Also known as: Hypochronic microcytic anemia
What is it?
Iron-deficiency anemia is a condition that occurs when there is not enough iron in the blood. Iron is a mineral the body needs to make hemoglobin, the part of the red blood cell that helps carry oxygen from the lungs to the rest of the body.
Who gets it?
Iron-deficiency anemia is the most common type of anemia in the world, affecting mostly women, young children, and older people. It is estimated that 15 percent of menstruating women are affected, and it is particularly common in women of Asian decent.
What causes it?
Any condition in which a person loses blood over a long period of time can cause iron-deficiency anemia. The most common cause in the United States is pregnancy and gastrointestinal bleeding. During pregnancy, a woman needs extra iron for her growing baby.
Bleeding and blood losses through gastrointestinal tract can be caused by colorectal cancer, hookworms, hemorrhoids, anal fissures, irritable bowel syndrome, aspirin-induced bleeding, blood clotting disorders, and diverticulosis (a condition caused by an abnormal opening from the intestine or bladder). Von Willebrand's disease, a genetic condition, can cause bleeding disorders which can cause gastrointestinal bleeding.
Other causes include menstruation, blood loss through the urine, donating blood more than five times per year, not eating healthy foods, chronic inflammation of the intestines, problems with iron absorption and surgery to remove part of the stomach.
What are the symptoms?
Many people who have iron-deficiency anemia don’t realize it. The most common symptoms are feeling tired and weak, paleness of skin, whites of eyes appear blue-like, shortness of breath, dizziness, abdominal pain and lack of appetite. These symptoms result because of the red blood cells are not functioning properly and cannot carry iron to exercising muscles. Other symptoms may include headache, feeling irritable, nails that break easily, burning and soreness on the tongue and in the mouth. Wanting to eat ice, paint, starch, or dirt (a condition called Pica) may be other signs of iron-deficiency anemia.
How is it diagnosed?
To diagnose iron-deficiency anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. A blood test in combination with a test for oral iron absorption may confirm the diagnosis. The doctor may also want to check the patient’s stools or get x-rays of the bowel to determine if blood loss is a cause of the anemia.
What is the treatment?
The doctor may recommend the patient take oral iron supplements to treat iron-deficiency anemia. If poor iron absorption is a problem, the doctor may recommend therapy with injections of iron. The doctor may recommend a surgery, called an upper and/or lower GI endoscopy, to detect any malignancy. The doctor may also recommend the patient change his or her eating habits to be sure of a well-balanced diet.
Self-care tips
Iron-deficiency anemia is easily cured. Patients should follow their doctor’s recommendations and take their iron supplements and follow a well-balanced, varied diet.
Sunday, March 8, 2009
Anemia
What is it?
Anemia is condition caused by low levels of healthy red blood cells or hemoglobin (the part of the red blood cells that delivers oxygen from the lungs to the rest of the body). There are over 400 different types of anemia ranging from mild to severe. Many of them are rare.
Who gets it?
Anyone with certain underlying conditions can develop anemia. Those at risk include anyone with chronic blood loss due to cancer, gastrointestinal tumors, hemorrhoids, heavy menstrual flow, stomach ulcers, alcohol abuse, or other medical conditions.
What causes it?
Anemia is caused by chronic bleeding, a decrease in red blood cell production, or an increase in red blood cell destruction. A poor diet low in iron can cause anemia, as can some hereditary disorders and certain diseases. However, excessive bleeding due to cancer, childbirth, injury, gastrointestinal tumors, heavy menstrual flow, hemorrhoids, nosebleeds, stomach ulcers, alcohol abuse and surgery is the most common cause of anemia.
What are the symptoms?
Symptoms of anemia include weakness; fatigue; pale sallow skin; dizziness; lack of color in the palms of hands, gums and nail beds; chest pain; cravings for ice, paint or dirt; headache; inability to concentrate; inflammation of the mouth; insomnia; irregular heartbeat; lack of appetite; nails that are dry and brittle; swelling of the hands and feet; thirst; ringing in the ears and unexplained bleeding or bruising.
How is it diagnosed?
To diagnose anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. Anemia may be diagnosed through laboratory tests that measure the percentage of red blood cells or the amount of hemoglobin in the blood. The doctor may also use the tests to determine the type of anemia responsible for the patient’s symptoms. In addition, the doctor may order x-rays and examinations of bone marrow to identify the source of the bleeding.
What is the treatment?
Treatment of anemia is usually directed at the underlying cause. The doctor may recommend anemia due to nutritional deficiencies be treated with iron supplements, injections of vitamin B12, or other vitamin supplements. If blood loss is severe, the doctor may recommend the patient undergo transfusions of red blood cells to accelerate their production. Medication or surgery may be necessary to control menstrual flow, repair a bleeding ulcer, or remove polyps (growths or nodules) from the bowels. Cancer-related anemias may be treated with blood transfusions and/or medication.
Self-care tips
While inherited anemias cannot be prevented, avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily multivitamin can help prevent many types of anemia.
Anemia is condition caused by low levels of healthy red blood cells or hemoglobin (the part of the red blood cells that delivers oxygen from the lungs to the rest of the body). There are over 400 different types of anemia ranging from mild to severe. Many of them are rare.
Who gets it?
Anyone with certain underlying conditions can develop anemia. Those at risk include anyone with chronic blood loss due to cancer, gastrointestinal tumors, hemorrhoids, heavy menstrual flow, stomach ulcers, alcohol abuse, or other medical conditions.
What causes it?
Anemia is caused by chronic bleeding, a decrease in red blood cell production, or an increase in red blood cell destruction. A poor diet low in iron can cause anemia, as can some hereditary disorders and certain diseases. However, excessive bleeding due to cancer, childbirth, injury, gastrointestinal tumors, heavy menstrual flow, hemorrhoids, nosebleeds, stomach ulcers, alcohol abuse and surgery is the most common cause of anemia.
What are the symptoms?
Symptoms of anemia include weakness; fatigue; pale sallow skin; dizziness; lack of color in the palms of hands, gums and nail beds; chest pain; cravings for ice, paint or dirt; headache; inability to concentrate; inflammation of the mouth; insomnia; irregular heartbeat; lack of appetite; nails that are dry and brittle; swelling of the hands and feet; thirst; ringing in the ears and unexplained bleeding or bruising.
How is it diagnosed?
To diagnose anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. Anemia may be diagnosed through laboratory tests that measure the percentage of red blood cells or the amount of hemoglobin in the blood. The doctor may also use the tests to determine the type of anemia responsible for the patient’s symptoms. In addition, the doctor may order x-rays and examinations of bone marrow to identify the source of the bleeding.
What is the treatment?
Treatment of anemia is usually directed at the underlying cause. The doctor may recommend anemia due to nutritional deficiencies be treated with iron supplements, injections of vitamin B12, or other vitamin supplements. If blood loss is severe, the doctor may recommend the patient undergo transfusions of red blood cells to accelerate their production. Medication or surgery may be necessary to control menstrual flow, repair a bleeding ulcer, or remove polyps (growths or nodules) from the bowels. Cancer-related anemias may be treated with blood transfusions and/or medication.
Self-care tips
While inherited anemias cannot be prevented, avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily multivitamin can help prevent many types of anemia.
Andropause
Also known as: Male Menopause
What is it?
Andropause, or male menopause, is a condition associated with declining androgen levels. It may result from primary or secondary hypogonadism or from a pathologic condition.
Who gets it?
Andropause affects about half of men older than age 50.
What causes it?
Andropause is caused by lower levels of testosterone and its consequences as men age. Recent studies show that after age 30, testosterone levels generally decrease by one to two percent per year - although this decline can vary widely.
Sudden, drastic declines in testosterone levels are usually caused by hypogonadism. Classified as either primary or secondary, hypogonadism should be ruled out in patients experiencing symptoms of andropause.
What are the symptoms?
Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss.
How is it diagnosed?
Andropause can be diagnosed by measuring the level of testosterone in the blood. Andropause occurs as a result of testosterone deficiency and a low free and bioavailable testosterone level is found in males with androgen deficiency. Total testosterone levels can be used as a screen for the Andropause but it is the decrease in the free form of testosterone that causes the symptoms.
Usually testosterone deficiency is not the most common cause of impotence; other causes include atherosclerosis, diabetes, hypertension, and use of certain medications. These factors, as well as previous genital trauma and other aspects of the patient’s medical history, are important in diagnosing andropause.
What is the treatment?
To treat andropause, the doctor may advise the patient to undergo hormone replacement therapy. Replacing testosterone can have a significant benefit particularly in older men with an improvement in well-being, improved sex drive, improved sexual function, improved muscle mass and strength and an increase in bone density. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive way.
Men who are carefully selected for hormone replacement therapy must be monitored for signs of prostate disease, dyslipidemia, hepatotoxicity, erythrocytosis, and other side effects.
Consult your physician and ask her/him whether you should have a testosterone level determined to see if you are deficient. If you are deficient and are a candidate for testosterone replacement therapy, your physician will prescribe just the right therapy for you. Questions can be directed to the Endocrine Clinic here at Penn State Hershey Medical Center.
Self-care tips
Patients diagnosed with andropause and being treated with hormone replacement therapy should be monitored to check testosterone, lipid and hematocrit levels. That way, treatment can be adjusted according to the patient’s needs and side affects closely monitored
What is it?
Andropause, or male menopause, is a condition associated with declining androgen levels. It may result from primary or secondary hypogonadism or from a pathologic condition.
Who gets it?
Andropause affects about half of men older than age 50.
What causes it?
Andropause is caused by lower levels of testosterone and its consequences as men age. Recent studies show that after age 30, testosterone levels generally decrease by one to two percent per year - although this decline can vary widely.
Sudden, drastic declines in testosterone levels are usually caused by hypogonadism. Classified as either primary or secondary, hypogonadism should be ruled out in patients experiencing symptoms of andropause.
What are the symptoms?
Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss.
How is it diagnosed?
Andropause can be diagnosed by measuring the level of testosterone in the blood. Andropause occurs as a result of testosterone deficiency and a low free and bioavailable testosterone level is found in males with androgen deficiency. Total testosterone levels can be used as a screen for the Andropause but it is the decrease in the free form of testosterone that causes the symptoms.
Usually testosterone deficiency is not the most common cause of impotence; other causes include atherosclerosis, diabetes, hypertension, and use of certain medications. These factors, as well as previous genital trauma and other aspects of the patient’s medical history, are important in diagnosing andropause.
What is the treatment?
To treat andropause, the doctor may advise the patient to undergo hormone replacement therapy. Replacing testosterone can have a significant benefit particularly in older men with an improvement in well-being, improved sex drive, improved sexual function, improved muscle mass and strength and an increase in bone density. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive way.
Men who are carefully selected for hormone replacement therapy must be monitored for signs of prostate disease, dyslipidemia, hepatotoxicity, erythrocytosis, and other side effects.
Consult your physician and ask her/him whether you should have a testosterone level determined to see if you are deficient. If you are deficient and are a candidate for testosterone replacement therapy, your physician will prescribe just the right therapy for you. Questions can be directed to the Endocrine Clinic here at Penn State Hershey Medical Center.
Self-care tips
Patients diagnosed with andropause and being treated with hormone replacement therapy should be monitored to check testosterone, lipid and hematocrit levels. That way, treatment can be adjusted according to the patient’s needs and side affects closely monitored
Androgenetic Alopecia
Also known as: Male Pattern Baldness
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
Anaphylaxis
What is it?
Anaphylaxis is a life-threatening allergic reaction to a substance that is normally harmless to most people.
Who gets it?
Anyone can suffer allergic reactions, but anaphylaxis occurs in people with an extreme sensitivity to a certain substance.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. An allergen is a substance, most often an insect sting, drug, or food, that causes an allergic response. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. Exercise or exposure to cold can trigger anaphylaxis in some people.
What are the symptoms?
Symptoms of anaphylaxis occur quickly and progress rapidly. They can include sudden anxiety and weakness, itching, swelling, hives, cramps, diarrhea, vomiting, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Anaphylaxis is diagnosed based upon its rapidly progressing symptoms. Your doctor may order blood and skin tests to identify specific allergens.
What is the treatment?
People who have anaphylactic reactions should, of course, avoid the allergens that trigger this response. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of anaphylactic reaction. Patients with anaphylactic reactions may need to receive supplementary oxygen and intravenous (IV) fluids. In severe cases, a breathing tube may need to be inserted to open the airways. People who are severely allergic may undergo a desensitization program, in which a series of injections of the allergen are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
The only way to prevent anaphylaxis is to avoid known allergens. Some of the most common include bee stings, fish and shellfish, penicillin, latex, certain vaccines, nuts and seeds, and certain food additives. If you have a history of anaphylaxis, you should wear a medical ID bracelet containing information on your allergies.
Anaphylaxis is a life-threatening allergic reaction to a substance that is normally harmless to most people.
Who gets it?
Anyone can suffer allergic reactions, but anaphylaxis occurs in people with an extreme sensitivity to a certain substance.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. An allergen is a substance, most often an insect sting, drug, or food, that causes an allergic response. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. Exercise or exposure to cold can trigger anaphylaxis in some people.
What are the symptoms?
Symptoms of anaphylaxis occur quickly and progress rapidly. They can include sudden anxiety and weakness, itching, swelling, hives, cramps, diarrhea, vomiting, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Anaphylaxis is diagnosed based upon its rapidly progressing symptoms. Your doctor may order blood and skin tests to identify specific allergens.
What is the treatment?
People who have anaphylactic reactions should, of course, avoid the allergens that trigger this response. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of anaphylactic reaction. Patients with anaphylactic reactions may need to receive supplementary oxygen and intravenous (IV) fluids. In severe cases, a breathing tube may need to be inserted to open the airways. People who are severely allergic may undergo a desensitization program, in which a series of injections of the allergen are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
The only way to prevent anaphylaxis is to avoid known allergens. Some of the most common include bee stings, fish and shellfish, penicillin, latex, certain vaccines, nuts and seeds, and certain food additives. If you have a history of anaphylaxis, you should wear a medical ID bracelet containing information on your allergies.
Anterior Cruciate Ligament (ACL) Injury
What is it?
Anterior cruciate ligament (ACL) injury is the most common knee injuring, resulting from a stretch or tear in the ligament. Ligaments are strong bands of tissue that connect one bone to another. The ACL is one of the major ligaments in the knee, connecting the thigh bone (femur) to the shin bone (tibia). It helps to keep the knee stable and protects the femur from sliding or turning on the tibia.
Who gets it?
While anyone can injure an ACL, it is unusual in childhood. The incidence of ACL injury peaks in adults during their middle years.
What causes it?
ACL injuries most often result from sports where the foot is planted on the ground while the leg is being twisted, such as in football, soccer, basketball and skiing. The ACL may also become injured when the knee is straightened further than it normal (hyperextended). It can also occur when the thigh bone is forcefully pushed across the shin bone, such as with a sudden stop while running or a sudden transfer of weight such as in skiing.
A chronic ACL injury is often the result of an injury in which the patient either did not consult a doctor after initial injury, the diagnosis was missed, or nonoperate care of an ACL injury was unsuccessful.
What are the symptoms?
Often the patient will hear a popping sound when the ACL injury occurs and will not be able to continue the activity. Swelling of the knee within the first several hours of injury will usually follow. In the case of a chronic ACL injury, the patient will sometimes experience increasing instability of the knee during twisting and pivoting movements and muscle weakness.
How is it diagnosed?
A doctor may suspect an ACL injury after noticing the knee is loose and swelling is present upon initial examination. To confirm diagnosis, the doctor may draw blood from the knee for testing and order x-rays to be taken to see if there is an injury to the bones in the knee. An MRI test may be done to show the condition of the ACL.
The doctor may also examine the ligament, lateral ligament and posterior cruciate ligament for injury, and may make a comparison of the injured and uninjured knee to make sure that another injury is not overlooked.
In a chronic ACL injury, the longer the injury has been present the more likely it is to have an abnormal appearance on MRI examination. The doctor should also determine if there is an associated instability from other tears.
What is the Treatment?
Initial treatment for an ACL injury may including icing the knee, keeping the knee elevated whenever possible and administering anti-inflammatory medications.
Long-term treatment for ACL injuries may vary for each patient. Activity level, age, job demands, and general medical condition may be factors in the decision to recommend reconstruction. If the knee "gives way" during daily activities, this is a strong indication for surgery to prevent injuries from falls.
Since a torn ACL will not heal by itself, reconstructions by using ligaments or tendons from another part of the body (graft) are used. During ACL reconstruction, holes are drilled in the femur and tibia, and the torn ACL is removed. The graft is passed through the drill holes to replace the ACL, and is anchored in place using screws or staples. The hope is that stabilized knees will allow patients to return to pre-injury activity level and prevent further damage to the knee.
New surgical equipment has made this operation easier to perform and more precise, so that more surgeons are able to perform it. Patients with a chronic ACL injury and recurrent giving way of the knee are also candidates for ACL reconstruction.
Self-care tips
With successful ACL reconstruction, the patient may expect to return to vigorous sporting activities and degenerative changes will be prevented. Current rehabilitation after ACL reconstruction includes achieving full motion very quickly after reconstructive surgery. Exercises such as the leg press, bicycling and stair-climbing machines are usually recommended during rehabilitation.
Anterior cruciate ligament (ACL) injury is the most common knee injuring, resulting from a stretch or tear in the ligament. Ligaments are strong bands of tissue that connect one bone to another. The ACL is one of the major ligaments in the knee, connecting the thigh bone (femur) to the shin bone (tibia). It helps to keep the knee stable and protects the femur from sliding or turning on the tibia.
Who gets it?
While anyone can injure an ACL, it is unusual in childhood. The incidence of ACL injury peaks in adults during their middle years.
What causes it?
ACL injuries most often result from sports where the foot is planted on the ground while the leg is being twisted, such as in football, soccer, basketball and skiing. The ACL may also become injured when the knee is straightened further than it normal (hyperextended). It can also occur when the thigh bone is forcefully pushed across the shin bone, such as with a sudden stop while running or a sudden transfer of weight such as in skiing.
A chronic ACL injury is often the result of an injury in which the patient either did not consult a doctor after initial injury, the diagnosis was missed, or nonoperate care of an ACL injury was unsuccessful.
