Health

What is Type 2 Diabetes?

noreply@blogger.com (Unknown) — Mon, 17 Jun 2013 16:30:00 +0000

Type 2 diabetes, also called adult-onset diabetes and non-insulin dependent diabetes, is a chronic condition caused by high levels of glucose (sugar) in the blood. Although some people can overcome the symptoms by losing weight and following a healthy diet and exercise plan, most people with type 2 diabetes will have it for life.

According to the American Diabetes Association (ADA), nearly 26 million people in the U.S. have diabetes; most of these people have type 2 diabetes, and as many as 7 million people are living un diagnosed (ADA, 2011). Almost 80 million more have “prediabetes”—the precursor to type 2 diabetes.

Symptoms of Type 2 Diabetes

Some people may have type 2 diabetes for years without noticing any symptoms. Early signs and symptoms of this condition may include:

the frequent need to urinate
feeling very hungry or thirsty
feeling very tired
frequent infections of the urinary tract or skin
blurry vision
erectile dysfunction
tingling, pain, or numbness in hands or feet

People experiencing these symptoms should seek care promptly from a health professional and ask to be tested for diabetes.

Causes of Type 2 Diabetes

Type 2 diabetes is caused by a problem with the way the body produces and uses insulin. Insulin helps the body move sugar from your blood into your muscles and cells for energy and storage.

In some people, the body stops producing enough insulin to move the glucose out of the blood and into the body’s cells. In others, the muscles and tissues begin to resist or ignore the insulin, keeping it from delivering the glucose to the parts of the body that need it. People become type 2 diabetics over time. As the body slowly loses the ability to use the glucose floating around in the blood, the sugar can build up, which causes hyperglycemia. Hyperglycemia happens occasionally in nearly all diabetics; it occurs when insulin isn’t clearing enough glucose from the blood after someone eats too much, exercises too little, or is experiencing stress or illness.

Being overweight increases the chances of being diagnosed with type 2 diabetes. A poor diet and a lack of exercise can also raise someone’s risk of becoming diabetic. Some people who are underweight, or even a healthy weight (mainly the elderly) can also be diagnosed with type 2 diabetes.

Risk Factors for Type 2 Diabetes

A type 2 diabetes diagnosis can occur in virtually anyone. Risk factors for type 2 diabetes include:

being overweight (BMI of 25 or greater), particularly around the midsection
exercising less than three times per week
having had gestational diabetes or given birth to a baby nine pounds or larger
having a family history of type 2 diabetes
blood pressure of 140/90 mmHg or higher
HDL cholesterol below 35 mg/dL
high blood triglyceride levels
being over the age of 45
having a diagnosis of polycystic ovary syndrome, metabolic syndrome, or acanthosis nigricans
non-Caucasian ethnicity

How Does Type 2 Diabetes Differ from Type 1 Diabetes?

Type 2 diabetes is most commonly diagnosed in adults. Under the age of 20, about one in 400 children have type 2 diabetes (although this number is rising); more than one in four adults aged 65 or over have the condition (ADA, 2011). Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, can occur at any age but is most commonly diagnosed in children and young adults.

People with type 1 diabetes produce little or no insulin to move glucose out of the blood and into cells. Individuals with type 2 diabetes may produce insulin but have tissue, muscles, and organs that don’t accept it. In both forms of diabetes, glucose can build up in the blood unless cells receive and accept the insulin or less sugar enters the bloodstream.

The exact cause of Type 1 diabetes is unknown, but there is a strong hereditary link and it may be an autoimmune disorder. There is no cure for type 1 diabetes, and virtually all diagnosed individuals use insulin every day to help their body process the glucose in their blood.

Some people with type 2 diabetes may avoid the need for medication with a healthy diet and lifestyle, and some can even eliminate their need for medication by losing weight and exercising. Type 1 and type 2 diabetics need to carefully track their blood glucose levels to avoid hypo- or hyperglycemia. The symptoms and tests for each type of diabetes can be similar.

Tests for Type 2 Diabetes

If you have any of the common symptoms of diabetes or if you are at a high risk due to age, ethnicity, heredity, or health status, you may be tested yearly or every three years for diabetes. The most common tests for diagnosing Type 2 diabetes include the hemoglobin A1C test, fasting blood glucose tests, oral glucose tolerance tests, and urine tests. Many physicians will need to test glucose and urine at more than one visit to make a diagnosis of type 2 diabetes.

Blood Sugar Levels and Type 2 Diabetes

In addition to their importance in diagnosing diabetes, blood sugar levels are crucial to staying healthy for diabetics and for others. Diet and physical activity can directly affect blood sugar levels. Blood glucose changes naturally throughout the day, but it is usually higher after meals and lower after sleeping or fasting.

A healthy fasting blood glucose range is 70–100 mg/dL. Your doctor may suspect diabetes if you have a test above 200 mg/dL or if you test higher than 126 mg/dL for fasting glucose levels on two occasions. Blood sugar can be checked quickly at home with a simple device.

Individuals with type 2 diabetes need to track their blood sugar levels to know how well they are managing their condition. If blood sugar levels get too high (hyperglycemia) or too low (hypoglycemia), serious health problems can occur. Glucose monitoring and diet management are among the most common treatments for type 2 diabetes.

Treatments for Type 2 Diabetes

In addition to monitoring blood glucose levels, two other main treatments for type 2 diabetes include diet and exercise. Some people with this condition may also need diabetes medicine or insulin. Oral diabetes medications help people with type 2 diabetes make or use their own insulin. In people with very poorly controlled or severe diabetes, insulin therapy may be essential for maintaining health.

Type 2 Diabetes Diet

Although diabetics don’t have to follow a very specific diet, there are general guidelines that are important. Eating a healthy, balanced diet can help manage blood sugar and prevent diabetes complications. Working with a dietitian to learn about a healthy diabetes diet can make the transition easier.

Although entire books have been devoted to the subject, there are some simple tricks for a diabetic diet. Planning meals in advance and learning to pay attention to the amount of carbohydrates, fats, and nutrients in foods can help make a diabetes diet simpler. Most people with type 2 diabetes will need to manage calorie intake and their weight, as well. Sometimes, weight loss can help reverse diabetes symptoms and blood glucose problems.

In general, type 2 diabetics should limit their intake of fats and sugars, and aim for a steady amount of carbohydrates with each meal. A healthy diabetes diet will also include plenty of high-fiber grains, beans and lentils, vegetables, lean protein, fresh fruits, and low-fat dairy (NIH, 2011). Aim to fill at least half of your plate at each meal with vegetables; the other half should be split between a lean protein (like chicken or fish) and a healthy starch or grain (like brown rice or beans) (ADA, 2012).

Exercise for Type 2 Diabetics

Most people with type 2 diabetes can benefit from regular physical activity. Exercise can help control blood sugar levels and even help reverse insulin resistance.

Individuals with type 2 diabetes should incorporate physical activity into their daily routine on a regular basis. If they were previously inactive, they can slowly build their way up to regular exercise by starting with a short walk every evening or some gentle stretching. Diabetics should aim for about 30 minutes of moderate physical activity at least five days each week.

Coupled with a healthy diet, exercise can be one of the most effective treatments for diabetes. Weight loss and exercise can help diabetics avoid the need for oral medications and prevent some complications of the disease.

Prognosis and Outcomes for Type 2 Diabetes

Diabetes can cause serious health problems. It is most dangerous when it is poorly controlled. People who don’t manage their blood glucose levels, have other health problems, are inactive, or are undergoing a lot of stress may experience serious complications of this disease.

Problems like hyper- and hypoglycemia can cause weakness, fatigue, confusion, and—over time—nerve and organ damage. Blood sugar difficulties have a slow and cumulative effect. Over time, the damage to nerves, blood vessels, and organs can cause serious health problems. These include vision problems, foot and skin problems, recurrent infections, heart problems, kidney disease or failure, pain and numbness in limbs, amputation of the feet or legs, and comas. According to the American Diabetes Association, diabetes plays a factor in nearly a quarter of a million deaths each year (ADA, 2011).

Despite these serious potential complications, type 2 diabetes can be safely managed. Many people live long, healthy lives despite having diabetes. With proper management, most or all of these serious side effects can be avoided.

Preventing Type 2 Diabetes or Its Effects

Diabetes prevention involves a healthy lifestyle. In most cases, type 2 diabetes can be prevented by maintaining a healthy body weight, eating a balanced diet, and staying physically active. Individuals who are prediabetic or at a high risk of getting type 2 diabetes for other reasons should take extra care to exercise and maintain a healthy weight.

In order to prevent complications and the negative symptoms of type 2 diabetes, careful treatment is essential. Managing blood sugar on a daily basis, following a healthy diet, and being physically active can all help to prevent many dangerous complications.

Maintaining a healthy blood pressure and keeping stress under control is important to preventing complications. Taking care of your feet by cleaning, drying, and checking them regularly can also be important to preventing problems. Sometimes, diabetes medications and other pharmaceuticals are used to protect health and prevent complications. These drugs help manage blood sugar, blood pressure, or other health problems that can impact the body’s ability to function safely.

Acidosis - Respiratory

noreply@blogger.com (Unknown) — Fri, 04 May 2012 17:31:00 +0000

Definition

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This disrupts the body's acid-base balance causing body fluids, especially the blood, to become too acidic.

