Introduction
In an age when we believe that we have the tools to conquer most diseases, the ancient scourge of tuberculosis (TB) still causes 2 million deaths a year worldwide—more than any other single infectious organism—reminding us that we still have a long way to go. Even equipped with drugs to treat TB effectively, we haven't managed to eradicate this deadly infection.
What is the history of tuberculosis? And how has it managed to survive for so long? This section will answer these questions, plus describe the symptoms and treatment options available for TB.
An Ancient Scourge That Still Kills Today
Mycobacterium tuberculosis, the bacteria that causes tuberculosis, has been around for centuries. Recently, fragments of the spinal columns from Egyptian mummies from 2400 B.C.E. were found to have definite signs of the ravages of this terrible disease. Also called consumption, TB was identified as the most widespread disease in ancient Greece, where it was almost always fatal. But it wasn't until centuries later that the first descriptions of the disease began to appear. Starting in the late seventeenth century, physicians began to identify changes in the lungs common in all consumptive, or TB, patients. At the same time, the earliest references to the fact that the disease was infectious began to appear.
In 1720, the English doctor Benjamin Marten was the first to state that TB could be caused by “wonderfully minute living creatures.” He went further to say that it was likely that ongoing contact with a consumptive patient could cause a healthy person to get sick. Although Marten's findings didn't help to cure TB, they did help people to better understand the disease.
The sanitorium, which was introduced in the mid-nineteenth century, was the first positive step to contain TB. Hermann Brehmer, a Silesian botany student who had TB, was told by his doctor to find a healthy climate. He moved to the Himalayas and continued his studies. He survived his bout with the illness, and after he received his doctorate, built an institution in Gorbersdorf, where TB patients could come to recuperate. They received good nutrition and were outside in fresh air most of the day. This became the model for the development of sanitoria around the world.
In 1865, French military doctor Jean-Antoine Villemin demonstrated that TB could be passed from people to cattle and from cattle to rabbits. In 1882, Robert Koch discovered a staining technique that allowed him to see the bacteria that cause TB under a microscope.
Until the introduction of surgical techniques to remove infected tissue and the development of x-rays to monitor the disease, doctors didn't have great tools to treat TB. TB patients could be isolated, which helped reduce the spread of the disease, but treating it remained a challenge.
Disease Diction
Tuberculosis was first formally described by Greek physician Hippocrates around 460 B.C.E. He called it phthsis which is the Greek word for consumption, because it described the way the disease consumed its victims. Consumption was the most widespread disease of the time, and most of its victims died. The word consumption was used to describe the disease until 1882, when the tuberculosis bacteria was identified as the cause of the disease.
Antigen Alert
Tuberculosis is spread through the air, so everyone is at some risk.
Saturday, May 3, 2008
Genital Herpes
Herpes simplex virus (HSV), better known as genital herpes, is a contagious viral infection estimated to infect 45 million Americans, with as many as 500,000 new cases occurring each year. Infections frequently go unrecognized by patients and/or clinicians. Two types of virus, HSV1 and HSV2, cause genital herpes. Both types produce sores in and around the vagina, penis, anal opening, and on the buttocks or thighs. Sores may also appear on other areas whenever broken skin comes into contact with HSV.
The virus invades nerves cells and can reside there for life, causing periodic symptoms. Genital herpes infection is acquired by sexual contact with a partner having an outbreak of herpes sores in the genital area. Oral herpes can be transmitted to the genital area of a partner during oral sex. Some herpes infections may make people more likely to get an HIV infection if exposed to the virus. Reliable tests for HSV antibodies are now readily available. In addition, PCR tests can be used to detect herpes infection.
Potent Fact
Genital herpes is not readily spread by contact with a toilet seat or in a hot tub.
There is no cure for herpes. However, there are a number of drugs that are effective in treating the herpes virus. Acyclovir, an antiviral drug, is the “gold standard” of therapy. These drugs reduce symptoms and help to speed healing. They also lessen the chances of outbreaks. There is no vaccine for genital herpes, although recent trials of vaccines reduced the risk of infection by 75 percent. The vaccine was not effective in men, however, making it the first time a vaccine worked in one sex and not in the other. Unfortunately, herpes can be spread even if the infection is inactive.
The virus invades nerves cells and can reside there for life, causing periodic symptoms. Genital herpes infection is acquired by sexual contact with a partner having an outbreak of herpes sores in the genital area. Oral herpes can be transmitted to the genital area of a partner during oral sex. Some herpes infections may make people more likely to get an HIV infection if exposed to the virus. Reliable tests for HSV antibodies are now readily available. In addition, PCR tests can be used to detect herpes infection.
Potent Fact
Genital herpes is not readily spread by contact with a toilet seat or in a hot tub.
There is no cure for herpes. However, there are a number of drugs that are effective in treating the herpes virus. Acyclovir, an antiviral drug, is the “gold standard” of therapy. These drugs reduce symptoms and help to speed healing. They also lessen the chances of outbreaks. There is no vaccine for genital herpes, although recent trials of vaccines reduced the risk of infection by 75 percent. The vaccine was not effective in men, however, making it the first time a vaccine worked in one sex and not in the other. Unfortunately, herpes can be spread even if the infection is inactive.
Terrifying Tetanus
Tetanus, also called lockjaw, is very rare in the United States because most children are vaccinated against it. Tetanus is caused by a bacterium that is common in the soil, but dies quickly when it is exposed to oxygen. People who haven't been vaccinated for tetanus can get the disease by stepping on a dirty nail or getting cut by a dirty tool. The bacterium produces a toxin, or poison, that spreads in the bloodstream and can result in severe muscle spasms, paralysis, and death.
Tetanus is difficult to treat, but proper vaccination prevents it. Children get a tetanus shot in combination with pertussis and diphtheria vaccines. Adults need a booster shot every ten years to make sure they are protected.