What are the symptoms?
Often the patient will hear a popping sound when the ACL injury occurs and will not be able to continue the activity. Swelling of the knee within the first several hours of injury will usually follow. In the case of a chronic ACL injury, the patient will sometimes experience increasing instability of the knee during twisting and pivoting movements and muscle weakness.
How is it diagnosed?
A doctor may suspect an ACL injury after noticing the knee is loose and swelling is present upon initial examination. To confirm diagnosis, the doctor may draw blood from the knee for testing and order x-rays to be taken to see if there is an injury to the bones in the knee. An MRI test may be done to show the condition of the ACL.
The doctor may also examine the ligament, lateral ligament and posterior cruciate ligament for injury, and may make a comparison of the injured and uninjured knee to make sure that another injury is not overlooked.
In a chronic ACL injury, the longer the injury has been present the more likely it is to have an abnormal appearance on MRI examination. The doctor should also determine if there is an associated instability from other tears.
What is the Treatment?
Initial treatment for an ACL injury may including icing the knee, keeping the knee elevated whenever possible and administering anti-inflammatory medications.
Long-term treatment for ACL injuries may vary for each patient. Activity level, age, job demands, and general medical condition may be factors in the decision to recommend reconstruction. If the knee "gives way" during daily activities, this is a strong indication for surgery to prevent injuries from falls.
Since a torn ACL will not heal by itself, reconstructions by using ligaments or tendons from another part of the body (graft) are used. During ACL reconstruction, holes are drilled in the femur and tibia, and the torn ACL is removed. The graft is passed through the drill holes to replace the ACL, and is anchored in place using screws or staples. The hope is that stabilized knees will allow patients to return to pre-injury activity level and prevent further damage to the knee.
New surgical equipment has made this operation easier to perform and more precise, so that more surgeons are able to perform it. Patients with a chronic ACL injury and recurrent giving way of the knee are also candidates for ACL reconstruction.
Self-care tips
With successful ACL reconstruction, the patient may expect to return to vigorous sporting activities and degenerative changes will be prevented. Current rehabilitation after ACL reconstruction includes achieving full motion very quickly after reconstructive surgery. Exercises such as the leg press, bicycling and stair-climbing machines are usually recommended during rehabilitation.
Ankylosing Spondylitis
Also known as: Rheumatoid spondylitis or Marie-Strumpell disease
What is it?
Ankylosing spondylitis (AS) is a disease of the connective tissue that results in the inflammation of the joints in the spine. The word "ankylosing" refers to a condition where the bones of a joint are fused, stiff, or rigid. "Spondylitis" is an inflammation of the spine.
Who gets it?
Ankylosing spondylitis (AS) is found in less than 1% of the population. It is three times more likely to occur in men than in women, with symptoms usually occurring for the first time between the ages of 20 and 40. People with a parent or sibling with AS are more likely to have the disorder. Afro-Americans have an approximately 25% higher incidence of AS than Caucasians.
What causes it?
The exact cause of AS is unknown. However, the fact that the disease tends to run in families makes genetics a likely factor. Researchers have identified a gene called HLA-B27 in more than 90% of patients with AS. However, the presence of this gene doesn't guarantee AS. Only around 10 to 15% of people who inherit the gene actually develop this disease.
What are the symptoms?
Like most forms of arthritis, AS flares up, so patients may have periods with no symptoms alternating with periods of mild to moderate symptoms. The most common symptom is back pain. Pain is often worse at night, and stiffness is worse upon waking in the morning. The pain and stiffness in the back can progress to the chest and neck. Patients may find that the pain is relieved by bending forward, which is why people with AS often have a stooped appearance. Eventually, the bones in the back may fuse. In some, the back ends up curved and inflexible. This condition is called "bamboo spine." In others, the back is straight and stiff. AS can also cause eye inflammation, damage to the heart valve, difficulty taking deep breaths, psoriasis, ileitis (inflammation of the small intestine), colitis (inflammation of the large intestine), fever, fatigue, and weight loss.
How is it diagnosed?
If your pattern of symptoms fits the description of AS, your doctor will order x-rays of the spine and pelvis. He or she will look for wear at the joint between the spine and the hip bone, and for abnormalities in the vertebrae. A simple blood test may also reveal the HLA-B27 gene. If AS is diagnosed, you will be referred to a rheumatologist, which is a doctor who specializes in treating arthritis.
What is the treatment?
Treatment of AS is focused on relieving pain and restoring mobility. Drugs called nonsteroidal anti-inflammatories (NSAIDs) are prescribed to relieve pain and stiffness. Your doctor may recommend corticosteroid drugs to treat severe joint and eye inflammation. Corticosteroids are only prescribed for short-term use because of potential side effects. A physical therapist can teach you exercises that will help with breathing and posture, as well as to increase and maintain flexibility. A back brace may also be needed to keep the back straight. Surgery, performed by an orthopedic surgeon, is only considered in severe cases where the hip or knee joint is completely worn away or permanently bent. Alternative treatments, such as herbal remedies and acupuncture, have brought relief to some patients. Consult your doctor before trying any alternative treatments.
Self-care tips
While there is no known way to prevent AS, most patients lead full, productive lives with treatment to control and relieve symptoms
What is it?
Ankylosing spondylitis (AS) is a disease of the connective tissue that results in the inflammation of the joints in the spine. The word "ankylosing" refers to a condition where the bones of a joint are fused, stiff, or rigid. "Spondylitis" is an inflammation of the spine.
Who gets it?
Ankylosing spondylitis (AS) is found in less than 1% of the population. It is three times more likely to occur in men than in women, with symptoms usually occurring for the first time between the ages of 20 and 40. People with a parent or sibling with AS are more likely to have the disorder. Afro-Americans have an approximately 25% higher incidence of AS than Caucasians.
What causes it?
The exact cause of AS is unknown. However, the fact that the disease tends to run in families makes genetics a likely factor. Researchers have identified a gene called HLA-B27 in more than 90% of patients with AS. However, the presence of this gene doesn't guarantee AS. Only around 10 to 15% of people who inherit the gene actually develop this disease.
What are the symptoms?
Like most forms of arthritis, AS flares up, so patients may have periods with no symptoms alternating with periods of mild to moderate symptoms. The most common symptom is back pain. Pain is often worse at night, and stiffness is worse upon waking in the morning. The pain and stiffness in the back can progress to the chest and neck. Patients may find that the pain is relieved by bending forward, which is why people with AS often have a stooped appearance. Eventually, the bones in the back may fuse. In some, the back ends up curved and inflexible. This condition is called "bamboo spine." In others, the back is straight and stiff. AS can also cause eye inflammation, damage to the heart valve, difficulty taking deep breaths, psoriasis, ileitis (inflammation of the small intestine), colitis (inflammation of the large intestine), fever, fatigue, and weight loss.
How is it diagnosed?
If your pattern of symptoms fits the description of AS, your doctor will order x-rays of the spine and pelvis. He or she will look for wear at the joint between the spine and the hip bone, and for abnormalities in the vertebrae. A simple blood test may also reveal the HLA-B27 gene. If AS is diagnosed, you will be referred to a rheumatologist, which is a doctor who specializes in treating arthritis.
What is the treatment?
Treatment of AS is focused on relieving pain and restoring mobility. Drugs called nonsteroidal anti-inflammatories (NSAIDs) are prescribed to relieve pain and stiffness. Your doctor may recommend corticosteroid drugs to treat severe joint and eye inflammation. Corticosteroids are only prescribed for short-term use because of potential side effects. A physical therapist can teach you exercises that will help with breathing and posture, as well as to increase and maintain flexibility. A back brace may also be needed to keep the back straight. Surgery, performed by an orthopedic surgeon, is only considered in severe cases where the hip or knee joint is completely worn away or permanently bent. Alternative treatments, such as herbal remedies and acupuncture, have brought relief to some patients. Consult your doctor before trying any alternative treatments.
Self-care tips
While there is no known way to prevent AS, most patients lead full, productive lives with treatment to control and relieve symptoms
Androgenetic Alopecia
Also known as: Male Pattern Baldness
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
Amyotrophic Lateral Sclerosis
Also known as: Lou Gehrig's disease
What is it?
Amyotrophic lateral sclerosis (ALS) is a progressive disease in which the nerve cells that control voluntary muscle movement gradually deteriorate, leading to muscle weakness and eventual paralysis. “Amyotrophic” means the loss of muscle bulk, “lateral” refers to the nerve tracks running down both sides of the spinal cord that are affected, and “sclerosis” refers to the thickening or hardening of the muscle tissue. Also called Lou Gehrig's disease, after the celebrated American baseball player who died of ALS. ALS is also referred to as a motor neuron disease.
Who gets it?
ALS is a rare disease, affecting approximately 30,000 Americans. It is usually diagnosed in people between the ages of 35 and 70. It is slightly more common in men than women.
What causes it?
The cause of ALS is not known. While it can run in families, called familial ALS, it is most often found in people with no family history of the disease, called sporadic ALS. There is a possibility that there is a connection between sporadic ALS and an overproduction of toxic molecular fragments called free radicals in the body, an autoimmune response, viral factors, environmental toxins, or premature aging. However, research has not been conclusive. Western Pacific ALS is a form of the disease that is seen in Guam and other Pacific islands. This form of ALS includes some symptoms of Parkinson's disease.
What are the symptoms?
The symptoms of ALS occur when the motor neurons in the brain and spinal cord begin to degenerate. The motor neurons are nerve cells responsible for sending messages from the brain to the muscles to stimulate movement. As the motor neurons degenerate and die, the muscles become weak and incapable of normal movement, which leads to a loss of muscle bulk, called wasting. The weakness usually begins in the hands, making everyday activities such as fastening buttons and tying a shoe difficult. This weakness then progresses up the arm. Weakness can also begin in the feet and progress up the leg. Weakness in the feet and ankles may first be noticed as frequent stumbling or clumsiness. It leads to a condition called foot drop, in which the feet drag when the patient walks. Over time, the patient experiences muscle cramps, spasms, and tremors. When muscles in the throat are affected, speech becomes slurred or slowed, and the patient may have difficulty swallowing. As the muscles of the diaphragm weaken, a respirator is needed to help with breathing. ALS does not affect mental function, the senses, bowel and bladder function, or the eye muscles. Because ALS progresses until it affects almost all the voluntary muscle groups in the body, patients are eventually able to move only their eyes. ALS is a fatal disease. Because the weakened respiratory and swallowing muscles make it difficult to cough and swallow food, the most likely cause of death is lung infection caused by the inhalation of food or saliva into the lungs, called aspiration.
How is it diagnosed?
ALS is diagnosed by a thorough physical examination and a study of the patient’s medical history and pattern of symptoms. While there is no specific diagnostic test for ALS, the doctor will order tests of the brain and nervous system to rule out other causes. A test called electromyography (EMG) is used to measure the electrical activity in the muscles, which will help determine if the symptoms are caused by an abnormality in the nerves or muscles. The doctor may also order blood and urine tests, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and x-rays.
What is the treatment?
There is no cure for ALS. Patients in the beginning stages of the disease should remain as active as possible. Studies have shown that taking a drug called riluzole early in the disease can slow the progression of symptoms slightly. As symptoms progress, treatment involves supporting the patient with physical therapy to prevent muscle shortening (contractures), keep the muscles as strong as possible, and maintain a good range of motion. Drugs are available to reduce muscle cramping. A speech pathologist can help with communication and swallowing difficulties. It is extremely important that ALS patients follow a special diet to prevent choking and aspiration of food. Some patients must be fed through a gastrostomy tube, which is inserted through the abdominal wall into the stomach. Patients who become unable to breathe on their own use a mechanical ventilator. Most ALS patients eventually require full-time nursing care.
Self-care tips
It is difficult to maintain a positive outlook in the face of ALS. For this reason, emotional support is extremely important. If you have been diagnosed with ALS, learn all you can about the disease and decide what type of medical treatment is acceptable to you as the disease progresses. Make sure your healthcare provider, family, and friends are aware of your choices.
What is it?
Amyotrophic lateral sclerosis (ALS) is a progressive disease in which the nerve cells that control voluntary muscle movement gradually deteriorate, leading to muscle weakness and eventual paralysis. “Amyotrophic” means the loss of muscle bulk, “lateral” refers to the nerve tracks running down both sides of the spinal cord that are affected, and “sclerosis” refers to the thickening or hardening of the muscle tissue. Also called Lou Gehrig's disease, after the celebrated American baseball player who died of ALS. ALS is also referred to as a motor neuron disease.
Who gets it?
ALS is a rare disease, affecting approximately 30,000 Americans. It is usually diagnosed in people between the ages of 35 and 70. It is slightly more common in men than women.
What causes it?
The cause of ALS is not known. While it can run in families, called familial ALS, it is most often found in people with no family history of the disease, called sporadic ALS. There is a possibility that there is a connection between sporadic ALS and an overproduction of toxic molecular fragments called free radicals in the body, an autoimmune response, viral factors, environmental toxins, or premature aging. However, research has not been conclusive. Western Pacific ALS is a form of the disease that is seen in Guam and other Pacific islands. This form of ALS includes some symptoms of Parkinson's disease.
What are the symptoms?
The symptoms of ALS occur when the motor neurons in the brain and spinal cord begin to degenerate. The motor neurons are nerve cells responsible for sending messages from the brain to the muscles to stimulate movement. As the motor neurons degenerate and die, the muscles become weak and incapable of normal movement, which leads to a loss of muscle bulk, called wasting. The weakness usually begins in the hands, making everyday activities such as fastening buttons and tying a shoe difficult. This weakness then progresses up the arm. Weakness can also begin in the feet and progress up the leg. Weakness in the feet and ankles may first be noticed as frequent stumbling or clumsiness. It leads to a condition called foot drop, in which the feet drag when the patient walks. Over time, the patient experiences muscle cramps, spasms, and tremors. When muscles in the throat are affected, speech becomes slurred or slowed, and the patient may have difficulty swallowing. As the muscles of the diaphragm weaken, a respirator is needed to help with breathing. ALS does not affect mental function, the senses, bowel and bladder function, or the eye muscles. Because ALS progresses until it affects almost all the voluntary muscle groups in the body, patients are eventually able to move only their eyes. ALS is a fatal disease. Because the weakened respiratory and swallowing muscles make it difficult to cough and swallow food, the most likely cause of death is lung infection caused by the inhalation of food or saliva into the lungs, called aspiration.
How is it diagnosed?
ALS is diagnosed by a thorough physical examination and a study of the patient’s medical history and pattern of symptoms. While there is no specific diagnostic test for ALS, the doctor will order tests of the brain and nervous system to rule out other causes. A test called electromyography (EMG) is used to measure the electrical activity in the muscles, which will help determine if the symptoms are caused by an abnormality in the nerves or muscles. The doctor may also order blood and urine tests, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and x-rays.
What is the treatment?
There is no cure for ALS. Patients in the beginning stages of the disease should remain as active as possible. Studies have shown that taking a drug called riluzole early in the disease can slow the progression of symptoms slightly. As symptoms progress, treatment involves supporting the patient with physical therapy to prevent muscle shortening (contractures), keep the muscles as strong as possible, and maintain a good range of motion. Drugs are available to reduce muscle cramping. A speech pathologist can help with communication and swallowing difficulties. It is extremely important that ALS patients follow a special diet to prevent choking and aspiration of food. Some patients must be fed through a gastrostomy tube, which is inserted through the abdominal wall into the stomach. Patients who become unable to breathe on their own use a mechanical ventilator. Most ALS patients eventually require full-time nursing care.
Self-care tips
It is difficult to maintain a positive outlook in the face of ALS. For this reason, emotional support is extremely important. If you have been diagnosed with ALS, learn all you can about the disease and decide what type of medical treatment is acceptable to you as the disease progresses. Make sure your healthcare provider, family, and friends are aware of your choices.
Amyloidosis
What is it?
Amyloidosis is a progressive disease in which deposits of a waxy, starch-like protein called amyloid accumulate in one or more organs or body systems. Amyloid proteins are not usually found in the body, but are manufactured by malfunctioning bone marrow. As the amyloid deposits build up, they begin to interfere with the normal function of the organ or body system.
Who gets it?
Amyloidosis occurs in only eight of every one million people. Symptoms usually occur after age 40. Males and females are equally affected.
What causes it?
There are at least 15 different types of amyloidosis. The major forms are primary, secondary, and hereditary. The cause of primary amyloidosis is not known. However, it is associated with abnormalities in blood cells because it often occurs in people with bone marrow cancer (multiple myeloma). Secondary amyloidosis occurs in people who have a chronic infection or inflammatory disease, such as tuberculosis, a bacterial infection called familial Mediterranean fever, bone infections (osteomyelitis), rheumatoid arthritis, inflammation of the small intestine (granulomatous ileitis), Hodgkin's disease, and leprosy. Hereditary amyloidosis occurs in most ethnic groups, and is the only inherited form of the disease. Researchers believe a child needs to receive just one copy of the defective gene to inherit amyloidosis. This pattern of inheritance is called autosomal dominance. If one parent has hereditary amyloidosis, the child will have a 50% chance of developing the disease. There is also a form of amyloidosis associated with Alzheimer's disease.
What are the symptoms?
Symptoms of amyloidosis depend upon the area of the amyloid deposits and can range from mild to severe. In some cases, amyloidosis can cause organ failure and death. The areas typically affected include the heart, gastrointestinal system, kidneys, liver and spleen, lungs, skin, thyroid and adrenal glands, lymph nodes, and blood vessels. Amyloid deposits in the heart make it difficult for the heart to function properly, resulting in shortness of breath, irregular heartbeat, and congestive heart failure. Symptoms of amyloid in the gastrointestinal system include a tongue that is thick and inflamed, signs of malnutrition caused by poor absorption of food, intestinal bleeding, abdominal pain, constipation, and diarrhea. Kidney damage is indicated by swelling in the feet and legs, protein in the urine, high cholesterol that cannot be reduced with medication, and a distaste for foods rich in protein. The liver and spleen will enlarge, and the spleen can rupture as amyloid accumulates. Amyloid deposits in the sinuses, larynx, and trachea will block the airways, making breathing difficult. Approximately half of all people with primary or secondary amyloidosis have skin symptoms. These include waxy-looking raised bumps, called papules, usually located on the face and neck; in the groin, armpits, or anal area; on the tongue; or in the ear canals. Patients may also have skin swelling, hair loss, and dry mouth. Amyloidosis can affect blood clotting, so symptoms may include abnormal bleeding or bruising. Hereditary amyloidosis almost always affects the nervous system. Symptoms may include inflammation and degeneration of the peripheral nerves (peripheral neuropathy), carpal tunnel, weakness, and abnormal sensations.
