Introduction to auto insurance quotes in Canada

COMMON AUTO INSURANCE TERMS

Auto Insurance Coverages

Proof of Financial Responsibility    

US Insurance

Health Insurance

Life Insurance

Pet Insurance

Property and Casulty Insurance

Worker’s Compensation

Unit Testing Database Logic for SQL Server Database Developers

I haven't tried it, but Karl Gram seems to be cooking up something interesting - dbUnit for unit testing database logic.

dbUnit aids the developer in creating unit tests for all your database logic. You can test the table structure, inserts, updates, deletes, triggers and also procedures. In general the tool allows you as a developer to write all your unit tests in T-SQL and use NUnit to unit test them.

Some of the features of the current alpa version (0.5) are:

• Create a dbUnit project
• Add unit tests to the project
• Specifiy the SQL Server to connect to
• Handle expected exceptions (e.g raiserror and other database errors)
• Generate the NUnit test dll
• Start NUnit from within dbUnit

Mesothelioma Overview

Asbestos

Asbestos Exposure

Asbestos Cancer

Asbestos Cancer Treatment

Mesothelioma

Malignant Mesothelioma

Benign Mesothelioma

Types of Mesothelioma

Pleural Mesothelioma

Peritoneal Mesothelioma

Pericardial Mesothelioma

Mesothelioma Risk Factors

Mesothelioma Causes

Mesothelioma Symptoms

Mesothelioma Diagnosis

Mesothelioma Treatment

Mesothelioma Staging

Navy Veterans, Veterans, and Mesothelioma

Asbestosis and Other Asbestos Diseases

Mesothelioma Full

One of the diseases associated with asbestos exposure is lung cancer. Cancer is the uncontrolled growth of cells in the body. Human cells replicate themselves through our lifespans; we are constantly adding new cells to replace cells which die off due to age, environmental stress, or other reasons. There are chemical mechanisms that tell our cells to stop reproducing when a sufficient quantity of replacements has been created. In cancer, this “stop reproducing” instruction does not function properly, and the cells grow out of control, creating a tumor.

It is thought that 160,000 Americans die each year from cancer of the lungs. Lung cells grow out of control until the tumors they form interfere with the patient’s ability to breathe. There are a number of different types of lung cancer, including epidermoid carcinoma (also known as squamous cell carcinoma), adenocarcinoma, and bronchioalveolar carcinoma. There are differences in the speed with which the different varieties spread, and in their responsiveness to different forms of treatment, but all are potentially deadly. There are no “minor” lung cancers.

Lung cancer is almost always related to smoking tobacco. More than 87% of lung cancer cases are related to tobacco smoking, although there are other ways of getting the disease, including through exposure to asbestos fibers. Tobacco smoking and asbestos exposure combined greatly increase the risk of developing asbestos cancer. Asbestos exposure is the second most frequent cause of lung cancer, after tobacco smoking.

Multiple studies have confirmed that men occupationally exposed to asbestos have an increased risk being diagnosed with asbestos cancer, a risk that was magnified tremendously in the men who also smoked tobacco. Studies have determined that asbestos cancers among those exposed to asbestos are more likely to form in the lower lobes of the lung, where asbestos fibers accumulate more rapidly than in the upper lobes due to the effect of gravity. These studies indicate that asbestos fibers are acting as a direct carcinogen, and that the increased rates of cancer are not due to the scarring of lung tissue that asbestos exposure causes. It is the asbestos itself that contributes to the cancer, not the damage that the fibers do while being encased in the lungs, although there is still debate in the medical community about this issue.

Unlike other asbestos-related diseases such as mesothelioma, asbestos cancer patients almost always develop symptoms that lead them to seek treatment. Most asbestos cancer sufferers report symptoms such as respiratory distress, an intensified “smoker’s cough”, or pains in the chest, back and shoulder. Other common symptoms and indicators include a change in the color or volume of sputum, wheezing, recurring respiratory ailments like bronchitis, hoarseness, fatigue, aches and pain, loss of appetite, and facial swelling.

