Cultural differences within medical aspects: April 2009

Tuesday, April 28, 2009

Corneal diseases

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

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

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

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

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

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

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

Instruction to the patient after change of a cornea

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

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

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

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

Dystonia and Botox Injections

The first thing you notice about "Joey" is that his head is turned and tipped to one side; his left ear rests on his hunched-up left shoulder. He has to turn his whole upper body to look at you. Joey has torticollis, also known as cervical dystonia, meaning that his neck muscles are in an involuntary spasm that forces his head into its painful, abnormal position.

Can affect any part of the body
Dystonia--those painful muscle spasms--can affect any part of the body including:

eyelids (blepharospasm)
face (oromandibular)
vocal cords (dysphonia)
arms, legs, or trunk

"Writer's cramp" is dystonia in the hand or arm muscles.

Causes
Dystonia affects people of all ages and ethnic backgrounds. Some forms of it can be inherited; researchers have identified more than 10 genes or chromosome locations associated with the disorder. Dystonia may also occur due to birth injury, traumatic injury, toxins (such as manganese), certain medications (such as haloperidol), stroke, or be part of another disorder such as Parkinson's disease. It generally develops gradually, and symptoms can appear at any age.

Diagnosis
There is no specific test for dystonia, so it is usually diagnosed based on the symptoms. Dystonia can come and go, so some people who experience it may have a hard time convincing health care providers that it exists. The spasms may change significantly with different actions. For example, hand dystonia may occur when trying to write but not during other activities.

Treatment
For most people with dystonia, the disorder does not shorten life, but it does cause pain and discomfort, and may interfere with basic activities such as walking, dressing, or eating.

There are a number of medications that can treat dystonia, either alone or in combination. One of the most common treatments is Botox (botulinum toxin) injections (marketed as Vistabel in Europe). Dysport is another brand available in Europe. Another formulation of botulinum toxin used is called Myobloc (U.S.) or Neurobloc (Europe).

Botox injections
Although most people in the U.S. know Botox as a vanity treatment for facial lines, it was originally developed in 1989 as an orphan drug to treat dystonia and muscle spasms. Injection of the drug causes weakness in the targeted muscle, thus relaxing the spasm and relieving dystonia.

Information for this article was taken from:
- Molloy, F. M. (2002). Botulinum toxin (Botox): Dystonia treatment. eMedicine, accessed at http://www.emedicine.com/neuro/topic585.htm
- Dystonia Medical Research Foundation

What Is It?

Shigellosis is an infection of the colon (large intestine) caused by Shigella bacteria. Shigellosis is also called bacillary dysentery because it can cause severe diarrhea. However, the infection often causes only mild symptoms.

Shigella can be found in water polluted with infected sewage. Bacteria commonly enter the body through a contaminated drinking supply. Shigella bacteria also can be found on food that has been rinsed with unclean water, grown in fields contaminated with sewage, or touched by flies that have touched feces. Shigella bacteria can reach the mouth on dirty fingers that have touched items soiled with feces, including dirty diapers, toilets and bathroom fixtures. Outbreaks of shigellosis are most common in areas where sanitation is poor, and in places where people live under confined or crowded conditions. Shigella also can be passed from person to person during anal-oral sex.

Worldwide, an estimated 140 million people develop shigellosis each year, and about 600,000 die. Most of these deaths occur in developing countries among children under age 5. In the United States, only 20,000 cases are reported each year, but the actual number of infections is probably more than 200,000 per year. Shigellosis is more common among children ages 1 to 4. Children of this age are especially at risk because they are starting to use the toilet and often forget to wash their hands. Infants are at the highest risk of becoming seriously ill from a Shigella infection.

Symptoms

Although health experts don't know why, some people take in Shigella bacteria without becoming ill. Others develop only a brief fever, or a brief fever with mild diarrhea that goes away on its own. About 25% of patients, however, develop high fever, abdominal cramping and severe diarrhea that can contain blood, mucus and pus. These people can have 10 to 30 bowel movements each day, along with a persistent urge to have a bowel movement that can lead to rectal prolapse (an abnormal protrusion of the rectum). Rarely, Shigella bacteria can affect other parts of the body far from the digestive tract. When this happens, there can be seizures, confusion or coma, kidney failure, arthritis, rashes or other symptoms.

Diagnosis

Your doctor will ask about your symptoms and about the appearance of your bowel movements. He or she will ask if you have recently traveled to developing countries, been in contact with people who have severe diarrhea, or might have been exposed to contaminated pools, lakes or food.

Your doctor will diagnose shigellosis based on a physical examination and the results of laboratory tests. These tests include taking a swab of your rectum or a sample of your stool (feces). If you have signs of dehydration (excessive loss of body water) or significant blood loss, additional blood tests may be necessary.

Expected Duration

In most otherwise healthy people with mild shigellosis, diarrhea goes away on its own within five to seven days. However, in very young children, the elderly or people with chronic illnesses, shigellosis can be severe and can lead to life-threatening dehydration and other complications within a few days.

Prevention

There is no vaccine to protect against shigellosis. To prevent the spread of Shigella bacteria, you should:

Practice good hygiene, especially frequent handwashing.
Wash your hands immediately after changing a child's diaper, especially if the child has diarrhea.
Dispose of soiled diapers in closed-lid garbage cans.
Swim only in lakes and pools whose water quality is monitored by local health officials.
When traveling to developing countries, drink only water that has beeb treated or boiled eat only foods that have been cooked thoroughly. Never eat unpeeled fruits, and always peel fruits yourself immediately before eating them.

Treatment

If you have a mild case of shigellosis, you probably won't need treatment because your symptoms will probably go away on their own. Sometimes, doctors may prescribe antibiotics if there are very young or very old members in a household who could get the infection.

If you have a severe case of shigellosis, your doctor will prescribe fluids to treat dehydration and an antibiotic based on how you became infected. For example, if you became infected with shigellosis in the United States, your infection probably will respond to common antibiotics such as ampicillin (Polycillin, Totacillin, Omnipen), trimethoprim-sulfamethoxazole (Bactrim, Septra and other brand names), tetracycline (sold under many brand names), or ciprofloxacin (Cipro). However, if you became infected during travel to a developing country, the infecting strain of Shigella is more likely to be resistant to these common antibiotics, and you may need a newer or less common antibiotic.

The use of antidiarrheal medicines to slow bowel movements is controversial. It can take longer to clear the bacteria from the lower intestine and the illness caused byt he infection could become more severe.

When To Call A Professional

Call your doctor if you develop severe diarrhea, especially if the bowel movements contain blood or mucus. Call your doctor whenever you have a fever and severe diarrhea. Seek immediate attention if you have signs of dehydration, such as very dry mouth and lips, and lightheadedness when you stand, whether or not you are thirsty.

Prognosis

In developed countries, most people with shigellosis recover completely. In underdeveloped countries, the risk of complications, including death, is signifcantly higher.

Factors and the conditions causing irritation of a dental pulp

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

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

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

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

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

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

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

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

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

The sheeting (direct) provides:

1) clarification of a surface of a pulp;

2) drying of a cavity;

3) imposing on the naked pulp of medical paste;

4) a seal from zinc oxide eugenic acid cement;

5) imposing of a constant seal.

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

Colitis - a problem of intestines

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

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

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

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

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

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

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

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

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

How is Down Syndrome Diagnosed?