How is it diagnosed?
If your doctor suspects you have amyloidosis, either because of organ failure or unexplained bleeding, he or she may order blood and urine tests to check for the amyloid protein. A definite diagnosis is made through a tissue sample (biopsy) from the liver, kidney, skin, gums, or rectum. A bone marrow biopsy might also be performed. Other laboratory and imaging tests can confirm the exact organ or system that is affected. The affected organs are usually enlarged, and feel rubbery and firm.
What is the treatment?
Treatment for amyloidosis is determined by the type and extent of the disease. Drugs such as colchicin, prednisone, and other anti-inflammatories are commonly used to slow or stop the progression of this disease. In fact, cholchicine has been known to prevent amyloidosis in patients with familial Mediterranean fever. Chemotherapy drugs, such as melphalan, may also be used to treat this disease. Doctors have found that patients are able to tolerate higher doses of melphalan, which are more effective against amyloidosis, if they undergo bone marrow or stem cell transplants. All blood cells originate from stem cells, which are found in the bone marrow. In cases of secondary amyloidosis, where amyloid deposits are caused by another disease, treating that disease can slow down or even reverse amyloidosis. Symptoms caused by heart or kidney damage are usually treated with medication and dialysis. Heart and kidney transplants may be considered; however, there is a possibility that amyloid will again build up in the new organ. Amyloid deposits sometimes can be surgically removed from a specific area of the body. Surgery can also be performed to relieve nerve pressure in people with hereditary amyloidosis
Self-care tips
The long-term outlook for people with amyloidosis depends upon the extent of the disease. If there is a history of hereditary amyloidosis in your family, you may want to seek genetic counseling before having children.
Amyloidosis is a progressive disease in which deposits of a waxy, starch-like protein called amyloid accumulate in one or more organs or body systems. Amyloid proteins are not usually found in the body, but are manufactured by malfunctioning bone marrow. As the amyloid deposits build up, they begin to interfere with the normal function of the organ or body system.
Who gets it?
Amyloidosis occurs in only eight of every one million people. Symptoms usually occur after age 40. Males and females are equally affected.
What causes it?
There are at least 15 different types of amyloidosis. The major forms are primary, secondary, and hereditary. The cause of primary amyloidosis is not known. However, it is associated with abnormalities in blood cells because it often occurs in people with bone marrow cancer (multiple myeloma). Secondary amyloidosis occurs in people who have a chronic infection or inflammatory disease, such as tuberculosis, a bacterial infection called familial Mediterranean fever, bone infections (osteomyelitis), rheumatoid arthritis, inflammation of the small intestine (granulomatous ileitis), Hodgkin's disease, and leprosy. Hereditary amyloidosis occurs in most ethnic groups, and is the only inherited form of the disease. Researchers believe a child needs to receive just one copy of the defective gene to inherit amyloidosis. This pattern of inheritance is called autosomal dominance. If one parent has hereditary amyloidosis, the child will have a 50% chance of developing the disease. There is also a form of amyloidosis associated with Alzheimer's disease.
What are the symptoms?
Symptoms of amyloidosis depend upon the area of the amyloid deposits and can range from mild to severe. In some cases, amyloidosis can cause organ failure and death. The areas typically affected include the heart, gastrointestinal system, kidneys, liver and spleen, lungs, skin, thyroid and adrenal glands, lymph nodes, and blood vessels. Amyloid deposits in the heart make it difficult for the heart to function properly, resulting in shortness of breath, irregular heartbeat, and congestive heart failure. Symptoms of amyloid in the gastrointestinal system include a tongue that is thick and inflamed, signs of malnutrition caused by poor absorption of food, intestinal bleeding, abdominal pain, constipation, and diarrhea. Kidney damage is indicated by swelling in the feet and legs, protein in the urine, high cholesterol that cannot be reduced with medication, and a distaste for foods rich in protein. The liver and spleen will enlarge, and the spleen can rupture as amyloid accumulates. Amyloid deposits in the sinuses, larynx, and trachea will block the airways, making breathing difficult. Approximately half of all people with primary or secondary amyloidosis have skin symptoms. These include waxy-looking raised bumps, called papules, usually located on the face and neck; in the groin, armpits, or anal area; on the tongue; or in the ear canals. Patients may also have skin swelling, hair loss, and dry mouth. Amyloidosis can affect blood clotting, so symptoms may include abnormal bleeding or bruising. Hereditary amyloidosis almost always affects the nervous system. Symptoms may include inflammation and degeneration of the peripheral nerves (peripheral neuropathy), carpal tunnel, weakness, and abnormal sensations.
How is it diagnosed?
If your doctor suspects you have amyloidosis, either because of organ failure or unexplained bleeding, he or she may order blood and urine tests to check for the amyloid protein. A definite diagnosis is made through a tissue sample (biopsy) from the liver, kidney, skin, gums, or rectum. A bone marrow biopsy might also be performed. Other laboratory and imaging tests can confirm the exact organ or system that is affected. The affected organs are usually enlarged, and feel rubbery and firm.
What is the treatment?
Treatment for amyloidosis is determined by the type and extent of the disease. Drugs such as colchicin, prednisone, and other anti-inflammatories are commonly used to slow or stop the progression of this disease. In fact, cholchicine has been known to prevent amyloidosis in patients with familial Mediterranean fever. Chemotherapy drugs, such as melphalan, may also be used to treat this disease. Doctors have found that patients are able to tolerate higher doses of melphalan, which are more effective against amyloidosis, if they undergo bone marrow or stem cell transplants. All blood cells originate from stem cells, which are found in the bone marrow. In cases of secondary amyloidosis, where amyloid deposits are caused by another disease, treating that disease can slow down or even reverse amyloidosis. Symptoms caused by heart or kidney damage are usually treated with medication and dialysis. Heart and kidney transplants may be considered; however, there is a possibility that amyloid will again build up in the new organ. Amyloid deposits sometimes can be surgically removed from a specific area of the body. Surgery can also be performed to relieve nerve pressure in people with hereditary amyloidosis
Self-care tips
The long-term outlook for people with amyloidosis depends upon the extent of the disease. If there is a history of hereditary amyloidosis in your family, you may want to seek genetic counseling before having children.
Saturday, March 7, 2009
Amenorrhea
Also found under: Menstrual Disorders
What is it?
The term menstrual disorders refers to any of a number of conditions that are related to the menstrual cycle. Menstruation is the shedding of the lining of the uterus (the endometrium) each month, also referred to as the menstrual period. Menstrual periods usually last for five to seven days. Amenorrhea is the term used to describe the absence of menstrual periods. There are two types of amenorrhea. Primary amenorrhea refers to menstrual periods that have not begun by the age of 16. Secondary amenorrhea refers to the absence of three or more menstrual periods in a woman who has had regular periods up to that point. A menstrual period is considered late if it is five or more days overdue according to the woman's usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
Who gets it?
Any female who has begun menstruating can experience secondary amenorrhea. Girls who do not undergo puberty, the stage of sexual growth during which the breasts begin to bud and the first menstrual period begins, experience primary amenorrhea.
What causes it?
Problems with the uterus, cervix, ovaries, and hormones can cause amenorrhea. The main cause of primary amenorrhea is delayed puberty. Delayed puberty can be caused by a hormonal problem; a birth defect in which the vagina, uterus, or fallopian tubes don't develop normally; or by chromosomal disorders. Chromosomal disorders include Turner's syndrome, in which the cells contain only one X chromosome instead of the two that should be present in females. In rare cases, puberty does not occur because the child may develop as a female, but is genetically male. This may be occur in children born with both sex organs, called hermaphrodites, or with a condition called male pseudohermaphroditism. Both primary and secondary amenorrhea can be caused by high or low levels of thyroid hormones and by Cushing's syndrome, a condition in which the adrenal glands produce too much corticosteroid hormone. The most common cause of secondary amenorrhea in adult women and teenagers is pregnancy. However, many teenagers have irregular periods during the first few years. Breastfeeding, discontinuing birth control pills, physical or emotional stress, depression, malnutrition, drugs used to treat stress and depression, and sudden weight loss or gain can also cause periods to stop. Other causes of secondary amenorrhea can be related to medical conditions such as traumatic brain injury; brain, ovary, or adrenal gland tumors; ovarian cysts; overproduction of prolactin by the pituitary gland; chronic illness; and Asherman's syndrome, which is scarring of the uterine lining caused by infection or surgery. Strenuous exercise can also cause delayed onset of menstruation or missed periods, and is often seen in young female athletes. When menstrual periods stop occurring after menopause, it is called permanent secondary amenorrhea.
What are the symptoms?
Symptoms of amenorrhea vary depending upon the cause. For example, if primary amenorrhea is caused by the failure to undergo puberty, symptoms will include lack of or below normal development of breasts and pubic and underarm hair. If the cause is related to high thyroid hormones, the symptoms will include anxiety, rapid heartbeat, and warm, moist skin. Cushing's syndrome causes symptoms including a round face, enlarged abdomen, and thin arms and legs. When secondary amenorrhea is caused by pregnancy, other signs of early pregnancy may be present, such as nausea, breast swelling, or weight gain. Asherman's syndrome usually produces no symptoms.
How is it diagnosed?
To diagnose amenorrhea, your doctor will take a complete medical history and will perform a physical examination, including a pelvic, or internal, exam. This doctor would most likely be your gynecologist, a doctor who specializes in women's reproductive health. He or she will ask questions about your lifestyle, diet, sexual activity, and any medications you are taking. The doctor will first look for obvious causes of your symptoms. For example, he or she will look for signs of puberty in a teenager who has never gotten her period. If you are sexually active and have had a normal period before your symptoms began, the doctor will order a pregnancy test. A blood sample will reveal if estrogen or the hormones produced by the pituitary, adrenal, or thyroid glands are at abnormal levels. If your doctor suspects a brain tumor or other brain injury is causing your symptoms, he may order a skull x-ray. Tumors of the ovaries or adrenal glands, as well as cysts, can be detected by computed tomography (CT) or ultrasound scans of the abdomen. Your doctor may recommend genetic testing if he suspects a chromosomal disorder such as Turner's syndrome. If your doctor finds nothing abnormal in your exam or tests, irregular periods may be normal for you at this time. This is especially common in teenagers.
What is the treatment?
The treatment of amenorrhea depends on the cause of the problem. If you are pregnant, treatment involves a good program of prenatal care. If symptoms are caused by delayed puberty, the doctor will monitor your progress at regular checkups, often every three to six months. He or she may recommend hormonal supplements of progesterone and/or estrogen to induce puberty. Tumors or cysts are usually treated with surgery, as is an abnormally developed vagina. If high levels of stress are causing your symptoms, your doctor will help you develop a plan for cutting back on some activities or avoiding situations that cause you stress. A therapist may be helpful in these situations. Amenorrhea caused by extreme dieting will resolve itself, and normal periods should start, once a healthy diet is followed. If your doctor finds no cause of your symptoms and you are otherwise healthy, you may simply have an irregular cycle and do not need treatment. Some causes, such as Turner's syndrome, cannot be cured.
Self-care tips
Always check with your doctor if you miss more than one menstrual period, especially if you are sexually active and have not used birth control. If you are overweight, avoid extreme diets that deprive you of the calories you need to stay active and maintain a normal energy level. If you have an irregular cycle, try keeping a record of when your period starts and stops each month. This information will be helpful if you need to see your doctor about your symptoms. Avoid cigarette smoking, recreational drugs, and excessive use of alcohol. Also avoid situations that you know cause extreme stress. If you are involved in strenuous physical activity, you may need to cut back on your program to help your periods become regular again.
What is it?
The term menstrual disorders refers to any of a number of conditions that are related to the menstrual cycle. Menstruation is the shedding of the lining of the uterus (the endometrium) each month, also referred to as the menstrual period. Menstrual periods usually last for five to seven days. Amenorrhea is the term used to describe the absence of menstrual periods. There are two types of amenorrhea. Primary amenorrhea refers to menstrual periods that have not begun by the age of 16. Secondary amenorrhea refers to the absence of three or more menstrual periods in a woman who has had regular periods up to that point. A menstrual period is considered late if it is five or more days overdue according to the woman's usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
Who gets it?
Any female who has begun menstruating can experience secondary amenorrhea. Girls who do not undergo puberty, the stage of sexual growth during which the breasts begin to bud and the first menstrual period begins, experience primary amenorrhea.
What causes it?
Problems with the uterus, cervix, ovaries, and hormones can cause amenorrhea. The main cause of primary amenorrhea is delayed puberty. Delayed puberty can be caused by a hormonal problem; a birth defect in which the vagina, uterus, or fallopian tubes don't develop normally; or by chromosomal disorders. Chromosomal disorders include Turner's syndrome, in which the cells contain only one X chromosome instead of the two that should be present in females. In rare cases, puberty does not occur because the child may develop as a female, but is genetically male. This may be occur in children born with both sex organs, called hermaphrodites, or with a condition called male pseudohermaphroditism. Both primary and secondary amenorrhea can be caused by high or low levels of thyroid hormones and by Cushing's syndrome, a condition in which the adrenal glands produce too much corticosteroid hormone. The most common cause of secondary amenorrhea in adult women and teenagers is pregnancy. However, many teenagers have irregular periods during the first few years. Breastfeeding, discontinuing birth control pills, physical or emotional stress, depression, malnutrition, drugs used to treat stress and depression, and sudden weight loss or gain can also cause periods to stop. Other causes of secondary amenorrhea can be related to medical conditions such as traumatic brain injury; brain, ovary, or adrenal gland tumors; ovarian cysts; overproduction of prolactin by the pituitary gland; chronic illness; and Asherman's syndrome, which is scarring of the uterine lining caused by infection or surgery. Strenuous exercise can also cause delayed onset of menstruation or missed periods, and is often seen in young female athletes. When menstrual periods stop occurring after menopause, it is called permanent secondary amenorrhea.
What are the symptoms?
Symptoms of amenorrhea vary depending upon the cause. For example, if primary amenorrhea is caused by the failure to undergo puberty, symptoms will include lack of or below normal development of breasts and pubic and underarm hair. If the cause is related to high thyroid hormones, the symptoms will include anxiety, rapid heartbeat, and warm, moist skin. Cushing's syndrome causes symptoms including a round face, enlarged abdomen, and thin arms and legs. When secondary amenorrhea is caused by pregnancy, other signs of early pregnancy may be present, such as nausea, breast swelling, or weight gain. Asherman's syndrome usually produces no symptoms.
How is it diagnosed?
To diagnose amenorrhea, your doctor will take a complete medical history and will perform a physical examination, including a pelvic, or internal, exam. This doctor would most likely be your gynecologist, a doctor who specializes in women's reproductive health. He or she will ask questions about your lifestyle, diet, sexual activity, and any medications you are taking. The doctor will first look for obvious causes of your symptoms. For example, he or she will look for signs of puberty in a teenager who has never gotten her period. If you are sexually active and have had a normal period before your symptoms began, the doctor will order a pregnancy test. A blood sample will reveal if estrogen or the hormones produced by the pituitary, adrenal, or thyroid glands are at abnormal levels. If your doctor suspects a brain tumor or other brain injury is causing your symptoms, he may order a skull x-ray. Tumors of the ovaries or adrenal glands, as well as cysts, can be detected by computed tomography (CT) or ultrasound scans of the abdomen. Your doctor may recommend genetic testing if he suspects a chromosomal disorder such as Turner's syndrome. If your doctor finds nothing abnormal in your exam or tests, irregular periods may be normal for you at this time. This is especially common in teenagers.
What is the treatment?
The treatment of amenorrhea depends on the cause of the problem. If you are pregnant, treatment involves a good program of prenatal care. If symptoms are caused by delayed puberty, the doctor will monitor your progress at regular checkups, often every three to six months. He or she may recommend hormonal supplements of progesterone and/or estrogen to induce puberty. Tumors or cysts are usually treated with surgery, as is an abnormally developed vagina. If high levels of stress are causing your symptoms, your doctor will help you develop a plan for cutting back on some activities or avoiding situations that cause you stress. A therapist may be helpful in these situations. Amenorrhea caused by extreme dieting will resolve itself, and normal periods should start, once a healthy diet is followed. If your doctor finds no cause of your symptoms and you are otherwise healthy, you may simply have an irregular cycle and do not need treatment. Some causes, such as Turner's syndrome, cannot be cured.
Self-care tips
Always check with your doctor if you miss more than one menstrual period, especially if you are sexually active and have not used birth control. If you are overweight, avoid extreme diets that deprive you of the calories you need to stay active and maintain a normal energy level. If you have an irregular cycle, try keeping a record of when your period starts and stops each month. This information will be helpful if you need to see your doctor about your symptoms. Avoid cigarette smoking, recreational drugs, and excessive use of alcohol. Also avoid situations that you know cause extreme stress. If you are involved in strenuous physical activity, you may need to cut back on your program to help your periods become regular again.
Alzheimer’s Disease
What is it?
Alzheimer's disease is the most common cause of a condition called dementia. Dementia is a general decline in mental ability, such as memory, language skills, judgment, and concentration. Alzheimer’s is a progressive disease, which means symptoms occur gradually and become worse over time. It is named for the German doctor who first described it, Alois Alzheimer.
Who gets it?
Alzheimer’s disease affects most commonly affects those over the age of 65, although it has been diagnosed in people in their 40s and 50s.
What causes it?
The degeneration of parts of the brain, which destroys brain cells, causes the symptoms of Alzheimer’s. However, at this time researchers are not sure what causes this degeneration. Those with a family history of Alzheimer’s are more likely to develop the disease as they age, so there is a gene abnormality that causes the disease in some people. Researchers are looking for links between Alzheimer’s disease and the environment, lifestyle, nutrition, and viruses.
