What is it?
Arthritis, meaning inflammation of a joint, can occur at any joint in the human body. Degenerative arthritis means inflammation of a joint due to wear and tear. This condition is called osteoarthritis. Doctors may also use the term “arthrosis” to describe the condition of a worn-out joint. There are many causes for arthritis, and the term is used to describe inflammatory conditions, such as gout, infection, and rheumatoid arthritis.
Who gets it?
In recent years, there has been increasing evidence that osteoarthritis is genetic and has a tendency to occur in families. Research suggests that osteoarthritis that occurs without any injury may be related to the chemical make-up of the cartilage in the joint.
What are the symptoms?
When the joint sustains an injury, the cartilage holding the joint together becomes damaged. The patient does not typically know that damage has been done, and they may not be experiencing significant pain. When asked if the pain limits their activities, the first answer may be “no”. However, in careful questioning, one would ask a patient “what activities are they doing now that they were doing five years ago that they cannot do now because of discomfort in their ankle”. The patient may be surprised by their response.
Because cartilage does not heal or grow back, this causes a defect in the joint. Over time, these defects fill with scar tissue, causing more pain and instability to the joint. The joint ultimately reaches a point when it is no longer able to properly function without significant pain because of the continual damage, resulting in increased inflammation and severe pain.
Diagnosis
Your orthopaedic physician will obtain a family history, considering all factors important in determining the type of arthritis you may have. He will also conduct a thorough physical examination of the joint to evaluate and determine the type and extent of damage to the joint. In this physical examination, the physician will measure the range of motion at the joint, and may draw fluid from the joint to determine if an infection is present. X-rays will then be taken to assess the amount of damage to the joint and determine the proper diagnosis.
Non-Operative Treatment
Arthritis in its mildest form may not need any treatment whatsoever except simple activity modification – avoiding impact activities such as jumping – and recommending activities that are more controlled with less impact such as swimming, cycling, and walking on cushioned surfaces. When arthritis becomes more severe, then the next appropriate step may be medication such as non-steroidal anti-inflammatories (NSAIDs), or other types of medications which are usually prescribed by a rheumatologist. There are many types of mediations that can be utilized as the first line of defense for arthritis prior to considering any surgical procedure.
For patients with stiff and painful joints, bracing is another form of treatment. The bracing may be simple, such as a brace that one would typically use for an ankle sprain.
Operative Treatment
When all these above measures fail and the patient still has significant arthritis limiting lifestyle, then there are three different types of surgical options that can be undertaken to help the patient improve their quality of life. If the joint destruction is on one side of the joint (asymmetric), then the physician can consider an osteotomy (or cutting the bone to change the weight-bearing surface of the joint and help distribute the weight more evenly). This is usually not successfully performed in the ankle, however, it is sometimes considered.
If you suspect that you may have arthritis, then you should see your family physician or internist, as most problems can be treated effectively with anti-inflammatory medications and/or bracing. However, if it is severe enough for surgical intervention, then you should consider being referred to a surgeon
Showing posts with label Medical abbrevations. Show all posts
Showing posts with label Medical abbrevations. Show all posts
Thursday, April 2, 2009
Cerebral AVM
Also known as: Cerebral Arteriovenous Malformation; High Flow AVM
What is it?
A Cerebral AVM (arteriovenous malformation) is an abnormal collection of tangled blood vessels. High-pressure blood in distorted abnormal arteries flows directly into large draining veins without the presence of an intervening network of capillaries. These are congenital lesions, which occur in less than 1% of the population. AVMs usually cause medical problems by bleeding or leaking blood. AVMs, may also cause seizures or progressive neurological dysfunction.
Who gets it?
Cerebral AVMs are congenital lesions which arise during fetal development. They occur in less than 1% of the population. AVMs can run in families and can be associated with other vascular lesions of the brain such as cerebral aneurysms.
What causes it?
Cerebral AVMs are the result of abnormal development of cerebral circulation. They result in a “tangle” of abnormal arteries connected to large draining veins, without the benefit of an intervening capillary network. These congenital lesions may then enlarge by recruiting more blood vessels throughout childhood and into adulthood.
