Thursday, December 30, 2010
Heart disease is the No. 1 killer of people in the United States. A diagnosis of heart disease doesn't spell out certain doom, however. Exercise and a healthy diet are one way to fight it, and fortunately, nowadays there are many safe and effective drug treatments as well. Some are new, some are old, and some work when others don't. Your doctor will know which is the best drug (or drugs) for you, but it helps to be informed so you can take part in your own health care (and heart care) planning.
1: Cholesterol-lowering Drugs
3: Calcium Channel Blockers
4: Angiotensin II Receptor Blockers (ARBs)
5: Blood Thinners (anticoagulants)
6: Beta Blockers
7: Digitalis Preparations
10: ACE Inhibitors
Wednesday, December 29, 2010
Being a parent is often considered to be one of the toughest jobs in the world. It seems as though new studies or articles come out on a regular basis telling you about something else you should do or avoid doing to raise the healthiest child possible. But you might look at it this way: Life is too short to sweat the small stuff -- especially when sweating can lead to heat rash.
Heat rash is a relatively common condition, particularly in young children. It usually develops in hot and humid weather when the sweat ducts become blocked and clothing rubs the skin, causing redness and irritation. Although annoying and uncomfortable, the good news is that heat rash usually heals on its own in just a few days. More good news (especially for children) -- heat rash is not infectious or contagious.
The best way to reduce the risk of getting heat rash is take preventive measures to avoid it. Babies usually develop heat rash because their parents dress them in too much clothing in hot and humid weather. There is no reason to stay inside when the weather is nice, but it is important to keep your child cool and dry if you want to beat the heat (and the heat rash). Use lightweight, soft clothing in the summer. Another way to avoid heat rash is to keep your child's room cool at night. And try not to overuse powders or creams; these can block pores and lead to heat rash. If your child does end up getting heat rash, find a cool, dry place.
Monday, December 27, 2010
As chronic diseases have assumed an increasingly common role in premature death and illness, interest in the role of sleep in the development and management of chronic diseases has grown. Notably, insufficient sleep has been linked to the development and management of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression.
Research has found that insufficient sleep is linked to an increased risk for the development of diabetes. Specifically, sleep duration and quality have emerged as predictors of levels of Hemoglobin A1c, an important marker of blood sugar control. Recent research suggests that optimizing sleep duration and quality may be important means of improving blood sugar control in persons with diabetes.
Persons with sleep apnea have been found to be at increased risk for a number of cardiovascular diseases. Notably, hypertension, stroke, coronary heart disease and irregular heartbeats (cardiac arrhythmias) have been found to be more common among those with disordered sleep than their peers without sleep abnormalities. Likewise, sleep apnea and hardening of the arteries (atherosclerosis) appear to share some common physiological characteristics, further suggesting that sleep apnea may be an important predictor of cardiovascular disease.
Laboratory research has found that short sleep duration results in metabolic changes that may be linked to obesity. Epidemiologic studies conducted in the community have revealed an association between short sleep duration and excess body weight. Notably, this association has been reported in all age groups—but has been particularly pronounced in children. It is believed that sleep in childhood and adolescence is particularly important for brain development and that insufficient sleep in youngsters may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy.
The relationship between sleep and depression is complex. While sleep disturbance has long been held to be an important symptom of depression, recent research has indicated that depressive symptoms may decrease once sleep apnea has been effectively treated and sufficient sleep restored. The interrelatedness of sleep and depression suggests it is important that the sleep sufficiency of persons with depression be assessed and that symptoms of depression are monitored among persons with a sleep disorder.
Monday, December 20, 2010
Night blindness may cause problems with driving at night. People with night blindness often have trouble seeing stars on a clear night or walking through a dark room, such as a movie theater.
These problems are often worse just after a person is in a brightly lit environment. Milder cases may just have a harder time adapting to darkness.
The causes of night blindness fall into two categories: treatable and nontreatable.
* Use of certain drugs
* Vitamin A deficiency (rare)
* Birth defects
* Retinitis pigmentosa
Take safety measures to prevent accidents in areas of low light. Avoid driving a car at night, unless you get your eye doctor's approval.
Vitamin A supplements may be helpful if you have a vitamin A deficiency. Ask your doctor.
When to Contact a Medical Professional
It is important to have a complete eye exam to determine the cause, which may be treatable. Call your eye doctor if symptoms of night blindness persist or significantly affect your life.
What to Expect at Your Office Visit
Your health care provider will examine you and your eyes. The goal of the medical exam is to determine if the problem can be corrected (for example, with new glasses or cataract removal), or if the problem is due to something more serious.
The doctor may ask you questions, including:
* When did the night blindness begin?
* Did it occur suddenly or gradually?
* Does it happen all the time or just sometimes?
* How severe is the night blindness?
* Are you nearsighted?
* Do you have other vision changes?
* What other symptoms do you have?
* Do you have unusual stress, anxiety, or a fear of the dark?
* Does using corrective lenses improve night vision?
* What medications do you use?
* How is your diet?
* Have you recently injured your eyes or head?
* Do you have a family history of diabetes?
The eye exam will include:
* Color vision testing
* Pupil light reflex
* Retinal exam
* Slit lamp examination
* Visual acuity
Other tests may be done:
* Electroretinogram (ERG)
* Visual field
Thursday, December 16, 2010
Cramps are usually harmless but may sometimes be symptomatic of an underlying medical disorder, such as atherosclerosis (narrowing of the arteries). Regular cramping or severe cramping that lasts longer than a few minutes should always be investigated by your doctor.
The symptoms of a muscle cramp include:
* Sudden sensation of uncontrollable and painful spasms in the muscle
* Muscle twitching.
Minerals and electrolytes
Muscle tissue relies, in part, on a range of minerals, electrolytes and other chemicals in order to contract and relax. Some of these important substances include calcium, magnesium, potassium and sodium. Inadequate diet, dehydration, vomiting and diarrhoea are just some of the factors that are thought to disturb the body’s balance of minerals and electrolytes, and make muscles more susceptible to cramping.
Tetany is a special form of cramping – it can be brought on by overbreathing, which results in a low level of carbon dioxide in the blood. It is usually caused by anxiety.
The exact cause of muscle cramp is not known, but risk factors may include:
* Tight, inflexible muscles
* Poor physical condition
* Poor muscle tone
* Inadequate diet
* Physical overexertion
* Physical exertion of cold muscles
* Muscle injury
* Muscle fatigue
* Excessive perspiration
* Dehydration – caused by, for example, a bout of gastroenteritis
* Reduced blood supply (ischaemia)
* Wearing high-heeled shoes for lengthy periods.
Muscle cramp associated with medical conditions
Certain diseases or conditions may increase the risk of muscle cramp, including:
* Atherosclerosis – a condition characterised by narrowed arteries due to the formation of fatty plaques. Muscles are more likely to cramp if their blood supply is inadequate.
* Sciatica – pain in the buttock and leg caused by pressure on nerves in the lower back. In some cases, the irritated nerve may prompt the associated muscles to contract.
* Medications – some medical conditions require the regular use of fluid pills (diuretics). These drugs can interfere with the body’s mineral balance and contribute to cramping.
Most muscle cramps resolve after a few seconds or minutes. Treatment options include:
* Stretch and massage – lengthen the cramping muscle using a gentle, sustained stretch then lightly massage the area until the cramp subsides. If you are unsure how to stretch leg muscles, see your physiotherapist for advice.
* Icepack – in cases of severe cramp, an icepack applied for a few minutes may help the muscle to relax.
* Medication – some medications can be helpful to control muscle cramps. See your doctor for further information.
* Further treatment – see your doctor if you experience regular muscle cramping or if cramps last longer than a few minutes. You may have an undiagnosed medical condition that requires treatment.
Suggestions on how to reduce the likelihood of muscle cramp include:
* Increase your level of physical fitness.
* Incorporate regular stretching into your fitness routine.
* Warm up and cool down thoroughly whenever you exercise or play sport.