What are the symptoms?
Alzheimer’s usually progresses in three stages, with each lasting anywhere from one to several years. The first symptom of Alzheimer’s disease is usually mild forgetfulness. Someone in the early stages may find him or herself unable to find the right word, recall where something was placed, or recall someone’s name. It may be difficult to concentrate. At this point, symptoms are so general that they do not signal a serious problem or have a great impact on day-to-day functioning. As the disease progresses to the second stage, the forgetfulness becomes worse, making it difficult to function at work, remember directions, or to even make it through the day without difficulty. The person may be restless and unable to sleep at night. His or her personality may change considerably, with increasing anxiety and decreasing emotions. By the late stages of Alzheimer’s, patients suffer from extreme confusion and memory loss. They are unable to recall the names of close friends and family or recent events, and cannot function socially or perform basic daily personal care. Late-stage Alzheimer’s patients may have hallucinations and delusions.
How is it diagnosed?
Alzheimer’s disease is diagnosed by taking a complete medical history and performing a thorough physical examination. Alzheimer’s is generally suspected when there is a gradual deterioration in mental ability. The doctor will perform tests, such as blood tests and brain scans, to rule out other possible causes of the symptoms. The doctor will also ask the patient a series of questions to test his or her mental status. One type of test of mental status is called neuropsychological testing, which is a standardized test of memory, concentration, and visual-spatial skills. Because a definite diagnosis can only be made by performing an autopsy after death, patients are diagnosed with “probable” Alzheimer’s. An autopsy of brain tissue, however, will show areas of abnormal tissue, called plaques, made up of abnormal proteins; a loss of nerve cells; and areas of tangles in the nerve cells that remain in patient’s with Alzheimer’s disease.
What is the treatment?
At this time, there is no cure for Alzheimer’s disease. Treatment focuses on maintaining the best possible quality of life for the patient by providing a supportive environment. Memory aids, such as calendars and other daily reminders of time and place, can help the patient feel more secure and reduce confusion. There are some medications that, when used in the early stages of this disease, can slow memory loss in some patients for a limited amount of time. However, these drugs are used with caution because of potential side effects. Other drugs may be prescribed to treat anxiety, sleeplessness, depression, and hallucinations, as necessary. In the early stages of Alzheimer’s, it is important to help the patient maintain as much independence as possible. As the disease progresses, it may be necessary to seek the help of a home healthcare aid, an adult daycare, or nursing home. While there is currently no treatment to prevent or stop the progression of Alzheimer’s, researchers are continuing to study this disease and test new drugs. There is a possibility that certain types of nonsteroidal anti-inflammatory drugs (NSAIDs) may slow the progression of Alzheimer’s.
Self-care tips
A diagnosis of probable Alzheimer’s is devastating for someone who has been accustomed to living an independent life. It is important to provide the patient with emotional and physical support as he or she adjusts to living with this disease. Keeping the daily routine consistent and as stress free as possible is helpful. Because depression is so common in the early stages of Alzheimer’s, you should be aware of the signs of depression and seek help for the patient as soon as possible. Caring for someone with Alzheimer’s can be demanding and discouraging, especially when the loved one does not remember who you are. Your doctor or local social services agency can direct you to support services to help make this time a little easier. Also seek legal advice so it is clear who has the power to make medical and financial decisions once your loved one is no longer able to do this for him or herself. If you have a family history of Alzheimer’s disease, see your doctor for regular checkups. An early diagnosis is important, especially as the medical community learns more about this disease and its treatment. While there is no way to prevent this disease, you can lower your risk and protect yourself from many illnesses by following a healthy diet that is high in fiber and antioxidants and low in saturated fat, and participating in regular physical exercise. Performing activities that stimulate your brain on a regular basis, such as crossword puzzles, word searches, or memory games, may also help maintain mental ability longer.
Alzheimer's disease is the most common cause of a condition called dementia. Dementia is a general decline in mental ability, such as memory, language skills, judgment, and concentration. Alzheimer’s is a progressive disease, which means symptoms occur gradually and become worse over time. It is named for the German doctor who first described it, Alois Alzheimer.
Who gets it?
Alzheimer’s disease affects most commonly affects those over the age of 65, although it has been diagnosed in people in their 40s and 50s.
What causes it?
The degeneration of parts of the brain, which destroys brain cells, causes the symptoms of Alzheimer’s. However, at this time researchers are not sure what causes this degeneration. Those with a family history of Alzheimer’s are more likely to develop the disease as they age, so there is a gene abnormality that causes the disease in some people. Researchers are looking for links between Alzheimer’s disease and the environment, lifestyle, nutrition, and viruses.
What are the symptoms?
Alzheimer’s usually progresses in three stages, with each lasting anywhere from one to several years. The first symptom of Alzheimer’s disease is usually mild forgetfulness. Someone in the early stages may find him or herself unable to find the right word, recall where something was placed, or recall someone’s name. It may be difficult to concentrate. At this point, symptoms are so general that they do not signal a serious problem or have a great impact on day-to-day functioning. As the disease progresses to the second stage, the forgetfulness becomes worse, making it difficult to function at work, remember directions, or to even make it through the day without difficulty. The person may be restless and unable to sleep at night. His or her personality may change considerably, with increasing anxiety and decreasing emotions. By the late stages of Alzheimer’s, patients suffer from extreme confusion and memory loss. They are unable to recall the names of close friends and family or recent events, and cannot function socially or perform basic daily personal care. Late-stage Alzheimer’s patients may have hallucinations and delusions.
How is it diagnosed?
Alzheimer’s disease is diagnosed by taking a complete medical history and performing a thorough physical examination. Alzheimer’s is generally suspected when there is a gradual deterioration in mental ability. The doctor will perform tests, such as blood tests and brain scans, to rule out other possible causes of the symptoms. The doctor will also ask the patient a series of questions to test his or her mental status. One type of test of mental status is called neuropsychological testing, which is a standardized test of memory, concentration, and visual-spatial skills. Because a definite diagnosis can only be made by performing an autopsy after death, patients are diagnosed with “probable” Alzheimer’s. An autopsy of brain tissue, however, will show areas of abnormal tissue, called plaques, made up of abnormal proteins; a loss of nerve cells; and areas of tangles in the nerve cells that remain in patient’s with Alzheimer’s disease.
What is the treatment?
At this time, there is no cure for Alzheimer’s disease. Treatment focuses on maintaining the best possible quality of life for the patient by providing a supportive environment. Memory aids, such as calendars and other daily reminders of time and place, can help the patient feel more secure and reduce confusion. There are some medications that, when used in the early stages of this disease, can slow memory loss in some patients for a limited amount of time. However, these drugs are used with caution because of potential side effects. Other drugs may be prescribed to treat anxiety, sleeplessness, depression, and hallucinations, as necessary. In the early stages of Alzheimer’s, it is important to help the patient maintain as much independence as possible. As the disease progresses, it may be necessary to seek the help of a home healthcare aid, an adult daycare, or nursing home. While there is currently no treatment to prevent or stop the progression of Alzheimer’s, researchers are continuing to study this disease and test new drugs. There is a possibility that certain types of nonsteroidal anti-inflammatory drugs (NSAIDs) may slow the progression of Alzheimer’s.
Self-care tips
A diagnosis of probable Alzheimer’s is devastating for someone who has been accustomed to living an independent life. It is important to provide the patient with emotional and physical support as he or she adjusts to living with this disease. Keeping the daily routine consistent and as stress free as possible is helpful. Because depression is so common in the early stages of Alzheimer’s, you should be aware of the signs of depression and seek help for the patient as soon as possible. Caring for someone with Alzheimer’s can be demanding and discouraging, especially when the loved one does not remember who you are. Your doctor or local social services agency can direct you to support services to help make this time a little easier. Also seek legal advice so it is clear who has the power to make medical and financial decisions once your loved one is no longer able to do this for him or herself. If you have a family history of Alzheimer’s disease, see your doctor for regular checkups. An early diagnosis is important, especially as the medical community learns more about this disease and its treatment. While there is no way to prevent this disease, you can lower your risk and protect yourself from many illnesses by following a healthy diet that is high in fiber and antioxidants and low in saturated fat, and participating in regular physical exercise. Performing activities that stimulate your brain on a regular basis, such as crossword puzzles, word searches, or memory games, may also help maintain mental ability longer.
Alport’s Syndrome
What is it?
Alport’s syndrome is a hereditary disease that affects kidney function and can also cause hearing and vision disorders.
Who gets it?
Alport’s syndrome is primarily seen in men. While this syndrome can cause some symptoms in childhood, first symptoms usually occur in men in their twenties and thirties.
What causes it?
Alport’s syndrome is caused by a defective gene carried on the X chromosome. Women have two X chromosomes, so those who carry the defective gene usually have milder symptoms than men because their second normal X chromosome can serve as backup for the abnormal one. Women, however, can pass the defective gene on to their sons. Men have one X and one Y chromosome, so a defective gene on the X chromosome will cause symptoms. In some cases, however, Alport’s syndrome occurs spontaneously, with no family history of the disease. This is called a spontaneous genetic mutation.
What are the symptoms?
One of the first symptoms of Alport’s syndrome is usually hematuria, or blood in the urine. Tests also may reveal high levels of protein and white blood cells in the urine and waste products such as urea in the blood (called uremia). Eventually, the kidneys are unable to perform the function they should -- to filter waste products from the blood and rid them from the body. Other symptoms may include hearing loss, particularly sounds at high frequencies; vision problems, such as cataracts, involuntary eye movements, and abnormalities of the cornea; nerve problems, such as polyneuropathy; skin problems; and low blood platelet counts that can compromise blood clotting. Although it is unusual, some patients develop nephrotic syndrome, which can cause high protein levels in the urine, low levels of a protein called albumin in the blood, and swelling, usually in the legs and/or abdomen. While women can live with Alport’s syndrome and have no noticeable symptoms other than a slight hearing loss or occasional blood in the urine, men are more likely to die from complications of this disease by middle age.
How is it diagnosed?
To diagnose Alport’s syndrome, your doctor will take a complete medical history and perform a thorough physical exam. He or she will order a urinalysis, a test in which a sample of the urine is studied for signs of blood or proteins, blood tests to check for low platelet counts, and a kidney biopsy. A kidney biopsy is a procedure in which a small sample of kidney tissue is removed with a long, thin needle and examined under a microscope for abnormalities. The biopsy is performed under a local anesthetic so the patient is awake but feels no pain. Genetic tests also are available that can determine whether a person has the defective Alport’s gene.
What is the treatment?
There is no cure for Alport’s syndrome, but treatment is available to ensure the kidneys can function as fully as possible. This includes limiting your intake of salts and fluids, high amounts of which put too much strain on the kidneys. Your doctor will also recommend that you take steps to control your blood pressure and potassium levels. If you have nephrotic syndrome, your doctor will recommend lowering your fluid intake; taking medications called diuretics, which help the kidneys eliminate wastes from the body by increasing urinatation; and eliminating all salts from your diet. You may also need to receive a transfusion of albumin. In cases where the kidneys begin to fail completely, you will need to undergo kidney dialysis or a kidney transplant.
Self-care tips
Because Alport’s syndrome has a genetic link, you may want to seek genetic counseling if you are planning to have children and there is a family history of the disease.
Alport’s syndrome is a hereditary disease that affects kidney function and can also cause hearing and vision disorders.
Who gets it?
Alport’s syndrome is primarily seen in men. While this syndrome can cause some symptoms in childhood, first symptoms usually occur in men in their twenties and thirties.
What causes it?
Alport’s syndrome is caused by a defective gene carried on the X chromosome. Women have two X chromosomes, so those who carry the defective gene usually have milder symptoms than men because their second normal X chromosome can serve as backup for the abnormal one. Women, however, can pass the defective gene on to their sons. Men have one X and one Y chromosome, so a defective gene on the X chromosome will cause symptoms. In some cases, however, Alport’s syndrome occurs spontaneously, with no family history of the disease. This is called a spontaneous genetic mutation.
What are the symptoms?
One of the first symptoms of Alport’s syndrome is usually hematuria, or blood in the urine. Tests also may reveal high levels of protein and white blood cells in the urine and waste products such as urea in the blood (called uremia). Eventually, the kidneys are unable to perform the function they should -- to filter waste products from the blood and rid them from the body. Other symptoms may include hearing loss, particularly sounds at high frequencies; vision problems, such as cataracts, involuntary eye movements, and abnormalities of the cornea; nerve problems, such as polyneuropathy; skin problems; and low blood platelet counts that can compromise blood clotting. Although it is unusual, some patients develop nephrotic syndrome, which can cause high protein levels in the urine, low levels of a protein called albumin in the blood, and swelling, usually in the legs and/or abdomen. While women can live with Alport’s syndrome and have no noticeable symptoms other than a slight hearing loss or occasional blood in the urine, men are more likely to die from complications of this disease by middle age.
How is it diagnosed?
To diagnose Alport’s syndrome, your doctor will take a complete medical history and perform a thorough physical exam. He or she will order a urinalysis, a test in which a sample of the urine is studied for signs of blood or proteins, blood tests to check for low platelet counts, and a kidney biopsy. A kidney biopsy is a procedure in which a small sample of kidney tissue is removed with a long, thin needle and examined under a microscope for abnormalities. The biopsy is performed under a local anesthetic so the patient is awake but feels no pain. Genetic tests also are available that can determine whether a person has the defective Alport’s gene.
What is the treatment?
There is no cure for Alport’s syndrome, but treatment is available to ensure the kidneys can function as fully as possible. This includes limiting your intake of salts and fluids, high amounts of which put too much strain on the kidneys. Your doctor will also recommend that you take steps to control your blood pressure and potassium levels. If you have nephrotic syndrome, your doctor will recommend lowering your fluid intake; taking medications called diuretics, which help the kidneys eliminate wastes from the body by increasing urinatation; and eliminating all salts from your diet. You may also need to receive a transfusion of albumin. In cases where the kidneys begin to fail completely, you will need to undergo kidney dialysis or a kidney transplant.
Self-care tips
Because Alport’s syndrome has a genetic link, you may want to seek genetic counseling if you are planning to have children and there is a family history of the disease.
Alopecia Areata
What is it?
Alopecia areata is a disease in which hair is lost suddenly, creating distinct bald patches, usually on the head or other parts of the body commonly covered with hair.
Who gets it?
People with a family history of alopecia areata are more likely to develop it. In children, it usually appears during the school years.
What causes it?
The cause of alopecia areata is unknown. However, researchers believe it is linked to the autoimmune system.
What are the symptoms?
Alopecia areata results in smooth, round or oval bald areas. There are usually no signs of inflammation. Symptoms can vary from bald patches (patchy alopecia areata), to complete scalp baldness (alopecia totalis), to loss of all scalp and body hair (alopecia universalis). People with this condition are otherwise in generally good health.
How is it diagnosed?
A skin specialist called a dermatologist may be able to diagnose your condition through a visual examination. In some cases, he or she may want to remove a small sample of skin, called a skin biopsy, to examine under a microscope.
What is the treatment?
Patchy alopecia areata usually clears up on its own within several months to several years. However, it is common for this condition to recur. It is less common for hair to grow back if hair loss is widespread, as in alopecia totalis or alopecia universalis. Some alopecia areata patients respond well to drugs that promote hair regrowth, such as those containing minoxidil and finasteride. A cream or ointment containing anthralin has also been found to stimulate new hair growth in those with mild cases of alopecia areata. Cortisone pills may be prescribed in cases of substantial hair loss.
Self-care tips
Check with your dermatologist before trying any home treatment for baldness. There are many forms of alopecia, some caused by disease, so it is important to determine the type of alopecia before treating the condition. People with all forms of alopecia usually find support groups dedicated to their condition helpful.
Alopecia areata is a disease in which hair is lost suddenly, creating distinct bald patches, usually on the head or other parts of the body commonly covered with hair.
Who gets it?
People with a family history of alopecia areata are more likely to develop it. In children, it usually appears during the school years.
What causes it?
The cause of alopecia areata is unknown. However, researchers believe it is linked to the autoimmune system.
What are the symptoms?
Alopecia areata results in smooth, round or oval bald areas. There are usually no signs of inflammation. Symptoms can vary from bald patches (patchy alopecia areata), to complete scalp baldness (alopecia totalis), to loss of all scalp and body hair (alopecia universalis). People with this condition are otherwise in generally good health.
How is it diagnosed?
A skin specialist called a dermatologist may be able to diagnose your condition through a visual examination. In some cases, he or she may want to remove a small sample of skin, called a skin biopsy, to examine under a microscope.
What is the treatment?
Patchy alopecia areata usually clears up on its own within several months to several years. However, it is common for this condition to recur. It is less common for hair to grow back if hair loss is widespread, as in alopecia totalis or alopecia universalis. Some alopecia areata patients respond well to drugs that promote hair regrowth, such as those containing minoxidil and finasteride. A cream or ointment containing anthralin has also been found to stimulate new hair growth in those with mild cases of alopecia areata. Cortisone pills may be prescribed in cases of substantial hair loss.
Self-care tips
Check with your dermatologist before trying any home treatment for baldness. There are many forms of alopecia, some caused by disease, so it is important to determine the type of alopecia before treating the condition. People with all forms of alopecia usually find support groups dedicated to their condition helpful.
Insect Venom Allergy
What is it?
Insect venom allergy is a harmful reaction to insect stings that occurs in people who have an abnormally high sensitivity to insect venom. It is an acquired trait, which is not present at the first exposure to the venom, but sensitization can occur after the first or subsequent exposures. Animals classified as insects usually have three main body segments (head, thorax and abdomen), six legs and a pair of sensory antennae. Winged insect species have two sets of wings, such as mosquitoes, bees, and wasps. Other biting or stinging insects include fleas, lice, and ants. Many other related animals that are frequently mistaken for insects such as ticks, spiders and mites also bite human beings. They can transmit infectious diseases or cause poisoning but generally do not cause allergic reactions. Allergic reactions to the venom of some stinging insects, such as honey bee, yellow jacket, hornet, wasp or fire ant can be life threatening.
Who gets it?