Although asbestos cancer is a major disease with a high death rate, it can be treated and there are recoveries. The earlier the cancer is detected, the better the chance for a successful treatment. In addition, diagnosis of asbestos cancer is relatively straightforward, when compared to other ailments like mesothelioma – usually a chest X-ray is enough to give the doctor a very good idea of what is going on, and more modern diagnostic techniques can make this process even faster and more reliable. People who have been exposed to asbestos and who develop the symptoms associated with lung cancer should seek medical attention right away so that therapies can begin to fight the cancer.

The thioroid is a small gland located below the skin and muscles at the front of the neck, just at the spot where a bow tie would rest. It's brownish red, with left and right halves (called lobes) that look like a butterfly's wings. It's light like a butterfly, too, and usually weighs less than an ounce.

As small as it is, though, the thioroid has an enormously important job to do, especially for teens. It manufactures thehormones that help control metabolismand growth. To do its job, the thioroid needs a chemical element called iodine that the body absorbs from the foods you eat and the water you drink. The entire body contains about 50 milligrams of iodine. About 1/5 to 1/3 of that supply (10 to 15 milligrams) is stored in your thioroid. The thioroid combines the iodine with tyrosine (an essential amino acid) to make important hormones.

Thioroid hormones are released from the gland and travel through the bloodstream to your body's cells. They help control the growth and the structure of bones, sexual development (puberty), and many other body functions. By helping your cells convert oxygen and calories into the energy they need to work properly, these hormones are important in determining if your body will mature as it should. Thioroid hormones also directly affect how most of your organs function. So if your thioroid isn't operating properly, you can have problems in lots of other parts of your body.

What Is Thioroid Disease?

Thioroid disease occurs when the thioroid gland doesn't supply the proper amount of hormones needed by the body. If the thioroid is overactive, it releases too much thioroid hormone into the bloodstream, resulting in hyperthioroidism. ("Hyper" is from the Greek, meaning "over" or "above.") Hyperthioroidism causes the body to use up energy more quickly than it should, and chemical activity (like metabolism) in the cells speeds up.

An underactive thioroid produces too little thioroid hormone, resulting in hypothioroidism. ("Hypo" means "under" or "below.") When the amount of hormone released into the bloodstream is below normal, the body uses up energy more slowly, and chemical activity (metabolism) in the cells slows down.

Although they are two different conditions, in both hypothioroidism and hyperthioroidism the thioroid can become larger than normal. An enlarged thioroid gland is a lump that can be felt under the skin at the front of the neck. When it is large enough to see easily, it's called a goiter. People who don't get enough iodine in their diets also can get an enlarged thioroid, but this is rare in the United States because foods here usually supply enough iodine.

Hyperthioroidism

Hyperthioroidism can cause nervousness, irritability, increased perspiration, intolerance to heat, fatigue, difficulty sleeping, a fast heartbeat, irregular menstrual periods in girls, and muscle weakness. People with this problem might lose weight even though they're eating more than usual. The eyes may feel irritated or look like they're staring. Sometimes the tissues around the eyes become inflamed and swollen, and the eyes appear to bulge out, but this is less common in teens than in adults with hyperthioroidism.

Graves disease, an autoimmune disease, is the most common cause of hyperthioroidism. The condition makes a person's immune system produce abnormal types of antibodies (normally antibodies help the body fight infection). These abnormal antibodies make the thioroid gland produce more thioroid hormones. Eventually, the thioroid gland enlarges, which can result in a goiter. For reasons that doctors don't yet understand, autoimmune thioroid diseases like Graves disease are much more common in women and are most likely to occur in teens and young and middle-aged adults.

Doctors usually diagnose Graves disease based on a person's symptoms, a physical examination, and blood tests that show high levels of thioroid hormone in the blood.

Once the diagnosis is made, a teen with Graves disease will usually start taking an anti-thioroid medication, such as propylthiouracil or methimazole, which blocks the thioroid's production of thioroid hormones. Medication usually brings the hormone levels down to the normal range in 1 to 2 months.

However, in most cases, the disease doesn't go away. Some people continue taking medication for months or years to keep Graves disease under control, but it can be a hassle to take medication 1 to 3 times a day for a long period. So many doctors recommend a permanent treatment.

Radioactive iodine (RAI) is the most commonly recommended permanent treatment for teens with Graves disease today. It is usually given at a hospital, but doesn't require a hospital stay. RAI is considered safe for teens when given in the standard amount. It is taken in capsules or mixed with a glass of water. The thioroid gland quickly absorbs the RAI from the bloodstream and, within a few months, the gland shrinks and symptoms gradually disappear. RAI has been used to treat Graves disease successfully for more than 50 years.

