CFD trading offers a sensible method to manage your hard earned money. This benefits you in leveraging your bets and with them within your fullest potential. A relatively small market movement can produce major changes with your portfolio. But usually there are some things you‘ll want to understand so as in order to manage your account correctly.
Minimum Deposit : Money lying within the account doesn‘t bear interest. The simplest way to use you money during this case is to stay as less money with your CFD trading account as you can. The very best way usually is to move funds electronically When you‘re trading within your account. This manner you will get the very best of both worlds, the interest from the checking account along with the leverage from CFDs. To do that, you should have a CFD account provider that permits zero balance inside the account.
Understand Withdrawal Procedures : Similarly capital gains should be moved towards the account where they bear interest. Please ensure that there aren‘t any charges for creating withdrawals as you‘ll lose valuable interest if you‘re stuck using the money with your CFD account.
Understand Your Risk Appetite : CFD accounts are highly leveraged and therefore provide facilities based on the customers risk appetite. There‘s a feature which provides guaranteed execution from the order at the marketplace price which were entered straight into the computer. This service is with a premium because it risked your downside. However there‘s a standard service where transaction costs are much lower. It‘s inside an investor's best interest to comprehend these options and also to pick what he / she wants. Many investors have lost lots of hard-earned money towards the simple ignorance of those facilities.
Understand the Bid Offer spread : CFD trading is really a type of derivatives contract. Such trading generally happens from the market and requires the investor to part having a bid-offer spread. Alternatively some big market makers permit the customers to position their order at the marketplace price with no spread. This causes it to be identical to trading upon the exchange albeit having a leverage.
Features : A lot of these trading platforms allow advanced features for research, which Isn‘t open to the retail buyer. The buyer can understand the liquidity on each side of the positioning prior to making a little. This is usually a very good indicator from the loss valueable that could happen just in case of a fast sale. The higher the liquidity, the lower the risk.
Security : Although it isn‘t advisable to keep your funds inside the trading account, though it‘s nonetheless safe. Most of those accounts are held in possession of the trust, which makes sure the money is safe and provides risk mitigating mechanisms equivalent to, otherwise better than the marketplace itself.
CFD trading benefits you leverage your positions at rock-bottom transaction costs. The well-known investor Warren Buffet is likewise famous for their apprehension of transaction costs. CFDs help solve a little bit of the matter, by lowering them otherwise eliminating them completely.
CFD Trading is a different way of trading that offers investors a good deal of leverage and flexibility. It provides you a chance to make huge profits a lot sooner. Dealing in CFD is taken into account safer than normal share dealing because it provides you the liberty to position your trades anytime and close your position when you would like. Even after such a lot of flexibility and leverage, the majority of folks see it too risky to put money into CFDs.
CFDs are a good source in order to make quick money by putting extremely less efforts. Still, most novice players suffer from losses when trading in CFDs because of the insufficient proper knowledge and patience. Even the knowledgeable players sometimes bear huge losses as they simply fail to create a right decision. This really is where CFD trading strategy comes into play.
In an effort to maximize your profits and minimize your losses, you desire to make effective strategies. Here are a few points that ought to be kept on your mind while dealing in CFDs :
Lack of information and proper understanding is that the biggest obstacle. Investors got to attain a good knowledge of the topic before actually jumping in it. The marketplace is extremely volatile ; and also to succeed, it requires thorough basic understanding of the topic along with current market trends.
It‘s recommended to take a position a small amount if you‘re a beginner. Before investing an enormous sum, you ought to convey more practical knowledge.
Tracking your performance and profit-loss ratio from time for them to time is a great idea. It benefits you know if you are able to invest an enormous amount or otherwise. Along with it, it benefits you analyze your trading style, mindset, and capcapacity to take risk.
Understand the tricks from the trade and research the marketplace thoroughly to play till long.
Pairs trading is said to become a tried and trusted approach to CFD trading because it involves low risk and high-probability gains. You are able to sell the older stock and purchase a brand new one for future, simultaneously. This provides you an opportunity to adjust your risk.
It‘s far better to trade more that certain financial instrument. Different financial instruments assist you adjust your risk of meeting losses.
Deal in CFDs only if you re able to spend a good deal of time as these are generally not ideal for buy and forget situations. You need to deal in them everyday.
Keep an eye upon the current market trends. It isn‘t advisable to purchase a financial instrument at sky-high prices. It might result into huge losses when market crashes down.
if you are a risk-averter, you are able to choose CFD day trading to guard yourself from overnight risk of stocks.