Tetanus is difficult to treat, but proper vaccination prevents it. Children get a tetanus shot in combination with pertussis and diphtheria vaccines. Adults need a booster shot every ten years to make sure they are protected.
Pertussis, or Whooping Cough
Pertussis, or whooping cough, was a major cause of illness and death among infants and children in the United States before vaccines were introduced in the 1940s. Following the introduction and widespread use of the combined pertussis, diphtheria, and tetanus vaccine (DTP) among infants and children in the late 1940s, the incidence of reported pertussis declined to a historic low of 1,010 cases in 1976.
Whooping cough is a very contagious and dangerous respiratory infection caused by the Bordetella pertussis bacterium. Symptoms of whooping cough generally include runny nose and a cough that gets worse and worse. Violent coughing spells can end with vomiting. Once the whooping stage begins, antibiotics don't work.
Disease Diction
Whooping cough got its name from the whooping sound children make when they try to breathe after a coughing spell.
Whooping cough is spread through the air, making it particularly infectious.
Whooping cough is a very contagious and dangerous respiratory infection caused by the Bordetella pertussis bacterium. Symptoms of whooping cough generally include runny nose and a cough that gets worse and worse. Violent coughing spells can end with vomiting. Once the whooping stage begins, antibiotics don't work.
Disease Diction
Whooping cough got its name from the whooping sound children make when they try to breathe after a coughing spell.
Whooping cough is spread through the air, making it particularly infectious.
SICKLE CELL DISEASE
Sickle-cell disease or sickle-cell anaemia (or anemia) is a blood disorder characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickling decreases the cells' flexibility and results in their restricted movement through blood vessels, depriving downstream tissues of oxygen. The disease is chronic and lifelong: individuals are most often well, but their lives are punctuated by periodic painful attacks and a risk of various other complications. Life expectancy is shortened, with older studies reporting an average life expectancy of 42 and 48 years for males and females, respectively.
Sickle-cell disease occurs more commonly in people (or their descendants) from parts of the world such as sub-Saharan Africa, where malaria is or was common, but it also occurs in people of other ethnicities. This is because those with one or two alleles of the sickle-cell disease are resistant to malaria since the sickle red blood cells are not conducive to the parasites - in areas where malaria is common there is a survival value in carrying the sickle-cell genes.
Sickle-cell disease occurs more commonly in people (or their descendants) from parts of the world such as sub-Saharan Africa, where malaria is or was common, but it also occurs in people of other ethnicities. This is because those with one or two alleles of the sickle-cell disease are resistant to malaria since the sickle red blood cells are not conducive to the parasites - in areas where malaria is common there is a survival value in carrying the sickle-cell genes.
Hepatitis
Hepatitis
(plural hepatitides) implies injury to liver characterized by presence of inflammatory cells in the liver tissue. Etymologically from ancient Greek hepar (ηπαÏ) or hepato- (ηπατο-), meaning 'liver,' and suffix -itis, denoting 'inflammation' (c. 1727). The condition can be self limiting, healing on its own, or can progress to scarring of the liver. Hepatitis is acute when it lasts less than 6 months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide. Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions that include, among other things, screening of harmful substances, regulation of blood composition, and production of bile to help digestion.
Causes
Acute hepatitis
* Viral Hepatitis: Hepatitis A to E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses.
* Non viral infection: toxoplasma, Leptospira, Q fever,[2] rocky mountain spotted fever[3]
* Alcohol
* Toxins: Amanita toxin in mushrooms, carbon tetrachloride, asafetida
* Drugs: Paracetamol, amoxycillin, antituberculosis medicines, minocycline and many others (see longer list below).
* Ischemic hepatitis (circulatory insufficiency)
* Pregnancy
* Auto immune conditions, e.g. Systemic Lupus Erythematosus (SLE)
* Metabolic diseases, e.g. Wilson's disease
Chronic hepatitis
* Viral hepatitis: Hepatitis B with or without hepatitis D, hepatitis C (Hepatitis A and E do not lead to chronic disease)
* Autoimmune: Autoimmune hepatitis
* Alcohol
* Drugs: methyl-dopa, nitrofurantoin, isoniazide, ketoconazole
* Non-alcoholic steatohepatitis
* Heredity: Wilson's disease, alpha 1-antitrypsin deficiency
* Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis
(plural hepatitides) implies injury to liver characterized by presence of inflammatory cells in the liver tissue. Etymologically from ancient Greek hepar (ηπαÏ) or hepato- (ηπατο-), meaning 'liver,' and suffix -itis, denoting 'inflammation' (c. 1727). The condition can be self limiting, healing on its own, or can progress to scarring of the liver. Hepatitis is acute when it lasts less than 6 months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide. Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions that include, among other things, screening of harmful substances, regulation of blood composition, and production of bile to help digestion.
Causes
Acute hepatitis
* Viral Hepatitis: Hepatitis A to E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses.
* Non viral infection: toxoplasma, Leptospira, Q fever,[2] rocky mountain spotted fever[3]
* Alcohol
* Toxins: Amanita toxin in mushrooms, carbon tetrachloride, asafetida
* Drugs: Paracetamol, amoxycillin, antituberculosis medicines, minocycline and many others (see longer list below).
* Ischemic hepatitis (circulatory insufficiency)
* Pregnancy
* Auto immune conditions, e.g. Systemic Lupus Erythematosus (SLE)
* Metabolic diseases, e.g. Wilson's disease
Chronic hepatitis
* Viral hepatitis: Hepatitis B with or without hepatitis D, hepatitis C (Hepatitis A and E do not lead to chronic disease)
* Autoimmune: Autoimmune hepatitis
* Alcohol
* Drugs: methyl-dopa, nitrofurantoin, isoniazide, ketoconazole
* Non-alcoholic steatohepatitis
* Heredity: Wilson's disease, alpha 1-antitrypsin deficiency
* Primary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis
Monday, March 3, 2008
Microdermabrasion
Microdermabrasion is a mini procedure that involves the skin being "sandblasted" by aluminum oxide crystals, baking soda, salt or corn cob granules to remove the stratum corneum (top) layer of the skin; dead skin cells.