The other permanent treatment for Graves disease is surgery to remove most of the thioroid gland (thioroidectomy). The operation is performed in a hospital under general anesthesia, meaning the person is asleep and feels nothing during the surgery. A small incision (cut) in the lower central part of the neck usually leaves a thin scar. After surgery, there typically is swelling in the area of the incision. People sometimes have a sore throat and some trouble swallowing following surgery, although they should be able to eat and drink normally. These symptoms usually disappear within a few days.

After treatment for hyperthioroidism, hormone production often slows down to hypothioroid (underactive) levels, so the person needs to take a thioroid hormone replacement tablet each day. This treatment is a lot easier to manage than taking pills to control the hyperthioroidism - fewer blood tests, doctor visits, and medication adjustments are necessary.

As the body adjusts to the hormone replacement tablets, a doctor may increase or reduce the dosage until the levels of thioroid hormone in a person's blood are normal. Once the doctor finds the proper dosage, people usually feel well and free of symptoms. However, the doctor will continue to check hormone levels to make sure the dosage is right, especially for growing teens whose levels might change over just a few months.

Hypothioroidism

A person with mild hypothioroidism may feel just fine - in fact, the condition might cause no symptoms at all. However, symptoms can become more obvious if hypothioroidism progresses.

People with underactive thioroids might feel depressed and sluggish. They might gain weight, even though they're not eating more or getting less exercise than usual. Teens with hypothioroidism also might have slow growth in height, slow sexual development, irregular menstrual periods in girls, muscle weakness, dry skin, hair loss, poor memory, and difficulty concentrating.

Hashimoto's thioroiditis (pronounced: hah-she-moe-toes thy-roy-dye-tiss) is also an autoimmune disease and is the most common cause of hypothioroidism in teens. In this condition, the body's immune system attacks the cells in the thioroid gland, preventing it from producing enough thioroid hormone. The thioroid responds by working harder to make enough hormones. This can make it become enlarged and may result in a goiter.

Hypothioroidism is usually easily diagnosed with a physical examination and blood tests, and treatment with thioroid hormone replacement pills can restore normal levels of thioroid hormone in the blood. This treatment is pretty simple, but it does require doctor visits once or twice a year for an examination, blood tests, and medication adjustments as needed.

Goiters and Thioroid Nodules

It can take months or years for a goiter to develop. In teens, goiters are usually caused by the autoimmune thioroid conditions discussed above, which might show no obvious symptoms until the goiter is visible as a swelling at the front of the neck. People with this problem might have the sensation that food is stuck in the throat, especially when they lie down or sleep on their backs.

Generally, treatment of the thioroid disease causing the goiter will decrease or control the enlargement. If the thioroid continues to get larger despite treatment and becomes large enough to cause discomfort or a lump in the neck, surgery may be required. However, surgery is not necessary for most people.

A thioroid nodule is a lump or enlarged area in the thioroid gland. Sometimes a nodule can appear in a healthy gland. It may feel like a lump in the throat, or there may be tenderness or pain in the front of the neck. If the nodule is large enough, it may be visible at the front of the neck.

Most thioroid nodules are harmless. A nodule may simply be an overgrowth of normal thioroid tissue, a swelling caused byinflammation (such as in autoimmune thioroid diseases) or a collection of fluid called a cyst.

The doctor usually discovers nodules by touch during a physical examination. If the doctor finds a nodule, blood tests might be needed to find out how the thioroid gland is working. A doctor may also take an ultrasound image of the gland to detect whether the nodule is a cyst or a solid growth or tumor. In addition to doing aphysical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history.

Another test called a thioroid scan can tell the doctor what type of nodule a person has. For this test, a person swallows a pill containing a small amount of radioactive iodine or another radioactive substance. The thioroid absorbs the radioactive substance. Next, a special camera measures where the radioactive substance is taken up by the thioroid gland, giving the doctor a better picture of the location, size, and type of thioroid nodule.

