Dementia

Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

Brain atrophy refers to a loss of brain cells or a loss in the number of connections between brain cells. People who experience brain atrophy typically develop poorer cognitive functioning as a result of this type of brain damage.

There are two main types of brain atrophy: focal atrophy, which occurs in specific brain regions, and generalized atrophy, which occurs across the brain.

Brain atrophy can occur as a result of the natural aging process. Other causes include injury, infections, and certain underlying medical conditions.

This article describes the symptoms and causes of brain atrophy. It also outlines the treatment options available in each case, as well as the outlook.

Symptoms

Brain atrophy can affect one or multiple regions of the brain.

The symptoms will vary depending on the location of the atrophy and its severity.

According to the National Institute of Neurological Conditions and Stroke, brain atrophy can cause the following symptoms and conditions:

Seizures

A seizure is a sudden, abnormal spike of electrical activity in the brain. There are two main types of seizure. One is the partial seizure, which affects just one part of the brain. The other is the generalized seizure, which affects both sides of the brain.

The symptoms of a seizure depend on which part of the brain it affects. Some people may not experience any noticeable symptoms, whereas others may experience one or more of the following:

  • behavioral changes
  • jerking eye movements
  • a bitter or metallic taste in the mouth
  • drooling or frothing at the mouth
  • teeth clenching
  • grunting and snorting
  • muscle spasms
  • convulsions
  • loss of consciousness

Aphasia

The term aphasia refers to a group of symptoms that affect a person’s ability to communicate. Some types of aphasia can affect a person’s ability to produce or understand speech. Others can affect a person’s ability to read or write.

According to the National Aphasia Association, there are eight different types of aphasia. The type of aphasia a person experiences depends on the part or parts of the brain that sustain damage.

Some cases of aphasia are relatively mild, whereas others may severely impair a person’s ability to communicate.

Dementia

Dementia is the term for a group of symptoms associated with a continuing decline in brain function. These symptoms may include:

  • memory loss
  • slowed thinking
  • language problems
  • problems with movement and coordination
  • poor judgment
  • mood disturbances
  • loss of empathy
  • hallucinations
  • difficulty carrying out daily activities

There are several different types of dementia. Alzheimer’s disease is the most common.

A person’s risk of dementia increases with age, with most cases affecting people aged 65 years and older. However, experts do not consider it to be a natural part of the aging process.

Causes

Brain atrophy can occur as a result of injury, either from a traumatic brain injury (TBI) or a stroke. It may also occur as a result of one of the following:

  • encephalitis
  • neurosyphilis
  • HIV

In some cases, brain atrophy may occur as a result of a chronic disorder or condition, such as:

  • cerebral palsy
  • multiple sclerosis (MS)
  • Huntington’s disease
  • frontotemporal dementia
  • Alzheimer’s disease
  • Pick’s disease
  • mitochondrial encephalomyopathies, which are a group of disorders that affect the nervous system
  • leukodystrophies, which are a group of rare genetic conditions affecting the nervous system

Diagnosis

When diagnosing brain atrophy, a doctor may begin by taking a full medical history and asking about a person’s symptoms. This may include asking questions about when the symptoms began and if there was an event that triggered them.

The doctor may also carry out language or memory tests, or other specific tests of brain function.

If they suspect that a person has brain atrophy, they will need to locate the brain damage and assess its severity. This will require an MRI or CT scan.

Treatment

The treatment options for brain atrophy will vary depending on its location, severity, and cause. The following sections list some treatment options by cause.

Injuries

Brain atrophy can occur as a long-term consequence of an injury. In these cases, treatment tends to focus on helping the surrounding brain issue heal over time.

Brain injuries typically require a rehabilitation period that may involve one or more of the following:

  • physical therapy
  • speech therapy
  • counseling

Infections

Medications will be necessary to treat infections that result in brain inflammation or atrophy.

Doctors prescribe antibiotics to treat bacterial infections and antiviral medications to treat viral infections. These medications will help fight the infection and alleviate the symptoms.

Disorders and conditions

Several disorders and conditions can lead to brain atrophy. Many of these conditions currently have no cure, so treatment generally focuses on managing the symptoms.

Treatment may involve a combination of medications and therapies such as occupational or speech therapy. These therapies may be necessary to help a person regain brain function or learn strategies to help them cope.

Some conditions, such as MS, cause symptoms to occur in cycles. A person’s doctor or healthcare team will adapt their treatment plan accordingly if this is the case.

Is it possible to reverse brain atrophy?

Until recently, many scientists considered the brain to be a relatively unchanging organ. However, research is increasingly showing how the brain adapts its structure and functioning throughout life.

It is currently unclear whether or not it is possible to reverse brain atrophy. However, the brain may alter how it works to compensate for damage. In some cases, this may be enough to restore functioning over time.

Exercise for brain atrophy

2011 review suggests that regular exercise could slow or even reverse brain atrophy related to aging or dementia.

