#Mastocytic
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giulliadella · 2 years ago
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WE HAVE SOLVED THE MYSTERY OF WHY CELLS HATE NEUTROPHILS SO MUCH IN CAW
So, last night, my boyfriend and I got into some random discussion about programmed cell death and some new breakthroughs in medicine, you know, the usual things you talk about with your boyfriend at 1 AM. It is well known that leftover bodies of dead cells are phagocytosed (literally consumed) by macrophages. And that’s why I always wondered why aren’t cells scared of macrophages as much as they are of neutrophils, since neutrophils don’t consume the dead cells. With my limited understanding of immunity (which we technically don’t learn a lot about in biology) I thought that neutrophils only consumed invader bacteria and fungi.
And OH BOY was I wrong about that.
Because (and yes I have spent whole night researching this, I’ll provide the links to papers in the end lol) neutrophils are little freaks and not only do they phagocytose leftovers of cells they actually cause them to die in the first place. This happens during infections, especially with viruses that cause the excess release of cytokines (like Coronaviridae). Cytokines activate neutrophils who basically just follow the signal towards the infection site and there all hell breaks loose. Neutrophils phagocytose bacteria and virions (those are viruses that haven’t infected a cell yet) which is fine, but they also degranulate and NETose. I’ll explain this in simple terms to my best ability.
Degranulation is when granulocytes (neutrophils, eosinophils, basophils and mastocytes are all different granulocytes) release their granules which are kind of like little sacks inside their cytoplasm which contain various chemicals. Releasing these chemicals happens when the cell receives appropriate stimulus, the little granules expel their contents out of the cell’s interior. In the case of neutrophils, granules contain very toxic compounds that cause the formation of free radicals which damage DNA and proteins of the surrounding cells, as well as granules filled with digestive enzymes which, well, digest the surrounding tissues.
NETosis is a special type of cell death specific to neutrophils in which they literally degranulate pieces of their own, or their mitochondrial DNA together with more toxic compounds. This creates a net of DNA strands called chromatin which entangles invading bacteria and severely damages them and also marks them for phagocytosis by macrophages. But this process is not well controlled and some of that chromatin and toxic compounds can land onto neighboring cells which is, as you can conclude, very bad for them.
With these two abilities at hand, neutrophils are very well equipped to kill cells and destroy tissue. Which is good in cases when the cells are infected and the tissue is damaged, but their quite aggressive methods can damage healthy cells in the area as well, some of them will die and neutrophils will phagocytose their dead particles. 
Basically, to neutrophils every infection is a huge kill and eat all you can buffet. They literally phagocytose until they physically cannot anymore and then go to the spleen or bone marrow to die. They also allow macrophages to consume them and thus pass on the antigens for antigen presentation which influences further immune response. But they can also cause a lot of damage, especially if cytokine storm happens and they completely lose control. This is what causes SARS and it can kill you if it’s severe enough. 
Biologically speaking, neutrophils are very important because they are the first ones to come to the sight of infection and their crazy methods usually finish the things before they get too severe. They themselves produce cytokines that mobilize macrophages and dendritic cells so that more immune cells can join and help them. They also have a role in repairing the tissues they damaged.
However, other immune cells, including macrophages and killer T cells, simply don’t cause as much damage. Neutrophils just go all out, which is why they live for such a short period of time compared to their colleagues (they live for only few days, compared to macrophages who can live up to a month and lymphocytes who can live for months, even years).
So, yeah, my boyfriend and I have concluded (at 4AM this morning) that neutrophils are so feared because they damage tissue, go crazy and violently kill healthy cells by accident, then consume them and that’s not by accident, it’s a mechanism to repair tissues.
I can’t believe I wasted whole night just for this. My boyfriend is also disappointed. But I hope that we finally have an explanation for this mystery. Tell me what you think lol.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8589350/
https://www.nature.com/articles/nri.2017.105
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820392/#:~:text=Neutrophils%20contribute%20to%20tissue%20injury,detail%20here%20(Kruger%20et%20al.
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neuthanasia · 14 days ago
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Mast cell
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info ↓
General: Mark is an immune cell in unit MC/LC (Mastocyte/Labrocyte).He is an envious granulocyte who doesn't tolerate anything that get's in his path or goal.He also intolerant to Iremia's (Basophil's) interactions with his friends because Mark is afraid that Iremia might leave him.
Nathaniel: Both Nathaniel and Mark do not like each other due to opposing views and methods that can possibly lead to a conflict between the two.
Iremia: As said before,Mark tends to watch Iremia's every move due to a fear of abadonment.Iremia is aware of this and often reassures Mark that he wont leave him.
Note: Mark and Den have mental similarities however,Mark does not have borderline personality disorder and only thinks Iremia will leave him whenever Iremia interacts with somebody else while Den has this feeling all the time despite his husband's reassurance.
Evysini (Eosinophil): Mark fears her due to her tough nature and sudden explosive outbursts due to her condition,despite that,Evy is good friends with Mark.
Trivia!
Mark used to be a whole 'nother person before i redesigned him
Mark has once threw a fish at Hesperious,that fish in question was Nathaniel.He did it because it was the time that he heard Nathaniel and Hesperious were a couple
Mark wasn't a shark before,he had wolf ears but no tail
Despite their unhealthy relationship,Nathaniel and Mark mostly ignore each other because it'd be a waste of time to argue with each other
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journaldunegargouille · 9 months ago
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24 Février 2024
Je ressors de crises d'intolérances assez importantes ayant étés accompagnées de candidoses.
Les douleurs à l'omoplate et autour du bras sont même devenues de moins en moins supportables. Cependant depuis un moment j'ai remarqué que certains trucs aident.
Le curcuma mitige les nuits infernales et réduit la toxicité de l'acide glutamique sur les neurones, réduisant donc mes paralysies du sommeil.
Le zinc (citrate) m'aide à retrouver odorat, les sensations, le goût et améliore la récupération musculaire. Il aide aussi à faire en sorte que le glutamate ne me fusille pas le cerveau non plus. Zinc et curcuma ont donc un effet bénéfique sur mes nuits.
L'oignon aide un peu aussi contre les candidoses (quercetine) et le lait de coco fait de même grâce à un acide spécial (caprylique) qu'il contient.
Le gingembre empêche les grosses réactions gastriques (inhibe les mastocytes) mais il n'est pas une solution pour tricher sur les aliments, je dois m'en souvenir... Il a également un effet sur la candidose et aide à lutter contre.
