Health and Care

Floater/myodesopsia-A strange thing in your eye

noreply@blogger.com (Pixsimo) — Tue, 16 Aug 2011 10:30:00 +0000

Floaters are deposits of various size, shape, consistency, refractive index, and motility within the eye's vitreous humour, which is normally transparent. They may be of embryonic origin or acquired due to degenerative changes of the vitreous humour or retina.The perceptionof floaters is known as myodesopsia, or less commonly as myiodeopsia, myiodesopsia, or myodeopsia. Floaters are visible because of the shadows they cast on the retina^[ or their refraction of the light that passes through them, and can appear alone or together with several others in one's field of vision

. They may appear as spots, threads, or fragments of cobwebs, which float slowly before the observer's eyes.Since these objects exist within the eye itself, they are not optical illusions but are entoptic phenomena.

One specific type of floater is either called Muscae volitantes (from the Latin, meaning 'flying flies'), or mouches volantes (from the French), and consist of small spots. These are present in most people's eyes and are attributed to minute remnants of embryonic structures in the vitreous humour.

Description

Floaters are suspended in the vitreous humour, the thick fluid or gel that fills the eye. Thus, they generally follow the rapid motions of the eye, while drifting slowly within the fluid. When they are first noticed, the natural reaction is to attempt to look directly at them. However, attempting to shift one's gaze toward them can be difficult since floaters follow the motion of the eye, remaining to the side of the direction of gaze. Floaters are, in fact, visible only because they do not remain perfectly fixed within the eye. Although the blood vessels of the eye also obstruct light, they are invisible under normal circumstances because they are fixed in location relative to the retina, and the brain "tunes out" stabilized images due to neural adaptation. This stabilization is often interrupted by floaters, especially when they tend to remain visible.

Floaters are particularly noticeable when looking at a blank surface or an open monochromatic space, such as blue sky. Despite the name "floaters", many of these specks have a tendency to sink toward the bottom of the eyeball, in whichever way the eyeball is oriented; the supine position (looking up or lying back) tends to concentrate them near the fovea, which is the center of gaze, while the textureless and evenly lit sky forms an ideal background against which to view them. The brightness of the daytime sky also causes the eyes' pupils to contract, reducing the aperture, which makes floaters less blurry and easier to see.

Floaters are essentially changeless, and the most prominent continue to be seen in the field of vision for a lifetime. They are not uncommon, and do not cause serious problems for most people; they represent one of the most common presentations to hospital eye services. A survey of optometrists in 2002 suggested that an average of 14 patients per month per optometrist presented with symptoms of floaters in the UK. However, floaters are more than a nuisance and a distraction to those with severe cases, especially if the spots seem to constantly drift through the field of vision. The shapes are shadows projected onto the retina by tiny structures of protein or other cell debris discarded over the years and trapped in the vitreous humour. Floaters can even be seen when the eyes are closed on especially bright days, when sufficient light penetrates the eyelids to cast the shadows. It is not, however, only elderly people who are troubled by floaters; they can also become a problem to younger people, especially if they are myopic. They are also common after cataract operations or after trauma. In some cases, floaters are congenital.^[

Floaters are able to catch and refract light in ways that somewhat blur vision temporarily until the floater moves to a different area. Often they trick people who are troubled by floaters into thinking they see something out of the corner of their eye that really is not there. Most people come to terms with the problem, after a time, and learn to ignore their floaters. For people with severe floaters it is nearly impossible to completely ignore the large masses that constantly stay within almost direct view. Some people have noted that after a while they are able to concentrate much better while reading, watching television, walking outdoors, and driving, especially when tired.

Floaters have been reported in patients as young as 9. However, floaters in teenage patients and young adults are usually harder to treat. For people in this age group, the floater that is seen usually looks like a kind of crystal (translucent) worm/web/cell. These particular floaters aren't really floaters in a technical sense as they aren't found in the vitreous humour, instead they are found right on top of the retina in thePremacular Bursa. Very little is known about this region, and it only becomes distinct after the vitreous detaches from the retina at later stages of life. Due to their microscopic size they cannot be seen by professional doctors. They only appear as big as they do because of their proximity to the retina. These types of floaters are still described occasionally in the third decade and very rarely occur in the 40 or older population.

Causes

There are various causes for the appearance of floaters, of which the most common are described here. Simply stated, any damage to the eye that causes material to enter the vitreous humour can result in floaters.

Vitreous syneresis

The most common cause of floaters is shrinkage of the vitreous humour: this gel-like substance consists of 99% water and 1% solid elements. The solid portion consists of a network of collagen and hyaluronic acid, with the latter retaining water molecules. Depolymerization of this network makes the hyaluronic acid release its trapped water, thereby liquefying the gel. The collagen breaks down into fibrils, which ultimately are the floaters that plague the patient. Floaters caused in this way tend to be few in number and of a linear form.

Posterior vitreous detachments and retinal detachments

In time, the liquefied vitreous body loses support and its framework contracts. This leads to posterior vitreous detachment, in which the vitreous body is released from the sensory retina. During this detachment, the shrinking vitreous can stimulate the retina mechanically, causing the patient to see random flashes across the visual field, sometimes referred to as "flashers", a symptom more formally referred to as photopsia. The ultimate release of the vitreous around the optic nerve head sometimes makes a large floater appear, usually in the shape of a ring ("Weiss ring").As a complication, part of the retina might be torn off by the departing vitreous body, in a process known as retinal detachment. This will often leak blood into the vitreous, which is seen by the patient as a sudden appearance of numerous small dots, moving across the whole field of vision. Retinal detachment requires immediate medical attention, as it can easily cause blindness. Consequently, both the appearance of flashes and the sudden onset of numerous small floaters should be rapidly investigated by an eye care provider.

Regression of the hyaloid artery

The hyaloid artery, an artery running through the vitreous humour during the fetal stage of development, regresses in the third trimester of pregnancy. Its disintegration can sometimes leave cell matter

Other common causes

Patients with retinal tears may experience floaters if red blood cells are released from leaky blood vessels, and those with a posterior uveitis or vitritis, as in toxoplasmosis, may experience multiple floaters and decreased vision due to the accumulation of white blood cells in the vitreous humour.

Other causes for floaters include cystoid macular edema and asteroid hyalosis. The latter is an anomaly of the vitreous humour, whereby calcium clumps attach themselves to the collagen network. The bodies that are formed in this way move slightly with eye movement, but then return to their fixed position.

Tear film debris

Sometimes the appearance of floaters has to be attributed to dark specks in the tear film of the eye. Technically, these are not floaters, but they do look the same from the viewpoint of the patient. People with blepharitis or a dysfunctional meibomian gland are especially prone to this cause, but ocular allergies can also cause the problem.^[^{citation needed}^] To differentiate between material in the vitreous humour of the eye and debris in the tear film, one can look at the effect of blinking: debris in the tear film will move quickly with a blink, while floaters are largely unresponsive to it. Tear film debris is diagnosed by eliminating the possibility of true floaters and macular degeneration.

Diagnosis

Floaters are often readily observed by an ophthalmologist or an optometrist with the use of an ophthalmoscope or slit lamp. However, if the floater is near the retina, it may not be visible to the observer even if it appears large to the sufferer.

Increasing background illumination or using a pinhole to effectively decrease pupil diameter may allow a person to obtain a better view of his or her own floaters. The head may be tilted in such a way that one of the floaters drifts towards the central axis of the eye. In the sharpened image the fibrous elements are more conspicuous.

The presence of retinal tears with new onset of floaters was surprisingly high (14%; 95% confidence interval, 12%-16%) as reported in a metaanalysis published as part of the Rational Clinical Examination Series in the Journal of the American Medical Association.Patients with new onset flashes and/or floaters, especially when associated with visual loss or restriction in the visual field, should seek more urgent ophthalmologic evaluation.

Most commonly, there is no treatment recommended.^{[citation needed]} The surgeon John Karickhoff has performed thousands of operations that have cured floaters with a 90% success rate

§ Vitrectomy may be successful in treating more severe cases; however, the procedure is typically not warranted in those with lesser symptoms due to the potential for complications to include cataracts, retinal detachment, and severe infection.^[^{citation needed}^] The technique usually involves making three openings through the part of the sclera known as the pars plana. Of these small gauge instruments, one is an infusion port to resupply a saline solution and maintain the pressure of the eye, the second is a fiber optic light source, and the third is a vitrector. The vitrector has a reciprocating cutting tip attached to a suction device. This design reduces traction on the retina via the vitreous material. A variant sutureless, self-sealing technique is sometimes used.

§ Laser vitreolysiis^.

in this procedure an ophthalmic laser (usually an Yttrium aluminium garnet "YAG" laser) is focused onto the floater and in a series of brief bursts, the laser vaporizes and lyses (cuts) the collagen strands of the floater. As of July 2010, laser treatment is not widely practiced and is only performed by very few specialists in the world. It is an outpatient process, which is much less invasive to the eye than a vitrectomy, with potentially fewer side effects.

source : google with edited

Progeria syndrome,"the curious case of benjamin button" disease

noreply@blogger.com (Pixsimo) — Thu, 30 Jun 2011 16:34:00 +0000

Progeria (also known as "Hutchinson–Gilford Progeria Syndrome",⁾ is an extremely rare genetic condition wherein symptoms resembling aspects of aging are manifested at an early age.

The disorder has very low incidences and occurs in an estimated 1 per 8 million live births. Those born with progeria typically live to their mid teens and early twenties. It is a genetic condition that occurs as a new mutation (de novo), and is not inherited. Although the term progeria applies strictly speaking to all diseases characterized by premature aging symptoms, and is often used as such, it is often applied specifically in reference to Hutchinson-Gilford Progeria Syndrome.

Sign and symptoms

The earliest symptoms include failure to thrive and a localized scleroderma-like skin condition. As a child ages past infancy, additional conditions become apparent. Limited growth,alopecia, and a distinctive appearance (small face and jaw, pinched nose) are all characteristics of progeria. People diagnosed with this disorder usually have small, fragile bodies, like those of elderly people. Later, the condition causes wrinkled skin, atherosclerosis, kidney failure, loss of eyesight, hair loss, and cardiovascular problems. It is not transferred by the offspring.

A child with this condition show signs of symptoms usually around 18–24 months. After being born a healthy looking baby, their height and weight suddenly fall below average for their age. Individuals generally retain normal mental and motor development. There are many signs and symptoms of this progressive disease, and they tend to get worse as the child ages. The facial appearance is usually wrinkled, with a larger head in relation to their body, with a narrow face and a beak nose. The child experiences full-body alopecia. Scleroderma, a hardening and tightening of the skin on trunk and extremities of the body, is also prevalent. Since they experience hair loss, prominent scalp veins are noticeable, as well as prominent eyes. Musculoskeletal degeneration causes loss of body fat and muscle, stiff joints, hip dislocations, and other symptoms generally absent in the non-elderly population.

Cause

Hutchinson-Gilford Progeria Syndrome (HGPS) is a childhood disorder caused by a point mutation in position 1824 of the LMNA gene, replacing cytosine with thymine, creating a form of the Lamin A protein which cannot be processed properly and accumulates in the cell nucleus. Lamin A is a major structural protein of the human cell nucleus.

Before the late 20th century, research on progeria yielded very little information about the syndrome. In 2003, the cause of progeria was discovered. The LMNA gene is responsible for producing lamin proteins, which provide strength and stability in cells. Lamin A and Lamin C support the nuclear envelope. When Lamin A is altered, it affects the shape and the function of the nuclear envelope. These changes cause other cells to die prematurely.

Unlike "accelerated aging diseases" (such as Werner's syndrome, Cockayne's syndrome, or xeroderma pigmentosum), progeria is not caused by defective DNA repair. Because these diseases display what are considered different aspects of aging, but never every aspect, they are often called "segmental progerias".

Diagnosis

Diagnosis is suspected according to signs and symptoms, such as skin changes, abnormal growth, and loss of hair. It can be confirmed through a genetic test.

Treatment

No treatments have been proven effective. Most treatment focuses on reducing complications (such as cardiovascular disease) with heart bypass surgery or low-dose aspirin Children may also benefit from a high-calorie diet.

Growth hormone treatment has been attempted.

A type of anticancer drug, the farnesyltransferase inhibitors (FTIs), has been proposed, but their use has been mostly limited to animal models. A Phase II clinical trial using the FTILonafarnib began in May 2007.

source : wikipedia with edited

Skizofrenia-a Brain Disease

noreply@blogger.com (Pixsimo) — Mon, 07 Feb 2011 13:36:00 +0000

Schizophrenia is a complex illness. Even experts in the field are not sure what causes it. Some doctors think that the brain may not be able to process information correctly.

Genetic factors appear to play a role. People who have family members with schizophrenia may be more likely to get the disease themselves.

Some researchers believe that events in a person's environment may trigger schizophrenia. For example, problems (infection) during development in the mother's womb and at birth may increase the risk for developing schizophrenia later in life.

Psychological and social factors may also affect its development. However, the level of social and family support appears to affect the course of illness and may protect against the condition returning.

There are 5 types of schizophrenia:

Catatonic
Disorganized
Paranoid
Residual
Undifferentiated

Schizophrenia usually begins before the age of 45, symptoms last for 6 months or more, and people start to lose their ability to socialize and work.

Schizophrenia is thought to affect about 1% of people worldwide.

Schizophrenia appears to occur in equal rates among men and women, but in women it begins later. For this reason, males tend to account for more than half of patients in services with high numbers of young adults. Although schizophrenia usually begins in young adulthood, there are cases in which the disorder begins later (over 45 years).

Childhood-onset schizophrenia begins after the age of 5 and, in most cases, after normal development. Childhood schizophrenia is rare and can be difficult to tell apart from other developmental disorders of childhood, such as autism.

Symptoms »

Schizophrenia may have a variety of symptoms. Usually the illness develops slowly over months or even years.

At first, the symptoms may not be noticeable. For example, you may feel tense, or have trouble sleeping or concentrating. You can become isolated and withdrawn, and have trouble making or keeping friends.

As the illness continues, psychotic symptoms develop:

An appearance or mood that shows no emotion (flat affect)
Bizarre motor behavior in which there is less reaction to the environment (catatonic behavior)
False beliefs or thoughts that have nothing to do with reality (delusions)
Hearing, seeing, or feeling things that are not there (hallucinations)
Thoughts "jump" between unrelated topics (disordered thinking)

Symptoms can be different depending on the type of schizophrenia.

Catatonic type:

Agitation
Decreased sensitivity to pain
Inability to take care of personal needs
Negative feelings
Motor disturbances
Rigid muscles
Stupor

Paranoid type:

Anger
Anxiety
Argumentativeness
Delusions of persecution or grandeur

Disorganized type:

Child-like (regressive) behavior
Delusions
Flat affect
Hallucinations
Inappropriate laughter
Not understandable (incoherence)
Repetitive behaviors
Social withdrawal

Undifferentiated type may include symptoms of more than one type of schizophrenia.

Residual type -- symptoms of the illness have gone away, but some features, such as hallucinations and flat affect, may remain.

Because other diseases can cause symptoms of psychosis, psychiatrists should make the final diagnosis. The diagnosis is made based on a thorough interview of the person and family members.

No medical tests for schizophrenia exist. The following factors may suggest a schizophrenia diagnosis, but do not confirm it:

Course of illness and how long symptoms have lasted
Changes from level of function before illness
Developmental background
Genetic and family history
Response to medication

CT scans of the head and other imaging techniques may find some changes that occur with schizophrenia and may rule out other disorders.

During an episode of schizophrenia, you may need to stay in the hospital for safety reasons, and to provide for basic needs such as food, rest, and hygiene.

Antipsychotic or neuroleptic medications change the balance of chemicals in the brain and can help control the symptoms of the illness. These medications are effective, but they can have side effects. However, many of these side effects can be addressed, and should not prevent people from seeking treatment for this serious condition.

Common side effects from antipsychotics may include:

Sleepiness (sedation)
Weight gain

Other side effects include:

Feelings of restlessness or "jitters"
Problems of movement and gait
Muscle contractions

Long-term risks include a movement disorder called tardive dyskinesia, in which people move without meaning to.

Newer drugs known as atypical antipsychotics appear to have fewer side effects. They also appear to help people who have not improved with the older medications. Treatment with medications is usually needed to prevent symptoms from coming back.

Supportive and problem-focused forms of therapy may be helpful for many people. Behavioral techniques, such as social skills training, can be used during therapy, or at home to improve function socially and at work.

Family treatments that combine support and education about schizophrenia (psychoeducation) appear to help families cope and reduce the odds of symptoms returning. Programs that emphasize outreach and community support services can help people who lack family and social support.