* Drink plenty of water before, during and after exercise.
* Make sure your diet is nutritionally adequate, and include plenty of fruits and vegetables.
* A regular massage may help to reduce muscle tension.
* Wear properly fitted shoes and avoid high heels.
Where to get help
* Your doctor
* Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
* Massage therapist
* An accredited practising dietitian, contact the Dietitians Association of Australia
* Australian Physiotherapy Association Tel. (03) 9534 9400
Things to remember
* A muscle cramp is an uncontrollable and painful spasm of a muscle.
* The exact cause is unknown, but some of the risk factors may include poor physical condition, dehydration and muscle fatigue.
* You can help reduce the duration and severity of cramp by gently stretching the muscle and massaging the area.
* See your doctor if you experience regular muscle cramping or if cramps last longer than a few minutes.
Sunday, December 12, 2010
Conjunctivitis is swelling (inflammation) or infection of the membrane lining the eyelids (conjunctiva).
The conjunctiva is exposed to bacteria and other irritants. Tears help protect the conjunctiva by washing away bacteria. Tears also contain enzymes and antibodies that kill bacteria.
There are many causes of conjunctivitis. Viruses are the most common cause. Other causes include:
* Allergies (allergic conjunctivitis)
* Certain diseases
* Chemical exposure
* Parasites (rarely)
* Use of contact lenses (especially extended-wear lenses)
"Pink eye" refers to a viral infection of the conjunctiva. These infections are especially contagious among children.
Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.
* Allergic conjunctivitis
* Keratoconjunctivitis sicca
* Neonatal conjunctivitis
* Vernal conjunctivitis
* Blurred vision
* Crusts that form on the eyelid overnight
* Eye pain
* Gritty feeling in the eyes
* Increased tearing
* Itching of the eye
* Redness in the eyes
* Sensitivity to light
Exams and Tests
* Examination of the eyes
* Swab of conjunctiva for analysis
Treatment of conjunctivitis depends on the cause.
Allergic conjunctivitis may respond to allergy treatment. It may disappear on its own when the allergen that caused it is removed. Cool compresses may help soothe allergic conjunctivitis.
Antibiotic medication, usually eye drops, is effective for bacterial conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eyedrop for pink eye to prevent bacterial conjunctivitis.
You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses (clean cloths soaked in warm water) to your closed eyes.
The outcome is usually good with treatment.
Reinfection within a household or school may occur if you don't follow preventive measures.
When to Contact a Medical Professional
Call for an appointment with your health care provider if your symptoms last longer than 3 or 4 days.
Good hygiene can help prevent the spread of conjunctivitis:
* Change pillowcases frequently.
* Do not share eye cosmetics.
* Do not share towels or handkerchiefs.
* Handle and clean contact lenses properly.
* Keep hands away from the eye.
* Replace eye cosmetics regularly.
* Wash your hands often.
Inflammation - conjunctiva; Pink eye
Monday, December 6, 2010
Just as physical activity keeps your body strong, mental activity can help keep your mind engaged and challenged as you age. Some research suggests that activities that engage your brain might offer some protection against cognitive decline. Here are some activities you might try:
* Learning to play a musical instrument
* Playing Scrabble or doing crossword puzzles
* Starting a new hobby, such as crafts, painting, biking, or bird-watching
* Staying informed about what's going on in the world
Also, some research suggests that physical activity, especially at high levels, may protect against cognitive decline.
Keep in mind the positive effects of aging on the brain. For instance, people can acquire new skills as they grow older. Middle-aged adults typically do better on tests involving knowledge and information than younger adults do. Vocabulary and word use improve with age. And although perhaps not “measurable,” a lifetime of building knowledge and real-world decision-making and experience results in wisdom that is rare in youth.
When Forgetting Isn't Normal
Although memory lapses are usually minor, serious memory loss and confusion are not a normal part of aging. Memory loss along with big changes in personality and behavior may mean there is a problem. Signs of a syndrome called dementia — the most common form is Alzheimer's disease — include symptoms such as:
* Asking the same questions over and over again
* Forgetting how to use everyday objects or words
* Becoming lost in familiar places
* Being unable to follow directions
* Neglecting personal safety, hygiene, and nutrition
These symptoms can also be caused by other more minor medical conditions, infections, nutrition problems, minor head injuries, bad reactions to medicine, or other physical problems that occur in later life. It's important to see a doctor right away to get a correct diagnosis and possibly fix the problem if it is not dementia.
Wednesday, December 1, 2010
Rheumatism is a term used by physicians as a general category of all diseases that cause pain and disability affecting the joints and their supporting structures. The term arthritis is used for conditions arising from involvement of the joints and their immediate surrounding structures. It is commonly used as a general term to describe rheumatic diseases which essentially attack the joints. Therefore we hear that "he/she has some form of arthritis"
Rheumatoid arthritis is a chronic inflammatory condition that affects the joints of the body, and that can profoundly affect an individual's ability to function at normal level. The effects of rheumatoid arthritis can be traced to inflammation caused by the body's normal response to infections, injury, wounds, or foreign objects in the body. There are over 100 different types of arthritis. Here is a quick overview on the five most common forms of arthritis.
Osteoarthritis: Also known as "degenerative joint disease is by far the most common type of arthritis. Osteoarthritis develops as a result of the continual wear and tear experienced by the cartilage that surrounds our joints. The symptoms of osteoarthritis can range from very mild to severe. In general, men experience the brunt of their symptoms in the knees and hips while women tend to suffer more in their fingers.
Rheumatoid Arthritis: This condition is different from most other types of arthritis conditions in that it is a disease of the autoimmune system. Rheumatoid arthritis can also affect the vital organs in more advanced cases. Women are at a greater risk for developing this form of arthritis.
Seronegative Arthritis: These are a class of arthritis disorders that manifest symptoms similar to those of rheumatoid arthritis. Seronegative arthritis disorders tend to be related to skin disorders. These may include psoriasis, disorders of the immune system, and intestinal disorders.
Gout: This is a form of arthritis cause by the overproduction of uric acid in the body. The uric acid creates small crystals that may be felt beneath the surface of the skin. Gout affects about half a million people in the United States, and it is much more common among men. Gout usually affects one joint of the time, and it commonly strikes in the big toe.
Infective arthritis: This form of arthritis occurs when bacteria enters the bloodstream and infects the joints. Infective arthritis is usually the result of a wound or injury that becomes infected. Illness may also cause it, including the mumps and chicken pox.
Sunday, November 21, 2010
Some people with asthma are allergic to the fungal spores. These can trigger an asthma attack if inhaled. Some people will develop a condition known as allergic bronchopulmonary aspergillosis (ABPA), in which asthma worsens significantly, as a result of increased lung inflammation.
In rare cases, a person may suffer serious lung or other organ infection with this fungus. Some severely ill people, or those whose resistance is lowered because they are taking medications which suppress their immune system, may be affected.
The structure of the lungs
The lungs are inside the chest, protected by the ribcage and wrapped in a membrane called the pleura. The windpipe (trachea) splits into two tubes, called bronchi, that service one lung each. The bronchi divide into smaller tubes called bronchioles, which ultimately branch into even smaller air sacs called alveoli. Each alveolus has a fine mesh of capillaries. This is where the exchange of oxygen and carbon dioxide takes place. A person with asthma who is allergic to Aspergillus will have spasms of the bronchioles, which causes breathlessness and wheezing.
Allergens and asthma
Nine out of 10 people with asthma find their symptoms worsen when they are exposed to certain triggers or allergens. An allergen is any substance that causes an overzealous response from the immune system, which treats the non-poisonous substance as if were poisonous. People with asthma are allergic to different triggers, such as cigarette smoke, wood smoke, pollen, dust mite or Aspergillus spores.
Men and women with asthma who are aged 20 to 40 years are most commonly affected. People with cystic fibrosis are also vulnerable. Treatment options include medications and avoiding exposure to the fungus whenever possible.