Anyone can experience an allergic reaction to an insect bite or sting. However, only a small number of people with insect bite or sting allergies suffer fatal reactions.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen, in this case the insect venom. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. In fact, most people with insect bite or sting allergies do not experience a severe reaction with their first bite. Multiple bites or stings increase the risk of an allergic reaction, but just one bite will cause serious symptoms for someone who is severely allergic.
What insects are usually involved?
Most serious allergic reactions to insect venom are caused by stinging insects, such as bees, yellow jackets, hornets, wasps and imported fire ants. As natives of the tropics, fire ants can live only in the warmer climate of the southern states and cannot survive in Pennsylvania. They are extremely aggressive and sting exposed parts of the skin when they feel threatened. Bites or stings from other insects usually do not cause allergic reaction.
What are the symptoms?
Symptoms of insect venom allergy often begin within 15 to 30 minutes and arise distant from the site of sting. The first symptom is often itchiness that can affect all or any part of the skin, the eyes and the nose. As symptoms progress, the patient begins to sneeze, cough and wheeze, feel congested, and develop hives or swelling. These symptoms may be warning signs of a dangerous condition called anaphylaxis. Symptoms of anaphylaxis include sudden anxiety and weakness, difficulty breathing, tightness in the chest, lightheadedness and palpitation, and loss of consciousness. Anaphylactic shock can occur within minutes and result in death. Anaphylaxis is a medical emergency that needs immediate medical treatment, and any delay may reduce the chance of survival.
How is it diagnosed?
Insect venom allergy is suspected based on a constellation of suggestive symptoms that follow an insect sting. The diagnosis is confirmed by performing a skin test with the venom of specific insects, such as honey bee, yellow jacket, hornet, wasp or fire ant that may be the culprit of the allergic reaction.
What is the treatment?
If you have been bitten or stung by an insect, carefully remove the stinger, if it is left behind. Wash the bite/sting area gently with soap and water. Apply ice to the site of sting. People who are allergic to insect bites should, of course, avoid situations in which they are likely to get stung or bitten. Mild reactions, such as pain, itching, and swelling, can be treated with an over-the counter antihistamine, pain reliever and topical corticosteroid creams. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe insect venom allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek emergency medical care after any type of reaction to an insect bite or sting.
People who are severely allergic to the venom of stinging insects, such as bees, yellow jackets, hornets, wasps or fire ants may, undergo a desensitization. First, skin testing is performed by an allergy specialist to determine the type of insect that responsible for the venom allergy. Then the patient receives a series of injections of the venom from the same insect(s). Starting dose is minute but increasingly larger doses are given until the venom doses several times larger than a single insect sting can be tolerated. This type of program must be administered by an allergy specialist, and it usually takes 20 weekly injections to eliminate this abnormal and exaggerated sensitivity. These are followed up with monthly booster shots and continued for 3 to 5 years to consolidate the cure.
Self-care tips
There are many ways you can help prevent insect bites and stings. Don’t use flowery colognes, soaps, or lotions, or wear brightly colored clothing, which attract insects. Do not keep open garbage or food that attract stinging insects when you are outdoors. Avoid drinking sweet beverages especially from open cans that have been left unattended and may harbor insects. Wear light, protective clothing such as long sleeves top and long pants whenever you will be outside for longer periods of time. Wear work gloves when you are gardening. Do not walk barefoot on the grass where insects are difficult to detect and can be stepped on. If an insect is near you, move away. Do not swat at the insect, which may awaken its defensive instincts and trigger aggressive behavior. Make sure any insect nests around your home are removed and destroyed.
Insect venom allergy is a harmful reaction to insect stings that occurs in people who have an abnormally high sensitivity to insect venom. It is an acquired trait, which is not present at the first exposure to the venom, but sensitization can occur after the first or subsequent exposures. Animals classified as insects usually have three main body segments (head, thorax and abdomen), six legs and a pair of sensory antennae. Winged insect species have two sets of wings, such as mosquitoes, bees, and wasps. Other biting or stinging insects include fleas, lice, and ants. Many other related animals that are frequently mistaken for insects such as ticks, spiders and mites also bite human beings. They can transmit infectious diseases or cause poisoning but generally do not cause allergic reactions. Allergic reactions to the venom of some stinging insects, such as honey bee, yellow jacket, hornet, wasp or fire ant can be life threatening.
Who gets it?
Anyone can experience an allergic reaction to an insect bite or sting. However, only a small number of people with insect bite or sting allergies suffer fatal reactions.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen, in this case the insect venom. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. In fact, most people with insect bite or sting allergies do not experience a severe reaction with their first bite. Multiple bites or stings increase the risk of an allergic reaction, but just one bite will cause serious symptoms for someone who is severely allergic.
What insects are usually involved?
Most serious allergic reactions to insect venom are caused by stinging insects, such as bees, yellow jackets, hornets, wasps and imported fire ants. As natives of the tropics, fire ants can live only in the warmer climate of the southern states and cannot survive in Pennsylvania. They are extremely aggressive and sting exposed parts of the skin when they feel threatened. Bites or stings from other insects usually do not cause allergic reaction.
What are the symptoms?
Symptoms of insect venom allergy often begin within 15 to 30 minutes and arise distant from the site of sting. The first symptom is often itchiness that can affect all or any part of the skin, the eyes and the nose. As symptoms progress, the patient begins to sneeze, cough and wheeze, feel congested, and develop hives or swelling. These symptoms may be warning signs of a dangerous condition called anaphylaxis. Symptoms of anaphylaxis include sudden anxiety and weakness, difficulty breathing, tightness in the chest, lightheadedness and palpitation, and loss of consciousness. Anaphylactic shock can occur within minutes and result in death. Anaphylaxis is a medical emergency that needs immediate medical treatment, and any delay may reduce the chance of survival.
How is it diagnosed?
Insect venom allergy is suspected based on a constellation of suggestive symptoms that follow an insect sting. The diagnosis is confirmed by performing a skin test with the venom of specific insects, such as honey bee, yellow jacket, hornet, wasp or fire ant that may be the culprit of the allergic reaction.
What is the treatment?
If you have been bitten or stung by an insect, carefully remove the stinger, if it is left behind. Wash the bite/sting area gently with soap and water. Apply ice to the site of sting. People who are allergic to insect bites should, of course, avoid situations in which they are likely to get stung or bitten. Mild reactions, such as pain, itching, and swelling, can be treated with an over-the counter antihistamine, pain reliever and topical corticosteroid creams. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe insect venom allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek emergency medical care after any type of reaction to an insect bite or sting.
People who are severely allergic to the venom of stinging insects, such as bees, yellow jackets, hornets, wasps or fire ants may, undergo a desensitization. First, skin testing is performed by an allergy specialist to determine the type of insect that responsible for the venom allergy. Then the patient receives a series of injections of the venom from the same insect(s). Starting dose is minute but increasingly larger doses are given until the venom doses several times larger than a single insect sting can be tolerated. This type of program must be administered by an allergy specialist, and it usually takes 20 weekly injections to eliminate this abnormal and exaggerated sensitivity. These are followed up with monthly booster shots and continued for 3 to 5 years to consolidate the cure.
Self-care tips
There are many ways you can help prevent insect bites and stings. Don’t use flowery colognes, soaps, or lotions, or wear brightly colored clothing, which attract insects. Do not keep open garbage or food that attract stinging insects when you are outdoors. Avoid drinking sweet beverages especially from open cans that have been left unattended and may harbor insects. Wear light, protective clothing such as long sleeves top and long pants whenever you will be outside for longer periods of time. Wear work gloves when you are gardening. Do not walk barefoot on the grass where insects are difficult to detect and can be stepped on. If an insect is near you, move away. Do not swat at the insect, which may awaken its defensive instincts and trigger aggressive behavior. Make sure any insect nests around your home are removed and destroyed.
Bee Sting Allergy
What is it?
Bee sting allergies occur in people who have an abnormally high sensitivity to bee stings, which cause a physical reaction. Allergic reactions to bee stings can be life threatening.
Who gets it?
Anyone can suffer allergic reactions to bee stings. Although more people die from severe allergic reactions to bee stings each year than from snake bites, only a small number of people with bee sting allergies suffer these types of fatal reactions.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen, in this case the bee sting. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. In fact, most people with bee sting allergies do not experience a severe reaction with their first sting. Multiple stings increase the risk of an allergic reaction, but just one sting will cause serious symptoms for someone who is severely allergic.
What are the symptoms?
Bee sting allergy symptoms often begin with a dry cough. Then, the eye area begins to itch and swell. As symptoms progress, the patient begins to sneeze and wheeze, and develop hives that itch. These symptoms may be warning signs of a dangerous condition called anaphylaxis. Symptoms include sudden anxiety and weakness, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Bee sting allergies are diagnosed according to the specific symptoms that follow a bee sting.
What is the treatment?
People who are allergic to bee stings should, of course, avoid situations in which they are likely to get stung. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe bee sting allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of reaction to a bee sting. People who are severely allergic may undergo a desensitization program, in which a series of injections of bee venom are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
There are many ways you can help prevent bee stings. Don’t use flowery colognes, soaps, or lotions, or wear brightly colored clothing, which attract bees. If a bee is near you, move away. Do not swat at the bee, which may aggravate it. Make sure any bee or wasp nests around your home are removed and destroyed
Bee sting allergies occur in people who have an abnormally high sensitivity to bee stings, which cause a physical reaction. Allergic reactions to bee stings can be life threatening.
Who gets it?
Anyone can suffer allergic reactions to bee stings. Although more people die from severe allergic reactions to bee stings each year than from snake bites, only a small number of people with bee sting allergies suffer these types of fatal reactions.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen, in this case the bee sting. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. In fact, most people with bee sting allergies do not experience a severe reaction with their first sting. Multiple stings increase the risk of an allergic reaction, but just one sting will cause serious symptoms for someone who is severely allergic.
What are the symptoms?
Bee sting allergy symptoms often begin with a dry cough. Then, the eye area begins to itch and swell. As symptoms progress, the patient begins to sneeze and wheeze, and develop hives that itch. These symptoms may be warning signs of a dangerous condition called anaphylaxis. Symptoms include sudden anxiety and weakness, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Bee sting allergies are diagnosed according to the specific symptoms that follow a bee sting.
What is the treatment?
People who are allergic to bee stings should, of course, avoid situations in which they are likely to get stung. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe bee sting allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of reaction to a bee sting. People who are severely allergic may undergo a desensitization program, in which a series of injections of bee venom are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
There are many ways you can help prevent bee stings. Don’t use flowery colognes, soaps, or lotions, or wear brightly colored clothing, which attract bees. If a bee is near you, move away. Do not swat at the bee, which may aggravate it. Make sure any bee or wasp nests around your home are removed and destroyed
Rhinitis
Also known as: Allergic Rhinitis, hay fever
What is it?
Rhinitis is inflammation of the nasal mucous membranes. Allergic rhinitis is rhinitis caused by allergies to airborne substances, such as pollen, dust, animal dander, or molds. The substances that cause allergic reactions are called allergens. Allergic rhinitis can be a seasonal or year-round (perennial) condition. The same person can have both types.
Who gets it?
Allergic rhinitis is an extremely common type of allergy that can affect anyone, and develop at any age. Allergies are not inherited, but it has been found that if a family member has a sensitivity to a certain substance, other family members are more likely to have the same or similar sensitivity.
What causes it?
Seasonal allergic rhinitis, while called hay fever, is actually caused by airborne pollens from grasses and trees. Dust mites, mold spores, animal dander, and feathers commonly cause perennial allergic rhinitis. However, other causes can include perfumes, chemicals, cigarette smoke, cleansers, and cosmetics. An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin and mucous membranes. This is why an allergic person experiences swelling, redness, itching, and runny nose.
What are the symptoms?
Allergic rhinitis affects the nose, causing sneezing, a clear discharge, and itching. The eyes may also be red, watery, and itchy. The throat may become irritated from nasal drip and coughing. Swelling in the sinuses causes congestion. Some patients with allergic rhinitis have headaches and feel tired because their symptoms make sleep difficult. Symptoms of seasonal allergic rhinitis occur in the spring, summer, and early fall and flare up after spending time outside. Symptoms of perennial allergic rhinitis flare up indoors.
How is it diagnosed?
If you have cold symptoms that last longer than a week, you doctor will test for a bacterial infection by studying a sample of your nasal discharge, called a nasal smear. He or she will also examine your nose for any abnormalities that could be causing your symptoms. If other possible causes are ruled out, your doctor may perform further tests for allergies, or refer you to a specialist called an allergist. A diagnosis of allergic rhinitis can usually be made without further tests if rhinitis symptoms come and go with the seasons. Tests for allergies include blood and skin tests, and nasal smears. Another type of test, called a provocation test, involves exposing the patient to very small amounts of possible allergens, either through swallowing or inhaling, to see if there is an allergic response.
What is the treatment?
If you have allergic rhinitis, your doctor will recommend that you avoid the substances that are known allergens for you. When rhinitis is seasonal or involves substances that are hard to avoid, medication can be prescribed to relieve symptoms. The most commonly used drugs are antihistamines, decongestants, corticosteroid sprays, and cromolyn nasal sprays. Immunotherapy is a type of desensitizing treatment in which a series of injections of a known allergen are given in increasingly larger doses until the body shows that it can be tolerated. An allergy specialist must administer this type of program and it may take a long period of time to develop an immunity. These injections are followed by periodic booster shots. There are many alternative treatments for allergic responses, most of which involve diet and lifestyle. Your doctor can discuss these with you and help you determine whether any are right for you.
Self-care tips
If you have allergic rhinitis, there are ways to reduce your exposure to allergens. For example, use an air conditioner and air purifier during the seasons when pollen levels are high. Keep your house as free of dust as possible by damp mopping and using a vacuum cleaner with a special filter designed to trap fine particles. Avoid contact with animals, or keep your pets bathed and well groomed.
What is it?
Rhinitis is inflammation of the nasal mucous membranes. Allergic rhinitis is rhinitis caused by allergies to airborne substances, such as pollen, dust, animal dander, or molds. The substances that cause allergic reactions are called allergens. Allergic rhinitis can be a seasonal or year-round (perennial) condition. The same person can have both types.
Who gets it?
Allergic rhinitis is an extremely common type of allergy that can affect anyone, and develop at any age. Allergies are not inherited, but it has been found that if a family member has a sensitivity to a certain substance, other family members are more likely to have the same or similar sensitivity.
What causes it?
Seasonal allergic rhinitis, while called hay fever, is actually caused by airborne pollens from grasses and trees. Dust mites, mold spores, animal dander, and feathers commonly cause perennial allergic rhinitis. However, other causes can include perfumes, chemicals, cigarette smoke, cleansers, and cosmetics. An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin and mucous membranes. This is why an allergic person experiences swelling, redness, itching, and runny nose.
What are the symptoms?
Allergic rhinitis affects the nose, causing sneezing, a clear discharge, and itching. The eyes may also be red, watery, and itchy. The throat may become irritated from nasal drip and coughing. Swelling in the sinuses causes congestion. Some patients with allergic rhinitis have headaches and feel tired because their symptoms make sleep difficult. Symptoms of seasonal allergic rhinitis occur in the spring, summer, and early fall and flare up after spending time outside. Symptoms of perennial allergic rhinitis flare up indoors.
How is it diagnosed?
If you have cold symptoms that last longer than a week, you doctor will test for a bacterial infection by studying a sample of your nasal discharge, called a nasal smear. He or she will also examine your nose for any abnormalities that could be causing your symptoms. If other possible causes are ruled out, your doctor may perform further tests for allergies, or refer you to a specialist called an allergist. A diagnosis of allergic rhinitis can usually be made without further tests if rhinitis symptoms come and go with the seasons. Tests for allergies include blood and skin tests, and nasal smears. Another type of test, called a provocation test, involves exposing the patient to very small amounts of possible allergens, either through swallowing or inhaling, to see if there is an allergic response.
What is the treatment?
If you have allergic rhinitis, your doctor will recommend that you avoid the substances that are known allergens for you. When rhinitis is seasonal or involves substances that are hard to avoid, medication can be prescribed to relieve symptoms. The most commonly used drugs are antihistamines, decongestants, corticosteroid sprays, and cromolyn nasal sprays. Immunotherapy is a type of desensitizing treatment in which a series of injections of a known allergen are given in increasingly larger doses until the body shows that it can be tolerated. An allergy specialist must administer this type of program and it may take a long period of time to develop an immunity. These injections are followed by periodic booster shots. There are many alternative treatments for allergic responses, most of which involve diet and lifestyle. Your doctor can discuss these with you and help you determine whether any are right for you.
Self-care tips
If you have allergic rhinitis, there are ways to reduce your exposure to allergens. For example, use an air conditioner and air purifier during the seasons when pollen levels are high. Keep your house as free of dust as possible by damp mopping and using a vacuum cleaner with a special filter designed to trap fine particles. Avoid contact with animals, or keep your pets bathed and well groomed.
Alcoholism and Alcohol Abuse
Also known as: Alcohol dependence
What is it?
Alcoholism is a disorder that is characterized by an excessive dependence upon and craving for alcoholic beverages. This dependence affects every aspect of the alcoholic’s life - socially, personally, and professionally – and can lead to physical and psychological harm to the alcoholic and often to those around him or her. Many people consider alcoholism and alcohol abuse to be the same. However, a person who abuses alcohol does not crave alcohol or become dependent on it. The alcohol abuser has a pattern of excessive drinking that results in poor judgment and recurring social, legal, or professional consequences of the abuse. Prolonged alcohol abuse often leads to alcoholism.
Who gets it?
Anyone who drinks alcohol can fall into the trap of alcoholism. However, people who have a family history of alcohol abuse disorders are more likely to also have this disorder. Men are more likely to become alcoholics than women. Adolescents are at higher risk for alcohol abuse because of the tendency to binge drink.
What causes it?
Many factors can contribute to alcoholism and alcohol abuse. These can include depression, a disruptive home life, peer pressure, and job problems. Those with a family history of alcoholism may have a genetically inherited lower sensitivity to alcohol, which means they can drink more without feeling the effects. It is difficult to separate the effects of environment and heredity as a cause of alcoholism.
What are the symptoms?