What are the symptoms?
Many patients with cerebral AVMs have no symptoms. However, the most common reason brain AVMs come to medical attention is through bleeding (rupture). Common symptoms of a bleeding brain AVM include, severe headache, nausea/vomiting and a new neurological deficit, such as numbness, weakness or paralysis. Patients may also present with seizures or progressive neurological decline in the absence of AVM bleeding.
How is it diagnosed?
Cerebral AVMs can be seen on CT scans, MRI/MRA, and CTAs. Specific sequences on the MRI can further help evaluate these vascular malformations. Cerebral angiography remains the gold standard in the evaluation and grading of cerebral AVMs. Cerebral angiography aids in better understanding the AVM’s inflow and outflow. An angiogram is essential to planning any treatment for the AVM.
What is the treatment?
There are three major treatment options for cerebral AVMs. These include a combination of open microsurgery, endovascular surgery, and stereotactic radiosurgery. Microsurgery uses traditional open surgical techniques with the help of a microscope and sometimes with computerized image guidance to remove the AVM. Some lesions may be too large, too deep, or located in too important of an area of the brain for safe microsurgical excision. In such cases other treatments may be necessary. In endovascular surgery, treatment is performed from within the affected blood vessel. Specially designed microcatheters are navigated by means of an angiogram into the nidus of the AVM. The lesion is then occluded from the inside using a process of embolization with either particles or glue. Some forms of endovascular treatment may be investigational and therefore require a special consent. Although very effective in reducing the size of an AVM, endovascular embolization is rarely able to completely obliterate all but the smallest of AVMs. Endovascular therapy, therefore, is usually combined with either microsurgery or stereotactic radiosurgery to give the best chance. Stereotactic radiosurgery involves the delivery of a highly focused beam of radiation to the AVM. The two most common forms of radiosurgery are linear accelerator based radiosurgery (also known as LINAC or photon knife) and gamma ray based radiosurgery (gamma knife). Radiosurgery may be less risky when compared to microsurgery, for patients with AVMs that are deep or located in important brain areas. However, the ability of conventional radiosurgery to cure an AVM drops off sharply as the AVM diameter goes above 2.5 cm (1 inch). With radiosurgery cure is not immediate and may take up to two or three years. During this time, the patient may require follow-up tests and will still be at risk for problems from the AVM. For these reasons, radiosurgery is especially appropriate for small lesions that are located in or near critical brain areas or are very deep.
What is it?
A Cerebral AVM (arteriovenous malformation) is an abnormal collection of tangled blood vessels. High-pressure blood in distorted abnormal arteries flows directly into large draining veins without the presence of an intervening network of capillaries. These are congenital lesions, which occur in less than 1% of the population. AVMs usually cause medical problems by bleeding or leaking blood. AVMs, may also cause seizures or progressive neurological dysfunction.
Who gets it?
Cerebral AVMs are congenital lesions which arise during fetal development. They occur in less than 1% of the population. AVMs can run in families and can be associated with other vascular lesions of the brain such as cerebral aneurysms.
What causes it?
Cerebral AVMs are the result of abnormal development of cerebral circulation. They result in a “tangle” of abnormal arteries connected to large draining veins, without the benefit of an intervening capillary network. These congenital lesions may then enlarge by recruiting more blood vessels throughout childhood and into adulthood.
What are the symptoms?
Many patients with cerebral AVMs have no symptoms. However, the most common reason brain AVMs come to medical attention is through bleeding (rupture). Common symptoms of a bleeding brain AVM include, severe headache, nausea/vomiting and a new neurological deficit, such as numbness, weakness or paralysis. Patients may also present with seizures or progressive neurological decline in the absence of AVM bleeding.
How is it diagnosed?
Cerebral AVMs can be seen on CT scans, MRI/MRA, and CTAs. Specific sequences on the MRI can further help evaluate these vascular malformations. Cerebral angiography remains the gold standard in the evaluation and grading of cerebral AVMs. Cerebral angiography aids in better understanding the AVM’s inflow and outflow. An angiogram is essential to planning any treatment for the AVM.