Microdermabrasion also promotes the production of new cells in the basal (deepest) layer of the dermis. This procedure may not give everyone the same results but if you have the money it is a nice treat and requires no down time. It can clean your pores incredibly and hinder any future breaks outs if used on a regular basis.
Are You Suitable for Microdermabrasion?
If you have or have had acne, discolorations, superficial lines and wrinkles, uneven texture or sun damaged skin -- you may be a candidate for Microdermabrasion.
Is Microdermabrasion Painful?
Microdermabrasion does not hurt although it may sting a little around the eye area. The patient normally works up to a level as they go to increase the penetration to the skin.
microdermabrasion products
Microdermabrasion also promotes the production of new cells in the basal (deepest) layer of the dermis. This procedure may not give everyone the same results but if you have the money it is a nice treat and requires no down time. It can clean your pores incredibly and hinder any future breaks outs if used on a regular basis.
Are You Suitable for Microdermabrasion?
If you have or have had acne, discolorations, superficial lines and wrinkles, uneven texture or sun damaged skin -- you may be a candidate for Microdermabrasion.
Is Microdermabrasion Painful?
Microdermabrasion does not hurt although it may sting a little around the eye area. The patient normally works up to a level as they go to increase the penetration to the skin.
microdermabrasion products
VigRx
VigRx is a natural herbal formula which is used for penis enlargement. VigRx helps in increasing the size of the erectile organ, improving sexual health strengthening erections when a man gets sexually aroused. VigRx contains potent aphrodisiac herbal concentrates from Europe, China and South America, these herbal concentrates are scientifically tested and help in stimulating sexual activity, maintaining a proper erection and increase pleasure during sexual intercourse. Men's health has become a major factor and VigRx helps in improving the Sexual health of a man.
All About Malignant Mesothelioma
Malignant mesothelioma is a rare form of cancer that affects the mesothelial cells of the serous membranes in the body. The most common form of mesothelioma, affecting the lining of the lung, is pleural mesothelioma. Two to three thousand new cases of malignant mesothelioma are diagnosed each year.
The mission of All About Malignant Mesothelioma is to provide a one-stop resource for comprehensive, up-to-date mesothelioma information. We cover the full scope of malignant mesothelioma issues including background, history, risk factors, diagnosis, and treatment. Please recommend the site to someone who may benefit from mesothelioma information.
Introduction to Malignant Mesothelioma
Malignant mesothelioma affects the lining or membranes of certain large cavities in the body. These cavities, called the serous cavities, house certain major organs in the body including the heart, lungs, abdomen and others. The membranes that surround these cavities are called the serous membranes. They serve to protect these major organs from the friction and abrasion that occur as the organs move against each other during typical daily functioning, such as breathing and heart beating. The serous membranes derive from specialized cells called mesothelial cells. These cells form to create the mesothelium, which is the major tissue layer of the serous membranes. Cancer that occurs in the mesothelium tissue is called mesothelioma.
Malignant mesothelioma takes on three forms:
* Peritoneal mesothelioma, in the peritoneum or membrane surrounding the abdomen. A rare form of peritoneal mesothelioma can also affect the male testicles, because the lining around the scrotum is an extension of the peritoneum.
* Pericardial mesothelioma, in the perdicardium or lining surrounding the heart.
* Pleural mesothelioma, which is the most common form of malignant mesothelioma and affects the lining of the lung cavity.
All mesotheliomas are now considered to be malignant, or cancerous. They start as a localized tumor and spread rapidly to include most of the surrounding tissues and organs. Originally, fibrous cists and other non-cancerous growths that appeared in the serous membranes were thought to be mesotheliomas and were termed "benign fibrous mesothelioma" and "multicystic mesothelioma." These conditions are now known not to originate in the mesothelial cells, but other cells within the serous membranes. These conditions are typically localized, non-cancerous and do not spread rapidly.
Etiology of Malignant Mesothelioma
Most cases of malignant mesothelioma are associated with a previous exposure to fibrous minerals, of which asbestos is the most important. There is now indisputable evidence of the role of these fibers in the development of this disease. This has been demonstrated in animal experiments and many other experiments. Not everyone who is exposed to asbestos fibers has developed malignant mesothelioma, suggesting that other factors may also be involved.
Although malignant mesothelioma is rare, it is a serious, deadly disease. It is often in the advanced stages when it is detected, so the outlook for the patients is not as good as it is for the cancers that are detected earlier. The average survival time after detection is 1 to 2 years. This survival time also depends on the type of mesothelioma.
Further Malignant Mesothelioma Information
Please continue reading the articles on this website for more mesothelioma information and asbestos information. In addition, we recommend the following malignant mesothelioma resources:
The mission of All About Malignant Mesothelioma is to provide a one-stop resource for comprehensive, up-to-date mesothelioma information. We cover the full scope of malignant mesothelioma issues including background, history, risk factors, diagnosis, and treatment. Please recommend the site to someone who may benefit from mesothelioma information.
Introduction to Malignant Mesothelioma
Malignant mesothelioma affects the lining or membranes of certain large cavities in the body. These cavities, called the serous cavities, house certain major organs in the body including the heart, lungs, abdomen and others. The membranes that surround these cavities are called the serous membranes. They serve to protect these major organs from the friction and abrasion that occur as the organs move against each other during typical daily functioning, such as breathing and heart beating. The serous membranes derive from specialized cells called mesothelial cells. These cells form to create the mesothelium, which is the major tissue layer of the serous membranes. Cancer that occurs in the mesothelium tissue is called mesothelioma.
Malignant mesothelioma takes on three forms:
* Peritoneal mesothelioma, in the peritoneum or membrane surrounding the abdomen. A rare form of peritoneal mesothelioma can also affect the male testicles, because the lining around the scrotum is an extension of the peritoneum.