How is Down's Syndrome Diagnosed?

Down syndrome is diagnosed one of two ways, either during pregnancy or shortly after birth. The diagnosis is always based on the presence of an extra number 21 chromosome on a karyotype (a picture of an individual's chromosomes).

At Birth

The diagnosis of Down's syndrome is usually made soon after birth because of some subtle differences in the baby's appearance. Children with Down syndrome have some distinctive facial features and physical characteristics that may lead your doctor to suspect that your baby has Down syndrome.

Some of the features include:

A flat facial profile, flat nasal bridge and somewhat small nose
Almond shaped eyes with epicanthal folds
A small mouth with a slightly enlarged tongue
A big space between the first and second toe
Small broad hands with short fingers and a little finger that curves inwards.
A single palmar crease on their hand
Reduced muscle tone (hypotonia) which results in floppiness

If the doctor suspects that the baby has Down syndrome, a chromosome test called a karyotype, will be ordered. It usually takes a few days to get the results of this blood test. It is almost always a shock when a baby is diagnosed with Down syndrome but there are some things that you can do to get through the first few months.

During pregnancy

Screening versus Diagnostic Testing

There are two kinds of testing that can be done during a pregnancy - diagnostic testing such as amniocentesis and chorionic villi sampling (CVS), and screening testing such as ultrasound (sonogram) and maternal serum screening tests. A screening test can never give you a firm diagnosis - a screening tests simply tells you if you have a slightly higher risk to have a baby with Down syndrome. A diagnostic test on other hand, gives you a firm diagnosis.

Down syndrome can be diagnosed in pregnancy by diagnostic tests such as amniocentesis or chorionic villi sampling (CVS). These are considered optional tests during pregnancy which means that it is your choice whether or not to have this testing. It is recommended that women considering testing speak with a genetic counselor to review their risks and to discuss risks and benefits of these procedures before making their decision about testing

The results of amniocentesis and CVS will give you a picture of the fetus’s chromosomes and the diagnosis of Down syndrome is very straightforward. Infants with Down syndrome have an extra number 21 chromosome for a total of 47 chromosomes rather than 46.

Dermatitis

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

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

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

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

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

Lyme disease and related tick-borne infections

Highlights

Lyme Disease Rates Double in Past 15 Years

The annual number of people newly infected with Lyme disease has doubled from around 10,000 cases per year in the early 1990s to about 20,000 cases per year now. Improved diagnosis and reporting probably contribute to this increase. In the United States, Massachusetts, New Jersey, and Pennsylvania have reported the highest number of Lyme disease cases in recent years. People ages of 5 - 14 years and 45- 54 years are at highest risk for contracting Lyme disease.

New Guidelines for Treatment of Neurological Lyme Disease

Most cases of Lyme disease can be prevented or cured with prompt antibiotic treatment following a deer tick bite. However, neurological complications can later develop in some patients. In 2007, the American Academy of Neurology released new guidelines for the treatment of nervous system Lyme disease. The guidelines recommend that patients with severe disease receive a 2 - 4 week course of intravenous antibiotics (penicillin, ceftriaxone, or cefotaxime). Patients with milder neurological cases may do well with a 2 - 4 week course of oral doxycycline. No guidelines currently recommend long-term antibiotic treatment for any stage or complication of Lyme disease.

Introduction

Lyme disease is the most commonly reported tick-borne disease in the United States. Vector-borne infections are transmitted by insects.

Borrelia Burgdorferi

The Lyme disease infection in the U.S. is caused by a spirochete called Borrelia (B.) burgdorferi. A spirochete is a bacteria-like organism with a cylinder-like shape surrounded by an outer membrane.

Lyme researchers have the completion of DNA encoding of B. burgdorferi. Researchers learned that certain proteins coat its outer surface. These proteins, collectively called Osp, are responsible for attaching the spirochete to cells in humans and other mammals.

Ixodes Ticks

The vector that carries B. burgdorferi in the U.S. Northeast and North Central states is the Ixodes scapularis tick. The Ixodes scapularis tick goes through three stages over the course of about two years:

It is born from eggs as a larva.
It develops into the nymph stage.
It develops into the adult stage.

The Cycle of Infection

Cycle of Infection in the Northeast and North Central U.S. For Lyme disease to exist in these regions, three factors must come into close contact:

The Borrelia (B.) burgdorferi spirochete
The spirochete's host, the Ixodes scapularis tick
The mammal for the tick to bite

The following describes the most common cycle in the Northeast and North Central U.S. by which the Lyme disease infection eventually reaches a person:

The cycle of infection is related to the tick's life cycle, which requires 2 years to complete. The tick typically first picks up the spirochete during its larva stage, when it needs a blood meal to mature further.
The tick's initial meal is typically blood from the white-footed mouse, which is commonly infected with Borrelia burgdorferi. After it dines on the infected blood, the tick then becomes a carrier of this spirochete.
Borrelia burgdorferi lodges in the tick throughout one of both of its following life stages, nymph and adult. It is during these stages that the infection is passed on to other animals, including humans. Nymph ticks emerge around mid-June and can be about the size of poppy seeds. They are very difficult to spot and are estimated to be responsible for 90% of all Lyme disease cases. Adult ticks can be as large as a raisin after feeding, and easy to spot, but they usually prefer their dinner on the white-tailed deer.
The infected nymph or adult tick crawls (it does not fly or jump) onto another animal, which can be mice or larger animals, such as deer, birds, or humans. If the tick bites these animals, it may then infect them with the B. Burgdorferi spirochete. (It should be noted that infected humans cannot pass the spirochete on to other humans by any means, including infected blood or urine or sexual contact.)
A tick can feed for several days while being imbedded in the skin, after which it falls off. The tick's bite is painless, however, so only about half of people with Lyme disease recall being bitten.

Cycle of Infection in the Northwest. In the Northwest, the infecting insect is the Western blacklegged tick, Ixodes Pacificus. Here, the frequency of Lyme disease is much lower than in the other two regions because the animal carrier of the infection is the dusky-footed wood rat. This animal is bitten and infected by the Ixodes neotomae tick, which does not bite humans. The actual tick that spreads B. burgdorferi to people is Ixodes pacificus, which must feed first on an already infected wood rat.

Diagnostics and treatment of tinea

A tinea represents a fungoid infection which can amaze set of parts of a body of the person. Below we shall designate sites of a body on which can appear dermatosis.
The-part of a head covered by hair.
- A smooth leather of a trunk.
- Nails.
- Stops of legs.
- Inguinal area.
- A skin of the face on which the vegetation settles down.

The given infection is widely widespread. If in time to undertake elimination of illness and to observe all doctor's instructions such effective treatment will give the favorable forecast. But can be and so, that at the started illness the chronic form tinea develops.
Infection tinea occurs at direct contact to the sick person, or through the polluted subjects. Among these subjects there can be a footwear, towels or mats in bathroom. The activator of disease tinea is the fungus.

Treatment of illness individually, depends on the form of its display. At disease of tinea it is necessary to address to the doctor. In fact depending on the form of disease of defeat of a leather differ on appearance and duration of existence of illness.

From a tinea of a hair parts of a head basically suffer children, and is characterized by occurrence small, one step at a time extending papules on a head, as well as a peeling, loss of hair on the amazed sites. Also on seat of papule can be formed inflamed, furuncular-like units.
At disease of a tinea of a smooth skin, papules extend on any sites of a skin, there are flat formations, dry, covered by scaly crust or damp, covered by crusts. Depending on a degree of their increase, the centers of spots are cleared, giving a classical picture of a leather in the form of circles.