What is the treatment?
There are three major treatment options for cerebral AVMs. These include a combination of open microsurgery, endovascular surgery, and stereotactic radiosurgery. Microsurgery uses traditional open surgical techniques with the help of a microscope and sometimes with computerized image guidance to remove the AVM. Some lesions may be too large, too deep, or located in too important of an area of the brain for safe microsurgical excision. In such cases other treatments may be necessary. In endovascular surgery, treatment is performed from within the affected blood vessel. Specially designed microcatheters are navigated by means of an angiogram into the nidus of the AVM. The lesion is then occluded from the inside using a process of embolization with either particles or glue. Some forms of endovascular treatment may be investigational and therefore require a special consent. Although very effective in reducing the size of an AVM, endovascular embolization is rarely able to completely obliterate all but the smallest of AVMs. Endovascular therapy, therefore, is usually combined with either microsurgery or stereotactic radiosurgery to give the best chance. Stereotactic radiosurgery involves the delivery of a highly focused beam of radiation to the AVM. The two most common forms of radiosurgery are linear accelerator based radiosurgery (also known as LINAC or photon knife) and gamma ray based radiosurgery (gamma knife). Radiosurgery may be less risky when compared to microsurgery, for patients with AVMs that are deep or located in important brain areas. However, the ability of conventional radiosurgery to cure an AVM drops off sharply as the AVM diameter goes above 2.5 cm (1 inch). With radiosurgery cure is not immediate and may take up to two or three years. During this time, the patient may require follow-up tests and will still be at risk for problems from the AVM. For these reasons, radiosurgery is especially appropriate for small lesions that are located in or near critical brain areas or are very deep.
Appendicitis
What is it?
Appendicitis is the inflammation of the appendix. The appendix is a worm-shaped pouch that projects from the cecum, which is the point at which the large intestine joins the small intestine. The appendix is located in the lower right abdomen and is not essential to the body’s function.
Who gets it?
Anyone can get appendicitis, and it is the most common reason for emergency abdominal surgery. Appendicitis is most likely to occur between the ages of 10 and 30. It occurs most often in boys between the ages of 10 and 14 and girls 15 to 19. It is less common in the elderly and infants.d
What causes it?
Researchers are not sure what causes appendicitis, but think it may be a blockage between the large intestine and appendix, or a viral or bacterial infection.
What are the symptoms?
An inflamed appendix causes mild to severe pain that moves from the navel to the lower right abdomen. The lower right abdomen may be extremely sensitive to touch and the pain is often worse with movement and strain, such as sneezing, coughing, or taking a deep breath. Other symptoms may include nausea, vomiting, loss of appetite, fever, diarrhea, constipation, weight loss, and a swollen abdomen. However, some people may not experience all of these symptoms. An inflamed appendix can become so swollen that it ruptures, spilling its infected contents into the abdominal cavity. This can cause a life-threatening infection called peritonitis. Never treat appendicitis symptoms with laxatives or enemas because they can cause the inflamed appendix to rupture. A ruptured appendix that is not treated immediately can cause death.
How is it diagnosed?
A diagnosis of appendicitis is based upon a physical examination and the patient’s symptoms. The doctor will ask you about the location of the pain and how long you have felt it. He or she will press gently on your abdomen to check for tenderness and swelling in the area of the appendix. The doctor may order blood tests to check for a high white blood count, which is a sign of infection, and ultrasound or computed tomography (CT) scans to check the condition of the appendix. He or she may order additional tests to rule out other disorders, such as urinary tract infections, tubal pregnancies, and bowel obstructions, that can cause similar symptoms. If you are a woman and your doctor suspects a cause other than appendicitis, he or she might recommend a laparoscopic study. A small, lighted viewing tube, called a laparoscope, is inserted into a small incision in the abdomen to check for disorders of the reproductive system.
What is the treatment?