Outlook (Prognosis)

Most people with schizophrenia find that their symptoms improve with medication, and some can get good control of their symptoms over time. However, others have functional disability and are at risk for repeated episodes, especially during the early stages of the illness.

To live in the community, people with schizophrenia may need supported housing, work rehabilitation, and other community support programs. People with the most severe forms of this disorder may be too disabled to live alone, and may need group homes or other long-term, structured places to live.

Possible Complications

People with schizophrenia have a high risk of developing a substance abuse problem. Use of alcohol or other drugs increases the risk of relapse.
Physical illness is common among people with schizophrenia due to side effects from medication and living conditions. These may not be detected because of poor access to medical care and difficulties talking to health care providers.
Not taking medication will often cause symptoms to return.

When to Contact a Medical Professional

Call your health care provider if:

Voices are telling you to hurt yourself.
You are feeling hopeless and overwhelmed.
You are seeing things that aren't really there.
You feel like you cannot leave the house.
You are unable to care for yourself.
Source :NY Times

Living creatures that can live in our brain and can cause disease

noreply@blogger.com (Pixsimo) — Sun, 17 Oct 2010 11:22:00 +0000

It may sound surprising, but there is one organism that can dwell in the brain and causes rapid death of the victim.

This organism called Naegleria amoeba flowleri, and found throughout the world.These organisms often appeared in the warm, stagnant bodies of fresh water,

such as lakes, rivers, hot springs, and pools are not given the chlorine. This amoeba can not enter simply by drinking or across the water; new infections occur when water rose to his nose. This amoeba enters the body through the nose, usually when the person is swimming underwater or diving. From the nose, the amoeba is spread to the nerve fibers, through the skull, and into the brain. Naegleria is like the warmth of the brain and will multiply until one day, usually within three to seven days, the victim was killed.

There are about 200 recorded cases of Naegleria infection throughout the world in the last 40 years. The children considered most at risk because their immune systems are weaker. However, although this infection is rarely, if agan and miss decided to swim in fresh water is warm, Do not Forget To Use Clamps Nose!

Naegleria fowleri (pronunciation / nə'ɡlɪə. ɹiə /) (also called 'brain-eating amoeba ") is the protists that live in warm fresh water, with a temperature of 25-35 degrees Celsius. This amoeba into Percolozoa group or Heterolobosea.

N. fowleri can invade the human nervous system, although it rarely occurs, the infection almost always causes the death of the victim.

From 1964 more than 60 cases of death in people because this parasitic infection that caused the disease "meningoencephalitis" (inflammation of the lining of the brain). This incident was reported from countries Czech, Slovak, United States, Africa, New Zealand and Australia. Naegleria fowleria in isolation from these deaths.Ameba was killing animals in a laboratory experiment at the time of injected intra nasal, intra-venous and intracerebral. These organisms do not form cyste or flagella in host body and vakuolanya contain cell debris (cell debris) from the host.

Almost all cases of meningoencephalitis is very closely related to the swimming pool or lake. It is very possible trophoszoit enter through the nose dive when people in the water. Cases have been reported indicate that infection occurs when Muslims perform ablutions with 5 X daily nasal washing occurred in Muslim farmers in Nigeria.After entry into the nose trophozoit then migrate along the nerve of this amoeba olfactorius through the slab and into the cranium Cribiform. Death is caused by damage to brain tissue rapidly and only several patients were rescued

Broken Bones in open condition - dont see the pic

noreply@blogger.com (Pixsimo) — Fri, 17 Sep 2010 09:19:00 +0000

Broken Bones in open condition

Definition
Broken bones where there is damage to the skin so that bacteria from outside can be infected hematoma caused by these fractures

• Soft tissue
• Bone tissue
• Fixation within and outside

Investigations

Roentgen photos

The classification of open fractures: according to the Gustilo
Type I
Small cuts less than 1 cm, there is little tissue damage, there were no signs of severe trauma to the soft tissues. Fractures that occur are usually simple, tranversal, short oblique or komunitif

Type II
Exceeding 1 cm skin laceration but no great damage to tissue or skin avulsion. There was damage and tissue

Type III
There is great damage to the soft tissues including muscle, skin and structure neovaskuler with severe contamination. Divided into 3 sub-types:
1. Type IIIA: soft tissue close enough broken bones
2. type IIIB: accompanied by destruction and loss of janingan software, the bone can not do the cover of soft tissue
3. type IIIC: accompanied by arterial injury requiring immediate repair

Reduction open fracture:
1. Treat as a gravity
2. Initial evaluation and diagnosis of abnormalities that might be the cause of death
3. Give antibiotics in the emergency room, operating room and after surgery
4. Immediate debridement and irrigation are doing good
5. Repeat debridement next 24-72 hours
6. Fracture stabilization
7. Leave the wound open between 5-7 days
8. Perform immediate autogenous bone graft
9. Rehabilitation of the affected limb

Open fracture treatment stages
1. Cleaning wounds
2. Excision of dead tissue and presumed dead
3. Treatment of fractures and determining types of traction
4. Skin closure
5. Giving antibiotics
6. Prevention of tetanus

Complications of open fractures
1. bleeding, septic shock death
2. septikemi, toxemia due to pyogenic infection
3. tetanus
4. gangrenous
5. ma non-union and union
6. joint stiffness
7. secondary bleeding
8. chronic osteomyelitis
9. delayed union

Further treatment and rehabilitation of open fractures
1. Relieve pain
2. Obtain and maintain adequate position and flagmen fractures
3. Pursuing the union
4. Restoring optimal function by maintaining muscle and joint function and prevention of complications.
5. Restoring function with a maximum of physiotherapy.

Operating Principles
Principles of debridement is to clean up contamination found in the vicinity of fracture by making the appointments of non-viable tissue and foreign material, such as sand embedded in soft tissue. Conducted an assessment on surrounding tissue around the bone, injured blood vessels, tendons, muscles, nerves. Debridement of muscle tissue is considered contaminated if the weight and lose muscle contractility. Debridement of the tendons consider contractility tendon, while the debridement of the skin performed until bleeding arise. In grade IIIB open fracture and IIIC done serially repeated debridement in interval 24-72 hours to reach a definitive surgical debridement.

Technical Operations
Prior to debridement, antibiotics given profilaks conducted in the emergency room.The best are the ones sefalosforin. Usually used sefalosforin first class. In an open fracture Gustilo III tape, provided additional benefits such as aminoglycoside group, such as tobramicin or gentamicin. Group sefalosforin third group considered here.While on a suspected fracture of contaminated bacteria Clostridia, given penicillin.

Self protection equipment required when surgery is google, boots and gloves extra.
Before the surgery, performed by povine iodine wash, then drapping area of operation. The use is not recommended, because we will examine the tissue bleeding. Debridement performed first on the skin area. Later hospitalized with bleeding in venous performs coagulation. Open to assess muscle fascia and tendons. Muscle viability was assessed by 4C, "Color, Contractility, Circulation and Consistency. Perform removal of contamination with the medullary canal saw or rongeur. Medulary canal curettage avoided by reason of preventing infection towards the proximal. Performed with normal saline irrigation. The use of normal saline is 60-10 liters for an open fracture grade II and III. Bone is maintained by repositioning. Can be used external fixation in grade III4 fracture.

Closure of wounds done if possible. In type III fractures that can not be performed wound closure, performed an open wound care, until the wound can be closed completely.

Complications Surgery
Complications of surgical debridement is almost nothing. Complications occurred in the form of infection in soft tissue and bone to postoperative sepsis.

Mortality
Associated with hemorrhagic shock and the presence of fat embolism

Post-Surgical Care
Postoperative antibiotics was continued until 2-3 days post-debridement. Pus culture, if there is a pussy, pussy do culture. In open fractures that require surgical debridement grade repetition, the replay will be debrided until healthy enough tissue to the bone and definitive therapy can be started. On a delayed wound closure, performed the installation of split thickness skin flap, vascularized pedicle flaps (such as gastrocnemeus flap) and free flaps such as flaps or myocutaneus fasciocutaneus flaps.

Syphilis-one of BAD genital disease

noreply@blogger.com (Pixsimo) — Sun, 12 Sep 2010 06:28:00 +0000

Syphilis
Definition:
Acute infectious disease, subacute, or chronic is caused by the bacterium Treponema pallidum is usually acquired through sexual contact with an infected person

Cause:
Spirochae T.phallidum first discovered in 1905 but the disease was

endemic in Europe in the XV century pertengaha. T.pallidum can penetrate through the normal mucosal epithelium and mild abrasion. Treponema breed slower than the primary pathological lesion is a focal endarteritis. Crease inflammation terhentuk around blood vessels attacked, had experienced an obliteration of the lumen, and heal with much fibrosis. Granulomatous reaction often found in secondary syphilis and information. Patients response to infection in the form of antibodies that a lot. These antibodies have any meaning for diagnosis

Sign & Symptoms:
Syphilis has several stages of infection. Once infected with syphilis, there is the incubation period, the period before the onset of symptoms until the open sore called a "chancre" approximately 90-90 days, generally on average during 21 days is already visible.

The first stage of syphilis can have an open sore called a chancre on the genitals, rectal, or oral. This open wound does not hurt. Enlarged lymph nodes may appear. A patient may not feel the pain and wounds usually heal by itself within 4-6 weeks, therefore the patient usually will not come to the doctor for treatment, but this does not mean syphilis disappear, but remain circulating in the body. If not handled properly, will continue into the next stage.

The second stage occurs about 1-6 months (averaging about 6-8 weeks) after the first infection, there are several different manifestations of this second stage. A red rash may occur without itchy in certain parts, like the palms of the hands and feet, or humid areas, such as the scrotum and labia. Besides the rash, other symptoms arise, such as fever, enlarged lymph nodes, sore throat, headaches, weight loss, muscle aches, and please note that the symptoms and signs of both syphilis infections will also be able to resolve on their own, but also keep in mind that this does not mean the syphilis is missing from your body, but continues until the stage of latent infection.

Latent stage is the stage where if you checked with lab tests, the results are positive, but there can be symptoms and signs or not. Latent stage is also divided as early and late latent stage. Expressed as early latent syphilis when syphilis was already inside the body for two years or less from the first infection with or without symptoms. While late latent syphilis if it has been suffering for two years or more of the first infection without evidence of clinical symptoms. In practice, it often is not known when began to hit so often has to be assumed that the patient has reached the latent stage.

Tertiary syphilis that appears on the third of the patients are not treated properly.Usually arise 10-10 years after initial infection, but in some cases up to 50 years can only arise, this stadium can be seen with the signs of such tumors arising from the soft lumps. At this stage, many organ damage that can occur, ranging from damage to bones, nerves, brain, muscle, eye, heart and other organs.

Diagnosis
Syphilis can be diagnosed by way of rubbing the wound and results of smears examined under a special microscope (a microscope dark field of view). Under the microscope, bacteria sprikoheta will look.
When the microscope is not available, then the diagnosis can be established with the typical appearance of syphilis wounds.
There is also a special blood test for syphilis that is scanning VDRL (venereal Disease Research Laboratory) and RPR (Rapid Plasminogen Reagent). This test checks the body response to disease, not directly to the bacteria spirokheta.

Treatment:
Syphilis primary, secondary, and early latent (less than one year): the drug of choice is penicillin G benzathine 2.4 million units IM once; or procain penicillin G, 600,000 units IM every day for eight days.
Advanced latent syphilis (more than I year old) and cardiovascular sifillis: drug of choice is penicillin G procaine, 600,000 units per day for 15 days; or pcnicillin G benzathine, 2.4 million units IM every week for three weeks.
Neurosyphilis: penicilline crystalline G, 24 million units IV every 4 hours for 10 days, or penicillin G procaine, 1.2 million units IM each day for 15 days.
Congenital syphilis with a liquid to a normal serebrospinalis: penicillin G benzathine, 50.00 units / kg IM given once; if serebrospinalis abnormal fluid, crystalline penicillin G ~ 25,000 units / kg IM or IV 2 times daily for at least 10 days, or penicillin G procaine, 50 000 units / kg IM sebari of at least 10 days.
Patients who are sensitive to penicillin, for all types of: tetracycline 500 mg four times daily peroral for 15 days, or erythromycin, 500 mg four times a day peroral for 15 days, an adequate replacement therapy.
Jariseh-Herxbeimer reaction may occur within 6-8 hours after initial therapy; fever, chills, myalgia, tachycardia, and various other systemic symptoms, mucosal lesions, and neurologic lesions may worsen. This reaction was found to the 50% of patients with primary syphilis, 75% with secondary syphilis, and 30% with neurosyphilis.

Prevention
How to prevent this disease is to avoid unsafe sex, do not have multiple sexual partners, and always maintain the cleanliness around the sex organs.

Leukemia- one of bad cancer

noreply@blogger.com (Pixsimo) — Fri, 10 Sep 2010 17:25:00 +0000

Leukemia is a disease that refers to a group of blood diseases characterized by cancer of the tissues that produce blood.
In more detail, the leukemia is a diverse group of neoplastic diseases, characterized by an abnormal multiplication or malignant or malignant transformation of blood-forming cells in bone marrow and lymphoid tissue. Normal cells in the bone marrow was replaced by normal or abnormal cells. These abnormal cells from the marrow and can be found in the peripheral blood or peripheral blood. Leukemia cells affecting hematopoiesis or blood cell formation process is normal and the patient's body immunity.
Leukemia can be classified on the basis of a natural way of disease: acute and chronic. Acute leukemia is marked by a very rapid course of the disease, deadly, and worse. If not treated immediately, the patient can die within weeks to days. While chronic leukemia have a disease that does not travel so quickly that it has a longer life expectancy, up to more than one year.

Causes
The cause of leukemia is not known with certainty,

but note several factors that can affect the frequency of leukemia, such as:
1. Radiation
2. Factor leukemogenik
There are several chemicals that have been identified may affect the frequency of leukemia:
• environmental toxins such as benzene
• industrial chemicals such as insecticides
• Drugs for chemotherapy
3. Epidemiology
• In Africa, 10-20% patients with acute myelogenous leukemia (LMA) has kloroma around orbital eye
• In Kenya, China, and India, Chronic myelogenous leukemia (CML) of patients aged 20-40 years
• In East Asians and East Indians Chronic lymphocytic leukemia is rarely encountered (LLK).
4. Hereditary
Down syndrome patients have acute leukemia incidence 20 times greater than normal people.
5. Virus
Viruses such as retroviruses can cause leukemia and feline leukemia virus.

Clinical symptoms
In acute leukemia showed clinical symptoms caused by:
1. Bone marrow failure, among others: pallor, lethargy, fever, mouth infection picture, tenggorakan, skin respiration, bruising, spontaneous bleeding gums, and pendarahanan from venous function caused by thrombocytopenia.
2. Infiltration of other organs, ie bone pain, hypertrophy and infiltration of the gums, headache, vomiting, blurred vision and swelling of the testes sometimes occurs in mediastum lla and sign emphasis (especially at lla).
According Mediarty, chronic leukemia includes two main types of chronic myelogenous leukemia granulositik chronic (CML) and chronic lymphocytic leukemia (LLK). Other chronic types including hair cell leukemia (hairy cell leukemia, leukemia prolimfositik) and various syndromes mielodisplastik that some regarded as a form of chronic leukemia.
Chronic myelogenous leukemia having clinical symptoms are:
1. Weight loss, weakness, anorexia, and night sweats.
2. Splenomegali there is almost always accompanied by large and often less frequently malaise, pain, feeling full in the stomach or indigestion.
3. Overview of anemia, including pale and limp.
4. Sometimes there is bruising and bleeding from other places.
5. Often found on the sternum tenderness and hepatomegaly.
6. Visual impairment.

Diagnosis
Acute leukemia can be diagnosed through several means, such as:
• Examination of morphology: peripheral blood, bone marrow aspiration, bone marrow biopsy
• Tint sitokimia
• Immunofenotipe
• Cytogenetics
• Molecular Diagnostis

Treatments
Treatment of acute blood cancer (acute leukemia) according Mediayarti curative or palliative aims:
Curative treatment includes:
1. Siteroduksi with the drug combination cytostatica cytostatica ranging from mild to aggressive with the need of "rescue" the patient's blood iduh cells from peripheral blood to rescue the bone marrow ablation.
2. Allogeni blood stem cell transplantation or autologous bone from marrow, peripheral blood or umbilical cord.
3. Supportive, through blood transfusion, vitamin B6 and 12, iron, adequate nutrition, antibiotics and anti-fungal if there is any indication.
While the treatment of chronic leukemia depends on the type and phase or stage where the patient is found.

Scabies on Human Diseases-STINGKY N UHHH disease

noreply@blogger.com (Pixsimo) — Thu, 09 Sep 2010 17:47:00 +0000

Scabies is a skin disease caused by infestation and sensitization to Sarcoptes scabiei hominis and product variants. Some synonyms of this disease are: Scabies, The Itch, Gudig,Itching Agogo.

