Binge eating

Definition

Binge eating is a disorder characterized by eating more than a person needs to satisfy hunger.

Alternative Names

Eating - binge

Considerations

The eating disorder bulimia is most common among female adolescents or young adults. People with bulimia typically consume large quantities of easily ingested high-calorie foods, usually in secrecy. This binge eating is usually followed by self-induced vomiting and accompanied by feelings of guilt or depression.

Complications resulting from prolonged bulimia include gastric dilatation, pancreatitis, dental decay, pharyngitis, esophagitis, pulmonary (lung) aspiration, and electrolyte abnormalities. Constipation and hemorrhoids are also common in people with bulimia.

Although death from bulimia is rare, the long-term outcome in severe bulimia can be worse than the outcome in anorexia nervosa, which suggests that the psychiatric disorder that causes bulimia is usually more severe.

Causes

While binge eating often begins during or after strict dieting, and may be caused by stress related to insufficient food intake, its cause remains unknown.

Home Care

Take measures to reduce stress and improve overall health.

Medication is usually not necessary for this disorder. However, antidepressants, as prescribed by a doctor, are often helpful. Supportive care and counseling are recommended. Individual, group, family, and behavioral therapy may provide some help.

When to Contact a Medical Professional

• bulimia is suspected

What to Expect at Your Office Visit

The health care provider will perform a physical examination. A history of the person's eating patterns may be sought from one or more family members because the person may not acknowledge that they are binge eating.

Medical history questions documenting binge eating in detail may include:

• How long has this been occurring?
• Are "purge" behaviors (such as self-induced vomiting or laxative abuse) also present?
• What other symptoms are also present?

Possible diagnostic tests include blood studies, such as electrolyte levels.

INTERVENTION

Behavior is usually controlled with counseling, biofeedback training (a process of monitoring body functions and altering these functions through relaxation), and individual or group psychotherapy.

References

Schmidt U, Lee S, Beecham J, et al. A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatry. 2007;164:591-598.

Read More......

Fetal heart monitoring

Definition

Fetal heart monitoring lets the health care provider monitor the baby's heartbeat in the uterus, including during labor. The procedure can be done with monitors outside the body (external monitoring) or in the uterus (internal monitoring).

Alternative Names

Non-stress test; NST; CST; Contraction; Scalp monitoring

How the Test is Performed

EXTERNAL FETAL MONITORING

By definition, external fetal monitoring is done through the skin and is not meant to be invasive. You will sit with knees and back partially elevated with a cushion under the right hip, which moves your uterus to the left. You can also sit in other comfortable positions, as long as your uterus is shifted to the left or, for brief periods, to the right.

Sensitive electrodes (connected to monitors) are placed on your abdomen over conducting jelly. The electrodes can sense the fetal heart rate (FHR) and the presence and duration of uterine contractions. Usually, the results of this test are continuous and are printed out, or they appear on a computer screen. External monitors, however, cannot tell how strong contractions are.

This allows your health care provider to check if your baby is experiencing fetal distress, and how well the baby is tolerating the contractions. The decision to move to internal fetal monitoring is based on the information first obtained by external fetal monitoring.

NONSTRESS TEST (NST)

The NST is another way of externally monitoring your baby. The NST can be done as early as the 27th week of pregnancy, and it measures the FHR accelerations with normal movement. For this test, you will sit with knees and back partially elevated with a cushion under the right hip, which moves your uterus to the left.

The same monitors described above are placed on your abdomen to measure the FHR and the ability of the uterus to contract. If there is no activity after 30 - 40 minutes, you will be given something to drink or a small meal which may stimulate fetal activity. Other interventions that might encourage fetal movement include the use of fetal acoustic stimulation (sending sounds to the fetus) and gently placing your hands on your abdomen and moving the fetus.

CONTRACTION STRESS TEST (CST)

The CST is a final method of externally monitoring your baby. This test measures the ability of the placenta to provide enough oxygen to the fetus while under pressure (contractions).

For this test, you will sit with knees and back partially elevated with a cushion under the right hip, which moves your uterus to the left. The same monitors described above are placed on your abdomen to measure uterine contractions and FHR. If contractions are not occurring spontaneously, either a medication (called oxytocin) will be given intravenously, or nipple stimulation will be used to induce contractions.

If oxytocin is administered, it is called the oxytocin challenge test (OCT). Oxytocin is administered through an IV until 3 uterine contractions are observed, lasting 40 - 60 seconds, over a 10-minute period.

Another test is called the nipple stimulation contractions stress test. Every effort will be taken to ensure your privacy, but the nurse will be with you through the entire procedure.

In this test, you will rub the palm of your hand across one nipple through your garments for 2 - 3 minutes. After a 5-minute rest, the nipple stimulation should continue until 40 minutes have elapsed, or 3 contractions have occurred, lasting more than 40 seconds, within a 10-minute period. If a uterine contraction starts, you should stop the nipple stimulation.

INTERNAL FETAL MONITORING

Internal fetal monitoring involves placing a electrode directly on the fetal scalp through the cervix. Your health care provider may use this method of monitoring your baby if external monitoring is not working well, or the information is suspicious.

A vaginal examination will be performed, and the electrode will be introduced with its plastic sheath into the vaginal canal. This plastic guide is moved through the cervix and placed on the fetus' scalp, then removed. The electrode's wire is strapped to your thigh, and attached to the monitor.

Read More......

Bleach Baths Safely and Effectively Treat Childhood Eczema

Relief for children who suffer from atopic dermatitis, commonly known as eczema, can be found just inside the household laundry room. While it is neither dangerous nor contagious, the allergic condition commonly affects children and babies and causes red, swollen and itchy skin. It is estimated that about 17 percent of school-aged children suffer from eczema.

Researchers from the Northwestern University Feinberg School of Medicine have discovered that diluted bleach baths offer safe and effective relief from the annoying itch of eczema while significantly improving the rash and reducing flare-ups of the condition. Bleach baths are simple and affordable, in addition to being a highly successful form of treatment.

The study found that patients who were given the diluted bleach baths over a one- to three-month period experienced a reduction in the severity of eczema that was five times greater than patients treated with placebos. The study was recently published in the journal Pediatrics.

According to lead author, Dr. Amy S. Paller, chair of dermatology and professor of pediatrics at the Feinberg School, the standard use of oral and topical antibiotics as treatment for eczema heightens the risk for bacterial resistance. Bacteria such as staphylococcus can aggravate eczema and cause more intense itching. This leads to more scratching that can break the skin and allow the bacteria to gain entry into the body. With the spread of deadly antibiotic-resistant staph bacteria known as MRSA (methicillin-resistant Staphylococcus aureus) on the rise, avoiding the risk of bacterial resistance as well as finding ways to combat bacteria has become increasingly important. The use of bleach creates no risk for bacterial resistance as the bleach simply kills the bacteria.

The analysis included 31 children between the ages of 6 months to 17 years who suffered from eczema. Over a three-month period, half of the children were bathed twice weekly for 5 to 10 minutes in a full bathtub of water containing 1/2 cup of bleach, while the other children were bathed in water containing a placebo. In addition, the children bathed in bleach were also given a nasal antibiotic to fight staph bacteria. Such a marked improvement was observed in the children bathed in bleach water that the researchers cut the study short in order to allow the children in the placebo group to benefit from the bleach baths as well.

Although no improvement was seen those bleach-bathed children who had eczema on their faces, this actually serves as further evidence that the bleach baths work. Since the children were not instructed to put their faces in the water, their faces were not treated. Furthermore, when considering why water in swimming pools has a tendency to worsen eczema instead of improving it, Dr. Paller says this is due to the many other chemicals in the pool and not from exposure to bleach.

Dr. Paller said that it is safe for parents to bathe their children in the highly diluted bleach solution used in the study. However, she recommends telling the child’s doctor that you are doing so. Dr. Paller also said that to receive benefits to the face, the bather could close his eyes and mouth and then dunk his face in the bleach water.

Read More......

Epispadias

Definition
Epispadias is a rare congenital (present from birth) defect in the location of the opening of the urethra.

Causes

The causes of epispadias are unknown at this time. It is believed to be related to improper development of the pubic bone.

In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. However, it is possible for the urethra to be open the entire length of the penis.

In girls, the opening is usually between the clitoris and the labia, but may be in the belly area.

Epispadias can be associated with bladder exstrophy, an uncommon birth defect in which the bladder is exposed, inside out, and sticks through the abdominal wall. However, epispadias can also occur alone or with defects.

Epispadias occurs in 1 in 117,000 newborn boys and 1 in 484,000 newborn girls. The condition is usually diagnosed at birth or shortly thereafter.

Symptoms

In males:

• Abnormal opening from the joint between the pubic bones to the area above the tip of the penis
• Backward flow of urine into the kidney (reflux nephropathy)
• Short, widened penis with an abnormal curvature
• Urinary tract infections
• Widened pubic bone

In females:

• Abnormal clitoris and labia
• Abnormal opening where the from the bladder neck to the area above the normal urethral opening
• Backward flow of urine into the kidney (reflux nephropathy)
• Widened pubic bone
• Urinary incontinence
• Urinary tract infections

Exams and Tests

• Blood test to check electrolyte levels
• Intravenous pyelogram (IVP), a special x-ray of the kidneys, bladder, and ureters
• Pelvic x-ray
• Ultrasound of the urogenital system

Treatment

Surgical repair of epispadias is recommended in patients with more than a mild case. Leakage of urine (incontinence) is not uncommon and may require a second operation.