Making decisions could be very critical at each stage. Do not make hasty decisions because it may land you inside a bigger trouble. You‘ll lose all of your money. Think, research, and analyze, after which have a move.
Buying and selling CFD could seem very simple and straightforward. It‘s recommended to not jump in it immediately. Review your finances and analyze if you can bear the loss in case you face any. As said earlier, one needs to attain a strong basic knowledge of the topic and become very cautious simultaneously.
Pendahuluan
Mesothelioma adalah sejenis kanker yang terjadi pada sel-sel mesothelial; yang merupakan jenis sel pelapis permukaan rongga tubuh seperti rongga dada (pleura), rongga perut (peritoneum), dan rongga jantung (pericardium). Seperti juga pada sel lainnya di tubuh, sel-sel mesothelial dapat tumbuh abnormal menjadi tumor yang walaupun bisa bersifat jinak, namun sebagian besarnya bersifat ganas menjadi kanker; sehingga kanker mesothelium biasa disebut satu kata dengan nama mesothelioma saja. Dalam artikel ini akan dibahas lebih banyak mesothelioma yang terjadi pada rongga dada (pleural mesothelioma), karena merupakan kasus mesothelioma yang paling sering terjadi.
Fakta Tentang Mesothelioma
Penyakit ini lebih sering terjadi pada ras Kaukasoid dan keturunan Hispanic.
Lebih sering kejadiannya pada pria, yang diduga terkait dengan kebiasaan dan pekerjaan.
Faktor resiko utamanya adalah asbestos dan asap rokok. Sebelum tahun 1970 mineral asbestos sangat banyak digunakan di dunia industri bangunan dan galangan kapal.
Jarak dari paparan asbestos untuk dapat mencetus mesothelioma berkisar antara 35-40 tahun.
Jaringan Mesothelium
Sebelum kita membahas lebih jauh tentang mesothelioma, mari kita perjelas dulu jaringan mesothelium-nya. Mesothelium terdiri dari 2 lapis yaitu lapisan luar dan dalam. Lapisan dalam yang menyelimuti organ, dan lapisan luar yang menempel ke bagian dalam rongga tubuh. Pada lapisan luar ini terdapat sel-sel yang memproduksi dan mensekresikan dalam jumlah yang kecil cairan pelumas untuk melumasi antara kedua lapisan tersebut bertujuan agar organ dapat bergerak dengan mulus di dalam rongga tubuh. Sel-sel kanker paling sering terjadi pada lapisan dalam yaitu lapisan yang menempel pada organ.
Lokasi Terjadinya Mesothelioma
Mesothelioma dapat terjadi pada jaringan mesothelium seperti yang dijelaskan di atas dengan insidensi sbb.
Pada mesothelium di rongga dada yang disebut sebagai Pleural Mesothelioma, dengan insidensi 75%
Pada mesothelium di rongga perut yang disebut sebagai Peritoneal Mesothelioma, dengan insidensi 10-20%
Pada mesothelium di rongga jantung yang disebut sebagai Pericardial Mesothelioma, dengan insidensi 1%
Pada mesothelium di skrotum, yang disebut sebagai Testicular Mesothelioma, dengan insidensi di bawah 1%.
Dalam artikel ini akan hanya dibahas Pleural Mesothelioma saja, karena merupakan kasus yang paling sering.
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Faktor Resiko Mesothelioma
Mesothelioma terjadi karena adanya perubahan struktur dari sel-sel mesothelial dengan faktor resiko tersering adalah paparan terhadap asbestos dan asap rokok.
1. Asbestos
Asbestos adalah sebuah mineral berupa serat keras dan fleksibel yang sering digunakan pada produk-produk industri seperti semen, produk lantai (tile), cakram rem, dan produk insulasi. Partikel asbestos yang halus dapat terbawa udara terutama pada proses produksi, kemudian dapat terhirup atau tertelan. Serat halus asbestos kemudian dapat sampai mempenetrasi pleura dan merusak sel-sel mesothelial sampai mencetus mesothelioma. Karena ada kecendrungan genetik juga bagi seseorang untuk terkena mesothelioma, maka jumlah dan durasi paparan asbestos tidak dapat menjadi patokan seseorang nantinya akan menderita mesothelioma. Mesothelioma dapat terjadi pada orang dengan paparan sedikit ataupun banyak, sebentar ataupun lama. Sebaliknya ada juga kelompok orang yang terpapar asbestos secara lama dan banyak, tapi tidak menderita mesothelioma. Mesothelioma bahkan juga dapat terjadi pada anggota keluarga dari orang yang terpapar asbestos karena diduga partikel halus asbestos menempel pada rambut dan pakaiannya dan terbawa ke rumah. Setelah penyakit ini semakin dimengerti, dimulai tahun 1970 banyak pemerintah negara di dunia yang melarang penggunaan secara luas mineral asbestos di dunia industri, dan menyarankannya untuk diganti dengan bahan lain yang lebih aman. Walaupun demikian asbestos saat ini masih tetap banyak digunakan.