Alcoholics have an uncontrollable craving for alcohol. While they may recognize that their use of alcohol is self-destructive and hurts others, they are unable to resist the compulsion to drink and are unable to control the amount of alcohol they drink at one time. With time, alcoholics need to drink more and more to feel good because they develop a tolerance for alcohol. An alcoholic who suddenly stops drinking will develop withdrawal symptoms, similar to a drug addict. These might include weakness, tremors, sweating, and nausea. More serious withdrawal symptoms include seizures, hallucinations, and delirium tremens (DTs). The DTs is a severe onset of anxiousness, confusion, and delirium, accompanied by high fever, that can be fatal if untreated. Untreated alcoholism can damage just about every organ in the body. Complications of alcoholism can include liver damage (cirrhosis), brain damage, heart failure, persistent tremor, depression, malnutrition, stomach ulcers, high blood pressure, decreased sex drive, bleeding in the esophagus, and certain cancers, particularly of the throat, liver, pancreas, and esophagus. Many alcoholics have a thiamine deficiency, which can cause Korsakoff’s and Wernicke’s syndromes.
With Korsakoff’s, the patient cannot remember recent events. Wernicke’s is characterized by a loss of coordination and abnormal eye movements. Abusing alcohol can also result in nausea, vomiting, diarrhea, memory loss, slurred speech, and difficulty with coordination. Pregnant women who drink are more likely to have children with birth defects (fetal alcohol syndrome), and drunken drivers are more likely to cause accidents that may result in death. Alcoholics are also more likely to commit suicide, or physically harm another person. People who abuse alcohol, but are not alcoholics, drink to the point where their good judgment is impaired. These people usually have a pattern of letting drinking interfere with personal or professional responsibilities, binge drinking, or drinking and driving. These patterns are also true of alcoholics.
How is it diagnosed?
Doctors define moderate alcohol use as up to two drinks per day for men and one drink per day for women and the elderly. To diagnose alcoholism or alcohol abuse, your doctor will ask you about your drinking habits. How often do you drink? How many drinks do you have per day or week? How do you feel if you don’t drink? Do you drink in the morning to relieve a hangover? The doctor will want to know why and when you are more likely to drink, if you have felt guilty about your drinking, if you ever experience withdrawal symptoms as a result of not drinking alcohol, if you find yourself choosing to drink over other activities, and if your drinking has had an effect on your job performance and personal relationships, or has resulted in legal problems. The doctor will take your medical history and perform a physical examination. He or she may order blood tests.
What is the treatment?
Someone who is an alcoholic or abuses alcohol regularly must stop drinking all together. There is no cure for alcoholism that allows the patient to drink socially without relapses into old habits. Successful treatment requires behavioral therapy and a strong support system. Because of this, treatment programs must have family participation, if possible. During treatment, your doctor will monitor your progress. Treatment begins with detoxification, which is a medically supervised program to rid the body of the toxic effects of the alcohol. Detoxification results in mild to severe withdrawals symptoms. Patients suffering severe withdrawal symptoms may be treated in a hospital setting with sedative medications to help relieve symptoms and intravenous (IV) fluids to replace those lost through nausea and vomiting. These fluids often include essential nutrients, such as thiamine, that are typically low in alcoholics. Detoxification is followed by rehabilitation, which helps restore the patient’s physical and mental health. Most alcoholics benefit from a program, such as Alcoholics Anonymous, that provides peer support and step-by-step guidance for abstaining from alcohol. Some patients take a prescription drug, such as disulfiram, which causes extremely unpleasant side effects if combined with alcohol, or naltrexone, which helps curb alcohol craving. People who are not alcoholics, but abuse alcohol, are also treated with behavioral therapy to help them examine the reasons they drink, face the consequences of their drinking, and find ways to avoid those situations.
Self-care tips
People who are diagnosed alcoholics or alcohol abusers face a life-long recovery process. While it is not uncommon to experience a relapse, it is important to seek the support you need to continue to be alcohol-free. Because teenagers are in the highest risk group for alcohol abuse, it is extremely important for parents to educate their children about the dangers of alcohol consumption and provide a model of healthy behavior in terms of alcohol use.
What is it?
Alcoholism is a disorder that is characterized by an excessive dependence upon and craving for alcoholic beverages. This dependence affects every aspect of the alcoholic’s life - socially, personally, and professionally – and can lead to physical and psychological harm to the alcoholic and often to those around him or her. Many people consider alcoholism and alcohol abuse to be the same. However, a person who abuses alcohol does not crave alcohol or become dependent on it. The alcohol abuser has a pattern of excessive drinking that results in poor judgment and recurring social, legal, or professional consequences of the abuse. Prolonged alcohol abuse often leads to alcoholism.
Who gets it?
Anyone who drinks alcohol can fall into the trap of alcoholism. However, people who have a family history of alcohol abuse disorders are more likely to also have this disorder. Men are more likely to become alcoholics than women. Adolescents are at higher risk for alcohol abuse because of the tendency to binge drink.
What causes it?
Many factors can contribute to alcoholism and alcohol abuse. These can include depression, a disruptive home life, peer pressure, and job problems. Those with a family history of alcoholism may have a genetically inherited lower sensitivity to alcohol, which means they can drink more without feeling the effects. It is difficult to separate the effects of environment and heredity as a cause of alcoholism.
What are the symptoms?
Alcoholics have an uncontrollable craving for alcohol. While they may recognize that their use of alcohol is self-destructive and hurts others, they are unable to resist the compulsion to drink and are unable to control the amount of alcohol they drink at one time. With time, alcoholics need to drink more and more to feel good because they develop a tolerance for alcohol. An alcoholic who suddenly stops drinking will develop withdrawal symptoms, similar to a drug addict. These might include weakness, tremors, sweating, and nausea. More serious withdrawal symptoms include seizures, hallucinations, and delirium tremens (DTs). The DTs is a severe onset of anxiousness, confusion, and delirium, accompanied by high fever, that can be fatal if untreated. Untreated alcoholism can damage just about every organ in the body. Complications of alcoholism can include liver damage (cirrhosis), brain damage, heart failure, persistent tremor, depression, malnutrition, stomach ulcers, high blood pressure, decreased sex drive, bleeding in the esophagus, and certain cancers, particularly of the throat, liver, pancreas, and esophagus. Many alcoholics have a thiamine deficiency, which can cause Korsakoff’s and Wernicke’s syndromes.
With Korsakoff’s, the patient cannot remember recent events. Wernicke’s is characterized by a loss of coordination and abnormal eye movements. Abusing alcohol can also result in nausea, vomiting, diarrhea, memory loss, slurred speech, and difficulty with coordination. Pregnant women who drink are more likely to have children with birth defects (fetal alcohol syndrome), and drunken drivers are more likely to cause accidents that may result in death. Alcoholics are also more likely to commit suicide, or physically harm another person. People who abuse alcohol, but are not alcoholics, drink to the point where their good judgment is impaired. These people usually have a pattern of letting drinking interfere with personal or professional responsibilities, binge drinking, or drinking and driving. These patterns are also true of alcoholics.
How is it diagnosed?
Doctors define moderate alcohol use as up to two drinks per day for men and one drink per day for women and the elderly. To diagnose alcoholism or alcohol abuse, your doctor will ask you about your drinking habits. How often do you drink? How many drinks do you have per day or week? How do you feel if you don’t drink? Do you drink in the morning to relieve a hangover? The doctor will want to know why and when you are more likely to drink, if you have felt guilty about your drinking, if you ever experience withdrawal symptoms as a result of not drinking alcohol, if you find yourself choosing to drink over other activities, and if your drinking has had an effect on your job performance and personal relationships, or has resulted in legal problems. The doctor will take your medical history and perform a physical examination. He or she may order blood tests.
What is the treatment?
Someone who is an alcoholic or abuses alcohol regularly must stop drinking all together. There is no cure for alcoholism that allows the patient to drink socially without relapses into old habits. Successful treatment requires behavioral therapy and a strong support system. Because of this, treatment programs must have family participation, if possible. During treatment, your doctor will monitor your progress. Treatment begins with detoxification, which is a medically supervised program to rid the body of the toxic effects of the alcohol. Detoxification results in mild to severe withdrawals symptoms. Patients suffering severe withdrawal symptoms may be treated in a hospital setting with sedative medications to help relieve symptoms and intravenous (IV) fluids to replace those lost through nausea and vomiting. These fluids often include essential nutrients, such as thiamine, that are typically low in alcoholics. Detoxification is followed by rehabilitation, which helps restore the patient’s physical and mental health. Most alcoholics benefit from a program, such as Alcoholics Anonymous, that provides peer support and step-by-step guidance for abstaining from alcohol. Some patients take a prescription drug, such as disulfiram, which causes extremely unpleasant side effects if combined with alcohol, or naltrexone, which helps curb alcohol craving. People who are not alcoholics, but abuse alcohol, are also treated with behavioral therapy to help them examine the reasons they drink, face the consequences of their drinking, and find ways to avoid those situations.
Self-care tips
People who are diagnosed alcoholics or alcohol abusers face a life-long recovery process. While it is not uncommon to experience a relapse, it is important to seek the support you need to continue to be alcohol-free. Because teenagers are in the highest risk group for alcohol abuse, it is extremely important for parents to educate their children about the dangers of alcohol consumption and provide a model of healthy behavior in terms of alcohol use.
Alcoholic Liver Disease
What is it?
Alcoholic liver disease is an inflammation of the liver cells from exposure to alcohol.
Who gets it?
Anyone who consumes alcohol is at risk to develop the disease, even moderate drinkers or social drinkers. Episodes of Alcoholic Hepatitis can place individuals at increased risk of developing cirrhosis. Women are at increased risk to develop liver damage.
What are the symptoms?
Symptoms of Alcoholic Liver Disease include nausea, vomiting, abdominal pain, fever jaundice, and loss of appetite. Alcoholic hepatitis may lead to cirrhosis of the liver with the continued ingestion of alcohol.
Diagnosis
Blood tests may aid in the diagnosis. Liver biopsy is helpful in establishing between alcoholic hepatitis and alcoholic cirrhosis. The disease may come and go depending on the amount and frequency of consumption.
Treatment
The most effective treatment is to stop alcohol consumption before cirrhosis develops. Alcoholic hepatitis may be treated with Corticosteroids to reduce inflammation, good nutrition and rest is also important. Avoidance of potentially liver toxic medications and chemicals is also important. The prognosis is hopeful for individuals with Alcoholic Hepatitis. Prevention of Alcoholic Cirrhosis is crucial to long term survival. Liver Transplantation may be necessary for progressive disease that leads to cirrhosis.
Alcoholic liver disease is an inflammation of the liver cells from exposure to alcohol.
Who gets it?
Anyone who consumes alcohol is at risk to develop the disease, even moderate drinkers or social drinkers. Episodes of Alcoholic Hepatitis can place individuals at increased risk of developing cirrhosis. Women are at increased risk to develop liver damage.
What are the symptoms?
Symptoms of Alcoholic Liver Disease include nausea, vomiting, abdominal pain, fever jaundice, and loss of appetite. Alcoholic hepatitis may lead to cirrhosis of the liver with the continued ingestion of alcohol.
Diagnosis
Blood tests may aid in the diagnosis. Liver biopsy is helpful in establishing between alcoholic hepatitis and alcoholic cirrhosis. The disease may come and go depending on the amount and frequency of consumption.
Treatment
The most effective treatment is to stop alcohol consumption before cirrhosis develops. Alcoholic hepatitis may be treated with Corticosteroids to reduce inflammation, good nutrition and rest is also important. Avoidance of potentially liver toxic medications and chemicals is also important. The prognosis is hopeful for individuals with Alcoholic Hepatitis. Prevention of Alcoholic Cirrhosis is crucial to long term survival. Liver Transplantation may be necessary for progressive disease that leads to cirrhosis.
HIV and AIDS
What is it?
HIV stands for human immunodeficiency virus. It is an infection that steadily attacks and destroys the body’s infection fighting cells, called lymphocytes, and causes the disease called AIDS (acquired immunodeficiency syndrome). HIV was identified in the United States in 1981. So many cases have been reported that HIV/AIDS is considered an epidemic.
Who gets it?
HIV and AIDS have been reported throughout the United States and the world, affecting all age groups, including infants born to mothers who are HIV infected. Certain groups of people are at a higher risk for getting HIV and eventually developing AIDS. These include homosexual and bisexual men, people who use intravenous (IV) drugs, people who share needles (for drug use, tattooing, or body piercing), heterosexuals who have more than one sexual partner, and anyone who has sex with anyone in these groups or has a sexual partner who has tested positive for HIV. Also at risk are people who receive transfusions of blood or blood products that haven’t been tested for HIV. While all donated blood is now carefully screened for HIV, that was not the case before HIV was identified. For this reason, men who have a blood condition called hemophilia were more likely to develop HIV through transfusions of blood and blood products. Healthcare professionals who are accidentally pricked by a contaminated needle also risk developing the infection. Many cases of AIDS have been reported in Haiti and east central Africa, so immigrants to the United States from these areas are also at higher risk.
What causes it?
HIV is caused by a retrovirus, which is a type of virus that releases its genetic code, called RNA, into a healthy cell. The virus also contains an enzyme called reverse transcriptase that converts the virus’ RNA to DNA and allows it to reproduce. This is how the virus attacks the immune system. The body’s immune system fights infection by producing white blood cells, called T-cell lymphocytes, and proteins called antibodies. HIV reproduces inside the T-cells. Eventually, this destroys the cells and releases particles of the virus, which then attack other T-cells and the damage continues. As more and more T-cells are destroyed, the immune system is weakened to the point that the body becomes unable to fight infections. The patient develops other diseases and cancers, called opportunistic infections because they take advantage of the patient’s weakened immune system. When this occurs, the patient is diagnosed with full-blown AIDS. You cannot get HIV through casual contact, such as hugging or shaking hands, by eating food prepared by someone with the virus, or through the air. HIV is spread by direct contact with infected bodily fluids, which includes blood, semen, or vaginal secretions. Direct contact refers to sex, HIV-infected blood transfusions or organ transplants, and needle sharing. Small amounts of HIV have also been found in saliva, tears, breast milk, cerebrospinal fluid (CSF), urine, and feces.
What are the symptoms?
Within weeks to months after being infected with HIV, a person may feel flu-like symptoms, such as a fever, swollen lymph nodes, headache, gastrointestinal disorders, skin rashes, loss of appetite, and general fatigue. These symptoms are referred to as acute retroviral syndrome and may come and go as the virus goes to work, reproducing and destroying lymphocytes. This is referred to as the latency period, and may last for as long as 10 years. While the patient may have no significant symptoms during this time, the lymph nodes in the jaw, neck, armpits, and groin usually remain enlarged. Symptoms of full-blown AIDS may not appear for months to even years. However, during this time the virus that causes HIV is circulating in the bloodstream and can be passed on to others through bodily fluids. Symptoms of AIDS include swollen lymph nodes, a fever that comes and goes and lasts anywhere from a few days to a month, chills, sweats, significant weight loss, fatigue, diarrhea, joint and muscle pain, sore throat, a fungal infection of the mouth called thrush, chronic vaginal yeast infections, and viral skin infections, such as herpes sores around the mouth. Opportunistic infections also indicate AIDS, and can include cancers such as Kaposi's sarcoma (a tumor that appears as red to purple raised patches on the skin), non-Hodgkin’s lymphoma, and cervical cancer; pneumonia caused by the fungus Pneumocystis carinii (PCP); tuberculosis; meningitis; and kidney disease. AIDS patients are very susceptible to viral infections, such as cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), and Epstein-Barr virus (EBV). CMV can affect the retina of the eye and cause blindness. In fact, vision problems may be one of the first signs of an opportunistic infection. AIDS can also affect the nervous system, with infection causing symptoms ranging from general weakness to a feeling of numbness or burning in the feet or lower legs. Symptoms such as a loss of strength in the arms or legs and problems with coordination and balance indicate a viral infection of the brain called progressive multifocal leukoencephalopathy (PML). AIDS dementia complex, which causes difficulty with reasoning, memory, and concentration, is another symptom of late stage AIDS. Children with HIV have symptoms that include growth problems, frequent infections, recurring fevers, and low blood cell counts. Children with AIDS generally develop lung inflammations, AIDS-related brain disorders, and bacterial infections.
How is it diagnosed?
HIV is diagnosed through a blood test called the ELISA test, which detects HIV antibodies. If the ELISA test is positive for HIV, your doctor will order additional blood tests, such as one called the Western blot test, to confirm the result. If you are diagnosed with HIV, your doctor will perform a complete physical exam and take a complete medical history, including a discussion of your sexual history, any sexually transmitted diseases you have had, and any history of drug use. Your doctor will order tests for other infections that can become worse if you have HIV. These include hepatitis B, tuberculosis, and syphilis. He or she will also order tests for opportunistic infections, according to the types of symptoms you are having.
What is the treatment?
Once HIV has been diagnosed, you will have regular laboratory tests to measure the progression of the disease. One of these is called a CD4 lymphocyte cell count. This test measures the number of CD4 cells, a white blood cell, in the blood. High levels mean the immune system is working well. If levels are good, your doctor will repeat the test every six months. Once levels drop below 600 per microliter of blood, the test will be performed more frequently. The viral load test measures the amount of HIV in your blood. Levels above 10,000 viruses per milliliter of blood are considered high. Treatment for HIV and AIDS focuses on slowing down or stopping the ability of the virus to reproduce and destroy healthy lymphocytes, and begins when the CD4 lymphocyte cell count and viral load test show the disease is progressing. Antiretroviral drugs such as zidovudine (ZDV or AZT), didanosine (ddI), lamivudine (3TC), and other drugs called protease inhibitors (saquinavir, ritonavir, indinavir, and nelfinavir) all stop the virus from reproducing and slow the progression of the HIV infection. Other drugs called non-nucleoside reverse transcriptase inhibitors, such as nevirapine and delavirdine, are also used. However, after a period of time, HIV develops a resistance to these drugs. For this reason, the drugs are used in a combination that may need to be changed frequently. These drugs do have possible side effects, which your doctor will discuss with you. Drugs are also prescribed to prevent infections such as pneumocystis pneumonia, tetanus, tuberculosis, and hepatitis B. Patients who have recurring thrush usually are given an antifungal drug such as fluconazole. Those who have repeated herpes simplex infections take the antiviral drug acyclovir. Pregnant women who are HIV positive can be treated with AZT during pregnancy to decrease the risk of passing the virus on to the baby. It is important to have regular dental exams if you have HIV so any infections in the mouth are identified quickly. Once HIV develops into AIDS, your doctor will prescribe additional and appropriate treatments for any opportunistic infections. New drug treatments have greatly improved the prognosis for someone with HIV or AIDS. Many people also turn to alternative treatments to help boost the immune system, control pain, and relieve the side effects of HIV/AIDS medications. These include herbal medicines, special diets, vitamin therapy, acupuncture, meditation, massage, chiropractic therapy, and creative visualization.
