell lung cancer is an extensive and pain enduring procedure. The primary treatments include surgical resection with curative intent, when possible. However, chemotherapy is nowadays given to the patient before and after the surgical procedure. A brief overview of the treatment options as per the stages has been given below.

Stage 0
Stage 0 of non-small cell lung cancer is when the cancer cells have not invaded the lung tissue or other areas and are limited to the lining of the airways. Such stages of cancer can be cured through surgery if the patient is healthy enough for surgery, without the need for chemotherapy or radiation therapy for non-small cell lung cancer.

Stage 1
In case of stage one, surgery is the only option available as a form of non-small cell lung cancer therapy. Surgery might include removing the lobe of the lung containing the tumor through sleeve resection, segmentectomy, or wedge resection. For people with stage 1 non-small cell lung cancer that has a high chance of recurrence after surgery, chemotherapy is provided to prevent its recurrence. If the patient starts suffering from severe health problems after the surgery, they are recommended a stereotactic body radiation therapy as the primary treatment for non-small cell lung cancer.

Stage 2
For stage 2 non-small cell lung cancer, if the patient is healthy enough, then the tumor is removed through lobectomy or sleeve resection. In some cases, the whole lung gets removed through a pneumonectomy. After surgery, the tissue removed is checked for cancer cells. If the tissue sample tests positive for cancer cells, it means that the cancerous cells have not been removed entirely. A second surgery might be required to remove cancer cells altogether.

Stage 3 and 4
Stage 3 and 4 non-small cell lung cancer is first treated with chemotherapy and radiation to reduce the size of the cancer cells that have spread extensively. Surgery is recommended at a later stage.

The type of non-small cell lung cancer therapy or treatment options available to patients is dependent on a lot of factors. Ensure to consult your doctor and discuss the various options before deciding on a course of action.



A brief insight on meningitis

A deadly and devastating disease, meningitis could result in a fatality in a matter of hours. What’s more, bacterial meningitis fatality rates remain high even though there has been the discovery of many new antibacterial agents. In fact, around 1,000 individuals every day are killed around the world as a result of meningitis, with many of them being young adults, children, and small kids.
Infectious meningitis is categorized based on several markers. These include the age of the host (adult, young, or neonatal), parasitic, viral, fungal, bacterial. Another important marker is the health status of the individual which includes the duration of symptoms:

Children lesser than the age of 4 years are the most commonly affected in bacterial meningitis in the pediatric population, with those between the ages of 3 and 8 years showing the highest occurrences. The commonest acute meningitis bacteria in young kids are Escherichia coli and Streptococcus agalactia. These bacteria usually infect infants up to the ages of 3 months. The bacteria are said to have been acquired by the infant at birth itself when the baby was delivered through the vaginal canal.

Listeria monocytogenes is said to be foodborne (uncooked vegetables, processed meat, and dairy products), and affects patients with compromised immunities. The Streptococcus pneumonia sometimes infects children and increases in frequency with age. The Neisseria meningitides affects young adults and children and is the only bacteria which causes a meningitis epidemic. Unvaccinated children between the ages of 6 years and 3-6 months on the other side are the most affected by the Haemophilus influenzae.

The early meningitis symptoms are altered mental status, seizures, neck stiffness, chills, fever, and headache, fever, and chills. The most common bacterial meningitis complications include prolonged fever, pyogenic arthritis, coagulation disorders, endocarditis, and shock. Other serious complications and shock result in fatality within a few hours of the appearance of meningitis symptoms. Amongst the survivors, the outcomes of meningitis seizure disorder, paresis/spasticity, mental retardation, and deafness. The clinical signs and symptoms of meningitis in children differ according to the duration of the disease and the age of the children.



Prevention of meningitis with vaccines

Acute meningitis is life-threatening and presents with increased morbidity and mortality. A distinguishing characteristic exists between bacterial meningitis and the more common viral meningitis. With the increased use of the said conjugate vaccines, the annual occurrences of bacterial meningitis in the US decreased from the earlier 1.9 down to1.5 cases per 100,000 persons between the years 1998 and 2003, with a total mortality rate of 15.6%. The frequency rates in developing countries, however, continue to hover around the higher numbers.

