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Balkinization
Jack Balkin: jackbalkin at yahoo.com Bruce Ackerman bruce.ackerman at yale.edu Ian Ayres ian.ayres at yale.edu Corey Brettschneider corey_brettschneider at brown.edu Mary Dudziak mary.l.dudziak at emory.edu Joey Fishkin joey.fishkin at gmail.com Heather Gerken heather.gerken at yale.edu Abbe Gluck abbe.gluck at yale.edu Mark Graber mgraber at law.umaryland.edu Stephen Griffin sgriffin at tulane.edu Jonathan Hafetz jonathan.hafetz at shu.edu Jeremy Kessler jkessler at law.columbia.edu Andrew Koppelman akoppelman at law.northwestern.edu Marty Lederman msl46 at law.georgetown.edu Sanford Levinson slevinson at law.utexas.edu David Luban david.luban at gmail.com Gerard Magliocca gmaglioc at iupui.edu Jason Mazzone mazzonej at illinois.edu Linda McClain lmcclain at bu.edu John Mikhail mikhail at law.georgetown.edu Frank Pasquale pasquale.frank at gmail.com Nate Persily npersily at gmail.com Michael Stokes Paulsen michaelstokespaulsen at gmail.com Deborah Pearlstein dpearlst at yu.edu Rick Pildes rick.pildes at nyu.edu David Pozen dpozen at law.columbia.edu Richard Primus raprimus at umich.edu K. Sabeel Rahmansabeel.rahman at brooklaw.edu Alice Ristroph alice.ristroph at shu.edu Neil Siegel siegel at law.duke.edu David Super david.super at law.georgetown.edu Brian Tamanaha btamanaha at wulaw.wustl.edu Nelson Tebbe nelson.tebbe at brooklaw.edu Mark Tushnet mtushnet at law.harvard.edu Adam Winkler winkler at ucla.edu Compendium of posts on Hobby Lobby and related cases The Anti-Torture Memos: Balkinization Posts on Torture, Interrogation, Detention, War Powers, and OLC The Anti-Torture Memos (arranged by topic) Recent Posts The Method Formerly Known as Prints
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Saturday, May 29, 2004
The Method Formerly Known as Prints
JB
Jennifer Mnookin explains why it was possible for three professional FBI fingerprint experts to mistakenly insist that Oregon lawyer Brandon Mayfield's fingerprint matched a partial print found on a bag in Madrid that contained explosive detonators:
The growing size of computer fingerprint databases makes this issue still more acute. As a database grows in size, the probability that a number of people will have strikingly similar prints also grows. Instead of ignoring the issue, forensic scientists need to investigate the frequencies of different ridge characteristics and develop difficult proficiency tests that examine the capability of fingerprint experts to accurately differentiate between superficially similar prints.
The FBI called the resemblance between Mayfield and Daoud's prints "remarkable." What is truly remarkable is that we simply do not know how often different people's prints may significantly resemble one another, or how good examiners are at distinguishing between such prints. DNA profiling provides what is called a "random match probability": the odds that the DNA of someone picked at random would match the profile in question. With fingerprinting, we entirely lack the information to provide an equivalent statistic. Yet without this knowledge we cannot accurately evaluate the evidentiary value of a supposed fingerprint match.
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mesothelioma Mesotheliomais a form of cancer that is almost always caused by exposure to Asbestos In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart the pericardium (a sac that surrounds the heart or tunica vaginalis.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing Mesothelioma Unlike lung cancer, there is no association between mesothelioma and smoking but smoking greatly increases risk of other asbestos induced cancer.Compensation via Asbestos funds or lawsuits is an important issue in mesothelioma The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis, which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing. Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesotheliomaSymptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. Mesothelioma that affects the pleura can cause these signs and symptoms: chest wall pain pleural effusion, or fluid surrounding the lung shortness of breath fatigue or anemia wheezing, hoarseness, or cough blood in the sputum (fluid) coughed up hemoptysis In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung The disease may metastasize, or spread, to other parts of the body. Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include: abdominal pain ascites, or an abnormal buildup of fluid in the abdomen a mass in the abdomen problems with bowel function weight loss In severe cases of the disease, the following signs and symptoms may be present: blood clots in the veins, which may cause thrombophlebitis disseminated intravascular coagulation a disorder causing severe bleeding in many body organs jaundice, or yellowing of the eyes and skin low blood sugar level pleural effusion pulmonary emboli, or blood clots in the arteries of the lungs severe ascites A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. There is no universally agreed protocol for screening people who have been exposed to asbestosScreening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for mesotheliomaThe level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells Incidence Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal. Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[ Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma. Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite. asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney. The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer bronchial carcinoma). The Kent brand of cigarettes used mesothelioma in its filters for the first few years of production in the 1950s and some cases of . have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma. Some studies suggest that simian virus 40 may act as a cofactor in the development of mesothelioma. Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with . exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of . exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure. Recent findings have shown that a mineral called erionite has been known to cause genetically pre-dispositioned individuals to have malignant mesothelioma rates much higher than those not pre-dispositioned genetically. A study in Cappadocia, Turkey has shown that 3 villiages in Turkey have death rates of 51% attributed to erionite related mesotheliomaExposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum. The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure. Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia. Family members and others living with asbestos workers have an increased risk of developing mesothelioma and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestosMany building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos Those performing renovation works or activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials. For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall. Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation Therapy when given alone with curative intent has never been shown to improve survival from mesothelioma The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic. Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery. This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give. Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin. In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates. Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer. mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects. A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells. What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs to glide easily against adjacent structures. The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The mesothelioma tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women. What is mesothelioma? mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum. How common is mesothelioma? Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of . exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. . has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney. Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung. Who is at increased risk for developing mesothelioma? asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure. The risk o f asbestosrelated disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma On the other hand, not all workers who are heavily exposed develop asbestos-related diseases. There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace. What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis How is mesotheliomadiagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment. Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs. How is .treated? Treatment for mesothelioma depends on the location of the cancerthe stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Surgery is a common treatment for mesotheliomaThe doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesotheliomaa lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Stereo Tactic Radiation Therapy also called radiotherapy, involves the use of high-energy rays to kill cancercells and shrink tumors Radiation therapy affects the cancercells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancercells are found (internal radiation therapy). Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesotheliomaare given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy). To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation Therapy and surgery may also be helpful in relieving symptoms.