Transmission mode
Scabies disease can be transmitted through direct contact or indirect contact.Scabies is transmitted by fleas that have been fertilized females, through close physical contact in the transmission through clothing, bedding, towels, after which the female louse will dig holes into the tunnel in the epidermis and stratum corneum membentu. Two days after fertilization, the female scabies begin the eggs are then developed through the larval stage, and possibly befallen become adult fleas within 10-14 days.

Old female louse lives about 30 days, then ticks off the end of the tunnel. Tunnels are more numerous in areas of thin-skinned and does not contain many follicles pilosebasea.

The disease is highly contagious, so if one family member affected, then usually another family member will come infected as well.

This disease is very closely related to personal hygiene and the environment. If the level of awareness possessed by many among the community is still quite low, the degree of involvement in serving the needs of the population who still lack health care, lack of health monitoring by the government, environmental factors terutama problem of providing clean water, and the failure of the implementation of health programs that are still frequently encountered, will increase the length of the environmental health problems that already exist.

Predisposing factors
Environmental cleanliness is very important in the transmission of this disease.Scabies is generally found on low-income communities (low income Communities) are paying less attention to personal hygiene (personal hygiene). Contracted scabies can also squeeze in those who live like refugees, members of the army in time of war, dormitories, nursing, school, etc..

Clinical symptoms
There are four cardinal signs of scabies:
1. Nokturna pruritus, itching at night means that mite activity is caused by higher temperatures are more humid and hot.
2. These diseases attack humans in groups, for example in a family usually all the family members infected. Similarly, in a densely populated village, most of the adjacent neighbors would be attacked by these mites. Known hiposensitisasi circumstances, the whole family is affected, although experiencing mite infestation, but gave no symptoms. This patient is a carrier (carrier).
3. The existence of the tunnel (kunikulus) at places predileksi a white or grayish, the form of straight or curved lines, the average length of 1 cm, at the end of the tunnel was discovered papule or vesicle. If secondary infections arising from skin rashes to polymorphs (pustule, excoriation and others). Predileksinya place is usually a place with a thin stratum corneum, ie the sidelines of the fingers, the volar wrist, elbow the outside, fold the front of the armpit, areola mammae (in women), umbilicus, buttocks, external genitalia (male) and abdominal below. In infants can attack palms and soles of the feet.
4. Finding mites, are the most diagnostic. Can be found in one or more life stages of this mite.

Diagnosis can be made to find two of these four cardinal signs.

Classification of scabies

There are several forms of scabies apitik rare and hard to know, so that it can lead to diagnostic errors. Some forms include:

1. Scabies on The Net
There on the level of cleanliness sufficient. Usually very hard to find tunnels. Ticks are usually lost due to bathe regularly. This form is characterized by lesions in the form of papule and tunnels are few in number, so it is hard to find.

2. Scabies incognito
Topical or systemic steroids may disguise the symptoms and signs of scabies, while the infestation persists. Instead of treatment with topical steroids can also lead to long lesions grow great. This is caused probably by the decrease in cellular imum response.

3. Nodular scabies
In this form, reddish brown lesions form a agtal nodes. Nodes are usually located in enclosed areas, especially in the male genitalia, inguinal and axillary. This arose as a reaction node hipersensetivitas against scabies mites. At the age of nodes more than one month mites are rarely found. Nodes may persist for several months to a year although it has been given anti-scabies treatment and corticosteroids.

4. Scabies are transmitted through animal
In America, the main source of scabies is a dog. This disorder is different from human scabies that there are no tunnels, no attack between your fingers and external genitalia. Lesions are usually found in areas where people often contact / hug pet namely the thighs, abdomen, chest and arms. The incubation period was shorter and easier transmission. This disorder is temporary (4-8 weeks) and can heal itself due to Sarcoptes scabiei in animals can not continue its life cycle in humans.

5. Norwegian scabies
Norwegian scabies or scabies krustosa characterized by extensive lesions with crusting, and hyperkeratosis is squama generalized thick. Place predileksi usually hairy scalp, ears, buttocks, elbows, knees, palms and feet that can be accompanied by nail dystrophy.
Unlike ordinary scabies, itch, Norwegian scabies in patients with non-obtrusive but the shape is very contagious because the number of mites that menginfestasi very many (thousands). Norwegian scabies caused by deficiency imunologic so the body's immune system fails to limit the proliferation of mites can breed easily.

6. Scabies in infants and children
Scabies lesions in children may be related to the entire body, including the entire head, neck, palms, soles of the feet and there is often a secondary infection such as impetigo, ektima so rarely found in the tunnel. In infants, lesions on the face.

7. Scabies was lying in bed (bed ridden).
Patients with chronic disease and older people were forced to stay in bed may be suffering from scabies which lesinya limited.

8. Scabies, accompanied by other sexually transmitted diseases
Scabies is often found with other sexually transmitted diseases like gonorrhea, syphilis, pedikulosis pubis, genital herpes and others.

Complication
If scabies is not treated for several weeks or months, can arise dermatitis due to scratching. Eruption can be shaped impetigo, ektima, sellulitis, limfangitis, and furuncle. Bacterial infections in infants and small children who were attacked scabies can cause complications in the kidneys. Irritant dermatitis can occur because of the use of anti-scabies preparations excessive, either at the beginning of therapy or the use of too often.

Prevention
Prevention of scabies can be done in various ways:
• Washing the net, some experts recommend even by boiling, towels, sheets and clothes people with scabies, and then leave them to dry.
• Avoiding the use of clothes, towels, bed sheets together.
• Treat all family members, or people who are infected to break the chain of transmission.

Hepatitis B - The moderate hepatic disease

noreply@blogger.com (Pixsimo) — Wed, 08 Sep 2010 16:38:00 +0000

Hepatitis B is a liver infection caused by the hepatitis B virus. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.

A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing HBV infection and its chronic consequences, and is the first vaccine against a major human cancer.

Symptoms

Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

HBV can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.

Transmission

Hepatitis B virus is transmitted between people by contact with the blood or other body fluids (i.e. semen and vaginal fluid) of an infected person. Modes of transmission are the same for the human immunodeficiency virus (HIV), but HBV is 50 to 100 times more infectious Unlike HIV, HBV can survive outside the body for at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

Common modes of transmission in developing countries are:

perinatal (from mother to baby at birth)
early childhood infections (inapparent infection through close interpersonal contact with infected household contacts)
unsafe injections practices
blood transfusions
sexual contact

In many developed countries (e.g. those in western Europe and North America), patterns of transmission are different than those mentioned above. Today, the majority of infections in these countries are transmitted during young adulthood by sexual activity and injecting drug use. HBV is a major infectious occupational hazard of health workers.

HBV is not spread by contaminated food or water, and cannot be spread casually in the workplace.

Treatment

There is no specific treatment for acute hepatitis B. Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Chronic hepatitis B can be treated with drugs, including interferon and anti-viral agents, which can help some patients. Treatment can cost thousands of dollars per year and is not available to most patients in developing countries.

Liver cancer is almost always fatal, and often develops in people at an age when they are most productive and have family responsibilities. In developing countries, most people with liver cancer die within months of diagnosis. In higher income countries, surgery and chemotherapy can prolong life for up to a few years in some patients.

Patients with cirrhosis are sometimes given liver transplants, with varying success.

Prevention

All infants should receive the hepatitis B vaccine: this is the mainstay of hepatitis B prevention.

The vaccine can be given as either three or four separate doses, as part of existing routine immunization schedules. In areas where mother-to-infant spread of HBV is common, the first dose of vaccine should be given as soon as possible after birth (i.e. within 24 hours).

The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. After age 40, protection following the primary vaccination series drops below 90%. At 60 years old, protective antibody levels are achieved in only 65 to 75% of those vaccinated. Protection lasts at least 20 years and should be lifelong.

All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine. People in high risk groups should also be vaccinated, including:

persons with high-risk sexual behaviour;
partners and household contacts of HBV infected persons;
injecting drug users;
persons who frequently require blood or blood products;
recipients of solid organ transplantation;
those at occupational risk of HBV infection, including health care workers; and
international travellers to countries with high rates of HBV.

The vaccine has an outstanding record of safety and effectiveness.

10 Diseases with the HIGHEST costs

noreply@blogger.com (Pixsimo) — Tue, 07 Sep 2010 05:50:00 +0000

Medical expenses each year almost all diseases is increasing. But among all types of diseases for which cost was very expensive. 10 Avoid this sickness if do not want falling into poverty.

1. Mental illness
Increased costs per year 6 per cent. Total cost of treatment of this disease in the United States has reached U.S. $ 142.2 billion

. Mental illness among the Alzheimer's, Parkinson's, Schizoprenia, depression and others. Recent drug development and the long healing process that makes this disease a disease with the most expensive among all the medical expenses of existing disease.

2. Heart disease
Increased cost of 5 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 123.1 billion. Heart disease remains the number one killer disease in the world. This is due to more people who smoke and increasing unhealthy lifestyle such as high cholesterol foods and infrequent exercise.

3. Trauma
Increased costs per year 6 per cent. Total cost of treatment of this disease in the United States has reached U.S. $ 100.2 billion. Cost of treatment of people affected by trauma continues to increase because each case varies cure. Besides the tools to diagnose this disease such as Computed tomography scans quite expensive.

4. Cancer
Increased cost of 7 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 99.4 billion. Cancer is the most expensive cost of treatment of colon cancer, breast cancer, lung cancer and prostate cancer. The key to avoiding this disease is by avoiding smoking and maintaining a healthy intake of food.

5. Phthisis
Increased costs per year 6 per cent. Total cost of treatment of this disease in the United States has reached U.S. $ 64.6 billion. Which include lung diseases including asthma, emphysema (swelling or inflammation of the lungs) and Obstructive Pulmonary Disease Chronic disease (COPD) others.

6. Hypertension (high blood pressure)
Increased cost of 9 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 50.2 billion. This disease requires a lot of cost because many doctors are giving the drug in quantities unsparing in his patients.Drug quality also determines the price. If it made its generic hypertension drug may cost the disease can be suppressed.

7. Osteoarthritis (arthritis / rheumatism)
Increased cost of 8 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 48 billion. Obesity and an enlarged waist size is a factor that increases the risk of this disease. Expensive drugs such as Vioxx and Celebrex that emerged in early 2000 adding expensive to cure this disease arthritis.In 2004, Vioxx, withdrawn from the market because the risk of triggering a heart attack.

8. Backache
Increased cost of 9 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 40.1 billion. Expenditures for this disease for many spent the operation. There are also drugs that are expensive narcotic (anesthetized) to overcome this disease. But a study published in the Journal of the American Medical Association, said that all the expensive treatment that does not make someone better.

9. Kidney disease
Increased cost of 13 percent per year. Total cost of treatment of this disease in the United States has reached U.S. $ 35.9 billion. The discovery of dialysis techniques for kidney patients make costly treatment of this disease. Dialysis technique was first a very expensive technology in dealing with kidney disease.

10. Diabetes
Increased cost of 8 percent per year. Total cost of treatment of this disease in America has reached U.S. $ 35.8 trillion. Nearly 24 million Americans affected by diabetes and obesity trigger is highest. Diabetes could trigger other diseases such as heart disease and cancer. However, because the diseases had been treated differently again, so that diabetes itself does not eat the higher costs of heart disease or cancer.

having sex can reduce heart disease risk

noreply@blogger.com (Pixsimo) — Mon, 06 Sep 2010 07:01:00 +0000

Men who have sex at least twice a week can reduce heart disease risk. According toresearch recently conducted a scientist at the New England Research Institute in Massachusetts, United States, which published the American Journal of Cardiology.

Compared with men who have sex only once a month, men who have sex regularly at least two times a week, the threat of heart disease 45 percent

smaller.

The study involved more than a thousand male respondents, aged between 40 and 70 years. During periods of more than 16 years, each man was given a question, in a period of more than 16 years, how often they have sex and then examined whether there are symptoms of heart disease.

The researchers are also considering other risk factors such as age of respondents, weight, blood pressure and cholesterol levels.

In its report about their findings, the researchers said that sex benefits associated with physical effects and emotional effects on the body. Men who desire sex more often and are able to do it look more healthy.

A previous study by the National Cancer Institute in the U.S. showed that male ejaculate through sex or masturbation at least five times a week less at risk of contracting prostate cancer.

Sex twice a week in winter can encourage the body's immune system and reduces the chance of a fever and flu, according to researchers at Wilkes University, Pennsylvania, United States.

source : the telegraph with some edited

Down Syndrome - love not hate

noreply@blogger.com (Pixsimo) — Thu, 02 Sep 2010 04:18:00 +0000

Down syndrome is a genetic disorder that occurs on chromosome 21 at q22 file SLC5A3 gene, which can be known by looking at a fairly typical clinical manifestations. Disorder which affects physical growth and mental retardation was first recognized in 1866 by Dr.John Longdon Down. Because the features that seemed strange as the relatively short stature, smaller head, flat nose that resembles a Mongoloid people so often also known as mongolisme. In 1970 experts from America and Europe to revise the name of the abnormalities that occur in children with reference to the first inventor of this syndrome with the term Down syndrome and up to now the disease is known by the same term.

symptoms or signs
Symptoms that arise due to down syndrome can vary

from completely invisible, visible at least until the appearance of typical signs.
Patients with typical signs of a very easily recognizable by the physical appearance of a prominent form of a relatively small head shape from the normal (microchephaly) by the anteroposterior head horizontally. On the face usually appears between the flat nose, mouth, tapering and protruding tongue (macroglossia). Often, the eyes become slanted at an angle to form the central part folds (epicanthal Folds). Clinical signs in other body parts such as short-hand including fingers segment and the distance between the first and second fingers on both hands and feet wide.

Meanwhile, the outer layers are usually visible wrinkles (dermatoglyphics). These chromosomal abnormalities can also cause interference or even damage to other organs systems.
Abnormalities in newborns can be either congenital heart disease. This disorder is usually fatal because the baby can die quickly. Can be found on the digestive system disorders such as obstruction of the esophagus (esophageal atresia) or duodenum (duodenal atresia).
If the child is experiencing blockages in these organs will usually be followed by vomiting. Prevention can be done by screening the chromosome via amniocentesis for pregnant women especially in the early months of pregnancy. Moreover pregnant women who never have children with down syndrome or those who were pregnant at the age of 40 years should carefully monitor the development of her fetus because they are subject to risks of childbirth with down syndrome is higher.
In the brains of Down syndrome patients, found increasing ratio of APP (amyloid precursor protein) as in patients with Alzheimer's.

Prevention
Prevention can be done by screening the chromosome via amniocentesis for pregnant women especially in the early months of pregnancy. Moreover pregnant women who never have children with down syndrome or those who were pregnant at the age of 40 years should carefully monitor the development of her fetus because they are subject to risks of childbirth with down syndrome is higher. Down syndrome can not be prevented, because the DS is a disorder caused by abnormal chromosome number. Number of kromosm 21 that should have only two to three. The cause is still not known with certainty, that it can be concluded so far is the older the higher the maternal age risk for the occurrence of DS.Diagnosis in the womb can be done, a definite diagnosis by chromosome analysis in a way making CVS (taking a bit of a fetus in the placenta) in pregnancy 10 -12 weeks) or amniocentesis (amniotic fluid intake) at 14-16 weeks of pregnancy.

Diagnostic checks
To detect any abnormality on the chromosome, there are some checks that can help diagnose this, among others:
§ Physical examination patients
§ Examination of chromosomes
§ Ultrasonography (USG)
§ echocardiogram (ECG)
§ Examination of blood (umbilical Precutaneus Blood Sampling)

Treatment
Until recently found the most effective treatment methods to overcome this disorder. In its development stage Down syndrome patients may also experience deterioration of the system vision, hearing or physical ability to remember tone of weak muscles. Thus the patient should receive adequate support and information as well as ease of use of appropriate facilities or facilities associated with the decline of both physical and mental development. Surgery is usually performed on patients to correct the defects of the heart, given that most patients die more quickly due to abnormalities in the heart. With the existence of acute leukemia causing the patient more susceptible to infection, so that these patients require monitoring and provision of adequate infection prevention therapy.

Rheumatic Fever - complicated disease

noreply@blogger.com (Pixsimo) — Fri, 27 Aug 2010 16:08:00 +0000

Rheumatic fever is one of the inflammatory rheumatic disease caused by bacterial infection of A beta hemolytic Streptococcus. Germs are often nested in a tooth infection or throat infection and is usually much attacking children aged 5-15 years.

Heart inflammation (Carditis) and Pollartritis (arthritis) is an acute manifestation of the most frequently found. Therefore the patient must be addressed before terkenan heart infection could be fatal.