In the year 2009, around 88,000-odd cases of meningococcal disease (assumed) were reported in the countries in the “meningitis belt,” which resulted in close to 5,000-5,500 deaths. The worst hit regions and countries were Niger and Nigeria where the combined fatalities and cases were close to 3,000 deaths and 69,500 cases. Between the year 2003 and 2007, 10% of the epidemic cases were due to W135 and 87.8% were due to serogroup A.

Prevention with meningitis vaccines
Conjugate vaccines administered in early childhood for the following – H. influenzae types S and B pneumonia have effectively decreased the occurrence of bacterial meningitis in both children and adults. While, the overall occurrences of pneumococcal meningitis have reduced with the administration of the said conjugate vaccine, the fraction of cases of meningitis caused due to the nonvaccine serotypes has gone up. Also, the number of isolates that were insusceptible to cefotaxime and penicillin has also gone up. The newer form of conjugate vaccine against Neisseria meningitides is suggested to be administered to all persons with complement component deficiencies, travelers to meningococcal disease endemic regions, and children between the ages of 11 and 18 years.

This vaccine is active against serogroups A, C, W135, and Y, but not serogroup B. Patients with asplenia (anatomic or functional) should be vaccinated against H. influenzae, pneumococcal and meningitis vaccine. Patients who are in the hospital suffering from meningitis of an uncertain etiology or with the N. meningitides infection will need droplet precautions for the first one day of the treatment, or until the latter can be eliminated.

Currently available meningitis vaccines
Meningococcal bacteria can cause meningitis and septicemia (meningococcal disease). Vaccines are now available for all the five groups – A, B, C, W, and Y, which are the common disease causing agents. These include Men B, Men C, Men ACWY, Hib, Pneumococcal conjugate vaccine (PCV), Pneumococcal polysaccharide vaccine (PPV), MMR, BCG and MenACWY for travel. It is always beneficial to consult the doctor before you take any vaccinations.



Cerebral edema and its management

Cerebral edema is the increase in the content of brain water, that is when the brain water content rises above the normal levels of 8/10ths. This disorder is usually a result of and response to a primary brain insult. Cerebral edemas are observed in a large number of cases related to brain injuries, including but not limited to toxic–metabolic derangements, inflammatory diseases, primary and metastatic neoplasms, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage or traumatic brain injury.

Medical treatment

Osmotic therapy: The most effective and quick method of reducing brain bulk and tissue water is Osmotherapy. Osmotic therapy is designed to decrease blood viscosity by sucking the water and fluids out of the brain using an osmotic gradient. These changes trigger a reduction in the ICP (intracranial pressure) and result in an increase of the CBF (cerebral blood flow, i.e., blood to the brain). The most-employed and popular osmotic agent are Mannitol, while another popular one is Glycerol. The latter is a beneficial agent which is employed to patients orally as a 2.5% saline solution in the form of 50g in 500 ml in the daily IV or amounts of 30 ml and given every 4-6 hours.

Diuretics: As is with osmotic therapy, the osmotic effect can be extended and lengthened using loop diuretics (Furosemide) after the infusion of an osmotic agent. The loop diuretics can be used as aides.

Corticosteroids: Corticosteroids are responsible for lowering the ICP (intracranial pressure) chiefly in the vasogenic edema, especially because of its positive effects and consequences on the blood vessel. The edema around the brain tumors, especially the metastatic brain tumors, responds excellently if the treatment is done with a high dosage of Dexamethasone.

Hyperventilation: Raised ICP can be reduced in a helpful way using controlled hyperventilation. The cerebral vascular system is susceptible to changes in arterial pCO2, especially when they waver from their usual levels of 40 mm Hg. While the ICP falls as soon as the commencement of hyperventilation happens, the extracellular fluid and the CSF have safeguarding mechanisms which quickly restore the pH level to normal, and the effects of which could last for a long time.

Surgical treatment: Sometimes, surgical treatment is suggested for life-threatening shifts in the brain and large hemispherical infarcts with edema. Temporary craniectomy or ventriculostomy could prevent the worsening and could even end up being a lifesaver. In severe cases of hydrocephalus, the VP shunt proves to be a boon.