Any risk that can be quantified can potentially be insured. Specific kinds of risk that may give rise to claims are known as "perils". An insurance policy will set out in detail which perils are covered by the policy and which are not. Below are (non-exhaustive) lists of the many different types of insurance that exist. A single policy may cover risks in one or more of the categories set out below. For example, auto insurance would typically cover both property risk (covering the risk of theft or damage to the car) and liability risk (covering legal claims from causing an accident). A homeowners insurance policy in the U.S. typically includes property insurance covering damage to the home and the owner's belongings, liability insurance covering certain legal claims against the owner, and even a small amount of coverage for medical expenses of guests who are injured on the owner's property.
Business insurance can be any kind of insurance that protects businesses against risks. Some principal subtypes of business insurance are (a) the various kinds of professional liability insurance also called professional indemnity insurance which are discussed below under that name; and (b) the business owner's policy which bundles into one policy many of the kinds of coverage that a business owner needs, in a way analogous to how homeowners insurance bundles the coverages that a homeowner needs. Vehicle insuranceAuto insurance protects you against financial loss if you have an accident. It is a contract between you and the insurance company. You agree to pay the premium and the insurance company agrees to pay your losses as defined in your policy. Auto insurance provides property, liability and medical coverage: Property coverage pays for damage to or theft of your car. Liability coverage pays for your legal responsibility to others for bodily injury or property damage. Medical coverage pays for the cost of treating injuries, rehabilitation and sometimes lost wages and funeral expenses. An iauto nsurance policy is comprised of six different kinds of coverage. Most countries require you to buy some, but not all, of these coverages. If you're financing a car, your lender may also have requirements. Most auto policies are for six months to a year. In the United States, your insurance company should notify you by mail when it’s time to renew the policy and to pay your premium. Home insuranceHome insurance provides compensation for damage or destruction of a home from disasters. In some geographical areas, the standard insurance excludes certain types of disasters, such as flood and earthquakes, that require additional coverage. Maintenance-related problems are the homeowners' responsibility. The policy may include inventory, or this can be bought as a separate policy, especially for people who rent housing. In some countries, insurers offer a package which may include liability and legal responsibility for injuries and property damage caused by members of the household, including pets. Health insurance and Dental iinsurance Health insurance policies by the National Health Service in the United Kingdom or other publicly-funded health programs will cover the cost of medical treatments. Dental insurance like medical insurance is coverage for individuals to protect them against dental costs. In the U.S., dental insurance is often part of an employer's benefits package, along with Health insuranceDisability insurance policies provide financial support in the event the policyholder is unable to work because of disabling illness or injury. It provides monthly support to help pay such obligations as mortgages and credit cards. Disability overhead insurance allows business owners to cover the overhead expenses of their business while they are unable to work. Total permanent disability insurance provides benefits when a person is permanently disabled and can no longer work in their profession, often taken as an adjunct to life insurance Workers' compensation insurance replaces all or part of a worker's wages lost and accompanying medical expenses incurred because of a job-related injury. Casualty insurance insures against accidents, not necessarily tied to any specific property. Casualty insuranceCrime insurance is a form of casualty insurance that covers the policyholder against losses arising from the criminal acts of third parties. For example, a company can obtain crime insurance to cover losses arising from theft or embezzlement. Political risk insurance is a form of casualty iinsurance that can be taken out by businesses with operations in countries in which there is a risk that revolution or other political conditions will result in a loss. Life insuranceLife insurance provides a monetary benefit to a decedent's family or other designated beneficiary, and may specifically provide for income to an insured person's family, burial funeral and other final expenses. Life insurance policies often allow the option of having the proceeds paid to the beneficiary either in a lump sum cash payment or an annuity. Annuities provide a stream of payments and are generally classified as insurance because they are issued by insurance companies and regulated as insurance and require the same kinds of actuarial and investment management expertise that life insurance requires. Annuities and pensions that pay a benefit for life are sometimes regarded as insurance against the possibility that a retiree will outlive his or her financial resources. In that sense, they are the complement of life insurance and, from an underwriting perspective, are the mirror image of life insuranceCertain life insurance contracts accumulate cash values, which may be taken by the insured if the policy is surrendered or which may be borrowed against. Some policies, such as annuities and endowment policies are financial instruments to accumulate or liquidate wealth when it is needed. In many countries, such as the U.S. and the UK, the tax law provides that the interest on this cash value is not taxable under certain circumstances. This leads to widespread use of life insurance as a tax-efficient method of saving as well as protection in the event of early death. In U.S., the tax on interest income on life insurance policies and annuities is generally deferred. However, in some cases the benefit derived from tax deferral may be