Symptoms of allergic bronchopulmonary aspergillosis include:
* Significant worsening of asthma symptoms
* A productive cough with brown mucus or mucus plugs
* Coughing up blood
* Loss of appetite
* General malaise.
Complications of ABPA
Some of the complications of untreated allergic bronchopulmonary aspergillosis include:
* Haemoptysis - the irritated and inflamed airways can bleed and bloodstained phlegm is coughed up.
* Bronchiectasis - recurring bouts of inflammation eventually damage the bronchiolar walls.
* Atelectasis - this involves varying degrees of lung tissue collapse.
* Respiratory failure - the airways become obstructed, or a severe asthma attack squeezes the airways closed. This is a medical emergency.
ABPA is diagnosed using a number of tests, including:
* Chest x-rays - to check for the presence of fluid in the lungs and for any abnormalities, such as enlarged, stretched or damaged airways. CT scans may also be used.
* Skin test - the skin is pricked and a tiny amount of the allergen is introduced. A person who is allergic to Aspergillus will experience swelling, itching and reddening of the site, usually within 20 minutes. However, the skin reaction may take as long as eight hours to develop in some people.
* Blood tests - antibodies are special proteins of the immune system that are tailor-made to counter specific antigens. Blood tests check for the presence of Aspergillus antibodies (Aspergillus precipitins). These precipitins bind with the spores and form tiny solids. Around half of all people with ABPA have elevated levels of immunoglobulin E, or IgE, which is a type of blood protein that prompts allergic reactions.
* Sputum tests - Aspergillus spores are sometimes visible in the person’s mucus when viewed under a microscope. The spores can be cultured from the mucus and positively identified using special dyes.
There is no cure for ABPA. The condition is managed with corticosteroids taken orally or with puffers. Antifungal medications generally have no effect. People with ABPA should be monitored regularly to make sure their condition is successfully managed.
Monitoring may include checking antibody levels and evaluating the airflow capacity of the lungs. People with asthma are generally advised to avoid their known triggers whenever possible. However, Aspergillus is a particularly common fungus. People with ABPA should try to stay away from marshes, forests, bogs, compost heaps and other areas where vegetation is known to be rotting.
Tuesday, November 9, 2010
Treatment for most of the leukodystrophies is symptomatic and supportive, and may include medications, physical, occupational, and speech therapies; and nutritional, educational, and recreational programs. Bone marrow transplantation is showing promise for a few of the leukodystrophies.
The prognosis for the leukodystrophies varies according to the specific type of leukodystrophy.
Monday, November 1, 2010
Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants.
Seborrheic dermatitis is thought to be due to a combination of an over production of skin oil and irritation from a yeast called malessizia.
Seborrheic dermatitis appears to run in families. Stress, fatigue, weather extremes, oily skin, infrequent shampoos or skin cleaning, use of lotions that contain alcohol, skin disorders (such as acne), or obesity may increase the risk.
Neurologic conditions, including Parkinson's disease, head injury, and stroke may be associated with seborrheic dermatitis. Human immunodeficiency virus (HIV) has also been linked to increased cases of seborrheic dermatitis.
Seborrheic dermatitis can occur on many different body areas. Typically it forms where the skin is oily or greasy. Commonly affected areas include the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the external ear, and along skin folds on the middle of the body.
Seborrheic dermatitis in infants, also called cradle cap, is a harmless, temporary condition. It appears as thick, crusty, yellow or brown scales over the child's scalp. Similar scales may also be found on the eyelids, ear, around the nose, and in the groin. Cradle cap may be seen in newborns and small children up to age 3 .
Cradle cap is not contagious, nor is it caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap may or may not itch. If it itches, excessive scratching of the area may cause additional inflammation, and breaks in skin may cause mild infections or bleeding.
In general, symptoms of seborrheic dermatitis include:
* Skin lesions
* Plaques over large area
* Greasy, oily areas of skin
* Skin scales -- white and flaking, or yellowish, oily, and adherent -- "dandruff"
* Itching -- may become more itchy if infected
* Mild redness
* Hair loss
Exams and Tests
The diagnosis is based on the appearance and location of the skin lesions.
You can treat flaking and dryness with over-the-counter dandruff or medicated shampoos. Shampoo the hair vigorously and frequently (preferably daily). Loosen scales with the fingers, scrub for at least 5 minutes, and rinse thoroughly. Active ingredients in these shampoos include salicylic acid, coal tar, zinc, resorcin, ketoconazole, or selenium.
Shampoos or lotions containing selenium, ketoconazole, or corticosteroids may be prescribed for severe cases. To apply shampoos, part the hair into small sections, apply to a small area at a time, and massage into the skin. If on face or chest, apply medicated lotion twice per day.
Seborrheic dermatitis may improve in the summer, especially after outdoor activities.
For infants with cradle cap:
1. Massage your baby's scalp gently with your fingers or a soft brush to loosen the scales and improve scalp circulation.
2. Give your child daily, gentle shampoos with a mild soap while scales are present. After scales have disappeared, you may reduce shampoos to twice weekly.
3. Be sure to rinse off all soap.
4. Brush your child's hair with a clean, soft brush after each shampoo and several times during the day.
5. If scales do not easily loosen and wash off, apply some mineral oil to the baby's scalp and wrap warm, wet cloths around his head for up to an hour before shampooing. Then, shampoo as directed above. Remember that your baby loses a lot of heat through his scalp. If you use warm, wet cloths with the mineral oil, check frequently to be sure that the cloths have not become cold. Cold, wet cloths could drastically reduce your baby's temperature.
6. If the scales continue to be a problem or concern, or if you child seems uncomfortable or scratches his scalp, contact your physician. He may prescribe a cream or lotion to apply to your baby's scalp several times a day.
Seborrheic dermatitis is a chronic (life-long) condition that can be controlled with treatment. It often has extended inactive periods followed by flare-ups.
* Psychological distress, low self esteem, embarrassment
* Secondary bacterial or fungal infections
When to Contact a Medical Professional
Call for an appointment with your health care provider if seborrheic dermatitis symptoms do not respond to self-care or over-the-counter treatments.
Also call if patches of seborrheic dermatitis drain fluid or pus, form crusts, or become very red or painful.
The severity of seborrheic dermatitis can be lessened by controlling the risk factors and by paying careful attention to skin care.
Dandruff; Seborrheic eczema; Cradle cap
Tuesday, October 26, 2010
While many things can cause ingrown nails, the most common causes are improperly fitted shoes and nails that are improperly trimmed. Shoes or stockings that are too tight press on the sides of the nail, causing it to curl and dig into the skin.Nails that are cut too short, rounded off at the tip, or are peeled off at the edges versus being cut straight across are more likely to become ingrown as well. Other causes include an abnormally shaped nail bed, trauma to the nail plate or toe and other nail deformities. Proneness to nail deformities that cause ingrown nails can also be genetic.
Symptoms of an ingrown nail include pain along the margins of the nail, worsening of pain when wearing shoes or other tight articles, and sensitivity to pressure of any kind, even that of light bedding. By the very nature of the condition, ingrown nails become easily infected unless special care is taken to treat the condition early on and keep the area as clean as possible. Signs of infection include redness and swelling of the area around the nail, drainage of pus and/or a watery discharge tinged with blood.
Treatment of ingrown nails ranges from soaking the afflicted area to surgery. In mild cases, doctors recommend daily soaking of the foot or hand in a mixture of warm water and Epsom salts and applying over-the-counter antibiotics while allowing the nail to grow out so it may be trimmed properly. Another remedy is to file the top of the nail flat. This will cause the nail to contract and pull the ingrown sides up.
Wednesday, October 20, 2010
Tears are necessary for the normal lubrication of the eye and to wash away particles and foreign bodies.