Self-care tips
You can prevent infection with HIV by practicing safe sex and choosing your sexual partners carefully. Never use intravenous drugs or share needles. If you have decided to get a tattoo or body piercing, make sure the person providing the service is using only clean, sterile needles that have not been used on anyone else. While it is now highly unlikely that you will develop HIV from an infected blood transfusion, you can donate your own blood before any surgeries to ensure the safety of the blood if you need a transfusion. If you engage in activities that put you at a high risk for HIV and AIDS, get tested. Even if your test is negative, you should follow your doctor’s recommendations for a schedule of retesting. If you have been diagnosed with HIV or AIDS, follow your doctor’s treatment recommendations. If you are sexually active, always use a condom and tell your partner that you are HIV positive. Call your doctor immediately if your symptoms change in any way. Never donate blood or blood products, semen, or any organs.
HIV stands for human immunodeficiency virus. It is an infection that steadily attacks and destroys the body’s infection fighting cells, called lymphocytes, and causes the disease called AIDS (acquired immunodeficiency syndrome). HIV was identified in the United States in 1981. So many cases have been reported that HIV/AIDS is considered an epidemic.
Who gets it?
HIV and AIDS have been reported throughout the United States and the world, affecting all age groups, including infants born to mothers who are HIV infected. Certain groups of people are at a higher risk for getting HIV and eventually developing AIDS. These include homosexual and bisexual men, people who use intravenous (IV) drugs, people who share needles (for drug use, tattooing, or body piercing), heterosexuals who have more than one sexual partner, and anyone who has sex with anyone in these groups or has a sexual partner who has tested positive for HIV. Also at risk are people who receive transfusions of blood or blood products that haven’t been tested for HIV. While all donated blood is now carefully screened for HIV, that was not the case before HIV was identified. For this reason, men who have a blood condition called hemophilia were more likely to develop HIV through transfusions of blood and blood products. Healthcare professionals who are accidentally pricked by a contaminated needle also risk developing the infection. Many cases of AIDS have been reported in Haiti and east central Africa, so immigrants to the United States from these areas are also at higher risk.
What causes it?
HIV is caused by a retrovirus, which is a type of virus that releases its genetic code, called RNA, into a healthy cell. The virus also contains an enzyme called reverse transcriptase that converts the virus’ RNA to DNA and allows it to reproduce. This is how the virus attacks the immune system. The body’s immune system fights infection by producing white blood cells, called T-cell lymphocytes, and proteins called antibodies. HIV reproduces inside the T-cells. Eventually, this destroys the cells and releases particles of the virus, which then attack other T-cells and the damage continues. As more and more T-cells are destroyed, the immune system is weakened to the point that the body becomes unable to fight infections. The patient develops other diseases and cancers, called opportunistic infections because they take advantage of the patient’s weakened immune system. When this occurs, the patient is diagnosed with full-blown AIDS. You cannot get HIV through casual contact, such as hugging or shaking hands, by eating food prepared by someone with the virus, or through the air. HIV is spread by direct contact with infected bodily fluids, which includes blood, semen, or vaginal secretions. Direct contact refers to sex, HIV-infected blood transfusions or organ transplants, and needle sharing. Small amounts of HIV have also been found in saliva, tears, breast milk, cerebrospinal fluid (CSF), urine, and feces.
What are the symptoms?
Within weeks to months after being infected with HIV, a person may feel flu-like symptoms, such as a fever, swollen lymph nodes, headache, gastrointestinal disorders, skin rashes, loss of appetite, and general fatigue. These symptoms are referred to as acute retroviral syndrome and may come and go as the virus goes to work, reproducing and destroying lymphocytes. This is referred to as the latency period, and may last for as long as 10 years. While the patient may have no significant symptoms during this time, the lymph nodes in the jaw, neck, armpits, and groin usually remain enlarged. Symptoms of full-blown AIDS may not appear for months to even years. However, during this time the virus that causes HIV is circulating in the bloodstream and can be passed on to others through bodily fluids. Symptoms of AIDS include swollen lymph nodes, a fever that comes and goes and lasts anywhere from a few days to a month, chills, sweats, significant weight loss, fatigue, diarrhea, joint and muscle pain, sore throat, a fungal infection of the mouth called thrush, chronic vaginal yeast infections, and viral skin infections, such as herpes sores around the mouth. Opportunistic infections also indicate AIDS, and can include cancers such as Kaposi's sarcoma (a tumor that appears as red to purple raised patches on the skin), non-Hodgkin’s lymphoma, and cervical cancer; pneumonia caused by the fungus Pneumocystis carinii (PCP); tuberculosis; meningitis; and kidney disease. AIDS patients are very susceptible to viral infections, such as cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), and Epstein-Barr virus (EBV). CMV can affect the retina of the eye and cause blindness. In fact, vision problems may be one of the first signs of an opportunistic infection. AIDS can also affect the nervous system, with infection causing symptoms ranging from general weakness to a feeling of numbness or burning in the feet or lower legs. Symptoms such as a loss of strength in the arms or legs and problems with coordination and balance indicate a viral infection of the brain called progressive multifocal leukoencephalopathy (PML). AIDS dementia complex, which causes difficulty with reasoning, memory, and concentration, is another symptom of late stage AIDS. Children with HIV have symptoms that include growth problems, frequent infections, recurring fevers, and low blood cell counts. Children with AIDS generally develop lung inflammations, AIDS-related brain disorders, and bacterial infections.
How is it diagnosed?
HIV is diagnosed through a blood test called the ELISA test, which detects HIV antibodies. If the ELISA test is positive for HIV, your doctor will order additional blood tests, such as one called the Western blot test, to confirm the result. If you are diagnosed with HIV, your doctor will perform a complete physical exam and take a complete medical history, including a discussion of your sexual history, any sexually transmitted diseases you have had, and any history of drug use. Your doctor will order tests for other infections that can become worse if you have HIV. These include hepatitis B, tuberculosis, and syphilis. He or she will also order tests for opportunistic infections, according to the types of symptoms you are having.
What is the treatment?
Once HIV has been diagnosed, you will have regular laboratory tests to measure the progression of the disease. One of these is called a CD4 lymphocyte cell count. This test measures the number of CD4 cells, a white blood cell, in the blood. High levels mean the immune system is working well. If levels are good, your doctor will repeat the test every six months. Once levels drop below 600 per microliter of blood, the test will be performed more frequently. The viral load test measures the amount of HIV in your blood. Levels above 10,000 viruses per milliliter of blood are considered high. Treatment for HIV and AIDS focuses on slowing down or stopping the ability of the virus to reproduce and destroy healthy lymphocytes, and begins when the CD4 lymphocyte cell count and viral load test show the disease is progressing. Antiretroviral drugs such as zidovudine (ZDV or AZT), didanosine (ddI), lamivudine (3TC), and other drugs called protease inhibitors (saquinavir, ritonavir, indinavir, and nelfinavir) all stop the virus from reproducing and slow the progression of the HIV infection. Other drugs called non-nucleoside reverse transcriptase inhibitors, such as nevirapine and delavirdine, are also used. However, after a period of time, HIV develops a resistance to these drugs. For this reason, the drugs are used in a combination that may need to be changed frequently. These drugs do have possible side effects, which your doctor will discuss with you. Drugs are also prescribed to prevent infections such as pneumocystis pneumonia, tetanus, tuberculosis, and hepatitis B. Patients who have recurring thrush usually are given an antifungal drug such as fluconazole. Those who have repeated herpes simplex infections take the antiviral drug acyclovir. Pregnant women who are HIV positive can be treated with AZT during pregnancy to decrease the risk of passing the virus on to the baby. It is important to have regular dental exams if you have HIV so any infections in the mouth are identified quickly. Once HIV develops into AIDS, your doctor will prescribe additional and appropriate treatments for any opportunistic infections. New drug treatments have greatly improved the prognosis for someone with HIV or AIDS. Many people also turn to alternative treatments to help boost the immune system, control pain, and relieve the side effects of HIV/AIDS medications. These include herbal medicines, special diets, vitamin therapy, acupuncture, meditation, massage, chiropractic therapy, and creative visualization.
Self-care tips
You can prevent infection with HIV by practicing safe sex and choosing your sexual partners carefully. Never use intravenous drugs or share needles. If you have decided to get a tattoo or body piercing, make sure the person providing the service is using only clean, sterile needles that have not been used on anyone else. While it is now highly unlikely that you will develop HIV from an infected blood transfusion, you can donate your own blood before any surgeries to ensure the safety of the blood if you need a transfusion. If you engage in activities that put you at a high risk for HIV and AIDS, get tested. Even if your test is negative, you should follow your doctor’s recommendations for a schedule of retesting. If you have been diagnosed with HIV or AIDS, follow your doctor’s treatment recommendations. If you are sexually active, always use a condom and tell your partner that you are HIV positive. Call your doctor immediately if your symptoms change in any way. Never donate blood or blood products, semen, or any organs.
Aging Skin
Also known as: Actinic Elastosis and Photoaging
What is it?
Skin undergoes normal changes with age. The most noticeable changes are dryness, wrinkles, changes in color and texture, and an increased number of benign (non-cancerous) and pre-cancerous growths. Some people who spend a lot of time in the sun experience a premature aging of the skin.
Who gets it?
Everyone’s skin changes with age. People with sun damage often see more dramatic effects than those who protect themselves from the sun. The fairer the skin, the more visible the effects of photoaging.
What causes it?
As we age, the skin becomes thinner. This is because the underlying fat, so abundant at infancy, is slowly lost. The skin’s connective tissue, called collagen and elastin, undergoes changes, causing the skin to lose firmness and become dry. The sweat- and oil-secreting glands in the skin also decrease, which makes it harder for the skin to hold moisture. The blood vessels naturally become more fragile, so they are more likely to rupture and leak into the skin. Effects of aging on the skin may also be attributed to damage caused by oxygen-free radicals. Free radicals are the waste products that result from all the chemical reactions that normally occur in the body. Oxygen-free radicals can damage cells and are believed to accelerate cancers and age-related diseases. Skin changes can also be caused by years of sun damage, poor nutrition, high stress levels, exposure to environmental pollution, and destructive lifestyle choices, such as cigarette smoking or alcohol and drug abuse.
What are the symptoms?
The symptoms of aging skin include dryness, itchiness, thinning or thickening of the skin, wrinkles and fine lines, areas of hyperpigmentation (called age or liver spots), and a mottled appearance. The skin may take more time to heal when injured. Blood vessels are easier to see through the thinning skin, also because they become dilated with age. These blood vessels may be visible as red dome-like formations on the skin (cherry angiomas), or as broken capillaries on the face (telangietasias). Many people develop senile or actinic purpura, which are purplish spots or patches on the skin created by small hemorrhages in the skin. Older skin has less protection against sun damage because protective cells called melanocytes decrease with age. Aging skin is also more likely to develop a variety of benign and pre-cancerous growths, such as seborrheic and actinic keratoses. Seborrheic keratoses often have a rough, brown appearance, and look like a wart. They are benign. Actinic keratoses are small, scaly growths on areas of the skin that have received sun exposure. They are an early sign of skin cancer.
How is it diagnosed?
Any changes in the skin should be checked by a dermatologist for signs of cancer or pre-cancer. Your doctor may need to take a tissue sample, called a biopsy, for examination under a microscope. Most symptoms of aging skin require no diagnosis.
What is the treatment?
Pharmaceutical and cosmetic companies have responded to the public’s desire to slow down or mask the aging process with a great number of treatments. Many of these are classified as antioxidants, which are substances that are thought to protect the body cells from the damaging effects of oxygen-free radicals. Antioxidants include vitamins A, C, E, and betacarotene, and are available in ointment, cream, lotion, and oral supplement forms. Some people use a vitamin-A based cream, or creams containing alpha-hydroxy acids (AHAs), to diminish the appearance of age spots and wrinkles. Laser treatments and bleaching are other options for removing age spots. Frequent moisturizing with an over-the-counter cream or lotion can relieve dry, itchy skin, but your doctor may prescribe a special lotion for severe dryness and itching. Other conditions of aging skin, such as seborrheic keratoses, broken blood vessels, and purpura require no treatment. However, they can be removed or their appearance diminished if they become irritated or are unsightly. Actinic keratoses are removed from the skin.
Self-care tips
Unfortunately, no one has figured out how to stop the aging process or reverse its effects. However, you can reduce the signs of aging in your skin by avoiding sun exposure during the peak hours of 10 a.m. to 2 p.m., and wearing sunscreen with a SPF of at least 15, a hat, and light, protective clothing. Follow a healthy lifestyle that includes a variety of nutritious foods, especially those rich in antioxidants; drinking plenty of water; and exercising regularly. Yearly skin exams are an effective way to catch new or changing skin grows in the early stages. See your doctor any time you notice an existing skin growth has changed in size, shape, or color.
What is it?
Skin undergoes normal changes with age. The most noticeable changes are dryness, wrinkles, changes in color and texture, and an increased number of benign (non-cancerous) and pre-cancerous growths. Some people who spend a lot of time in the sun experience a premature aging of the skin.
Who gets it?
Everyone’s skin changes with age. People with sun damage often see more dramatic effects than those who protect themselves from the sun. The fairer the skin, the more visible the effects of photoaging.
What causes it?
As we age, the skin becomes thinner. This is because the underlying fat, so abundant at infancy, is slowly lost. The skin’s connective tissue, called collagen and elastin, undergoes changes, causing the skin to lose firmness and become dry. The sweat- and oil-secreting glands in the skin also decrease, which makes it harder for the skin to hold moisture. The blood vessels naturally become more fragile, so they are more likely to rupture and leak into the skin. Effects of aging on the skin may also be attributed to damage caused by oxygen-free radicals. Free radicals are the waste products that result from all the chemical reactions that normally occur in the body. Oxygen-free radicals can damage cells and are believed to accelerate cancers and age-related diseases. Skin changes can also be caused by years of sun damage, poor nutrition, high stress levels, exposure to environmental pollution, and destructive lifestyle choices, such as cigarette smoking or alcohol and drug abuse.
What are the symptoms?
The symptoms of aging skin include dryness, itchiness, thinning or thickening of the skin, wrinkles and fine lines, areas of hyperpigmentation (called age or liver spots), and a mottled appearance. The skin may take more time to heal when injured. Blood vessels are easier to see through the thinning skin, also because they become dilated with age. These blood vessels may be visible as red dome-like formations on the skin (cherry angiomas), or as broken capillaries on the face (telangietasias). Many people develop senile or actinic purpura, which are purplish spots or patches on the skin created by small hemorrhages in the skin. Older skin has less protection against sun damage because protective cells called melanocytes decrease with age. Aging skin is also more likely to develop a variety of benign and pre-cancerous growths, such as seborrheic and actinic keratoses. Seborrheic keratoses often have a rough, brown appearance, and look like a wart. They are benign. Actinic keratoses are small, scaly growths on areas of the skin that have received sun exposure. They are an early sign of skin cancer.
How is it diagnosed?
Any changes in the skin should be checked by a dermatologist for signs of cancer or pre-cancer. Your doctor may need to take a tissue sample, called a biopsy, for examination under a microscope. Most symptoms of aging skin require no diagnosis.
What is the treatment?
Pharmaceutical and cosmetic companies have responded to the public’s desire to slow down or mask the aging process with a great number of treatments. Many of these are classified as antioxidants, which are substances that are thought to protect the body cells from the damaging effects of oxygen-free radicals. Antioxidants include vitamins A, C, E, and betacarotene, and are available in ointment, cream, lotion, and oral supplement forms. Some people use a vitamin-A based cream, or creams containing alpha-hydroxy acids (AHAs), to diminish the appearance of age spots and wrinkles. Laser treatments and bleaching are other options for removing age spots. Frequent moisturizing with an over-the-counter cream or lotion can relieve dry, itchy skin, but your doctor may prescribe a special lotion for severe dryness and itching. Other conditions of aging skin, such as seborrheic keratoses, broken blood vessels, and purpura require no treatment. However, they can be removed or their appearance diminished if they become irritated or are unsightly. Actinic keratoses are removed from the skin.
Self-care tips
Unfortunately, no one has figured out how to stop the aging process or reverse its effects. However, you can reduce the signs of aging in your skin by avoiding sun exposure during the peak hours of 10 a.m. to 2 p.m., and wearing sunscreen with a SPF of at least 15, a hat, and light, protective clothing. Follow a healthy lifestyle that includes a variety of nutritious foods, especially those rich in antioxidants; drinking plenty of water; and exercising regularly. Yearly skin exams are an effective way to catch new or changing skin grows in the early stages. See your doctor any time you notice an existing skin growth has changed in size, shape, or color.
Age-Related Macular Degeneration
See also: Macular Degeneration
What is it?
Age-related macular degeneration is a condition in which the cells of the macula, the center part of the retina, progressively degenerate, causing blurred central vision.
Who gets it?
Age-related macular degeneration affects middle-aged individuals and occurs more often in females than males. The risk for developing macular degeneration increases with age, and may be higher in people who smoke, have high cholesterol, light-colored eyes, or a family history of the disease.
What causes it?
The retina is a light-sensitive membrane that lines the inner part of the eye and is connected to the brain by the optic nerve. The macula is the central part of the retina. It contains cells that are responsible for sharp central vision. What causes damage to these cells is not known for sure, but it could be caused by hardening of the arteries that supply blood to the retina. Most people develop a form called dry age-related macular degeneration where the cells of the macula gradually disappear, so the macula becomes thin. As little as 10 percent develop wet age-related macular degeneration. With this form, blood vessels grow in the layer of tissue under the macula. As they grow toward the macula, they may leak blood and other fluids under the macula, damaging it.
