Blood Lines
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A view into the souls of HIV+ youth Produced & Directed by: Rebecca Guberman & Jennifer Jako

New updated 2015 version now available

The New York Times calls Blood Lines "a pointed, moving documentary" and "an eloquent plea for understanding"
Dominal channels or minor lymphaticovenous communications. Most, but not all, bloodborne metastases occur after lymph node involvement. generic viagra online buy cheap viagra buy viagra generic viagra for sale online cheap cheap generic viagra buy cheap viagra buy viagra This is of obvious practical importance in treatment and prognosis. Despite surgical excision of negative retroperitoneal lymph nodes, the distant failure rate is approximately 5% (whitmore, 1973). This is probably due to the fact that testicular lymphatics may very occasionally bypass retroperitoneal lymph nodes altogether and communicate directly with the thoracic duct. In patients undergoing surveillance alone after inguinal orchiectomy for clinical stage a nonseminoma, approximately 30% fail, most with retroperitoneal lymph node metastasis (80% of failures) and the remainder with extralymphatic distant metastasis (20% of failures) independent of retroperitoneal deposits (duchesne et al, 1990). With the exception of seminoma, the growth rate among gcts tends to be high. Doubling times calculated on the basis of serial chest radiographs usually range from 10 to 30 days. Alterations in the production of tumor marker substances (bhcg, afp, lactic acid dehydrogenase [ldh]) are in keeping with rapid metabolic activity and growth. The anticipated rapid demise of patients failing treatment has been confirmed by clinical observation; 85% of patients dying from gcts do so within 2 years and the majority of the remainder within 3 years. Because of a sometimes indolent course, seminoma may recur from 2 to 10 years after apparently successful initial management. Because of the short natural history of germinal tumors, it has become customary to regard 2-year survival as an end point for judging the effectiveness of therapy. With the evolution of multimodal therapy, surviving patients may not be actually cured of their neoplasm, and a disease-free interval of 5 years may be a more appropriate yardstick for assessing curability. Longer follow-up after chemotherapy is mandatory, however, because relapse has been noted up to 10 years after treatment. In summary, with the notable exception of choriocarcinoma, testicular cancer generally spreads in a predictable pattern. This has led to the development of new surgical techniques, which provide accurate pathologic staging while at the same time providing therapeutic benefit. These techniques are also associated with reduced morbidity when compared with the classic full retroperitoneal lymph node dissection (rplnd). Clinical manifestations in general, survival in patients with gct is related to the stage at presentation and therefore to the amount of tumor burden as well as to the effectiveness of subsequent treatment. Patients who present with advanced disease (stage iii) generally have a much poorer prognosis than do those with disease confined to the testis or those with regional nodal.
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