Causes of watery eyes include:
* Allergy to mold, dander, dustAllergy to mold, dander, dust
* Blockage of the tear duct
* Environmental irritants (smog or chemicals in the air, wind, strong light, blowing dust)
* Eyelid turning inward or outward
* Foreign bodies and abrasions
* Inward-growing eyelashes
Increased tearing sometimes accompanies:
Oddly enough, one of the most common causes of excess tearing is dry eyes. Drying causes the eyes to become uncomfortable, which stimulates the body to produce too many tears. One of the main tests for tearing is to check whether the eyes are too dry.
Consider the cause of the tearing. If the eyes feel dry and burn and then begin to tear, consider using artificial tears before tearing occurs. This prevents the reflex tearing.
If the eyes are itchy and uncomfortable, consider allergy as a cause. Over-the-counter antihistamines can be useful. A mucous discharge from the eyes or red eyes may indicate a blocked tear duct or eyelid problem.
When to Contact a Medical Professional
Tearing is not an emergency, but it can be very annoying and usually can be treated.
Contact your health care provider if you have:
* Prolonged unexplained tearing
* Red eyes, excess discharge
* Tearing associated with pain in the eye
* Tearing associated with tenderness around the nose or sinuses
What to Expect at Your Office Visit
The doctor will take a medical history and examine your eyes.
Medical history questions documenting increased tearing may include:
* Time pattern
o When did it begin?
o Is this the first occurrence?
o Does it occur all the time or off and on?
o Is there a pattern to the occurrences?
o Is your vision affected?
o Do you wear or need corrective lenses?
o Is the increased tearing related to emotional responses?
o Is the tearing accompanied by pain? Stinging? Itching?
o Is the fluid clear?
o Are your eyes red or swollen?
o Is drainage or crusting present when you wake up?
o Does increased tearing affect both eyes?
o If so, are they affected equally?
* Aggravating factors
o What seems to cause or increase the tearing?
o What medications are you taking?
o Do you have allergiesallergies?
o Are you often exposed to wind, dust, chemicals, sun, or light?
o Have you had any recent injuries to the eyes?
* Relieving factors
o What seems to help reduce the tearing?
o Have you tried eye solutions?
o What other symptoms do you have?
o Is there any loss of visionloss of vision?
o Have there been changes in visionchanges in vision?
o Do you have a headacheheadache?
o Do you have nasal congestionnasal congestion or a runny noserunny nose?
o Do you have joint achesjoint aches or muscle achesmuscle aches?
o Has anyone else had similar symptoms recently?
The physical examination may include a detailed eye examination.
Diagnostic tests that may be performed are:
* Culture and sensitivity testing of tear specimen
* Schirmer's testSchirmer's test
Once the symptoms are explained, the cause is usually clear. Treatment can include:
* Artificial tears
* Topical antihistamines
If you might have a blockage of the tear system, your doctor may use a probe to test the tear drainage system. This is painless. If you have a blockage, you may have surgery to correct the problem. Minor surgery can fix improper eyelid position.
Monday, October 18, 2010
Dandruff (pityriasis capitis) is the term used to describe simple scaling of the skin on the scalp. About 50 per cent of the population suffers from dandruff. Applying simple oils (for example, bath oil) to the scalp can be useful in the treatment of dandruff.
Why dandruff occurs
The top layer of the skin is constantly being shed and renewed. Although this usually goes unnoticed when it occurs on most areas of the body, it may become more visible on the scalp as the hair traps the scaling skin.
Itching scalp, with or without scaling, is a very common problem. It commonly occurs in middle aged people, for no obvious reason. The usual response is to scratch, and this will often cause scratch marks and little crusty sores throughout the scalp. Dandruff can cause itching scalp. There are also a number of less common skin conditions that can present as itching in the scalp.
Seborrhoeic dermatitis can cause itching scalp
Seborrhoeic dermatitis is the name given to a red, itchy, scaly reaction in the scalp. It is similar to dandruff, except the scale is more marked and the scalp is often inflamed. It can be very itchy and can affect other parts of the body, including the face, eyebrows, beard and central chest area.
Seborrhoeic dermatitis symptoms
Symptoms of seborrhoeic dermatitis develop gradually and may include:
* Dry or greasy diffuse scaling of the scalp. This is the most usual presentation.
* Yellow-red scaling on those areas of the body that are generally affected in extreme disease - along the hairline, behind the hairs, on the eyebrows, on the bridge of the nose, over the sternum (middle of the chest), in the creases between the nose and the lips, and inside the ears.
Why it occurs
Seborrhoeic dermatitis affects areas with high densities of large oil glands. The inflammation is caused by the body’s reaction to a yeast on the scalp and to products that break down oil produced by the oil gland.
Cradle cap is a form of seborrhoeic dermatitis that occurs in newborns. It results in a thick, yellow-crusted scalp lesion. Other symptoms can include:
* Splits in the skin and behind the ears
* Red facial pustules
* Stubborn nappy rash.
Older children can develop thick, stubborn plaques on the scalp, measuring one to two centimetres across.
Factors that can make seborrhoeic dermatitis worse
The incidence and severity of seborrhoeic dermatitis seems to be affected by:
* Other illnesses - for example, patients with neurologic disease (especially Parkinson’s disease) or HIV may have severe seborrhoeic dermatitis.
* Emotional or physical stress.
* Genetic factors.
* The season - seborrhoeic dermatitis is usually worse in winter.
Psoriasis can cause itching scalp
Psoriasis is a relatively common skin condition that affects about three per cent of the population. It is often confined to the scalp, elbows and knees. While seborrhoeic dermatitis tends to involve almost all the scalp, psoriasis often occurs in small, localised patches of redness with quite prominent thick scaling. Because psoriasis may only occur on the scalp, it can be mistaken for a severe case of dandruff. Psoriasis has a genetic link - there is often a family history of the condition. It may be triggered by some form of stress.
Medicated shampoos can help dandruff and itching scalp
Regular washing of the scalp with medicated soaps may be all that is required to relieve itching scalp. The most common anti-dandruff shampoos contain one or more of the following ingredients:
* Tar - shampoos containing tar have been used for years, usually for more severe scalp conditions. In the past, the scent of the tar-based shampoos made them less acceptable. However, newer preparations are well tolerated and simple to use.
* Selenium sulphide.
* Zinc pyrithione or zinc omadine.
* Piroctone olamine - this is the most recent addition to the medicated shampoos. It is known as a 'second generation' anti-dandruff agent. It is less toxic than zinc pyrithione and is therefore safer for family use.
* Antifungal agents.
How often to use medicated shampoos
How often you need to use medicated shampoos will depend on how severe your dandruff is and what treatment you are using. Always read the directions on the shampoo pack before using it. Some products are mild enough to be used every day, while others should only be used once a week. Over time, you will work out how often to use the shampoo to keep your dandruff under control.
Where to get help
* Your doctor
* Your local chemist
* Australasian College of Dermatologists website
Things to remember
* Dandruff affects about 50 per cent of the population.
* Itching scalp can be caused by a number of conditions, including dandruff, seborrhoeic dermatitis and psoriasis.
* Medicated shampoos can be used to treat dandruff and relieve itchy scalp.
Monday, October 11, 2010
But what about promises of instant youth in a jar? Experts say that over-the-counter creams and lotions can help ease dry skin — which is more common as you age — but they can't turn back time.
Prescription creams, chemical peels, laser treatments, Botox, and other cosmetic procedures are being used to treat sun spots, wrinkles, and other signs of aging. But results vary and some treatments remain unproven. These treatments also don't prevent further damage. So for now, to ward off future signs of aging and lower your risk of skin cancer:
* Avoid the sun when its rays are strongest — between 10 a.m. and 3 p.m.
* Use sunscreen that has a high SPF number (15 or higher). It should also protect your skin from both UVA and UVB rays. Experts recommend using sunscreen daily, year-round — especially on your face.
* If you're out in the sun for a long time, protect your ears and scalp with a hat. For extra body protection, wear lightweight long-sleeved shirts and pants.