offset by a low return. This depends upon the insuring company, the type of policy and other variables (mortality, market return, etc.). Moreover, other income tax saving vehicles may be better alternatives for value accumulation. A combination of low-cost term life insurance and a higher-return tax-efficient retirement account may achieve better investment return. Property insurance Property insurance provides protection against risks to property, such as fire, theft or weather damage. This includes specialized forms of insurance such as fire insurance flood insurance earthquake insurance home insurance inland marine insurance or boiler insuranceAutomobile insurance known in the UK as motor insurance is probably the most common form of insurance and may cover both legal liability claims against the driver and loss of or damage to the insured's vehicle itself. Throughout the United States an auto insurance policy is required to legally operate a motor vehicle on public roads. In some jurisdictions, bodily injury compensation for automobile accident victims has been changed to a no-fault system, which reduces or eliminates the ability to sue for compensation but provides automatic eligibility for benefits. Credit card companies insure against damage on rented cars. Driving School insurance provides cover for any authorized driver whilst undergoing tuition, cover also unlike other motor policies provides cover for instructor liability where both the pupil and driving instructor are equally liable in the event of a claim. Aviation insurance insures against hull, spares, deductibles, hull wear and liability risks. Boiler insurance (also known as boiler and machinery iinsurance or equipment breakdown insurance insures against accidental physical damage to equipment or machinery. Builder's risk insurance insures against the risk of physical loss or damage to property during construction. Builder's risk insurance is typically written on an "all risk" basis covering damage due to any cause (including the negligence of the insured) not otherwise expressly excluded. Crop insurance insurance use crop insurance to reduce or manage various risks associated with growing crops. Such risks include crop loss or damage caused by weather, hail, drought, frost damage, insects, or disease, for instance." Earthquake insurance is a form of property insurance that pays the policyholder in the event of an earthquake that causes damage to the property. Most ordinary homeowners insurance policies do not cover earthquake damage. Most earthquake insurance policies feature a high deductible. Rates depend on location and the probability of an earthquake, as well as the construction of the home A insurance bond is a form of casualty insurance that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures a business for losses caused by the dishonest acts of its employees. Flood insurance protects against property loss due to flooding. Many insurers in the U.S. do not provide flood insurance in some portions of the country. In response to this, the federal government created the National Flood insurance Program which serves as the insurer of last resort. Home insurance or homeowners' insurance Property insurance Landlord insurance is specifically designed for people who own properties which they rent out. Most house insurance cover in the U.K will not be valid if the property is rented out therefore landlords must take out this specialist form of home insurance Marine insurance and marine cargo insurance cover the loss or damage of ships at sea or on inland waterways, and of the cargo that may be on them. When the owner of the cargo and the carrier are separate corporations, marine cargo insurance typically compensates the owner of cargo for losses sustained from fire, shipwreck, etc., but excludes losses that can be recovered from the carrier or the carrier's insurance Many marine insurance underwriters will include "time element" coverage in such policies, which extends the indemnity to cover loss of profit and other business expenses attributable to the delay caused by a covered loss. Surety bond insurance is a three party insurance guaranteeing the performance of the principal. Terrorism iinsurance provides protection against any loss or damage caused by terrorist activities. Volcano insurance is an insurance that covers volcano damage in Hawaii. Windstorm insurance is an insurance covering the damage that can be caused by hurricanes and tropical cyclones. Liability insuranceLiability insurance is a very broad superset that covers legal claims against the insured. Many types of insurance include an aspect of liability coverage. For example, a homeowner's insurance policy will normally include liability coverage which protects the insured in the event of a claim brought by someone who slips and falls on the property; automobile insurance also includes an aspect of liability insurance that indemnifies against the harm that a crashing car can cause to others' lives, health, or property. The protection offered by a liability insurance policy is twofold: a legal defense in the event of a lawsuit commenced against the policyholder and indemnification (payment on behalf of the insured) with respect to a settlement or court verdict. Liability policies typically cover only the negligence of the insured, and will not apply to results of wilful or intentional acts by the insured. Directors and officers liability insurance protects an organization (usually a corporation) from costs associated with litigation resulting from mistakes made by directors and officers for which they are liable. In the industry, it is usually called for short. Environmental liability insurance protects the insured from bodily injury, property damage and cleanup costs as a result of the dispersal, release or escape of pollutants. Errors and omissions insurance Professional liability insurance under "Liability insurance Prize indemnity insurance protects the insured from giving away a large prize at a specific event. Examples would include offering prizes to contestants who can make a half-court shot at a basketball game, or a hole-in-one at a golf tournament. Professional liability insurance also called professional indemnity insurance protects insured professionals such as architectural corporation and medical practice against potential negligence claims made by their patients/clients. Professional liability insurance may take on different names depending on the profession. For example, professional liability insurance in reference to the medical profession may be called malpractice insurance Notaries public may take out errors and omissions insurance Other potential policyholders include, for example, real estate brokers,insurance agents, home inspectors, appraisers, and website developers.