Alternative Names

Ventilatory failure; Respiratory failure; Acidosis - respiratory

Causes

Causes of respiratory acidosis include:

Diseases of the airways (such as asthma and chronic obstructive lung disease), which send air into and out of the lungs
Diseases of the chest (such as scoliosis), which make the lungs less efficient at filling and emptying
Diseases affecting the nerves and muscles that "signal" the lungs to inflate or deflate
Drugs that suppress breathing (including powerful pain medicines, such as narcotics, and "downers," such as benzodiazepines), especially when combined with alcohol
Severe obesity, which restricts how much the lungs can expand

Chronic respiratory acidosis occurs over a long period of time. This leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance.
Acute respiratory acidosis is a severe condition in which carbon dioxide builds up very quickly and before the kidneys can return the body to a state of balance.

Symptoms

Symptoms may include:

Confusion
Easy fatigue
Lethargy
Shortness of breath
Sleepiness

Exams and Tests

Arterial blood gas (measures levels of oxygen and carbon dioxide in the blood; in respiratory acidosis, the level of carbon dioxide is too high)
Chest x-ray
Pulmonary function test

Treatment

Treatment is aimed at the underlying lung disease, and may include:

Bronchodilator drugs to reverse some types of airway obstruction
Noninvasive positive-pressure ventilation (sometimes called CPAP or BiPAP) or mechanical ventilation if needed
Oxygen if the blood oxygen level is low
Treatment to stop smoking

Outlook (Prognosis)

How well you do depends on the disease causing the respiratory acidosis.

Possible Complications

Poor organ function
Respiratory failure
Shock

When to Contact a Medical Professional

Severe respiratory acidosis is a medical emergency. Seek immediate medical help if you have symptoms of this condition.

Call your health care provider if you have symptoms of lung disease.

Prevention

Do not smoke. Smoking leads to the development of many severe lung diseases that can cause respiratory acidosis.

Losing weight may help prevent respiratory acidosis due to obesity (obesity-hypoventilation syndrome).

Be careful about taking sedating medicines, and never combine these medicines with alcohol.

References

Seifter, JL. Acid base disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 119.

Metabolic Acidosis

noreply@blogger.com (Unknown) — Mon, 23 Apr 2012 08:00:00 +0000

Definition

Metabolic acidosis is a condition in which there is too much acid in the body fluids.

Alternative Names

Acidosis - metabolic

Causes

Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body. There are several types of metablic acidosis:

Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances known as ketone bodies, which are acidic, build up during uncontrolled diabetes
Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, as can happen with severe diarrhea
Lactic acidosis is a buildup of lactic acid. It can be caused by:
- Alcohol
- Cancer
- Exercising for a very long time
- Liver failure
- Low blood sugar (hypoglycemia)
- Medications such as salicylates
- Prolonged lack of oxygen from shock, heart failure, or severe anemia
- Seizures

Other causes of metabolic acidosis include:

Kidney disease (distal tubular acidosis and proximal renal tubular acidosis)
Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
Severe dehydration

Symptoms

Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself usually causes rapid breathing. Confusion or lethargy may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, chronic (ongoing) condition.

Exams and Tests

Arterial blood gas
Serum electrolytes
Urine pH

Arterial blood gas analysis or a serum electrolytes test (such as a basic metabolic panel) will confirm acidosis is present and determine whether it is respiratory acidosis or metabolic acidosis.
Other test may be needed to determine the cause of the acidosis.

Treatment

Treatment is aimed at the underlying condition. In certain circumstances, sodium bicarbonate (baking soda) may be given to improve the acidity of the blood.

Outlook (Prognosis)

What can be expected will depend on the underlying disease causing the metabolic acidosis.

Possible Complications

When very severe, metabolic acidosis can lead to shock or death.

When to Contact a Medical Professional

Seek medical treatment if you develop symptoms of any disease that can cause metabolic acidosis.

Prevention

Keeping type 1 diabetes under control may help prevent diabetic ketoacidosis, one type of metabolic acidosis.

References

Seifter JL. Acid-base disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 119.

Acidosis

noreply@blogger.com (Unknown) — Thu, 19 Apr 2012 10:35:00 +0000

Definition

Acidosis is a condition in which there is excessive acid in the body fluids. It is the opposite of alkalosis (a condition in which there is excessive base in the body fluids).

Causes

The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory acidosis or metabolic acidosis.

Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused by a decreased ability to remove carbon dioxide from the body through effective breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis.

Causes of respiratory acidosis include:

Chest deformities, such as kyphosis
Chest injuries
Chest muscle weakness
Chronic lung disease
Overuse of sedative drugs

Metabolic acidosis develops when too much acid is produced or when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis:

Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes.
Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, as can happen with severe diarrhea.
Lactic acidosis is a buildup of lactic acid. This can be caused by:

Alcohol
Cancer
Exercising vigorously for a very long time
Liver failure
Low blood sugar (hypoglycemia)
Medications such as salicylates
Prolonged lack of oxygen from shock, heart failure, or severe anemia
Seizures

Other causes of metabolic acidosis include:

Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis)
Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol Severe dehydration

Symptoms

See: Metabolic acidosis or Respiratory acidosis

Exams and Tests

Arterial or venous blood gas analysis
Serum electrolytes
Urine pH

An arterial blood gas analysis or serum electrolytes test, such as a basic metabolic panel, will confirm that acidosis is present and indicate whether it is metabolic acidosis or respiratory acidosis. Other tests may be needed to determine the cause of the acidosis.

Treatment

Treatment depends on the cause. See the specific types of acidosis.

Outlook (Prognosis)

Acidosis can be dangerous if untreated. Many cases respond well to treatment.

Possible Complications

See the specific types of acidosis.

When to Contact a Medical Professional

Although there are several types of acidosis, all will cause symptoms that require treatment by your health care provider.

Prevention

Prevention depends on the cause of the acidosis. Normally, people with healthy kidneys and lungs do not experience significant acidosis.

References

Seifter JL. Acid-base disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 119.

Achondroplasia

noreply@blogger.com (Unknown) — Thu, 19 Apr 2012 10:18:00 +0000

Definition

Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism.
Causes Achondroplasia is one of a group of disorders called chondrodystrophies or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from one parent, the child will have the disorder. If one parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that two parents without achondroplasia may give birth to a baby with the condition.

Symptoms

The typical appearance of achondroplastic dwarfism can be seen at birth.

Symptoms may include:
Abnormal hand appearance with persistent space between the long and ring fingers
Bowed legs
Decreased muscle tone
Disproportionately large head-to-body size difference
Prominent forehead (frontal bossing)
Shortened arms and legs (especially the upper arm and thigh)
Short stature (significantly below the average height for a person of the same age and sex)
Spinal stenosis
Spine curvatures called kyphosis and lordosis

Exams and Tests

During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus ("water on the brain"). X-rays of the long bones can reveal achondroplasia in the newborn.
Treatment
There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems.

Outlook (Prognosis)

People with achondroplasia seldom reach 5 feet in height. Intelligence is in the normal range. Infants who receives the abnormal gene from both parents do not often live beyond a few months.

Possible Complications

Clubbed feet
Fluid buildup in the brain (hydrocephalus)

When to Contact a Medical Professional

If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider.

Prevention

Genetic counseling may be helpful for prospective parents when one or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible.

Achondrogenesis

noreply@blogger.com (Unknown) — Sat, 16 Apr 2011 06:16:00 +0000

Definition

Achondrogenesis is a rare type of growth hormone deficiency in which there is a defect in the development of bone and cartilage.

Causes, Incidence, and Risk factors

Achondrogenesis is inherited, which means it is passed down through families.

Some types are known to be recessive, meaning both parents carry the defective gene and the chance for a subsequent child to be affected is about 25%.

Symptoms

Very short trunk, arms, legs and neck
Head appears large in relation to the trunk
Small lower jaw
Narrow chest

Signs and tests

X-rays show bone problems associated with the condition.

Treatment

There is no current therapy. Talk to your doctor about care decisions.

Genetic counseling may be appropriate.

Expectations (prognosis)

The outcome is generally very poor. Many infants with achondrogenesis are stillborn or die shortly after birth because of breathing problems related to the abnormally small chest.

Complications

This condition is often fatal early in life.

Acetone Poisoning

noreply@blogger.com (Unknown) — Fri, 08 Apr 2011 14:27:00 +0000

Definition

Acetone is a chemical used in many household products. This article discusses poisoning from swallowing acetone-based products.

Alternative Names

Dimethyl formaldehyde poisoning; Dimethyl ketone poisoning; Nail polish remover poisoning

Poisonous Ingredient

Acetone; Dimethyl formaldehyde; Dimethyl ketone

Where Found

Fingernail polish remover
Some cleaning solutions
Some glues, including rubber cement
Some lacquers

Note: This list may not be all inclusive.

Symptoms

Cardiovascular system

Low blood pressure

Gastrointestinal system

Nausea
Pain in belly area (abdomen)
Person may have a fruity odor
Sweet taste in mouth
Vomiting

Nervous system

Acting as if drunk
Coma
Drowsiness
Stupor

Respiratory system

Difficulty breathing
Slowed breathing rate
Shortness of breath

Urinary system

Increased need to urinate

Home Treatment

Seek immediate medical help. Do NOT make a person throw up unless told to do so by poison control or a health care professional.
Before Calling Emergency

Determine the following information:

The patient's age, weight, and condition
The name of the product (ingredients and strengths if known)
The time it was swallowed
The amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) (911)can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:

Activated charcoal if the patient arrives immediately after swallowing the poison
Tube through the nose into the stomach to empty the stomach (gastric lavage)
Oxygen, if needed

Expectations (prognosis)

Accidentally drinking small amounts of acetone/nail polish remover is unlikely to harm you as an adult. However even small amounts can be dangerous to your child, so it is important to keep this and all household chemicals in a safe place.