Read More......

Endophthalmitis

Definition

Endophthalmitis is a serious condition involving swelling (inflammation) within the eyeball.

Causes

Endophthalmitis is most often caused by infection with bacteria or other microorganisms. It can also occur as a rare complication of cataract or other eye surgery.

Symptoms

The symptoms are:

• Decreased vision
• Pain
• Redness
• Swelling of the eyelids

If you have these symptoms after eye surgery, call your doctor immediately.

---

Read More......

Viral encephalitis

Highlights

West Nile Virus

In 2007, 3,510 cases of West Nile virus were reported to the U.S. Centers for Disease Control. States with the highest number of reported cases included Colorado, California, and North Dakota. Of the reported cases, two-thirds were in the form of West Nile fever, and one-third were diagnosed as West Nile neuroinvasive disease (encephalitis and meningitis). However, the high proportion of neuroinvasive disease cases is due to the fact that serious cases of West Nile virus are more likely to be reported to health authorities than mild cases. In general, less than 1% of people who become infected with West Nile virus develop encephalitis.

West Nile Virus Symptoms and Diagnosis

Most people (80%) who are infected with West Nile virus do not have any symptoms. About 20% of people develop mild symptoms that include fever, headache, body aches, and nausea and vomiting. These symptoms can last from a few days to a few weeks. For the minority of people who develop neuroinvasive disease, symptoms can include high fever, headache, neck stiffness, muscle weakness, and convulsions. While West Nile neuroinvasive disease is rare, its neurological complications such as paralysis can be permanent.

Prevention

West Nile virus is carried by mosquitoes and is most common during the summer and early fall. The best way to prevent becoming infected with West Nile virus is to avoid being bitten by a mosquito. Use insect repellant when you go outside, especially during the peak mosquito hours of dusk and dawn. Remove mosquito-breeding environments (such as standing water in flower pots) from your property. Scientists are testing several different vaccines to protect against West Nile virus, but it will be many years before they are commercially available.

Introduction

Encephalitis is a rare but potentially life-threatening inflammation of the brain that can occur in people of all ages. The most common cause of encephalitis is infection by a virus. In very rare cases, encephalitis can also be caused by bacterial infection, parasites, or complications from other infectious diseases. This report focuses on viral encephalitis.

Encephalitis: Viral Infection of the Brain

Many viruses can cause encephalitis. The West Nile virus, for example, has been responsible for high-profile outbreaks in the U.S. Most people exposed to encephalitis-causing viruses have no symptoms. Others may experience a mild flu-like illness, but do not develop full-blown encephalitis.

In severe cases, the infection can have devastating effects, including:

• Swelling of the brain (cerebral edema)
• Bleeding within the brain (intercerebral hemorrhage)
• Nerve damage

The damage may cause long-term cognitive or physical problems, depending on the specific areas of the brain affected.

Other Viral Infections of the Central Nervous System. Viral infection and inflammation can affect multiple areas of the central nervous system, and is categorized by its location:

• Meningitis: infection of the meninges (the membranes that surround the brain and spinal cord)
• Meningoencephalitis: infection of both the brain and meninges
• Encephalomyelitis: infection of the brain and spinal cord

Specific Viruses Implicated in Encephalitis

Encephalitis caused by viruses in the United States generally fall into the following groups:

• Arboviruses are the primary cause of acute encephalitis (sudden-onset encephalitis caused by direct infection). Arboviruses, short for "arthropod-borne viruses," are spread by mosquitoes and ticks.
• Enteroviruses, such as coxsackievirus.
• Herpes viruses are the other major cause of encephalitis in the U.S. This virus family includes herpes simplex, Epstein-Barr, cytomegalovirus, and varicella-zoster.
• In rare cases, secondary encephalitis can develop following childhood viral diseases such as measles, mumps, and rubella.

[For more information, see the Causes section in this report.]

How Viruses Can Infect the Central Nervous System

Encephalitis can develop shortly after an initial viral infection, or it can develop when a virus that was lying dormant in the body suddenly reactivates. Viruses are simple, but powerful infectious organisms.

• The virus infects a person (host) by penetrating a cell membrane and ejecting its genetic material (its DNA or RNA) into the cell.
• The viral DNA or RNA takes control of important cell processes, telling the cell to make more viruses.
• The cell ruptures, releasing new viral particles that infect other cells.

There are two ways that viruses can infect brain cells:

• The virus silently invades the body. There are no initial symptoms. The virus is carried by the bloodstream to the nerve cells of the brain, where they gather and multiply. Viruses that enter the brain in this manner are often widely scattered throughout the brain. This is called diffuse encephalitis.
• A virus first infects other tissue and then invades brain cells. Viruses that are transmitted from other tissues usually cause focal infection, meaning they produce extensive damage in only a small area of the brain.

The Central Nervous System

The brain and spinal cord comprise the central nervous system. The adult human brain weighs about 3 pounds (1.4 kilograms). There are two major parts of the brain:

• The higher and larger forebrain (the cerebrum)
• The lower and smaller brain stem

The Cerebrum

The cerebrum is the uppermost and largest part of the brain. It is the most highly developed section of the brain. There cerebrum has several components:

The Cerebral Cortex. The cortex is the outermost layer of the cerebrum. It is made of gray and white matter:

• Gray matter is a thin sheet of nerve cells that cover the surface of the brain.
• White matter is a bundle of insulated nerve fibers that underlies the cortex and makes up the core of the cerebral hemispheres.

The Hemispheres. The two hemispheres control higher brain functions, such as memory, learning, decision making, and processing input from the senses. They are each divided into four lobes, which regulate different brain functions:

• Frontal lobe: This is the brain's "gatekeeper." It controls higher motor functions, including speech, and governs concentration, attention, inhibition, judgment, and personality traits.
• Parietal lobe: Processes information from the senses and controls walking, posture, and head and eye movements.
• Occipital lobe: Responsible for interpreting visual input from the eyes.
• Temporal lobe: Responsible for interpreting auditory input from the ears. Also regulates how language is interpreted and retrieves information for memory storage.

The Basal Ganglia. The basal ganglia are clusters of gray matter within each of the lobes. They are important for coordinating voluntary muscle movement, balance, and posture.

The Limbic System. The limbic system is located deep in the cerebrum and controls interpretation of smell, instinctive behavior, emotions, and drives.

Brain Stem

The brain stem is responsible for all vital functions. It is divided into the following areas, which are responsible for specific functions:

• Medulla: sleep, breathing, heartbeat, digestion, activation of higher forebrain functions
• Pons: sleep, breathing, motor control, activation of higher forebrain functions
• Cerebellum: movement coordination
• Midbrain: walking, posture, head, eye movement
• Hypothalamus: body temperature, appetite, sexual behavior, reproductive hormones
• Thalamus: communication with higher forebrain

The Spinal Cord

The spinal cord extends out of the base of the skull through the vertebrae of the spinal column. It is continuous with the brain. Thirty-one pairs of nerves extend from the sides of the spinal cord to other parts of the body (the peripheral nervous system).

The Meninges and Cerebrospinal Fluid

The meninges are three membranes that enclose the brain and spinal cord. They contain cerebrospinal fluid, which protects the central nervous system from pressure and injury.

Causes

Arboviruses

Arboviruses, including the West Nile virus, are transmitted by blood-sucking insects such as mosquitoes and ticks. Most of the time, the viral infections initially develop in birds. Insects that feed on the infected blood from a diseased bird (or reservoir ) carry the virus, and transmit it when they bite a susceptible host (such as an animal or a human). Because these insects play a role in the disease-transmission process, they are referred to as vectors.

Arboviruses multiply in blood-sucking vectors, nearly always mosquitoes. There is no evidence that these infections can be transmitted casually from one infected person or animal directly to another uninfected person without passing through a mosquito (or tick) first. (Although, a small number of West Nile virus cases have occurred through blood transfusions, organ transplantation, and possibly breast-feeding.) It should be stressed that only about 10% of people who are infected by an arbovirus develop encephalitis and that only about 1% of those infected show symptoms.

Arboviruses that cause encephalitis are primarily found in three virus families: Togaviridae, Bunyaviridae, and Flaviviridae. In the United States, the main mosquito-borne encephalitis strains are: Eastern equine, Western equine, St. Louis, La Crosse, and West Nile. Equine encephalitis causes disease in both humans and, as its name implies, horses. Powassan encephalitis is a less common tick-borne flavivirus that occurs primarily in the northern United States. Japanese encephalitis is the most common form of viral encephalitis to occur outside of the United States. It is endemic in rural areas in east, south, and southwest Asia, especially China and Korea. Venezuelan equine encephalitis is found in South and Central America.