Appendicitis is treated with surgery to remove the appendix, called an appendectomy. This surgery is usually performed as soon as possible after the diagnosis has been made to avoid a rupture. In many cases, appendectomies can be performed with laparoscopic surgery. The surgeon makes a small incision in the abdomen and inserts the laparoscope. The laparoscope is like a tiny video camera that gives the surgeon a clear view of the abdominal area. Other small incisions are made to insert the surgical instruments used to remove the appendix. Because the appendix is not necessary to the body’s function, people who have an appendectomy make a full recovery and are able to continue with life as usual.
Self-care tips
There is no known way to prevent appendicitis. However, a healthy lifestyle, including a diet high in fiber and antioxidants, as well as moderate exercise, goes a long way in preventing illness and disease.
Appendicitis is the inflammation of the appendix. The appendix is a worm-shaped pouch that projects from the cecum, which is the point at which the large intestine joins the small intestine. The appendix is located in the lower right abdomen and is not essential to the body’s function.
Who gets it?
Anyone can get appendicitis, and it is the most common reason for emergency abdominal surgery. Appendicitis is most likely to occur between the ages of 10 and 30. It occurs most often in boys between the ages of 10 and 14 and girls 15 to 19. It is less common in the elderly and infants.d
What causes it?
Researchers are not sure what causes appendicitis, but think it may be a blockage between the large intestine and appendix, or a viral or bacterial infection.
What are the symptoms?
An inflamed appendix causes mild to severe pain that moves from the navel to the lower right abdomen. The lower right abdomen may be extremely sensitive to touch and the pain is often worse with movement and strain, such as sneezing, coughing, or taking a deep breath. Other symptoms may include nausea, vomiting, loss of appetite, fever, diarrhea, constipation, weight loss, and a swollen abdomen. However, some people may not experience all of these symptoms. An inflamed appendix can become so swollen that it ruptures, spilling its infected contents into the abdominal cavity. This can cause a life-threatening infection called peritonitis. Never treat appendicitis symptoms with laxatives or enemas because they can cause the inflamed appendix to rupture. A ruptured appendix that is not treated immediately can cause death.
How is it diagnosed?
A diagnosis of appendicitis is based upon a physical examination and the patient’s symptoms. The doctor will ask you about the location of the pain and how long you have felt it. He or she will press gently on your abdomen to check for tenderness and swelling in the area of the appendix. The doctor may order blood tests to check for a high white blood count, which is a sign of infection, and ultrasound or computed tomography (CT) scans to check the condition of the appendix. He or she may order additional tests to rule out other disorders, such as urinary tract infections, tubal pregnancies, and bowel obstructions, that can cause similar symptoms. If you are a woman and your doctor suspects a cause other than appendicitis, he or she might recommend a laparoscopic study. A small, lighted viewing tube, called a laparoscope, is inserted into a small incision in the abdomen to check for disorders of the reproductive system.
What is the treatment?
Appendicitis is treated with surgery to remove the appendix, called an appendectomy. This surgery is usually performed as soon as possible after the diagnosis has been made to avoid a rupture. In many cases, appendectomies can be performed with laparoscopic surgery. The surgeon makes a small incision in the abdomen and inserts the laparoscope. The laparoscope is like a tiny video camera that gives the surgeon a clear view of the abdominal area. Other small incisions are made to insert the surgical instruments used to remove the appendix. Because the appendix is not necessary to the body’s function, people who have an appendectomy make a full recovery and are able to continue with life as usual.
Self-care tips
There is no known way to prevent appendicitis. However, a healthy lifestyle, including a diet high in fiber and antioxidants, as well as moderate exercise, goes a long way in preventing illness and disease.
Aphasia
What is it?
Aphasia is the partial or total loss of the ability to understand words and use language because of a brain injury
Who gets it?
Aphasia often occurs in people who have had a stroke. In fact, 20% of all people who have a stroke each year, develop some type of aphasia. People who have suffered brain damage from a head injury, infection (such as encephalitis), or brain tumor may develop aphasia. Aphasia also occurs in people with Alzheimer's disease. Researchers have found no connection between aphasia and age, gender, or race.
What causes it?