mesothelioma Mesotheliomais a form of cancer that is almost always caused by exposure to Asbestos In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart the pericardium (a sac that surrounds the heart or tunica vaginalis.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing Mesothelioma Unlike lung cancer, there is no association between mesothelioma and smoking but smoking greatly increases risk of other asbestos induced cancer.Compensation via Asbestos funds or lawsuits is an important issue in mesothelioma The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis, which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing. Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesotheliomaSymptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. Mesothelioma that affects the pleura can cause these signs and symptoms: chest wall pain pleural effusion, or fluid surrounding the lung shortness of breath fatigue or anemia wheezing, hoarseness, or cough blood in the sputum (fluid) coughed up hemoptysis In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung The disease may metastasize, or spread, to other parts of the body. Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include: abdominal pain ascites, or an abnormal buildup of fluid in the abdomen a mass in the abdomen problems with bowel function weight loss In severe cases of the disease, the following signs and symptoms may be present: blood clots in the veins, which may cause thrombophlebitis disseminated intravascular coagulation a disorder causing severe bleeding in many body organs jaundice, or yellowing of the eyes and skin low blood sugar level pleural effusion pulmonary emboli, or blood clots in the arteries of the lungs severe ascites A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. There is no universally agreed protocol for screening people who have been exposed to asbestosScreening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for mesotheliomaThe level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells Incidence Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal. Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[ Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma. Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite. asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney. The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer bronchial carcinoma). The Kent brand of cigarettes used mesothelioma in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma. Some studies suggest that simian virus 40 may act as a cofactor in the development of mesothelioma. Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure. Recent findings have shown that a mineral called erionite has been known to cause genetically pre-dispositioned individuals to have malignant mesothelioma rates much higher than those not pre-dispositioned genetically. A study in Cappadocia, Turkey has shown that 3 villiages in Turkey have death rates of 51% attributed to erionite related mesotheliomaExposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum. The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure. Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia. Family members and others living with asbestos workers have an increased risk of developing mesothelioma and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestosMany building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos Those performing renovation works or activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials. For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall. Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation Therapy when given alone with curative intent has never been shown to improve survival from mesothelioma The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic. Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery. This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give. Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin. In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates. Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer. mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects. A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells. What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs to glide easily against adjacent structures. The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The mesothelioma tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women. What is mesothelioma? mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum. How common is mesothelioma? Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney. Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung. Who is at increased risk for developing mesothelioma? asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure. The risk o f asbestosrelated disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma On the other hand, not all workers who are heavily exposed develop asbestos-related diseases. There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace. What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis How is mesotheliomadiagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary. If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment. Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs. How is mesotheliomatreated? Treatment for mesothelioma depends on the location of the cancerthe stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Surgery is a common treatment for mesotheliomaThe doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesotheliomaa lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Stereo Tactic Radiation Therapy also called radiotherapy, involves the use of high-energy rays to kill cancercells and shrink tumors Radiation therapy affects the cancercells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancercells are found (internal radiation therapy). Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesotheliomaare given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy). To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation Therapy and surgery may also be helpful in relieving symptoms. First Drunk Driving Conviction The first time you are arrested in the State of Texas for drunk driving you will receive a fine up to $2,000. You will also be confined to jail for no less than 72 hours and no more than 180 days. Your drivers license will be suspended for no less than 90 days and no more than 1 year. You may also be ordered to install an ignition interlock device on the vehicle at your own expense. Second Drunk Driving Conviction The second time you are arrested and convicted of a DWI in Texas you will be fined up to $4,000. You will also serve a minimum of 30 days in jail up to 1 year. Your drivers license will be suspended for a minimum of 6 months or up to 2 years. You may also be ordered to install an ignition interlock device on the vehicle at your own expense. Third Drunk Driving Conviction The 3rd conviction for a DWI in Texas is considered a 3rd degree felony. You will be fined up to $10,000 and serve no less than 2 years or up to 10 years in the penitentiary. Your drivers license will also be suspended up to 2 years. You may also be ordered to install an ignition interlock device on the vehicle at your own expense. The State of Texas prohibits the operation of a motor vehicle by drivers with a .08 percent or above blood alcohol concentration (BAC). The .08 limit is used across the United States as the benchmark for the "impaired" driver. Texas has lower limits in place for commercial drivers (.04) and for drivers under the age of 21 (.02). The Texas DWI law also makes it illegal to drive while under the influence of controlled substances such as marijuana, cocaine, inhalants and other intoxicants
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Obat untuk kencing keluar nanah Obat kimia kencing nanah Obat kampung kencing nanah Obat kapsul kencing nanah Obat khusus kencing nanah Kamboja obat kencing nanah Konsultasi obat kencing nanah Kunyit obat kencing nanah Kulit manggis obat kencing nanah obat sipilis denature indonesia obat sipilis resep dokter obat sipilis denature obat sipilis paling manjur obat sipilis alami obat sipilis di apotik umum obat sipilis kaskus obat sipilis pada wanita obat sipilis paling ampuh Pengobatan herpes di kelamluan pria jenis obat herpes jamu obat herpes jagung obat herpes obat herpes kulit obat herpes kulit alami obat herpes kulit pada bayi obat herpes kulit di apotik obat herpes kelamin pria obat herpes kemaluan
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Bagaimana Cara Mengobati Jengger Ayam Obat Tradisional Penyakit Jengger Ayam Cara Pengobatan Jengger Ayam Mujarab Cara Menyembuhkan Jengger Ayam Obat Herbal Penyakit Jengger Ayam Obat Mujarab Untuk Jengger Ayam Mengobati Jengger Ayam Pada Wanita Mengobati Jengger Ayam Pada Pria Pengobatan Tradisional Jengger Ayam Apa Nama Obat Jengger Ayam Obat Jengger Ayam Ampuh di Apotik Nama Obat Herpes Genital Ampuh Cara Mengobati Herpes Genital Manjur Pengobatan Herpes Genital Untuk Wanita Pengobatan Herpes Genital Untuk Pria Cara Mengobati Penyakit Herpes Genital Cara Pengobatan Herpes Genital Mujarab Obat Penyakit Herpes Genital Manjur Obat Tradisional Penyakit Herpes Pengobatan Ampuh Herpes Genital Obat Herpes Genital di Apotik Tips Pengobatan Herpes Genital
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Obat Kondiloma Akuminata Manjur Pengobatan Kondiloma Akuminata Mujarab Nama Obat Kondiloma Atau Kutil Kelamin Cara Mengobati Kondiloma Akuminata Herbal Pengobatan Ampuh Kondiloma Akuminata Tradisional Bagaimana Mengobati Kondiloma Obat Penyakit Kondiloma Akuminata Alami Kondiloma Akuminata dan Pengobatannya Pengobatan Alternatif Kondiloma Akuminata Pengobatan Kondiloma Akuminata Pada Wanita Penyebab Kondiloma dan Pengobatannya Obat Kanker Payudara Paling Manjur Mengobati Kanker Payudara Dengan Cepat dan Aman Pengobatan Herbal Kanker Payudara Stadium 3 Mengobati Kanker Payudara Tanpa Operasi Cara Mengobati Kanker Payudara Ampuh Stadium Akhir Cara Mengobati Kanker Payudara Mujarab Inilah Obat Kanker Payudara Yang Ampuh Penyakit Kanker Payudara Tanpa Operasi Obat Kanker Payudara Tanpa Operasi Stadium 2 Cara Tradisional Menyembuhkan Kanker Payudara Cara Menyembuhkan Kanker Payudara Tanpa Operasi
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Nama Obat Gonore Ampuh di Apotik, Cara Mengobati Penyakit Gonore, Cara Pengobatan Gonore Manjur, Obat Gonore Ampuh, Cara Mengobati Gonore Pada Wanita, Cara Mengobati Gonore Ampuh, Obat Penyakit Gonore Pada Pria, Obat Gonore Manjur, Cara Mengatasi Gonore Aman, Pengobatan Gonore Ampuh De Nature, Obat Penyakit Gonore Paling Ampuh, Pengobatan Paling Ampuh Gonore, Cara Pengobatan Gonore, Cara Mengobati Gonore Pada Pria, Cara Mengobati Gonore Pada Pria, Penyakit Gonore dan Obatnya, Obat Gonore Tradisional, Obat Gonore Paling Manjur De Nature, Obat Gonore Ampuh Resep Dokter, Obat Gonore Tradisional || Pengobatan Penyakit Sipilis Paling Ampuh, Obat Penyakit Sipilis Paling Ampuh, Pengobatan Penyakit Sipilis Pada Wanita, Cara Menyembuhkan Sipilis, Obat Herbal Untuk Penyakit Sipilis, Cara Mengobati Sipilis Paling Manjur, Cara Menyembuhkan Gejala Sipilis, Cara Pengobatan Penyakit Sipilis, Obat Alami Untuk Gejala Penyakit Sipilis, Obat Penyakit Sipilis De Nature, Cara Menghilangkan Gejala Sipilis, Nama Obat Sipilis Paling Ampuh, Pengobatan Sipilis Untuk Pria, Resep Obat Sipilis Tradisional, Mengobati Penyakit Sipilis, Apa Obat Sipilis Yang Ampuh, Mengobati Penyakit Sipilis Dengan Cepat, Pengobatan Sipilis Ampuh di Bandung, Cara Pengobatan Sipilis Pada Pria, Cara Pengobatan Sipilis Pada Wanita
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Cara Mengatasi Keputihan Berwarna Hijau, Obat Alami Wasir Atau Ambeien Pasca Melahirkan, Obat Untuk Kutil di Sekitar Vagina, Cara Mengatasi Keputihan, Obat Alami Wasir, Obat Untuk Kutil Kelamin, Obat Gonore Murah, Obat Penyakit Gonore, Pengobatan Tradisional Sipilis, Cara Mengatasi Sipilis, Obat Tradisional Sipilis
obat kutil kelamin resep dokter