Ce n'est pas énorme mais le fait que la plupart de ces choses fonctionnent me réjouis un peu.
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zehub · 1 year ago
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L'Inserm fait une découverte capitale dans la lutte contre les allergies
Une découverte de l'Inserm portant sur les mastocytes, des cellules immunitaires méconnues, ouvre de nouvelles perspectives dans la compréhension et le traitement des allergies. Une étud
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doc-fibromyalgie · 1 year ago
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365daysofabby · 5 years ago
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July 9th, 2019
If my body’s going to decide to stop working, I’m still gonna try to be a cute non-working human
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celluloscope · 3 years ago
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Mastocyte
Ubiquitaire des tissus conjonctifs, proche des basophiles
20 à 30 µm, ronde, ovalaire, polygonale ou fusiforme
Cytoplasme basophile, granulations peu visibles en routine
hydrosolubilité, dégranulation par sollicitation mécanique
métachromasie : deviennent rouge /violet au bleu de toluidine
Noyau rond central
Coloration spéciale non précisée ; Sources :
Young B., O’Dowd G, Woodford P. Atlas d’histologie fonctionnelle de Wheather. 6e édition. Paris : De Boeck Supérieur; 2013, 455p.
Wikipédia. Mastocyte. [En ligne]. https://fr.wikipedia.org/wiki/Mastocyte. Consulté le 02 mai 2022.
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mcatmemoranda · 4 years ago
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From Wikipedia:
Mastocytosis, a type of mast cell disease, is a rare disorder affecting both children and adults caused by the accumulation of functionally defective mast cells (also called mastocytes) and CD34+ mast cell precursors.[1]
People affected by mastocytosis are susceptible to a variety of symptoms, including itching, hives, and anaphylactic shock, caused by the release of histamine and other pro-inflammatory substances from mast cells.
Mast cells are located in connective tissue, including the skin, the linings of the stomach and intestine, and other sites. They play an important role in the immune defence against bacteria and parasites. By releasing chemical "alarms" such as histamine, mast cells attract other key players of the immune defense system to areas of the body where they are needed.[citation needed]
Mast cells seem to have other roles as well. Because they gather together around wounds, mast cells may play a part in wound healing. For example, the typical itching felt around a healing scab may be caused by histamine released by mast cells. Researchers also think mast cells may have a role in the growth of blood vessels (angiogenesis). No one with too few or no mast cells has been found, which indicates to some scientists we may not be able to survive with too few mast cells.[citation needed]
Mast cells express a cell surface receptor, c-kit[7] (CD117), which is the receptor for stem cell factor (scf). In laboratory studies, scf appears to be important for the proliferation of mast cells. Mutations of the gene coding for the c-kit receptor (mutation KIT(D816V)), leading to constitutive signalling through the receptor is found in more than 90% of patients with systemic mastocytosis.[8]
Systemic mastocytosis-> excess histamine release-> pruritis, stomach pain (due to histamine stimulating parietal cells to release HCl), hypotension, flushing. A maculopapular rash will be positive for KIT (CD 117).
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pettyanddogs · 5 years ago
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How Are mastocyte Tumors Different from Other Dog Cancers?
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There are many sorts of dog cancer, each affecting a specific part of the body, causing different symptoms and requiring a selected kind of treatment. One such type of canine cancer is mastocyte tumors. Although it's the first common sort of carcinoma in dogs, it's one among the smallest amount understood by the general public due to its variability.
One of the diagnoses dog parents fears the foremost is cancer. Dog cancer is usually understood to cause a lifetime of hardship and suffering for dogs and is generally believed to be a death sentence—but this is often not always the case. What is a mastocyte tumor?
A mastocyte tumor also referred to as mastocytoma, maybe a mass that's commonly found on or under the skin in dogs. Like other tumors, the expansion is caused by the rapid replication of cells during a dog's body. What primarily differentiates mastocyte tumors from different sorts of cancer is that some cells affected: Mast cells.
Mast cells are a kind of white blood corpuscle. They will be found in connective tissues like nerves and vessels, particularly within the skin. These cells defend the body against parasites, rebuild damaged tissue and make new blood vessels. They've also involved allergy and inflammatory responses throughout the body and contain histamine.
In most cases, mastocyte tumors present themselves on or directly under the skin. Most dogs have one mass on the surface, but multiple weights may occur.
Unfortunately, another characteristic of this type of cancer may be a tumor's high level of variability from dog to dog. Some tumors may resemble other sorts of tumors, whether benign or malignant, large or small. Others may appear as innocuous as an sting . It's common for mastocyte tumors to grow slowly initially, then increase during a short amount of your time. Sometimes, cancer may appear to fluctuate in size. The mass can also be red, inflamed or itchy, but they're usually not painful. The differences in mastocyte tumors make them somewhat difficult to spot.
Nearly half all mastocyte tumors are found on the skin of a dog's trunk, particularly near the anus. Almost half are located on a paw, and a minority are found on the top or neck. Should a mastocyte tumor metastasize, it's going to spread to other parts of the body. The foremost common areas affected are the lymph nodes, spleen, liver, and bone marrow.
Some breeds are more likely to develop mastocyte tumors, including Boston Terriers, Boxers, Pugs, and Bulldogs. The real explanation for mastocyte tumors is unknown. It's believed they need a genetic component, given their commonality in certain breeds, but they'll even be influenced by environmental factors, age, and more. Symptoms of mastocyte tumors
The main symptom of a mastocyte tumor in your dog is going to be the presence of a lump or bump on or below the skin. Unfortunately, it's going to be difficult to detect these bumps thanks to mastocyte tumors' size variability.
In many cases, the presence of a tumor is the only noticeable symptom of cancer. If the disease progresses to a better stage, though, other, more traditional signs of cancer may become apparent, including vomiting, diarrhea, and inappetence.
The sad brindle dog held by her owners at the vet
In addition to those symptoms, mastocyte tumors can also cause seemingly unrelated symptoms. Manipulation of a mastocyte tumor can cause what's called degranulation, which is that the release of granules containing histamine and other chemicals into the bloodstream. Large quantities of those chemicals can cause damage to the organs. Complications of degranulation are often life-threatening, including stomach ulcers, a drop by vital sign, or shock caused by systemic inflammation.