Different arboviruses cause different forms of encephalitis. Although the overall disease is the same, there are subtle differences in symptoms and the type of brain damage they produce.

Read More......

Empyema

Definition

Empyema is a collection of pus in the cavity between the lung and the membrane that surrounds it (pleural space).

Causes

Empyema is caused by an infection that spreads from the lung and leads to an accumulation of pus in the pleural space. The infected fluid can build up to a quantity of a pint or more, which puts pressure on the lungs, causing shortness of breath and pain.

Risk factors include recent pulmonary (lung) conditions including bacterial pneumonia, lung abscess, thoracic surgery, trauma or injury to the chest, or rarely, a needle inserted through the chest wall to draw off fluid in the pleural space (thoracentesis).

Symptoms

• Dry cough
• Fever and chills
• Excessive sweating, especially night sweats
• General discomfort, uneasiness, or ill feeling (malaise)
• Unintentional weight loss
• Chest pain, which worsens on deep inhalation (inspiration)

Exams and Tests

The health care provider may note abnormal findings, such as decreased breath sounds or a friction rub, when listening to the chest with a stethoscope (auscultation).

Tests may include the following:

• Chest x-ray
• Thoracentesis
• Pleural fluid gram stain and culture
• CT scan of chest

Treatment

The goal of treatment is to cure the infection and remove the collection of pus from the lung. Antibiotics are prescribed to control the infection. A doctor will place a chest tube to completely drain the pus. A surgeon may need to perform a procedure to peel away the lining of the lung (decortication) if the lung does not expand properly.

Outlook (Prognosis)

Usually, empyema does not result in permanent pulmonary damage.

Possible Complications

A possible complication is pleural thickening.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of empyema.

Prevention

Prompt treatment of pulmonary (lung) infections may prevent some cases of empyema.

References

Mason RJ, Broaddus VC, Murray JF, Nadel JA. Murray and Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders; 2005.

Ahmed RA, Marrie TJ, Huang JQ. Thoracic empyema in patients with community-acquired pneumonia. Am J Med. October 2006;119:877-883.

Qureshi NR, Gleeson FV. Imaging of Pleural Disease. Clin Chest Med. June 2006;27:193-213.

Read More......

Emphysema of lungs

What is emphysema?

The concept of emphysema of lungs unites the raised lightness and the lowered mobility of a pulmonary tissue.
More often all is amazed lungs (diffuse emphysema). Sometimes bloated sites of lungs are combined with a normal pulmonary tissue. Such sites name as bullas, and emphysema as bullous.

How it occurrence?

Principal cause of disease - a chronic bronchitis. As a matter of fact, a total of a chronic bronchitis is formation emphysema of lungs.
In development of bullous emphysema the important role hereditary factors, and also the transferred diseases of lungs (play a tuberculosis, etc.).
Smoking, impurity of air various dust particles also assist progress of disease.

What occurs?

It is as a result long current inflammatory process (a chronic bronchitis) a tissue of lungs loses ability dynamically to be stretched and be fallen down according to breath that leads hyperextension of lungs and to increase of quantity of air in them. Such superfluous air does not participate in breath and the hyperinflate pulmonary tissue does not work is high-grade.
The basic complaint of patients with emphysema a short wind significantly amplifying at physical activity. If the reason of disease a heredity the short wind appears already at young age.
Without treatment emphysema progresses, that leads to infringement of work of respiratory and cardiovascular systems.
Bullous emphysema can proceed imperceptibly, being shown already complication by development aeropleura (break bullas and forcing of air in a thorax), demanding urgent surgical treatment.

Diagnosis

Besides survey, for diagnostics emphysema of lungs use:

* Radiological research of lungs it is characteristic distention a pulmonary fabric and increase of its lightness;
* the Computer tomography of lungs apply to diagnostics and definition of a precise arrangement bulla is more often;
* Research of function of external breath — allows to reveal a degree of infringement of function of lungs.

Treatment

The basic methods of treatment emphysema are oxygen therapy (inhalation of air with the raised content of oxygen) and respiratory gymnastics. These methods allow to suspend progress of infringements of work of respiratory and cardiovascular systems.
At bllous emphysema a surgical treatment is recommended. An essence of treatment removal bullas. Such operations can be carried out as by means of classical access with opening a thorax, and endoscopic (by means of special tools, through punctures of a thorax). Endoscopic removal of bullas is more preferential: significantly the regenerative period after operation is shorter, is absent extensive cicatrical tissue on a thorax.
Duly removal of bullas warns progress of such terrible complication as aeropleura hit of air in a thorax owing to break bullas.
If the reason of emphysema is the chronic bronchitis, the important role is played with the prevention of development of aggravations of a bronchitis. At development of an aggravation its rational treatment under the control of the doctor, including with application of antibiotics.

Read More......

Corneal diseases

Cornea - a front part of an external fibrous envelope of an eyeball; nonvascular, high-sensitivity, transparent, an optically homogeneous envelope with smooth, a smooth surface. Except for protective and basic function the cornea is the main refracting surface of optical system of an eye.

Diseases of a cornea makes about 25 % of the general number of diseases of eyes, and quite often are the reasons of blindness and lowering of vision.

Diseases of a cornea are rather various. Most often there are inflammatory diseases of a cornea (keratitis), differing greater variety of forms and being one of principal causes of decrease in sight and blindness, and also keratikonus. The Most frequent reasons of keratitis and keratoconjunctivitis are virus and bacterial infections.

Keratikonus - a condition of an eye at which the normal spherical form of a cornea is broken, the cornea is bent. On a surface of an eye the camber similar to a cone that leads to strong easing of sight develops.

Dystrophies and degenerations of a cornea happen primary and secondary. In a basis primary local and general infringements of a metabolism with adjournment in a cornea of products of a pathological exchange lay. Secondary dystrophies develop after transferred keratitis, traumas, burns of eyes.

For the prevention of heavy complications of diseases of a cornea are required: proper diagnostics, duly and active treatment. Various medicinal substances are applied to local treatment in the form of drops, injections. Methods of electrophoresis, phonophoresis, treatment by laser radiation are used also.

For carrying out of purposeful treatment bacterial keratitis definition of sensitivity of microflora to antibiotics by crop of defeat separated from the center is necessary.

Instruction to the patient after change of a cornea

To you the microsurgery of change of a cornea is lead. The thin seam keeping a donor fabric, can long-standing time (about one year) to remain in a cornea. It allows you to start to work with the moderate physical activity earlier. At the same time, it is necessary to remember the periodic medical control over a condition of a seam.
Durable healing of a wound after change of a cornea comes only in 6-10 months after operation. Therefore after an extract from a hospital it is necessary for you to continue the recommended treatment in house conditions. Instilling drops or loading ointments can be made the purest hands before a mirror or in a prone position, as well as by means of relatives, using those receptions with which you have got acquainted in a hospital.

During the first month to sleep it is necessary on a back or on the party opposite to the operated eye. The food can be usual, it is necessary to exclude alcoholic drinks. Surplus of sweets is not desirable. Easy gymnastic exercises without jumps, run and inclinations are useful. During rest and walks during the first year after operation it is necessary to avoid stay on the bright sun. It is impossible to sunbathe. It is possible to use the blacked out glasses. The replaced cornea during several months, and sometimes several years, has the lowered sensitivity. Therefore it is impossible to rub sharply an eye a scarf or a hand, it is necessary to be cautious at washing, to cover the operated eye during a strong wind and to avoid walks in frosty days even on the second or the next years after operation. It will help to save a cornea from damages and freezing injury.

You can watch TV, go to museums, cinema and theatre if it is not connected with difficult and close moving to transport. It is possible to start the usual or limited work in 2-4 months depending on a condition of the operated eye and working conditions. Expansion of the general mode should be carried out one step at a time, however during the first year work with a slope of a head downwards, outdoor games, run, heavy physical work is absolutely counter-indicative. After an output for work do not forget to show to the oculist each 2-3 months within the first year after operation, especially if it is not removed an encircling stitch.

In case of occurrence of reddening and an ache in an eye, and blear-eyedness to you it is necessary for photophobia to see a doctor promptly. Only early the begun treatment can prevent deterioration of vision.

Read More......

Lymphatic System

You probably know about the body's extensive network of arteries and veins. Maybe less familiar is the distribution of another network of vessels that are similar to veins, but not as extensive. Instead of transporting blood, they carry a clear fluid called lymph (pronounced "limf") that is similar to plasma (the liquid part of blood). As nutrients seep from the blood into the tissues, the lymphatic system collects this fluid (which is now called lymph) along with any associated wastes and returns it to the blood. Lymph is a great place to fight microbes and it's filled with lymphocytes and other white blood cells. Before the lymph gets recycled into the bloodstream, lymphocytes work to identify any harmful microbes so they can be destroyed.

Definition: The lymphatic system is part of your immune system and the term includes all of the organs and cells which are part of the immune system. This includes the lymph nodes, lymphocytes (i.e. special disease-fighting white blood cells) and organs like the spleen and bone marrow which make and store lymphocytes. The lymphatic system is inter-connected by a fine network of tiny microscopic lymphatic vessels, which are present throughout your body like a net, through which lymphatic fluid circulates.