A tinea nails begins with tips of one or more nails on legs or hands. In the second case disease is shown far less often, than in the first. Illness leads to a gradual thickening of nails, variation of their color, a curvature. Under them the substance formed from of died cells accumulates. As a result, the nail can be completely destroyed.
A tinea stop causes finely lamellar peeling of a skin, occurrence of bubbles between fingers. In heavy cases the infection can lead to inflammatory process of all the stops, described a strong itch and a pain at walking.

A tinea of an inguinal areas it is characterized by occurrence red, with precise borders, spots in an inguinal areas. The designated spots can extend on buttocks, internal surfaces of a hips and external genitals.
At diagnostics of a tinea, it is carried out scrape from the amazed sites of a leather. The received material investigate by means of a microscope.
A tinea, as a rule, it is treated by preparations for external application. Local treatment proceeds within two weeks after disappearance of symptoms. Also, at treatment of a tinea use the open damp bandages.

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

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

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

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

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

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

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

Lichen Myxedematosus

The terms lichen myxedematosus, papular mucinosis, and scleromyxedema are used to describe different forms of the same disorder, a chronic connective tissue disorder in which mucin deposits form in the skin. Lichen myxedematosus or papular mucinosis refers to the less severe form that is limited to the skin. Scleromyxedema refers to the rare, more severe form in which other body systems are affected in addition to the skin.

The cause of lichen myxedematosus and scleromyxedema is not known. The diseases affect both males and females and individuals of all ethnic backgrounds. Symptoms usually begin in adulthood.

Symptoms
Lichen myxedematosus or papular mucinosis – Bumps (papules), either skin-colored or reddened, appear on the skin, and may form groups. The papules may have a pattern of parallel ridges. Papules are found on the backs of the hands, on the face, or the arms and legs. The ridges and folds of the face may be distorted, with ridges and furrows developing on the brow and cheeks. This is known as leonine (“lion-like”) facies (leontiasis).
Scleromyxedema – Areas of red, raised skin appear, and the skin becomes tight like in scleroderma. There is difficulty moving the face, fingers, and arms and legs. Scleromyxedema also causes problems with the lungs and breathing, and with the heart and circulation. It may cause muscle weakness and joint pain, and neurological symptoms like those in brain disease, such as seizures, may be present.

Diagnosis
Diagnosis of lichen myxedematosus and scleromyxedema is based on the symptoms the individual is experiencing, especially what the skin looks like. A special blood test for a paraprotein (7S-IgG) can be done, and is usually positive. Other laboratory tests, including thyroid function tests, are normal. Skin and tissue samples can be examined under a microscope for deposits of mucin, which are characteristic of the disease.

Treatment
Many types of treatment for lichen myxedematosus and scleromyxedema have been tried in small numbers of people in research studies, but none has been consistently effective in reducing symptoms. Symptoms may improve with the use of high-dose dexamethasone and/or thalidomide, but over time the symptoms may return or even worsen. Chemotherapy drugs such as melphalan have also been tried, but without consistent success in treatment.

Individuals with lichen myxedematosus and scleromyxedema have long-term, often disfiguring, and possibly disabling disorders. The risks and benefits of drug treatment should be carefully considered.

Research
Researchers at the University of Texas M.D. Anderson Cancer Center studied eight individuals with scleromyxedema who had the disease for 3-1/2 years and had other symptoms in addition to the skin symptoms. All the individuals underwent high dose chemotherapy with melphalan followed by autologous stem cell transplantation. Seven of the eight individuals had a marked improvement in their symptoms after the transplant. In five individuals, the skin symptoms resolved completely. The researchers concluded that high-dose melphalan appears to be a safe and effective treatment, but also recommended further studies be done. The research was published in the January 15, 2006, issue of Blood.

Information for this article was taken from:
- Donato, M.L., et al. Scleromyxedema: Role of high-dose melphalan with autologous stem cell transplantation. Blood, 107; 415, pp. 463-466
- Liotta, E. A. (2005). Lichen myxedematosus. eMedicine, accessed at http://www.emedicine.com/derm/topic231.htm
- Scleromyxedema Survivors

Stem Cell Transplant May Reverse Type 1 Diabetes

Type 1 diabetes is a lifelong disease that affects more than a million American children and adults. It occurs when the person’s own immune system attacks and destroys the insulin-producing beta cells in the pancreas. Since the cells no longer produce insulin, people with type 1 diabetes must supply it themselves. This means undergoing multiple injections throughout the day and night, or having insulin delivered by an insulin pump through a permanent tube under the skin. But scientists may have found a way to free type 1 diabetics from their constant struggle.

In a dynamic new study, Dr. Julio Voltarelli of the University of São Paulo in Brazil and colleagues from Northwestern University in Chicago were able to reverse the course of type 1 diabetes with a patient’s own stem cells. “I wouldn’t use the word cure,” said Dr. Richard Burt, one of the co-authors from Northwestern. “But it appears we changed the natural history of the disease. It’s the first therapy for patients that leaves them treatment-free—no insulin, no immune suppression for almost five years.”

Burt reported the team’s initial achievement in 2007, with 15 diabetic patients who received their own stem cells and no longer needed insulin to control their blood sugar levels. In this follow-up, they detail the same success with eight additional patients. Insulin-free time lasted more than four years for one patient, more than three years for four patients, more than two years for three patients, and at least one year for four patients. Eight had to go back to using insulin, but required lower doses than they did before the procedure.

To confirm the lasting effects of the therapy, the researchers measured the patient’s levels of C-peptides, which show how well the body is producing insulin. They found those levels increased in 20 of the 23 patients. And even the eight who relapsed still had significantly higher levels of C-peptide by 36 months. “Because late complications of diabetes on the microvascular compartment are inversely related to C-peptide levels, it is probable that even those patients who resumed insulin are at lower risk for long-term diabetes complications,” the researchers said.

The strategy behind the procedure, known as autologous non-myeloablative hematopoietic stem-cell transplantation, is simple. First, CD34 stem cell, which can grow into all white blood cells of the immune system, are extracted from the patient’s bone morrow and stored. Next, the patients receive drugs that destroy what remains of their immune system, at the same time eliminating the components of the immune system that attack the islets. Finally, the stored stem cells are returned to the patient and left to regenerate a fresh immune system that will no longer attack the islet cells.

Burt says a larger randomized trial is now planned in both Brazil and in the United States. As with the existing trial, newly-diagnosed patients will be selected but this time, some of the patients will receive placebo. Other researchers are pursuing new stem cell options, including stem cells that can be grown from a patient’s own skin, which would eliminate the need for extracting immune stem cells from bone marrow. “Every door that we open leads to another door,” said Burt. “All research is built by sitting on the shoulders of other studies. This trial is something that will contribute to and move the field of stem cell therapy forward.”

A similar procedure developed by Burt has already shown success in another autoimmune disease—multiple sclerosis. Results published in January showed that many patients benefitted through the reprogramming of their immune systems, this time to stop it from attacking nerve and brain cells.

Living with diabetes is a daily challenge. In addition to having to check their insulin levels and take injections, diabetics must also carefully balance their food intake and their exercise to regulate their blood sugar levels in an attempt to avoid hypoglycemic (low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life-threatening. Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage.