To understand what causes aphasia, it helps to know a little bit about the structure of the brain. The main portion of the brain, the cerebrum, is divided into halves called the left and right hemispheres. The cerebrum is further divided into lobes, the frontal, parietal, occipital, and temporal. In most people, language control is located in the left hemisphere of the brain, called the language dominant area of the brain. It is here that we store information about word meaning, how to formulate spoken and written language, and how and when to use words properly. So, damage to the left hemisphere most often results in the symptoms of aphasia. However, research has shown that many left-handed people have language areas in both the left and right hemispheres of the brain. These people can develop aphasia from damage to either side of the brain. Injuries that result in aphasia can be caused by stroke, head injury, brain tumor, or infection.
Types of aphasia are classified according to the area of the brain that is injured. One type, called Broca's aphasia, results from damage to the frontal lobe of the language-dominant area of the brain. Wernicke's aphasia is caused by damage to the temporal lobe, or the side portion, of the language-dominant area of the brain. Global aphasia is caused by damage to both the left temporal and frontal lobes. Transcortical aphasia is caused by damage to the language areas of the left hemisphere that are outside the primary language areas. Subcortical aphasia results from damage to areas of the brain that are not language-dominant areas.
What are the symptoms?
The symptoms of aphasia may be temporary or permanent, depending upon the amount of brain damage. Aphasia affects one or more of a person's language functions. These could include speech, naming, repetition, hearing comprehension, reading, and writing. The functions affected depend upon the type of aphasia an individual has. For example, people with Broca's aphasia may not be able to speak at all. Or they may be able to use single-word statements or full sentences after great effort. They frequently omit words that are conjunctions and articles (and, or, but, the, a), which results in speech that sounds abrupt and choppy. People with Broca's aphasia can understand and process what others are saying, so they often become depressed and frustrated by their own inability to communicate. They may have difficulty reading, and weakness on the right side of the body may make writing difficult. Broca's aphasia is also called motor aphasia.
People with Wernicke's aphasia speak in long, run-on sentences that include words that aren't needed, difficult to understand, or simply made up. These patients are completely unaware of their language difficulties, and may not even understand what other people say at all. While they may still be able to write, what they write may not be understandable. People with Wernicke's aphasia also have difficulty reading. Because global aphasia affects more than one area of the brain, it can affect all language areas, and is the most severe form of aphasia. However, symptoms vary depending on the location and extent of injury.
There are three types of transcortical aphasia: transcortical motor aphasia, transcortical sensory aphasia, and mixed transcortical aphasia. People with transcortical aphasia suffer partial or total loss of the ability to communicate verbally or use written words, but can still repeat words, phrases, or sentences. Subcortical aphasia results in either the partial or total loss of the ability to speak or use written words. It is typical of a person who has had a stroke or other injury to the brain to have difficulty naming people or objects. This is called anomic or nominal aphasia. The patient might describe the object or person instead of naming it. All other language functions are unaffected. People with conduction, or associative, aphasia cannot repeat words, sentences, and phrases. While they can understand what others say, they may have difficulty finding the right words when speaking, and so may correct themselves frequently and skip or repeat words. Conduction aphasia is uncommon. Aphasia is rare in children, but the symptoms can begin with speech delays and progress to the loss of communication skills in all areas.
How is it diagnosed?
Anyone who has suffered a stroke or any type of brain injury is assessed for any effects on language skills. The doctor will listen to the patient speak, and ask him or her to identify and name common objects, repeat words or phrases, and demonstrate understanding of things that are said. It is important to determine whether the patient is having difficulty with speaking or difficulty with understanding. The patient will also be asked to write down some thoughts to assess written language skills. Standardized tests, administered by a speech pathologist or neuropsychologist, are often used in the diagnosis. These tests might include the Boston Diagnostic Aphasia Examination, the Western Aphasia Battery, and the Porch Index of Speech Ability. Test results are used to pinpoint the area of the brain that has been injured and to develop a speech therapy program best suited to the patient. Magnetic resonance imaging (MRI) and computed tomography scans (CT) are also helpful in mapping the area of the brain that is affected and to diagnose a brain tumor.
What is the treatment?