If the person survives past 48 hours, the chances for recovery are good.

Acetaminophen Overdose

noreply@blogger.com (Unknown) — Thu, 07 Apr 2011 13:54:00 +0000

Definition

Acetaminophen overdose is one of the most common poisonings worldwide. People often think that acetaminophen, a pain-relieving medicine, is extremely safe. However, it may be deadly if taken in large doses.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911).

Alternative Names

Tylenol overdose; Paracetamol overdose

Where Found

Acetaminophen is found in a variety of over-the-counter and prescription pain relievers.

Tylenol is a brand name for acetominophen. Other medicines that contain acetominophen include:

Anacin-3
Liquiprin
Panadol
Percocet
Tempra
Various cold and flu medicines

Note: This list is not all inclusive.

Common dosage forms and strengths:

Suppository: 120 mg*, 125 mg, 325 mg, 650 mg
Chewable tablets: 80 mg
Junior tablets: 160 mg
Regular strength: 325 mg
Extra strength: 500 mg
Liquid: 160 mg/teaspoon
Drops: 100 mg/mL, 120 mg/2.5 mL

*mg = milligrams

You should not take more than 4000 mg of acetaminophen a day. Taking more, especially 7000 mg or more, can lead to a severe overdose if not treated.

Symptoms

Abdominal pain
Appetite loss
Coma
Convulsions
Diarrhea
Irritability
Jaundice
Nausea
Sweating
Upset stomach
Vomiting

Note: Symptoms may not occur until 12 or more hours after the acetaminophen was swallowed

Home Treatment

There is no home treatment. Seek immediate medical help.
Before Calling Emergency

Determine the following information:

Patient's age, weight, and condition
Name of the product (ingredients and strengths, if known)
Time it was swallowed
Amount swallowed

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood tests will be done to check how much acetaminophen is in the blood. The patient may receive:

Medicines to treat symptoms
Activated charcoal
Laxative
Medicine (antidote) to reverse the effect of the poison

Expectations (prognosis)

If treatment is received within 8 hours of the overdose, there is a very good chance of recovery.

However, without rapid treatment, a very large overdose of acetaminophen can lead to liver failure and death in a few days.

Acetaminophen and Codeine Overdose

noreply@blogger.com (Unknown) — Wed, 06 Apr 2011 11:52:00 +0000

Definition

Acetaminophen (Tylenol) and codeine is a prescription pain medicine. It is a narcotic, which means it has the potential to relieve pain while making you feel sleepy.

Acetaminophen and codeine overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

See also:

Acetaminophen overdose
Codeine overdose
Hydrocodone and acetaminophen overdose

Alternative Names

Tylenol #3 overdose; Phenaphen with codeine overdose; Tylenol with codeine overdose

Poisonous Ingredient

Acetaminophen combined with codeine

Where Found

Acetaminophen with codeine is commonly sold under the name Tylenol #3.

Symptoms

Airways and lungs
Breathing shallow
Breathing slow and labored
Respiratory arrest

Eyes, ears, nose, and throat

Pinpoint pupils

Heart and blood vessels

Low blood pressure

Nervous system

Coma
Convulsions
Drowsiness
Stupor (lack of alertness)

Skin

Bluish skin (fingernails and lips)
Cold, clammy skin
Heavy sweating

Stomach and gastrointestinal system

Nausea and vomiting
Spasms of the stomach and intestines
Vomiting
Liver failure

Urinary system

Kidney failure

Home Treatment

Seek immediate medical help. This type of overdose can cause death. Do NOT make the person throw up unless told to do so by Poison Control or a health care professional.
Before Calling Emergency

Determine the following information:

Patient's age, weight, and condition
Name of the product (as well as the ingredients and strength, if known)
Time it was swallowed
Amount swallowed
If the medication was prescribed for the patient

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may be admitted to the hospital and may receive:

Activated charcoal
Breathing support (artificial respiration)
Fluids by IV
Medicine (antidote) called naloxone to reverse the effect of the poison (multiple doses may be needed)
Tube through the mouth into the stomach to empty the stomach (gastric lavage)

If there is a high level of acetaminophen in the blood, the patient will be given N-acetyl cysteine. Without this counteracting drug, called an antidote, deadly liver failure may occur.

Expectations (prognosis)

How well a patient does depends on the amount of medication swallowed and how quickly treatment was received. The faster a patient gets medical help, the better the chance for recovery.

If an antidote can be given, recovery from an acute overdose often occurs within 24 - 48 hours. Recovery takes longer if the liver is affected.

Acanthosis Nigricans

noreply@blogger.com (Unknown) — Mon, 04 Apr 2011 09:47:00 +0000

Definition

Acanthosis nigricans is a skin disorder characterized by dark, thick, velvety skin in body folds and creases.

Causes, Incidence, and Risk factors

Acanthosis nigricans can affect otherwise healthy people, or it can be associated with medical problems. Some cases are genetically inherited. It is most common among people of African descent.

Obesity can lead to acanthosis nigricans, as can many endocrine disorders. It is frequently found in people with diabetes.

Some drugs, particularly hormones such as human growth hormone or oral contraceptives ("the pill"), can also cause acanthosis nigricans.

People with lymphoma or cancers of the gastrointestinal or genitourinary tracts can also develop severe cases of acanthosis nigricans.

Symptoms

Acanthosis nigricans usually appears slowly and doesn't cause any symptoms other than skin changes.

Eventually, dark, velvety skin with very visible markings and creases appears in the armpits, groin, and neck. Sometimes, the lips, palms, soles of feet, or other areas may be affected.

Signs and Tests

Your physician can usually diagnose acanthosis nigricans by simply looking at your skin. A skin biopsy may be needed in unusual cases.

If no clear cause of acanthosis nigricans is obvious, it may be necessary to search for one. Your physician may order blood tests, an endoscopy, or x-rays to eliminate the possibility of diabetes or cancer as the cause.

Treatment

Because acanthosis nigricans itself usually only causes changes to the appearance of the skin, no particular treatment is needed.

It is important, however, to attempt to treat any underlying medical problem that may be causing these skin changes.

Expectations (prognosis)

Acanthosis nigricans often fades if the cause can be found and treated.

Abdominal Aortic Aneurysm

noreply@blogger.com (Unknown) — Fri, 01 Apr 2011 15:14:00 +0000

Definition

An abdominal aortic aneurysm is when the large blood vessel that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward.

Alternative Names

Aneurysm - aortic; AAA

Causes, Incidence, and Risk factors

The exact cause is unknown, but risk factors for developing an aortic aneurysm include:

Smoking
High blood pressure
High cholesterol
Male gender
Emphysema
Genetic factors
Obesity

An abdominal aortic aneurysm can develop in anyone, but is most often seen in males over 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to rupture and break open.

Symptoms

Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.

The symptoms of rupture include:

Pain in the abdomen or back -- severe, sudden, persistent, or constant. The pain may radiate to the groin, buttocks, or legs.
Clammy skin
Nausea and vomiting
Rapid heart rate
Shock

Signs and tests

Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and sensation in your legs. The doctor may find:

Abdominal mass
Stiff or rigid abdomen
Pulsating sensation in the abdomen

You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your doctor may have found out about this problem from special tests called ultrasound of the abdomen or CT scan of the abdomen.

Either of these tests may be done when you're having symptoms.

Treatment

If you have bleeding inside your body from an aortic aneurysm, you will have open abdominal aortic aneurysm repair.

If the aneurysm is small and there are no symptoms:

You and your doctor must decide whether the risk of having surgery is smaller than the risk of bleeding if you do not have surgery.
Your doctor may recommend checking the size of the aneurysm with a yearly ultrasound test, to see if the aneurysm is getting bigger.

Surgery is usually recommended for patients who have aneurysms bigger than 2 inches or 5.5 cm across and aneurysms that are growing quickly. The goal is to perform surgery before complications or symptoms develop.

There are two approaches to surgery:

In a traditional (open) repair, a large cut is made in your abdomen. The abnormal vessel is replaced with a graft made of man-made material, such as Dacron.
The other approach is called endovascular stent grafting. This procedure can be done without making a large cut in your abdomen, so you may get well faster. Endovascular repair is rarely done for a leaking or bleeding aneurysm.

Expectations (prognosis)

The outcome is usually good if an experienced surgeon repairs the aneurysm before it ruptures. However, less than 40% of patients survive a ruptured abdominal aneurysm.
Complications

When an abdominal aortic aneurysm ruptures, it is a true medical emergency. Aortic dissection occurs when the innermost lining of the artery tears and blood leaks into the wall of the artery. This most commonly occurs in the aorta within the chest.

Complications include:

Arterial embolism
Heart attack
Hypovolemic shock
Kidney failure
Stroke

Prevention

To reduce the risk of developing aneurysms:

Eat a heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again.
Your health care provider may give you medicine to help lower your cholesterol.
If you were given medicines for blood pressure or diabetes, take them as your doctor has asked you to.

Men over age 65 who have ever smoked should have a screening ultrasound performed once.