In recent years, pancreas transplants have been used to treat type 1 diabetes, but not only is the operation itself serious, the side effects of the drugs required to prevent the immune system from fighting the new organ may be worse than the problems caused by diabetes. Islet cell transplant is also being investigated and has been achieved in rodents and in experimental trials in humans. However, the function of transplanted islets is lost over time, and few recipients are able to stop using insulin for very long. They also have side effects from immunosuppressive drugs.

The new findings were reported in the April 15 issue of the Journal of the American Medical Association.

New Prostate Cancer Vaccine Shows Promise

There are many health concerns today when it comes to illnesses, but one of the number one health concerns for a man to consider is prostate cancer. There are already treatments available for this type of cancer, but now there is a new one to consider. Provenge, which an experimental treatment vaccine for advanced prostate cancer, has met researchers’ goal in a key trial that is needed to get FDA approval. This news was recently announced by Dendreon, which is the company that makes the vaccine Provenge.

Mitchell Gold, M.D. and the president and chief executive of Dendreon, said that they believe that this vaccine is truly a breakthrough for the prostate cancer community a testament to the promise of the field for cancer immunotherapies. Provenge is a biologic drug that is given by infusion to spur the immune system to help fight against advanced prostate cancer that does not respond to anti-androgen treatment.

In 2007, an FDA advisory panel recommended that the FDA approve the new vaccine Provenge. However, the FDA requested that more information be collected to see whether Provenge prolongs survival. This request led to a new study of approximately 512 men that has advanced prostate cancer. These men had metastatic, androgen-independent prostate cancer, which means their cancer had spread and it was not responding to the anti-androgen treatment.

In this study, the overall survival was significantly better for the men that were taking Provenge than those that were taking a placebo. The results of this study were “unambiguous” and “very consistent” with previous trials for Provenge, says Gold. Dendreon plans to submit the results of this study to the FDA in the fourth quarter of 2009, and after that the FDA will have approximately six months to review all of the material.

Gold stated that this new data can support the use of Provenge being used as a frontline treatment in men that have metastatic, androgen-independent prostate cancer. He also noted that no new side effects from the vaccine stood out in the recent study. In the previous trials conducted, the most common side effects in the men taking Provenge were headache, chills, shortness of breath, fever, tremor, fatigue, and vomiting, mainly at a low level and for one to two days following the infusion of the vaccine.

Gold said that most of the men would first have surgery or some other form of local therapy, then the anti-androgen therapy if their cancer recurred, and if their PSA levels rose after these steps, then the Provenge vaccine would come into play as potential treatment option for them if these others didn’t work. In the men that had prostate cancer, PSA or prostate-specific androgen levels are used to help gauge the success of the treatment for the cancer.

However, at this time Dendreon is not releasing any further details of this study until April 28th, when the findings of the study will be presented at the American Urological Association’s annual meeting held in Chicago. The technology that is used to make the Provenge vaccine may also prove to be useful against other forms of cancer as well, Gold says.

The American Cancer Society has also released a statement about the Provenge news. The statement was made by Otis W. Brawley, MD, and the chief medical officer at the American Cancer Society. Brawley stated that Dendreon’s announcement about the new study for vaccine Provenge has shown reason for optimism for a vaccine that has generated controversy for the past several years. “We have to respect the scientific process, an important part of which is a full disclosure and careful review and discussion of the data, which the company says will not be released until an upcoming medical meeting. One of the most important question’s we’ll be looking at will be the magnitude of the survival advantage; how much longer the men taking the vaccine lived compared to those on standard therapy. As with any new therapy, it will take a detailed analysis to fully understand the impact of this potential new treatment for patients with advanced prostate cancer. We look forward to the presentation of the study at the upcoming meeting.”

Definition

Ulnar nerve dysfunction is a problem with the nerve that travels from the wrist to the shoulder, which leads to movement or sensation problems in the wrist and hand.

Alternative Names

Neuropathy - ulnar nerve; Ulnar nerve palsy

Causes

Ulnar nerve dysfunction is a common form of peripheral neuropathy. It occurs when there is damage to the ulnar nerve, which travels down the arm. The ulnar nerve is near the surface of the body where it crosses the elbow, so long-term pressure on the elbow may cause damage.

The damage involves the destruction of the nerve covering (myelin sheath) or part of the nerve (axon). This damage slows or prevents nerve signaling.

A problem with one single nerve group (such as the ulnar nerve) is called mononeuropathy. The usual causes are:

Direct injury
Long-term pressure on the nerve
Pressure on the nerve caused by swelling or injury of nearby body structures

Entrapment involves pressure on the nerve where it passes through a narrow structure.

The ulnar nerve is commonly injured at the elbow because of elbow fracture or dislocation. Prolonged pressure on the base of the palm may also damage part of the ulnar nerve. Temporary pain and tingling of this nerve is common if the elbow is hit, producing the experience of hitting the "funny bone" at the elbow.

In some cases, no cause can be found.

Symptoms

Abnormal sensations in the 4th or 5th fingers, usually on the palm side
Numbness, decreased sensation
Pain
Tingling, burning sensation
Weakness of the hand

Pain or numbness may awaken you from sleep. Activities such as tennis or golf make the condition worse.

Exams and Tests

An exam of the hand and wrist can reveal ulnar nerve dysfunction. Signs may include:

"Claw-like" deformity (in severe cases)
Difficulty moving the fingers
Wasting of the hand muscles (in severe cases)
Weakness of wrist and hand bending

A detailed history may be needed to determine the cause of the neuropathy.

Tests may include:

Blood tests
Imaging scans
Nerve conduction tests
Recording of the electrical activity in muscles (EMG)
X-rays

Treatment

The goal of treatment is to allow you to use the hand and arm as much as possible. The cause should be identified and treated. Sometimes, no treatment is required and you will get better on your own.

Treatments may include:

A supportive splint or elbow pad to help prevent further injury
Corticosteroids injected into the area to reduce swelling and pressure on the nerve
Surgery to relieve pressure on the nerve, if the symptoms get worse, movement is difficult, or there is proof that part of the nerve is wasting away. Surgical decompression may be recommended if the symptoms are from entrapment of the nerve.
Over-the-counter analgesics or prescription pain medications to control pain (neuralgia)
Other medications, including gabapentin, phenytoin, carbamazepine, or tricyclic antidepressants such as amitriptyline or duloxitine, to reduce stabbing pains.
Physical therapy exercises to help maintain muscle strength
Occupational counseling, occupational therapy, job changes, or retraining

Definition

Baker's cyst is an accumulation of joint fluid (synovial fluid) that forms behind the knee.

Alternative Names

Popliteal cyst

Causes

A Baker's cyst may form by the connection of a normal bursa (a normal lubricating fluid sac) with the knee joint. This type is more common in children.

The condition can also be caused by the herniation of the knee joint capsule out into the back of the knee, which is more common in adults. This commonly occurs with a tear in the meniscal cartilage of the knee.

In older adults, Baker's cysts are frequently associated with knee arthritis.

Symptoms

A large cyst may cause some discomfort or stiffness but generally has no symptoms. There may be a painless or painful swelling behind the knee.