Thus, mastocyte tumors shouldn't be manipulated reception, and you ought to attempt to keep your dog from biting or licking it. Degranulation can also occur spontaneously, which ends up in size changes within the tumor.
Treating mastocyte tumors
Mast cell tumors are easily diagnosed employing a fine-needle aspirate, where your vet will extract cells from the tumor to look at.
Once a diagnosis is given, your dog's treatment prognosis will ultimately depend upon the grade of the tumor. Low-grade tumors, or ones that haven't metastasized and are highly differentiated, are relatively simple to treat. High-grade tumors, or ones that have a better chance of metastasizing and are poorly differentiated, could also be harder to treat.
Typically, low-grade mastocyte tumors are going to be removed through surgery. Sometimes, cancer will have spread to the nearby lymph nodes, during which case the lymph nodes can also get to be removed. Radiation could also be necessary for tumors that are difficult to get rid of entirely with surgery.
If cancer has spread to other parts of the body, your vet may recommend chemotherapy additionally to surgical removal of the first tumor. However, chemotherapy might not end in long-term recovery.
Using alternative or palliative therapies may help improve your dog's quality of life during and after treatment. Many pets will develop new tumors after their initial surgery, so close monitoring is crucial to detecting new tumors as early as possible.
Mast cell tumors are often easy to treat, or they will be extremely dangerous. Like all other sorts of cancer, however, early detection and fast treatment are likely to enhance your pet's chances of health and happiness.
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yourpets2019 · 5 years ago
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10 Signs of Cancer in Dogs
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Illnesses are frightening enough, but there’s something particularly scary about canine cancers. They depend upon us for his or her health, yet can’t tell us when something’s not feeling right. That’s why being on the lookout for signs of cancer in dogs is so important. It’d be wonderful if this were a rare and minor health issue with dogs, but unfortunately, 1 in 3 will suffer from dog cancers in their lifetime consistent with the National Canine Cancer Foundation. Now, let’s get into the warnings signs of canine cancer also as its commonest types. Noticing any of those doesn’t necessarily mean your dog has cancer, but there’s an honest chance of another health issue at a minimum, so you ought to contact your vet immediately if any are observed. SIGNS OF CANCER IN DOGS Notice one or multiple signs during this list? Contact your vet directly.
1. WEIRD SMELLS
You’ve probably grown familiar with your dog’s bad breath, but you ought to get on the design out for any unusually bad (or just plain different) smell coming from your dog when you’re close enough to smell their breath. Most times, it'll just flow from to something easily explainable sort of a change in diet, but you'll never be too careful. Also, concentrate for any odd odors coming from the nose or rectal area as potential signs of dog cancer.
2. PALE GUMS
Be sure to sometimes check the color of your dog’s gums. Pale gums are often a symbol of the many health issues with dogs, cancer included. If you notice a change during this area, contact your veterinarian directly. Here’s the way to check your dog’s gums: lift the jowl so you'll get an honest look press the gums with the ball of your finger observe the gum’s color where you’ve pressed In healthy dogs, after pressing on their gums the world should turn white briefly. After about 2 to three seconds, the color should return to its normal pink. If not, concentrate for other warning signs and consider lecture your vet.
3. LACK OF ENERGY
Have there been any significant changes in your dog’s energy level? Lethargy is additionally one of the common signs of cancer in dogs. nobody knows your dog’s normal behavior better than you, so this is often one your veterinarian might not always catch. Is your dog spending less time playing? Do they tire quickly? Are they spending tons longer sleeping or simply generally seeming disinterested in their usual activities? Look out for these, and when noticed begin trying to find other signs your dog has cancer.
4. VOMITING AND DIARRHEA
Sometimes when your dog is vomiting or has diarrhea it is often thanks to something gross but normally harmless, like eating poop. Unfortunately, though, it’s also one of the common signs of cancer in dogs. If you notice your dog having diarrhea or vomiting — especially when amid other warnings signs from this list — consult your veterinarian directly. albeit it’s not dog cancer, there might be another health issue that must be addressed.
5. BREATHING TROUBLE
Like with people, there are many various sorts of dog cancer. And like people, you would like to get on the lookout for the warning signs of carcinoma in dogs. concentrate on your dog as they play and set about their usual life. Are you noticing differences in their breathing, like coughing, wheezing, or becoming in need of breath far more quickly than normal? get on the lookout for other warning signs and consider chatting with your veterinarian very soon.
6. BUMPS OR LUMPS
If you’re not already, you ought to get into the habit of checking your dog’s skin daily. About once a month is ok. Check by slowly and gently running your hands over your dog’s body, taking notice of what you are feeling. Make note of anything that seems unusual or out of place, and if this isn’t your first time checking you’ll certainly want to research anything new. Your dog should enjoy this petting, so don’t be afraid to require some time. Don’t forget to feel behind their ears and around their faces. If your dog doesn't want to be touched in certain areas, investigate closely. Contact your vet immediately if you notice any bleeding or discharge.
7. UNEXPECTED WEIGHT LOSS
If you don’t have your dog on a weight loss regimen and haven’t been feeding them weight control pet food, then unexpected weight loss is one among the foremost common signs of dog cancer you ought to get on the lookout for. Your dog suddenly losing weight might not be cancer, but if there’s no other obvious explanation there’s a really good chance some sort of health issue is that the cause and you ought to get into touch together with your veterinarian.
8. CHANGE IN APPETITE
Have you noticed any changes in your dog’s appetite? Are they eating less or not showing interest in the food they normally love? Many health issues for dogs might be the cause here, and cancer is unfortunately among them. Sometimes it is often just a quick issue of not feeling great, or even somebody else has been sneaking them food once you weren’t looking. Pay close attention to their eating habits any time you notice a change and ask your vet directly when problems persist.
9. CHANGE IN BEHAVIOR
Another sign of cancer in dogs you’ll want to be watching out for changes in behavior. Is your dog limping, walking, or playing differently than normal? Is your normally quiet dog irritable and barking or snapping even at you? Dogs, a bit like people, get annoyed or lethargic once they aren’t feeling well. If your dog begins acting strangely and there’s no obvious reason why there’s an honest chance they’re sick and you ought to speak to your veterinarian.