Aarskog Syndrome

noreply@blogger.com (Unknown) — Thu, 31 Mar 2011 08:24:00 +0000

Definition

Aarskog syndrome is an inherited disease that affects a person's height, muscles, skeleton, genitals, and appearance of the face. Inherited means that it is passed down through families.

Alternative Names

Facial-digital-genital syndrome

Causes, incidence, and risk factors

Aarskog syndrome is a genetic disorder that is linked to the X chromosome. It affects mainly males, but females may have a milder form. The condition is caused by changes (mutations) in a gene called "faciogenital dysplasia" (FGDY1).

Symptoms

Belly button that sticks out
Bulge in the groin or scrotum (inguinal hernia)
Delayed sexual maturation
Delayed teeth
Downward palpebral slant to eyes
Hairline with a "widow's peak"
Mildly sunken chest (pectus excavatum)
Mild to moderate mental problems
Mild to moderate short stature (which may not be obvious until the child is 1 - 3 years old)
Poorly developed midportion of the face
Rounded face
"Shawl" scrotum, testicles that have not come down (undescended)
Short fingers and toes with mild webbing
Single crease in palm of hand
Small, broad hands and feet with short fingers and curved-in fifth finger
Small nose with nostrils tipped forwardTop portion of the ear folded over slightly
Wide groove above the upper lip, crease below the lower lip
Wide-set eyes with droopy eyelids

Signs and tests

Genetic testing for mutations in the FGDY1 gene
X-rays

Treatment

Moving the teeth (orthodontic treatment) may be done for some of the abnormal facial features.

Expectations (prognosis)

Some people may have mild degrees of mental slowness, but affected children usually have good social skills. Some males may have problems with fertility.

Complications

Cystic changes in the brain
Difficulty growing in the first year of life
Poorly aligned teeth
Seizures
Undescended testicle

Prevention

Prenatal testing may be available for persons with a family history of the condition or a known mutation of the gene.

Aase Syndrome

noreply@blogger.com (Unknown) — Wed, 30 Mar 2011 05:37:00 +0000

Definition

Aase syndrome is a rare disorder that involves anemia and certain joint and skeletal deformities.

Alternative Names

Aase-Smith syndrome; Hypoplastic anemia/Triphalangeal thumb syndrome

Causes, Incidence, and Risk factors

Most cases of Aase syndrome occur without a known reason and are not passed down through families (inherited). However, some cases have been shown to be inherited.

The anemia in Aase syndrome is caused by poor development of the bone marrow, which is where blood cells are formed.

Symptoms

Absent or small knuckles
Cleft palate
Decreased skin creases at finger joints
Deformed ears
Droopy eyelids
Inability to fully extend the joints from birth (contracture deformity)
Narrow shoulders
Pale skin
Triple-jointed thumbs

Signs and tests

Signs may include:

Delayed closure of soft spots (fontanelles)
Mildly slowed growth

Tests that may be done include:

Bone marrow biopsy
Complete blood count (CBC)
Echocardiogram
X-rays

Treatment

Blood transfusions are given in the first year of life to treat anemia. Prednisone has also been used to treat anemia associated with Aase syndrome. However, it should only be used after reviewing the benefits and risks with a doctor who has experience treating anemias.

A bone marrow transplant may be necessary if other treatment fails.
Expectations (prognosis)

The anemia tends to improve with age.

Complications

Complications related to anemia include:

Fatigue
Decreased oxygen in the blood
Weakness

Heart problems can lead to a variety of complications, depending on the specific defect.

Severe cases of Aase syndrome have been associated with stillbirth or early death.

Calling your health care provider

Call your health care provider if you notice possible signs of Aase syndrome in your child. Genetic counseling is recommended if you have a family history of Aase syndrome. Genetic counseling can help families understand issues such as how the disease is inherited, and the care, treatment, and possible outcome of the patient.

Prevention

There is no known prevention.With prompt recognition and treatment of infections in childhood, the complications of low white blood cell counts may be limited.

Astrocytoma - Brain Tumor

noreply@blogger.com (Unknown) — Sat, 05 Dec 2009 04:34:00 +0000

Astrocytoma is a malignant, or cancerous, type of brain tumor. This type of tumor arises from small, star-shaped cells in the brain called astrocytes. Astrocytes are one of several types of supporting cells in the brain called glial cells. Therefore, an astrocytoma is sometimes called a glioma.

Astrocytoma is the most common form of glioma, and may occur anywhere in the brain. However, it is most commonly found in the cerebrum in adults, and in the cerebellum in children.

When an astrocytoma is diagnosed, the most important factors are:

Type of tumor
Size
Location
Degree of neurological side effects produced by the tumor
Age of the patient

These factors will determine the symptoms, prognosis, and treatment.

Causes

The exact cause of astrocytoma is unknown. Some possible causes of brain tumors include:

Heredity
Certain occupations (see Risk Factors below)
Environmental factors
Viruses

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. Although the exact risk factors for astrocytomas have not been identified, some studies implicate the following:

Genetic disorders
Occupational exposure to:Radiation

Chemicals
Oil refining
Rubber manufacturing

History of neurofibromatosis or tuberous sclerosis

Symptoms

The first symptoms of astrocytoma, or any brain tumor, are caused by increased pressure in the brain as the tumor grows. Symptoms may include:

Headaches
Visual changes
Vomiting
Seizures
Personality changes
Dementia, or problems with memory, thinking, and concentration
Problems with walking

Subsequent symptoms will vary, depending on the location of the astrocytoma. For example:

Frontal lobe – gradual changes in mood and personality; paralysis on one side of the body.
Temporal lobe – problems with coordination, speech, and memory.
Parietal lobe – problems with sensation, writing, or fine motor skills.
Cerebellum – problems with coordination and balance.
Occipital lobe – problems with vision, visual hallucinations

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

MRI Scan – a test that uses magnetic waves to define the anatomy of the brain; his is the most sensitive and clearest way to define a brain tumor
CT Scan – a common x-ray device that takes circular pictures of the brain using x-ray beams
Angiogram – x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries that lead to the brain
Biopsy – removal of a sample of brain tissue to test for cancer cells

Grading

Once the test results are confirmed, your doctor will determine the grade of the tumor. Tumors are graded from I to IV. These grades indicate the prognosis and rate of tumor growth.

Grades I and II – low-grade astrocytomas. These grow slowly and generally stay localized in an area of the brain. They are the primary type found in children.
Grades III and IV – high-grade tumors. They grow rapidly and can spread throughout the brain and spinal cord. Aggressive treatment will be necessary. This is the most common type of astrocytoma found in adults. Grade III tumors are called anaplastic astrocytoma. Grade IV tumors are called glioblastoma multiforme.

Treatment

Treatment is based on the location, size, and grade of the tumor. Treatment may include:

Surgery – surgical removal of the tumor and possibly nearby tissues. If the tumor is high grade, surgery should be followed by radiation or chemotherapy to help prevent further spread.

Radiation Therapy (or Radiotherapy) – the use of radiation to kill cancer cells or shrink the tumor. Radiation may be:

External Radiation Therapy – radiation directed at the tumor from a source outside the body

Internal Radiation Therapy – radioactive materials placed into the body near the cancer cells

Glucocorticoid Medication – cortisone drugs, such as dexamethasone, given to decrease swelling in the brain.

Chemotherapy – the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, or by catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

Prevention

There are no guidelines for preventing astrocytoma because the exact cause is not known. It has been suggested that the electromagnetic waves emitted from high-tension wires or even cellular phone may increase the risk of developing brain tumors, but, to date, there is not scientific evidence supporting this theory.

Acute Myelogenous Leukemia

noreply@blogger.com (Unknown) — Thu, 03 Dec 2009 15:08:00 +0000

Definition

Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow. With AML, the bone marrow makes abnormal blood cells including:

Myeloblasts—a type of white blood cell, fight infection
Red blood cells (RBCs)—carry oxygen
Platelets—makes blood clot, stops bleeding in cuts or bruises

AML begins in immature myeloblasts and progresses very quickly. It may also be the end state of chronic myelogenous leukemia (CML). AML may occur in either children or adults.

Cancer occurs when cells in the body become abnormal. They divide without control or order. Leukemia is cancer of the white blood cells and their parent cells. Leukemia cells do not function normally. They cannot do what normal blood cells do. In this case they can not fight infections. This means that the person is more likely to become infected with viruses or bacteria. The cancerous cells also overgrow the bone marrow. This forces other normal components, like platelets out. Platelets are needed to help the blood clot. As a results people with leukemia may bleed more easily.

Causes

The cause of AML is unknown. However, smoking after age 60 doubles the risk of this condition.