2. Merokok
Asap rokok, baik yang dihisap oleh perokok maupun yang dihisap oleh orang lain sebagai perokok pasif, mengandung zat-zat karsinogenik (penyebab kanker) yang sudah pasti salah satunya adalah kanker di paru-paru dan pleura (rongga dada); yang kita bahas kali ini yaitu mesothelioma. Asap rokok akan memperbesar resiko seseorang untuk terkena mesothelioma.
3. Faktor Resiko Lainnya
Ada beberapa faktor resiko lain bagi seseorang untuk terkena mesothelioma di antaranya:
Radiasi. Dilaporkan pernah terjadi pada orang yang terpapar terapi sinar (radiation therapy) menggunakan thorium dioxide.
Zeolite. Merupakan mineral silikat dan senyawa kimia yang mirip dengan asbestos. Zeolite ini banyak terdapat pada tanah di negara Turkey di mana insidensi mesothelioma lebih tinggi di sana.
Simian Virus 40 (SV40). Di duga SV40 yang merupakan virus pada spesies monyet dapat menulari manusia dan dapat mencetus mesothelioma karena virus ini sering ditemukan pada sel mesothelial penderitanya.
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Tanda dan Gejala Mesothelioma
Gejala mesothelioma muncul secara gradual, tapi bisa tidak muncul sampai 30-50 tahun dari paparan. Bila penderita mengeluhkan diagnosis bisa ditegakkan. Gejalanya adalah; sulit bernafas (dyspnea) yang merupakan gejala tersering, rasa tidak nyaman atau nyeri di dada, batuk, mudah lelah, demam, dan berat badan turun. Gejala-gejala tersebut bisa juga terjadi pada kondisi medis lain, sehingga pemeriksaan penunjang sangat diperlukan untuk memastikan mesothelioma. Bila seseorang menderita gejala tersebut berturut-turut selama 4-6 bulan, sebaiknya ia memeriksakan diri ke dokter untuk memastikannya.
Penegakan Diagnosis Mesothelioma
Karena gejala mesothelioma mirip dengan banyak kondisi medis, pemeriksaan penunjang harus dilakukan seperti; Pemeriksaan darah untuk memeriksa kondisi kesehatan secara umum, Rontgen dada, CT scan, MRI, bahkan sampai pemeriksaan Positron Emission Tomography (PET) scan. Pada kondisi yang memungkinkan, dokter bisa melakukan thoracoscopy, yaitu memasukkan kamera ke rongga dada melalui sayatan kecil di kulit. Thoracosopy juga dilakukan untuk melakukan biopsi jaringan mesothelium yang dapat memastikan diagnosisnya hingga 98%.
Menentukan Stadium Mesothelioma
Mesothelioma dikategorikan dalam 2 kelompok; terlokalisir dan tahap lanjut (advanced). Dikatakan terlokalisir bila masih terdapat pada permukaan lapisan mesothelium, dan dikatakan lanjut bila sudah menyebar ke jaringan di sekitarnya. Mesothelioma yang terlokalisir juga dikatakan sebagai stadium 1. Sementara tahap lanjut dibagi lagi menjadi: Stadium 2, bila sudah menyebar ke dinding dada dan kelenjar getah bening di dada. Stadium 3, bila sudah menyebar ke mediastinum, diafragma, serta dinding perut. Dan stadium 4, bila sudah menyebar ke jaringan dan organ yang lebih jauh.
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Penanganan Mesothelioma
Penanganan Tumor
Seperti pada kanker lainnya, semakin dini penanganan mesothelioma di mulai, maka akan semakin baik hasilnya. Penanganannya sangat tergantung kepada lokasi dan stadium tumor, serta keadaan kesehatan penderitanya. Penanganan klasik dari mesothelioma sama seperti kanker lainnya yang dapat berupa; operasi pengangkatan tumor, kemoterapi, dan terapi radiasi.