resep obat kutil kelamin obat kutil kelamin salep obat kutil di sekitar kelamin obat sakit kutil kelamin obat kutil kelamin terbaik Obat kutil kelamin yang untuk wanita hamil obat kutil kelamin terbaru obat tradisional kutil kelamin obat tradisional untuk kutil kelamin obat herbal untuk kutil kelamin cara menyembuhkan herpes kelamin obat herpes pada alat kelamin pria obat herpes paling mujarab obat herpes paling ampuh obat herpes paling manjur obat herpes pada alat vital obat herpes pada balita obat herpes propolis obat herpes pada pria obat herpes pada tangan obat herpes penyakit kelamin Obat wasir untuk ibu hamil Obat wasir untuk ibu hamil Obat wasir apotik Obat wasir paling ampuh Obat wasir ardium Obat wasir di apotik Obat wasir luar Obat wasir ampuh di apotik Obat wasir alami dari tumbuhan Obat wasir untuk ibu menyusui Obat wasir parah Obat wasir venaron Obat kutil kelamin
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Cara mengobati kanker dengan herbal, Cara mengobati kanker dengan tradisional, Cara mengobati kanker dengan alami, Cara mengobati kanker dengan cepat, Cara mengobati kanker stadium 3, Cara mengobati kanker stadium 4, Cara mengobati kanker stadium awal, Cara mengobati kanker stadium 2, Cara mengobati kanker stadium akhir, Cara mengobati kanker tanpa ke dokter, Gambar obat kanker yang ampuh, Gambar obat kanker yang ampuh, Obat kanker ampuh dengan singkong, Cara mengobati kanker stadium awal tanpa operasi, Obat kanker manjur dari tumbuhan, Cara mengobati kanker stadium 1 tanpa operasi, Obat kanker ampuh dengan daun sirsak, Cara mengobati kanker stadium 2 tanpa operasi, Obat kanker paling mujarab yang efektif, Cara mengobati kanker stadium 3 tanpa operasi, Cara mengobati kanker stadium 3, Cara mengobati kanker stadium 4 tanpa operasi, Obat kanker paling manjur 2016, Cara mengobati kanker stadium akhir tanpa operasi, Pengobatan kanker mujarab tanpa operasi, Cara pengobatan kanker yang manjur, Pengobatan kanker manjur dan aman, Cara pengobatan kanker yang mujarab, Cara pengobatan kanker tanpa operasi, Cara pengobatan kanker yang ampuh, Obat kanker mujarab tanpa operasi, Obat kanker manjur tanpa operasi, Obat De Nature
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Obat jengger ayam paling murah, Obat jengger ayam alami dan ampuh, Obat jengger ayam di apotik ampuh, Obat jengger ayam manjur tanpa operasi, Obat jengger ayam herbal, Cara obat jengger ayam ampuh, Ciri ciri penyakit jengger ayam, Gejala penyakit jengger ayam dan obatnya, Gambar penyakit jengger ayam, Obat mujarab untuk penyakit jengger ayam, Pengobatan de nature jengger ayam, Obat jengger ayam di apotik, Obat jengger ayam mujarab, Pengobatan jengger ayam untuk wanita, Penyakit kelamin jengger ayam, Cara mengobati jengger ayam, Pengobatan jengger ayam manjur, Pengobatan jengger ayam paling murah, Pengobatan penyakit jengger ayam kutil kelamin, Obat alami untuk penyakit jengger ayam, Pengobatan penyakit jengger ayam kutil kelamin, Cara mengobati jengger ayam, Cara menyembuhkan jengger ayam, Cara menghilangkan jengger ayam, Cara mengatasi jengger ayam, Cara pengobatan jengger ayam tradisional, Cara pengobatan jengger ayam herbal, Cara pengobatan jengger ayam alami, Cara pengobatan jengger ayam alternatif, Obat jengger ayam murah, Obat De Nature
obat penyakit kutil kelamin
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Obat Ambeien Dalam Obat Ambeien Tradisional Cina Obat Ambeien Ardium Obat Ambeien Herbal Yang Ampuh Obat Ambeien Salep Obat Ambeien Ibu Menyusui Obat Ambeien Untuk Anak Obat Ambeien Apotik Obat Ambeien Ambeclear Obat Wasir Yang Murah dan Ampuh Obat Ambeien Secara Alami Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir Obat Ambeien 3 Hari Tuntas | Cara Mengobati Wasir
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Obat Jengger Ayam Untuk Pria Obat Jengger Ayam Untuk Wanita Cara Mengobati Jengger Ayam Pada Wanita Cara Mengobati Jengger Ayam Wanita Gambar Penyakit Jengger Ayam Wanita Gambar Obat Tradisional Jengger Ayam Nama Obat Jengger Ayam Obat Jengger Ayam Yang Murah di Apotek Apakah Jengger Ayam Bisa Sembuh Obat Manjur Untuk Jengger Ayam Cara Ampuh Menghilangkan Jengger Ayam Obat Jengger Ayam Herbal Obat Jengger Ayam Alami Obat Jengger Ayam Tradisional Obat Jengger Ayam Alternatif Obat Jengger Ayam di Apotek Obat Jengger Ayam Untuk Wanita Obat Jengger Ayam Untuk Pria Obat Jengger Ayam Ibu Hamil Obat Jengger Ayam Ibu Menyusui Obat Jengger Ayam Tanpa Efek Samping
obat kanker serviks stadium 4 natural herbal
obat kanker serviks secara medis ampuh natural dari alam obat alami penyakit kanker serviks mujarab tanpa operasi obat alami mencegah kanker serviks obat alami mencegah kanker serviks obat herbal buat kanker serviks stadium lanjut Daun sirsak obat kanker serviks yang ampuh dan ajib Daun sirsak sebagai obat kanker serviks obat tradisional gejala kanker serviks obat herbal penyembuh kanker serviks dan pencegah kanker serviks obat herbal menyembuhkan kanker serviks tuntas hilangka penyakit obat herbal atasi kanker serviks pencega obat herbal mengobati kanker serviks stadium 3 obat alami untuk mencegah kanker serviks obat medis untuk kanker serviks wwwobat kanker serviks obat vaksin kanker serviks obat untuk mengatasi kanker serviks
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Jamu Obat Kondiloma Harga Obat Kondiloma Akuminata Gambar Penyakit Kondiloma Akuminata Cara Menyembuhkan Kondiloma Akuminata Menyembuhkan Penyakit Kondiloma Akuminata Harga Obat Kondiloma Akuminata Murah Tanda Tanda Penyakit Kondiloma Akuminata Apa Obat Kondiloma Akuminata Obat Penyembuh Kondiloma Akuminata Nama Obat Kondiloma Akuminata Cara Ampuh Mengobati Kondiloma Akuminata Obat Kutil Genitalis Kondiloma Akuminata Obat Mujarab Untuk Kondiloma Obat Herbal Kondiloma Obat Tradisional Kondiloma Akuminata Obat Herbal Kondiloma Akuminata Mengatasi Penyakit Kondiloma Akuminata Obat Menyembuhkan Kondiloma Obat Salep Kondiloma Akuminata Obat Untuk Penyakit Kondiloma Akuminata Obat Alami Kondiloma Akuminata Obat Ampuh Mengatasi Kondiloma
obat herbal mengobati kanker serviks stadium 3
obat alami untuk mencegah kanker serviks obat medis untuk kanker serviks wwwobat kanker serviks obat vaksin kanker serviks obat untuk mengatasi kanker serviks Tumbuhan untuk obat kanker serviks Obat untuk menyembuhkan kanker serviks obat untuk penderita kanker serviks obat tradisional untuk kanker serviks obat utk kanker serviks obat untuk kanker serviks obat tradisional utk kanker serviks sirsak obat kanker serviks obat sakit kanker serviks hello world obat untuk kanker rahim stadium 3 obat herbal kanker rahim stadium 4 obat kanker rahim stadium 1 1 Obat kanker rahim stadium 2 Obat penyakit herpes kelamin pria