Risk Factors

The following factors increase your chance of developing AML:

Sex: male
Smoking, especially after age 60
Previous chemotherapy or radiation therapy treatment
Previous treatment for childhood acute lymphoblastic leukemia (ALL) , Hodgkin’s disease , non-Hodgkin’s lymphoma , and certain other cancers
Exposure to atomic bomb radiation or nuclear reactor accident
Exposure to the chemical benzene
History of a blood disorder, such as myelodysplastic syndrome (precancerous changes in the white cells and precursor cells of the bone marrow)

The following risk factors are specific to childhood AML:

Having a brother or sister with leukemia
Race: Hispanic
Exposure to cigarette smoke or alcohol before birth
History of myelodysplastic syndrome or aplastic anemia
Previous chemotherapy or radiation therapy treatment
Exposure to ionizing radiation
Exposure to chemicals such as benzene
Certain genetic disorders, such as Down’s syndrome

Symptoms

These may also be caused by other, less serious health conditions. See a doctor if you have any of the following:

Fever
Shortness of breath
Paleness (a sign of anemia )
Easy bruising or bleeding
Petechiae (flat, pinpoint spots under the skin caused by bleeding)
Weakness
Tiredness
Loss of appetite
Weight loss
Bone pain
Joint pain
Enlargement of the liver and spleen
Swelling, pain, and bleeding of the gums
Painless lumps in the neck, underarms, stomach, or groin

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Swelling of the liver; spleen will be looked for. The doctor will also look for swelling in lymph nodes in the armpits, groin, or neck. You will likely be referred to an oncologist. This is a doctor who focuses on treating cancer.

Tests may include the following:

Blood tests—to check for changes in the number or appearance of different types of blood cells
Bone marrow aspiration—removal of a sample of liquid bone marrow to test for cancer cells
Bone marrow biopsy —removal of a sample of liquid bone marrow and a small piece of bone to test for cancer cells
Spinal tap —removal of a small amount of cerebrospinal fluid to check for cancer cells
Routine microscopic exam—examination of a sample of blood, bone marrow, lymph node tissue, or cerebrospinal fluid
Bone, blood marrow, lymph node tissue, or cerebrospinal fluid tests—to distinguish between types of leukemia
Cytogenetic analysis—a test to look for certain changes of the chromosomes (genetic material) of the lymphocytes
Immunophenotyping—examination of the proteins on cell surfaces and the antibodies produced by the body; to distinguish lymphoblastic from myeloid leukemia and determine types of therapy
Chest x-ray —x-rays of the chest that may detect signs of lung infection or cancer in the chest
CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
Gallium scan and bone scan—injection of a radioactive chemical into the bloodstream to detect areas of cancer or infection
Ultrasound —a test that uses sound waves to examine masses and organs inside the body

Once AML is identified, it can be classified as one of eight subtypes. These are based on the type of cell from which leukemia developed. Classification is important. It can help make a prognosis and design a treatment plan.

Treatment

Talk with your doctor about the best plan for you. Treatment of AML usually involves two phases:

Remission induction therapy—to kill leukemia cells
Maintenance therapy—to kill any remaining leukemia cells that could grow and cause a relapse

Treatment options include:

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms. This includes pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body. While this will focus on cancer cells, some healthy cells are also killed.

Some AML may spread to the brain and spinal cord. In this case, intrathecal chemotherapy may be used. Chemotherapy drugs are placed directly into the spinal column.

Radiation Therapy

Radiation therapy involves the use of radiation to kill cancer cells and shrink tumors. For AML, external radiation therapy is used.

The radiation is directed at the tumor from outside the body. This type of treatment is used for AML that has spread, or may spread, to the brain and spinal cord. It can also be used to treat bone pain that comes from bone affected by the leukemia.

Chemotherapy With Stem Cell Transplant

Chemotherapy is followed by a transplantation of stem cells (immature blood cells). These will replace blood-forming cells destroyed by cancer treatment. Stem cells are removed from the blood or bone marrow of the patient or donor. They are then infused into the patient.

Other Drug Therapy

These drugs may be used with certain types of leukemia. They can kill leukemia cells, stop them from dividing, or help them mature into white blood cells:

Arsenic trioxide
All-trans retinoic acid (ATRA)

A targeted therapy has been approved by FDA. It is approved for patients older then 60 years who relapsed after initial therapy. The CD33 receptor on leukemia cells is targeted with:

Gemtuzumab ozogamicin (Mylotarg)

Biologic Therapy

This is the use of medications or substances made by the body. The substance is used to increase or restore the body's natural defenses against cancer. This type of therapy is also called biological response modifier therapy. It is still being tested in clinical trials.

Treatment of Side Effects

Patients will suffer side effects not only from the leukemia, but from therapy. These include:

A reduction in red blood cells (anemia)
Reduced numbers of platelets that assist in blood clotting (thrombocytopenia)
Decreased numbers of the white blood cells that fight infection

Anemia may lead to fatigue. If severe enough, it can complicate respiratory or cardiac disease. Thrombocytopenia may lead to bleeding and bruising. Decreased numbers of white blood cells leave a patient more vulnerable to infection.

Your doctor may prescribe a number of different treatments to decrease these side effects. Drugs are available to increase production of normal blood cells. In addition, when your counts are particularly low, blood transfusions or changes in daily activities may be needed. These step will reduce the chance of fatigue, bleeding, or infection.

Prevention

Many people who develop AML have no risk factors. There is no way to prevent the condition in most people. However, 20% of cases are related to smoking tobacco. Not smoking is the best known way to prevent AML.

Acute Cystitis (Bladder Infection)

noreply@blogger.com (Unknown) — Thu, 03 Dec 2009 14:54:00 +0000

Definition

Cystitis is an infection of the bladder. The bladder is the part of the urinary tract that collects the urine from the kidneys.

Causes

The urinary tract normally contains no microorganisms. However, sometimes bacteria or yeast from the lower gastrointestinal tract or rectal area enter the urinary tract, usually through the urethra (tube that allows urine to pass out from the bladder). When bacteria or yeast cling to the urethra, they can multiply and infect the urethra. They can then travel up and infect the bladder.

Most cases of cystitis are caused by bacteria from the rectal area. In women, the rectum and urethra are fairly close to each other. This makes it relatively easy for bacteria to make their way into the urethra. Some women develop cystitis after a period of frequent sexual intercourse. This happens because bacteria enter the urethra during sex and cause infection.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: female
• Being sexually active
• Using a diaphragm for birth control
• Menopause
• Abnormalities of the urinary system, including vesicoureteral reflux or polycystic kidneys
• Paraplegia and other neurologic conditions
• Sickle-cell anemia
• History of kidney transplant
• Diabetes
• Kidney stones
• Enlarged prostate
• Weak immune system
• Bladder catheter in place, or recent instrumentation of the urinary system

Symptoms

The symptoms of cystitis vary from person to person and can range from mild to severe. They include:

• Frequent and urgent need to urinate
• Passing only small amounts of urine
• Pain in the abdomen or pelvic area, or in the low back
• Burning sensation during urination
• Leaking urine
• Increased need to get up at night to urinate
• Cloudy, bad-smelling urine
• Blood in the urine
• Low-grade fever

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. In addition, a sample of your urine will be tested for blood, pus, and bacteria. If bacteria are present in the urine, you will likely be diagnosed with cystitis.

Children and men who develop cystitis may require additional testing. The doctor will look to see if there are structural abnormalities of the urinary system that predispose them to infection.

Treatment

Cystitis is treated with antibiotic drugs. Antibiotics will be prescribed for at least 2 to 3 days and perhaps for as long as several weeks. The length of the treatment depends on the severity of the infection and on your personal history. You will probably start to feel better after a day or two. However, it is important that you complete the entire course of medication. Otherwise, the infection is likely to return. You may have your urine checked after you finish taking the antibiotic. This is to make sure that the infection is truly gone.

If you experience recurrent infections, your doctor may prescribe stronger antibiotics or have you take them for a longer period of time. He or she may also recommend that you take low-dose antibiotics as a preventive measure, either daily or after sexual intercourse. If you still experience recurrent infections, you may be referred to a specialist.

Pyridium is a medicine that decreases pain and bladder spasms. Taking pyridium will turn your urine and sometimes your sweat an orangish color.

Prevention

You can lessen your chance of having cystitis by preventing bacteria from entering the urinary tract. Here are some steps you can take:

• Drink plenty of liquids.
• Urinate when you have the urge and do not resist it.
• After sexual intercourse, empty your bladder and then drink a full glass of water.
• Wash genitals daily.
• Take showers instead of baths.
• If you're a woman, always wipe from the front to the back after having a bowel movement.
• Avoid using douches and feminine hygiene sprays.
• Drinking cranberry juice may help prevent and relieve cystitis.

Acromegaly:Definition,Causes,Symptoms,Diagnosis,Treatment

noreply@blogger.com (Unknown) — Wed, 02 Dec 2009 16:34:00 +0000

Definition

Acromegaly is a rare disorder of excessive bone and soft tissue growth due to elevated levels of growth hormone. In young children, prior to the completed fusion and growth of bones, excessive growth hormone can cause a similar condition called gigantism.

Causes

In most cases, acromegaly is caused by over-secretion of growth hormone (GH) produced by a benign tumor of the pituitary gland. The pituitary gland is a small gland located at the base of the brain that produces many hormones. In a small number of cases, tumors of other organs may be the source of excess GH.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. Some rare cases of acromegaly are hereditary. No other risk factors have been identified.