Pronunciation: lim-fat-ik system

Examples: The spleen had to be removed during surgery for ovarian cancer, but the rest of the lymphatic system was left intact.

Read More......

Glucose, Sucrose or Fructose: Is One Better Than Another?

It’s impossible to figure out through taste alone what gives our favorite soft drink or yummy dessert that perfect sweetness we have come to crave. And the complicated ingredient names on the nutritional labels usually leave us clueless as well. But even if we can’t tell the difference between sucrose, glucose and fructose, our bodies apparently can.

In a new study published this week in the Journal of Clinical Investigation, researchers from the University of California, Davis randomly assigned 32 overweight or obese men and women to drink three daily servings (25 percent of their daily energy requirements) of a glucose- or fructose-sweetened beverage for 10 weeks. The participants had an average age of 50 and a body mass index of 29. They were instructed to follow their normal diet but not to drink any other sugary drinks, including fruit juice.

At the end of the study period, both groups had gained similar amounts of weight, but those consuming fructose-sweetened drinks showed an increase in intra-abdominal fat, the kind that embeds itself between tissues in organs, became less sensitive to insulin (the hormone released by the pancreas that controls blood sugar), and showed signs of dyslipidemia—elevated blood levels of lipids. The fructose group also showed increased fat production in the liver, elevated LDL or bad cholesterol and larger increases in blood triglycerides. The group drinking glucose-sweetened beverages showed none of these changes.

“This suggests that in the same way that not all fats are the same, not all dietary carbohydrates are the same either,” says Dr. Peter J. Havel, professor of nutrition at the University of California Davis and lead author of the study. He added that most of the sugar present in market and restaurant products is not glucose, but rather high fructose corn syrup or sucrose (each a combination of glucose and fructose). He further held that it is difficult to find anything that’s mainly glucose, which means that almost all sweeteners could contribute to weight gain and metabolic changes that could increase the risk of heart disease and diabetes.

Havel said the findings could be important given that in 2005, the average American consumed 141 pounds of added sugar, a sizeable proportion of which came through drinking soft drinks. Consumption of sugars and sweeteners in the U.S. went up by 19 per cent between 1970 and 2005, according to a commentary accompanying the study.

“This study provides the best argument yet that we should either decide to consume less sugar-sweetened beverages in general, or that we should conduct more research into the possibility of using other sweeteners that may be more glucose-based,” says Matthias Tschoep, an obesity researcher at the Obesity Research Center in the University of Cincinnati, and author of a commentary accompanying the study. “It’s an unbelievable piece of work.”

However, Dr. David Jenkins, who holds the Canada Research Chair in nutrition and metabolism at the University of Toronto, is of a differing opinion. He says fructose is no worse than glucose if taken in moderation. “We’re talking about excess in people who are gaining weight, people who are overweight to begin with and people who are not exercising to begin with,” Jenkins said.

Havel’s research team is currently in the early stages of a study comparing the metabolic effects of fructose, glucose, sucrose (table sugar), and high fructose corn syrup in normal and obese men and women.

Read More......

Cell-Engineered Blood Vessels Show Promise for Dialysis Patients

More than 330,000 Americans with end-stage renal disease (ESRD) currently rely on regular dialysis treatment to replace many of the normal duties their failing kidneys are no longer able to perform. The procedure is straightforward: two needles are inserted into an access point in the arm, leg, or sometimes in the neck, one on the artery side and one on the vein side. Blood drains into the dialysis machine, where it is cleansed of potentially toxic waste, salt and extra water and is then returned to the body. The best access for most patients is called a fistula; an artery joined to a vein under the skin to make a larger vessel. If no vessels are suitable for a fistula, the doctor might use a synthetic tube or a graft to join an artery and vein. A graft made from a segment of the patient’s own vein typically works best but many times, the person doesn’t have a suitable vein segment. However, stem cells may soon provide a solution.

In what experts have hailed a “revolutionary milestone,” researchers at Cytograft Tissue Engineering of California have developed grafts made entirely of a patient’s own cells. To make the graft, tissue is taken from the back of the patient’s hand, from which two cell types are extracted—fibroblasts that provide the structural backbone of the vein, and endothelial cells that form the lining of the vein. The cells are grown into a sheet, then rolled into a tube and allowed to fuse at the seam. The process takes about six to nine months and, unlike other vein grafts that have been developed using a patient’s own cells, contains no plastic scaffolding to give the vein strength. “What we have done is provide something that has no foreign material, therefore minimizing or eliminating the foreign body (rejection) response so the body doesn’t degrade the tissue,” said Dr. Todd McAllister, chief executive of Cytograft. “The fact that there is no synthetic material makes this novel.”

The grafts were then tested for strength and stability in ten seriously ill patients undergoing kidney dialysis. All the patients either had an earlier graft fail or were going to need a plastic tube graft in order to continue treatment. During the initial phase of the trial, three of the grafts failed, which the researchers say is a normal failure rate for such a high-risk group. One patient withdrew because of severe stomach bleeding, and one died of unrelated causes. The five remaining patients used the grafts for dialysis for six to twenty months, and needed fewer interventions including surgeries, to maintain the vessels than regular dialysis patients. “We had extremely good long-term performance,” McAllister said. “The tissue-engineered vascular graft actually appeared slightly better” than using either a plastic tube or the patient’s vein, he added.

In an editorial accompanying the study findings, Dr. Vladimir Mironov, director of the Shared Tissue Engineering lab at the Medical University of South Carolina, called the technique a “milestone” in tissue engineering. “We have the first commercial clinically tested, completely biological tissue-engineered vascular graft. It is a historic milestone,” he said. “Clinical vascular tissue engineering is a reality—the always-promising field of tissue engineering finally delivered its promises.” However, Mironov worries that the vessels, which cost between $15,000 and $20,000, compared to the $3,000 conventional product made using plastic, might not be cost effective enough to be used widely.

“The ability to use a blood vessel grown in the laboratory is really quite remarkable,” said Dr. Ajay Singh, clinical chief of the renal division and director of dialysis at Brigham and Women’s Hospital in Boston and an associate professor of medicine at Harvard Medical School. “This could become a very important alternative to what is done presently.”

McAllister said Cytograft wants to study the graft in a much larger trial and hopes to have a product on the U.S. market in about three years. They are also working on replacement veins to repair heart damage and to replace diseased veins in patients that would otherwise need an amputation.

Studies estimate there are between 1.5 and 2.0 million people around the world receiving dialysis and many more are in need of treatment. Today, 20 million Americans have been diagnosed with chronic kidney disease (CKD), while another 20 million more are at risk for kidney disease but are unaware of their condition. In 2006, the number of people receiving dialysis treatments in the U.S. increased by nearly 95,000.

The study is published in the medical journal The Lancet.

Read More......

Factors and the conditions causing irritation of a dental pulp

The irritation of a pulp of a tooth can arise owing to caries of a teeth, as a result of preparation of a tooth and carious cavities, under influence a filler material, owing to penetration of microorganisms at not tight seal, at an exposure dentin.

Caries of a tooth serves as a principal cause of changes in a pulp and its inflammations. Already at initial damage dentin fibrilloblasts react adjournment secondary and formation of a layer scleroid dentin (adjournment of salts of calcium on walls of dentinal canaliculus) down to full occlusion of dentinal canaliculus. These processes should be considered as display of protective mechanisms of a pulp on action of a cue.

At processing of a caries and destruction of enamel of a bacterium get in dentin, however the inflammation of a pulp does not arise. It is established, that first signs of an inflammation come, when carious the cavity is separated from a pulp by a layer of 1,1 mm [Reeves R., Stanley H. R., 1996], i.e. the pulp practically is not infected up to an instant of penetration of microorganisms in secondary dentin [Massler, Pawlak J., 1977].

Preparation of a cavity without use of a water spray leads to its damage. Thus probability of damage of the in direct proportion area of preparation and depth of damage. Thus, preparation of a tooth under vinirs or artificial crownwork without due cooling serves a serious risk factor for a pulp.

Filler materials. There are the numerous data specifying irritating influence various of filler materials. From cements the most expressed adverse action renders silicate though specify, that it is shown at formation of a clearance between edge of enamel and dentin as microorganisms nestle close in dentin [Brannstrom, 1979].

Composites also are considered as irritating materials. First of all, toxicity of composites of the first generation was marked. Materials let out now as specify numerous supervision, render insignificant influence on a pulp.

During many years use of bondings was studied at sealing. It is proved, that improvement of a compounding bondings has allowed to achieve favorable reaction of a dental pulp to used composites.

Regional permeability as considers a number of researchers, is a principal cause of irritation of a pulp after sealing. The leading part thus belongs to microorganisms. With the purpose of the prevention of the specified changes in a pulp it is recommended to spend padding fabrics of a tooth and use bonding systems.

The exposure of dentin can occur after loss of a seal, as a result of deleting fabrics, at erosion, etc., that is accompanied by sensitivity action of irritating factors. Sensitivity can arise also at an exposure cervical dentin because canaliculus of dentin become opened.