Checking your skin regularly is a good idea. Tell your doctor right away about skin changes, such as new growths, sores that don’t heal, or changes in the size, shape, color, or feel of an existing mole. Skin changes are not always cancer. But you should have a doctor check out a skin change to be sure. Many types of skin cancer can be cured if found and treated early.
Thursday, October 7, 2010
The calorie burner calculator is used to estimate the amount of calories burned during given activity and duration.
Blood alcohol level calculator determines the percentage of alcohol sustained in your bloodstream.
Among the different health calculators Hip, waist, chest ratio calculator is the popular most calculators. Hip, waist, chest ratio calculator are designed specifically to measure the waist, hip and chest ratio of the people.
Body fat calculator is designed to know the percentage of fat in the body. The calculator can be used to know the body fat.for more information visit http://www.liveinfitnesscamp.com/
Monday, October 4, 2010
Some disorders will produce specific, characteristic odors to the breath.
Bad breath related to poor oral hygiene is most common and caused by release of sulphur compounds by bacteria in the mouth.
A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a sign of ketoacidosisketoacidosis, which may occur in diabetes. It is a potentially life-threatening condition.
Breath that smells like feces can occur with prolonged vomitingvomiting, especially when there is a bowel obstructionbowel obstruction. It may also occur temporarily if a person has a tube placed through the nose or mouth to the stomach to drain the stomach contents (nasogastric tube) in place.
The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failurechronic kidney failure.
If previously normal breath turns into halitosis, causes could include:
* Abscessed toothAbscessed tooth
o Triamterene and inhaled anesthetics
o Insulin - injection
* Food or beverages consumed (such as cabbage, garlic, raw onions, or coffee)
* Foreign body in the nose (usually in children)
o Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
* Gum disease (gingivitisgingivitis, gingivostomatitisgingivostomatitis)
* Impacted toothImpacted tooth
* Lung infection
* Poor dental hygienedental hygiene
* Throat infection
* Tobacco smoking
* Vitamin supplements (especially in large doses)
Diseases that may be associated with breath odor (not presented in order of likelihood -- some are extremely unlikely):
* Acute necrotizing ulcerative gingivitisAcute necrotizing ulcerative gingivitis
* Acute necrotizing ulcerative mucositis
* Acute renal failureAcute renal failure
* Bowel obstruction (can cause breath to smell like feces)
* Chronic renal failure (can cause breath to smell like ammoniaammonia)
* DiabetesDiabetes (fruity or sweet chemical smell with ketoacidosis)
* Esophageal cancerEsophageal cancer
* Gastric carcinomaGastric carcinoma
* Gastrojejunocolic fistulafistula (fruity-smelling breath)
* Hepatic encephalopathyHepatic encephalopathy
* Diabetic ketoacidosisDiabetic ketoacidosis
* Lung abscessLung abscess
* OzenaOzena, or atrophic rhinitis
* Periodontal diseasePeriodontal disease
* Zenker's diverticulumdiverticulum
Use proper dental hygiene (especially flossing), and remember that mouthwashes are not effective in treating the underlying problem.
Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking. Otherwise, follow prescribed therapy to treat the underlying cause.
When to Contact a Medical Professional
When to Contact a Medical Professional
* Breath odor persists and there is not an obvious cause (such as smoking or eating odor-causing foods).
* You have breath odor and signs of a respiratory infection, such as fever, cough, or face pain with discharge from the nose
What to Expect at Your Office Visit
Your doctor will take a medical history and perform a physical examination.
You may be asked the following medical history questions:
* Is there a specific odor?
* Is there a fishy smell?
* Does the breath smell like ammonia or urine?
* Does the breath smell like fruit or is there a sweet-chemical smell?
* Does the breath smell like feces?
* Does the breath smell like alcohol?
* Have you recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
* Do you take vitamin supplements?
* Do you smoke?
* Does good oral hygiene improve the odor?
* What home care measures have you tried? How effective are they?
* Is there a recent sore throat, sinus infection, tooth abscess, or other illness?
* What other symptoms do you have?
The physical examination will include a thorough examination of the mouth and the nose. A throat culturethroat culture may be taken if you have a sore throat or mouth sores.
In rare cases, diagnostic tests that may be performed include:
* Blood tests to screen for diabetes or kidney failure
* Endoscopy (EGDEGD)
* X-ray of the abdomenX-ray of the abdomen
* X-ray of the chestX-ray of the chest
Antibiotics may be prescribed for some conditions. For an object in the nose, the doctor will use an instrument to remove it.
Thursday, September 30, 2010
Symptoms can include
* Sneezing, often with a runny or clogged nose
* Coughing and postnasal drip
* Itching eyes, nose and throat
* Dark circles under the eyes
Taking medicines, using nasal sprays and rinsing out your nose can relieve symptoms. Allergy shots can help make you less sensitive to pollen and provide long-term relief.
Sunday, September 26, 2010
Normally, your body's immune systemimmune system defends against potentially harmful substances, such as bacteria, viruses, and toxins. In some people, an immune response is triggered by a substance that is generally harmless, such as a specific food.
The cause of food allergies is related to your body making a type of allergy-producing substance called immunoglobulin E (IgE) antibodiesantibodies to a particular food.
Although many people have a food intolerance, food allergies are less common. In a true food allergy, the immune system produces antibodies and histamine in response to the specific food.
Any food can cause an allergic reaction, but a few foods are the main culprits. In children, the most common food allergies are to:
* Shellfish (shrimp, crab, lobster, snails, clams)
* Tree nuts
A food allergy frequently starts in childhood, but it can begin at any age. Fortunately, many children will outgrow their allergy to milk, egg, wheat, and soy by the time they are 5 years old if they avoid the offending foods when they are young. Allergies to peanuts, tree nuts, and shellfish tend to be lifelong.
In older children and adults, the most common food allergies are:
* Tree nuts
Food additives -- such as dyes, thickeners, and preservatives – may rarely cause an allergic or intolerance reaction.
An oral allergy syndrome may occur after eating certain fresh fruits and vegetables. The allergens in these foods are similar to certain pollens. Examples are melon/ragweed pollen and apple/tree pollen.
Many Americans believe they have food allergies, while in reality fewer than 1% have true allergies. Most people's symptoms are caused by intolerances to foods such as:
* Corn products
* Cow's milk and dairy products (See: Lactose intoleranceLactose intolerance)
* Wheat and other gluten-containing grains (See: Celiac diseaseCeliac disease)
Symptoms usually begin immediately, within 2 hours after eating. Rarely, the symptoms may begin hours after eating the offending food.
If you develop symptoms shortly after eating a specific food, you may have a food allergy. Key symptoms include hiveshives, hoarse voice, and wheezingwheezing.
Other symptoms that may occur include:
* Abdominal painAbdominal pain
* Difficulty swallowingDifficulty swallowing
* ItchingItching of the mouth, throat, eyes, skin, or any area
* Lightheadedness or faintingfainting
* Nasal congestionNasal congestion
* Runny noseRunny nose
* Swelling (angioedemaangioedema), especially of the eyelids, face, lips, and tongue
* Shortness of breathShortness of breath
* Stomach crampsStomach cramps
Symptoms of oral allergy syndrome:
* Itchy lips, tongue, and throat
* Swollen lips (sometimes)
Exams and Tests
In severe reactions, you may have low blood pressurelow blood pressure and blocked airways.
A blood or skin test can be done to identify elevated antibody levels (particularly IgE) and confirm that you have an allergy.
With elimination diets, you avoid the suspected food until your symptoms disappear. Then the foods are reintroduced to see if you develop an allergic reaction.
In provocation (challenge) testing, you are exposed to a suspected allergen under controlled circumstances. This may be done in the diet or by breathing in the suspected allergen. This type of test may provoke severe allergic reactions. Challenge testing should only be done by a doctor.
Never try to deliberately cause a reaction or reintroduce a food on your own. These tests should only be performed under the guidance of a health care provider -- especially if your first reaction was severe.