Symptoms
Symptoms of the disease depends on

the person's age. In children and adolescents the main symptom is the feeling of fever accompanied by inflammation in the joints followed by infection of the heart and often found a lump under the skin. Whereas in adulthood, many of fever accompanied by inflammation of the joints. On the skin rash may also appear pink.

Joint pain in rheumatic fever usually appear suddenly and peaked within 12-24 hours. Pain attacks, especially on the knee and ankle joints. Pain will be gone within 2-6 weeks with or without treatment.

Treatment
The main treatment is to provide anti-inflammatory drugs and streptococcal eradication and prevention of streptococcal bacteria, such as routine dental examination and treatment of children with sore throat as early as possible. In addition to maintaining a healthy environment.

Dense population and inadequate economic socio be a major factor why the disease is still prevalent, especially in developing countries such as Africa, India and Southeast Asia.

Prevention
The best defense against rheumatic heart disease is to prevent rheumatic fever from ever happening. By treating strep throat with penicillin or other antibiotics, doctors can usually stop acute rheumatic fever from developing.
People who had rheumatic fever are more susceptible to repeated attacks and heart damage.That's why they will get continuous antibiotic treatment monthly or daily, probably for life. If their hearts have been damaged by rheumatic fever, they are also at increased risk for developing infective endocarditis (also known as bacterial endocarditis), infection of the heart lining or valves.
In 2007, the American Heart Association updated guidelines for prevention of endocarditis and concluded that there is no convincing evidence linking the teeth, digestive tract or genitourinari procedures with the development of endocarditis. The use of antibiotic prophylaxis before dental procedures now recommended ONLY for patients with the highest risk of poor outcome resulting from endocarditis, such as patients with artificial heart valves, previous endocarditis, or those with specific forms of congenital heart disease. Guidelines are no longer recommends prophylaxis before dental procedures for patients with rheumatic heart disease unless they also have one of the underlying heart conditions listed above.
Antibiotic prophylaxis to prevent endocarditis is not only longer recommended for patients undergoing gastrointestinal procedures or genitourinari.

Hepatitis A - common liver disease

noreply@blogger.com (Pixsimo) — Thu, 26 Aug 2010 15:43:00 +0000

Hepatitis A (formerly known as infectious hepatitis) is an acute infectious disease of the liver caused by the hepatitis A virus (HAV),which is most commonly transmitted by the fecal-oral route via contaminated food or drinking water. Every year, approximately 10 million people worldwide are infected with the virus.The time between infection and the appearance of the symptoms, (the incubation period), is between two and six weeks and the average incubation period is 28 days.

In developing countries, and in regions with poor hygiene standards, the incidence of infection with this virus is high and the illness is usually contracted in early childhood. HAV has also been found in
samples taken to study ocean water quality.Hepatitis A infection causes no clinical signs and symptoms in over 90% of infected children and since the infection confers lifelong immunity, the disease is of no special significance to the indigenous population. In Europe, the United States and other industrialized countries, on the other hand, the infection is contracted primarily by susceptible young adults, most of whom are infected with the virus during trips to countries with a high incidence of the disease.

Hepatitis A does not have a chronic stage, is not progressive, and does not cause permanent liver damage. Following infection, the immune system makes antibodies against HAV that confer immunity against future infection. The disease can be prevented by vaccination, and hepatitis A vaccine has been proven effective in controlling outbreaks worldwide.

Signs and symptoms

Early symptoms of hepatitis A infection can be mistaken for influenza, but some sufferers, especially children, exhibit no symptoms at all. Symptoms typically appear 2 to 6 weeks, (theincubation period), after the initial infection.^]

Symptoms can return over the following 6–9 months and include:

Fatigue
Fever
Abdominal pain
Nausea
Diarrhea
Appetite loss
Depression
Jaundice, a yellowing of the skin or whites of the eyes
Sharp pains in the right-upper quadrant of the abdomen
Weight loss
Itching
Bile is removed from blood stream and excreted in urine giving a dark amber colour
Feces tend to be light in colour due to lack of bilirubin in bile

Cause

The Hepatitis virus (HAV) is a Picornavirus; it is non-enveloped and contains a single-stranded RNA packaged in a protein shell. There is only one serotype of the virus

Diagnosis

Serum IgG, IgM and ALT following Hepatitis A virus infection

Although HAV is excreted in the feces towards the end of the incubation period, specific diagnosis is made by the detection of HAV-specificIgM antibodies in the blood.^[10] IgM antibody is only present in the blood following an acute hepatitis A infection. It is detectable from one to two weeks after the initial infection and persists for up to 14 weeks. The presence of IgG antibody in the blood means that the acute stage of the illness is past and the person is immune to further infection. IgG antibody to HAV is also found in the blood following vaccination and tests for immunity to the virus are based on the detection of this antibody.

During the acute stage of the infection, the liver enzyme alanine transferase (ALT) is present in the blood at levels much higher than is normal. The enzyme comes from the liver cells that have been damaged by the virus.

Hepatitis A virus is present in the blood, (viremia), and feces of infected people up to two weeks before clinical illness develops.

Treatment

There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol (these may be poorly tolerated for some additional months during the recovery phase and cause minor relapses), eat a well-balanced diet, and stay hydrated. Approximately 6–10% of people diagnosed with hepatitis A may experience one or more symptomatic relapse(s) for up to 40 weeks after contracting this disease.

Prevention.

Hepatitis A can be prevented by vaccination, good hygiene and sanitation.^[1][12] Hepatitis A is also one of the main reasons not to surf or go in the ocean after rains in coastal areas that are known to have bad runoff.

The vaccine protects against HAV in more than 95% of cases for 10 years. It contains inactivated Hepatitis A virus providing active immunity against a future infection. The vaccine was first phased in 1996 for children in high-risk areas, and in 1999 it was spread to areas with elevating levels of infection.

The vaccine is given by injection into the muscle of the upper arm. An initial dose provides protection starting two to four weeks after vaccination; the second booster dose, given six to twelve months later, provides protection for up to twenty years.

Transmission

The virus spreads by the fecal-oral route and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route but very rarely by blood and blood products. Food-borne outbreaks are not uncommon,and ingestion ofshellfish cultivated in polluted water is associated with a high risk of infection. Approximately 40% of all acute viral hepatitis is caused by HAV. Infected individuals are infectious prior to onset of symptoms, roughly 10 days following infection. The virus is resistant to detergent, acid (pH 1), solvents (e.g., ether, chloroform), drying, and temperatures up to 60^oC. It can survive for months in fresh and salt water. Common-source (e.g., water, restaurant) outbreaks are typical. Infection is common in children in developing countries, reaching 100% incidence, but following infection there is life-long immunity. HAV can be inactivated by: chlorine treatment (drinking water), formalin (0.35%, 37^oC, 72 hours), peracetic acid (2%, 4 hours), beta-propiolactone (0.25%, 1 hour), and UV radiation (2 μW/cm²/min).

Genital Warts - OMG,speechless

noreply@blogger.com (Pixsimo) — Wed, 25 Aug 2010 16:09:00 +0000

§ Description
Sex warts, also known as Genital Warts or Condiloma acuminata, are one type of sexually transmitted diseases are most common. As the name suggests, genital warts affect the moist tissue in the genital area. Sex looks ketch or warts look like cauliflower. Although very small, Genital wartsdapat breed in large groups.

In women, genital warts can grow on the vulva, vaginal wall, the area between the external genitals and anus, and cervix. In men, genital warts can occur on the tip or shaft of the penis, scrotum or anus. Genital warts can also develop in the mouth or throat of someone who might perform oral sex with an infected person.

Symptoms

Condyloma akuminata disaerah which often appears moist, usually on the penis, vulva, vaginal walls and walls of the cervix and can spread to

the perianal area
Smells rotten
§ Warts / warts provides an illustration of a pink, flat, cauliflower picture
§ In the men can attack the penis, urethra and rectal areas. Infection can be dormant or can not be detected, because some lesions hidden in hair follicles or in the inner circle who are not circumcised penis.
§ At the women attack condiloma akuminata humid areas of the labia minora and vagina. Most lesions occur without symptoms. In most cases usually occur after coitus bleeding, itching or vaginal discharge
§ The size of each wart usually 1-2 mm, but if you gather up to 10 diameter, 2 cm and stemmed. And usually there is very little to no attention. Sometimes it occurs more than one area.
§ In rare cases, bleeding and urinary tract obstruction if the virus reaches the urethra tract
§ Having a history of active sexual life with multiple partners

Often, genital warts have no symptoms. This is due to the wart grows very small and flat so it can not be seen with the naked eye.

Cause
Genital warts or condyloma caused by infection in the epidermis by the Human papilloma virus type-specific in most lesions caused by HPV 6 and 11 were found, but sometimes 16 or other types of HPV also found a relationship between genital warts with skin warts usually has been discussed previously but there was no clinical or virological evidence of a relationship between them but nevertheless a small number of patients with common skin warts also experienced the same warts on the genital HIV autoinokulasi with 1.2 or 4 seems to be the most likely explanation, because the species - species have been identified warts on some material.

Condyloma DURING PREGNANCY

Pregnancy and condyloma acuminata / HPV
Women exposed to HPV during pregnancy have a concern that this virus will harm their baby. In most cases of HPV does not affect fetal development.
Effect of condyloma during pregnancy
If a woman is exposed to condyloma during pregnancy, condyloma will quickly grow, possibly due to excessive vaginal discharge that makes a good environment for viruses, change or decline in the immune horminal.
Effect of condyloma acuminata / HPV to infants
HPV does not affect pregnancy and infant health directly. The risk of transmission of this virus to babies is very low.
If the baby is exposed to the virus during pregnancy or while giving birth then this transmission can lead to the development of the wart / warts on cords vocalist and occasionally on other areas in the infantry or the children. This condition is called recurrent respiratory papillomatous (RRP), this sangaat dangerous, but that in very rare.

Treatments
Because viruses are subclinical HPV infection is latent and, hence there is no specific therapy against this virus, treatment is directed at cleaning warts - warts that look and not the destruction of the virus. Inspection is a lesion that appears before sangant cervical cancer is important for patients who have lesions Wanit clinical or contact history. Personal Attention must be emphasized because the humidity support the growth of warts
Drugs
1. podophylin
Podophylin is a resin extracted from plants containing several cytotoxic compounds that ratio can not be changed. Podophylin the most active are podophylotoksin. This type may consist of various concentrations of 10-25% with compound benzoin tinoture, spirit and paraffin cair.yang podofilin tincture used is 25%, the surrounding skin is protected with petroleum jelly or paste form to avoid irritation after 4-6 hours of washing. If no healing can be repeated after three days, each time giving no more than 0.3 cc because it will be absorbed and is toxic. Toxic symptoms are nausea, vomiting, abdominal pain disorders breathing equipment and the skin cold sweat. In pregnant women should not be given because of fetal death can occur. Response to this type of treatment varied, some patients require several sessions perawaan to achieve clinical cure, whereas patients - other patients showed little response and other types of treatments should dipertimbangkan.

2. podofilytocin
This is an active ingredient podophylin resin and available as much as 0.5% in solution eatnol.This is an anti mitotis agent and is not recommended for use during kehamiolan or menysui, this species is more secure than self apilkasi podophylin can be allowed in the case - a case an appropriate complaint.

3. Triklorasetik acid (TCA)
This alternative topical agent and is often used on warts with a concentration of 30-50% is applied each week and the provision must be very careful - my heart because it may cause deep ulcer. This material can be used in pregnancy.

4. Topical 5-fluorouracil (5 FU)
Cream 5 Fu can be used especially for the treatment of urethral and vulvar vaginal warts, concentration 1-5% giving is done every day until the lesions disappeared and did not miksi during delivery. Local irritation buakn thing you can not.

5. Interferon
Although interferon has shown results for verucciformis menjanjinkan and anogenital HPV infection, the effectiveness of these materials in the treatment of genital warts is still questionable. Parentral and intra-lesional therapy terhadapa genital warts with natural interferon preparations and recombination has yielded response rates ranging from 870-80% in the report - a preliminary report. Has demonstrated that the combination of IFN with other ablative surgical procedures produce the recurrence rate (Relapse rate) and lower. Inerferon side effects of systemic treatment include flu-like panyakit and transient neutropenia

Surgical treatment
1. Curette or Kauter (Elektrokauterisasi)
Curette or Kauter (Elektrokauterisasi) with the condition of local anesthetics can be used for the treatment of warts that resister to the treatment of topical scars scar appearance is one of the deficiencies of this method.

2. Frozen Surgery (N2, N2O liquid)

3. Laser
Karbodioksida effective laser is used to destroy a few warts - warts that are difficult. There are no concerns about the ineffectiveness of the carbon dioxide generated during the procedure is complete, leaving little scarring.

4. Combination Therapy
Various combination therapies have been used against a stubborn genital warts, for example interferon combination with surgical procedures, combined with podophylin TCAA, surgery with podophylin. Someone must be very careful - careful when using this combination therapy because some of these treatments can cause very serious reactions

Prevention
Keep away from freesex is one way of preventing, condom use may not be fully protected against genital warts because of its location - the location is not necessarily clear and known. Do not have a sex until you and your partner completed treatment if you are infected with HPV.

Source: from multiple reliable sources.

Penile Fracture - the best SUCK disease for MAN

noreply@blogger.com (Pixsimo) — Mon, 23 Aug 2010 11:06:00 +0000

A penile fracture is an injury caused by the rupture of the tunica albuginea, which envelops the corpus cavernosum penis. It is most often caused by a blunt trauma to an erect penis.

Many men don't realize that it is possible to injure their penis during sex. A penile fracture is also called a broken penis.

Symptoms

A popping or cracking sound, significant pain, immediate flaccidity, and skin hematoma of various sizes are commonly associated with the event. These symptoms are similar to a common bruising or contusion of the penis.

Causes of Penile Fracture

When a man becomes aroused,
rapidly pumping blood is trapped in his penis. Two spongy tubes that run through the shaft swell and strain against the surrounding stretchy sheath. The stretchy sheath is called white tunic.

As the penis thickens and lengthens, the white tunic expands and thins. However, the white tunic stretches too much, the layers can rip, releasing a small surge of blood. When penile tissue rips, the rip is usually accompanied by a popping sound, then swelling and discoloration of the penis. The discoloration of the penis is usually to a deep purple hue. Usually, the erection is immediately lost and pain occurs. Sometimes the pain is so intense that that man will have difficulty urinating.

Penile fracture can also be caused by sudden blunt trauma or abrupt lateral bending of the penis in an erect state.

Who is at risk for Penile Fractures?

Engaging in some sexual positions will increase the risk of a penile fracture. When a woman is on top, the risk of penile fracture increases. If the woman bends too far forward or backward, she can create excessive torque on the penis.

Engaging in rear-entry vaginal intercourse also increases the risk of penile fracture. Rear entry is more risky because the penis is more likely to bend too far at its base.

Other positions and mishaps can also increase the risk of penile fracture. For example, if a woman is sitting on a desk and the man is facing her, if he misjudges and suddenly pushes his penis into the desk, penile fracture may occurs.

Penile Fracture Treatment

Surgery is the only way to fix a broken penis. Surgery is often successful and the patient will regain is sexual function. Recovery takes about six weeks.

If a penile fracture is untreated, serious complications might occur. The small bruise the occurs immediately after a penile fracture will develop into a scar in the penis. Scarred penile tissue is very difficult to treat.

It is important to remember that penile fracture is is a minor injury and that men can go completely back to normal after surgery.

Other types of Penile Injuries

Wear and tear caused by mild, painless injuries to the penis during sex can lead to Peyronie's disease. Peyronie's disease leaves the penis with a dramatic bend.

Chron's disease-the "WOW" disease in digestion system

noreply@blogger.com (Pixsimo) — Sat, 21 Aug 2010 08:16:00 +0000

Crohn's disease, also known as granulomatous enteritis and colitis, is an inflammatory disease of the intestines that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. It primarily causes abdominal pain, diarrhea (which may be bloody if inflammation is at its worst), vomiting, or weight loss,but may also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, inflammation of the eye, tiredness, and lack of concentration.

Crohn's disease is thought to be an autoimmune disease, in which the body's immune system attacks the gastrointestinal tract, causing

inflammation; it is classified as a type of inflammatory bowel disease. There has been evidence of a genetic link to Crohn's disease, putting individuals with siblings afflicted with the disease at higher risk.It is understood to have a large environmental component as evidenced by the higher number of cases in western industrialized nations. Males and females are equally affected. Smokers are three times more likely to develop Crohn's disease.Crohn's disease affects between 400,000 and 600,000 people in North America.^[6] Prevalence estimates for Northern Europe have ranged from 27–48 per 100,000. Crohn's disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age.