10. WOUNDS OR SORES
If you notice any wounds or open sores on your dog that aren’t healing as quickly as you’d normally expect or are appearing with no obvious explanation, get in-tuned together with your veterinarian as soon as possible. Unexplained sores or slow healing times are often the sign of something serious — including dog cancer. Don’t hesitate to urge in-tuned with knowledgeable directly who can examine your dog for love or money that must be addressed. TYPES OF DOG CANCER We’ve already covered the signs of canine cancers, now let’s quickly cover the various, commonest sorts of dog cancer. LYMPHOMA This type of dog cancer is found within the lymph nodes or bone marrow and typically diagnosed in dogs between 6 to 9 years old. It attacks the dog’s system and can spread rapidly if not addressed. There are five stages of lymphoma in dogs, with each having their treatment options and prognosis. Dog lymphoma is typically first noticed during a painless but swollen lymph gland behind your dog’s neck or knees. HEMANGLOSARCOMA A cancer of the blood vessels, hemangiosarcoma is more commonly found in dogs than the other species. it's most frequently found within the spleen, liver, and heart but can spread to any organ or occur slightly below the skin. Unfortunately, there are not any obvious early warning signs with hemangiosarcoma and oftentimes it's not found until it's in its advanced stages. this sort of canine cancer is most often found in large breeds like German Shepherds or golden retrievers. MELANOMA A type of skincare that you’ve likely heard about thanks to its frequency in humans, melanoma is most frequently found in or around a dog’s mouth or lips. It also can be found in their nail beds, footpads, and eyes. Melanoma in dogs is often particularly aggressive, spreading from the skin deep into a dog’s organs. Early signs of melanoma in dogs include swollen paws, a draining eye, or sores in or around their mouth. MAST CELL TUMORS Found within the skin and other tissues just like the tract or intestines, mastocyte tumors attack a dog’s system by turning normally protective enzymes and histamines against the dog. Mast cell tumors are quite common in older dogs. Mixed breeds should be particularly on the lookout also as boxers, Boston terriers, beagles, and schnauzers. The earliest sign is typically skin lesions, with agitation caused by discomfort also common. OSTEOSARCOMA A cancer of the bone, about 85% of osteosarcoma tumors are malignant and can grow very quickly. it's most ordinarily found in large breed dogs that are 4 to 7 years in age. Early signs include swelling and lameness. Breeds most in danger include Great Danes, Irish setters, Doberman pinschers, Rottweilers, German Shepherds, and golden retrievers. MAMMARY CANCER Mammary cancer is most frequently found in female dogs that weren't spayed, or weren't spayed until after they were 2 years old. Roughly 50% of mammary tumors in dogs are malignant and have metastasized (spread) by the time of surgical removal. It is tough to identify, with mammary tumors usually appearing only as a little nodule on or around the dog’s nipple. Please make certain to concentrate on those signs of cancer in dogs. If you notice anybody or multiple signs, then you ought to contact your veterinarian immediately. Cure rates haven't been better, and improve even more with early detection. Best wishes to you and your pup, and please make certain to pin or share this so you'll help other dog parents to understand the warning signs of canine cancer!
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buozstore · 5 years ago
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10 Signs of Cancer in Dogs
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Illnesses are frightening enough, but there’s something particularly scary about canine cancers. They depend upon us for his or her health, yet can’t tell us when something’s not feeling right. That’s why being on the lookout for signs of cancer in dogs is so important. It’d be wonderful if this were a rare and minor health issue with dogs, but unfortunately, 1 in 3 will suffer from dog cancers in their lifetime consistent with the National Canine Cancer Foundation. Now, let’s get into the warnings signs of canine cancer also as its commonest types. Noticing any of those doesn’t necessarily mean your dog has cancer, but there’s an honest chance of another health issue at a minimum, so you ought to contact your vet immediately if any are observed. 
SIGNS OF CANCER IN DOGS 
Notice one or multiple signs during this list? Contact your vet directly. 
1. WEIRD SMELLS 
You’ve probably grown familiar with your dog’s bad breath, but you ought to get on the design out for any unusually bad (or just plain different) smell coming from your dog when you’re close enough to smell their breath. Most times, it'll just flow from to something easily explainable sort of a change in diet, but you'll never be too careful. Also, concentrate for any odd odors coming from the nose or rectal area as potential signs of dog cancer.
 2. PALE GUMS 
Be sure to sometimes check the color of your dog’s gums. Pale gums are often a symbol of the many health issues with dogs, cancer included. If you notice a change during this area, contact your veterinarian directly. Here’s the way to check your dog’s gums: lift the jowl so you'll get an honest look press the gums with the ball of your finger observe the gum’s color where you’ve pressed In healthy dogs, after pressing on their gums the world should turn white briefly. After about 2 to three seconds, the color should return to its normal pink. If not, concentrate for other warning signs and consider lecture your vet. 
3. LACK OF ENERGY 
Have there been any significant changes in your dog’s energy level? Lethargy is additionally one of the common signs of cancer in dogs. nobody knows your dog’s normal behavior better than you, so this is often one your veterinarian might not always catch. Is your dog spending less time playing? Do they tire quickly? Are they spending tons longer sleeping or simply generally seeming disinterested in their usual activities? Look out for these, and when noticed begin trying to find other signs your dog has cancer. Free Dog Training Video Series Free Dog Training Video Series END behavior issues that are driving you CRAZY! Learn puppy training, handling aggression, & more! Your Email SEND NOW! symptoms of dog cancer 
4. VOMITING AND DIARRHEA 
Sometimes when your dog is vomiting or has diarrhea it is often thanks to something gross but normally harmless, like eating poop. Unfortunately, though, it’s also one of the common signs of cancer in dogs. If you notice your dog having diarrhea or vomiting — especially when amid other warnings signs from this list — consult your veterinarian directly. albeit it’s not dog cancer, there might be another health issue that must be addressed. 
5. BREATHING TROUBLE 
Like with people, there are many various sorts of dog cancer. And like people, you would like to get on the lookout for the warning signs of carcinoma in dogs. concentrate on your dog as they play and set about their usual life. Are you noticing differences in their breathing, like coughing, wheezing, or becoming in need of breath far more quickly than normal? get on the lookout for other warning signs and consider chatting with your veterinarian very soon. 