Obat herpes kelamin herbal de nature
Obat herpes Obat herpes alami Obat herpes zoster Obat herpes kulit Obat herpes simplex Obat herpes genital Obat herpes di apotik Obat herpes kulit di apotik Obat herpes genital di apotik Obat herpes untuk bayi resep obat kutil kelamin obat kutil kelamin salep obat kutil di sekitar kelamin obat sakit kutil kelamin obat kutil kelamin terbaik Obat kutil kelamin yang untuk wanita hamil obat kutil kelamin terbaru obat tradisional kutil kelamin obat tradisional untuk kutil kelamin obat herbal untuk kutil kelamin obat tradisional untuk menyembuhkan kutil kelamin Obat jengger ayam ampuh obat kutil kelamin salep obat kutil di sekitar kelamin obat sakit kutil kelamin obat kutil kelamin terbaik Obat kutil kelamin yang untuk wanita hamil obat kutil kelamin terbaru obat tradisional kutil kelamin obat tradisional untuk kutil kelamin obat herbal untuk kutil kelamin obat tradisional untuk menyembuhkan kutil kelamin Obat herpes simplex dan herpes zoster Obat herpes alami Obat herpes zoster Obat herpes kulit Obat herpes simplex Obat herpes genital Obat herpes di apotik Obat herpes kulit di apotik Obat herpes genital di apotik Obat herpes untuk bayi Obat herpes untuk ibu hamil
obat penyakit herpes genital
obat alami herpes genitalis tanaman obat herpes genital nama dan macam obat herpes genital apa nama obat herpes genital apa obat herpes genital obat antibiotik untuk herpes genital obat antivirus herpes genital obat alami penyakit herpes genital obat ampuh herpes genital obat alami untuk herpes genital obat herpes kulit untuk anak obat tradisional gejala kanker serviks obat herbal gejala kanke rserviks obat kanker serviks herbal harga obat kanker serviks obat herbal pencegah kanker serviks Obat herbal penyembuh kanker serviks Obat herbal pencegahan kanker serviks obat herbal mengobati kanker serviks obat herbal mengatasi kanker serviks obat herbal mencegah kanker serviks tanaman herbal obat kanker serviks obat herbal menyembuhkan kanker serviks
obat sipilis paling ampuh
obat sipilis yang ada di apotik obat sipilis jogja obat sipilis de nature obat sipilis tradisional daun sirih obat sipilis antibiotik obat sipilis kimia farma obat sipilis dokter obat sipilis murah obat sipilis thiamycin obat sipilis apotik Cara untuk menghilangkan jengger ayam obat herbal untuk jengger ayam obat penyakit kulit jengger ayam obat untuk menghilangkan jengger ayam obat penyakit jengger ayam alami obat ampuh jengger ayam obat antibiotik jengger ayam obat alami untuk penyakit jengger ayam obat ampuh penyakit jengger ayam obat kutil atau jengger ayam
Ramuan tradisional obat kencing nanah
Ramuan untuk obat kencing nanah Resep obat tradisional kencing nanah Resep obat untuk kencing nanah Obat kencing nanah surabaya Obat kencing nanah secara tradisional Obat kencing nanah super tetra Obat kencing nanah semarang Obat sakit kencing nanah Super tetra obat kencing nanah Cara mengobati jengger ayam dan kutil kelamin obat kutil kelamin obat kutil kelamin di apotik obat kutil kelamin tradisional obat kutil kelamin wanita obat kutil kelamin pada pria obat kutil kelamin apotik obat kutil kelamin murah obat kutil kelamin de nature obat kutil kelamin untuk ibu hamil obat kutil kelamin dokter
ramuan obat herpes tradisional
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Obat tradisional buat kutil kelamin
Obat salep buat kutil kelamin Www.obat kutil kelamin.com Obat cina kutil kelamin Cuka obat kutil kelamin Obat cina untuk kutil kelamin obat herpes secara tradisional obat herpes soster obat herpes selain asiklovir obat herpes simplex untuk ibu hamil obat herpes simplex pada anak obat herpes simplex adalah obat sakit herpes kulit obat salep herpes zoster obat salep herpes kelamin obat herpes tradisional Obat kutil kelamin yang untuk wanita hamil obat kutil di sekitar kelamin obat sakit kutil kelamin obat kutil kelamin terbaik obat kutil kelamin salep obat kutil kelamin terbaru obat tradisional kutil kelamin obat tradisional untuk kutil kelamin obat herbal untuk kutil kelamin obat tradisional untuk menyembuhkan kutil kelamin obat kutil kelamin yang tersedia di apotek
obat tradisonal kanker serviks
obat tradisional kanker serviks obat herbal kanker serviks ampuh obat herbal ampuh mujarab kanker serviks obat untuk menyembuhkan kanker serviks obat kanker serviks obat kanker serviks almi obat kanker serviks stadium 3 obat kanker serviks 2011 gejala kanker serviks obat kanker serviks stadium awal apa obat herpes harga obat herpes obat herpes embuh tuntas obat herbal herpes genital alami obat herpes cepat kering obat herpes apotik obat herpes ibu hamil obat herpes jelly gamat obat penghilang luka herpes obat menghilangkan herpes obat herpes alat vital obat herpes di mulut tanaman untuk obat kanker serviks
obat tradisonal kanker serviks
obat tradisional kanker serviks obat herbal kanker serviks ampuh obat herbal ampuh mujarab kanker serviks obat untuk menyembuhkan kanker serviks obat kanker serviks obat kanker serviks almi obat kanker serviks stadium 3 obat kanker serviks 2011 gejala kanker serviks obat kanker serviks stadium awal apa obat herpes harga obat herpes obat herpes embuh tuntas obat herbal herpes genital alami obat herpes cepat kering obat herpes apotik obat herpes ibu hamil obat herpes jelly gamat obat penghilang luka herpes obat menghilangkan herpes obat herpes alat vital obat herpes di mulut tanaman untuk obat kanker serviks
Obat wasir alami yang ampuh
Obat wasir anoral Obat wasir ambeven Obat wasir ardium hd Obat wasir berdarah di apotik Obat wasir bentuk peluru Obat wasir bengkak Obat wasir boraginol Obat wasir bagus Obat wasir paling ampuh Obat wasir ardium Obat wasir di apotik Obat wasir luar Obat wasir ampuh di apotik Obat wasir alami dari tumbuhan Obat wasir untuk ibu menyusui Obat wasir parah Obat wasir venaron Obat wasir dalam Obat wasir alami bagus Obat wasir ampuh tanpa operasi Obat wasir ambeien Obat wasir ambeclear Obat wasir akut Obat wasir atau ambeien Obat wasir aman untuk ibu hamil Obat wasir ampuh bagus Obat wasir alami untuk ibu hamil Obat wasir anak Cuka apel obat kutil kelamin Obat ampuh menghilangkan kutil kelamin Obat alami menyembuhkan kutil kelamin Obat apotek untuk kutil kelamin Apa obat untuk kutil kelamin
Obat alami untuk mengobati kutil kelamin