The sheeting (direct) provides:

1) clarification of a surface of a pulp;

2) drying of a cavity;

3) imposing on the naked pulp of medical paste;

4) a seal from zinc oxide eugenic acid cement;

5) imposing of a constant seal.

Most widely used materials for protection of a pulp contain all calcium hydroxide. As a result of it above a site of an exposure it is postponed secondary dentin, forming the dentin bridge. Consider, that formation of a barrier occurs not due to the calcium containing in a material, closing a pulp.

Read More......

Organ Donations Tied to Time of Request

When a relative dies from trauma or a sudden illness the family is stunned and and in a state of disbelief or denial. That is not a good time for a doctor to request the donation of organs to provide transplants. To most people it would add “insult to injury” and the request would probably be denied.

This was confirmed in a recent study in the U.K. that showed the request for donation of organs was denied more often when family members were asked for consent at the same time they were informed their relative has been declared brain dead or has died. Dr. Duncan Young, of John Radcliffe Hospital in Oxford, along with his research colleagues found that the decision to donate a dying relative's organs is directly tied to who makes the request and when.

The group reviewed 20 studies and found that a time gap between the delivery of bad news and a request for organ donations is important. The success rate of requests was also higher when it involved a transplant coordinator and the hospital staff. Other important factors in the donation decision were:

• amount of information given to survivors
• quality of care perceived to have been given to their loved one
• understanding of what brain death actually means
• location of the request, private locations being more successful
• approach, expertise and empathy of the person making the request
• amount of time the family has to decide on the request

The researchers said that the results might appear logical, but using the right procedures could increase the number of organ donations and save lives.

Teresa Shafer, of the LifeGift Organ Donation Center in Texas, wrote in an editorial which accompanied the study that requesting an organ donation is more than “popping the question.” It requires observation, collaboration, planning, and action based on the family and hospital dynamics. Shafer said that hospitals and organ procurement groups have to work together to increase the availability of transplant organs. She added that “the donation request is too important to delegate to those who are not expert, prepared and focused on a successful outcome.”

Dr. Young and colleagues said that the reasons for refusal were important because 41 percent of requests were denied in a recent British study.

Shafer said that organ requests should be presented to the family a second time, even if initially refused because families often alter their original position and consent to donate at a later time. There is a relatively short period of time for successful organ transplants and in order to be prepared and to secure more organ donors, hospitals and medical centers need to have trained transplant coordinators on staff to deal with survivors.

There are thousands of individuals on organ transplant waiting lists. Each death, no matter how unfortunate or traumatic could provide several life saving transplants. Individuals who have already made their choice and decided to become organ donors should make it clear to their relatives that this is their choice, and in the event their life is terminated they want their decision to be honored.

Read More......

Paralysis Affects One in Fifty Americans

Christopher Reeve is well known for his leading role as “Superman,” but probably best known as a symbol of persistence and courage after a 1995 horse riding accident left him paralyzed from the neck down. He sought the help of the American Paralysis Foundation (APF), an organization that now carries his name, and spent the remainder of his life working tirelessly on behalf of spinal cord research, not just for himself, but for the 250,000 Americans believed to be affected by spinal cord injuries. But Reeve was skeptical of that number, believing it was much higher—and it turns out he was right.

According to a new study funded by the Christopher and Dana Reeve Foundation, nearly 1.3 million people are living with spinal cord injury, more than five times the estimate in 2008. And over 5.6 million Americans, about one in 50, live with some degree of paralysis due to a variety of neurologic problems; about 40 percent more than previously estimated. The leading cause of paralysis was stroke (29 percent), followed by spinal cord injury (23 percent) and multiple sclerosis (17 percent). “Nobody had any idea what the numbers were, because no one ever tried to find out,” said Joseph Canose, vice president for quality of life at the Reeve Foundation’s Paralysis Resource Center. “There were many different ways of counting it, and there was no common definition, and the numbers were all over the place.”

Lead investigator of the study, Anthony Cahill, a disability specialist at the University of New Mexico, said earlier estimates of paralysis patients were limited by medical-billing data that missed past diagnoses, medical centers that handle only the most severe cases and small geographic areas. The new estimate was based on a telephone survey of more than 33,000 U.S. households in which respondents were asked whether they or any other member of their household had any difficulty moving their arms or legs. Only those whose paralysis was due to a disease or injury affecting their central nervous system, such as a spinal cord injury, stroke, multiple sclerosis or cerebral palsy were included in the analysis. Mobility problems from muscular dystrophy, obesity, arthritis or diabetes, which aren’t central nervous system disorders, weren’t counted.

Cahill said he was surprised by the ethnic disparities revealed in the study; the most striking being that 7.3 percent of those with a spinal cord injury said they were Native American or Alaskan natives, who make up only 0.8 percent of the U.S. population. Motor vehicle accidents might be to blame, he says, noting that 90 percent of Navajo Nation roads aren’t paved.

The study also found that people living with paralysis have households with lower incomes. Sixty percent of people with paralysis have annual household incomes of less than $25,000. Worse, roughly 25 percent of households with a person who is paralyzed earn less than $10,000 per year, compared with only 7 percent of households in the general population.

“This study reveals important findings about the prevalence of paralysis and spinal cord injury, but we must also remember that behind each of these statistics are real people, who along with the rest of their families are facing urgent needs,” said Dr. Edwin Trevathan, Director of the CDC’s National Center on Birth Defects and Developmental Disabilities. “This is a crucial first step to providing appropriate public health supports for this community in understanding how many people live with the condition, who they are, and what they need.”

Alexandra Reeve Givens, daughter of Christopher Reeve, said the higher numbers revealed in the study is just one more reason the nation needs to make an investment in paralysis research. “It really hit home for us that we need to do a better job,” she said. “We need to make an investment for the entire country—to help people get back into the work force, to educate employers, too, because something of a stigma is still there.”

Next, the Reeve foundation will lobby in Washington, D.C., using the findings to push for health policy changes, including ending a federal requirement that disabled workers wait 24 months before getting health care through Medicare and in insurance policies that forbid $400 air cushions for wheelchairs until someone has already suffered a pressure-caused skin ulcer that can require a $75,000 hospital stay. They will also seek better adherence to the Americans With Disabilities Act, more support for the family caregivers of those who are paralyzed, and more and better trained home health attendants.

Last month, President Barack Obama signed legislation that was titled the Christopher and Dana Reeve Paralysis Act before it was folded into an unrelated bill, which authorizes Congress to set aside $25 million in federal funding for expanded and more coordinated research on paralysis and programs to help those who have trouble moving. Obama said the new law “will connect the best minds and best practices from the best labs in the country and focus their endeavors through collaborative scientific research into the cure for paralysis, saving effort, money and, most importantly, time.” The law designates the National Institutes of Health to coordinate research and work with other agencies and private groups to enhance paralysis research, rehabilitation and treatment programs. “Today is a day of progress for the millions of Americans who are living with paralysis and multiple sclerosis,” said Sen. Tom Harkin, D-Iowa, a co-sponsor of the measure.The new law will help scientists “find ways to improve the lives of so many living with disabilities, bringing hope to those in need,” Harkin said.

Read More......

Bariatric Surgery Centers Weigh In with Performance Levels Equivalent Hospitals

What’s in a name? After all, a bariatric surgery performed in a “center of excellence” is still a surgical procedure performed nonetheless. In spite of the impressive name, these hospitals have the occurrence of just as many deaths and complications from the surgical weight-loss procedures as other hospitals.

A group of U.S. researchers says that the additional costs and requirements for hospitals to warrant the designation of bariatric surgery centers of excellence might not be worth the effort. According to Dr. Edward Livingston of the University of Texas Southwestern School of Medicine, “Designation as a bariatric surgery center of excellence does not ensure better outcomes.” The new study appears in the Archives of Surgery.

To be designated a “center of excellence” by the American Society for Metabolic and Bariatric Surgery or the American College of Surgeons, a hospital must meet specified requirements such as performing a minimum of 125 operations per year and must employ a bariatric surgery coordinator as well as trained personnel to perform long-term patient follow-up and record patient outcomes into proprietary databases. In addition, the hospital must pay the cost to subscribe to such a database.

Given all the cost and effort, why seek the bariatric surgery center of excellence designation? Because both Medicaid and Medicare require patients to undergo bariatric surgery at designated centers of excellence, and these federal programs as well as large insurance companies help pay for the costs of the procedure, which ranges from $15,000 to $35,000. In addition, bariatric surgery is fast becoming a popular treatment for obesity. The procedure alters the digestive tract, causing a reduction in the amount of food that can be consumed and digested.

Livingston set out on a quest to find out if patients at centers of excellence, in fact, received better care than other hospitals were able to provide. Data on 19,363 patients who underwent the surgery in the year 2005 was analyzed including data on 5,420 patients who had the surgery performed at a center of excellence. Findings revealed that 1.7 percent of bariatric surgery patients treated at a center of excellence died, compared with a death rate of .09 at other hospitals, In addition, 6.3 percent of patients developed complications compared to 6.4 percent at hospitals with no center of excellence designation. Dr. Livingston concluded that “the much larger number of hospitals that perform low volumes of bariatric procedures have outcomes similar to the high-volume centers of excellence.”