The cyst may feel like a water-filled balloon. Occasionally, the cyst may rupture, causing pain, swelling, and bruising on the back of the knee and calf

It is very important to tell the difference between a ruptured Baker's cyst and a blood clot (deep venous thrombosis), which can also cause pain, swelling, and bruising on the back of the knee and calf. A blood clot may be dangerous and requires immediate medical attention.

Exams and Tests

During a physical exam, the doctor will look for a soft mass in the back of the knee. If the cyst is small, comparing the affected knee to the normal knee can be helpful. There may be limitation in range of motion caused by pain or by the size of the cyst. In some cases there will be signs and symptoms of a meniscal tear.

Transillumination, or shining a light through the cyst, can demonstrate that the mass is fluid filled.

If the mass demonstrates any abnormal signs, like rapid growth, night pain, severe pain, or fever, a more involved work-up is indicated to rule out non-cystic tumors that can grow in the back of the knee.

X-rays will not show the cyst or a meniscal tear but will show other abnormalities that may be present including arthritis.

MRI can be helpful to visualize the cyst and to demonstrate any meniscal injury.

Treatment

Often no treatment is necessary and the practitioner can observe the cyst over time. If the cyst is painful, treatment is usually aimed at correcting the underlying problem, such as arthritis or a meniscus tear. Removal of the cyst is generally not done because it may damage nearby blood vessels and nerves.

Sometimes, a cyst can be drained (aspirated) or, in rare cases, removed surgically, if the cyst becomes excessively large or causes symptoms.

Outlook (Prognosis)

A Baker's cyst will not cause any long-term harm, but can be annoying and painful. Baker's cysts usually go away on their own, but how fast this occurs varies from person to person.

Long-term disability is very rare, as most cases improve with time or arthroscopic surgery.

Possible Complications

Complications are unusual, but may include:

Long-term pain and swelling
Complications from associated injuries, like meniscal tears

When to Contact a Medical Professional

Call for an appointment with your health care provider if there is a swelling behind the knee that becomes large or painful. Pain could be a sign of infection, which is not normally associated with Baker's cyst.

Cataracts

Cataracts are a common age-related vision problem. About 20.5 million Americans age 40 and older have cataracts, and the older a person gets the greater the risk for developing cataracts. Women are more likely to develop cataracts than men, and African Americans and Hispanic Americans are at particularly high risk.

In addition to age, other factors may increase the risk of cataract development. These include:

Diabetes
Smoking
Over-exposure to sunlight

Symptoms

During the early stages, cataracts may have little effect on vision. Symptoms vary due to the location of the cataract in the eye (nuclear, cortical, or posterior subcapsular). Depending on the type and extent of the cataract, patients may experience the following symptoms:

Cloudy vision
Double or blurry vision
Glare and sensitivity to bright lights
Colors appear faded
Difficulty reading due to reduced black-white contrast

Treatment

Cataracts never go away on their own, but some stop progressing after a certain point. But if cataracts continue to grow and progress, they can cause blindness if left untreated. Fortunately, cataracts can usually always be successfully removed with surgery. Millions of cataract surgeries are performed each year in the United States, and there is a very low risk for complications. However, before opting for surgery, patients need to consider on an individual basis how severely a cataract interferes with their quality of life. Cataract surgery is rarely an emergency, so patients have time to consult with their doctors and carefully consider the risks and benefits of surgery.

Cataract Removal Surgery

Surgery involves removing the cataract and replacing the abnormal lens with a permanent implant called an intraocular lens (IOL). The operation takes less than 1 hour and is performed on an outpatient basis. The procedure is generally painless and most patients remain awake during it. If you have cataracts in both eyes, doctors recommend waiting at least 1 month between surgeries.

Introduction

A cataract is an opacity, or clouding, of the lens of the eye.

The lens of an eye is normally clear. If the lens becomes cloudy or is opacified, it is called a cataract.

The prevalence of cataracts increases dramatically with age. It typically occurs in the following way:

The lens is an elliptical structure that sits behind the pupil and is normally transparent. The function of the lens is to focus light rays into images on the retina (the light-sensitive tissue at the back of the eye).
In young people, the lens is elastic and changes shape easily, allowing the eyes to focus clearly on both near and distant objects.
As people reach their mid-40s, biochemical changes occur in the proteins within the lens, causing them to harden and lose elasticity. This causes a number of vision problems. For example, loss of elasticity causes presbyopia, or far-sightedness, requiring reading glasses in almost everyone as they age.
In some people, the proteins in the lens, notably those called alpha crystallins, may also clump together, forming cloudy (opaque) areas called cataracts. They usually develop slowly over several years and are related to aging. In some cases, depending on the cause of the cataracts, loss of vision progresses rapidly.
Depending on how dense they are and where they are located, cataracts can block the passage of light through the lens and interfere with the formation of images on the retina, causing vision to become cloudy.

Click the icon to see an image of eye anatomy.

Cataracts can form in any of three parts of the lens and are named by their location.

Nuclear cataracts. These form in the nucleus (the inner core) of the lens. This is the most common variety of cataract associated with the aging process.
Cortical cataracts. These form in the cortex (the outer section of the lens).
Posterior subcapsular cataracts. These form toward the back of a cellophane-like capsule that surrounds the lens. They are more frequent in people with diabetes, who are overweight, or those taking steroids.

Causes

Although older age is the primary risk factor for cataracts, experts are still not certain about the exact biologic mechanisms that tie cataracts to aging.

Oxygen-Free Radicals (Oxidants) and Glutathione

Researchers have been focusing on particles called oxygen-free radicals as a major factor in the development of cataracts. They cause harm in the following way:

Oxygen-free radicals (also called oxidants) are molecules produced by natural chemical processes in the body. Toxins, smoking, ultraviolet radiation, infections, and many other factors can create reactions that produce excessive amounts of these oxygen-free radicals.
Oxidants are missing an electron, so they are unstable and tend to chemically bind with other molecules in the body. When oxidants are overproduced, these chemical reactions can be very harmful to nearly any type of cell in the body. At times these reactions can even affect genetic material in cells.
Cataract formation is one of many destructive changes that can occur with overproduction of oxidants, possibly in concert with deficiencies of an important protective anti-oxidant called glutathione.
Glutathione occurs in high levels in the eye and helps clean up these free radicals. One theory posits that in the aging eye, barriers develop that prevent glutathione and other protective antioxidants from reaching the nucleus in the lens, thus making if vulnerable to oxidation.

Radiation and Electromagnetic Waves

Sunlight and Ultraviolet Radiation. Sunlight consists of ultraviolet (referred to as UVA or UVB) radiation, which penetrates the layers of the skin. Both have destructive properties that can promote cataracts. The eyes are protected from the sun by eyelids and the structure of the face (overhanging brows, prominent cheekbones, and the nose). Long-term exposure to sunlight, however, can overcome these defenses.

UVB radiation produces the shorter wavelength, and primarily affects the outer skin layers. It is the primary cause of sunburn. It is also the UV radiation primarily responsible for cataracts. Long-term exposure to even low levels of UVB radiation can eventually cause changes in the lens, including pigment changes, which contribute to cataract development. (UVB also appears to be responsible for macular degeneration, an age-related disorder of the retina.) Some scientists suggest that global warming and ozone depletion may increase peoples exposure to UVB, leading to a greater incidence of cataracts.
UVA radiation is composed of longer wavelengths. They penetrate more deeply and efficiently into the inner skin layers and are responsible for tanning. The main damaging effect of UVA appears to be the promotion of the release of oxidants.