Symptoms

Symptoms usually develop very slowly over time. Acromegaly can cause serious complications and premature death if not treated.
In children, excess GH production causes elongation of the bones and associated soft tissue swelling. If not treated, children with this disorder can grow to a height of 7-8 feet.
Symptoms and complications in adults may include the following:

• Abnormally large growth and deformity of the:

Hands (rings no longer fit)
Feet (need a bigger size shoe)
Face (protrusion of brown and lower jaw)
Jaw (teeth do not line up correctly when the mouth is closed)
Lips
Tongue

• Carpal tunnel syndrome
• Skin changes, such as:

Thickened, oily, and sometimes darkened skin
Severe acne
Excessive sweating and offensive body order due to enlargement of the sweat glands

• Deepening voice due to enlarged sinuses, vocal cords, and soft tissues of the throat
• Fatigue and weakness
• Sleep apnea
• Arthritis and other joint problems
• Headaches and visual problems, due to a growing tumor at the base of the brain
• Hypothyroidism
• Enlargement of the liver, kidneys, spleen, heart, and/or other internal organs, which can lead to:

Diabetes
High blood pressure
Cardiovascular disease

• In women:

Irregular menstrual cycles
In some cases, galactorrhea (abnormal production of breast milk)

• In men:

In about 1/3 of cases, impotence

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. The symptoms of acromegaly develop slowly over a number of years. So it is often not diagnosed until years after its onset.
Blood tests will be done to measure the level of GH, related substances, and other pituitary hormones. A glucose challenge test may also be given to see if the GH level drops—it will not drop in cases of acromegaly. If these tests confirm acromegaly, the following may be done to locate the tumor that is causing the disorder:

• Head CT scan – a type of x-ray that uses a computer to make pictures of the inside of the brain and surrounding structures
• MRI scan – a test that uses magnet waves to make pictures of this inside of the body, in this case the head

Treatment

The goals of treatment are to:

• Reduce production of GH to normal levels
• Stop and reverse the symptoms caused by over-secretion of GH

Treatment may include:

Surgery – surgical removal of the pituitary tumor, or other tumor, that is believed to be causing acromegaly. In most cases, this is the preferred treatment.

Radiosurgery – the use of highly focused external beams of radiation to shrink the tumor. Used most often in patients who do not respond to conventional surgery or medications.

Medication – drugs may be given to reduce the level of GH secretion from the pituitary gland. These include:
• Cabergoline (Dostinex) – given orally
• Pergolide (Permax) – given orally
• Bromocriptine (Parlodel) – may be given before surgery to shrink tumor
• Octreotide (Sandostatin) – given by injections

Medications must often be combined with other therapies to treat larger tumors affecting surrounding structures.

Prevention

There are no guidelines for preventing acromegaly. Early diagnosis and treatment, however, will help prevent serious complications, some of which are irreversible.

Acoustic Neuroma (Neurolemmoma, Vestibular Schwannoma):Definition,Causes,Symptoms,Diagnosis,Treatment

noreply@blogger.com (Unknown) — Wed, 02 Dec 2009 16:26:00 +0000

Definition

An acoustic neuroma is a benign (non-cancerous) tumor on the eighth cranial nerve leading from the brainstem to the ear. This nerve is involved in hearing and maintaining equilibrium. Acoustic neuromas grow relatively slowly.

Causes

The exact cause of an acoustic neuroma is unknown.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

• Age: 30-60 (Average age of diagnosis is 50)
• History of the disease neurofibromatosis type 2 (for bilateral neuromas only, which are very rare)

Symptoms

The first symptoms of an acoustic neuroma include:

• Gradual hearing loss in one ear
• Decrease in sound discrimination, especially when talking on the telephone
• Ringing in the ears, called tinnitus

As the neuroma gradually enlarges, symptoms may include:

• Balance problems
• Facial numbness and tingling
• Weakness of the facial muscles

Finally, if headaches or mental confusion occurs, the tumor may be life threatening. A doctor should be contacted immediately.

Diagnosis

The doctor will ask about your symptoms and medical history, and examine your ears and nervous system. Tests may include:

• Audiogram – A test that measures hearing in both ears.
• Auditory Brainstem Response Test (ABR, BAER, or BSER) – A test that measures the rate of electric impulses traveling from the inner ear to the brainstem. A slowed or absent impulse may indicate the presence of an acoustic neuroma. This test is almost always abnormal in the presence of an acoustic neuroma.
• MRI Scan – A test that uses magnetic waves to make pictures of the inside of the body.
• CT Scan – A type of x-ray that uses a computer to make pictures of the inside of the body.

Treatment

Treatment depends on your age, general health, the size and location of the tumor, and its rate of growth. Treatment may include:

Observation – If the tumor is very small, your doctor may just monitor its growth. This is common among people over age 70.
Microsurgical Removal – As the tumor grows and/or hearing becomes impaired, removal of the tumor may be necessary. The surgical approach depends on the size and location of the tumor. Complications of surgery may include permanent hearing loss and/or paralysis of facial muscles on the affected side.
Radiation Therapy (or Radiotherapy) – The use of radiation to kill cells and shrink tumors. Radiation may be used when tumors are small and surgery is not possible. This method may preserve hearing.

Prevention

There are no guidelines for preventing the development of an acoustic neuroma because the cause is not usually known.

Acne:Definition,Causes,Symptoms,Diagnosis,Treatment

noreply@blogger.com (Unknown) — Wed, 02 Dec 2009 04:16:00 +0000

Definition

Acne is a condition in which the pores of the skin become clogged, inflamed, and sometimes infected. These clogged pores can result in blackheads, whiteheads, or pimples. Acne tends to occur in teenagers, but can also occur in adults.

Causes

Acne starts in the skin's sebaceous glands, which secrete an oily substance called "sebum." The sebum normally travels from the sebaceous gland to the skin's surface via a tiny hair follicle. But with acne, the sebum becomes trapped, sometimes mixing with dead skin cells and bacteria, causing a clogged pore called a "comedo" (plural: "comedones"). Blackheads are comedones that reach the skin's surface, while whiteheads are comedones that stay beneath the surface of the skin. Small red bumps, pimples, and cysts may also develop. Contrary to popular myths, chocolate and greasy foods have not been shown to cause acne.
The main causes of acne include:

Changes in levels of male hormones called androgens
Increased sebum production
Changes inside the hair follicle
Bacteria

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.
•Age: Between 12 and 24 years old
• Race: Caucasian
• Changes in hormone levels, such as during:

Puberty
Pregnancy
Before a menstrual period

• Stress
• Certain medications (such as androgens, lithium, and barbiturates)

Symptoms

The symptoms of acne vary from person to person and can range from mild to severe. They include:

• Excess oil in the skin
• Blackheads
• Whiteheads
• Papules - small pink bumps that may be tender to the touch
• Pimples - inflamed, pus-filled bumps that may be red at the base (also called "pustules")
• Nodules - large, painful, solid lumps that are lodged deep within the skin
• Cysts - deep, inflamed, pus-filled lumps that can cause pain and scarring

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will examine the areas of your skin with the most sebaceous glands, which is where acne is most likely to occur. These are the face, neck, back, chest, and shoulders. In some situations (usually only if your acne is severe), you may be referred to a doctor who specializes in skin disorders (a dermatologist).

Treatment

There are several over-the-counter and prescription medications for acne. Some are applied directly to the skin (topical medication), others are taken by mouth (oral medication), and others are injected into the acne cysts or pustules. Acne may require a combination of oral, topical, and surgical treatments (although, most acne does not require surgery). Some treatments may take several weeks to work, and your skin may actually appear to get worse before it gets better.

Over-the-counter Topical Medications

These include cleansers, creams, lotions, and gels aimed at reducing the amount of oil and/or bacteria in the pores. They may contain one or more of the following ingredients:
• Benzoyl peroxide
• Salicylic acid
• Sulfur
• Resorcinol

Prescription Topical Medication

These include cleansers, creams, lotions, and gels aimed at reducing the amount of oil and/or bacteria in the pores. They include:

• Benzoyl peroxide
• Sulfur
• Resorcinol
• Salicylic acid
• Antibiotics, such as clindamycin (Cleocin T), erythromycin, tetracycline
• Tretinoin (Retin-A, Avita)
• Adapalene (Differin)
• Azelaic acid (Azelex)
• Tazarotene (Tazorac)

Prescription Oral Medications

These include antibiotics, medications for hormone-related acne, and vitamin A derivatives called "retinoids." They are generally used for moderate to severe cases of acne.

Oral Antibiotics - aimed at controlling the amount of bacteria in pores. These drugs include:
• Erythromycin
• Tetracycline
• Doxycycline
• Minocycline
• Clindamycin
• Ampicillin
• Cephalosporins
• Trimethoprim-sulfamethoxazole

Oral Medications - aimed at controlling androgen levels. These drugs include:
• Birth control pills (in female patients)
• Prednisone
• Dexamethasone
• Spironolactone

Oral Retinoids - aimed at reducing the size and secretions of sebaceous glands. The main drug in this category is isotretinoin (Accutane). This is a potent drug used only for severe cases of cystic acne. It must not be taken by women who are pregnant or who may become pregnant, because of the risk of serious birth defects.

Intralesional Corticosteroids
The injection of a steroid preparation directly into the cyst. This treatment is mostly used for large, cystic acne lesions.

Acne Surgery
Specialized (comedo) extractors are used to open, drain, and remove the contents of acne lesions. Multiple lesions can be removed per session. May require repeated sessions. If you are considering this surgery, discuss the risks, such as scarring and infection, with your surgeon.

Acne Scar Revision
These are procedures done to minimize acne scars. Scar revision procedures include:

• Chemical peels – glycolic acid and other chemical agents are applied to loosen blackheads and decrease acne papules
• Dermabrasion – "sandpapers" the skin to smooth it out
• Scar excision – uses a tiny punch tool or a scalpel to remove scars
• Collagen fillers – fill the pits of scars with a collagen substance
• Laser resurfacing – a laser is used to remove scars and tighten underlying skin
If you are considering one of these treatments, discuss the risks, such as scarring and infection, with your doctor or surgeon.