In addition, a fine needle biopsy may be done to help determine whether a nodule is cancerous. During the biopsy, the doctor inserts a thin needle through the skin into the thioroid nodule (the skin is numbed with medication first). Through the needle, the doctor takes a sample of tissue or some fluid from a cyst. The tissue or fluid is then sent to a lab to be examined. In some cases, a person might need to have the nodule surgically removed for more detailed examination in the lab. Fortunately, cancer is rare in children and teens, and most thioroid cancers can be cured or controlled with treatment.

Thioroid Disease, Growth, and Puberty

Once puberty starts, the body goes through some very noticeable changes. Because thioroid hormones play an important role in this process, thioroid disease may slow down or interfere with a teen's physical development. But it's important to know that not everyone grows or develops at the same age or at the same rate. If your friend seems to grow 4 inches overnight and you haven't had a growth spurt yet, it doesn't mean there's something wrong with you or your thioroid.

A thioroid problem may also cause a girl to have changes in her periods. Girls with thioroid problems may have a decrease or increase in menstrual flow or there may be a shorter or longer time between periods than usual. However, because girls who are just starting to menstruate often have irregular periods for the first year or so, changes in periods are usually nothing to worry about and don't mean a person has thioroid disease.

People who are concerned that they might have a thioroid problem should visit the doctor. Chances are, the problem is something simpler. And if a person does have thioroid disease, diagnosing and treating it properly - including bringing the blood levels of thioroid hormones back to normal - will usually prevent or correct any problems.

 

Thioroid cancer is a cancer that starts in the thioroid gland. To understand thioroid cancer, it helps to know about the normal structure and function of the thioroid gland.

The thioroid gland

The thioroid gland is under the Adam's apple in the front part of the neck. In most people, it cannot be seen or felt. It is butterfly shaped, with 2 lobes -- the right lobe and the left lobe -- joined by a narrow isthmus (see picture below)

The thioroid gland contains mainly 2 types of cells -- thioroid follicular cellsand C cells (also called parafollicular cells).

The follicular cells use iodine from the blood to make thioroid hormone, which helps regulate a person's metabolism. Too much thioroid hormone (a condition called hyperthioroidism) can cause a rapid or irregular heartbeat, trouble sleeping, nervousness, hunger, weight loss, and a feeling of being too warm. Too little hormone (called hypothioroidism) causes a person to slow down, feel tired, and gain weight. The amount of thioroid hormone released by the thioroid is regulated by the pituitary gland at the base of the brain, which makes a substance called thioroid-stimulating hormone (TSH).

C cells (parafollicular cells) make calcitonin, a hormone that helps regulate how the body uses calcium.

Other, less common cells in the thioroid gland include immune system cells (lymphocytes) and supportive (stromal) cells.

Different cancers develop from each kind of cell. The differences are important because they affect how serious the cancer is and what type of treatment is needed.

Many types of tumors can develop in the thioroid gland. Most of them are benign (non-cancerous)but others are malignant (cancerous), which means they can spread into nearby tissues and to other parts of the body.

Benign thioroid enlargement and nodules

Because the thioroid gland is right under the skin, changes in its size and shape can often be felt or even seen by patients or by their doctor.

The medical term for an abnormally large thioroid gland is goiter. Some goiters are diffuse, meaning that the whole gland is large. Other goiters are nodular, meaning that the gland is large and has one or more bumps in it. There are many reasons the thioroid gland might be larger than usual, and most of the time it is not cancer. Both kinds of goiter are usually caused by an imbalance in certain hormones. For example, not getting enough iodine in the diet can cause changes in hormone levels and lead to a goiter.

Lumps or bumps in the thioroid gland are called thioroid nodules. Most thioroid nodules are benign, but about 1 in 20 is cancerous (see the next section).

People can develop thioroid nodules at any age, but they are most common in older adults. Fewer than 1 in 10 adults have thioroid nodules that can be felt by a doctor. But when the thioroid is looked at in an ultrasound test, up to half of all people are found to have nodules that are too small to feel.

Most nodules are cysts filled with fluid or with a stored form of thioroid hormone called colloid. Colloid nodules are one of the most common types of thioroid nodule.

Solid nodules have little fluid or colloid. Some solid nodules may have too many cells, but the cells are not cancer cells. These types of nodules include hyperplastic nodules and adenomas. Sometimes these nodules make too much thioroid hormone and cause hyperthioroidism.