The only proven treatment for a food allergy is to avoid the food. If you suspect you or your child has a food allergy, consult an allergy specialist.
If you have symptoms on only one area of the body (for example, a hive on the chin after eating the specific food), you may not need any treatment. The symptoms will likely go away in a brief time. Antihistamines may relieve the discomfort. Soothing skin creams may provide some relief.
Consult your doctor if you think you have had an allergic reaction to food, even if it is only a local reaction.
Anyone diagnosed with a food allergy should carry (and know how to use) injectable epinephrine at all times. If you develop any type of serious or whole-body reaction (even hives) after eating the offending food, inject the epinephrine. Then go to the nearest hospital or emergency facility, preferably by ambulance. Seek immediate medical attention after injecting epinephrine for a food reaction.
When to Contact a Medical Professional
* Call your local emergency number, such as 911, if you have any serious or whole-body reactions (particularly wheezing or difficulty breathing) after eating a food.
* If your doctor prescribed epinephrine for severe reactions, inject it as soon as possible, even before calling 911. The sooner you inject the epinephrine, the better.
* Anyone who has had an allergic reaction to a food should be evaluated by an allergy specialist.
BreastfeedingBreastfeeding may help prevent allergies. Otherwise, there is no known way to prevent food allergies except to delay introducing allergy-causing foods to infants until their gastrointestinal tract has had a chance to mature. The timing for this varies from food to food and from baby to baby.
Once an allergy has developed, carefully avoiding the offending food usually prevents further problems.
Thursday, September 23, 2010
Pain that starts in the face may be caused by a nerve disorder, an injury, or an infection in a structure of the face. Face pain may also begin elsewhere in the body.
Sometimes face pain occurs for no known reason.
* Abscessed toothAbscessed tooth (continuous throbbing pain on one side of the lower face aggravated by eating or touching)
* Cluster headacheCluster headache
* Herpes zosterHerpes zoster (shingles) or herpes simplexherpes simplex (cold sores) infection
* Injury to the face
* Myofascial pain syndrome
* SinusitisSinusitis or sinus infection (dull pain and tenderness around the eyes and cheekbones that worsens when bending forward)
* Tic douloureuxTic douloureux
* Temporomandibular joint dysfunction syndrome
Follow the treatment prescribed for the cause of the pain.
Painkillers may provide temporary relief. If the pain is severe or persistent, call your primary health care provider or dentist.
When to Contact a Medical Professional
When to Contact a Medical Professional
* Face pain is accompanied by chest, shoulder, neck, or arm pain. This could mean a heart attackheart attack. Call your local emergency number (such as 911).
* Pain is throbbing, worse on one side of the face, and aggravated by eating. Call a dentist.
* Pain is persistent, unexplained, or accompanied by other unexplained symptoms. Call your primary health care provider.
What to Expect at Your Office Visit
What to Expect at Your Office Visit
In emergency situations (such as a possible heart attack), you will first be stabilized. Then, the health care provider will take a medical history and perform a physical examination. For tooth problems, expect a referral to a dentist or orthodontist.
You may be asked the following questions:
* What part of your face is in pain?
* Is the pain on both sides?
* If the pain is only on one side, which side is it on?
* Is the pain over a sinus (forehead, cheekbones)?
* Did the pain begin suddenly?
* Is face pain occurring repeatedly (is it recurrent)?
* How long have the episodes of face pain lasted (for how many months)?
* How long does each episode of pain last (how many seconds)?
* Is the pain worse when speaking, chewing, or swallowing?
* Does the pain develop when touching a specific part of the face (trigger point)?
* Did face pain occur before the start of a brain or nervous system problem (weaknessweakness, speech loss)?
* What other symptoms do you have?
Diagnostic tests that may be performed include:
* Dental x-raysDental x-rays (if a tooth problem is suspected)
* ECGECG (if heart problems are suspected)
* TonometryTonometry (if glaucomaglaucoma is suspected)
* X-rays of the sinusesX-rays of the sinuses
Neurological tests will be performed if nerve damage is suspected.
Tuesday, September 21, 2010
Hyperthermia (also called thermal therapy or thermotherapy) is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 113°F). Research has shown that high temperatures can damage and kill cancer cells, usually with minimal injury to normal tissues. By killing cancer cells and damaging proteins and structures within cells, hyperthermia may shrink tumors.
Hyperthermia is under study in clinical trials (research studies with people) and is not widely available.
· How is hyperthermia used to treat cancer?
Hyperthermia is almost always used with other forms of cancer therapy, such as radiation therapy and chemotherapy. Hyperthermia may make some cancer cells more sensitive to radiation or harm other cancer cells that radiation cannot damage. When hyperthermia and radiation therapy are combined, they are often given within an hour of each other. Hyperthermia can also enhance the effects of certain anticancer drugs.
Numerous clinical trials have studied hyperthermia in combination with radiation therapy and/or chemotherapy. These studies have focused on the treatment of many types of cancer, including sarcoma, melanoma, and cancers of the head and neck, brain, lung, esophagus, breast, bladder, rectum, liver, appendix, cervix, and peritoneal lining. Many of these studies, but not all, have shown a significant reduction in tumor size when hyperthermia is combined with other treatments. However, not all of these studies have shown increased survival in patients receiving the combined treatments.
What are the different methods of hyperthermia?
Several methods of hyperthermia are currently under study, including local, regional, and whole-body hyperthermia.
* In local hyperthermia, heat is applied to a small area, such as a tumor, using various techniques that deliver energy to heat the tumor. Different types of energy may be used to apply heat, including microwave, radiofrequency, and ultrasound. Depending on the tumor location, there are several approaches to local hyperthermia:
o External approaches are used to treat tumors that are in or just below the skin. External applicators are positioned around or near the appropriate region, and energy is focused on the tumor to raise its temperature.
o Intraluminal or endocavitary methods may be used to treat tumors within or near body cavities, such as the esophagus or rectum. Probes are placed inside the cavity and inserted into the tumor to deliver energy and heat the area directly.
o Interstitial techniques are used to treat tumors deep within the body, such as brain tumors. This technique allows the tumor to be heated to higher temperatures than external techniques. Under anesthesia, probes or needles are inserted into the tumor. Imaging techniques, such as ultrasound, may be used to make sure the probe is properly positioned within the tumor. The heat source is then inserted into the probe. Radiofrequency ablation (RFA) is a type of interstitial hyperthermia that uses radio waves to heat and kill cancer cells.
* In regional hyperthermia, various approaches may be used to heat large areas of tissue, such as a body cavity, organ, or limb.
o Deep tissue approaches may be used to treat cancers within the body, such as cervical or bladder cancer. External applicators are positioned around the body cavity or organ to be treated, and microwave or radiofrequency energy is focused on the area to raise its temperature.
o Regional perfusion techniques can be used to treat cancers in the arms and legs, such as melanoma, or cancer in some organs, such as the liver or lung. In this procedure, some of the patient’s blood is removed, heated, and then pumped (perfused) back into the limb or organ. Anticancer drugs are commonly given during this treatment.
o Continuous hyperthermic peritoneal perfusion (CHPP) is a technique used to treat cancers within the peritoneal cavity (the space within the abdomen that contains the intestines, stomach, and liver), including primary peritoneal mesothelioma and stomach cancer. During surgery, heated anticancer drugs flow from a warming device through the peritoneal cavity. The peritoneal cavity temperature reaches 106–108°F.
* Whole-body hyperthermia is used to treat metastatic cancer that has spread throughout the body. This can be accomplished by several techniques that raise the body temperature to 107–108°F, including the use of thermal chambers (similar to large incubators) or hot water blankets.
The effectiveness of hyperthermia treatment is related to the temperature achieved during the treatment, as well as the length of treatment and cell and tissue characteristics. To ensure that the desired temperature is reached, but not exceeded, the temperature of the tumor and surrounding tissue is monitored throughout hyperthermia treatment. Using local anesthesia, the doctor inserts small needles or tubes with tiny thermometers into the treatment area to monitor the temperature. Imaging techniques, such as CT (computed tomography), may be used to make sure the probes are properly positioned.
