What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

What is niacin, a drug or a vitamin?

Niacin is nicotinic acid, one of the B vitamins. It’s found in many foods, especially whole grains and milk products. As a vitamin, you need only about 15 milligrams of niacin a day. However, when used to lower cholesterol niacin is used in what are called pharmacological levels rather than in vitamin amounts. One positive side to niacin is that it’s the least expensive of all cholesterol lowering medications available, although the drug does have a high rate of side effects.
The pharmacological levels can range from a few hundred up to 6,000 milligrams per day. If you take 100 milligrams, the only side effect you may experience is some flushing and warmth for a few minutes (this dosage is too low to lower blood cholesterol). When you are taking 1,000 to 6,000 milligrams a day, the rate of side effects is very high. The minimum dose for any real effect on cholesterol is about 1,000 milligrams. One usually starts with 100 milligrams (or a few hundred milligrams), slowly increasing the dose to over 1,000 milligrams. Only about two out of three people can tolerate the required dose. The most common complaints are indigestion and flushing. Some special formulations are becoming available that are absorbed more slowly and appear to cause less flushing and fewer side effects.

Niacin can raise blood sugar levels, so if you have diabetes, niacin should not be taken. Niacin is one of the few drugs that can lower triglycerides as well as cholesterol, and that, together with the very low price, is why it is still prescribed. Nationally, the number of prescriptions written annually for niacin is very low, but that figure is misleading because niacin is available over the counter and could be used for lowering cholesterol without a prescription.

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