Operasi Mesothelioma
Tujuan dari operasi adalah untuk membuang jaringan kanker. Tapi bila sel kanker telah menyebar, operasi dilakukan bertujuan untuk mengurangi rasa nyeri. Ada dua jenis operasi yang dapat dilakukan sesuai dengan tujuan dari operasi, sbb.:
Pleurectomy. Kedua lapis jaringan mesothelium akan dibuang. Operasi ini bukan untuk penyembuhan, karena tidak mungkin membuang seluruh lapisan mesothelial. Tapi operasi ini dapat mengurangi rasa nyeri penderita.
Extrapleural pneumectomy. Merupakan operasi yang sangat ekstenfsif karena bukan hanya membuang jaringan mesothelium tapi juga sisi luar paru-paru, diafragma, dll. Operasi ini dilakukan bila kanker belum menyebar ke KGB di mediastinal.
Penanganan/Terapi Paliatif
Terapi paliatif dilakukan untuk mengatasi keluhan dan komplikasi dari penyakit ini, bukan untuk penyembuhan. Biasa dilakukan untuk penderita yang karena beberapa faktor seperti usia, kondisi kesehatan, sebaran tumor, dll., sudah tidak bisa dilakukan tindakan lain. Tujuan utamanya adalah untuk membuat hidup penderita senyaman mungkin dan meningkatkan kualitas hidupnya. Di antaranya adalah melakukan thoracentesis. Thoracentesis adalah usaha mengeluarkan cairan dari rongga pleura dengan menggunakan jarum di dinding dada. Tindakan ini dapat meringankan keluhan sesak dan nyeri dada, serta untuk memasukkan obat dari selang tersebut untuk mencegah cairan kembali terbentuk.
Keluhan lain yang bisa ditangani melalui terapi paliatif adalah kesulitan bernafas, lelah, hilang nafsu makan, masalah pencernaan, kecemasan sampai dengan depresi.
Agar terapi paliatif ini dapat berhasil, penderita harus berkomunikasi secara terbuka kepada dokter yang merawatnya. Dokter bisa semaksimal mungkin untuk menghilangkan dan mengurangi keluhan dan gejala yang muncul akibat penyakit ini. Selain itu juga dilakukan pendekatan psikologis agar penderita dapat merasa lebih tenang dan ikhlas dengan penyakitnya.
Terapi paliatif juga biasa menggunakan CAM (Compelementary and Alternative Medicine) atau terapi alternatif seperti: terapi ozon, terapi pijat, dan terapi suara. Tujuan utamanya adalah untuk meringankan keluhan dengan harapkan ke depan juga dapat membantu ke arah kesembuhan. Ada artikel bagus mengenai terapi suara dan mestohelioma yang saya temui di internet yang bisa Anda baca (https://mesothelioma.net/sound-therapy-mesothelioma-patients/). Artikel ini ditulis oleh salah seorang penderita mesothelioma. Di sana ia mengaitkan penyakit ini dengan sound therapy dan hubungannya dengan usaha mengurangi stres dan merubah STRES yang ada untuk menjadi HEBAT!
Uji Klinis untuk Mesothelioma
Karena mesothelioma sulit untuk ditangani, banyak penelitian berkembang untuk meningkatkan usaha penanganan penyakit ini. Banyak penderita yang dimasukkan ke dalam uji klinis dari metoda pengobatan baru. Dewasa ini yang sudah mulai dilakukan adalah photodynamic therapy, immunotherapy, dan gene therapy.
Prognosis Mesothelioma
Seperti kebanyakan kanker, prognosis mesothelioma tergantung kepada seberapa dini diagnosis dapat ditegakkan untuk segera dimulai terapi. Tanpa mendapatkan penanganan sama sekali, mesothelioma stadium lanjut dapat menyebabkan kematian dalam waktu 4 – 8 bulan, sedangkan bila mendapatkan penanganan trimodal (operasi, kemoterapi, dan terapi radiasi), dapat memperpanjang harapan hidup penderitanya menjadi 16 – 19 bulan. Dari keseluruhan kasus, hanya sedikit orang yang dapat bertahan sampai 5 tahun.
Pencegahan Mesothelioma
Karena asbestos dan asap rokok adalah dua faktor resiko utama penyebab mesothelioma, maka menghindari diri dari paparan kedua unsur tersebut secara signifikan dapat mencegah seseorang terkena mesothelioma. Bila memang harus terpapar oleh asbestos karena profesi dan pekerjaannya, seseorang harus menggunakan alat keselamatan diri semaksimal mungkin seperti masker dan baju khusus. Ia juga harus mengganti bajunya sebelum pulang ke rumah agar tidak membawa faktor resikonya ke rumah.
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