The primary treatment for most causes of aphasia is speech therapy, which is begun as soon as the patient's condition allows. There are no drugs available to cure or treat aphasia. The speech therapist works with the patient to strengthen his or her remaining language skills and to find ways to compensate for the skills that have been lost. Techniques might include exercising the facial muscles, repetition of words, using flash cards to improve memory of object names, using pictures of objects and activities to communicate with others, completing reading and writing exercises in workbooks, and using computer programs to aid in speech, hearing, and reading comprehension, as well as recall. Recovery from aphasia depends upon the severity of the brain injury. More than half of the patients who have symptoms of aphasia after a stroke, infection, head injury, or as a result of a brain tumor will recover. While people who are left handed are more likely to develop aphasia after a brain injury, they tend to recover more fully. This is because they have language centers on the right and left side of the brain so language abilities can be recovered from either side. Surgery is only used to treat the cause of aphasia, such as to reduce pressure from a brain tumor or to reduce swelling from head trauma.
Self-care tips
The types of events that cause aphasia, such as stroke and head injury, are difficult to predict or prevent. For this reason, there are no guidelines for preventing aphasia. However, individual and family commitment to a physician-guided speech therapy program can result in full to partial recovery.
Aphasia is the partial or total loss of the ability to understand words and use language because of a brain injury
Who gets it?
Aphasia often occurs in people who have had a stroke. In fact, 20% of all people who have a stroke each year, develop some type of aphasia. People who have suffered brain damage from a head injury, infection (such as encephalitis), or brain tumor may develop aphasia. Aphasia also occurs in people with Alzheimer's disease. Researchers have found no connection between aphasia and age, gender, or race.
What causes it?
To understand what causes aphasia, it helps to know a little bit about the structure of the brain. The main portion of the brain, the cerebrum, is divided into halves called the left and right hemispheres. The cerebrum is further divided into lobes, the frontal, parietal, occipital, and temporal. In most people, language control is located in the left hemisphere of the brain, called the language dominant area of the brain. It is here that we store information about word meaning, how to formulate spoken and written language, and how and when to use words properly. So, damage to the left hemisphere most often results in the symptoms of aphasia. However, research has shown that many left-handed people have language areas in both the left and right hemispheres of the brain. These people can develop aphasia from damage to either side of the brain. Injuries that result in aphasia can be caused by stroke, head injury, brain tumor, or infection.
Types of aphasia are classified according to the area of the brain that is injured. One type, called Broca's aphasia, results from damage to the frontal lobe of the language-dominant area of the brain. Wernicke's aphasia is caused by damage to the temporal lobe, or the side portion, of the language-dominant area of the brain. Global aphasia is caused by damage to both the left temporal and frontal lobes. Transcortical aphasia is caused by damage to the language areas of the left hemisphere that are outside the primary language areas. Subcortical aphasia results from damage to areas of the brain that are not language-dominant areas.
What are the symptoms?
The symptoms of aphasia may be temporary or permanent, depending upon the amount of brain damage. Aphasia affects one or more of a person's language functions. These could include speech, naming, repetition, hearing comprehension, reading, and writing. The functions affected depend upon the type of aphasia an individual has. For example, people with Broca's aphasia may not be able to speak at all. Or they may be able to use single-word statements or full sentences after great effort. They frequently omit words that are conjunctions and articles (and, or, but, the, a), which results in speech that sounds abrupt and choppy. People with Broca's aphasia can understand and process what others are saying, so they often become depressed and frustrated by their own inability to communicate. They may have difficulty reading, and weakness on the right side of the body may make writing difficult. Broca's aphasia is also called motor aphasia.
People with Wernicke's aphasia speak in long, run-on sentences that include words that aren't needed, difficult to understand, or simply made up. These patients are completely unaware of their language difficulties, and may not even understand what other people say at all. While they may still be able to write, what they write may not be understandable. People with Wernicke's aphasia also have difficulty reading. Because global aphasia affects more than one area of the brain, it can affect all language areas, and is the most severe form of aphasia. However, symptoms vary depending on the location and extent of injury.