Prevention

It can be difficult to prevent acne from occurring, because it can be difficult to control the factors that cause it. But there are some things you can do to keep your acne from getting worse:
• Gently wash your face with mild soap and warm water twice a day (no more than twice) to remove excess oil. Scrubbing or washing too often can make acne worse.
• When washing your face:

Use your hands rather than a washcloth.
Use mild soap rather than a harsh "acne cleanser."
Allow your face to thoroughly dry before applying any topical preparations.

• Don't pick at or squeeze blemishes.
• Use lotions, soaps, and cosmetics labeled "noncomedogenic." These won't clog your pores.
• Use topical acne treatments only as directed. Using them more often could make your condition worse.
• Recognize and limit emotional stress.
• Wear sunscreen year-round. This is especially important if you are using medications. Medications can make your skin more sensitive to the sun.

Anterior Cruciate Ligament (ACL) Injury :Causes, Symptoms, Diagnosis, Treatment, Prevention

noreply@blogger.com (Unknown) — Wed, 02 Dec 2009 03:54:00 +0000

Definition

An anterior cruciate ligament (ACL) injury is a tear in the ACL ligament. The ACL is located in the middle of the knee joint and connects the lower leg bone to the thigh bone and prevents the leg bone from sliding too far forward at the knee, which would cause instability.

Causes

Most ACL tears occur during non-contact injuries, such as:

• Planting the foot and cutting
• Pivoting
• Landing on a straight leg
• Making a sudden stop

The ACL can also be injured from a direct blow to the knee.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: Female
• Muscle imbalance between the quadriceps and hamstrings (weaker hamstrings)
• Weak quadriceps and hamstrings
• Playing sports that require sudden changes of direction and deceleration
• Incorrect technique for cutting, planting, pivoting or jumping

Symptoms

When the ACL tears, you may hear a popping sound. When you stand, the knee will probably give-way immediately, and it will be difficult to walk on the affected leg. There is usually moderate pain and swelling of the knee joint, although in the first several hours, this may be minor. It will, however, worsen over the first two days, and then begin to subside.

Diagnosis

The doctor will ask about your symptoms and how you injured your knee, and perform a physical exam.
Tests may include:

MRI scan - a test that uses magnetic waves to show the structures inside the knee joint

Arthroscopy - a thin, lighted tube inserted through a small incision in the knee to look at the structures inside the knee

Treatment

Treatments include:

Knee brace
You may need to wear a knee brace while recovering from your knee injury, as well as when you return to your sport. This may be needed regardless of whether or not you have surgery to reconstruct the ligament.

Surgery
Surgery may be needed to fully restore function of the knee, particularly in younger and athletic people. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and associated factors.

Physical therapy

Range of motion exercises- The therapist will assist you with moving your knee through its full range of motion. Stretching is a part of this treatment.
Strengthening exercises - Due to its lack of use, the affected leg muscles will atrophy (shrink) and lose strength. Therapy will help you regain strength in the thigh muscles, especially the quadriceps and hamstrings.

Prevention

Because ACL tears most often occur due to non-contact injuries, precautions can be taken to prevent them.

• When jumping and landing, or turning and pivoting, your hips and knees should be bent, not straight.
• Incorporate adequate warm-up exercises to prepare the knee for your sport.
• Plyometrics, a form of jumping exercises, can be used to train and strengthen the leg muscles for jumping and landing. However, this should only be done under professional supervision if your doctor has determined it is right for you.
• Strengthen both the quadriceps and the hamstrings.
• Keep the quadriceps and hamstrings flexible by stretching regularly.

Achondroplasia : Causes, Symptoms, Diagnosis, Treatment, Prevention

noreply@blogger.com (Unknown) — Tue, 01 Dec 2009 04:45:00 +0000

Definition

Achondroplasia is a genetic disorder that causes dwarfism (short stature). It is a disorder in which bone and cartilage do not grow normally. It is the most common cause of dwarfism.

This condition leads to patients attaining a full-grown height of less than four feet. The greatest shortening occurs in the humerus (the bone between the shoulder and the elbow) and the femur (the bone between the hip and the knee). There may also be underdevelopment of the face.

Achondroplasia is the most common form of inherited disproportionate short stature. It occurs in one in 15,000 to one in 40,000 live births.

Causes

Achondroplasia is a genetic disorder. It is caused by mutations in the FGFR3 gene that inhibits growth of cartilage at the growth plate. The result is that the growth of bones, which normally occurs in the cartilage of the growth plate, is slowed. This leads to shorter bones, abnormally shaped bones, and shorter stature.

The gene for achondroplasia can be passed from one generation to the next. If a parent has the disorder there is a 50% chance of passing the gene for achondroplasia on to offspring (Autosomal Dominant Inheritance). In most cases of achondroplasia (80-90%), it more commonly is the result of a spontaneous mutation (a sudden genetic defect) that occurs in the developing embryo.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. Those at risk of inheriting achondroplasia are:

• Children of a parent with achondroplasia

• Children of normal-sized parents who carry a mutated FGFR3 gene

• Advanced paternal age causing spontaneous mutations

Symptoms

Patients with achondroplasia have:

• Short stature, a long trunk, and shortened limbs, which are noticeable at birth

• Adults usually reach a height of between 42 and 56 inches

• The head is large and the forehead is prominent

• Portions of the face can be underdeveloped

• At birth, the legs appear straight, but as a child begins to walk, he or she develops a knock-knee or bowed-leg deformity

• The hands and the feet appear large, but the fingers and toes are short and stubby

• Straightening of the arm at the elbow may be restricted, but usually does not keep a patient with achondroplasia from doing any specific activities

• Children may develop an excessive curve of the lower back and a waddling walking pattern

Other common symptoms include:

• Weight control problems

• Bowed legs

• Middle ear infections, especially in children

If not treated properly, can result in hearing loss

• Dental problems (from overcrowding of teeth)

• Hydrocephalus (water on the brain)

• Neurologic and respiratory problems

• Spinal compression

• Fatigue, pain, and numbness in the:

Lower back
Spine

People with achondroplasia are generally of normal intelligence. Other than short stature, their overall development is usually normal. However, children often take longer to develop normal motor skills.

Diagnosis

Diagnosis includes:

• Clinical Evaluation

• Radiographs

• Molecular genetic testing can be used to detect a mutation in the FGFR3 gene (chromosomal locus 4p16.3). Such testing is 99% sensitive and is available in clinical laboratories. A doctor can usually diagnose the disorder in a newborn from observation of physical symptoms. To confirm that dwarfism is caused by achondroplasia, x-rays are taken.

It is important to follow a doctor to make sure that spinal stenosis does not develop. The physician evaluates the strength of the extremities and bladder control. Weakness and loss of bladder control are both signs of developing spinal stenosis.

Treatment

Unfortunately, there is no treatment that can cure this condition.

Surgery is sometimes needed to correct specific skeletal deformities. For example, in patients with severe knock-knee or bowed legs, the pediatric orthopedic surgeon can perform an osteotomy in which he or she cuts the bones of the leg and allows them to heal in a more correct anatomical position. For significant spinal kyphosis, a spinal fusion sometimes is performed (permanently connecting otherwise separate vertebrae).

The most serious complication of achondroplasia is the narrowing of the spinal canal called "spinal stenosis." The canal houses the spinal cord and such narrowing can lead to a compression of the cord and severe neurological problems. Surgical decompression of the cord is needed to relieve the pressure on it. This is done by opening the canal at the affected levels in a procedure called a "laminectomy."

The prognosis depends on the severity of the disease. Patients who have two copies of the deficient gene (i.e. one from each parent, also known as "homozygous") generally die a few weeks to months after birth. Those with one copy (i.e. from only one parent, also known as "heterozygous") have a normal life span and intelligence. They are usually independent in their daily life activities. Many of these patients, in fact, have gone on to do great things in life.

Achilles Tendinitis : Causes, Symptoms, Diagnosis, Treatment, Prevention

noreply@blogger.com (Unknown) — Tue, 01 Dec 2009 04:28:00 +0000

Definition

Achilles tendinitis is an inflammation and/or degeneration of the Achilles tendon. The Achilles tendon connects the calf muscles to the heel bone.

Causes

The Achilles tendon can become irritated for several reasons including:

• Increasing your speed or running long distances too quickly
• Suddenly adding strenuous hills or stair climbing to your exercise routine
• Doing too much too soon after taking time away from exercising
• A sudden or violent contraction of the calf muscles, such as during an all-out sprint
• Running too much—overuse
• Lack of flexibility of the calf muscles

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Improper or badly worn footwear
• Improper warm-up for your activity
• Inflexibility of the calf muscles
• Improper cool-down
• An improper training program

Symptoms

Symptoms may include:

• Tenderness usually located one to two inches above the point where the Achilles tendon attaches to the heel bone (noticeable in the morning upon rising)
• Stiffness that gradually eases as the tendon is warmed-up
• Pain after activity that gradually worsens
• Radiating or localized pain along the tendon during and/or after running
• Swelling in the area of the Achilles

Diagnosis

The doctor will ask about your symptoms and exercise habits, and perform a physical exam.
Tests may include:

• X-rays to see if there is calcium in the tendon
• MRI scan to view areas of interior damage to the tendon

Treatment

Rest
Take a break from the activity that caused the tendinitis. Switch to an activity, such as swimming, that doesn't put stress on the tendon.