6. BUMPS OR LUMPS 
If you’re not already, you ought to get into the habit of checking your dog’s skin daily. About once a month is ok. Check by slowly and gently running your hands over your dog’s body, taking notice of what you are feeling. Make note of anything that seems unusual or out of place, and if this isn’t your first time checking you’ll certainly want to research anything new. Your dog should enjoy this petting, so don’t be afraid to require some time. Don’t forget to feel behind their ears and around their faces. If your dog doesn't want to be touched in certain areas, investigate closely. Contact your vet immediately if you notice any bleeding or discharge. canine cancers 
7. UNEXPECTED WEIGHT LOSS 
If you don’t have your dog on a weight loss regimen and haven’t been feeding them weight control pet food, then unexpected weight loss is one among the foremost common signs of dog cancer you ought to get on the lookout for. Your dog suddenly losing weight might not be cancer, but if there’s no other obvious explanation there’s a really good chance some sort of health issue is that the cause and you ought to get into touch together with your veterinarian. 
8. CHANGE IN APPETITE 
Have you noticed any changes in your dog’s appetite? Are they eating less or not showing interest in the food they normally love? Many health issues for dogs might be the cause here, and cancer is unfortunately among them. Sometimes it is often just a quick issue of not feeling great, or even somebody else has been sneaking them food once you weren’t looking. Pay close attention to their eating habits any time you notice a change and ask your vet directly when problems persist. 
9. CHANGE IN BEHAVIOR 
Another sign of cancer in dogs you’ll want to be watching out for changes in behavior. Is your dog limping, walking, or playing differently than normal? Is your normally quiet dog irritable and barking or snapping even at you? Dogs, a bit like people, get annoyed or lethargic once they aren’t feeling well. If your dog begins acting strangely and there’s no obvious reason why there’s an honest chance they’re sick and you ought to speak to your veterinarian. 
10. WOUNDS OR SORES 
If you notice any wounds or open sores on your dog that aren’t healing as quickly as you’d normally expect or are appearing with no obvious explanation, get in-tuned together with your veterinarian as soon as possible. Unexplained sores or slow healing times are often the sign of something serious — including dog cancer. Don’t hesitate to urge in-tuned with knowledgeable directly who can examine your dog for love or money that must be addressed. 
TYPES OF DOG CANCER 
We’ve already covered the signs of canine cancers, now let’s quickly cover the various, commonest sorts of dog cancer. 
LYMPHOMA 
This type of dog cancer is found within the lymph nodes or bone marrow and typically diagnosed in dogs between 6 to 9 years old. It attacks the dog’s system and can spread rapidly if not addressed. There are five stages of lymphoma in dogs, with each having their treatment options and prognosis. Dog lymphoma is typically first noticed during a painless but swollen lymph gland behind your dog’s neck or knees. 
HEMANGLOSARCOMA
 Cancer of the blood vessels, hemangiosarcoma is more commonly found in dogs than the other species. it's most frequently found within the spleen, liver, and heart but can spread to any organ or occur slightly below the skin. Unfortunately, there are not any obvious early warning signs with hemangiosarcoma and oftentimes it's not found until it's in its advanced stages. this sort of canine cancer is most often found in large breeds like German Shepherds or golden retrievers. 
MELANOMA
 A type of skincare that you’ve likely heard about thanks to its frequency in humans, melanoma is most frequently found in or around a dog’s mouth or lips. It also can be found in their nail beds, footpads, and eyes. Melanoma in dogs is often particularly aggressive, spreading from the skin deep into a dog’s organs. Early signs of melanoma in dogs include swollen paws, a draining eye, or sores in or around their mouth. 
MAST CELL TUMORS 
Found within the skin and other tissues just like the tract or intestines, mastocyte tumors attack a dog’s system by turning normally protective enzymes and histamines against the dog. Mast cell tumors are quite common in older dogs. Mixed breeds should be particularly on the lookout also as boxers, Boston terriers, beagles, and schnauzers. The earliest sign is typically skin lesions, with agitation caused by discomfort also common.
 OSTEOSARCOMA 
Cancer of the bone, about 85% of osteosarcoma tumors are malignant and can grow very quickly. it's most ordinarily found in large breed dogs that are 4 to 7 years in age. Early signs include swelling and lameness. Breeds most in danger include Great Danes, Irish setters, Doberman pinschers, Rottweilers, German Shepherds, and golden retrievers.
 MAMMARY CANCER
 Mammary cancer is most frequently found in female dogs that weren't spayed, or weren't spayed until after they were 2 years old. Roughly 50% of mammary tumors in dogs are malignant and have metastasized (spread) by the time of surgical removal. It is tough to identify, with mammary tumors usually appearing only as a little nodule on or around the dog’s nipple. Please make certain to concentrate on those signs of cancer in dogs. If you notice anybody or multiple signs, then you ought to contact your veterinarian immediately. Cure rates haven't been better, and improve even more with early detection. Best wishes to you and your pup, and please make certain to pin or share this so you'll help other dog parents to understand the warning signs of canine cancer!