* Pericardial mesothelioma, in the perdicardium or lining surrounding the heart.
* Pleural mesothelioma, which is the most common form of malignant mesothelioma and affects the lining of the lung cavity.
All mesotheliomas are now considered to be malignant, or cancerous. They start as a localized tumor and spread rapidly to include most of the surrounding tissues and organs. Originally, fibrous cists and other non-cancerous growths that appeared in the serous membranes were thought to be mesotheliomas and were termed "benign fibrous mesothelioma" and "multicystic mesothelioma." These conditions are now known not to originate in the mesothelial cells, but other cells within the serous membranes. These conditions are typically localized, non-cancerous and do not spread rapidly.
Etiology of Malignant Mesothelioma
Most cases of malignant mesothelioma are associated with a previous exposure to fibrous minerals, of which asbestos is the most important. There is now indisputable evidence of the role of these fibers in the development of this disease. This has been demonstrated in animal experiments and many other experiments. Not everyone who is exposed to asbestos fibers has developed malignant mesothelioma, suggesting that other factors may also be involved.
Although malignant mesothelioma is rare, it is a serious, deadly disease. It is often in the advanced stages when it is detected, so the outlook for the patients is not as good as it is for the cancers that are detected earlier. The average survival time after detection is 1 to 2 years. This survival time also depends on the type of mesothelioma.
Further Malignant Mesothelioma Information
Please continue reading the articles on this website for more mesothelioma information and asbestos information. In addition, we recommend the following malignant mesothelioma resources:
The Best Acne Treatments
There are too many acne fighting products on the market to count, and the majority of them simply do not work. However, there are some that do work quite well. The problem is that many people who suffer from acne will spend quite a bit of time and money trying to find the best acne treatments. Teenagers often outgrow acne before they find a treatment that works.
One of the better acne treatments on the market today is ProActiv. ProActiv seems to be helping many people who could not find other solutions that worked. It has been featured on infomercials, news stories, magazine articles, and newspaper articles. Proactiv is a system that includes a renewing cleanser, revitalizing toner, and repairing lotion. Prescription grade benzoyl peroxide is the active ingredient in ProActiv. ProActiv does not require a prescription.
A treatment that is available by prescription is Accutane. Accutane is a very strong medication, that is only suitable for those who suffer from severe and persistent acne. The medication is taken internally, and there are possible side effects, including birth defects, dry and cracked lips, and liver dysfunction.
Another one of that is used topically is retin-a. Many people have had great success with retin-a, which is used to treat acne, acne scars, wrinkles, stretch marks, skin discoloration, and a variety of other skin afflictions. Retin-a is available by prescription, but some over the counter medications contain retin-a.
Not all treatments come in the form of chemicals. Certain essential oils are also beneficial in the treatment of acne. These essential oils can be applied topically for the treatment of mild to moderate acne. The best essential oils for acne treatment are: Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. If the essential oil needs to be diluted, mix it with Grapeseed Oil for best results.
In order to find the best acne treatment for you, start with essential oils. If that doesn't work, go to the next step by trying ProActive. If ProActive doesn't work, then try a prescription alternative. You may also consider being tested for food allergies, as certain allergies can cause acne. In this case, the only treatment you need is to eliminate those certain foods from your diet.
One of the better acne treatments on the market today is ProActiv. ProActiv seems to be helping many people who could not find other solutions that worked. It has been featured on infomercials, news stories, magazine articles, and newspaper articles. Proactiv is a system that includes a renewing cleanser, revitalizing toner, and repairing lotion. Prescription grade benzoyl peroxide is the active ingredient in ProActiv. ProActiv does not require a prescription.
A treatment that is available by prescription is Accutane. Accutane is a very strong medication, that is only suitable for those who suffer from severe and persistent acne. The medication is taken internally, and there are possible side effects, including birth defects, dry and cracked lips, and liver dysfunction.
Another one of that is used topically is retin-a. Many people have had great success with retin-a, which is used to treat acne, acne scars, wrinkles, stretch marks, skin discoloration, and a variety of other skin afflictions. Retin-a is available by prescription, but some over the counter medications contain retin-a.
Not all treatments come in the form of chemicals. Certain essential oils are also beneficial in the treatment of acne. These essential oils can be applied topically for the treatment of mild to moderate acne. The best essential oils for acne treatment are: Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. If the essential oil needs to be diluted, mix it with Grapeseed Oil for best results.
In order to find the best acne treatment for you, start with essential oils. If that doesn't work, go to the next step by trying ProActive. If ProActive doesn't work, then try a prescription alternative. You may also consider being tested for food allergies, as certain allergies can cause acne. In this case, the only treatment you need is to eliminate those certain foods from your diet.
Medifast Diet: Complete Review
The Medifast diet plan is popular.
Forbes recently placed the company at number 28 in their 200 best small companies list), and Medifast have even produced a book (What Physicians Have Always Known About Weight Loss).
But what is Medifast all about? One clue is the name - it contains the word fast...
The Basics
The Medifast brand has been around for a number of decades, and at one time was only available via physicians. Nowadays the products can be ordered on-line and through a number of distributors.
Medifast offer a stable of meal replacement products - all generally formulated to be low-calorie and low-fat, and containing the optimum levels of vitamins. The formula will generally take users into a mild state of ketosis.
The most popular plan is called 5 and 1. This plan (800-1000 calories daily) comprises 5 meal replacements and one "real" meal containing a lean protein and vegetables and salad. Medifast claim a weight loss of 2-5 pounds per week on this plan.
Proof?
What many people don't realize is that very few commercial weight loss programs have ever undergone any clinical studies. Medifast heavily promote the fact that a Johns Hopkins university study has shown that Medifast results in significant weight loss (67 pound average loss in males and 57 pound average loss in females). It's worth pointing out that this study looked at patients who attended Medifast clinics.