Frequency of bone-density testing in older women

Osteoporosis is a condition that leads to the bones being weakened and a heightened likelihood of fractures. Millions of people across the US are already suffering from osteoporosis or are now exposed to greater risk for fractures because of their BMD (bone mineral density) being much less than usual, which means they are suffering from osteopenia.

Osteoporosis usually progresses silently and slowly with no symptoms until one sees a fracture happen. However, early screening can identify if the bone density is low, following which therapies and lifestyle changes can help lessen the fractures risk and even remove any issues related to bone density. Therefore, current osteoporosis management guidelines recommend routine bone mineral density (BMD) test for women 65 years of age or older. But there is no enough data to specify how often to undergo the test.

To help clinicians decide on the intervals for BMD testing in women in whose initial assessment osteoporosis doesn’t show up, Dr. Gourlay and his research team at the University of NC analyzed data on a total of 4957 women, 67 years of age or older, and followed prospectively for up to 15 years.

Based on their original bone density test, the study subjects were divided into four groups – advanced, moderate or normal or mild osteopenia. The women were given two to five BMD tests at varying intervals during the study period.

The study report published in the New England Journal of Medicine on 19th January 2012, showed results that are suggestive that are less than 1% of women with regular bone mineral density progressed to developing osteoporosis during the study period. Only 5% who had somewhat low bone density initially went on to have osteoporosis. This suggests that women from these two categories need not be rescreened for around 15 years as they are likely to be safe until then. That’s great news for this category of women.

However, the data shows that 10% (that’s 1 out of 10 women) with moderate osteopenia during their initial assessment made the transition to osteoporosis in 5 years. And for women with advanced osteopenia initially, close to 10% got osteoporosis in a matter of a year, indicating that this group needed the 1-year screening intervals.

Of note, the study report also suggests that frequency of screening may also be influenced by other risk factors, including age, specific diseases or medications.



Things you should know about percutaneous lumbar laser disc decompression

Spinal stenosis is usually categorized as either a postnatal developmental disorder or one that is caused by congenital abnormalities, that is a primary one. It can also be acquired as a result of deteriorating changes or as outcomes of surgery, trauma or even a local infection. Degenerative lumbar spinal stenosis can happen anywhere – the foramina, lateral recess, the central canal or even every and any combination of these locations. Hence spinal stenosis treatment is important.

In 1934, Barr and Mixter described the clinical treatment for rupturing the intervertebral disc. Ever since that time, the surgical procedures becoming open have become quite common in practice. Disc herniations are usually categorized as either being non-contained or contained.

As for contained disc herniation, the consequences of open surgical discectomy for the same have not been favorable. Keeping this in view, several minimally invasive techniques were developed, one of which is percutaneous lumbar laser disc decompression.

The idea of using lasers for the treatment of herniations of the lumbar disc was conceived in the early 1980’s. After a series of laboratory experiments, Choy and colleagues carried out the first percutaneous lumbar laser disc decompression on a patient in February 1986. This procedure, fortunately, received FDA approval in 1991. Since then, many laser spine institutes locations have been performing percutaneous lumbar laser disc decompressions as well as laser surgery spinal stenosis worldwide.

Clinical evidences
A prospective uncontrolled study by Duarte and Costa published in 2000 evaluated the efficacy of percutaneous lumbar laser disc decompression performed under CT guidance and local anesthetic. An appropriate selection criterion was employed. Utilizing MacNab criteria to include functional recovery, pain reduction and absence of drug dependency, the study results showed that 67% of patients experienced good results and 9% acceptable outcomes.

Laser decompression technology has shown a relatively stable success rate over time. In another observational study report by Knight and Goswami in 2002, the authors reported good or satisfactory results in 80% of patients with lumbar disc herniations.

In a case-control study report by Zhao and coworkers, published in 2005, the authors found that 82% of patients with a “good” indication experienced either a good or excellent treatment response, which favorably compared to 56% of patients who had less than a good indication.
Based on the evidence from a large number of similar observational studies, laser disc decompression appears to provide considerable relief in properly selected patients with lumbar disc herniation.