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hachych · 5 years ago
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Learn About The 10 Signs Of Cancer In Dogs
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Illnesses are frightening enough, but there’s something particularly scary about canine cancers. They depend upon us for his or her health, yet can’t tell us when something’s not feeling right. That’s why being on the lookout for signs of cancer in dogs is so important. It’d be wonderful if this were a rare and minor health issue with dogs, but unfortunately, 1 in 3 will suffer from dog cancers in their lifetime consistent with the National Canine Cancer Foundation. Now, let’s get into the warnings signs of canine cancer also as its commonest types. Noticing any of those doesn’t necessarily mean your dog has cancer, but there’s an honest chance of 
another health issue at a minimum,so you ought to contact your vet immediately if any are observed. SIGNS OF CANCER IN DOGS Notice one or multiple signs during this list? Contact your vet directly. 1. WEIRD SMELLS You’ve probably grown familiar with your dog’s bad breath, but you ought to get on the design out for any unusually bad (or just plain different) smell coming from your dog when you’re close enough to smell their breath. Most times, it'll just flow from to something easily explainable sort of a change in diet, but you'll never be too careful. Also, concentrate for any odd odors coming from the nose or rectal area as potential signs of dog cancer. 2. PALE GUMS Be sure to sometimes check the color of your dog’s gums. Pale gums are often a symbol of the many health issues with dogs, cancer included. If you notice a change during this area, contact your veterinarian directly. Here’s the way to check your dog’s gums: lift the jowl so you'll get an honest look press the gums with the ball of your finger observe the gum’s color where you’ve pressed In healthy dogs, after pressing on their gums the world should turn white briefly. After about 2 to three seconds, the color should return to its normal pink. If not, concentrate for other warning signs and consider lecture your vet. 3. LACK OF ENERGY Has there been any significant changes in your dog’s energy level? Lethargy is additionally one of the common signs of cancer in dogs. nobody knows your dog’s normal behavior better than you, so this is often one your veterinarian might not always catch. Is your dog spending less time playing? Do they tire quickly? Are they spending tons longer sleeping or simply generally seeming disinterested in their usual activities? Look out for these, and when noticed begin trying to find other signs your dog has cancer. 4. VOMITING AND DIARRHEA Sometimes when your dog is vomiting or has diarrhea it is often thanks to something gross but normally harmless, like eating poop. Unfortunately, though, it’s also one of the common signs of cancer in dogs. If you notice your dog having diarrhea or vomiting — especially when amid other warnings signs from this list — consult your veterinarian directly. albeit it’s not dog cancer, there might be another health issue that must be addressed. 5. BREATHING TROUBLE Like with people, there are many various sorts of dog cancer. And like people, you would like to get on the lookout for the warning signs of carcinoma in dogs.concentrate to your dog as they play and set about their usual life. Are you noticing differences in their breathing, like coughing, wheezing, or becoming in need of breath far more quickly than normal? get on the lookout for other warning signs and consider chatting with your veterinarian very soon. 6. BUMPS OR LUMPS If you’re not already, you ought to get into the habit of checking your dog’s skin daily. About once a month is ok. Check by slowly and gently running your hands over your dog’s body, taking notice of what you are feeling. Make note of anything that seems unusual or out of place, and if this isn’t your first time checking you’ll certainly want to research anything new. Your dog should enjoy this petting, so don’t be afraid to require some time. Don’t forget to feel behind their ears and around their faces. If your dog doesn't want to be touched in certain areas, investigate closely. Contact your vet immediately if you notice any bleeding or discharge. 7. UNEXPECTED WEIGHT LOSS If you don’t have your dog on a weight loss regimen, and haven’t been feeding them weight control pet food, then unexpected weight loss is one among the foremost common signs of dog cancer you ought to get on the lookout for. Your dog suddenly losing weight might not be cancer, but if there’s no other obvious explanation there’s a really good chance some sort of health issue is that the cause and you ought to get into touch together with your veterinarian. 8. CHANGE IN APPETITE Have you noticed any changes in your dog’s appetite? Are they eating less or not showing interest in the food they normally love? Many health issues for dogs might be the cause here, and cancer is unfortunately among them. Sometimes it is often just a quick issue of not feeling great, or even somebody else has been sneaking them food once you weren't looking. Pay close attention to their eating habits any time you notice a change and ask your vet directly when problems persist. 9. CHANGE IN BEHAVIOR Another sign of cancer in dogs you’ll want to be watching out for changes in behavior. Is your dog limping, walking, or playing differently than normal? Is your normally quiet dog irritable and barking or snapping even at you? Dogs, a bit like people, get annoyed or lethargic once they aren't feeling well. If your dog begins acting strangely and there’s no obvious reason why there’s an honest chance they’re sick and you ought to speak to your veterinarian. 10. WOUNDS OR SORES If you notice any wounds or open sores on your dog that aren’t healing as quickly as you’d normally expect, or are appearing with no obvious explanation, get in-tuned together with your veterinarian as soon as possible. Unexplained sores or slow healing times are often the sign of something serious — including dog cancer. Don’t hesitate to urge-tuned with knowledgeable directly who can examine your dog for love or money that must be addressed. TYPES OF DOG CANCER We’ve already covered the signs of canine cancers, now let’s quickly cover the various, commonest sorts of dog cancer. LYMPHOMA This type of dog cancer is found within the lymph nodes or bone marrow and typically diagnosed in dogs between 6 to 9 years old. It attacks the dog’s system and can spread rapidly if not addressed. There are five stages of lymphoma in dogs, with each having their treatment options and prognosis. Dog lymphoma is typically first noticed during a painless but swollen lymph gland behind your dog’s neck or knees. HEMANGLOSARCOMA A cancer of the blood vessels, hemangiosarcoma is more commonly found in dogs than the other species. it's most frequently found within the spleen, liver, and heart but can spread to any organ or occur slightly below the skin. Unfortunately, there are not any obvious early warning signs with hemangiosarcoma and oftentimes it's not found until it's in its advanced stages. this sort of canine cancer is most often found in large breeds like German Shepherds or golden retrievers. MELANOMA A type of skincare that you’ve likely heard about thanks to its frequency in humans, melanoma is most frequently found in or around a dog’s mouth or lips. It also can be found in their nail beds, footpads, and eyes. Melanoma in dogs is often particularly aggressive, spreading from the skin deep into a dog’s organs. Early signs of melanoma in dogs include swollen paws, a draining eye, or sores in or around their mouth. MAST CELL TUMORS Found within the skin and other tissues just like the tract or intestines, mastocyte tumors attack a dog’s system by turning normally protective enzymes and histamines against the dog. Mast cell tumors are quite common in older dogs. Mixed breeds should be particularly on the lookout also boxers, Boston terriers, beagles, and schnauzers. The earliest sign is typically skin lesions, with agitation caused by discomfort also common. OSTEOSARCOMA A cancer of the bone, about 85% of osteosarcoma tumors are malignant and can grow very quickly. it's most ordinarily found in large breed dogs that are 4 to 7 years in age. Early signs include swelling and lameness. Breeds most in danger include Great Danes, Irish setters, Doberman pinschers, Rottweilers, German Shepherds, and golden retrievers. MAMMARY CANCER Mammary cancer is most frequently found in female dogs that weren't spayed, or weren't spayed until after they were 2 years old. Roughly 50% of mammary tumors in dogs are malignant and have metastasized (spread) by the time of surgical removal. It is tough to identify, with mammary tumors usually appearing only as a little nodule on around the dog’s nipple. Please make certain to concentrate on those signs of cancer in dogs. If you notice anybody or multiple signs, then you ought to contact your veterinarian immediately. Cure rates haven't been better, and improve even more with early detection. Best wishes to you and your pup, and please make certain to pin or share this so you'll help other dog parents to understand the warning signs of canine cancer!
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5millionfriends · 5 years ago
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Mastocytic Enterocolitis - A Patient Guide to Mastocytic Inflammatory Bowel Disease (MIBD)
Mastocytic Enterocolitis – A Patient Guide to Mastocytic Inflammatory Bowel Disease (MIBD)
WHAT IS MASTOCYTIC ENTEROCOLITIS?