In a separate study published in the same journal, Dr. Michel Suter of Hospital du Chablais in Lausanne, Switzerland, and colleagues studied 492 obese patients having a body mass index (BMI) of 40 to 49 and 133 grossly obese patients having a BMI of 50 or higher, who were treated with gastric bypass surgery between the years 1999 and 2006. Body mass index, is a statistical measurement, which compares a person's weight and height. A BMI of 25 to 30 is considered overweight, while a BMI over 30 is considered obese.

The results of the analysis showed that the grossly obese patients lost 37.3 percent of their body weight compared to the obese patients who lost 34.7 percent of their body weight. Yet, less than half of the grossly obese patients attained a BMI that would indicate simply being overweight even six years after surgery although over 90 percent of the obese patients successfully attained a BMI considered overweight.

However, overall the study showed that patients to benefit from the surgical procedure as the improvements observed in quality of life as well as other health measures were found to similar in both groups. The finding coincides with prior studies that have shown that obese people who undergo weight-loss surgery have a decreased likelihood of dying from heart disease, diabetes and cancer than obese people who don’t.

Read More......

Dermatitis

Dermatitis is an inflammatory process arising in integuments. Its reason can become various physical or chemical factors of an environment. The degree of influence of the harmful agent sometimes depends on individual sensitivity of an organism, in this case it is a question of the allergic nature of disease. It takes place both at external contact with cue, and after its hit inside of an organism. Depending on it, distinguish contact forms of illness and toxicoderma.

Ordinary contact reactions result from hit on a leather of caustic chemical substances, for example, acids or alkalis. Depth and the area of defeat thus neatly depends on concentration, area and time of influence of the negative factor. At long-standing contact to small dozes of toxin pathological process gets chronic character, and at lots — immediately there is a sharp reaction. It is accompanied by reddening of a leather, formation of bubbles, a suppuration, occurrence of hypostases, pains, burnings and an itch.

As a rule, its reason are solar burns, significant differences of temperatures, toxic substances of a vegetative or animal origin, cosmetic and perfumery means, medicinal creams and ointments. As most often meeting form sharp dermatits the attrition and the water callouses formed on a leather owing to mechanical friction serves. Usually on palms of hands it is observed after heavy physical work, and on stops — as a result of long carrying close footwear. At people with excess weight quite often attritions arise on a body between folds of a leather.

For chronic process bluish painting of integuments, occurrence of cracks, a thickening of a horn layer and a peeling is characteristic. The reason of similar reactions can become various fungoid, bacterial or virus infections, strong diaphoresis, especially in a combination to synthetic clothes. To cause the allergic form of disease some foodstuff are capable. At children such condition has received the name of a diathesis. More often it is connected with the use in food of dairy products, citron, nuts, eggs.

Constant stay in a condition of stress provokes occurrence or strengthening of negative symptoms of dermatitis. It is necessary to comply with caution to people with a dry leather, especially in cold and windy weather. During this period for protection of the open sites of an integument it is necessary to use special creams. For preventive maintenance of disease it is necessary to adhere strictly to the safety precautions at the reference with dangerous substances on work and houses, in time to eliminate activators of infections, with caution to approach to use of medical products.

Read More......

Colitis - a problem of intestines

Very often at people the wrong opinion concerning such disease as colitis is created. They assume, that colitis is a gripe. However, this incorrect assumption. The word colitis has occurred from the Greek word "kolon" which is translated as a large gut. Actually colitis is an inflammatory disease of a mucous membrane of thick intestines.

Colitis in sharp forms pass very violently, but during too time it is very fast. Chronic colitis in turn proceed very long and languidly. Sharp colitis are very often accompanied by an inflammation of thin guts and a stomach. The medicine knows some types of colitis. Among them: ulcer, infectious, ischemic, medicinal, radiating and some other types of colitis. Ulcer colitis it is accompanied by occurrence of chancres in paries of intestines. At ischemic prick blood badly reaches intestines.

There is a big number of the reasons of occurrence colitis. It can be intestinal infections, an infection in a bilious bubble or a pancreas, long application of antibiotics, infringement of blood supply of a gut. If to speak about a wrong feed it also influences formation of colitis. More often this abusing flour and animal food, also a spicy food and alcohol. If at you a dysbacteriosis of intestines, worms, a bad heredity or a food allergy, quite probably, that you become "hostage" of colitis. One more very frequent factor of occurrence of colitis is the wrong mode of day, a frequent mental or physical overstrain.

The basis of any colitis includes damage of a mucous membrane of a gut. If colitis is caused by an intestinal infection then disease passes with rough influence on an organism. During the moment of disease various bacteria and parasites get on a mucous membrane of a gut and start it to damage. During this moment in a gut of the patient there is an inflammatory process. Because of it the wall of a gut swells. The gut cannot normally function any more. The wrong operating mode causes desires on defecation, a diarrhea and painful sensations in a stomach. At the patient at prick constantly the temperature raises.

First attributes of colitis are a pain in the field of a stomach and a unstable chair. Rumbling and a swelling of a stomach can disturb the patient. In a dung there can be a slime or blood. The person with colitis feels slackness, weakness. The given disease proceeds more often, approximately, some weeks.

If happens you got a colitis, it is necessary for you to address necessarily to the gastroenterologist. Only him can put you the correct diagnosis. Also you should hand over the analysis кала and to pass some researches on various devices.

Treatment of any kind of colitis requires a special diet. All other treatment is appointed depending on the reasons of disease. If at you has appeared colitis because of an intestinal infection then to you will necessarily appoint antibiotics. In case of if you became the owner of this disease because of application of a plenty of medicines then all medical products are canceled.

Medicinal therapy, physiotherapy, psychotherapy – all this methods of treatment colitis. Sanatorium treatment of this disease very well helps.

Colitis, as well as all other diseases, requires duly treatment. For this reason leave all businesses on then and engage for the beginning in the health. Visiting of the gastroenterologist will help you to get rid from colitis and to feel far more confidently and better.

Read More......

Autism Jargon: Terms and Definitions You'll Need to Know

Aspie: An affectionate term used by individuals with Asperger syndrome to refer to themselves.

Classic Autism: This is not a real medical term, but it is often used to refer to an individual on the lowest end of the spectrum.

Delay: We initially thought this was a nice way to say disabled. In fact, for a majority of children on the autism spectrum, it really does mean delay. Our son, for example, is about three years behind in his emotional and behavioral development -- but he keeps improving!

Echolalia or echolalic: Many autistic children do use language, but tend to repeat what they've heard rather than create novel phrases on their own. When a child is echolalic, he is "echoing" what he's heard.

Extraordinary: This sounds like a positive term, but it really means "not ordinary" -- and generally implies atypical development.

On the Spectrum: Anyone with any diagnosis that falls anywhere within the autism spectrum.

Pervasive: Most autistic people have delays in more than one area. Many are delayed in their social, behavioral, linguistic and physical skills. "Pervasive" refers to the fact that the delays are not in just one area.

Read More......

Alagille Syndrome

What is it?
Alagille syndrome is an inherited disorder that affects many systems of the body. Little is known about what causes it. A small number of people with Alagille syndrome have a genetic defect on Chromosome 20. It is estimated that the syndrome affects 1 in 100,000 people.

Alagille syndrome causes problems in the liver, heart, eyes, spine, and kidneys, although not all may be affected in the same person, or to the same degree. People with the syndrome often have a distinctive facial appearance.

What are the symptoms?
Within the first 3 to 6 months of life, symptoms may include:

• jaundice and skin itching (sign of liver disease)
• pale, loose stools
• poor growth
• heart murmur (sign of heart defect)

These symptoms may alert a physician to the existence of Alagille syndrome. If the syndrome is mild it may not be diagnosed until the child is older. Usually the child with Alagille syndrome has liver disease plus problems in two other systems of the body.

How is it treated?
Although there is no cure for Alagille syndrome, there are many treatments available to relieve its effects on the body.

• fat soluble vitamins (A, D, E, and K) (needed due to liver disease)
• cholestyramine (Questran) is given for high cholesterol and skin itching (due to liver disease)
• surgery may be needed to correct serious heart defects
• may need to take medicine for high blood pressure or other problems caused by kidney disease

If the liver disease becomes so severe that the liver no longer functions (about 15% of people with Alagille syndrome), a liver transplant may be necessary.

Information for this article was taken from:
- Children's Liver Association. Alagille Syndrome.
- Scheimann, A. (2002). Alagille syndrome. eMedicine, accessed at http://www.emedicine.com/ped/topic60.htm

Read More......

Periodontal Disease

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of periodontal disease

Alternative Names

Gingivitis

Prevention

Healthy habits and good oral hygiene are critical in preventing gum disease. Regular and effective tooth brushing and mouth washing, however, are effective only above and slightly below the gum line. Once periodontal disease develops more intensive treatments are needed.

Dietary Changes

It is important to reduce both the quantity, and in particular the frequency, of sugar intake. Snacks and drinks should be free of sugars (other than natural sugars found in fruits and vegetables); sugar-containing foods should be consumed with meals and ideally followed by brushing. Since fruit juices can also cause tooth erosion in children, milk and water use should be emphasized.