Radiation Treatments. Cataracts are common side effects of total body radiation treatments, which are administered for certain cancers.

Electromagnetic Waves. Questions have been raised about the hazards of low-level radiation from computer screens. To date, no study has demonstrated an association between cataract development and video display terminals. It is a good idea, in any case, to sit at least a foot away from the front of a screen.

Definition

Juvenile angiofibroma is a noncancerous growth of the back of the nose or upper throat.

Alternative Names

Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor

Causes

Juvenile angiofibroma is not very common. It is usually found in adolescent boys. The tumor contains many blood vessels, spreads within the area in which it started (locally invasive), and can cause bone damage.

Symptoms

Difficulty breathing through the nose
Easy bruising
Frequent or repeated nosebleeds
Hearing loss
Nasal discharge, usually bloody
Prolonged bleeding
Stuffy nose

Exams and Tests

The doctor may see the angiofibroma when examining the upper throat.

Tests that may be done include:

CT scan of the head
Nasal mucosal biopsy (this can be very dangerous, and should only be done after using CT scan or arteriogram to see the blood supply to the growth)
X-ray

Treatment

Treatment is required if the angiofibroma is growing larger, blocking the airways, or causing repeated nosebleeds. In some cases, no treatment is necessary.

Surgery may be needed to remove the tumor. Removal is often difficult because the tumor is not enclosed and may have spread deeply to other areas.

A procedure called embolization may be done to prevent the tumor from bleeding. The procedure may correct the nosebleeds by itself, or it may be followed by surgery to remove the tumor.

Outlook (Prognosis)

Although not cancerous, angiofibromas may continue to grow. Some may disappear on their own.

It is common for the tumor to return after surgery.

Possible Complications

Anemia
Pressure on the brain (rare)
Spread of the tumor to the nose, sinuses, and other structures

When to Contact a Medical Professional

Call your health care provider if you often have nosebleeds.

Prevention

There is no known way to prevent this condition.

References

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo: Mosby; 2005.

Grainger RC, Allison D, Adam, Dixon AK. Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. Orlando, Fl: Churchill Livingstone; 2001.

Definition

Anencephaly is the absence of a large part of the brain and the skull.

Alternative Names

Aprosencephaly with open cranium

Causes

Anencephaly is one of the most common neural tube defects. Neural tube defects are birth defects that affect the tissue that grows into the spinal cord and brain. Anencephaly occurs early in the development of an unborn baby. It results when the upper part of the neural tube fails to close. Why this happens is not known. Possible causes include environmental toxins and low intake of folic acid during pregnancy.

Anencephaly occurs in about 4 out of 10,000 births. The exact number is unknown, because many of these pregnancies result in miscarriage. Having one infant with this condition increases the risk of having another child with neural tube defects.

Symptoms

Absence of the skull
Absence of the brain (cerebral hemispheres and cerebellum)
Facial feature abnormalities
Heart defects

Exams and Tests

A pregnancy ultrasound is done to confirm the diagnosis. The ultrasound may reveal too much fluid is in the uterus. This condition is called polyhydramnios.

Other tests that may be done on the pregnant mother:

Amniocentesis (to look for increased levels of alpha-fetoprotein)
Alpha-fetoprotein level (increased levels suggest a neural tube defect)
Urine estriol level

A pre-pregnancy serum folic acid test may also be done.

Treatment

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

Outlook (Prognosis)

This condition usually causes death within a few days.

When to Contact a Medical Professional

A health care provider usually detects this condition during routine prenatal testing and ultrasound. Otherwise, it is recognized at birth.

If anencephaly is detected before birth, further counseling will be needed.

Prevention

It is important for women who may become pregnant to get enough folic acid.

There is good evidence that folic acid can help reduce the risk of certain birth defects, including anencephaly. Women who are pregnant or planning to become pregnant should take a multivitamin with folic acid every day. Many foods are now fortified with folic acid to help prevent these kinds of birth defects.

Getting enough folic acid can reduce the chance of neural tube defects by 50 percent.

Pancreatitis

Pancreatitis is more common in men

Pancreatitis is a serious, potentially life threatening disease in which inflammation causes the pancreatic enzymes to digest itself. Because of its location inflammation can spread easily and quickly to the surrounding area and its organs.
There are two stages of the disease in which an acute stage pancreatitis can sometimes goes on to become a chronic illness.

Function of the pancreas
The pancreas is a gland that lies behind the stomach. Its role is to produce hormones that control the body’s use of sugar, insulin and glucagons, and to secrete digestive juices, enzymes and sodium bicarbonate, into the small intestine. It is the functions that are affected by the inflammation.

Causes of pancreatitis
The causes of pancreatitis are not fully understood but it is usually caused by gall stones or alcohol abuse. Gallstones can block the drainage of enzymes from the pancreas causing a build up resulting in inflammation and damage. Alcohol affects the pancreas in a number of negative ways, (it causes protein plugs to block outflow, increases duct permeability and the accumulation of digestive enzymes), all of which damage this vital organ.

Other less common causes include:

Some medications such as methyldopa, NSAIDs, tetracyclines and corticosteroids

Peptic ulcer disease

Cancer of the pancreas

Trauma to the abdomen or back

Viral infections such as mumps, hepatitis, rubella.

Scorpion or snake bites

People more prone to pancreatitis
Pancreatitis affects over 80000 Americans a year. African Americans aged between 35-64 years are 10 times more at risk than any other group. More men than women have chronic pancreatitis.

Symptoms of pancreatitis

Pain in the stomach area that radiates to the back

Nausea and/or vomiting

Fever

Breathing difficulties

Shock

Weight loss

Symptoms of sugar diabetes

Treatment for pancreatitis
Treatment will obviously depend on the symptoms and the severity of the pancreatitis. Admission to hospital is often required to support and monitor the patient during the initial stages. When the condition is life threatening intensive care will be needed. Fluid balance, a period with no nutrition by mouth, antibiotics, strong analgesics, oxygen even surgery are treatment options for the person with pancreatitis.

Prognosis for pancreatitis
As pancreatitis can recur education to manage and maximise well being will be very important. If the cause of the pancreatitis is alcohol then all drinking must stop. If gallstones led to pancreatitis then removal of the gallbladder is the best way to avoid future recurrences. If the gall bladder is not removed then fatty foods should be avoided.

Article Sources Include: NHS Direct, University of Pittsberg Medical Center, BBC Health, Womenshealth About.com

Successful Cancer Detection From a Single Drop of Blood

Technological advancements in the field of cancer detection may soon end the need for use of surgical biopsies to remove lumps of tissue for lab analysis and pave the way for the use of a simple prick of the finger instead. New technology has now made it possible for cancer proteins to be analyzed from just a tiny drop of blood or minute tissue sample that is equivalent to four nanograms, which is smaller in size than the dot of the punctuation mark commonly called a period.

The use of the same procedure may also enhance cancer therapy by allowing for fast and easy monitoring of patient response to treatment. Although current research has analyzed only blood cancers with the use of the new methodology, scientists are optimistic that they will also be able to apply the technique to solid tumors and have already begun testing it on head and neck tumors.