There are three types of transcortical aphasia: transcortical motor aphasia, transcortical sensory aphasia, and mixed transcortical aphasia. People with transcortical aphasia suffer partial or total loss of the ability to communicate verbally or use written words, but can still repeat words, phrases, or sentences. Subcortical aphasia results in either the partial or total loss of the ability to speak or use written words. It is typical of a person who has had a stroke or other injury to the brain to have difficulty naming people or objects. This is called anomic or nominal aphasia. The patient might describe the object or person instead of naming it. All other language functions are unaffected. People with conduction, or associative, aphasia cannot repeat words, sentences, and phrases. While they can understand what others say, they may have difficulty finding the right words when speaking, and so may correct themselves frequently and skip or repeat words. Conduction aphasia is uncommon. Aphasia is rare in children, but the symptoms can begin with speech delays and progress to the loss of communication skills in all areas.
How is it diagnosed?
Anyone who has suffered a stroke or any type of brain injury is assessed for any effects on language skills. The doctor will listen to the patient speak, and ask him or her to identify and name common objects, repeat words or phrases, and demonstrate understanding of things that are said. It is important to determine whether the patient is having difficulty with speaking or difficulty with understanding. The patient will also be asked to write down some thoughts to assess written language skills. Standardized tests, administered by a speech pathologist or neuropsychologist, are often used in the diagnosis. These tests might include the Boston Diagnostic Aphasia Examination, the Western Aphasia Battery, and the Porch Index of Speech Ability. Test results are used to pinpoint the area of the brain that has been injured and to develop a speech therapy program best suited to the patient. Magnetic resonance imaging (MRI) and computed tomography scans (CT) are also helpful in mapping the area of the brain that is affected and to diagnose a brain tumor.
What is the treatment?
The primary treatment for most causes of aphasia is speech therapy, which is begun as soon as the patient's condition allows. There are no drugs available to cure or treat aphasia. The speech therapist works with the patient to strengthen his or her remaining language skills and to find ways to compensate for the skills that have been lost. Techniques might include exercising the facial muscles, repetition of words, using flash cards to improve memory of object names, using pictures of objects and activities to communicate with others, completing reading and writing exercises in workbooks, and using computer programs to aid in speech, hearing, and reading comprehension, as well as recall. Recovery from aphasia depends upon the severity of the brain injury. More than half of the patients who have symptoms of aphasia after a stroke, infection, head injury, or as a result of a brain tumor will recover. While people who are left handed are more likely to develop aphasia after a brain injury, they tend to recover more fully. This is because they have language centers on the right and left side of the brain so language abilities can be recovered from either side. Surgery is only used to treat the cause of aphasia, such as to reduce pressure from a brain tumor or to reduce swelling from head trauma.
Self-care tips
The types of events that cause aphasia, such as stroke and head injury, are difficult to predict or prevent. For this reason, there are no guidelines for preventing aphasia. However, individual and family commitment to a physician-guided speech therapy program can result in full to partial recovery.
Congenital Aortic Valve Stenosis
What is it?
Aortic valve stenosis is a narrowing of the aortic valve. The aortic valve opens to allow blood to flow from the left ventricle of the heart to the aorta, and then to the body. Because the opening is narrowed, the left ventricle has to pump extra hard to propel blood through the valve. This causes the left ventricle to become enlarged. The valve may also have two leaflets, instead of three, or may have an abnormal funnel shape. The narrowed valve may not be a problem during infancy, but becomes one as the child grows and the heart cannot keep up with the body’s demand for blood. “Congenital” aortic valve stenosis means the condition is present at birth.
Who gets it?
Males are four times more likely to get this disease. Aortic valve stenosis accounts for approximately 7% of all cases of congenital heart disease.
What causes it?
Aortic valve stenosis can run in families or may be due to something that happened to the fetus during pregnancy.
Unless it is severe, the condition is often not detected until later in life.
What are the symptoms?