Orthoses

You may be advised to wear a shoe insert that will place your foot in the correct position for walking and running.

Physical therapy

• Stretching
• Massage
• Ultrasound
• Strengthening exercises

Medications

• Non-steroidal anti-inflammatory drugs (NSAIDS) to ease the pain and decrease inflammation. This is not curative and must be combined with other treatment.

Prevention

To decrease your chances of getting Achilles tendinitis:
• Take the time to warm-up and cool-down properly.
• Wear appropriate footwear for your sport.
• Do not use shoes beyond the recommended duration. This will depend on:

How frequently you exercise
The surface on which you exercise
The conditions in which you exercise

• Gradually add hill work, stairs, speed, and distance to your exercise routine.
• Stretch and strengthen the calf muscles regularly.

Achalasia : Causes, Symptoms, Diagnosis, Treatment, Prevention

noreply@blogger.com (Unknown) — Fri, 20 Nov 2009 18:15:00 +0000

Definition

Achalasia is a relatively rare disorder of the smooth muscle of the esophagus. The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach. Achalasia makes it difficult for food and liquid to pass into the stomach from the esophagus.

Causes

At the bottom of the esophagus where it meets the stomach is a muscle called the lower esophageal sphincter (LES). When not swallowing, the LES remains closed to keep food, liquid, and stomach acid from moving back into the esophageal tube. When swallowing, nerve signals tell muscles to contract to push food down the esophagus (an action called peristalsis), and allow the LES to open.

In people with achalasia, the nerve cells in the lower esophageal tube and the LES do not work correctly. This results in:

• Uncoordinated peristaltic (muscular) activity

• Failure of the LES to open completely

While achalasia is associated with the loss of nerve cells in the esophagus, the cause of this process is unknown.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. Because the exact cause of achalasia is unknown, risk factors are unknown.

Symptoms

Symptoms of achalasia can occur between the ages of 25 and 60. Symptoms rarely develop in children. Symptoms tend to be mild at first, and then grow worse over months or years. The main symptom is difficulty swallowing solids and, as the disorder progresses, liquids. As many as 70-97% of patients with achalasia have difficulty swallowing both solids and liquids.

Other symptoms may include:

• Discomfort or pain in the chest (under the breastbone, especially after meals)

• Coughing, especially when lying down

• Heartburn

• Weight loss (as the disorder progresses)

• Vomiting or regurgitating food or liquids; in some people this occurs during sleep. This can result in inhalation of food particles or liquid, which can lead to aspiration pneumonia and other respiratory infections.

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. Tests may include:

• Manometry – a tube is inserted down the throat to test the pressure in the esophagus and the stomach when swallowing

• Esophagography – x-rays are taken of the esophagus while you swallow barium (a thick liquid that lights up on x-rays)

Treatment

The goal of treatment is to make it easier for the LES to open. Treatment may include:

Pneumatic dilation – this treatment stretches the LES muscle. A thin tube is inserted into the throat. At the end of this tube is an un-inflated balloon. Once the tube reaches the point of the LES muscle, the balloon is inflated. Pneumatic dilation has a high success rate. It is the primary treatment in most patients, although the procedure may need to be repeated.

Botulinum toxin – tiny amounts of botulinum toxin, type A, are injected into the LES. Botulinum causes the LES to relax, which makes it easier to open. Since the effect is temporary, repeat injections are almost always needed, but the response decreases with successive injections.

Surgery – small incisions are made in the LES to help it to relax. This is called Heller cardiomyotomy surgery. This can usually be performed via laparoscopy, making it a relatively minor surgical procedure. Because the LES is partially cut, about 15% of patients experience gastroesophageal reflux symptoms (i.e., acid reflux) after this surgery.

Medication – in mild cases, certain medications may help relieve symptoms temporarily. Drugs that reduce LES pressure include:

• Nifedipine

• Nitroglycerin

Prevention

There are no guidelines for the prevention of achalasia because the cause is usually not known.

Tooth Abscess: Causes, Symptoms, Diagnosis, Treatment, Prevention

noreply@blogger.com (Unknown) — Fri, 20 Nov 2009 18:06:00 +0000

Definition

A tooth abscess is a sac of pus (infected material) in a tooth or the gums that results from bacterial infection. There are two types of tooth abscesses:

• Abscess of the pulp (inside) of the tooth
• Abscess between the tooth and gum

Causes

A tooth abscess begins when bacteria invades and infects a tooth, resulting in the build up of pus. When the pus is unable to drain, an abscess results.
Conditions that allow bacteria to invade a tooth include:

• Severe tooth decay
• Break or crack in a tooth that allows bacteria to invade the pulp of the tooth

Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in that location.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Build-up of tartar beneath the gum line
• Inadequate fluoride application to teeth, via fluoridated water, toothpaste, or mouthwash
• Poor dental hygiene leading to untreated caries and periodontal diseases
• Malnutrition, including severe vitamin and mineral deficiencies

Symptoms

Symptoms include:

• Throbbing/lingering pain in a tooth or gum area
• Pain when biting on a tooth
• Redness or swelling of the gums
• Swollen glands in the neck
• Discoloration of a tooth
• Bad breath or foul taste in mouth
• Open, draining sore on the gums

If left untreated, complications of tooth abscess can include:

• Loss of tooth
• Spread of infection to surrounding tissue or bone

Diagnosis

A dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.
The examination will include testing the tooth for pain and sensitivity by:

• Lightly tapping on the tooth
• Placing ice on the tooth
• Stimulating the tooth nerve with a low electrical current
• Sliding a probe between the tooth and gum

Your dentist will also take an x-ray of the tooth and surrounding bone.

Treatment

Treatment includes:

Removal of Abscess Via Root Canal

• If abscess results from tooth decay or a break or crack in the tooth:

The tooth is numbed and a hole is drilled through top of the tooth.
Pus and dead tissue are removed from the tooth.
The interior of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
A crown is placed on the tooth to protect it.

• If abscess results from infection between the tooth and gum:

The abscess is drained and thoroughly cleaned.
The surface of tooth is smoothed.
In some cases, surgery to reshape the gum is performed to prevent recurrence of infection.

Tooth Extraction (Removal)

• Removal of the tooth may be required if:

Tooth decay and/or tooth infection is too extensive for filling or root canal.
The break or crack in the tooth is too severe to be repaired.
The infection between the tooth and gum is extensive.

• If the tooth is extracted, it will be replaced with:

A partial bridge
A denture
A tooth implant

Medication

• Antibiotics to fight residual infection of the tooth or gums
• Non-prescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses

Prevention

Most tooth abscesses can be prevented with:

• Proper dental hygiene, including:

Brushing teeth with fluoride toothpaste after meals or at least twice per day
Daily flossing between teeth and gums
Regular dental check ups (every 6 months)
Regular professional teeth and gum cleaning (every 6 months)

• Limiting the amount of sugar you eat to prevent cavities

Aarskog-Scott Syndrome : Definition,Causes,Symptoms,Diagnosis,Treatment

noreply@blogger.com (Unknown) — Fri, 20 Nov 2009 17:55:00 +0000

Definition

Aarskog-Scott syndrome is an extremely rare genetic disorder. This syndrome causes changes in the size and shape of certain bones and cartilage in the body. The face, fingers, and toes are most often affected.

Causes

Aarskog-Scott syndrome is an inherited disorder. It is caused by a gene mutation that is passed from mothers to male children.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. This disorder mainly affects males. Those at risk of inheriting Aarskog-Scott syndrome are male children of:

• Parents with the disorder
• Mothers who do not have the disorder but who carry the gene for it

Symptoms

The main symptoms of Aarskog-Scott syndrome are:
• Disproportionately short stature
• Abnormalities of the head and face, including:

Rounded face
Wide-set eyes
Slightly slanted eyes
Drooping eyelids
Small nose
Front facing nostrils
Mid portion of the face is underdeveloped
Wide groove above the upper lip
Crease below the lower lip
Folding of the top portion of the ear
Delayed growth of the teeth
In some cases, cleft lip or palate

Other symptoms may include:

• A malformed scrotum
• Un-descended testicles
• Small, wide hands and feet
• Short fingers and toes
• In some cases, mild webbing of fingers and toes
• Abnormalities of the sternum
• Protruding navel
• Inguinal hernias
• Ligament problems, resulting in hyperextension of the knees
• Mild mental deficiencies (in about one-third of those affected)

Diagnosis

The doctor will ask about your symptoms and medical history and perform a physical exam. The diagnosis of Aarskog-Scott syndrome is usually based on facial characteristics. The diagnosis can be confirmed by x-rays of the face and skull.

Treatment

There is no known cure for Aarskog-Scott syndrome. Treatment is limited to surgical procedures to treat conditions caused by the disorder and supportive treatment. Orthodontic treatment is often needed as well.
Treatment may include:

Surgery

Conditions that may be treated with surgery include:

• Inguinal hernia
• Cleft lip or palate
• Un-descended testicles

Orthodontics

In some cases, orthodontic treatment may help certain facial and dental abnormalities caused by the disorder.

Supportive Treatment

Supportive treatment generally includes educational assistance to those afflicted with mental deficiencies. Parents often need advice and supportive treatment.

Prevention

There is no known way to prevent Aarskog-Scott syndrome. If you have Aarskog-Scott syndrome or have a family history of the disorder, you can talk with a genetic counselor when deciding to have children.