There is no known pharmaceutical or surgical cure for Crohn's disease.Treatment options are restricted to controlling symptoms, maintaining remission and preventing relapse.

The disease was named for American gastroenterologist Burrill Bernard Crohn, who in 1932, along with two colleagues, described a series of patients with inflammation of the terminal ileum, the area most commonly affected by the illness.For this reason, the disease has also been called regional ileitis or regional enteritis. The condition, however, has been independently identified by others in the literature prior, most notably in 1904 by Polish surgeon Antoni Leśniowski for whom the condition is additionally named (Leśniowski-Crohn's disease) in the Polish literature.

Distribution of gastrointestinal Crohn's disease. Based on data from American Gastroenterological Association.

Crohn's disease is one type of inflammatory bowel disease (IBD). It affects the gastrointestinal tract and can be categorized by the area of the gastrointestinal tract which it affects. Ileocolic Crohn's disease, which affects both the ileum (the last part of the small intestine that connects to the large intestine) and the large intestine, accounts for fifty percent of cases. Crohn's ileitis, affecting the ileum only, accounts for thirty percent of cases, and Crohn's colitis, affecting the large intestine, accounts for the remaining twenty percent of cases and may be particularly difficult to distinguish from ulcerative colitis. Gastroduodenal Crohn's disease causes inflammation in the stomach and first part of the small intestine, called the duodenum. Jejunoileitis causes spotty patches of inflammation in the top half of the small intestine, called the jejunum (MedlinePlus 2010). The disease can attack any part of the digestive tract, from mouth to anus. However, individuals affected by the disease rarely fall outside these three classifications, being affected in other parts of the gastrointestinal tract such as the stomach and esophagus.

Crohn's disease may also be categorized by the behavior of disease as it progresses. This was formalized in the Vienna classification of Crohn's disease. There are three categories of disease presentation in Crohn's disease: stricturing, penetrating, and inflammatory.Stricturing disease causes narrowing of the bowel that may lead to bowel obstruction or changes in the caliber of the feces. Penetrating disease creates abnormal passageways (fistulae) between the bowel and other structures such as the skin. Inflammatory disease (or non-stricturing, non-penetrating disease) causes inflammation without causing strictures or fistulae.

Gastrointestinal symptoms

Endoscopy image of colon showingserpiginous ulcer, a classic finding in Crohn's disease

Many people with Crohn's disease have symptoms for years prior to the diagnosis.The usual onset is between 15 and 30 years of age but can occur at any age. Because of the 'patchy' nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more vague than with ulcerative colitis. People with Crohn's disease will go through periods of flare-ups and remission.

Abdominal pain may be the initial symptom of Crohn's disease. It is often accompanied by diarrhea, especially in those who have had surgery. The diarrhea may or may not be bloody. People who have had surgery or multiple surgeries often end up with short bowel syndrome of the gastrointestinal tract. The nature of the diarrhea in Crohn's disease depends on the part of the small intestine or colon that is involved. Ileitis typically results in large-volume watery feces. Colitis may result in a smaller volume of feces of higher frequency. Fecal consistency may range from solid to watery. In severe cases, an individual may have more than 20 bowel movements per day and may need to awaken at night to defecate. Visible bleeding in the feces is less common in Crohn's disease than in ulcerative colitis, but may be seen in the setting of Crohn's colitis. Bloody bowel movements are typically intermittent, and may be bright or dark red in colour. In the setting of severe Crohn's colitis, bleeding may be copious.Flatulence and bloating may also add to the intestinal discomfort.

Symptoms caused by intestinal stenosis are also common in Crohn's disease. Abdominal pain is often most severe in areas of the bowel with stenoses. In the setting of severe stenosis, vomiting and nausea may indicate the beginnings of small bowel obstruction. Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts.

Perianal discomfort may also be prominent in Crohn's disease. Itchiness or pain around the anus may be suggestive of inflammation, fistulization or abscess around the anal area oranal fissure. Perianal skin tags are also common in Crohn's disease. Fecal incontinence may accompany peri-anal Crohn's disease. At the opposite end of the gastrointestinal tract, the mouth may be affected by non-healing sores (aphthous ulcers). Rarely, the esophagus, and stomach may be involved in Crohn's disease. These can cause symptoms including difficulty swallowing (dysphagia), upper abdominal pain, and vomiting.

Systemic symptoms

Crohn's disease, like many other chronic, inflammatory diseases, can cause a variety of systemic symptoms. Among children, growth failure is common. Many children are first diagnosed with Crohn's disease based on inability to maintain growth. As Crohn's disease may manifest at the time of the growth spurt in puberty, up to 30% of children with Crohn's disease may have retardation of growth. Fever may also be present, though fevers greater than 38.5 ˚C (101.3 ˚F) are uncommon unless there is a complication such as an abscess.Among older individuals, Crohn's disease may manifest as weight loss. This is usually related to decreased food intake, since individuals with intestinal symptoms from Crohn's disease often feel better when they do not eat and might lose their appetite. People with extensive small intestine disease may also have malabsorption of carbohydrates or lipids, which can further exacerbate weight loss.

Extraintestinal symptoms

Erythema nodosum on the back of a person with Crohn's disease.

Pyoderma gangrenosum on the leg of a person with Crohn's disease.

In addition to systemic and gastrointestinal involvement, Crohn's disease can affect many other organ systems. Inflammation of the interior portion of the eye, known as uveitis, can cause eye pain, especially when exposed to light (photophobia). Inflammation may also involve the white part of the eye (sclera), a condition called episcleritis. Both episcleritis and uveitis can lead to loss of vision if untreated.

Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloarthropathy. This group of diseases is characterized by inflammation of one or more joints(arthritis) or muscle insertions (enthesitis). The arthritis can affect larger joints such as the knee or shoulder or may exclusively involve the small joints of the hand and feet. The arthritis may also involve the spine, leading to ankylosing spondylitis if the entire spine is involved or simply sacroiliitisif only the lower spine is involved. The symptoms of arthritis include painful, warm, swollen, stiffjoints and loss of joint mobility or function.

Crohn's disease may also involve the skin, blood, and endocrine system. One type of skin manifestation, erythema nodosum, presents as red nodules usually appearing on the shins. Erythema nodosum is due to inflammation of the underlying subcutaneous tissue and is characterized by septal panniculitis. Another skin lesion, pyoderma gangrenosum, is typically a painful ulcerating nodule. Crohn's disease also increases the risk of blood clots; painful swelling of the lower legs can be a sign of deep venous thrombosis, while difficulty breathing may be a result ofpulmonary embolism. Autoimmune hemolytic anemia, a condition in which the immune system attacks the red blood cells, is also more common in Crohn's disease and may cause fatigue, pallor, and other symptoms common in anemia. Clubbing, a deformity of the ends of the fingers, may also be a result of Crohn's disease. Finally, Crohn's disease may cause osteoporosis, or thinning of the bones. Individuals with osteoporosis are at increased risk of bone fractures.

Crohn's disease can also cause neurological complications (reportedly in up to 15% of patients).The most common of these are seizures, stroke, myopathy, peripheral neuropathy,headache and depression.

Crohn's patients often also have issues with small bowel bacterial overgrowth syndrome, which has similar symptoms.

Complications

Endoscopic image of colon canceridentified in the sigmoid colon on screeningcolonoscopy for Crohn's disease.

Crohn's disease can lead to several mechanical complications within the intestines, including obstruction, fistulae, and abscesses. Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents. Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. Abscesses are walled off collections of infection, which can occur in the abdomen or in the perianal area in Crohn's disease sufferers.

Crohn's disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohn's disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn's colitis have a relative risk of 5.6 for developing colon cancer. Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn's colitis for at least eight years.Some studies suggest that there is a role for chemoprotection in the prevention of colorectal cancer in Crohn's involving the colon; two agents have been suggested, folate and mesalamine preparations.

Individuals with Crohn's disease are at risk of malnutrition for many reasons, including decreased food intake and malabsorption. The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohn's disease are referred to a dietitian for assistance in nutrition.

Crohn's disease can cause significant complications including bowel obstruction, abscesses, free perforation and hemorrhage.

Crohn's disease can be problematic during pregnancy, and some medications can cause adverse outcomes for the fetus or mother. Consultation with an obstetrician and gastroenterologist about Crohn's disease and all medications allows preventative measures to be taken. In some cases, remission can occur during pregnancy. Certain medications can also impact sperm count or may otherwise adversely affect a man's ability to conceive.

Cause

Although the exact cause of Crohn's disease is still unknown, a combination of environmental factors and genetic predisposition seems to cause the disease. The genetic risk factors have now more or less been comprehensively elucidated, making Crohn's disease the first genetically complex disease of which the genetic background has been resolved. The relative risks of contracting the disease when one has a mutation in one of the risk genes, however, are actually very low (approximately 1:200). Broadly speaking, the genetic data indicate that innate immune systems in patients with Crohn's disease malfunction, and direct assessment of patient immunity confirms this notion. This had led to the notion that Crohn's disease should be viewed as innate immune deficiency, chronic inflammation being caused by adaptive immunity trying to compensate for the reduced function of the innate immune system.

Genetics

Schematic of NOD2 CARD15 gene, which is associated with certain disease patterns in Crohn's disease.

Some research has indicated that Crohn's disease may have a genetic link. The disease runs in families and those with a sibling with the disease are 30 times more likely to develop it than the general population.

Mutations in the CARD15 gene (also known as the NOD2 gene) are associated with Crohn's disease and with susceptibility to certain phenotypes of disease location and activity. In earlier studies, only two genes were linked to Crohn's, but scientists now believe there are over thirty genes that show genetics play a role in the disease, either directly through causation or indirectly as with a mediator variable. Anomalies in the XBP1 gene have recently been identified as a factor, pointing towards a role for the unfolded protein response pathway of theendoplasmatic reticulum in inflammatory bowel diseases.

Environmental factors

Diet is believed to be linked to its higher prevalence in industrialized parts of the world. A positive correlation has been found between the incidence of the disease and an increased intake of animal protein, milk protein and an increased ratio of n-6 to n-3 polyunsaturated fatty acids.^[42] Negative correlation of the disease incidence was found to the increased consumption of vegetable protein, and no correlation to fish protein.Smoking has been shown to increase the risk of the return of active disease, or "flares". The introduction of hormonal contraception in the United States in the 1960s is linked with a dramatic increase in the incidence rate of Crohn's disease. Although a causal linkage has not been effectively shown, there remain fears that these drugs work on the digestive system in ways similar to smoking.

Immune system

Abnormalities in the immune system have often been invoked as being causes of Crohn's disease. Crohn's disease is thought to be an autoimmune disease, with inflammation stimulated by an over-active T_h1 cytokine response. However, more recent evidence has shown that T_h17 is of greater importance in the disease. The most recent gene to be implicated in Crohn's disease is ATG16L1, which may induce autophagy and hinder the body's ability to attack invasive bacteria.

Contrary to the prevailing view that Crohn's disease is a primary T cell autoimmune disorder, there is an increasing body of evidence in favor of the hypothesis that Crohn's disease results from an impaired innate immunity.The immunodeficiency, which has been shown to be due to (at least in part) impaired cytokine secretion by macrophages, is thought to lead to a sustained microbial-induced inflammatory response, particularly in the colon where the bacterial load is especially high.

Microbes

A variety of pathogenic bacteria were initially suspected of being causative agents of Crohn's disease. However, most health care professionals now believe that a variety of microorganisms are taking advantage of their host's weakened mucosal layer and inability to clear bacteria from the intestinal walls, both symptoms of the disease. Some studies have suggested that Mycobacterium avium subspecies paratuberculosis (MAP) plays a role in Crohn's disease, in part because it causes a very similar disease, Johne's disease, in cattle.The mannose bearing antigens (mannins) from yeast may also elicit an antibody response. Other studies have linked specific strains of enteroadherent E. coli to the disease. Still, this relationship between specific types of bacteria and Crohn's disease remains unclear.

Some studies have suggested that some symptoms of Crohn's disease, ulcerative colitis and irritable bowel syndrome have the same underlying cause. Biopsy samples taken from the colons of all three patient groups were found to produce elevated levels of a serine protease. Experimental introduction of the serine protease into mice has been found to produce widespread pain associated with irritable bowel syndrome as well as colitis, which is associated with all three diseases. The authors of that study were unable to identify the source of the protease, but a separate review noted that regional and temporal variations in those illnesses follow those associated with infection with a poorly understood protozoan,Blastocystis.

A study in 2003 put forth the "cold-chain" hypothesis, that psychrotrophic bacteria such as Yersinia spp and Listeria spp contribute to the disease. A statistical correlation was found between the advent of the use of refrigeration in the United States and various parts of Europe and the rise of the disease. Later studies have provided support for this hypothesis.

Studies done at the University of Liverpool have offered ideas that would explain the apparent connection between Crohn's disease, Mycobacterium, other pathogenic bacteria, and genetic markers. In many individuals genetic factors predispose individuals to Mycobacterium avium subsp. paratuberculosis infection. This bacteria then produce mannins which protect both itself and various bacteria from phagocytosis, which causes a variety of secondary infections. Other mycobacterial diseases, such as leprosy and Tuberculosis could be considered similar in that they have strong genetic components, but are not genetic per se.

Diagnosis

Endoscopic image of Crohn's colitis showing deep ulceration

CT scan showing Crohn's disease in the fundus of the stomach

Crohn's disease can mimic ulcerative colitis on endoscopy. This endoscopic image is of Crohn's colitis showing diffuse loss ofmucosal architecture, friability of mucosa in sigmoid colon and exudate on wall, all of which can be found with ulcerative colitis.

The diagnosis of Crohn's disease can sometimes be challenging, and a number of tests are often required to assist the physician in making the diagnosis.Even with a full battery of tests it may not be possible to diagnose Crohn's with complete certainty; a colonoscopy is approximately 70% effective in diagnosing the disease with further tests being less effective. Disease in the small bowel is particularly difficult to diagnose as a traditional colonoscopy only allows access to the colon and lower portions of the small intestines; introduction of the capsule endoscopyaids in endoscopic diagnosis. Multinucleated giant cells, a common finding in the lesions of Crohn's disease, are less common in the lesions of lichen nitidus.

Endoscopy

A colonoscopy is the best test for making the diagnosis of Crohn's disease as it allows direct visualization of the colon and the terminal ileum, identifying the pattern of disease involvement. Occasionally, the colonoscope can travel past the terminal ileum but it varies from patient to patient. During the procedure, the gastroenterologist can also perform a biopsy, taking small samples of tissue for laboratory analysis which may help confirm a diagnosis. As 30% of Crohn's disease involves only the ileum, cannulation of the terminal ileum is required in making the diagnosis. Finding a patchy distribution of disease, with involvement of the colon or ileum but not the rectum, is suggestive of Crohn's disease, as are other endoscopic stigmata.The utility of capsule endoscopy for this, however, is still uncertain.

Radiologic tests

A small bowel follow-through may suggest the diagnosis of Crohn's disease and is useful when the disease involves only the small intestine. Because colonoscopy and gastroscopy allow direct visualization of only the terminal ileum and beginning of the duodenum, they cannot be used to evaluate the remainder of the small intestine. As a result, a barium follow-through x-ray, wherein barium sulfate suspension is ingested and fluoroscopic images of the bowel are taken over time, is useful for looking for inflammation and narrowing of the small bowel.Barium enemas, in which barium is inserted into the rectum and fluoroscopy used to image the bowel, are rarely used in the work-up of Crohn's disease due to the advent of colonoscopy. They remain useful for identifying anatomical abnormalities when strictures of the colon are too small for a colonoscope to pass through, or in the detection of colonic fistulae.

CT and MRI scans are useful for evaluating the small bowel with enteroclysis protocols.They are additionally useful for looking for intra-abdominal complications of Crohn's disease such as abscesses, small bowel obstruction, or fistulae.Magnetic resonance imaging (MRI) is another option for imaging the small bowel as well as looking for complications, though it is more expensive and less readily available

Blood tests

A complete blood count may reveal anemia, which may be caused either by blood loss or vitamin B₁₂ deficiency. The latter may be seen with ileitis because vitamin B₁₂ is absorbed in the ileum. Erythrocyte sedimentation rate, or ESR, and C-reactive protein measurements can also be useful to gauge the degree of inflammation. It is also true in patients with ilectomy done in response to the complication. Another cause of anaemia is anaemia of chronic disease, characterized by its microcytic and hypochromic anaemia. There can be various reasons for anaemia, including medication used in treatment of inflammatory bowel disease like azathioprine which can lead to cytopenia and sulfasalazine which can also result in folate malabsorption, etc. Testing for anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) has been evaluated to identify inflammatory diseases of the intestine and to differentiate Crohn's disease from ulcerative colitis. Furthermore, increasing amounts and levels of serological antibodies such as ASCA, anti-laminaribioside [Glc(β1,3)Glb(β); ALCA], anti-chitobioside (GlcNAc(β1,4)GlcNAc(β); ACCA], anti-mannobioside [Man(α1,3)Man(α)AMCA], anti-Laminarin [Glc(β1,3))3n(Glc(β1,6))n; anti-L] and anti-Chitin [(GlcNAc(β1,4)n; anti-C] associate with disease behavior and surgery, and may aid in the prognosis of Crohn's disease.