What are the symptoms?
The main symptom of age-related macular degeneration is blurred central vision, which looks like a blind spot right in the middle of your vision. You might first notice it when reading, driving, or watching TV. Macular degeneration does not affect peripheral (side) vision or the ability to see colors. Dry age-related macular degeneration usually begins in one eye, but may affect the other eye at a later time, or it can occur in both eyes at the same time. The dry type progresses slowly until central vision is very poor. Wet age-related macular degeneration causes the same symptoms, but they occur more rapidly. Lines that should be straight may also look wavy or distorted.
How is it diagnosed?
Age-related macular degeneration is diagnosed through an eye exam. Your doctor will test your vision by having you read an eye chart. He or she will also show you a card with a grid pattern and a dot in the center. This is called an Amsler grid and is used to test central vision. You will stare at the dot and tell the doctor if there is any distortion in any area of the grid. He or she may also dilate your pupils for a better view of the retina. Yellow deposits, called drusen, on the retina can be a sign of the disease. Your doctor may want to perform a procedure called fluorescein angiography. A healthcare professional will inject a dye into a vein, then photograph the retina. These photos will help your doctor determine if there are any leaky blood vessels behind the retina.
What is the treatment?
There is currently no treatment for dry age-related macular degeneration, which progresses so slowly. You can improve your vision with special lenses called low vision aids. Wet age-related macular degeneration can be treated with laser surgery. The laser is used to destroy the abnormal blood vessels behind the retina and stop further loss of vision. Right after the surgery, vision will be blurry and you may feel some discomfort in the eye. Your doctor will continue to monitor your condition with fluorescein angiography during routine visits. It is not unusual for more new blood vessels to grow after existing ones have been destroyed. Your doctor may recommend another type of laser surgery, called photodynamic therapy. With this procedure, you receive an injection of a photosensitive dye that affects the abnormal blood vessels. They become sensitive to a special laser light, which then destroys only the blood vessels and no other tissues of the retina. Research into anti-angiogenic drugs may hold promise for treating wet macular degeneration. This treatment would disable the molecules that stimulate the growth of blood vessels.
Self-care tips
Everyone should see an eye care professional for a regular eye exam. If you are at risk for age-related macular degeneration, your doctor may give you an Amsler grid to check your central vision periodically at home. Contact your doctor any time you notice a change in vision. People with dry age-related macular degeneration may benefit from a diet low in saturated fats and high in antioxidants, found in vitamins C and E and beta-carotene, as well as zinc and copper. Talk to your doctor before changing your diet or taking supplements. Not smoking can reduce your risk of age-related macular degeneration and of recurrence of the wet type after laser surgery.
What is it?
Age-related macular degeneration is a condition in which the cells of the macula, the center part of the retina, progressively degenerate, causing blurred central vision.
Who gets it?
Age-related macular degeneration affects middle-aged individuals and occurs more often in females than males. The risk for developing macular degeneration increases with age, and may be higher in people who smoke, have high cholesterol, light-colored eyes, or a family history of the disease.
What causes it?
The retina is a light-sensitive membrane that lines the inner part of the eye and is connected to the brain by the optic nerve. The macula is the central part of the retina. It contains cells that are responsible for sharp central vision. What causes damage to these cells is not known for sure, but it could be caused by hardening of the arteries that supply blood to the retina. Most people develop a form called dry age-related macular degeneration where the cells of the macula gradually disappear, so the macula becomes thin. As little as 10 percent develop wet age-related macular degeneration. With this form, blood vessels grow in the layer of tissue under the macula. As they grow toward the macula, they may leak blood and other fluids under the macula, damaging it.
What are the symptoms?
The main symptom of age-related macular degeneration is blurred central vision, which looks like a blind spot right in the middle of your vision. You might first notice it when reading, driving, or watching TV. Macular degeneration does not affect peripheral (side) vision or the ability to see colors. Dry age-related macular degeneration usually begins in one eye, but may affect the other eye at a later time, or it can occur in both eyes at the same time. The dry type progresses slowly until central vision is very poor. Wet age-related macular degeneration causes the same symptoms, but they occur more rapidly. Lines that should be straight may also look wavy or distorted.
How is it diagnosed?
Age-related macular degeneration is diagnosed through an eye exam. Your doctor will test your vision by having you read an eye chart. He or she will also show you a card with a grid pattern and a dot in the center. This is called an Amsler grid and is used to test central vision. You will stare at the dot and tell the doctor if there is any distortion in any area of the grid. He or she may also dilate your pupils for a better view of the retina. Yellow deposits, called drusen, on the retina can be a sign of the disease. Your doctor may want to perform a procedure called fluorescein angiography. A healthcare professional will inject a dye into a vein, then photograph the retina. These photos will help your doctor determine if there are any leaky blood vessels behind the retina.
What is the treatment?
There is currently no treatment for dry age-related macular degeneration, which progresses so slowly. You can improve your vision with special lenses called low vision aids. Wet age-related macular degeneration can be treated with laser surgery. The laser is used to destroy the abnormal blood vessels behind the retina and stop further loss of vision. Right after the surgery, vision will be blurry and you may feel some discomfort in the eye. Your doctor will continue to monitor your condition with fluorescein angiography during routine visits. It is not unusual for more new blood vessels to grow after existing ones have been destroyed. Your doctor may recommend another type of laser surgery, called photodynamic therapy. With this procedure, you receive an injection of a photosensitive dye that affects the abnormal blood vessels. They become sensitive to a special laser light, which then destroys only the blood vessels and no other tissues of the retina. Research into anti-angiogenic drugs may hold promise for treating wet macular degeneration. This treatment would disable the molecules that stimulate the growth of blood vessels.
Self-care tips
Everyone should see an eye care professional for a regular eye exam. If you are at risk for age-related macular degeneration, your doctor may give you an Amsler grid to check your central vision periodically at home. Contact your doctor any time you notice a change in vision. People with dry age-related macular degeneration may benefit from a diet low in saturated fats and high in antioxidants, found in vitamins C and E and beta-carotene, as well as zinc and copper. Talk to your doctor before changing your diet or taking supplements. Not smoking can reduce your risk of age-related macular degeneration and of recurrence of the wet type after laser surgery.
Diabetes Mellitus
Also known as: Type 1 diabetes, Type 2 diabetes
What is it?
Diabetes Mellitus, more commonly known as just diabetes, is a disease where your body doesn’t make enough insulin, or isn’t able to appropriately use the insulin being made by your body. Insulin is a hormone made by the body to regulate the amount of sugar in the blood. High levels of sugar in the blood can seriously affect other body systems, particularly over long periods of time.
There are two types of diabetes, Type I or juvenile onset, and Type II or adult onset.
Type I
Commonly known as insulin dependent diabetes since these patients require insulin to control their blood sugars. In this type of diabetes, the pancreas is damaged. This is the organ which produces insulin in cells called beta cells, and if they cannot produce insulin because they are damaged, sugar levels in the blood become elevated.
Type II
Non-insulin dependent diabetes, is more common, almost 90 to 95% of all diabetic cases. This type is a result of the pancreas not being able to produce enough insulin to control the blood sugar levels, or the patient’s body not being able to utilize the insulin correctly. Another form of Type II diabetes is known as gestational diabetes. This type develops during pregnancy, and usually resolves when the pregnancy is over. It does, however, put the woman at risk for developing the more permanent disease later in life.
Who gets it, and what are its causes?
Recent reports in 1997 from the American Diabetes Association and the Centers for Disease Control report that there are now 15.7 million Americans with diabetes. Although anyone can get diabetes, there are several factors that can increase the risk of developing the disease. Some of these factors cannot be changed. These include a family history of diabetes, age over 45, having delivered a baby over nine pounds, and ethnicity. It has been found that there is a higher incidence of diabetes in African-Americans, Hispanics, and Native Americans. There are a few risk factors that can be reduced. These include being overweight and not exercising regularly. By adjusting their lifestyle, patients can reduce their risk of developing the disease.
Type 1
The cause of diabetes is dependent on the type of diabetes the patient has. In Type I the beta cells in the pancreas, the one’s responsible for producing the body’s insulin, are gradually destroyed. This is thought to be caused by the body’s own immune system attacking the beta cells. The immune system goes into overdrive, usually after fighting an infection, and the starts to destroy the body’s own tissues. In the case of diabetes, the cells destroyed are the beta cells. This is known as an autoimmune response. It is not known what triggers the body into this autoimmune response, but it seems to be that there is a genetic disposition to it, as well as influence from environmental factors. These factors can include viral infections or chemicals.
Type II
Type II diabetes results from the body developing insulin resistance. Insulin is being produced, but the body’s cells are not able to use the insulin to take up the sugar in the blood, known as glucose. It is thought that there are three factors involved in the development of obesity and insulin resistance that lead to Type II diabetes. They are: free fatty acids (acids in the blood produced by breakdown of fat); leptin (a protein produced by fat cells); and tumor-necrosis factor, or TNF (a component of the immune system). It has still not been completely determined how each of these factors contribute to the development of Type II diabetes. There are also genetic factors involved in the development of type II diabetes. Researchers are studying several genes thought to be responsible to some degree for people getting the disease.
What are the symptoms?
Type 1
Symptoms for Type I don’t really show up until the destruction of the beta cells is almost complete. The symptoms start to show when the insulin production is almost done, and then they appear rather suddenly. Symptoms include frequent urination, excessive thirst, especially for sweet drinks, extreme hunger along with sudden weight loss, weakness, extreme fatigue, visual changes especially blurred vision, and irritability. Severe cases may have no symptoms, then be diagnosed by a sudden onset of a diabetic coma caused by the extremely high levels of blood sugar.
Type II
Type II diabetes have very similar symptoms including the frequent urination, unusual thirst, fatigue, blurred vision and weight loss, but they tend to appear more slowly than with Type I. Women may also have frequent vaginal yeast infections, and fungal infections are common in the groin area or under the breasts.
Diagnosis
Experts are recommending that patients at risk be evaluated for Type I diabetes, and that everyone over age 45 be tested regularly for diabetes. Younger adults should be tested if they have any of the risk factors. Pregnant women should be tested between their 24th to 28th week routinely, and sooner if they are at high risk. The tests that can be done to diagnose diabetes are:
Fasting plasma glucose testing-this has become the standard test. It is a simple blood test drawn after the patient fasts for 8 hours. Normal levels are up to 110 mg/dl. The diagnosis of diabetes is made when this level is 126 mg/dl or higher on two different days. Levels between 110 mg/dl and 126 mg/dl are considered to have impaired fasting glucose and are at risk for later developing diabetes.
Glucose Tolerance Testing-this test is more elaborate than the fasting glucose testing. First a fasting glucose level is drawn, then the patient drinks a special glucose solution. Two hours later, another glucose level is drawn. Normally, blood sugar increases moderately after drinking the glucose solution, and decreases after two hours. In diabetics, the initial level is extremely high, and it doesn’t decrease significantly after two hours.
Glycolated Hemoglobin-this test examines the blood for levels of hemoglobin A1C or glycolated hemoglobin. Hemoglobin is a protein found in red blood cells, and it becomes modified by having glucose bound to it. The degree of modification depends on the average level of blood sugar that the protein is exposed to over its life span.
Treatment
Type 1
The medical treatment will always involve insulin administration. Diet modification as well as weight control are also important. It has been found that by tightly controlling the blood sugar level, many of the major complications of diabetes can be delayed, although not eliminated completely.
Type II
One third of the patients can control their disease through diet and exercise alone. The rest, however, need oral medications that stimulate the pancreas to secrete additional insulin, or increase the body’s sensitivity to the insulin being made already. Eventually, though, it is seen that the natural insulin starts to fail, and insulin replacement is necessary. Again, controlling the blood sugar levels very closely will help to reduce the risk for complications from diabetes.
Surgical treatment
For Type II
diabetes, there is no surgical treatment. Type I has only one surgical treatment, pancreatic transplantation. This doesn’t make a difference in Type II diabetics since they still are making insulin, but the body can’t manage it effectively. A new pancreas would still be making insulin, but the body still wouldn’t manage it. Type I diabetics must not have other problems resulting from their disease, such as severe heart disease, that would make surgery difficult. They should also have poorly controlled glucose levels despite following a strict medical regimen.
What is it?
Diabetes Mellitus, more commonly known as just diabetes, is a disease where your body doesn’t make enough insulin, or isn’t able to appropriately use the insulin being made by your body. Insulin is a hormone made by the body to regulate the amount of sugar in the blood. High levels of sugar in the blood can seriously affect other body systems, particularly over long periods of time.
There are two types of diabetes, Type I or juvenile onset, and Type II or adult onset.
Type I
Commonly known as insulin dependent diabetes since these patients require insulin to control their blood sugars. In this type of diabetes, the pancreas is damaged. This is the organ which produces insulin in cells called beta cells, and if they cannot produce insulin because they are damaged, sugar levels in the blood become elevated.
Type II
Non-insulin dependent diabetes, is more common, almost 90 to 95% of all diabetic cases. This type is a result of the pancreas not being able to produce enough insulin to control the blood sugar levels, or the patient’s body not being able to utilize the insulin correctly. Another form of Type II diabetes is known as gestational diabetes. This type develops during pregnancy, and usually resolves when the pregnancy is over. It does, however, put the woman at risk for developing the more permanent disease later in life.
Who gets it, and what are its causes?
Recent reports in 1997 from the American Diabetes Association and the Centers for Disease Control report that there are now 15.7 million Americans with diabetes. Although anyone can get diabetes, there are several factors that can increase the risk of developing the disease. Some of these factors cannot be changed. These include a family history of diabetes, age over 45, having delivered a baby over nine pounds, and ethnicity. It has been found that there is a higher incidence of diabetes in African-Americans, Hispanics, and Native Americans. There are a few risk factors that can be reduced. These include being overweight and not exercising regularly. By adjusting their lifestyle, patients can reduce their risk of developing the disease.
Type 1
The cause of diabetes is dependent on the type of diabetes the patient has. In Type I the beta cells in the pancreas, the one’s responsible for producing the body’s insulin, are gradually destroyed. This is thought to be caused by the body’s own immune system attacking the beta cells. The immune system goes into overdrive, usually after fighting an infection, and the starts to destroy the body’s own tissues. In the case of diabetes, the cells destroyed are the beta cells. This is known as an autoimmune response. It is not known what triggers the body into this autoimmune response, but it seems to be that there is a genetic disposition to it, as well as influence from environmental factors. These factors can include viral infections or chemicals.
Type II
Type II diabetes results from the body developing insulin resistance. Insulin is being produced, but the body’s cells are not able to use the insulin to take up the sugar in the blood, known as glucose. It is thought that there are three factors involved in the development of obesity and insulin resistance that lead to Type II diabetes. They are: free fatty acids (acids in the blood produced by breakdown of fat); leptin (a protein produced by fat cells); and tumor-necrosis factor, or TNF (a component of the immune system). It has still not been completely determined how each of these factors contribute to the development of Type II diabetes. There are also genetic factors involved in the development of type II diabetes. Researchers are studying several genes thought to be responsible to some degree for people getting the disease.
What are the symptoms?
Type 1
Symptoms for Type I don’t really show up until the destruction of the beta cells is almost complete. The symptoms start to show when the insulin production is almost done, and then they appear rather suddenly. Symptoms include frequent urination, excessive thirst, especially for sweet drinks, extreme hunger along with sudden weight loss, weakness, extreme fatigue, visual changes especially blurred vision, and irritability. Severe cases may have no symptoms, then be diagnosed by a sudden onset of a diabetic coma caused by the extremely high levels of blood sugar.
Type II
Type II diabetes have very similar symptoms including the frequent urination, unusual thirst, fatigue, blurred vision and weight loss, but they tend to appear more slowly than with Type I. Women may also have frequent vaginal yeast infections, and fungal infections are common in the groin area or under the breasts.
Diagnosis
Experts are recommending that patients at risk be evaluated for Type I diabetes, and that everyone over age 45 be tested regularly for diabetes. Younger adults should be tested if they have any of the risk factors. Pregnant women should be tested between their 24th to 28th week routinely, and sooner if they are at high risk. The tests that can be done to diagnose diabetes are:
Fasting plasma glucose testing-this has become the standard test. It is a simple blood test drawn after the patient fasts for 8 hours. Normal levels are up to 110 mg/dl. The diagnosis of diabetes is made when this level is 126 mg/dl or higher on two different days. Levels between 110 mg/dl and 126 mg/dl are considered to have impaired fasting glucose and are at risk for later developing diabetes.
Glucose Tolerance Testing-this test is more elaborate than the fasting glucose testing. First a fasting glucose level is drawn, then the patient drinks a special glucose solution. Two hours later, another glucose level is drawn. Normally, blood sugar increases moderately after drinking the glucose solution, and decreases after two hours. In diabetics, the initial level is extremely high, and it doesn’t decrease significantly after two hours.
Glycolated Hemoglobin-this test examines the blood for levels of hemoglobin A1C or glycolated hemoglobin. Hemoglobin is a protein found in red blood cells, and it becomes modified by having glucose bound to it. The degree of modification depends on the average level of blood sugar that the protein is exposed to over its life span.
Treatment
Type 1
The medical treatment will always involve insulin administration. Diet modification as well as weight control are also important. It has been found that by tightly controlling the blood sugar level, many of the major complications of diabetes can be delayed, although not eliminated completely.
Type II
One third of the patients can control their disease through diet and exercise alone. The rest, however, need oral medications that stimulate the pancreas to secrete additional insulin, or increase the body’s sensitivity to the insulin being made already. Eventually, though, it is seen that the natural insulin starts to fail, and insulin replacement is necessary. Again, controlling the blood sugar levels very closely will help to reduce the risk for complications from diabetes.
Surgical treatment
For Type II
diabetes, there is no surgical treatment. Type I has only one surgical treatment, pancreatic transplantation. This doesn’t make a difference in Type II diabetics since they still are making insulin, but the body can’t manage it effectively. A new pancreas would still be making insulin, but the body still wouldn’t manage it. Type I diabetics must not have other problems resulting from their disease, such as severe heart disease, that would make surgery difficult. They should also have poorly controlled glucose levels despite following a strict medical regimen.
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