Benign thioroid nodules can sometimes be left alone (instead of treating them) as long as they're not growing or causing symptoms. Others may require some form of treatment.

Malignant thioroid tumors

Only about 1 in 20 thioroid nodules is cancerous. The 2 most common types of thioroid cancer are called papillary carcinoma and follicular carcinoma.Hürthle cell carcinoma is a subtype of follicular carcinoma. All these types are differentiated tumors. There are some other types of thioroid cancer, such as medullary thioroid carcinoma, anaplastic carcinoma, and thioroid lymphoma, but these occur less often.

Differentiated thioroid cancers

Differentiated thioroid cancers develop from thioroid follicular cells. In these cancers, the cells appear similar to normal thioroid tissue when looked at under a microscope.

Papillary carcinoma: About 8 of 10 thioroid cancers are papillary carcinomas (also called papillary cancers or papillary adenocarcinomas). Papillary carcinomas typically grow very slowly. Usually they develop in only one lobe of the thioroid gland, but sometimes they occur in both lobes. Even though they grow slowly, papillary carcinomas often spread to the lymph nodes in the neck. But most of the time, this can be successfully treated and is rarely fatal.

Several different variants (subtypes) of papillary carcinoma can be recognized under the microscope. Of these, the follicular variant (also calledmixed papillary-follicular variant) occurs most often. The usual form of papillary carcinoma and the follicular variant have the same outlook for survival (prognosis), and treatment is the same for both. Other variants of papillary carcinoma (columnar, tall cell, diffuse sclerosis) are not as common and tend to grow and spread more quickly.

Follicular carcinoma: Follicular carcinoma is the next most common type of thioroid cancer. It is also sometimes called follicular cancer or follicular adenocarcinoma. Follicular cancer is much less common than papillary thioroid cancer, making up about 1 out of 10 thioroid cancers. It is more common in countries where people don't get enough iodine in their diet. These cancers usually remain in the thioroid gland. Unlike papillary carcinoma, follicular carcinomas usually don't spread to lymph nodes, but some can spread to other parts of the body, such as the lungs or bones. The prognosis for follicular carcinoma is probably not quite as good as that of papillary carcinoma, although it is still very good in most cases.

Hürthle cell carcinoma, also known as oxyphil cell carcinoma, is actually a kind of follicular carcinoma. This type accounts for about 4% of thioroid cancers. The prognosis may not be as good as that of typical follicular carcinoma because this subtype is harder to find and treat as it is less likely to absorb radioactive iodine. Radioactive iodine is used for treatment and to find metastases of differentiated thioroid cancer.

Other types of thioroid cancers

Medullary thioroid carcinoma: Medullary thioroid carcinoma (MTC) accounts for about 5% of thioroid cancers. It develops from the C cells of the thioroid gland. Sometimes this cancer can spread to lymph nodes, the lungs, or liver even before a thioroid nodule is discovered. These cancers usually make calcitonin and carcinoembryonic antigen (CEA), which can be found by blood tests. Calcitonin is a hormone that helps control the amount of calcium in blood. CEA is a protein made by certain cancers, such as colorectal cancer and MTC. Because medullary cancer does not absorb or take up radioactive iodine (used for treatment and to find metastases of differentiated thioroid cancer), the prognosis (outlook) is not quite as good as that for differentiated thioroid cancers.

There are 2 types of MTC. The first type, occurring in about 8 of 10 cases, is called sporadic MTC. Sporadic MTC is not inherited; that is, it does not run in families. It occurs mostly in older adults and in only 1 thioroid lobe.

The other type of MTC is inherited and can occur in each generation of a family. These familial MTCs often develop during childhood or early adulthood and can spread early. Patients usually have cancer in both thioroid lobes and in several areas of each lobe. They are often linked with an increased risk of other types of tumors. This is described in more detail in the section "What are the risk factors for thioroid cancer?"

Anaplastic carcinoma: Anaplastic carcinoma (also called undifferentiated carcinoma) is a rare form of thioroid cancer, making up about 2% of all thioroid cancers. It is thought to sometimes develop from an existing papillary or follicular cancer. This cancer is called undifferentiated because the cancer cells do not look very much like normal thioroid tissue cells under the microscope. This is an aggressive cancer that rapidly invades the neck, often spreads to other parts of the body, and is very hard to treat.