Obat kutil kelamin yang ada di apotik Dimana beli obat kutil kelamin Obat tradisional buat kutil kelamin Beli obat kutil kelamin Obat salep buat kutil kelamin Www.obat kutil kelamin.com Obat cina kutil kelamin Cuka obat kutil kelamin Obat cina untuk kutil kelamin Obat cina penghilang kutil kelamin Obat china untuk kutil kelamin Obat kutil di kelamin pria Obat tradisional kutil di kelamin Obat kutil di daerah kelamin Obat untuk menghilangkan kutil di kelamin Obat dokter untuk kutil kelamin Obat kutil di sekitar kelamin Obat farmasi untuk kutil kelamin Obat generik untuk kutil kelamin Obat kutil kelamin imiquimod Jual obat kutil kelamin Jual obat kutil kelamin murah Obat kutil kelamin yg di jual di apotik Jual obat penghilang kutil kelamin
obat herpes ampuh
obat herpes kulit kumpulan tips obat herpes apa obat herpes biar cepat kering obat buat herpes genital obat herpes genital wanita obat herpes kulit alami obat herpes mujarab obat herpes pada mulut obat herpes resep dokter obat herpes tumbuhan obat tradisional herpes genital
obat herpes ampuh
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kanker serviks gejala awal
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Books by Balkinization Bloggers
Brian Z. Tamanaha, A Realistic Theory of Law (Cambridge University Press 2017)
Sanford Levinson, Nullification and Secession in Modern Constitutional Thought (University Press of Kansas 2016)
Sanford Levinson, An Argument Open to All: Reading The Federalist in the 21st Century (Yale University Press 2015)
Stephen M. Griffin, Broken Trust: Dysfunctional Government and Constitutional Reform (University Press of Kansas, 2015)
Frank Pasquale, The Black Box Society: The Secret Algorithms That Control Money and Information (Harvard University Press, 2015)
Bruce Ackerman, We the People, Volume 3: The Civil Rights Revolution (Harvard University Press, 2014) Balkinization Symposium on We the People, Volume 3: The Civil Rights Revolution
Joseph Fishkin, Bottlenecks: A New Theory of Equal Opportunity (Oxford University Press, 2014)
Mark A. Graber, A New Introduction to American Constitutionalism (Oxford University Press, 2013)
John Mikhail, Elements of Moral Cognition: Rawls' Linguistic Analogy and the Cognitive Science of Moral and Legal Judgment (Cambridge University Press, 2013)
Gerard N. Magliocca, American Founding Son: John Bingham and the Invention of the Fourteenth Amendment (New York University Press, 2013)
Stephen M. Griffin, Long Wars and the Constitution (Harvard University Press, 2013) Andrew Koppelman, The Tough Luck Constitution and the Assault on Health Care Reform (Oxford University Press, 2013)
James E. Fleming and Linda C. McClain, Ordered Liberty: Rights, Responsibilities, and Virtues (Harvard University Press, 2013) Balkinization Symposium on Ordered Liberty: Rights, Responsibilities, and Virtues Andrew Koppelman, Defending American Religious Neutrality (Harvard University Press, 2013)
Brian Z. Tamanaha, Failing Law Schools (University of Chicago Press, 2012)
Sanford Levinson, Framed: America's 51 Constitutions and the Crisis of Governance (Oxford University Press, 2012)
Linda C. McClain and Joanna L. Grossman, Gender Equality: Dimensions of Women's Equal Citizenship (Cambridge University Press, 2012)
Mary Dudziak, War Time: An Idea, Its History, Its Consequences (Oxford University Press, 2012)
Jack M. Balkin, Living Originalism (Harvard University Press, 2011)
Jason Mazzone, Copyfraud and Other Abuses of Intellectual Property Law (Stanford University Press, 2011)
Richard W. Garnett and Andrew Koppelman, First Amendment Stories, (Foundation Press 2011)
Jack M. Balkin, Constitutional Redemption: Political Faith in an Unjust World (Harvard University Press, 2011) Gerard Magliocca, The Tragedy of William Jennings Bryan: Constitutional Law and the Politics of Backlash (Yale University Press, 2011)
Bernard Harcourt, The Illusion of Free Markets: Punishment and the Myth of Natural Order (Harvard University Press, 2010)
Bruce Ackerman, The Decline and Fall of the American Republic (Harvard University Press, 2010) Balkinization Symposium on The Decline and Fall of the American Republic
Ian Ayres. Carrots and Sticks: Unlock the Power of Incentives to Get Things Done (Bantam Books, 2010)
Mark Tushnet, Why the Constitution Matters (Yale University Press 2010) Ian Ayres and Barry Nalebuff: Lifecycle Investing: A New, Safe, and Audacious Way to Improve the Performance of Your Retirement Portfolio (Basic Books, 2010) Jack M. Balkin, The Laws of Change: I Ching and the Philosophy of Life (2d Edition, Sybil Creek Press 2009)
Brian Z. Tamanaha, Beyond the Formalist-Realist Divide: The Role of Politics in Judging (Princeton University Press 2009) Andrew Koppelman and Tobias Barrington Wolff, A Right to Discriminate?: How the Case of Boy Scouts of America v. James Dale Warped the Law of Free Association (Yale University Press 2009) Jack M. Balkin and Reva B. Siegel, The Constitution in 2020 (Oxford University Press 2009) Heather K. Gerken, The Democracy Index: Why Our Election System Is Failing and How to Fix It (Princeton University Press 2009)
Mary Dudziak, Exporting American Dreams: Thurgood Marshall's African Journey (Oxford University Press 2008)
David Luban, Legal Ethics and Human Dignity (Cambridge Univ. Press 2007)
Ian Ayres, Super Crunchers: Why Thinking-By-Numbers is the New Way to be Smart (Bantam 2007)
Jack M. Balkin, James Grimmelmann, Eddan Katz, Nimrod Kozlovski, Shlomit Wagman and Tal Zarsky, eds., Cybercrime: Digital Cops in a Networked Environment (N.Y.U. Press 2007)
Jack M. Balkin and Beth Simone Noveck, The State of Play: Law, Games, and Virtual Worlds (N.Y.U. Press 2006) Andrew Koppelman, Same Sex, Different States: When Same-Sex Marriages Cross State Lines (Yale University Press 2006) Brian Tamanaha, Law as a Means to an End (Cambridge University Press 2006) Sanford Levinson, Our Undemocratic Constitution (Oxford University Press 2006) Mark Graber, Dred Scott and the Problem of Constitutional Evil (Cambridge University Press 2006) Jack M. Balkin, ed., What Roe v. Wade Should Have Said (N.Y.U. Press 2005) Sanford Levinson, ed., Torture: A Collection (Oxford University Press 2004) Balkin.com homepage Bibliography Conlaw.net Cultural Software Writings Opeds The Information Society Project BrownvBoard.com Useful Links Syllabi and Exams |