shaokim

shaokim t1_j99heib wrote

To add to this: we can't determine the exact reason why cancers were caused in the great majority of cases. However, there are cases and certain types of cancer where we can determine with great confidence that a certain cause was at its origin.

For example, in cervical cancer, usually caused by a virus called Human Papilloma Virus, that same virus leaves a kind of hallmark when viewed under the microscope called a koilocyte. AFAIK, detecting cancer of squamous cells in the cervix together with koilocytes OR the actual isolation of the virus is pathognomonic for HPV-caused cervical cancer.

For people with familial cancer syndromes, like Familial Adenomatous Polyposis (FAP), if a person comes in at an early age ie. 25 years old, and we see on colonoscopy a colon that is littered with growths, and after biopsy one of those growths comes back as malignant, we can tell with a high degree of certainty that the familial cancer syndrome (the heritable gene defect) was at the cause of the cancer.

Another type is a mucosa associated lymphoid lymophoma of the stomach. If we find a bacterium called Helicobacter pylori in the stomach, together with a tumor we determine to be a MALT lymphoma, and especially if that tumour regresses in antibiotic therapy, we can determine with high certainty that H. pylori caused that exact tumour, IIRC.

Actinic keratosis is a skin condition that's caused by chronic excess UV-exposure (usually the Sun). It can lead to the development of skin cancer. If skin cancer arises from actinic keratosis, we can say with a high degree of certainty that UV light caused it.

There are many more examples: liver cancer in a patient with an alcoholic cirrhotic liver; esophageal cancer on the part closest to the esophagus in know stomach acid reflux, etc etc…

these may not be ‘caused by this definite exact cause’ but ‘caused by this to a high degree of certainty’.

There's bound to be more examples in genetic cancer syndromes (such as Li-Fraumeni, Multiple Endocrine Neoplasia) and infectious cancer syndromes.

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shaokim t1_iy9dq7p wrote

I have it like this:

There is bleeding. At a certain point, blood pressure measured in the aortic arch and carotid body baroreceptors drops. The body compensates by triggering a release of circulating adrenaline as well as noradrenaline signaling to the sinus node. This will briefly increase contractility of the heart and heart rate, as well as induce peripheral vasoconstriction through signaling at alpha receptors.

All this would serve to compensate for blood pressure loss that goes with blood loss. So if I have that right, in this initial stage of bleeding blood pressure and venous return (preload) could be kept relatively constant by this compensation mechanism.

Over time, the bleeding overwhelms this compensation mechanism, and as intravascular volume drops, blood pressure drops and central venous pressure drops.

At no point, I think, will any of these parameters be significantly increased over baseline: blood pressure and venous return will be compensated (equal) at best, initially, before dropping.

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shaokim t1_iy8trca wrote

I'm not sure if your premise is correct. In hypovolemic shock, central venous pressure (which I think is a useful proxy for preload) will decrease or remain equal because of lower circulating blood volume. I'm not sure if your reference to "blood cells" is of relevance in this particular bit of physiology.

Total intravascular volume goes down, therefore preload goes down. I think it's roughly as straightforward as that, in any case I don't think it would increase.

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shaokim t1_ivqcdff wrote

Institute for the Study of War assesses their stockpiles of precision ammunition as dwindling. They seem to be making deals with Iran for increased ammo and drones, in return for cash and captured western/Ukrainian arms technology, as well as potentially help with their nuclear weapons program and geostrategic partnership on an equal footing.

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