However, one 2018 study found that high intensity exercise and strength training did not slow cognitive impairment in people with mild-to-moderate dementia. Additional research is therefore necessary to determine what effect, if any, exercise has on preventing or reversing brain atrophy due to dementia.

Drugs to reverse brain atrophy

Scientists are currently working to develop drugs that can reverse brain atrophy. For example, one 2019 study investigated whether or not the dementia drug donepezil could reverse alcohol-induced brain atrophy in rats.

The researchers found that the rats they treated with donepezil experienced a reduction in brain inflammation and showed an increased number of new brain cells. However, it was not clear if donepezil would have similar effects on brain atrophy resulting from causes other than alcohol-induced damage.

It is also not clear whether or not the same effects would occur in humans. Clinical trials involving human participants are necessary.

Outlook

The outlook for brain atrophy varies depending on the location and extent of the damage, as well as its underlying cause. For people with mild cases, there may be few long-term consequences.

When brain atrophy occurs due to a disease or condition, however, symptoms may worsen over time. Long-term treatments and therapies can help slow this process and help a person manage any resulting cognitive impairments.

For injuries such as TBI and stroke, receiving immediate and effective care can significantly improve the outlook.

Summary

Brain atrophy refers to a loss of neurons within the brain or a loss in the number of connections between the neurons. This loss may be the result of an injury, infection, or underlying health condition.

Mild cases of brain atrophy may have little effect on daily functioning. However, brain atrophy can sometimes lead to symptoms such as seizures, aphasia, and dementia. Severe damage can be life threatening.

A person should see a doctor if they experience any symptoms of brain atrophy. The doctor will work to diagnose the cause of the atrophy and recommend appropriate treatments.

The majority of people can donate blood. However, those who use nicotine products, cannabis products, or both may wonder whether or not they can donate blood.

Hospitals and health clinics use donated blood to treat various medical conditions. According to the World Health Organization (WHO), the number of blood donations collected around the world per year exceeds 117.4 millionTrusted Source.

Blood donations can help with:

  • serious injuries
  • surgery
  • anemia
  • cancer
  • chronic illnesses

Read on to learn more about how different ways of using cigarettes, cannabis, and other drugs can affect a person’s ability to donate blood.

Nicotine

If a person smokes cigarettes or vapes, it does not disqualify them from donating blood.

However, both tobacco cigarettes and electronic cigarettes (e-cigarettes) contain harmful chemicals that may affect a person’s blood.

The American Lung Association claim that a burning cigarette produces more than 7,000 chemicals, including carbon monoxide, ammonia, and arsenic. Several of these chemicals are toxic, and 69 of them can cause cancer.

In addition to nicotine, e-cigarettes may contain the following harmful substances:

  • propylene glycol, which is present in paint solvents, antifreeze, and some foods (as an additive)
  • acetaldehyde, which is a toxic product of ethanol alcohol
  • formaldehyde, which is a chemical preservative present in disinfectants, glue, and plywood
  • diacetyl, which is a flavoring agent that tastes like butter
  • heavy metals, including nickel and lead
  • benzene, which is a chemical compound present in car exhaust

Currently, minimal information exists regarding the exact effects of vaping on blood donations. One thing to keep in mind is the fact that both vaping and smoking cigarettes can increase blood pressure.

According to American Red Cross guidelines, people can donate blood as long as their blood pressure is between 90/50 millimeters of mercury (mm Hg) and 80/100 mm Hg.

In one 2018 studyTrusted Source, researchers compared blood donations from people who smoke with donations from people who do not smoke. They concluded that smoking cigarettes does not affect the overall quality of the donated blood.

However, the researchers did note that the donations from the people who smoke had higher concentrations of carboxyhemoglobin (COHb) in the red blood cells. COHb forms when red blood cells come into contact with carbon monoxide, significantly reducing the amount of oxygen that red blood cells can carry.

Based on these findings, the researchers recommend that people avoid smoking for 12 hoursTrusted Source before donating blood.

Cannabis

Like smoking cigarettes and vaping, smoking cannabis does not disqualify a person from donating blood.

Current scientific researchTrusted Source suggests that cannabis use can negatively impact the cardiovascular system by:

  • increasing blood pressure and heart rate
  • narrowing the blood vessels
  • causing inflammation in the vessel walls
  • promoting blood clots

However, these potential adverse health effects should not impact the quality of any donated blood.

That being said, Vitalant — a nonprofit blood service provider — explain that people must not be under the influence of recreational drugs or alcohol at the time of donation.

Other drugs

According to the American Red Cross, people with a history of recreational intravenous drug use are not eligible to donate blood. This requirement helps prevent the spread of HIV and hepatitis.

It is important to note that this is not the case for people who have used drugs in other ways, such as by smoking them or taking them orally. The American Red Cross and other blood donation companies do not specify drug use as an excluding factor.

However, a person does need to make sure that substances such as nicotine and cannabis are not in their system when donating blood.