Most children with aortic valve stenosis have no symptoms, so it’s difficult to detect. In general, many patients will be easily fatigued, but show no other symptoms until their thirties to fifties. A small number of children may be prone to dizziness and fainting (syncope) within the first ten years of life. If the obstruction is great, infants may suffer from severe heart failure. Sudden death is uncommon, but possible. Adolescents with hypertrophic cardiomyopathy, a type of aortic stenosis where the left ventricle is noticeably enlarged, have the greatest risk of sudden heart failure. How is it diagnosed? Children with aortic valve stenosis usually have a heart murmur that can be heard with a stethoscope. A doctor can also detect pulse abnormalities and will see irregularities on an electrocardiogram (ECG). A chest x-ray may also show an enlarged left ventricle. An echocardiogram may also be ordered. This technique uses ultrasound waves to create an image of the heart and its function. In cases where severe blockage is suspected and surgery most likely, doctors may do a left heart cardiac catheritization. In this procedure, a thin tube (catheter) is inserted through an artery and moved into the heart chambers. This procedure will measure the pressure difference between the left ventricle and the aorta.
What is the treatment?
Children with aortic valve stenosis require close medical supervision and should undergo yearly exercise testing after the age of six. Most children with mild to moderate aortic valve stenosis can engage in normal physical activities. Surgery is only performed in cases of severe obstruction. The most common treatments are surgical valve repair and balloon valvuloplasty. A balloon-tipped catheter is inserted into the aortic valve. The balloon is then inflated to expand the valve opening. Some forms of aortic valve stenosis require medical management with beta-blockers or calcium channel blockers.
Self-care tips
If your child has been diagnosed with aortic valve stenosis, follow your doctor’s recommendations for treatment and physical activity.
Aortic valve stenosis is a narrowing of the aortic valve. The aortic valve opens to allow blood to flow from the left ventricle of the heart to the aorta, and then to the body. Because the opening is narrowed, the left ventricle has to pump extra hard to propel blood through the valve. This causes the left ventricle to become enlarged. The valve may also have two leaflets, instead of three, or may have an abnormal funnel shape. The narrowed valve may not be a problem during infancy, but becomes one as the child grows and the heart cannot keep up with the body’s demand for blood. “Congenital” aortic valve stenosis means the condition is present at birth.
Who gets it?
Males are four times more likely to get this disease. Aortic valve stenosis accounts for approximately 7% of all cases of congenital heart disease.
What causes it?
Aortic valve stenosis can run in families or may be due to something that happened to the fetus during pregnancy.
Unless it is severe, the condition is often not detected until later in life.
What are the symptoms?
Most children with aortic valve stenosis have no symptoms, so it’s difficult to detect. In general, many patients will be easily fatigued, but show no other symptoms until their thirties to fifties. A small number of children may be prone to dizziness and fainting (syncope) within the first ten years of life. If the obstruction is great, infants may suffer from severe heart failure. Sudden death is uncommon, but possible. Adolescents with hypertrophic cardiomyopathy, a type of aortic stenosis where the left ventricle is noticeably enlarged, have the greatest risk of sudden heart failure. How is it diagnosed? Children with aortic valve stenosis usually have a heart murmur that can be heard with a stethoscope. A doctor can also detect pulse abnormalities and will see irregularities on an electrocardiogram (ECG). A chest x-ray may also show an enlarged left ventricle. An echocardiogram may also be ordered. This technique uses ultrasound waves to create an image of the heart and its function. In cases where severe blockage is suspected and surgery most likely, doctors may do a left heart cardiac catheritization. In this procedure, a thin tube (catheter) is inserted through an artery and moved into the heart chambers. This procedure will measure the pressure difference between the left ventricle and the aorta.
What is the treatment?
Children with aortic valve stenosis require close medical supervision and should undergo yearly exercise testing after the age of six. Most children with mild to moderate aortic valve stenosis can engage in normal physical activities. Surgery is only performed in cases of severe obstruction. The most common treatments are surgical valve repair and balloon valvuloplasty. A balloon-tipped catheter is inserted into the aortic valve. The balloon is then inflated to expand the valve opening. Some forms of aortic valve stenosis require medical management with beta-blockers or calcium channel blockers.
Self-care tips
If your child has been diagnosed with aortic valve stenosis, follow your doctor’s recommendations for treatment and physical activity.
Sunday, March 8, 2009
Iron-deficiency Anemia
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.
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.
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.
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