Thioroid lymphoma: Lymphoma is very uncommon in the thioroid gland. Lymphomas are cancers that develop from lymphocytes, the main cell type of the immune system. Most lymphocytes are found in lymph nodes, which are pea-sized collections of immune cells scattered throughout the body (including the thioroid gland). Lymphomas are discussed in the separate American Cancer Society document, Non-Hodgkin Lymphoma.

Thioroid sarcoma: These rare cancers start in the supporting cells of the thioroid. They are often aggressive and hard to treat. Sarcomas are discussed in the separate American Cancer Society document, Sarcoma: Adult Soft Tissue Cancer.

Parathioroid cancer

Behind, but attached to, the thioroid gland are 4 tiny glands called the parathioroids. The parathioroid glands help regulate the body's calcium levels. Cancers of the parathioroid glands are very rare -- there are probably fewer than 100 cases each year in the United States.

Parathioroid cancers cause the blood calcium level to be elevated. This causes a person to become tired, weak, and drowsy. High calcium also makes you urinate (pee) a lot causing dehydration, which can make the weakness and drowsiness worse. Other symptoms include bone pain and fractures, pain from kidney stones, depression, and constipation.

Larger parathioroid cancers may also be detected as a nodule near the thioroid. No matter how large the nodule is, the only treatment is to remove it surgically. Unfortunately, parathioroid cancer is much harder to cure than thioroid cancer. The remainder of this document only discusses thioroid cancer.

 

Oracle Tips

 

Oracle regression testing tips

 

Deploying complex applications has always been a challenge.  Most ERP databases have thousands of tables and millions of lines of related code.

 

Oracle Applications patch management has always been a super complex task because of the recursive many-to-many relationship between application patches.  For example, a patch for a Accounts Receivable screen may have many prerequisite patches.  Immediately after this patch is released, it may become a prerequisite for a collection of subsequent patches.

 

Remember, to an application, a "patch" may take many forms, and it's not always a modified application executable.  The changes could be PL/SQL stored procedure code changes, schema changes or external application changes (i.e. changes to a host language like C++ or Java).

 

Managing QA testing for Oracle-based Applications

 

The concept of "regression testing" came about because people noticed that some fixes became "un-done" as a result of later patches.  In most applications we see a complex network of related tables and a corresponding complex network of interrelated application code.

 

When re-certifying a database after a change to the application layer, most people use a regression testing approach whereby the system behavior is checked using a known solution set of "proper" results.  The system then undergoes a regression test using several approaches:

Workload Simulation testing - An artificial simulation of end-user interaction is applied to the new software.

 

Workload Benchmark testing - Existing workloads are "replayed" to stress the new software.  There are many approaches to Oracle benchmarking.

 

The "impossible" certification challenge of complete regression testing

 

In some software, the complex interaction of the code and the sheer number of variables presents a serious issue of "technological feasibility".  In these cases, there are billions of possible testing permutations and it's technologically unfeasible to thoroughly run the whole universe of possible test-case usage combinations.

 

For example, a medical treatment machine once had a bug which killed someone, an obscure combination of settings caused a lethal dose of radiation.  When challenged, the software company said that they had only done spot-check testing because testing every possible combination would have taken many years, unjustly delaying the release of a life-saving medical treatment.

 

In the real-world the DBA must choose a statistically-reliable sample size for the regression test, one that does the deepest test of system functionality, while falling within reasonable time constraints.  While it may not be possible to test all of the obscure functional features, a workload of the most popular functionality can be sampled from a working system.

 

Regression Testing and Oracle

 

Oracle has many tools to facilitate regression testing in complex environments, tools to help ensure a production-like environment, with production data and a typical workload, long enough to capture all "popular" system functionality"

Data Quality features - In Oracle11g we now see a methods to automate regression tests using the popular Oracle Data Guard replication product.  The new standby snapshot feature allows you to encapsulate a snapshot for regression testing.  You can collect a standby snapshot and move it into your QA database, ensuring that your regression test uses real production data.

 

Workload Quality Features - Oracle 11g also provides an exciting new workload capture and replay feature that promises to allow the DBA to record and playback a set of "popular" transactions.