Mastocytic enterocolitis (entero=small intestine, colitis- colon + -itis= inflammation) is a relatively new term for a subset of irritable bowel syndrome condition where there are discovered to be increased mast cells in the intestine. Mast cells are a type of immune cell. They are present in low levels in everyone’s intestinal lining as well in lots of tissues…
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butlercarter01-blog · 6 years ago
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A South African Blog On Home Loans
A South African Blog On Home Loans
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Hypoparathyroidism Associated with Plaque Psoriasis-A Case Report
Hypoparathyroidism Associated with Plaque Psoriasis-A Case Report by  Fatemeh Khodaei in  Advances in Complementary & Alternative medicine
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Abstract
A 17-year-old Afghani male is described with hypoparathyroidism and plaque psoriasis associated with multiple intracranial calcifications. A diagnosis of hypoparathyroidism was made based on hypocalcaemia, hyperphosphatemia and low PTH level. A skin biopsy was compatible histopatholigically with psoriasis. He mentioned a listed problem consisted of frequent paroxysmal spells of generalized tonic-clonic seizures during the past ten years and a history of suffering from tingling and numbness of the extremities especially localized at the lower limbs, during the recent years. Also, he had frequently spontaneous episodes of invasive behaviors happened during the recent years seemed to be another manifestation of hypocalcemia due to hypoparathyroidism. Considerably, he had an unsuccessful history of phenobarbital therapy during the past years. At admission, positive trousseau and chvostek signs besides a prolonged QT interval obtained on ECG, revealed hypocalcemia, and confirmed by low serum calcium level. After initial treatment with calcium infusion, the maintenance therapy continued with calcium supplement and calcitriol. Surprisingly after serum calcium correction, the clinical condition improved, and the skin rash showed significant improvement.
Keywords: Hypoparathyroidism; Psoriasis; Hypocalcaemia; Intracranial calcifications
Introduction
Psoriasis, a common papulosquamous disease of the skin, affects about 1-3% of the population. Aetiopathogenesis of this dermatosis is complex and not yet well known. It involves the innate immune system (keratinocytes, dendritic cells, histiocytes, mastocytes, and endothelial cells) and acquired immune system (T lymphocytes). Once the innate immune system is activated, dendritic cells present an antigen (not yet defined) to lymphocytes [1]. Finally, a response is generated that leads to an expansion and activation of lymphocytes with a Th1/Th2 imbalance in favor of Th1 [2]. Intracellular calcium plays an important part in the regulation of proliferation and differentiation of keratinocytes [3]. Some cases of various forms of this skin disease have been found to show disturbances in systemic calcium metabolism [4]. The association of psoriasis with hypocalcemia has previously been described by several authors [5,6]. Para Thyroid Hormone (PTH) is one of the two major calciotropic hormones, the other being calcitriol, that regulate calcium and phosphate homeostasis [7]. Reportedly, hypoparathyroidism may cause the onset or aggravate psoriasis in patients with surgical hypoparathyroidism and primary hypoparathyroidism. Association of the disease with pseudohypoparathyroidism was also reported [8]. However, in most cases the metabolic disturbance was secondary to hypoparathyroidism. Reports of less frequent etiologies of psoriasis-associated hypocalcemia are only to be found in Laymon et al. [9] describing psoriasiform plaques in a patient with pseudohypoparathyroidism, and in another description of a girl with pseudohypoparathyroidism and psoriasis vulgaris [10].
Case Report
A 17-year-old Afghani male, born of a non-consanguineous marriage, with plaque psoriasis was admitted to Loghman Hakim Hospital, Tehran, Iran in 2015. He had a history of seizures from the age of 7. During this period, the patient has been treated with Phenobarbital 60mg twice daily. His condition was episodically during recent years, approximately every 3 to 4 months, he experienced seizure by falling followed by abnormal movements lasting for 3 to 4 minutes and then by impairing consciousness for few seconds. She also mentioned that the frequency of episodes has increased during the last 6 months. The patient worked in a welding workshop and recently complained of muscle pain and cramps during work. Additionally, he had been suffering numbness, stiffness and tingling of upper and especially lower extremities frequently. Past surgical history for prior parathyroid, thyroid or neck surgery was negative. His mother mentioned episodes of invasive behavior which happened every 2 or 3 months during the last years. Also, there was no history of delayed puberty or erectile dysfunction. No history of any other condition compatible to autoimmune disease has been detected. The patient had additionally noted a history of erythematous scaly and pustular lesions on the face, chest, scalp, on the elbows and knees, which began approximately 3 years before admission (Figure 1). With respect to family history, his sister had psoriasis. At the time of admission his height was 150cm and his weight was 55kg and his vital signs were stable. He presented with somehow normal mental status and acceptable orientation and speech. On examination following inflating sphygmomanometer cuff above systolic blood pressure, he experienced painful spasm of his examined hand revealing positive Trousseau’s sign. The Chvostek sign was also positive and there were no localized neurological signs. Upon investigation, total blood count, liver and renal function tests were normal. Also, the serum calcium was 6mg/dl (8.5-10mg/dl), phosphorus 8.2mg/dl (2.7-4.9mg/dl) and parathyroid hormone (PTH) level was 1.6pg/ ml (10.9-65pg/ml). Brain CT showed widespread intracranial calcification (Figure 2). ECG showed prolonged QT interval according to hypocalcemia. According to pathologic study on skin punch biopsy, regular acanthosis with elongated rete ridges along with suprapapillary thinning of epidermis was seen, additional findings were parakeratosis, neutrophilic micro-abscesses, and loss of granular layer with dilated papillary blood vessels in superficial dermal layer. A diagnosis of hypoparathyroidism was made based on hypocalcemia, hyperphosphatemia and low PTH level. This was further supported by diffuse patchy intracranial calcification in brain CT scan. It was found that the patient had seizures due to hypocalcemia. A skin biopsy was compatible with psoriasis. The EEG obtained from the patient was normal besides revealing widespread slow activity. In view of severe symptomatic hypocalcemia, the patient was started on intravenous infusion of a %10 solution of calcium gluconate (elemental calcium 9.3mg/ dl) at a rate of 0.5-1.ml/min while the heart rate was monitored and a total dose not to exceed 20mg of elemental calcium/kg. When serum calcium level reached above 8mg/dl, calcitriol with initial dosage of 0,5 microgram daily in two equal divided doses added and the regime continued for 48 hours. Then to taper the calcium gluconate infusion, calcium carbonate tablet 400mg for 4 times daily added to the drug list. Finally, calcitriol reached to 2 micrograms daily as a maintenance therapy. Although the seizure was due to the underlying hypocalcemia, the patient benefited sodium valproate 500mg twice daily to taper the phenobarbital prescribed for the patients formerly without any positive results in controlling seizures. One week later, the patient was discharged with clinical and laboratory improvement and therapy continued calcium carbonate tablet for four times daily besides oral calcitriol prescription as the dose mentioned for maintenance therapy. He advised to reduce foods with high phosphorus content such as milk, eggs, and cheese in the diet. Also, he was asked to be visited one week later to be reevaluated and to regulate the drug doses. One month later the patient showed significant regression of the psoriatic lesions and presented without any complains of tingling, muscle weakness and seizure which showed the recovery of underlying hypocalcemia.