There is also an additional study that compared the Medifast program with diabetes medication. The study found Medifast more effective at controlling type 2 diabetes than an ADA-recommended program (see PR).
Both studies were led by Associate Professor Lawrence Cheskin of Johns Hopkins Bloomberg School of Public Health and were funded by Medifast.
Successes
Due to the popularity of the program, Medifast have a number of "success stories" - one of which is Nnedi Uzowihe-Igwe of Maryland, USA (currently featured on the Medifast site). She also appeared in People magazine in January 2006 describing a massive transformation that resulted in a 160lb weight loss between June 2004 and April 2005. Nnedi subsequently became pregnant and gave birth to her second daughter)
I was able to find out how Nnedi was going now, and she appears to have maintained her massive initial weight loss (and is aiming to lose the weight she put on with the second baby by the end of this year).
What you can expect
Drastic
Protein fasts and low-calorie meal replacements are a drastic solution, and in my opinion appropriate for drastic situations. Given the choice between gastric bypass surgery or Medifast, then Medifast must surely be a better answer.
The biggest test of a program such as Medifast is the long-term consequences - and in particular weaning off a program based around shakes and soups. The transition phase should be four to six weeks, and often starts off by introducing some oatmeal at breakfast, and some fruit for snacks. Also exercise must become a part of life (5 days a week). Exercise must be fairly low-key during the restrictive part of Medifast - but once transitioning - it becomes increasingly important.
Due to the level of energy intake and exercise levels - it is likely that some muscle loss will occur during the weight loss phase. Once again, the best course of action would be to gradually include strength training during the transition phase - and begin to build up muscle tone.
Costs
The Medifast 5 and 1 plan cost $275 for 4 weeks. However - that's the cost of the "5" - you will still need to buy your daily "lean and green" meal (lean protein plus salad/vegetables).
Men & Women
Different formulations are used for men and women. Some shakes are called Medifast 55 or Medifast 70. The latter has a higher soy protein content and is more suitable for men (or women who prefer higher protein).
Behavior Change Required
Behavioral changes are critical to the long-term success of Medifast. Unless these lifestyle changes are applied, then the weight could easily swing back on like a yo-yo. It's worth taking a look at the post 10 Questions To Ask Before Changing Your Diet.
Conclusion
I don't believe Medifast is for the person who wants to lose 20 pounds. This is a serious program for serious situations, and it may be advisable to follow the program while receiving regular support from a clinic, and even under medical advisement.
However ample proof exists that the program does work and can lead to significant weight loss provided the transition phase is followed correctly.
Forbes recently placed the company at number 28 in their 200 best small companies list), and Medifast have even produced a book (What Physicians Have Always Known About Weight Loss).
But what is Medifast all about? One clue is the name - it contains the word fast...
The Basics
The Medifast brand has been around for a number of decades, and at one time was only available via physicians. Nowadays the products can be ordered on-line and through a number of distributors.
Medifast offer a stable of meal replacement products - all generally formulated to be low-calorie and low-fat, and containing the optimum levels of vitamins. The formula will generally take users into a mild state of ketosis.
The most popular plan is called 5 and 1. This plan (800-1000 calories daily) comprises 5 meal replacements and one "real" meal containing a lean protein and vegetables and salad. Medifast claim a weight loss of 2-5 pounds per week on this plan.
Proof?
What many people don't realize is that very few commercial weight loss programs have ever undergone any clinical studies. Medifast heavily promote the fact that a Johns Hopkins university study has shown that Medifast results in significant weight loss (67 pound average loss in males and 57 pound average loss in females). It's worth pointing out that this study looked at patients who attended Medifast clinics.
There is also an additional study that compared the Medifast program with diabetes medication. The study found Medifast more effective at controlling type 2 diabetes than an ADA-recommended program (see PR).
Both studies were led by Associate Professor Lawrence Cheskin of Johns Hopkins Bloomberg School of Public Health and were funded by Medifast.
Successes
Due to the popularity of the program, Medifast have a number of "success stories" - one of which is Nnedi Uzowihe-Igwe of Maryland, USA (currently featured on the Medifast site). She also appeared in People magazine in January 2006 describing a massive transformation that resulted in a 160lb weight loss between June 2004 and April 2005. Nnedi subsequently became pregnant and gave birth to her second daughter)
I was able to find out how Nnedi was going now, and she appears to have maintained her massive initial weight loss (and is aiming to lose the weight she put on with the second baby by the end of this year).
What you can expect
Drastic
Protein fasts and low-calorie meal replacements are a drastic solution, and in my opinion appropriate for drastic situations. Given the choice between gastric bypass surgery or Medifast, then Medifast must surely be a better answer.
The biggest test of a program such as Medifast is the long-term consequences - and in particular weaning off a program based around shakes and soups. The transition phase should be four to six weeks, and often starts off by introducing some oatmeal at breakfast, and some fruit for snacks. Also exercise must become a part of life (5 days a week). Exercise must be fairly low-key during the restrictive part of Medifast - but once transitioning - it becomes increasingly important.
Due to the level of energy intake and exercise levels - it is likely that some muscle loss will occur during the weight loss phase. Once again, the best course of action would be to gradually include strength training during the transition phase - and begin to build up muscle tone.
Costs
The Medifast 5 and 1 plan cost $275 for 4 weeks. However - that's the cost of the "5" - you will still need to buy your daily "lean and green" meal (lean protein plus salad/vegetables).
Men & Women
Different formulations are used for men and women. Some shakes are called Medifast 55 or Medifast 70. The latter has a higher soy protein content and is more suitable for men (or women who prefer higher protein).
Behavior Change Required
Behavioral changes are critical to the long-term success of Medifast. Unless these lifestyle changes are applied, then the weight could easily swing back on like a yo-yo. It's worth taking a look at the post 10 Questions To Ask Before Changing Your Diet.