Researchers from Stanford University in California have developed a machine capable of separating cancer-associated proteins by means of their electric charge. This varies according to modifications on the protein's surface. Since immune system agents known as antibodies bind to specific molecules, they can be used to identify comparative amounts and positions of various proteins. This technique allowed researchers to detect varying levels of activity of common cancer genes in human lymphoma samples as well as to distinguish between different types of lymphoma. The team found that the procedure worked on lymphoma samples drawn from laboratory mice as well as on cultured tumor cells. The system is called nanofluidic proteomic immunoassay (NIA).

According to researcher, Dr Dean Feisher, “This technology allows us to analyze cancer-associated proteins on a very small scale. Not only can we detect picogram levels—one trillionth of a gram—of protein, but we can also see very subtle changes in the ways the protein is modified.”

The research team was also able to confirm the anti-cancer effect of a cholesterol-lowering statin drug on one lymphoma patient. Regarding this accomplishment, Feisher noted, “This is the first time we have been able to see that this compound affects the biology of cancer cells in patients.” He also acknowledged, “Now we have a tool that will really help us look at what's happening in cells over time.” The findings of the analysis were published in the online version of the journal Nature Medicine.

Alice Fan, a clinical instructor in the division of oncology at Stanford’s medical school, believes the technique offers hope of a major advancement in tracking tumor cells during treatment. She said, “The standard way we measure if a treatment is working is to wait several weeks to see if the tumor mass shrinks. It would really be a leap forward if we could detect what is happening at a cellular level.” However, the researchers cautioned that more research would be necessary before the methodology will be clinically available.

Heart Problems + Depression = Increased Heart Failure Risks

Patients who have heart problems and become depressed have increased odds of heart failure, according to new data. Previous research has shown risks of depression increases nearly three times following an initial heart attack and also increases the risk of a second heart attack. This makes heart disease combined with depression an increased concern, especially since the new research has discovered antidepressants didn’t seem to curb increased risks of heart failure with depression and heart problems.

The recently released findings by Dr. Heidi May, an epidemiologist at the Intermountain Medical Center in Murray, Utah, where she investigated patient’s heart problems combined with depression, shows the combination increases the odds of heart failure. Dr. May’s study evaluated nearly 14,000 patients who were recruited from the cardiac catheterization registry from the center where Dr. May is employed. One of the leading heart hospitals in the U.S. When the patients were diagnosed with heart problems they did not have signs of heart failure or depression, but they were tracked until they developed heart failure or died. Dr. May and researchers found that patients who were diagnosed with depression following a diagnosis of coronary heart disease had a two fold increase in their odds of heart failure, a condition where the heart losses its ability to pump blood efficiently. According to the study, heart failure in non-depressed patients following a diagnosis of coronary artery disease was 3.6 per 100, but for those patients with post-heart disease depression diagnosis, their odds increased to 16.4 per 100.

Heart disease, depression and stress disorders are two conditions which can significantly limit a patients daily life and activities, as well as contribute to mounting medical expenses. During Dr. May’s study, she determined that patients who had developed depression after a heart disease diagnosis odds of developing heart failure didn’t decrease with antidepressant medication. Dr. May said, "Patients need to be carefully screened for depression so that interventions that alter some of the risk associated with depression can be used and the related risk of heart failure and other cardiovascular events can be diminished."

Based on previous studies, patients suffering from depression are less likely to take their medication and follow their doctors' advice, which according to May could be a contributing factor to heart failure among patients with heart disease and depression. "I think that doctors can maybe pay closer attention to the patients that have depression and really follow them to make sure they're taking their medications, that they're following the right diet, they're exercising and do the things that they're asking them to do," according to May .

With the new research, that will be published in the April 21 issue of the Journal of American College of Cardiology we can see the increased risk of heart failure among heart disease patients who later develop depression. Dr. May and researchers hope their study can help uncover reasons that may contribute to heart failure and relieve some of the burdens that it puts on the health care system, as well as learn better ways to treat depression. With the 50 percent increase in risk’s for patients with heart disease developing heart failure, Dr. May believes additional studies would help to delve into the association between heart disease, depression and heart failure, along with other cardiovascular issues.

Nevus pigmentary, dysplastic, blue, boundary, removal of nevus

Pigmentary nevus - a good-quality congestion of pigmentary cells on a skin. Pigmentary nevus it is seldom possible to meet at babies; they start to be shown in the childhood, and especially much they appear in youthes, and with the years number of pigmentary nevuses one step at a time decreases. The type of pigmentary nevuses can be various - they can be flat or acting above a surface of a leather, the smooth or covered hair. It is necessarily necessary for adult people to pay attention to variation of their form, color or appearance as it can be one of initial symptoms developing malignant melanoma.

Dysplastic nevuses is pigment spots of the complex form and with not sharp borders, slightly rise above a level of a skin, painting varies them from red-brown up to dark-brown on a pink background.

Dysplastic nevuses for the first time have drawn to itself attention the unusual type and the raised frequency in some families (are transferred by right of succession). As a rule, dysplastic nevuses is larger than ordinary birthmarks, reaching 5–12 mm in diameter.

Boundary pigmentary nevus. Develops in the field of dermo-epidermal joints and it is characterized raised melanocyte by activity. Clinically it looks like flat is dark-brown or black papule in diameter up to 1 sm, with a smooth dry surface is more often. The important differential-diagnostic sign boundary pigmentary nevus is the total absence on it of hair. Boundary nevus can sometimes look a spot roundish or wrong outlines with equal wavy edges. Favourite localization at boundary nevus is not present. It can settle down on a leather of the person, a neck, a trunk. According to the literature, pigmentary nevuses on a skin of a palm, soles, genitals almost always are boundary. Boundary nevus is congenital is more often, however can appear in the first years of a life or even after puberty.

Blue (dark blue) nevus represents sharply limited from a surrounding skin papule is dark-dark blue or bluish color, roundish outlines, densely-elastic consistence with a smooth hairless surface. It is characterized by massive congestions of melanin in deep layers of derma, that causes its blue color. The size of papule no more than 0,5 sm though in the literature individual supervision huge blue nevus are described, reaching several centimeters in diameter. Settles down blue nevus more often on the person, finitenesses, buttocks. Localization in an oral cavity is possible. Blue nevus meets at representatives of Asian people is more often. Congenital it never happens and appears mainly after puberty. Progress of melanoma on seat blue nevus is observed seldom, but such cases are described, as has induced it to carry to danger of melanoma.

Huge pigmentary nevus - always congenital. It increases in sizes in process of growth of the child, reaching the big size (from a palm and it is more) and borrows sometimes the most part of a trunk, a neck and other areas. Usually on a significant extent a surface of nevus is torous, warty, with deep cracks on a skin. Often there are sites trichauxis (hair nevus). Color variate from grayish up to black, often non-uniform on various sites of nevus. Malignization of huge pigmentary nevus according to various authors occurs in 1,8 % up to 10 % of cases.

Papillomatous nevus is characterized rough, torous by a surface. It is often localized on hair parts of a head, but happens and on any other site of an integument. The sizes more often greater, up to several centimeters, outlines are wrong, color variates from color of a normal skin up to brownish, less often - is dark-brown or even black. Similar fibroepithelial papilloma quite often happens it is penetrated by hair.

Removal of nevuses

Any pigmentary new growths of a skin require attention and vigilance.

Their treatment consists in radical (within the limits of not changed leather) removal by a method surgical ablation (stages are presented on illustrations in the bottom of page). Use modern noninvasive sutural and rules of aesthetic surgery allows to achieve materials undistinguished postoperative cicatrical tissue.