Comparison with ulcerative colitis

The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.^[1][8][16]

Comparisons of various factors in Crohn's disease and ulcerative colitis
	Crohn's disease	Ulcerative colitis
Terminal ileum involvement	Commonly	Seldom
Colon involvement	Usually	Always
Rectum involvement	Seldom	Usually^[83]
Involvement around the anus	Common^[84]	Seldom
Bile duct involvement	No increase in rate of primary sclerosing cholangitis	Higher rate^[85]
Distribution of Disease	Patchy areas of inflammation (Skip lesions)	Continuous area of inflammation^[83]
Endoscopy	Deep geographic and serpiginous (snake-like) ulcers	Continuous ulcer
Depth of inflammation	May be transmural, deep into tissues^[1][84]	Shallow, mucosal
Fistulae	Common^[84]	Seldom
Stenosis	Common	Seldom
Autoimmune disease	Widely regarded as an autoimmune disease	No consensus
Cytokine response	Associated with T_h17 ^[45]	Vaguely associated with T_h2
Granulomas on biopsy	May have non-necrotizing non-peri-intestinal crypt granulomas^[84][86][87]	Non-peri-intestinal crypt granulomas not seen^[83]
Surgical cure	Often returns following removal of affected part	Usually cured by removal of colon
Smoking	Higher risk for smokers	Lower risk for smokers^[83]

Treatment

Currently there is no cure for Crohn's disease and remission may not be possible or prolonged if achieved. In cases where remission is possible, relapse can be prevented andsymptoms controlled with medication, lifestyle changes and in some cases, surgery. Adequately controlled, Crohn's disease may not significantly restrict daily living. Treatment for Crohn's disease is only when symptoms are active and involve first treating the acute problem, then maintaining remission.

Medication

Acute treatment uses medications to treat any infection (normally antibiotics) and to reduce inflammation (normally aminosalicylate anti-inflammatory drugs and corticosteroids). When symptoms are in remission, treatment enters maintenance with a goal of avoiding the recurrence of symptoms. Prolonged use of corticosteroids has significant side-effects; as a result they are generally not used for long-term treatment. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs. It has been also suggested that antibiotics change the enteric flora and their continuous use may pose the risk of overgrowth with pathogens such asClostridium difficile.

Medications used to treat the symptoms of Crohn's disease include 5-aminosalicylic acid (5-ASA) formulations, prednisone, immunomodulators such as azathioprine, mercaptopurine,methotrexate, infliximab, adalimumab, certolizumab and natalizumab. Hydrocortisone should be used in severe attacks of Crohn's disease.

Low doses of the opiate receptor antagonist Naltrexone (also Low dose naltrexone) have been found to be effective in inducing remission in 67% of patients with Crohn's disease in a small study conducted at Pennsylvania State University. Dr. Jill Smith, Professor of Gastroenterology at Pennsylvania State University's College of Medicine concluded that "LDN therapy appears effective and safe in subjects with active Crohn’s disease." Smith and her colleagues have since received a NIH grant and are proceeding with a definitive Phase II placebo-controlled clinical trial.

Since late 1990s, biological medications are available

Lifestyle changes

Certain lifestyle changes can reduce symptoms, including dietary adjustments, proper hydration and smoking cessation. Smoking may increase Crohn's disease, stopping is recommended. Eating small meals frequently instead of big meals may also help with a low appetite. To manage symptoms have a balanced diet with proper portion control. Fatigue can be helped with regular exercise, a healthy diet, and enough sleep. A food diary may help with identifying foods that trigger symptoms. Some patients should follow a low dietary fiber diet to control symptoms especially if fibrous foods cause symptoms.

Surgery

Crohn's cannot be cured by surgery, though it is used when partial or a full blockage of the intestine occurs. Surgery may also be required for complications such as obstructions, fistulas and/or abscesses, or if the disease does not respond to drugs. After the first surgery, Crohn's usually shows up at the site of the resection though it can appear in other locations. After a resection, scar tissue builds up which can cause strictures. A stricture is when the intestines become too small to allow excrement to pass through easily which can lead to a blockage. After the first resection, another resection may be necessary within five years. For patients with an obstruction due to a stricture, two options for treatment are strictureplasty and resection of that portion of bowel. There is no statistical significance between strictureplasty alone versus strictureplasty and resection in cases of duodenal involvement. In these cases, re-operation rates were 31% and 27%, respectively, indicating that strictureplasty is a safe and effective treatment for selected patients with duodenal involvement.

Short bowel syndrome (SBS, also short gut syndrome or simply short gut) can be caused by the surgical removal of the small intestines. It usually develops if a person has had half or more of their small intestines removed.Diarrhea is the main symptom of short bowel syndrome though other symptoms may include cramping, bloating and heartburn. Short bowel syndrome is treated with changes in diet, intravenous feeding, vitamin and mineral supplements and treatment with medications. Another complication following surgery for Crohn's disease where the terminal ileum has been removed is the development of excessive watery diarrhea. This is due to an inability to reabsorb bile acids after resection of the terminal ileum.

In some cases of SBS, intestinal transplant surgery may be considered; though the number of transplant centres offering this procedure is quite small and it comes with a high risk due to the chance of infection and rejection of the transplanted intestine.

Prospective treatments

Researchers at University College London have questioned the wisdom of suppressing the immune system in Crohn's, as the problem may be an under-active rather than an over-active immune system: their study found that Crohn's patients showed an abnormally low response to an introduced infection, marked by a poor flow of blood to the wound, and the response improved when the patients were given sildenafil citrate.

Recent studies using helminthic therapy or hookworms to treat Crohn's Disease and other (non-viral) auto-immune diseases seem to yield promising results.

Complementary and alternative medicine

More than half of Crohn's disease sufferers have tried complementary or alternative therapy. These include diets, probiotics, fish oil and other herbal and nutritional supplements. The benefit of these medications is uncertain.

Acupuncture is used to treat inflammatory bowel disease in China, and is being used more frequently in Western society. However, there is no evidence that acupuncture has benefits beyond the placebo effect.
Methotrexate is a folate anti-metabolite drug which is also used for chemotherapy. It is useful in maintenance of remission for those no longer taking corticosteroids.
Metronidazole and ciprofloxacin are antibiotics which are used to treat Crohn's that have colonic or perianal involvement, although, in the United States, this use has not been approved by the Food and Drug Administration. They are also used for treatment of complications, including abscesses and other infections accompanying Crohn's disease.
Thalidomide has shown response in reversing endoscopic evidence of disease.
Cannabis-derived drugs may be used to treat Crohn's Disease with their anti-inflammatory properties. Cannabis-derived drugs may also help to heal the gut lining.
Soluble Fiber has been used by some to treat symptoms
Probiotics include Sacchromyces boulardii and E. coli Nissle 1917.
Boswellia is an ayurvedic (Indian traditional medicine) herb, used as a natural drug. One study has found that the effectiveness of "Boswellia serrata extract H 15" is not inferior tomesalazine, and concludes that the Boswellia extract's safety and efficacy make it superior to mesalazine in benefit-risk evaluations.

Source : WIKIpedia with some edited

arthritis GOUT - one of disease in the joint

noreply@blogger.com (Pixsimo) — Fri, 20 Aug 2010 05:25:00 +0000

Definition
Gout or laymen say "uric acid" is a condition in which the body can not control the uric acid, so that the excessive uric acid crystals will accumulate in body tissues. Gout is marked by elevated levels of uric acid in the body and cause inflammation (inflammation) in the joints (arthritis). Gout, chronic (long term) can cause the buildup of uric acid in and around the joints, reducing kidney function and form kidney stones.

Cause
Uric acid is a substance formed by

the rest of the body at the time of cell regeneration. Some people with gout form more uric acid in his body (10%). The rest (90%), your body does not effectively dispose of uric acid through urine. Genetic, sex and nutrition (drinking alcohol, obesity) play an important role in the formation of gout.

Symptoms and Signs
The initial symptoms of gout arthritis is a hot, redness and swelling in the joints that typical and suddenly. Frequently affected joints are small joints at the base of the toes. Several others who may be affected joints are ankles, knees, wrists, fingers, and elbows. In patients with acute attacks of gout can cause symptoms of fever and severe pain which usually lasted for hours until the day, with or without treatment. Over time arthritis, gout attacks occur more often and longer.
Patients with gout increases the likelihood of the formation of kidney stones.
Uric acid crystals can form tophi (hard painless lumps around the joints) outside the joints.Tophi often found around your finger, at the end of the elbow and around my toes, apart from that can be found also on the ear, tendons achiles (area behind the ankle) and vocal cords (very rare).

Additional Inspection
Gout disease is not easily diagnosed only by blood tests, because most people who have high uric acid levels are not affected by gout.
Additional examination of the most reliable for gout is finding uric acid crystals in the synovial fluid by joint aspiration (arthrocentesis). Arthrocentesis is a common procedure performed under local anesthesia. By using a sterile technique, fluid is taken from the inflamed joints using syringes and needles.
In addition, the diagnosis of gout can also by finding uric acid crystals from tophi lumps.

Treatment
Gout is not curable, but can be treated and controlled. Symptoms within 24 hours will usually disappear after starting treatment.
Gout is generally treated with anti-inflammatory drugs. That includes:
• NSAIDs, like ibuprofen or naproxen, are commonly given to treat severe and sudden attacks, these medications reduce inflammation and pain bisasanya within a few hours.
• Corticosteroids may be given to people who can not use NSAIDs. Steroids decrease inflammation work. Steroid injection (injection) directly on the affected joints or taken in pill form.
• colchicine is often also used to treat inflammation in gout.
• Allupurinol can lower uric acid levels by suppressing the production of uric acid. These drugs work on the metabolism of uric acid by preventing changes in purine substances in food into uric acid. This medication is not recommended for people with poor kidney function, in addition, can cause side effects such as redness and liver damage.

Prevention
Foods that contain high protein, high-purine and has long been known to cause and increase the risk of gout.
• Restrictions purine
If there is swelling of the joints disorders gout sufferers should make a purine-free diet. But because almost all foods contain protein sources nucleoprotein then this is nearly impossible.So what should be done is to limit intake to 100-150 mg purine purine per day (normal diet usually contains 600-1000 mg purine per day). Eating foods containing purines, among others;
o Offal (heart, liver, tongue, kidney, intestines)
o Sardines
o Shells
o Herrings
o Nuts
o Spinach
o Shrimp
o Leaf melinjo

• Calorie needs
Total caloric intake should be properly adjusted to the body's needs based on height and weight. Patients with uric acid disorder is overweight, her weight should be reduced while maintaining total calorie consumption. Calorie intake is too little can also increase uric acid levels due to ketone bodies which will reduce spending through urine uric acid

• High carbohydrate
Complex carbohydrates such as rice, cassava, and sweet bread is best eaten by patients with disorders of uric acid because it will increase spending on uric acid through urine. This complex carbohydrate consumption should not be less than 100 grams per day. Simple carbohydrates fructose species such as sugar, candy, spun sugar, cotton candy, and syrup should be avoided because of fructose will increase uric acid levels in the blood.

• Low protein
Protein primarily derived from animals can raise levels of uric acid in the blood. Source of animal protein foods containing high amounts, such as liver, kidney, brain, lung and spleen. Protein intake recommended for patients with uric acid disorders amounted to 50-70 grams / day or 0.8 to 1 g / kg body weight / day. The recommended protein source is vegetable protein derived from milk, cheese and eggs.

• Low-fat
Fat may inhibit the excretion of uric acid through urine. Fried foods, bersantan, as well as margarine and butter should be avoided. Fat consumption should be as much as 15 percent of total calories. \

• High fluid
High fluid intake may help to remove uric acid through urine. Therefore, you are advised to spend as much as drinking a minimum of 2.5 liters or 10 cups a day. This can include drinking water cook the white water, tea, or coffee. Apart from the drinks, the liquid can be obtained through the fresh fruits that contain lots of water. Recommended fruits are watermelon, melon, cantaloupe, pineapple, sweet star fruit, guava and water. Apart from these fruits, other fruits may also be consumed because very few fruits contain purine. Fruits that should be avoided is the avocado and durian, because both have high fat content.

• Without alcohol
Based on research it is known that uric acid levels of those who consume alcohol than those who did not consume alcohol. This is because the alcohol will increase plasma lactic acid. This lactic acid will inhibit the body's expenditure of uric acid

Disseminated intravascular coagulation- a disease in the blood

noreply@blogger.com (Pixsimo) — Thu, 19 Aug 2010 16:22:00 +0000

DEFINITIONS Disseminated intravascular coagulation (DIC) is a state where a small blood clot clot-spread throughout the blood stream, causing blockage of small blood vessels and reducing the clotting factors needed to control bleeding.

CAUSE This condition begins with excessive blood clotting, which are usually stimulated by a toxic substance in the blood. Because the amount of clotting factor decreases, the excessive bleeding. People who have the highest risk for suffering from DIC:
Women who had undergone surgery or
childbirth content accompanied by complications, in which uterine tissue into the bloodstream
Patients with severe infections, where bacteria release endotoxins (a substance that causes clotting activation) Certain leukemia patients or patients with gastric cancer, pancreatic and prostate. People who have not too high risk to suffer from DIC:
Patients with severe head injury Men who had undergone prostate surgery Exposed to snake bites

. SYMPTOMS DIC usually appear suddenly and can be very heavy. If this situation occurs after surgery or childbirth, then the surface of the incision or tear tissue may develop severe and uncontrolled bleeding. Bleeding can be settled in the area where the injection or puncture; massive haemorrhage can occur in the brain, gastrointestinal tract, skin. Muscle and body cavity.
Blood clots in small blood vessels that can damage the kidneys (sometimes permanent nature) so that no urine is formed.
DIAGNOSIS Blood tests showed: - Decrease the amount of clotting factor - The existence of a small clot clot-unusual
- Solving a large number of blood clots.

TREATMENT The cause must be sought and addressed, whether the disruption of midwifery, infection or cancer. If the cause is addressed, then the clotting disorder can be reduced. DIC can be fatal, so that must be addressed as soon as possible. Platelet transfusions are given to replace the clotting factor and kekurangand's stop the bleeding. To slow freezing sometimes given heparin.

Meningitis-a disease which can KILL in hours

noreply@blogger.com (Pixsimo) — Thu, 19 Aug 2010 05:49:00 +0000

Meningitis is an inflammation of the meninges, the membrane or the membranes covering the brain and nervous . Meningitis can be caused by various organisms such as viruses, bacteria or fungi that spread into the blood and migrate into the brain fluid.

Patients suspected of having meningitis should be an accurate examination, both were caused by viruses, bacteria or fungi. This is necessary for the specification of treatment, because each will receive therapy according to the cause.

Causes of Meningitis Disease

Meningitis caused by viruses are generally not dangerous, will recover without specific treatment and care. However Meningitis caused by bacteria can cause serious conditions such as brain damage, hearing loss, lack of learning ability, can even cause death. Meningitis is caused by the fungus, while very rare, this type commonly suffered by people with damaged immune (immune system) as in patients with AIDS.

Bacteria that can cause an attack of meningitis include:
1. Streptococcus pneumoniae (pneumococcus).
This is the most common bacterial cause of meningitis in infants or children. This type of bacteria that can cause infection pneumonia, ear and nasal cavity (sinus).

2. Neisseria meningitidis (meningococcus).
This bacterium is the cause of the second largest after Streptococcus pneumoniae, meningitis due to infection of the upper respiratory tract and then the bacteria enter the bloodstream.

3. Haemophilus influenzae (Haemophilus).
Haemophilus influenzae type b (Hib) is a type of bacteria that can cause meningitis. This strain as the cause upper respiratory infections, middle ear and sinusitis. Vaccine (Hib vaccine) has shown a decrease in the number of meningitis cases caused by bacteria of this type.

4. Listeria monocytogenes (listeria).
This is one type of bacteria that can cause meningitis. This bacterium can be found in many places, in the dust and in contaminated food. These foods are usually the type of cheese, hot dogs and beef sandwiches where the bacteria comes from the local animals (pets).