Figure 1:Erythematous scaly lesions on the chest.
Figure 2:CT brain shows diffuse patchy calcification.
Discussion
In the present case, we have described an unusual association of plaque psoriasis and hypoparathyroidism. Hypoparathyroidism had not been diagnosed prior to current admission. In this case, the PTH level stayed at the lower limit of the normal range. Biochemical diagnosis of hypoparathyroidism is based on a combination of hypocalcemia and hyperphosphatemia with low or inappropriately normal PTH. Clinical manifestations of hypoparathyroidism are in large part due to low serum-ionized calcium levels varying from no symptoms to those of complete and long-lasting deficiency. Mild deficiency may be revealed only by appropriate laboratory studies. Muscular pain and cramps are early manifestations; they progress to numbness, stiffness, and tingling of the hands and feet. There may be only a positive Chvostek or Trousseau sign or laryngeal and carpopedal spasms. Convulsion with or without loss of consciousness can occur at intervals of days, weeks, or months. These episodes can begin with abdominal pain, followed by tonic rigidity, retraction of the head and cyanosis. Hypoparathyroidism is often mistaken for epilepsy. Headache, vomiting, increased intracranial pressure and papilledema may be associated with convulsion and might suggest a bra tumor. Also, the skin may become dry and scaly, and the nails might have horizontal lines. Cataracts in patients with long-lasting untreated disease are a direct consequence of hypoparathyroidism; other autoimmune ocular disorders such as keratoconjunctivitis can also occur. Permanent physical and mental deterioration occur if initiation of treatment is long delayed [11]. Although our patient had several classic clinical and biochemical features of hypoparathyroidism, but according to the probably long-lasting underlying hypocalcemia, the absence of other manifestations of hypocalcemia was unusual. He had a longstanding erythematous scaly lesion on his chest. Hypocalcemia is an exacerbating factor of psoriasis and severe psoriasis often accompanies hypocalcemia. There are case reports of hypoparathyroidism-induced hypocalcemia leading to the worsening of skin symptoms in psoriatic patients [12-14]. Correction of the hypocalcemia usually results in clearing of the skin disease. It has been suggested that this disturbance is an inherited disease with variable penetration, although it is believed that environmental factors also play a role in its clinical expression. Thus, the possibility that the association between psoriasis and hypoparathyroidism is related to other mutations not yet characterized for these diseases cannot be excluded.
Conflict of Interest: The authors declare that they have no conflict of interest.
References
Lowes MA, Bowcock AM, Krueger JG (2007) Pathogenesis and therapy of psoriasis. Nature 445(7130): 866-873.
Cayir A, Engin RI, Turan MI, Pala E (2014) Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report. J Pediatr Endocrinol Metab 27(7-8): 791-793. `
Lebwohl M, Ortonne JP, Andres P, Briantais P (2009) Calcitriol ointment 3 microg/g is safe and effective over 52 weeks for the treatment of mild to moderate plaque psoriasis. Cutis 83(4): 205-212.
Plavina T, Hincapie M, Wakshull E, Subramanyam M, Hancock WS (2008) Increased plasma concentrations of cytoskeletal and Ca2+-binding proteins and their peptides in psoriasis patients. Clin Chem 54(11): 1805-1814.
Poojary SA, Lodha N, Gupta N (2015) Psoriasis in autoimmune polyendocrine syndrome type I: A possible complication or a non-endocrine minor component? Indian J Dermatol Venereol Leprol 81(2): 166-169.
Imaeda K, Kimura R, Kato T, Kaneko N, Morita A, et al. (2012) A case of idiopathic hypoparathyroidism associated with psoriasis vulgaris. Nagoya Med J 52: 67-75.
Fuleihan G, Brown E, Rosen C, Mulder J (2014) Parathyroid hormone secretion and action. UpToDate p.14.
Braun GS, Witt M, Mayer V, Schmid H (2007) Hypercalcemia caused by vitamin D3 analogs in psoriasis treatment. Int J Dermatol 46(12): 1315-1317.
Lima K, Abrahamsen TG, Wolff AB, Husebye E, Alimohammadi M, et al. (2011) Hypoparathyroidism and autoimmunity in the 22q11. 2 deletion syndrome. European Journal of Endocrinology 165(2): 345-352.
John M, Sudeep K, Thomas N, Thomas M (2006) A mentally challenged adult with tonic convulsions, dysmorphic face and sebopsoriasis. J Postgrad Med 52(2): 145-147.
Jabbour SA (2003) Cutaneous manifestations of endocrine disorders. Am J Clin Dermatol 4(5): 315-331.
Lee Y, Nam YH, Lee JH, Park JK, Seo YJ (2005) Hypocalcaemia-induced pustular psoriasis-like skin eruption. Br J Dermatol 152(3): 591-593.
Maeda T, Hasegawa H, Matsuda A, Kinoshita M, Matsumura O, et al. (2003) Severe hypocalcemia compatible with idiopathic hypoparathyroidism associated with psoriasis vulgaris. Nihon Naika Gakkai Zasshi 92(12): 2412-2414.
Montenegro JRM, Paula FJAd, Foss NT, Foss MC (2002) Familial association of pseudohypoparathyroidism and psoriasis: case report. Sao Paulo Med J 120(1): 23-27.
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365daysofabby · 5 years ago
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July 3rd, 2019
WOW today started with a bang. Instantly puking as soon as I wake up and an epi pen soon after. Then I worked for what felt like forever and I just felt incompetent and awkward. What else is new.
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