Excluding factors

To donate blood, the general requirement is that a person should be at least 17 years old. A person can be 16 years old, but they must have a legal guardian’s consent.

Other factors that may disqualify a person from giving blood include:

  • feeling sick or having cold or flu symptoms
  • using intravenous drugs not prescribed by a licensed doctor
  • having an active infection
  • having HIV or testing positive for hepatitis B or C
  • having uncontrolled diabetes
  • having a blood clotting disorder
  • having ever had the Ebola virus
  • having blood cancers, such as leukemia or lymphoma
  • having received a blood transfusion within the past 12 months
  • having a heart rate below 50 beats per minute (BPM) or above 100 BPM
  • having recently traveled to a foreign country
  • being pregnant, or having given birth within the past 6 weeks

Read more about the advantages and disadvantages of donating blood here.

Summary

Although smoking cigarettes, vaping, and using cannabis will not disqualify a person from donating blood, they should refrain from smoking for at least 2 hoursTrusted Source before and after donating blood.

A person may feel lightheaded or weak after giving blood, and smoking can exacerbate these symptoms. It is a good idea to avoid smoking until these symptoms go away.

New research in mice suggests that adopting a diet rich in extra virgin olive oil can prevent the toxic accumulation of the protein tau, which is a hallmark of multiple types of dementia.

Due to its monounsaturated fatty acids, or “good” fats, extra virgin olive oil is known for its ability to lower the risk of high cholesterol and heart disease.

Recently, however, several studies have suggested that extra virgin olive oil also has neuroprotective and cognitive benefits.

For instance, a 2012 study in mice found that the oil improves rodents’ learning and performance in memory tests.

The presumed reason for these findings is that extra virgin olive oil is rich in polyphenols. These are powerful antioxidant compounds that may reverse disease- or aging-related learning and memory impairment.

A couple of years ago, a study that Medical News Today reported on found that extra virgin olive oil reduced early neurological signs of Alzheimer’s disease in mice.

The extra virgin olive oil intervention improved autophagy — that is, brain cells’ ability to eliminate toxic waste — and helped maintain the integrity of the rodents’ synapses, which are the connections between neurons.

Dr. Domenico Praticò — a professor in the Departments of Pharmacology and Microbiology and the Center for Translational Medicine at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA — spearheaded that research.

He has recently led a new team in a study of the neurological benefits of extra virgin olive oil. As part of this study, the researchers looked at the oil’s effect on “tauopathies.” These are age-related cognitive conditions wherein the protein tau accumulates to toxic levels in the brain, triggering various forms of dementia.

Dr. Praticò and his colleagues have published their findings in the journal Aging Cell.

Studying the tau protein in mice

The researchers used a mouse model of tauopathy. They genetically tweaked the rodents so that they were prone to accumulate excessive amounts of the otherwise normal protein tau.

In Alzheimer’s and other forms of dementia, such as frontotemporal dementia, the tau protein accumulates inside neurons in the form of toxic “tangles.”

By contrast, in a healthy brain, normal levels of tau help stabilize the microtubules, which are supportive structures for neurons.

In tauopathies, the buildup of tangles inside neurons stops the nerve cells from receiving nutrients and communicating with other neurons. This eventually leads to their death.

In this study, the mice prone to accumulations of tau consumed a diet high in extra virgin olive oil from the age of 6 months. According to some estimates, this is the equivalent of around 30 years of human age.

Control mice were also prone to tau accumulations but consumed a regular diet.

Olive oil means 60% less tau, better memory

Around a year later — which would equate to around 60 years of human age — the experiments revealed that the tauopathy-prone rodents had 60% fewer tau deposits than the control rodents, which had not received an extra virgin olive oil-enriched diet.

Mice that had received extra virgin olive oil also performed better in standard maze and novel object recognition memory tests.

Furthermore, brain tissue sample analyses revealed that the mice who consumed the extra virgin olive oil had better synapse function than the control mice, as well as better neuroplasticity.

The analyses also revealed an increase in a protein called complexin 1. This is a “presynaptic” protein key for maintaining healthy synapses.

“Our findings demonstrate that [extra virgin olive oil] directly improves synaptic activity, short‐term plasticity, and memory while decreasing tau neuropathology in the [tau-prone] mice,” conclude Dr. Praticò and team, adding:

“These results strengthen the [healthful] benefits of [extra virgin olive oil] and further support the therapeutic potential of this natural product not only for [Alzheimer’s disease] but also for primary tauopathies.”

Olive oil protects against various dementias

“[Extra virgin olive oil] has been a part of the human diet for a very long time and has many benefits for health, for reasons that we do not yet fully understand,” explains Dr. Praticò.

“The realization that [extra virgin olive oil] can protect the brain against different forms of dementia gives us an opportunity to learn more about the mechanisms through which it acts to support brain health,” he says, highlighting some directions for future research.

“We are particularly interested in knowing whether [extra virgin olive oil] can reverse tau damage and ultimately treat tauopathy in older mice,” concludes Dr. Praticò.