Conclusion
I don't believe Medifast is for the person who wants to lose 20 pounds. This is a serious program for serious situations, and it may be advisable to follow the program while receiving regular support from a clinic, and even under medical advisement.
However ample proof exists that the program does work and can lead to significant weight loss provided the transition phase is followed correctly.
Saturday, March 1, 2008
Phobias
The Phobia List
There are many hundreds of named phobias, and this is the most complete list of which we know.
Although there are many hundreds of 'different' phobias, all phobias are in fact very similar: a particular stimulus, be it spiders, snakes, or pretty well anything else triggering the phobic individuals fear response when it isn't appropriate.
The Phobia List: A
Ablutophobia — Fear of washing, bathing, or cleaning
Acarophobia — Fear of itching or the insects that cause itching
Acerophobia — Fear of sourness or things that are sour
Achluophobia — Fear of darkness or the dark
Acousticophobia — Fear of noise or sound
Acrophobia — Fear of heights or high levels
Aeroacrophobia — Fear of open high places
Aeronausiphobia — Fear of vomiting secondary to airsickness
Aerophobia — Fear of draft, swallowing air, or airbourne noxious substances
Agateophobia — Fear of insanity or becoming insane
Agliophobia — Fear of pain
Agoraphobia — Fear of open spaces, leaving a safe place, or crowded public places
Agraphobia — Fear of sexual abuse
Agrizoophobia — Fear of wild animals
Agyrophobia — Fear of streets or crossing the street
Aichmophobia — Fear of needles, pins, or pointed objects
Ailurophobia — Fear of cats
Albuminurophobia — Fear of kidney disease
Alektorophobia — Fear of chickens
Algophobia — Fear of garlic
Alliumphobia — Fear of opinions or beliefs
Altophobia — Fear of dust
Amathophobia — Fear of riding in cars
Amaxophobia — Fear of walking
Amnesiphobia — Fear of amnesia
Amychophobia — Fear of scratches or being scratched
Anablephobia — Fear of looking up
Androphobia — Fear of men
Anemophobia — Fear of wind or air drafts
Anginophobia — Fear of angina, choking, or narrowness
Anglophobia — Fear of England, English Culture, or English People
Angrophobia — Fear of anger or becoming angry
Ankylophobia — Fear of immobility of a joint
Anthophobia — Fear of flowers
Anthropophobia — Fear of people or society
Antlophobia — Fear of floods
Anuptaphobia — Fear of staying single
Anxiety — Fear of Anxiety
Apeirophobia — Fear of infinity
Aphenphosmphobia — Fear of being touched
Apiphobia — Fear of bees
Apotemnophobia — Fear of persons with amputations
Arachibutyrophobia — Fear of peanut butter sticking to the roof of the mouth
Arachnephobia — Fear of spiders
Arithmophobia — Fear of numbers
Arsonphobia — Fear of fire or flames
Asthenophobia — Fear of fainting or weakness
Astraphobia — Fear of thunder and lightning
Astrophobia — Fear of stars and celestial space
Asymmetriphobia — Fear of asymmetrical things
Ataxiophobia — Fear of ataxia (muscular incoordination)
Ataxophobia — Fear of disorder or untidiness
Atelophobia — Fear of imperfection
Atephobia — Fear of ruin or ruins
Athazagoraphobia — Fear of being forgotton, being ignored, or forgetting
Atomosophobia — Fear of atomic explosions
Atychiphobia — Fear of failure
Aulophobia — Fear of flutes
Aurophobia — Fear of gold
Auroraphobia — Fear of Northern lights
Autodysomophobia — Fear of one that has a vile odor
Automatonophobia — Fear of ventriloquist's dummies, animatronic creatures or wax statues
Automysophobia — Fear of being dirty
Autophobia — Fear of solitude, being alone, oneself, or being by oneself
Aviophobia — Fear of flying
The Phobia List: B
Bacillophobia — Fear of microbes
Bacteriophobia — Fear of bacteria
Ballistophobia — Fear of missiles or bullets
Barophobia — Fear of gravity
Basiphobia — Fear of inability to stand or falling
Bathmophobia — Fear of stairs or steep slopes
Bathophobia — Fear of depth
Batophobia — Fear of heights or being close to high buildings
Batrachophobia — Fear of amphibians, frogs, newts, or salamanders
Bibliophobia — Fear of books
Blennophobia — Fear of slime
Body Dysmorphic Disorder — Fear of having ugly or unattractive features
Bogyphobia — Fear of bogies or the bogeyman
Bolshephobia — Fear of Bolsheviks
Botanophobia — Fear of plants
Bromidrophobia — Fear of bodily odor or bodily smell
Bufonophobia — Fear of toads
The Phobia List: C
Cacophobia — Fear of ugliness or things that are ugly
Cainophobia — Fear of newness or novelty
Caligynephobia — Fear of beautiful women
Cancerophobia — Fear of cancer
Cardiophobia — Fear of the heart
Carnophobia — Fear of meat
Catagelophobia — Fear of being ridiculed or ridicule
Catapedaphobia — Fear of jumping from high and low places
Cathisophobia — Fear of sitting
Catoptrophobia — Fear of mirrors
Cheimaphobia — Fear of cold
Chemophobia — Fear of chemicals or working with chemicals
Cherophobia — Fear of gaiety
Chionophobia — Fear of snow
Chirophobia — Fear of hands
Cholerophobia — Fear of anger or Cholera
Chorophobia — Fear of dancing
Chrematophobia — Fear of money
Chromatophobia — Fear of colors
Chronomentrophobia — Fear of clocks
Chronophobia — Fear of time
Claustrophobia — Fear of confined or small spaces