Does hyperthermia have any complications or side effects?
Most normal tissues are not damaged during hyperthermia if the temperature remains under 111°F. However, due to regional differences in tissue characteristics, higher temperatures may occur in various spots. This can result in burns, blisters, discomfort, or pain. Perfusion techniques can cause tissue swelling, blood clots, bleeding, and other damage to the normal tissues in the perfused area; however, most of these side effects are temporary. Whole-body hyperthermia can cause more serious side effects, including cardiac and vascular disorders, but these effects are uncommon. Diarrhea, nausea, and vomiting are commonly observed after whole-body hyperthermia.
What does the future hold for hyperthermia?
A number of challenges must be overcome before hyperthermia can be considered a standard treatment for cancer. Many clinical trials are being conducted to evaluate the effectiveness of hyperthermia. Some trials continue to research hyperthermia in combination with other therapies for the treatment of different cancers. Other studies focus on improving hyperthermia techniques.
Thursday, September 16, 2010
The tonsils are lymph nodes in the back of the mouth and top of the throat. They normally help to filter out bacteria and other microorganisms to prevent infection in the body.
They may become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis. The infection may also be present in the throat and surrounding areas, causing inflammation of the pharynx. The pharynx is in the back of the throat, between the tonsils and the voicebox (larynx). See: PharyngitisPharyngitis
Tonsillitis is extremely common, particularly in children.
* Difficulty swallowingDifficulty swallowing
* Ear pain
* FeverFever, chills
* Sore throat - lasts longer than 48 hours and may be severe
* Tenderness of the jaw and throat
* Voice changes, loss of voiceloss of voice
Exams and Tests
The health care provider will look in the mouth and throat for swollen tonsils. The tonsils are usually reddened and may have white spots on them. The lymph nodes in the jaw and neck may be swollen and tender to the touch.
Tests that may be done include:
* Rapid strep testRapid strep test
* Throat swab cultureThroat swab culture
If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection. The antibiotics may be given once as a shot, or taken for 10 days by mouth.
If antibiotic pills are used, they must be taken for the entire amount of time prescribed by the doctor. DO NOT stop taking them just because the discomfort stops, or the infection may not be cured.
Rest to allow the body to heal. Fluids, especially warm (not hot), bland fluids or very cold fluids may soothe the throat. Gargle with warm salt water or suck on lozenges (containing benzocaine or similar ingredients) to reduce pain.
Over-the-counter medications, such as acetaminophen (Tylenol) or ibuprofen may be used to reduce pain and fever. Do NOT give a child aspirin. Aspirin has been linked to Reye syndromeReye syndrome.
Some people who have repeated infections may need surgery to remove the tonsils (tonsillectomytonsillectomy).
Tonsillitis symptoms usually improve 2 or 3 days after treatment starts. The infection usually is cured after treatment is completed, but some people may need more than one course of antibiotics.
Complications of untreated strep tonsillitis may be severe. Children with tonsillitis related to strep throat or pharyngitis should generally be kept home from school or day care until they have been on antibiotics for 24 hours. This helps reduce the spread of illness.
* Blocked airway from swollen tonsils
* Dehydration from difficulty swallowing fluids
* Kidney failure
* Peritonsillar abscessPeritonsillar abscess or abscess in other parts of the throat
* Pharyngitis - bacterial
* Post-streptococcal glomerulonephritisPost-streptococcal glomerulonephritis
* Rheumatic feverRheumatic fever and related cardiovascular disorders
When to Contact a Medical Professional
Call your health care provider if:
* A sore throat lasts longer than 48 hours
* New symptoms develop
* Symptoms get worse
* You have other symptoms with the sore throat
Sunday, September 12, 2010
Sore throats are common. Most of the time the soreness is worse in the morning and improves as the day progresses.
Like colds, the vast majority of sore throats are caused by viral infections. This means most sore throats will NOT respond to antibiotics. Many people have a mild sore throat at the beginning of every cold. When the nose or sinuses become infected, drainage can run down the back of the throat and irritate it, especially at night. Or, the throat itself can be infected.
Some viruses can cause specific types of sore throat. For example, Coxsackievirus sometimes causes blisters in the throat, especially in the late summer and early fall. Mononucleosis and the flu can also cause specific viral throat infections.
Strep throatStrep throat is the most common bacterial cause of sore throat. Because strep throat can occasionally lead to rheumatic feverrheumatic fever, antibiotics are given. Strep throat often includes a feverfever (greater than 101°F), white, draining patches on the throat, and swollen or tender lymph glandslymph glands in the neck. Children may have a headacheheadache and stomach painstomach pain.
A sore throat is less likely to be strep throat if it is a minor part of a typical cold (with runny noserunny nose, stuffy ears, coughcough, and similar symptoms). Strep can NOT be accurately diagnosed by looking at the throat alone. It requires a laboratory test.
Sometimes breathing through the mouth will cause a sore throat in the absence of any infection. During the months of dry winter air, some people will wake up with a sore throat most mornings. This usually disappears after having something to drink.
In addition, allergies (allergic rhinitisallergic rhinitis) can cause a sore throat.
With a sore throat, sometimes the tonsils or surrounding parts of the throat are inflamed. Either way, removing the tonsils to try to prevent future sore throats is not recommended for most children.
* Breathing through the mouth (can cause drying and irritation of the throat)
* Common coldCommon cold
* Endotracheal intubationEndotracheal intubation (tube insertion)
* Infectious mononucleosisInfectious mononucleosis
* Something stuck in the throat (See: Choking child or adultChoking child or adult and CPRCPR)
* Strep throatStrep throat
* Surgery such as tonsillectomytonsillectomy and adenoidectomyadenoidectomy
* Viral pharyngitispharyngitis
Most sore throats are soon over. In the meantime, the following remedies may help:
* Drink warm liquids. Honey or lemon tea is a time-tested remedy.
* Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
* Cold liquids or popsicles help some sore throats.
* Sucking on hard candies or throat lozenges can be very soothing, because it increases saliva production. This is often as effective as more expensive remedies, but should not be used in young children because of the choking risk.
* Use a cool-mist vaporizer or humidifier to moisten and soothe a dry and painful throat.
* Try over-the-counter pain medications, such as acetaminophen. Do NOT give aspirin to children.
When to Contact a Medical Professional
When to Contact a Medical Professional
Call your health care provider if there is:
* Excessive drooling in a young child
* Fever, especially 101°F or greater
* Pus in the back of the throat
* Red rash that feels rough, and increased redness in the skin folds
* Severe difficulty swallowing or breathing
* Tender or swollen lymph glandsswollen lymph glands in the neck
Clean your hands frequently, especially before eating. This is a powerful way to help prevent many sore throat infections. You might avoid some sore throats by reducing contact with people with sore throats, but often these people are contagious even before they have symptoms, so this approach is less effective.
Not too long ago, tonsils were commonly removed in an attempt to prevent sore throats. This is no longer recommended in most circumstances.
A cool mist vaporizer or humidifier can prevent some sore throats caused by breathing dry air with an open mouth.
Friday, September 10, 2010
Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of TS are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.
What are the symptoms?
Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished.
What is the course of TS?
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood.
Can people with TS control their tics?
Although the symptoms of TS are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed. Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.
What causes TS?
Although the cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equally complex.
What disorders are associated with TS?
Many with TS experience additional neurobehavioral problems including inattention; hyperactivity and impulsivity (attention deficit hyperactivity disorder—ADHD) and related problems with reading, writing, and arithmetic; and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors. For example, worries about dirt and germs may be associated with repetitive hand-washing, and concerns about bad things happening may be associated with ritualistic behaviors such as counting, repeating, or ordering and arranging. People with TS have also reported problems with depression or anxiety disorders, as well as other difficulties with living, that may or may not be directly related to TS. Given the range of potential complications, people with TS are best served by receiving medical care that provides a comprehensive treatment plan.