Bronchiolitis

Ethiology

Many diseases have bronchiolitis like clinical displays, vast majority from them virus ethiology. A respiratory-syncytial virus (РС) consider as the most frequent reason bronchiolitis. It is established, that from 40 up to 75 % of children acts in hospital with the diagnosis bronchiolitis, caused this virus. Other activators can be rhinovirus, a virus parainfluenza (type 3), adenovirus (type 3, 7 and 21), a virus of a flu and, occasionally, a virus of an epidemic parotitis. Though in children of advanced age Mycoplasma pneumoniae usually causes disease of the bottom respiratory ways, but at chest age it seldom causes bronchiolitis.

Epidemiology

Using widely widespread clinical term «the whistling child at a respiratory infection», Henderson and co-author. Have noted, that the highest frequency of disease was at children of the first year of a life: 11,4 cases on 100 children in a year. On the second to year of a life frequency decreased to 6 cases on 100 children in a year. In Houston frequency РС bronchiolitis, demanding hospitalization, in families with a low social level made 5 cases on 100 chest babies in a year. About 80 % of the hospitalized children 6 months Therefore authors were more younger have come to conclusion: the the child is more younger, the more hard at it disease proceeds and is more often hospitalization is required.

Babies with heavy forms bronchiolitis have a low level of the antibodies transferred from mother. From the hospitalized children with the proved Óß-infection at 18-20 % can arise apnoea to which contribute prematurity and early age of the child. Other group of high risk for occurrence of the Óß-infection is made by patients with VPS. At the general lethality 1-2 % in this group at the Óß-infection it reaches 37 %.

Epidemic of the Óß-virus develops annually in the winter while frequency contamination viruses parainfluenza decreases a little. The disease caused by the Óß-virus, is very infectious, if in collective there is a patient, as a rule, all contact children (98 %) fall ill. Transfer of the Óß-virus to family as is significant. Reasonably to be ill to one member of family that 46 % of the others were infected.

Frequency of hospital infections is high. During flash of the Óß-infection of 45 % of tentatively not infected hospitalized children were ill with this infection. The risk of disease raised with an increase of duration of hospitalization. Probably, its basic source in hospital is the medical personnel which distributed a virus, catching through the secrets allocated by infected patients. Infection occured approximately in 42 %.

Clinical aspects

Usually the baby catches from the senior children or adults with an infection of respiratory ways.

Diagnosis: bronchiolitis

Cough, cold, ptarmus are the first symptoms of disease. In the subsequent at patients on a background of irritability respiratory frustration with polypnea, participation in breath of auxiliary muscles, dry rattles progress. There can be an insignificant fever. The appreciable short wind causes difficulty of the certificate sucking. Physical survey reveals signs of sharp inflammatory disease of respiratory ways: polypnea, cyanosis, inflating of wings of a nose and impaction compliant seats of a chest wall. Lungs emphysematous, the edge of a liver can act on some fingers from under a costal arch. At lungs auscultation - dry diffuse and damp rattles, lengthening of an exhalation.

Indispensable laboratory researches at the patient with heavy bronchiolitis include: the roentgenogram of a thorax; the clinical analysis of blood; research of arterial gases of blood; virologic definition of the Óß-virus and antibodies to it; crop of blood on microflora if it is impossible to exclude a bacterial pneumonia.

Radiological inspection of the child with sharp bronchiolitis shows availability sharp emphysema lungs at the majority of patients. At half of children define peribronchial sealings. Leukocytosis usually is absent. RS the virus can be identified by reaction of linkage complement or indirect immunofluorescence antibodies in film, taken with a mucous membrane of a nose.

For diagnostics of respiratory insufficiency at bronchiolitis it is necessary to investigate arterial gases of blood. On the basis of a series from 32 patients the Hall and co-authors have established, that average saturation by oxygen of hemoglobin has made 87 %. Hypoxemia persistence, proceeding 3-7 weels, even on a background of clinical improvement of a condition.

Basal ganglia of endbrain and movement

Basal ganglia are located in the basis of a endbrain and represent the important subcrustal connecting link between associative areas of a cerebral cortex and impellent areas of a cerebral cortex. Following structures are concern to basal ganglia: a striped kernel of basal ganglia consisting caudate nucleus of basal ganglia and shells of basal ganglia, a pale sphere of basal ganglia subdivided on internal and external departments, a black substance of basal ganglia and a subthalamic kernel of basal ganglia. In structure of basal ganglia often include also a fencing and less often - amygdala.

Infringements of movements are caused by defeat of basal kernels - the anatomically isolated group of pair subcrustal structures.

Basal kernels facilitate movements started by a bark and suppress extra accompanying movements. Striatum receives the somatotopic organized projections almost from all zones of a bark. These projections are organized in the form of parallel ways which begin from frontal areas, postcentral (somatotopic) areas, precentral (motor) areas and parietotemporal-occipital areas.

Neurocytes of striatum send fibres to the structures shaping the main axifugal way of basal kernels - to a mesh part of a black substance and a medial pale sphere.

Thus, at braking neurocytes a mesh part of a black substance and a medial pale sphere exciting influence thalamus on a bark amplifies - as promotes simplification of movement started by a bark.

On the contrary, at excitation neurocytes a mesh part of a black substance and a medial pale sphere exciting influence таламуса on a bark suppresses - that leads to braking of unnecessary movement.

On a spinal cord basal kernels have no direct output. The direct way from striatum to a mesh part of a black substance and a medial pale sphere is formed brake by fibres. Their function consists in strengthening exciting influence of kernels thalamus on those departments of a motor bark which are responsible for the necessary movement. The indirect way is organized more difficultly. Its function consists in suppression of exciting influence thalamus on other departments of a motor bark.

Thus, if activation of a direct way from striatum strengthens excitation of a motor bark activation of an indirect way - weakens.

Activity of these two ways is adjusted with the compact part of a black substance sending to striatum dopaminergic fibres. These fibres raise direct a axifugal way to striatum (through neurocytes with D1-receptors) and brake - indirect (through neurocytes with D2-receptors). Striatum sends also brake gamma-aminobutyric acid fibres to a compact part of a black substance, forming that with it a negative feedback. Finally, activity of striatum modulate it cholinergic inserted neurocytes - antagonists dopaminergic neurocytes.

Tuesday, April 28, 2009

Friday, April 24, 2009

What Is It?

Symptoms

Diagnosis

Expected Duration

Prevention

Treatment

When To Call A Professional

Prognosis

Wednesday, April 22, 2009

How is Down's Syndrome Diagnosed?

At Birth

During pregnancy

Screening versus Diagnostic Testing

Monday, April 20, 2009

Highlights

Introduction

Borrelia Burgdorferi

Ixodes Ticks

The Cycle of Infection

Thursday, April 16, 2009

Definition

Alternative Names

Causes

Symptoms

Exams and Tests

Treatment

Definition

Alternative Names

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional

Wednesday, April 15, 2009

Introduction

Causes

Oxygen-Free Radicals (Oxidants) and Glutathione

Radiation and Electromagnetic Waves

Definition

Alternative Names

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional

Prevention

References

Definition

Alternative Names

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

When to Contact a Medical Professional

Prevention

Tuesday, April 14, 2009

Pancreatitis is more common in men

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