Cleisiophobia — Fear of being locked in an enclosed place
Cleithrophobia — Fear of being enclosed
Cleptophobia — Fear of stealing
Climacophobia — Fear of stairs, climbing stairs, or falling down stairs
Clinophobia — Fear of going to bed
Cnidophobia — Fear of stings or being stung
Coimetrophobia — Fear of cemeteries
Coitophobia — Fear of coitus, sex, or sexual intercourse
Cometophobia — Fear of comets
Coprastasophobia — Fear of constipation
Coprophobia — Fear of feces and fecal matter
Coulrophobia — Fear of clowns
Counterphobia — Fear of The preference by a phobic for fearful situations
Cremnophobia — Fear of precipices
Cryophobia — Fear of extreme cold, ice, or frost
Crystallophobia — Fear of crystals or glass
Cyberphobia — Fear of computers or working on a computer
Cyclophobia — Fear of bicycles
Cymophobia — Fear of waves or wave-like motion
Cynophobia — Fear of dogs, canines, or rabies
Cyprianophobia — Fear of prostitutes, venereal disease, or STDs
The Phobia List: D
Daemonophobia — Fear of demons or daemons
Decidophobia — Fear of making decisions
Defecaloesiophobia — Fear of painful bowels movements
Deipnophobia — Fear of dining or dinner conversation
Demophobia — Fear of crowds
Dendrophobia — Fear of trees
Dentophobia — Fear of dentists
Dermatopathophobia — Fear of skin disease or skin lesions
Dextrophobia — Fear of objects at the right side of the body
Diabetophobia — Fear of diabetes
Didaskaleinophobia — Fear of going to school
Dikephobia — Fear of justice
Dinophobia — Fear of dizziness or whirlpools
Diplophobia — Fear of double vision
Dipsophobia — Fear of drinking
Dishabiliophobia — Fear of undressing in front of someone
Doraphobia — Fear of fur or skins of animals
Doxophobia — Fear of expressing opinions or of receiving praise
Driving Phobia — Fear of driving a motorized vehicle
Dromophobia — Fear of crossing streets
Dutchphobia — Fear of the Netherlands, the Dutch, Dutch Culture
Dysmorphophobia — Fear of deformity
Dystychiphobia — Fear of accidents
The Phobia List: E
Earthquakophobia — Fear of earthquakes
Ecclesiophobia — Fear of churchs
Eisoptrophobia — Fear of mirrors or of seeing oneself in a mirror
Electrophobia — Fear of electricity
Eleutherophobia — Fear of freedom
Emetophobia — Fear of vomiting or throwing up
Enetophobia — Fear of pins
Enissophobia — Fear of having committed an unpardonable sin or criticism
Entomophobia — Fear of insects or bugs
Eosophobia — Fear of dawn or daylight
Ephebiphobia — Fear of teenagers
Epistaxiophobia — Fear of nosebleeds
Epistemophobia — Fear of knowledge
Equinophobia — Fear of horses
Eremophobia — Fear of being oneself or lonliness
Ereuthophobia — Fear of redlights, blushing, or the color red
Ergasiophobia — Fear of work, functioning, or Surgeon's operating
Ergophobia — Fear of work
Erotophobia — Fear of sexual love or sexual questions
Euphobia — Fear of hearing good news
The Phobia List: F
Francophobia — Fear of France, French people, or French culture
Frigophobia — Fear of cold or cold things
The Phobia List: G
Gamophobia — Fear of marriage
Geliophobia — Fear of laughter
Geniophobia — Fear of chins
Genuphobia — Fear of knees
Gephydrophobia — Fear of crossing bridges
Gerascophobia — Fear of growing old or old people
Germanophobia — Fear of Germany, German People, or German culture
Geumaphobia — Fear of taste
Globophobia — Fear of balloons
Glossophobia — Fear of speaking in public or trying to speak
Graphophobia — Fear of writing or handwriting
Gymnophobia — Fear of nudity
Gynephobia — Fear of women
The Phobia List: H
Hadephobia — Fear of hell
Hagiophobia — Fear of saints or holy things
Harpaxophobia — Fear of being robbed
Hedonophobia — Fear of feeling pleasure
Heliophobia — Fear of the sun
Hellenologophobia — Fear of Greek terms or complex scientific terminology
Helminthophobia — Fear of being infested with worms
Hemaphobia — Fear of blood
Hereiophobia — Fear of challenges to official doctrine or of radical deviation
Herpetophobia — Fear of reptiles or creepy, crawly things
Heterophobia — Fear of the opposite sex
Hierophobia — Fear of priests or sacred things
Hippopotomonstrosesquippedaliophobia — Fear of long words
Hobophobia — Fear of bums or beggars
Hodophobia — Fear of road travel
Homichlophobia — Fear of fog
Homilophobia — Fear of sermons
Homophobia — Fear of sameness, monotony, homosexuality, or becoming homosexual
Hoplophobia — Fear of firearms
Hormephobia — Fear of shock
Hyalophobia — Fear of glass
Hydrargyophobia — Fear of mercurial medicines
Hydrophobia — Fear of water
Hydrophobophobia — Fear of rabies
Hygrophobia — Fear of liquids, dampness, or moisture
Hylephobia — Fear of materialism or epilepsy
Hypegiaphobia — Fear of responsibility
Hypnophobia — Fear of sleep or being hypnotized
The Phobia List: I
Iatrophobia — Fear of doctors or going to the doctor
Ichthyophobia — Fear of fish
Ideophobia — Fear of ideas
Illyngophobia — Fear of vertigo or feeling dizzy when looking down
Insomnia — Fear of Inability to Sleep
Iophobia — Fear of poison
Isopterophobia — Fear of termites, insects that eat wood
The Phobia List: J
Japanophobia — Fear of Japanese
Judeophobia — Fear of Jewish People
The Phobia List: K
Kakorrhaphiophobia — Fear of failure or defeat
Kenophobia — Fear of voids or empty spaces