5. Other bacteria can also cause meningitis are Staphylococcus aureus and Mycobacterium tuberculosis.

Signs and Symptoms of Meningitis Disease

Typical and general symptoms displayed by patients over the age of two years of meningitis are fever, headache and neck muscle stiffness that lasted for hours or be felt up to two days. Other signs and symptoms are photophobia (fear / avoid bright beam of light), phonophobia (fear / disturbed by loud noises), nausea, vomiting, often looking confused, difficulty to wake up from sleep, even unconscious.

In infants the symptoms and signs of meningitis disease may be very difficult to know, but generally the baby will look weak and quiet (inactive), tremor, vomiting and was reluctant to breastfeed.

Treatment of Disease Meningitis

If there are signs and symptoms as above, then the patient was taken to the hospital immediately to get the health service intensive. Physical examination, inspection labs include blood tests (elektrolite, liver and kidney functions, as well as complete blood), and X-ray examination (x-rays) will help the team pulmonary physician in diagnosing disease. While the examination is very important if the patient has suspected meningitis Lumbar puncture is the examination (examination of the fluid lining of the brain).

If on examination the patient was diagnosed as meningitis, then an infusion of antibiotic (intravenous) is a good step to ensure recovery and reduce or avoid the risk of complications.Antibiotics are given to patients depending on the type of bacteria found.

The few antibiotics that are often prescribed by doctors in cases of meningitis caused by Streptococcus pneumoniae and Neisseria meningitidis among others Cephalosporin (ceftriaxone or cefotaxime). While bacterial meningitis caused by Listeria monocytogenes will be given Ampicillin, Vancomycin and Carbapenem (meropenem), chloramphenicol or Ceftriaxone.

Treatment or other therapy that leads to symptoms such as headaches and fever (paracetamol), shock and convulsions (diazepam) and others.

Prevention of transmission of disease Meningitis

Meningitis caused by viruses can be transmitted through coughing, sneezing, kissing, sharing eating a spoon, use a toothbrush with and smoking alternately in one trunk. So for those of you who know your colleague or around there that experienced this type of meningitis must be careful. Mancuci clean hands before eating and after ketoilet general, holding pets. Maintain your stamina (endurance), body with nutritious eating and regular exercise is very good to avoid various diseases.

Granting Vaccine Immunization (vaccine) Meningitis is an appropriate action on the area which is known primarily susceptible to meningitis outbreaks, as for the vaccine that has been known as a precaution against meningitis, among others;
- Haemophilus influenzae type b (Hib)
- Pneumococcal conjugate vaccine (PCV7)
- Pneumococcal polysaccharide vaccine (PPV)
- Meningococcal conjugate vaccine (MCV4)

Steven Johnson syndrome - the second "speechless" diseases

noreply@blogger.com (Pixsimo) — Wed, 18 Aug 2010 14:04:00 +0000

Steven-Johnson Syndrome (SSJ) is a set of clinical symptoms of mucocutaneous eruption characterized by the triad of skin disorders on vesikulobulosa, orifice and eye mucosa accompanied by severe general symptoms. Synonyms include:-Rendu syndrome de Friessinger, erythema multiform major eksudativum, erythema poliform pemphigoid, Muko-kutaneo syndrome-ocular, dermatostomatitis, etc..

CLINICAL SYMPTOMS

Prodromal symptoms ranged from 1-14 days of fever, malaise, cough, korizal, pain swallowing, chest pain, vomiting, muscle aches and atralgia which vary greatly in degree of weight and combination of these symptoms.

After that will arise in the lesions:

• The skin form of erythema, chapel, vesicle, or bull symmetrically on almost the entire body.

• mucosa in the form of vesicles, bull, erosion, excoriation, bleeding red and leprosy. Bula occur suddenly in 1-14 days prodormal symptoms, appeared on the mucous membrane, membrane of the nose, mouth, anorectal, vulvovaginal region, and the urethral meatus. Ulcerative stomatitis and crusting hemoragis is the main picture.

• Eyes: konjungtivitas kataralis, blefarokonjungtivitis, iritis, iridosiklitis, eyelid edema and difficult to open, in case of severe erosion and perforation of the cornea that can cause blindness.Ocular mucosal injury is the trigger factors that cause ocular cicatricial pemphigoid, a chronic inflammation of the ocular mucosa, which causes blindness. The time required from onset until the occurrence of ocular cicatricial pemphigoid varies from several months to 31 years.

DIAGNOSIS

Diagnose directed against manifestations in accordance with triad abnormalities of skin, mucosa, eye, and its relationship with clinical factors that have shaped the target lesion, or eye sliced beef, abnormalities in the mucosa, fever. Also supported by laboratory examinations including peripheral blood examination, inspection imunologic, culturing the bacteria and test the resistance of the blood and the lesion, and histopathological examination of skin biopsy.Anemia can be found in cases with severe bleeding, leukocytes usually normal or slightly raised, there was an increase of eosinophils. IgG and IgM can be high, C3 and C4, normal or slightly decreased and can be detected circulating immune complexes. Skin biopsy was planned if there is no classic lesions. Imunoflurosesensi director can help the diagnosis of atypical cases.

Differential diagnosis

The main differential diagnosis is a toxic epidermal necrosis (NET) in which similar clinical manifestations but the general state of NET looks worse than SSJ.

Treatment

In general, patients generally a condition SSJ come with heavy, so therapy is usually given are:

• Fluids and electrolytes, as well as parenteral calories and protein.

• broad-spectrum antibiotics, followed by the results of bacterial culture and resistance tests of skin lesions and blood supply.

• Kortikosteroid Parenteral: 1mg/kg BW deksamentason initial bolus dose, then for three days from 0.2 to 0.5 mg / kg body weight every six hours. The use of systemic steroids is still controversial, there is assuming that the use of systemic steroids in children can cause slow healing and significant side effects, but there are also consider steroids beneficial and save lives.

• Antihistamines if necessary. Especially when there is itching Feniramin example hydrogen maleate (Avil. eyes and skin treatments and topical antibiotics.

• Bula in skin treated with wet compresses Burowi solution.

• Not allowed to use topical steroids on skin lesions.

• mouth lesions are given kenalog in orabase.

• Treatment of secondary infections with antibiotics is rarely cause allergies, broad spectrum, is bactericidal, non-nephrotoxic, such as intravenous clindamycin

neprholithiasis disease- a kidney with STONE

noreply@blogger.com (Pixsimo) — Wed, 18 Aug 2010 13:29:00 +0000

Back pain occurs when the rock entered obstruction in the kidney. Meanwhile, severe pain in the abdomen occurs when a stone has been moved into the ureter. Nausea and vomiting are always followed severe pain. Kidney stone patients sometimes also experience fever, chills, blood in the urine of stone if injure the ureter, abdominal distension, pus in the urine.

IN terms of medicine, kidney stones or renal calculi Nephrolithiasis called. Kidney stone is a state consists of one or more stones in the pelvis or calyces of the kidney or ureter in the channel. The formation of kidney stones can occur in any part of the urinary tract, but usually formed in two parts most of the kidney, namely in the tubs kidney (renal pelvis) and the renal calix. Stone can be formed from calcium, phosphate, or a combination of uric acid is usually dissolved in the urine.
Kidney stones vary in size, can be either single or double. The stones stay in kidney tubs or to enter into the ureters and can destroy kidney tissue. Large stone will damage the tissue by pressure or cause an obstruction, resulting in back flow of fluid. Most kidney stones can occur repeatedly.
cause

Is the cause? Kidney stones were found

on one of 1,000 people, usually more prevalent in men (aged 30-50 years) than women. Also encountered in certain areas. Although it is certainly not known to cause kidney stones, the likelihood is that if the urine becomes too concentrated and substances in urine form crystals in the stone. Other causes are infection, obstruction, excess secretion of parathyroid hormone, in renal tubular acidosis, elevated levels of uric acid (usually in conjunction with inflammation of the joints), damage to the metabolism of several types of materials in the body, too much use of vitamin D or consuming too much calcium .

Symptom
Although a large and varied stone location, the pain caused by obsruksi is the main symptom.Large stone with a rough surface that comes into the ureter will increase the frequency and force of contraction ureter automatically. The pain starts from the waist down toward the hips, then to the external genitals. Fluctuating pain intensity and pain is the culmination of tremendous pain. If kidney stones are in tubs and in the calix, the pain settled and less intensity. Back pain occurs when the rock entered obstruction in the kidney. Meanwhile, severe pain in the abdomen occurs when a stone has been moved into the ureter. Nausea and vomiting are always followed severe pain. Kidney stone patients sometimes also experience fever, chills, blood in the urine of stone if injure the ureter, abdominal distension, pus in the urine.

Diagnosis
The doctor will ask for symptoms, then perform the following tests:
1.Foto X-ray of the kidneys, ureters, and bladder to show the existence of kidney stones.
2.Ultrasound kidney, is a non-invasive tests that use high frequency waves will detect obstruction and its changes.
3.give intravenous dyes and scan to confirm diagnosis and determine the size and location of kidney stones.
4.Analisis stone to determine its mineral content.
5.Analisis urine culture to show the type of bacteria causing the infection, and others.

Preventing and treating
Because 90% of kidney stones less than 5 mm in diameter, is usually sufficient given the water decoction of the plant Desmodium stryracifulium and given to drink 6-8 glasses of water per day, was given antibiotics to prevent infection, as well as reduction of pain medication. In general, the stone will be out within 50-10 days.
If the stone is too large to be released naturally, surgery can be done. If the stones are in the ureter, cystoscopy can be used through the urethra and the stone manipulated with catheters.Rocks from other areas of expenditure (on calix and pelvis) require surgery from the side or lower abdomen. Percutaneus ultrasonic procedure called Lithotripsy and Extracorporeal Shock Wave Lithotripsy will break up kidney stones into small fragments, which can be expelled naturally or by suction.
For the prevention of kidney stones should drink water frequently stryracifolium decoction Desmodium plants, or advisable to eat less calcium, was given medication to prevent uric acid stone formation, and vitamin C which give the acidity of the urine. If the parathyroid glands also include the cause, doctors will recommend actions paratiroidektomi (parathyroid glands removed).
Complications:
1. Kidney stones recur.
2. Urinary tract infection.
3. Blockage in the ureter.
4. Partial damage of kidney tissue.
5. The decrease or loss of function of the affected kidney

Coronary heart disease - the second best killer in the world

noreply@blogger.com (Pixsimo) — Tue, 17 Aug 2010 14:32:00 +0000

Coronary heart disease

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

Causes

Coronary heart disease is usually caused by a condition called atherosclerosis , which occurs when fatty material and a substance called plaque build up on the walls of your arteries.

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Many things increase your risk for heart disease:

Men in their 40s have a higher risk of CHD than women. But as women get older (especially after they reach menopause ), their risk increases to almost equal that of a man's risk. See: Heart disease and women
Bad genes (heredity) can increase your risk. You are more likely to develop the condition if someone in your family has had a history of heart disease -- especially if they had it before age 50. Your risk for CHD goes up the older you get.
Diabetes is a strong risk factor for heart disease.
High blood pressure increases your risk of coronary artery disease and heart failure.
Abnormal cholesterol levels: your LDL ("bad") cholesterol should be as low as possible, and your HDL("good") cholesterol should be as high as possible.
Metabolic syndrome refers to high triglyceride levels , high blood pressure, excess body fat around the waist, and increased insulin levels. People with this group of problems have an increased chance of getting heart disease.
Smokers have a much higher risk of heart disease than nonsmokers.
Chronic kidney disease can increase your risk.
Already having atherosclerosis or hardening of the arteries in another part of your body (examples arestroke and abdominal aortic aneurysm ) increases your risk of having coronary heart disease.
Other risk factors including alcohol abuse, not getting enough exercise, and excessive amounts of stress.

Higher-than-normal levels of inflammation-related substances, such as C-reactive protein and fibrinogen are being studied as possible indicators of an increased risk for heart disease.

Increased levels of a chemical called homocysteine, an amino acid , are also linked to an increased risk of a heart attack.

Symptoms

When a sudden blockage of coronary arteries and their function can not be readily replaced by other coronary blood vessels so the heart muscle will die who should be served. Symptoms depend how many percent blockage occurred and how many of the affected blood vessels.

SYMPTOMS (starting from the lightest to heaviest):

Chest pain (angina pectoris)
Unstable chest pain (Unstable Angina pectoris)
Death of some heart muscle (infarction Myocard)
Sudden death

Exams and Tests

Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis.

Tests may include:

Electrocardiogram (ECG)
Exercise stress test
Echocardiogram
Nuclear scan
Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD
CT angiography -- a noninvasive way to perform coronary angiography
Magnetic resonance angiography
Coronary angiography/arteriography -- an invasive procedure designed to evaluate the heart arteries under x-ray

Treatment

You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels.Follow your doctor's directions closely to help prevent coronary artery disease from getting worse. Goals for treating these conditions in those who have coronary artery disease are:

LDL cholesterol level less than or equal to 100 mg/dL
Glycosylated hemoglobin ( HbA1c ) levels less than or equal to 7%
Blood pressure less than or equal to 120/80 mmHg

Taking aspirin with or without clopidogrel (Plavix) helps prevent blood clots from forming in your arteries and reduces your risk of having a heart attack. Ask your doctor if you should be taking these.

Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat CHD, including:

ACE inhibitors to lower blood pressure and protect your heart
Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
Calcium channel blockers to relax arteries, lowering blood pressure and reducing strain on the heart
Diuretics to lower blood pressure and treat congestive heart failure
Nitrates (such as nitroglycerin) to stop chest pain and improve blood supply to the heart
Statins to lower cholesterol

NEVER ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack.

Procedures and surgeries used to treat CHD include:

Angioplasty and stent placement , called percutaneous coronary interventions (PCIs)
Coronary artery bypass surgery
Minimally invasive heart surgery

Lifestyle changes are very important. Your doctor may tell you to:

Avoid or reduce the amount of salt (sodium) you eat
Eat a heart healthy diet -- one that is low in saturated fats, cholesterol, and trans fat
Get regular exercise and maintain a healthy weight
Keep your blood sugar strictly under control if you have diabetes
Stop smoking

Possible Complications

Heart attack
Heart failure
Unstable angina
Sudden death

When to Contact a Medical Professional

If you have any of the risk factors for CHD, contact your doctor to discuss prevention and possible treatment.

Immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room if you have:

Angina
Shortness of breath
Symptoms of a heart attack

Prevention

See your health care provider regularly.

Tips for preventing CHD or lowering your risk of the disease:

Avoid or reduce stress as best as you can.
Don't smoke.
Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables.
Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 - 90 minutes of exercise every day.
Keep your blood pressure below 130/80 mmHg if you have diabetes or chronic kidney disease, and below 140/90 otherwise
Keep your cholesterol and blood sugar under control.

Moderate amounts of alcohol (one glass a day for women, two for men) may reduce your risk of cardiovascular problems. However, drinking larger amounts does more harm than good.

If you have one or more risk factors for coronary heart disease, talk to your doctor about possibly taking an aspirin a day to help prevent a heart attack or stroke. You may be prescribed low-dose aspirin therapy if the benefit is likely to outweigh the risk of gastrointestinal side effects.

New guidelines no longer recommend hormone replacement therapy, vitamins E or C, antioxidants, or folic acid to prevent heart disease. The use of hormone replacement therapy in women who are close to menopause or who have finished menopause is controversial at this time.

LIVER Cirrhosis-silent bad disease

noreply@blogger.com (Pixsimo) — Mon, 16 Aug 2010 15:25:00 +0000

Cirrhosis is a condition in which the liver slowly deteriorates and malfunctions due to chronic injury. Scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.

A healthy liver is able to regenerate most of its own cells when they become damaged. With end-stage cirrhosis, the liver can no longer effectively replace damaged cells. A healthy liver is necessary for survival.

Cirrhosis has various causes.

In the United States, heavy alcohol consumption and chronic hepatitis C have been the most common causes of cirrhosis. Obesity is becoming a common cause of cirrhosis, either as the sole cause or in combination with alcohol, hepatitis C, or both. Many people with cirrhosis have more than one cause of liver damage.

Cirrhosis is not caused by trauma to the liver or other acute, or short-term, causes of damage. Usually years of chronic injury are required to cause cirrhosis.

Alcohol-related liver disease. Most people who consume alcohol do not suffer damage to the liver. But heavy alcohol use over several years can cause chronic injury to the liver. The amount of alcohol it takes to damage the liver varies greatly from person to person. For women, consuming two to three drinks—including beer and wine—per day and for men, three to four drinks per day, can lead to liver damage and cirrhosis. In the past, alcohol-related cirrhosis led to more deaths than cirrhosis due to any other cause. Deaths caused by obesity-related cirrhosis are increasing.

Chronic hepatitis C. The hepatitis C virus is a liver infection that is spread by contact with an infected person's blood. Chronic hepatitis C causes inflammation and damage to the liver over time that can lead to cirrhosis.