Quitting Smoking

Smoking may play a significant role in over half the cases of chronic periodontal disease, according to research published in 2000. For smokers, quitting is one of the most important steps toward regaining periodontal health.

Fluoride Treatments

Fluoride treatment in children has helped to account for the decline in periodontal disease in adults. Because fluoride prevents decay, back molars, which keep the teeth in place, are spared, and are thus less vulnerable to bacteria. Even before teeth first erupt, babies' gums should be wiped clean with a bit of gauze bearing a dab of fluoride toothpaste. Supplementation with fluoride tablets or drops may be recommended for children 6 months or older who drink unfluoridated water or who are at risk for dental problems. A prescription from the child's pediatrician or dentist is required.

Some dentists recommend a fluoride gel for adult patients who are still at risk for tooth decay or sensitivity, but extra fluoride is generally not necessary for adults who use fluoride toothpaste.

Dental Examinations

Periodontitis is a silent disease; individuals rarely experience pain and may not be aware of the problem. A periodontal examination by a general dentist once or twice a year should reveal any incipient or progressive problems. A full mouth series of X-rays is advised every two to three years. This will alert the dentist to early bone loss and other disorders of the oral cavity.

Dentists now often perform Periodontal Screening and Recording (PSR) using a probe to measure gum pockets. This procedure used to be performed only by periodontists but is now encouraged as part of a regular dental examination. The dentist will identify any areas where deep pocketing has occurred, where the health of the gingiva appears compromised, and where there is undue mobility of teeth. It is the general dentist's responsibility to identify periodontal disease and inform the patient. If the condition is severe, the dentist may want to refer the patient to a periodontist.

Daily Dental Care

Correct tooth brushing, mouth cleansing, and flossing should be everyone's defense against periodontal disease. (It should be noted that good hygiene is probably not sufficient to prevent periodontal disease in many people who are susceptible to this autoimmune condition. Regular visits to a dentist are extremely important in high-risk individuals.)

Brushing Guidelines. The following are some recommendations for brushing:

• First use a dry brush. One study reported that when people brushed their teeth without toothpaste first, using a soft dry brush, their plaque deposits were reduced by 67% and gum bleeding dropped by 50%.
• No brush of any size, shape, or gimmick is effective if it is incorrectly positioned in the mouth. Place the brush where the gum meets the tooth, with bristles resting along each tooth at a 45-degree angle.
• Begin by dry brushing the inside the bottom row of teeth, then the inner top teeth, and last the outer surfaces.
• Wiggle the brush back and forth so the bristles extend under the gum line.
• Scrub the broad, biting surfaces of the back teeth.
• Dry brushing should take about a minute and a half.
• A paste is then applied and the teeth should be rebrushed in the same way.
• The tongue should be scrubbed for a total of about 30 seconds. A tongue scraper used with an anti-bacterial mouthwash (such as Listerine) is more effective than a toothbrush in removing bacteria.
• One should rinse the toothbrush thoroughly and then tap it on the edge of the sink at least five times to get rid of debris. (It should be noted that detergents in toothpaste that remain on the brush may help prevent bacterial contamination of the brush.)
• Flossing should finish the process. A mouthwash may also be used.

If brushing after each meal is not possible, rinsing the mouth with water after eating can reduce bacteria by 30%.

Toothbrushes. A vast assortment of brushes of varying sizes and shapes are available, and each manufacturer makes its claim for the benefits of a particular brush. People should look for the American Dental Association (ADA) seal on both electric and regular brushes.

In spite of the wide variety of nonelectric toothbrushes, both in shape and bristle design, a study of eight brands found no significant differences in effectiveness among them.

Electric toothbrushes, particularly those with a stationary grip and revolving tufts of bristles, can be advantageous for some people with physical disabilities. They include the following:

• Electric toothbrushes with heads that move back and forth up to 4,200 times a minute remove significantly more plaque than ordinary brushes. Brands are Bausch & Lomb's Interplak, Braun's Oral-B Plaque Remover, and Water Pik's Plaque Control.
• Even more high-tech brushes are now available that use sound waves to remove plaque. Brands include Sonicare, SenSonic, Soniplak, and UltraSonex.

In general, studies have reported no differences between electric and manual toothbrushes in their ability to remove plaque. (One study showed considerable improvement in groups using sonic toothbrushes, particularly in those with moderate periodontal disease.) Experts recommend, however, that if a regular toothbrush works, then it isn't necessary to buy an expensive electric one.

For individuals with average dexterity, a four- or five-rowed, soft, nylon-bristled toothbrush is sufficient. The most important factor in buying any toothbrush, electric or manual, is to choose one with a soft head. Soft bristles get into crevices easier and do not irritate the gums. One study found that those who used a soft toothbrush had 4.7% of exposed tooth below the gum line compared to 9.4% with hard brush users. A useful toothbrush called Alert has been developed that flashes a red light when too much pressure is being placed on the gums.

Experts generally recommend replacing toothbrushes each month Not only do they become breeding grounds for bacteria, but the worn bristles are less effective at removing plaque. (One study reported that a three-month old toothbrush was as effective as a new one at removing plaque, although it's probably wise not to go longer than three months.)

Toothpaste. The object of a good toothpaste is to reduce the development of plaque and eliminate periodontal causing microorganisms without destroying the organisms that are important for a healthy mouth. All brands should show ADA approval. Even a good toothpaste, however, cannot be delivered past 3 mm below the gum line, where periodontitis develops.

Toothpastes are a combination of abrasives, binders, colors, detergents, flavors, fluoride, humectants, preservatives, and artificial sweeteners. Highly abrasive toothpastes should not be used, especially by individuals whose gums have receded.

Active agents contained in toothpastes may include the following:

• Fluoride. Most commercial toothpastes contain fluoride, which both strengthens tooth enamel against decay and enhances remineralization of the enamel. Fluoride also inhibits acid-loving bacteria, especially after eating, when the mouth is more acidic. Some argue that this antibacterial activity may help control plaque.
• Triclosan. Colgate's Total toothpastes contain a fluoride and triclosan, an extremely potent anti-bacterial agent. The toothpaste also contains an agent that keeps triclosan active in the mouth for 12 hours. Total is the first FDA approved toothpaste for the prevention of tooth decay, gingivitis, and plaque. Still the benefits of this toothpaste are limited and are most pronounced in people with severe gingivitis. Of some concern are studies reporting development of bacteria resistant to triclosan. More studies are needed. Anyone with periodontal disease should not rely on this product alone.
• Metal salts. Metal salts, such as stannous and zinc, serve mostly as anti-bacterial agents in toothpastes. Stannous fluoride gel toothpastes do not reduce plaque, however, even though they have some effect against the bacteria that cause it, but slightly reduce gingivitis. Such toothpastes can cause staining that requires professional cleaning. Crest Plus Gum Care contains a stabilized form of stannous fluoride. Studies conducted by the manufacturer suggest that is has antibacterial activity and that it might be more effective than Colgate's Total in reducing gingivitis and bleeding.
• Enzymes called glucanases.
• Plant extracts (such as sanguinarine). Viadent toothpaste and mouthwash contain an anti-bacterial herbal extract called sanguinarine. The two products provide minimal results when used individually, but if the mouthwash and toothpaste are used together they have produced plaque reductions of 17% to 42% and reductions of gingivitis of 18% to 57% during a six-month period. It should be noted that some questions have been raised about the safety of prolonged use of sanguinarine.
• Peroxide and baking soda. Toothpastes with these ingredients (Mentadent) appear to offer no benefits against gum disease. In fact, tooth whiteners are usually made with carbamide peroxide, which breaks down into hydrogen peroxide, and brushing with hydrogen peroxide is not recommended. Studies have indicated that overuse of this solution may actually damage cells and soften tooth surfaces. Of concern was a recent animal study suggesting a link between hydrogen peroxide and precancerous cell changes in the mouth. Researchers retracted the findings because of these implications and pointed out that no cancer lesions have developed in any animals since the study began. People who smoke or drink alcohol, however, might avoid products with hydrogen peroxide in them.
• Antibacterial sugar substitutes (e.g., xylitol), and detergents (delmopinal).

Mouthwashes. The value of many mouthwashes is highly controversial. Many have only temporary antibacterial value. Some can even harm the mucus membrane and they can be dangerous to children who drink them. Those that are considered plaque fighters are chlorhexidine and Listerine, which is available over the counter.