How is TS diagnosed?
TS is a diagnosis that doctors make after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions can also help doctors arrive at a diagnosis. Common tics are not often misdiagnosed by knowledgeable clinicians. But atypical symptoms or atypical presentation (for example, onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. There are no blood or laboratory tests needed for diagnosis, but neuroimaging studies, such as magnetic resonance imaging (MRI), computerized tomography (CT), and electroencephalogram (EEG) scans, or certain blood tests may be used to rule out other conditions that might be confused with TS.
It is not uncommon for patients to obtain a formal diagnosis of TS only after symptoms have been present for some time. The reasons for this are many. For families and physicians unfamiliar with TS, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about TS from others.
How is TS treated?
Because tic symptoms do not often cause impairment, the majority of people with TS require no medication for tic suppression. However, effective medications are available for those whose symptoms interfere with functioning. Neuroleptics are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide). Unfortunately, there is no one medication that is helpful to all people with TS, nor does any medication completely eliminate symptoms. In addition, all medications have side effects. Most neuroleptic side effects can be managed by initiating treatment slowly and reducing the dose when side effects occur. The most common side effects of neuroleptics include sedation, weight gain, and cognitive dulling. Neurological side effects such as tremor, dystonic reactions (twisting movements or postures), parkinsonian-like symptoms, and other dyskinetic (involuntary) movements are less common and are readily managed with dose reduction. Discontinuing neuroleptics after long-term use must be done slowly to avoid rebound increases in tics and withdrawal dyskinesias. One form of withdrawal dyskinesia called tardive dyskinesia is a movement disorder distinct from TS that may result from the chronic use of neuroleptics. The risk of this side effect can be reduced by using lower doses of neuroleptics for shorter periods of time.
Other medications may also be useful for reducing tic severity, but most have not been as extensively studied or shown to be as consistently useful as neuroleptics. Additional medications with demonstrated efficacy include alpha-adrenergic agonists such as clonidine and guanfacine. These medications are used primarily for hypertension but are also used in the treatment of tics. The most common side effect from these medications that precludes their use is sedation.
Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with TS. Recent research shows that stimulant medications such as methylphenidate and dextroamphetamine can lessen ADHD symptoms in people with TS without causing tics to become more severe. However, the product labeling for stimulants currently contraindicates the use of these drugs in children with tics/TS and those with a family history of tics. Scientists hope that future studies will include a thorough discussion of the risks and benefits of stimulants in those with TS or a family history of TS and will clarify this issue. For obsessive-compulsive symptoms that significantly disrupt daily functioning, the serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) have been proven effective in some patients.
Psychotherapy may also be helpful. Although psychological problems do not cause TS, such problems may result from TS. Psychotherapy can help the person with TS better cope with the disorder and deal with the secondary social and emotional problems that sometimes occur. More recently, specific behavioral treatments that include awareness training and competing response training, such as voluntarily moving in response to a premonitory urge, have shown effectiveness in small controlled trials. Larger and more definitive NIH-funded studies are underway.
Is TS inherited?
Evidence from twin and family studies suggests that TS is an inherited disorder. Although early family studies suggested an autosomal dominant mode of inheritance (an autosomal dominant disorder is one in which only one copy of the defective gene, inherited from one parent, is necessary to produce the disorder), more recent studies suggest that the pattern of inheritance is much more complex. Although there may be a few genes with substantial effects, it is also possible that many genes with smaller effects and environmental factors may play a role in the development of TS. Genetic studies also suggest that some forms of ADHD and OCD are genetically related to TS, but there is less evidence for a genetic relationship between TS and other neurobehavioral problems that commonly co-occur with TS. It is important for families to understand that genetic predisposition may not necessarily result in full-blown TS; instead, it may express itself as a milder tic disorder or as obsessive-compulsive behaviors. It is also possible that the gene-carrying offspring will not develop any TS symptoms.
The sex of the person also plays an important role in TS gene expression. At-risk males are more likely to have tics and at-risk females are more likely to have obsessive-compulsive symptoms.
People with TS may have genetic risks for other neurobehavioral disorders such as depression or substance abuse. Genetic counseling of individuals with TS should include a full review of all potentially hereditary conditions in the family.
What is the prognosis?
Although there is no cure for TS, the condition in many individuals improves in the late teens and early 20s. As a result, some may actually become symptom-free or no longer need medication for tic suppression. Although the disorder is generally lifelong and chronic, it is not a degenerative condition. Individuals with TS have a normal life expectancy. TS does not impair intelligence. Although tic symptoms tend to decrease with age, it is possible that neurobehavioral disorders such as depression, panic attacks, mood swings, and antisocial behaviors can persist and cause impairment in adult life.
What is the best educational setting for children with TS?
Although students with TS often function well in the regular classroom, ADHD, learning disabilities, obsessive-compulsive symptoms, and frequent tics can greatly interfere with academic performance or social adjustment. After a comprehensive assessment, students should be placed in an educational setting that meets their individual needs. Students may require tutoring, smaller or special classes, and in some cases special schools.
All students with TS need a tolerant and compassionate setting that both encourages them to work to their full potential and is flexible enough to accommodate their special needs. This setting may include a private study area, exams outside the regular classroom, or even oral exams when the child's symptoms interfere with his or her ability to write. Untimed testing reduces stress for students with TS.
What research is being done?
Within the Federal government, the leading supporter of research on TS and other neurological disorders is the National Institute of Neurological Disorders and Stroke (NINDS). The NINDS, a part of the National Institutes of Health (NIH), is responsible for supporting and conducting research on the brain and central nervous system.
NINDS sponsors research on TS both in its laboratories at the NIH and through grants to major medical institutions across the country. The National Institute of Mental Health, the National Center for Research Resources, the National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders also support research of relevance to TS. And another component of the Department of Health and Human Services, the Centers for Disease Control and Prevention, funds professional education programs as well as TS research.
Knowledge about TS comes from studies across a number of medical and scientific disciplines, including genetics, neuroimaging, neuropathology, clinical trials (medication and non-medication), epidemiology, neurophysiology, neuroimmunology, and descriptive/diagnostic clinical science.
Genetic studies. Currently, NIH-funded investigators are conducting a variety of large-scale genetic studies. Rapid advances in the technology of gene finding will allow for genome-wide screening approaches in TS, and finding a gene or genes for TS would be a major step toward understanding genetic risk factors. In addition, understanding the genetics of TS genes will strengthen clinical diagnosis, improve genetic counseling, lead to the clarification of pathophysiology, and provide clues for more effective therapies.
Neuroimaging studies. Within the past 5 years, advances in imaging technology and an increase in trained investigators have led to an increasing use of novel and powerful techniques to identify brain regions, circuitry, and neurochemical factors important in TS and related conditions.
Neuropathology. Within the past 5 years, there has been an increase in the number and quality of donated postmortem brains from TS patients available for research purposes. This increase, coupled with advances in neuropathological techniques, has led to initial findings with implications for neuroimaging studies and animal models of TS.
Clinical trials. A number of clinical trials in TS have recently been completed or are currently underway. These include studies of stimulant treatment of ADHD in TS and behavioral treatments for reducing tic severity in children and adults. Smaller trials of novel approaches to treatment such as dopamine agonist and GABAergic medications also show promise.
Epidemiology and clinical science. Careful epidemiological studies now estimate the prevalence of TS to be substantially higher than previously thought with a wider range of clinical severity. Furthermore, clinical studies are providing new findings regarding TS and co-existing conditions. These include subtyping studies of TS and OCD, an examination of the link between ADHD and learning problems in children with TS, a new appreciation of sensory tics, and the role of co-existing disorders in rage attacks. One of the most important and controversial areas of TS science involves the relationship between TS and autoimmune brain injury associated with group A beta-hemolytic streptococcal infections or other infectious processes. There are a number of epidemiological and clinical investigations currently underway in this intriguing area.