Chronic hepatitis B and D. The hepatitis B virus is a liver infection that is spread by contact with an infected person's blood, semen, or other body fluid. Hepatitis B, like hepatitis C, causes liver inflammation and injury that can lead to cirrhosis. The hepatitis B vaccine is given to all infants and many adults to prevent the virus.Hepatitis D is another virus that infects the liver and can lead to cirrhosis, but it occurs only in people who already have hepatitis B.

Nonalcoholic fatty liver disease (NAFLD). In NAFLD, fat builds up in the liver and eventually causes cirrhosis. This increasingly common liver disease is associated with obesity, diabetes, protein malnutrition, coronary artery disease, and corticosteroid medications.

Autoimmune hepatitis. This form of hepatitis is caused by the body's immune system attacking liver cells and causing inflammation, damage, and eventually cirrhosis. Researchers believe genetic factors may make some people more prone to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are female.

Diseases that damage or destroy bile ducts. Several different diseases can damage or destroy the ducts that carry bile from the liver, causing bile to back up in the liver and leading to cirrhosis. In adults, the most common condition in this category is primary biliary cirrhosis, a disease in which the bile ducts become inflamed and damaged and, ultimately, disappear. Secondary biliary cirrhosis can happen if the ducts are mistakenly tied off or injured during gallbladder surgery. Primary sclerosing cholangitis is another condition that causes damage and scarring of bile ducts. In infants, damaged bile ducts are commonly caused by Alagille syndrome or biliary atresia, conditions in which the ducts are absent or injured.

Inherited diseases. Cystic fibrosis, alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases are inherited diseases that interfere with how the liver produces, processes, and stores enzymes, proteins, metals, and other substances the body needs to function properly.Cirrhosis can result from these conditions.

Drugs, toxins, and infections. Other causes of cirrhosis include drug reactions, prolonged exposure to toxic chemicals, parasitic infections, and repeated bouts of heart failure with liver congestion.

Symptoms

Many people with cirrhosis have no symptoms in the early stages of the disease. However, as the disease progresses, a person may experience the following symptoms:

weakness
fatigue
loss of appetite
nausea
vomiting
weight loss
abdominal pain and bloating when fluid accumulates in the abdomen
itching
spiderlike blood vessels on the skin

complications

As liver function deteriorates, one or more complications may develop. In some people, complications may be the first signs of the disease.

Edema and ascites. When liver damage progresses to an advanced stage, fluid collects in the legs, called edema, and in the abdomen, called ascites. Ascites can lead to bacterial peritonitis, a serious infection.

Bruising and bleeding. When the liver slows or stops producing the proteins needed for blood clotting, a person will bruise or bleed easily.

Portal hypertension. Normally, blood from the intestines and spleen is carried to the liver through the portal vein. But cirrhosis slows the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension.

Esophageal varices and gastropathy. When portal hypertension occurs, it may cause enlarged blood vessels in the esophagus, called varices, or in the stomach, called gastropathy, or both. Enlarged blood vessels are more likely to burst due to thin walls and increased pressure. If they burst, serious bleeding can occur in the esophagus or upper stomach, requiring immediate medical attention.

Splenomegaly. When portal hypertension occurs, the spleen frequently enlarges and holds white blood cells and platelets, reducing the numbers of these cells in the blood. A low platelet count may be the first evidence that a person has developed cirrhosis.

Jaundice. Jaundice occurs when the diseased liver does not remove enough bilirubin from the blood, causing yellowing of the skin and whites of the eyes and darkening of the urine. Bilirubin is the pigment that gives bile its reddish-yellow color.

Gallstones. If cirrhosis prevents bile from flowing freely to and from the gallbladder, the bile hardens as gallstones.

Sensitivity to medications. Cirrhosis slows the liver's ability to filter medications from the blood. When this occurs, medications act longer than expected and build up in the body. This causes a person to be more sensitive to medications and their side effects.

Hepatic encephalopathy. A failing liver cannot remove toxins from the blood, and they eventually accumulate in the brain. The buildup of toxins in the brain—called hepatic encephalopathy—can decrease mental function and cause coma. Signs of decreased mental function include confusion, personality changes, memory loss, trouble concentrating, and a change in sleep habits.

Insulin resistance and type 2 diabetes. Cirrhosis causes resistance to insulin—a hormone produced by the pancreas that enables the body to use glucose as energy. With insulin resistance, the body's muscle, fat, and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more, but excess glucose builds up in the bloodstream causing type 2 diabetes.

Liver cancer. Hepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis. Hepatocellular carcinoma has a high mortality rate, but several treatment options are available.

Other problems. Cirrhosis can cause immune system dysfunction, leading to the risk of infection. Cirrhosis can also cause kidney and lung failure, known as hepatorenal and hepatopulmonary syndromes.

Examination

The diagnosis of cirrhosis is usually based on the presence of a risk factor for cirrhosis, such as alcohol use or obesity, and is confirmed by physical examination, blood tests, and imaging. The doctor will ask about the person's medical history and symptoms and perform a thorough physical examination to observe for clinical signs of the disease. For example, on abdominal examination, the liver may feel hard or enlarged with signs of ascites. The doctor will order blood tests that may be helpful in evaluating the liver and increasing the suspicion of cirrhosis.

To view the liver for signs of enlargement, reduced blood flow, or ascites, the doctor may order a computerized tomography (CT) scan, ultrasound, magnetic resonance imaging (MRI), or liver scan. The doctor may look at the liver directly by inserting a laparoscope into the abdomen. A laparoscope is an instrument with a camera that relays pictures to a computer screen.

A liver biopsy can confirm the diagnosis of cirrhosis but is not always necessary. A biopsy is usually done if the result might have an impact on treatment. The biopsy is performed with a needle inserted between the ribs or into a vein in the neck. Precautions are taken to minimize discomfort. A tiny sample of liver tissue is examined with a microscope for scarring or other signs of cirrhosis. Sometimes a cause of liver damage other than cirrhosis is found during biopsy.

How is the severity of cirrhosis measured?

The model for end-stage liver disease (MELD) score measures the severity of cirrhosis. The MELD score was developed to predict the 90-day survival of people with advanced cirrhosis. The MELD score is based on three blood tests:

international normalized ratio (INR)—tests the clotting tendency of blood
bilirubin—tests the amount of bile pigment in the blood
creatinine—tests kidney function

MELD scores usually range between 6 and 40, with a score of 6 indicating the best likelihood of 90-day survival.

Treatments

Treatment for cirrhosis depends on the cause of the disease and whether complications are present. The goals of treatment are to slow the progression of scar tissue in the liver and prevent or treat the complications of the disease. Hospitalization may be necessary for cirrhosis with complications.

Eating a nutritious diet. Because malnutrition is common in people with cirrhosis, a healthy diet is important in all stages of the disease. Health care providers recommend a meal plan that is well balanced. If ascites develops, a sodium-restricted diet is recommended. A person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection. To improve nutrition, the doctor may add a liquid supplement taken by mouth or through a nasogastric tube—a tiny tube inserted through the nose and throat that reaches into the stomach.

Avoiding alcohol and other substances. People with cirrhosis are encouraged not to consume any alcohol or illicit substances, as both will cause more liver damage. Because many vitamins and medications—prescription and over-the-counter—can affect liver function, a doctor should be consulted before taking them.

Treatment for cirrhosis also addresses specific complications. For edema and ascites, the doctor will recommend diuretics—medications that remove fluid from the body. Large amounts of ascitic fluid may be removed from the abdomen and checked for bacterial peritonitis. Oral antibiotics may be prescribed to prevent infection.Severe infection with ascites will require intravenous (IV) antibiotics.

The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower the pressure in the varices and reduce the risk of bleeding.Gastrointestinal bleeding requires an immediate upper endoscopy to look for esophageal varices. The doctor may perform a band-ligation using a special device to compress the varices and stop the bleeding. People who have had varices in the past may need to take medicine to prevent future episodes.

Hepatic encephalopathy is treated by cleansing the bowel with lactulose—a laxative given orally or in enemas. Antibiotics are added to the treatment if necessary.Patients may be asked to reduce dietary protein intake. Hepatic encephalopathy may improve as other complications of cirrhosis are controlled.

Some people with cirrhosis who develop hepatorenal failure must undergo regular hemodialysis treatment, which uses a machine to clean wastes from the blood.Medications are also given to improve blood flow through the kidneys.

Other treatments address the specific causes of cirrhosis. Treatment for cirrhosis caused by hepatitis depends on the specific type of hepatitis. For example, interferon and other antiviral drugs are prescribed for viral hepatitis, and autoimmune hepatitis requires corticosteroids and other drugs that suppress the immune system.

Medications are given to treat various symptoms of cirrhosis, such as itching and abdominal pain.

When is a liver transplant indicated for cirrhosis?

A liver transplant is considered when complications cannot be controlled by treatment. Liver transplantation is a major operation in which the diseased liver is removed and replaced with a healthy one from an organ donor. A team of health professionals determines the risks and benefits of the procedure for each patient.Survival rates have improved over the past several years because of drugs that suppress the immune system and keep it from attacking and damaging the new liver.

The number of people who need a liver transplant far exceeds the number of available organs. A person needing a transplant must go through a complicated evaluation process before being added to a long transplant waiting list. Generally, organs are given to people with the best chance of living the longest after a transplant. Survival after a transplant requires intensive follow-up and cooperation on the part of the patient and caregiver.

Points to Remember

Cirrhosis is a condition in which the liver slowly deteriorates and malfunctions due to chronic injury. Scar tissue replaces normal, healthy liver tissue, preventing the liver from working as it should.
In the United States, heavy alcohol consumption and chronic hepatitis C have been the most common causes of cirrhosis. Obesity is becoming a common cause of cirrhosis, either as the sole cause or in combination with alcohol, hepatitis C, or both. Many people with cirrhosis have more than one cause of liver damage.
Other causes of cirrhosis include hepatitis B, hepatitis D, and autoimmune hepatitis; diseases that damage or destroy bile ducts, inherited diseases, and nonalcoholic fatty liver disease; and drugs, toxins, and infections.
Many people with cirrhosis have no symptoms in the early stages of the disease. As the disease progresses, symptoms may include weakness, fatigue, loss of appetite, nausea, vomiting, weight loss, abdominal pain and bloating, itching, and spiderlike blood vessels on the skin.
As liver function deteriorates, one or more complications may develop. In some people, complications may be the first signs of the disease.
The goals of treatment are to stop the progression of scar tissue in the liver and prevent or treat complications.
Treatment for cirrhosis includes avoidance of alcohol and other drugs, nutrition therapy, and other therapies that treat specific complications or causes of the disease.
Hospitalization may be necessary for cirrhosis with complications.
A liver transplant is considered when complications of cirrhosis cannot be controlled by treatment.

measles - child disease that can be fatal

noreply@blogger.com (Pixsimo) — Sun, 15 Aug 2010 17:52:00 +0000

Measles is an acute disease is easily transmitted and often serious complications occur.Almost all children under 5 years old in developing countries will be attacked by this disease, whereas in developed countries usually attacks children aged adolescents or young adults who are not protected by immunization.

Measles disease is fatal if not actually attacking the children healthy and well nourished. But if in a country where children are suffering from malnutrition are numerous, measles is a disease that is fatal.Measles is caused by paramiksovirus.

Transmission occurs via saliva spray from the nose, mouth and throat patients with measles.

The incubation period is 10-14 days before symptoms appear.

Acquired immunity to measles after vaccination, the infection is active and passive immunity in infants born to a mother who has been resistant (lasts for one year).

Transmission mode

Who should watch out, measles transmission took place very rapidly through the medium of air or saliva spray (droplet) that inhaled through the nose or mouth.

Clinical symptoms

Symptoms begin within 7-14 days (other references say about 10-20 days) after infection, which include: - sore throat - runny nose - cough - sore muscles - fever - red eyes - fotofobia (susceptible to light, glare) . However, not all of these symptoms in each patient tergatnung terjadai of stamina respectively.

Clinical symptoms were divided into three stages, namely:

• Stadium early (prodromal)

• Stadium incidence of spotting (eruption)

• Stage a period of healing (konvalesen)

Early-stage (prodromal)

Generally lasts about 4-5 days, characterized by fever, weakness (malaise), muscle aches, cough, runny nose, red eyes, fotofobia (fear of light), diarrhea caused by inflammation of the respiratory and digestive tract.

At this stage, symptoms similar to influenza. But diagnosis can be made towards Morbili 2-4 days later when the little white spots appear inside the mouth (Koplik spots). On the wall of the inner cheek (mucosa bukalis) and the patient had contact with patients morbili in the last two weeks.

Stadium incidence of spotting (eruption)

Rash (redness of the skin) which feels a bit itchy appeared occurs about 2-5 days after the initial stage. Characterized by fever rises, the red spots spread throughout the body, accompanied with itching. This can form macular rash (reddish rash that horizontal) or papules (reddish rash that stand out). At first the rash appeared on the face, ie in front of and below the ears and the neck next to the side. Within 1-2 days, the rash spreads to the torso, arms and legs, while a rash on his face began to fade. Furthermore, these symptoms will disappear around the third day.

Sometimes accompanied by diarrhea and vomiting.

At the peak of disease, patients feel very sick, ruamnya widespread and body temperature reaches 40 ° Celsius. 3-5 days later his body temperature falls, the patient began to feel better and the rash disappeared soon left. Fever, fatigue, runny nose, cough and sore and red eyes for a few days followed by a rash of red pimples on the face and began to spread into the body and there for four days to seven days.

Convalescing Stadium (konvalesen)

At this stage, the above symptoms gradually disappear. Body temperature becomes normal, unless there are complications.

Complication

In healthy children and adequate nutrition, measles is rarely serious repercussions. However, complications can occur due to decreased immunity as a result of measles disease. Some complications that can accompany measles:

1. Bacterial infections: pneumonia and middle ear infections

2. Sometimes it happens thrombocytopenia (decrease in platelet count), so pendeita easy bruising and bleeding

3. Encephalitis (inflammation of the brain) occurs in 1 of 1.000 to 2000 cases.

4. Bronkopnemonia (respiratory tract infection)

5. Otitis media (ear infection)

6. Laryngitis (infection of the larynx)

7. Diarrhea

Examination

Based on the anamnesis which may be of measles are fever, cough, red eyes, runny nose and sore throat

Physical examination

In measles, a physical examination obtained is the existence of a widespread rash makupapular, coplic spot, panasny increases.

Laboratory examination

On blood examination showed a normal leukocyte count or increased if there are complications of bacterial infections. IgM antibodies inspection is the fastest way to ensure there is an acute measles infection. Because IgM may not be detected on the second day of the first appearance of rash, then to draw blood IgM examination conducted on the third day to avoid any false negative. IgM titer began is hard to measure at four weeks after the rash appears. While IgG antibodies can be detected four days after the rash appears, most of IgG can be detected one week after onset until 3 weeks after onset. IgG can still be found until several years later.Measles virus could be isolated from urine, nasopharyngeal aspirates, blood that was given heparin, and throat swab during the prodromal period until 24 hours after the resulting spots. The virus can remain active for at least 34 hours in room temperature.

Treatment

1. Non Medika mentosa

a. provision of adequate fluid, eg water, fresh fruit juices, tea, etc. to restore the body fluids lost through heat and sweating with fever.

b. appropriate calorie and food type to suit your level of awareness and presence of complications

c. nutritional supplements

2. Medika mentosa

Indications hospitalization: hiperpireksia (temperature> 39.00 C), dehydration, seizures, oral intake is difficult, or there are complications.

Measles without complication:

1. Avoid infection

2. Bed rest

3. 100 000 IU vitamin A,

4. Diet foods have plenty of fluids, adequate calories. Type of food adjusted to the level of awareness of patients and the presence or absence of complications

Measles with complications:

1. Encephalopathy / encephalitis

a. Antibiotics when necessary, according to antivirus and other encephalitis PDT

b. Corticosteroids, if necessary in accordance with encephalitis PDT

c. Needs the amount of fluid is adjusted to the needs and correction of electrolyte disturbances

2. Bronchopneumonia:

a. Antibiotics in accordance with pneumonia PDT

b. Or with nasal oxygen mask

c. Correction of acid-base balance disturbances, electrolyte, blood gas nd

3. Enteritis: correction of dehydration according to the degree of dehydration (see Chapter enteritis dehydration).

4. In the case of measles with complications bronkhopneumonia and malnutrition need to be monitored for the presence of latent TB infection. Monitor the clinical symptoms and tuberculin test done after 1-3 months of healing.

Preventive

Measles immunization is included in the national immunization program since 1982, immunization coverage rates declined <80% in the last three years so it is still found areas of high risk pockets of measles virus transmission.