• Chlorhexidine (Peridex or PerioGard) is available by prescription only. It reduces plaque by 55% and gingivitis by 30% to 45%. Patients should rinse for one minute twice daily. They should wait at least 30 minutes between brushing and rinsing since chlorhexidine can be inactivated by certain compounds in toothpastes. It has a bitter taste. It also binds to tannins, which are in tea, coffee, and red wine, so it has tendency to stain teeth in people who drink these beverages.
• Listerine is composed of essential oils and is available over the counter. It reduces plaque and gingivitis, when used for 30 seconds twice a day. It leaves a burning sensation in the mouth that most people better tolerate after a few days of use. Some people might object to or have concerns about the high alcohol content in the standard version. Other forms of Listerine that have a different taste and lower alcohol content retain the same active ingredients and appear to be as effective. The usual regimen is to rinse twice a day. Generic equivalents are available. (Listerine PocketPaks, which are strips that dissolve on the tongue, have no proven effects on plague and gingivitis.)
• Mouthwashes containing cetylpyridinium (Scope, Cepacol) have moderate effect on plaque, but only if they are used an hour after brushing. None are as effective as Listerine or chlorhexidine, but they may still have some value for people who cannot tolerate the other mouthwashes.
• Mouthwashes containing stannous fluoride and amine fluoride (Meridol) is moderately effective, but also not as effective as effective as Listerine or chlorhexidine.
• Fluoride mouthwashes (Reach Act) are helpful in preventing cavities.
• Plax offers only modest protection against plaque and gingivitis. Even Advanced Formula Plax, which may show a minor reduction in plaque levels, does not seem to provide any protection against periodontal disease.
• Some chemicals are being investigated for their use in mouthwashes. For example, one mouthwash (HistaWash) is produced from histatins, peptides found in saliva. Studies are reporting that it protect against gum disease and prevents other infections in the mouth as well.

Read More......

Hernias at children: inguinal, umbilical, a hernia of a white line of a stomach. Symptoms. Methods of treatment.

Hernia is an outwandering bodies from a cavity in norm them borrowed through properly existing or pathologically generated aperture with conservation of an integrity of envelopes, their covering, or availability of conditions for this purpose.
Let's consider a hernia of a forward belly wall of a stomach. It is the most widespread surgical pathologies at children. An original cause of progress of hernias - defect of progress of a belly wall. However there are some features which we shall consider separately.

Umbilical hernia. For 4-5 day after a birth of the child the umbilical cord disappears. The umbilical ring consists of two parts. The bottom part where pass umbilical arteries and a uric channel, are well reduced and form a dense cicatricial fabric. In the top part there passes a umbilical vein. Its walls thin, have no muscular environment, are badly reduced in the further. Quite often at weak peritoneal band and patent to a umbilical vein the umbilical hernia is formed. Except for it the major factor promoting occurrence of this pathology, frequent increase of intrabelly pressure is. It can be caused, for example, frequent we cry the child.
The aperture in the top part of a umbilical ring can be wide, and not trouble the child. But in case of small defect with firm edges concern of the child probably. As a rule, a umbilical hernia always can be reduced. The restrained umbilical hernia to meet in an adult practice more often. However we quite often should operate children with unreducible hernias (when hernial contents are attached to an internal wall of a leather of a forward belly wall by solderings).

Experience of out-patient supervision of children with the umbilical hernias diagnosed at early age, allows to tell with confidence, that to 5-7 years age often there comes self-healing. Liquidation of a hernia is assisted with strengthening a belly wall. It certainly massage, laying of children on a tummy, gymnastics. Surgical treatment it is begun not earlier than 5 years age. Properly and accurately lead operation, allows to eliminate a hernia with good cosmetic effect. As a rule, relapses does not happen.

Hernia of "a white line" stomach (anteperitoneal adipoma). If to lead a line between omphalus and ensiform shoot of a brest is and there is "a white line" stomach. At a direct muscle of the stomach, shaping given area, is from 3-6 tendinous crosspieces. In seat of intersection of these crosspieces and "a white line" stomach sometimes there are small defects. In them it is often stuck out anteperitoneal fat. If they settle down in immediate proximity from a umbilical ring, them name paraumbilical (periomphalic) hernias. Unfortunately, these hernias are not inclined to spontaneous closing. Treatment only operative, similar to operation at a umbilical hernia.

An inguinal hernia. Very frequent surgical disease at children. As a rule, all hernias at children of early age congenital. What reasons of occurrence of this pathology? It is a lot of opinions in this occasion at children's surgeons. It and weakness of a forward belly wall and feature of a structure inguinal areas and nonclosure vaginal a shoot abdominal membrane and a heredity. We shall try under the order, on an example of an congenital inguinal at the boy.
About from 6-th month of intra-uterine progress of the boy orchis fall from a belly cavity in marsupium on inguinal to the channel. Therefore these hernias name slanting. For presentation present itself, that on a tube (vaginal to a shoot abdominal membrane) as on the lift, orchis, conducted by the lowering mechanism from a belly cavity goes down in marsupium. Then under the plan there is a closing a pipe (vaginal shoot abdominal membrane) and by that the termination of the message between belly completely and marsupium. If it does not occur, at increase of intrabelly pressure in the nonclosure vaginal shoot of abdominal membrane leaves contents of a belly cavity. It is an inguinal hernia.
What for to an organism to strain and stretch a stomach when there is an opportunity to dump a superfluous pressure in "hernial contents". And frequently the child grows and … increases hernial bulge. Treatment of the given pathology only operative. Technically to carry out it at the child easier is more senior 1 year. However quite often operation is shown to the child at once at statement of the diagnosis. To wait dangerously. Occurrence of terrible complication - infringement inguinal hernias is possible. Hernial bulge in inguinal areas earlier that arising disappearing suddenly became firm, the child has begun to worry and has begun to cry, there was a vomiting, refusal of meal. At touch up to firm "bulla" in a groin to the child it is very painfull!!!
Most likely, there was an infringement inguinal hernias. To not give food, not give water and it is urgent to bring the child to the hospital. Muscles of a stomach have restrained contents of a hernial bag. It can be a site of a gut, a bladder or ootheca at girls. If urgently to not help the child after a while the site, deprived blood supplies, can be sphacelous, i.e. become lifeless. In that case treatment very heavy and long. In my practice there were 2 cases, hernial contents at the restrained hernia were a site of a blind gut with again changed an appendicular shoot. It was necessary to lead simultaneously with celotomy.

Believe, it is better to not lead up to infringement. To operate the child with a hernia it is necessary healthy, with good analyses and in the daytime. And it is possible only at scheduled operation. Every year in our branch, about to 500 children with the given pathology, scheduled operative interventions are spent. Operations last about 15-20 minutes, pass under a mask narcosis and the control of skilled anaesthesiologists. And here, after the small period of rehabilitation - your child is completely healthy. We have made all in time and properly.

Read More......

Rheumatoid arthritis

Definition

Rheumatoid arthritis (RA) is a long-term disease that causes inflammation of the joints and surrounding tissues. It can also affect other organs.

Alternative Names

RA; Arthritis - rheumatoid

Causes

The cause of RA is unknown. It is considered an autoimmune disease. The body's immune system normally fights off foreign substances, like viruses. But in an autoimmune disease, the immune system confuses healthy tissue for foreign substances. As a result, the body attacks itself.

RA can occur at any age. Women are affected more often than men.

RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected. The course and the severity of the illness can vary considerably. Infection, genes, and hormones may contribute to the disease.

Symptoms

The disease usually begins gradually with:

• Fatigue
• Loss of appetite
• Morning stiffness (lasting more than 1 hour)
• Widespread muscle achesWeakness

Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may effect the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes and neck.

Additional symptoms include:

• Anemia due to failure of the bone marrow to produce enough new red cells
• Eye burning, itching, and discharge
• Hand and feet deformities
• Limited range of motion
• Low-grade fever
• Lung inflammation (pleurisy)
• Nodules under the skin (usually a sign of more severe disease)
• Numbness or tingling
• Paleness
• Skin redness or inflammation
• Swollen glands

Joint destruction may occur within 1-2 years after the appearance of the disease.

Exams and Tests

A specific blood test is available for diagnosing RA and distinguishing it from other types of arthritis. It is called the anti-CCP antibody test. Other tests that may be done include:

• Complete blood count
• C-reactive protein
• Erythrocyte sedimentation rate
• Joint ultrasound or MRI
• Joint x-rays
• Rheumatoid factor test (positive in about 75% of people with symptoms)
• Synovial fluid analysis

Treatment

RA usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for RA can delay joint destruction.

MEDICATIONS

Disease modifying antirheumatic drugs (DMARDs): These drugs are the current standard of care for RA, in addition to rest, strengthening exercises, and anti-inflammatory drugs. Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis. Leflunomide (Arava) may be substituted for methotrexate. These drugs are associated with toxic side effects, so you will need frequent blood tests when taking them.

Anti-inflammatory medications: These include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Although NSAIDs work well, long-term use can cause stomach problems, such as ulcers and bleeding, and possible heart problems. NSAID packaging now carries a warning label to alert users of an increased risk for cardiovascular events (such as heart attack or stroke) and gastrointestinal bleeding.

Antimalarial medications: This group of medicines includes hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine), and is usually used in combination with methotrexate. It may be weeks or months before you see any benefit from these medications.

Corticosteroids: These medications work very well to reduce swelling and inflammation in a joint. Because of potential long-term side effects, however, corticosteroids should be taken only for a short time and in low doses when possible.

Cyclooxygenase-2 (COX-2) inhibitors: These drugs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest possible duration. Talk to your doctor about whether COX-2s are right for you.

Read More......