Kinesophobia — Fear of movement or motion
Koinoniphobia — Fear of rooms
Kolpophobia — Fear of genitals, particularly female
Kopophobia — Fear of fatigue
Kosmikophobia — Fear of cosmic phenomenon
Kyphophobia — Fear of stooping
The Phobia List: L
Lachanophobia — Fear of vegetables
Lalophobia — Fear of speaking
Lepraphobia — Fear of leprosy
Leukophobia — Fear of the color white
Levophobia — Fear of things to the left side of the body
Ligyrophobia — Fear of loud noises
Lilapsophobia — Fear of tornado or hurricanes
Limnophobia — Fear of lakes
Linonophobia — Fear of string
Liticaphobia — Fear of lawsuits
Lockiophobia — Fear of childbirth
Logizomechanophobia — Fear of computers
Logophobia — Fear of words
Luiphobia — Fear of lues or syphillis
Lutraphobia — Fear of otters
The Phobia List: M
Macrophobia — Fear of long waits
Mageirocophobia — Fear of cooking
Malaxophobia — Fear of love play
Maniaphobia — Fear of insanity
Mastigophobia — Fear of punishment
Mechanophobia — Fear of machines
Medomalacuphobia — Fear of losing an erection
Medorthophobia — Fear of an erect penis
Megalophobia — Fear of large things
Melanophobia — Fear of the color black
Melophobia — Fear of music
Meningitophobia — Fear of brain disease
Menophobia — Fear of menstruation
Merinthophobia — Fear of being bound or tied up
Metallophobia — Fear of metal
Metathesiophobia — Fear of changes
Meteorophobia — Fear of meteors
Metrophobia — Fear of poetry
Microbiophobia — Fear of microbes
Microphobia — Fear of small things
Misophobia — Fear of being contaminated with dirt or germs
Mnemophobia — Fear of memories
Monopathophobia — Fear of definite disease
Motorphobia — Fear of automobiles
Mottephobia — Fear of moths
Murophobia — Fear of mice
Mycophobia — Fear of mushrooms
Myrmecophobia — Fear of ants
Mythophobia — Fear of myths, stories, or false statements
The Phobia List: N
Narcissistic Personality Disorder — Fear of -
Necrophobia — Fear of death or dead things
Neopharmaphobia — Fear of new drugs
Nephophobia — Fear of clouds
Noctiphobia — Fear of the night
Nomatophobia — Fear of names
Nosocomephobia — Fear of hospitals
Nosophobia — Fear of becoming ill
Nostophobia — Fear of returning home
Novercaphobia — Fear of your step-mother
Nucleomituphobia — Fear of nuclear weapons
Nudophobia — Fear of nudity or nakedness
Nyctohylophobia — Fear of dark wooded areas or forests at night
The Phobia List: O
Obesophobia — Fear of gaining weight
Ochlophobia — Fear of crowds or mobs
Ochophobia — Fear of vehicles
Octophobia — Fear of the figure 8
Odontophobia — Fear of teeth or dental surgery
Oenophobia — Fear of wines
Oikophobia — Fear of houses, home surroundings, or being in a house
Olfactophobia — Fear of smells
Ombrophobia — Fear of rain or of being rained on
Ommatophobia — Fear of eyes
Oneirogmophobia — Fear of wet dreams
Oneirophobia — Fear of dreams
Onomatophobia — Fear of hearing a certain word or of names
Ophidiophobia — Fear of snakes
Ophthalmophobia — Fear of being stared at
Opiophobia — Fear of Fear of medical doctors experience of prescribing needed pain medications for patients
Optophobia — Fear of opening one's eyes
Ornithophobia — Fear of birds
Orthophobia — Fear of property
Ostraconophobia — Fear of shellfish
Ouranophobia — Fear of heaven
The Phobia List: P
Pagophobia — Fear of ice or frost
Panophobia — Fear of everything
Panthophobia — Fear of suffering or disease
Papaphobia — Fear of the Pope
Papyrophobia — Fear of paper
Paralipophobia — Fear of neglecting duty or neglecting responsibility
Paraphobia — Fear of sexual perversion
Parasitophobia — Fear of parasites
Paraskavedekatriaphobia — Fear of Friday the 13th
Parthenophobia — Fear of virgins or young girls
Pathophobia — Fear of disease
Patroiophobia — Fear of heredity
Peccatophobia — Fear of sinning
Pediculophobia — Fear of lice
Pediophobia — Fear of dolls
Pedophobia — Fear of children
Peladophobia — Fear of bald people
Pellagrophobia — Fear of pellagra
Peniaphobia — Fear of poverty
Pentheraphobia — Fear of mother-in-law
Phagophobia — Fear of swallowing or eating
Phalacrophobia — Fear of becoming bald
Pharmacophobia — Fear of taking medicine or drugs
Phengophobia — Fear of daylight or sunshine
Philemaphobia — Fear of kissing
Philophobia — Fear of falling in love or being in love
Philosophobia — Fear of philosophy
Phobophobia — Fear of phobias
Phonophobia — Fear of noises, voices, one's own voice, or telephones
Photoaugliaphobia — Fear of glaring lights
Photophobia — Fear of light
Phronemophobia — Fear of thinking
Phthisiophobia — Fear of tuberculosis
Placophobia — Fear of tombstones
Plutophobia — Fear of wealth
Pneumatiphobia — Fear of spirits
Pnigerophobia — Fear of choking of being smothered
Pogonophobia — Fear of beards
Poliosophobia — Fear of contracting poliomyelitis
Politicophobia — Fear of politicians
Polyphobia — Fear of many things
Ponophobia — Fear of overworking or of pain
Porphyrophobia — Fear of the color purple
Potamophobia — Fear of rivers or running water
Potophobia — Fear of alcohol
Proctophobia — Fear of rectums
Prosophobia — Fear of progress
Psellismophobia — Fear of stuttering
Psychophobia — Fear of the mind
Psychrophobia — Fear of the cold
Pteromerhanophobia — Fear of flying
Pteronophobia — Fear of being tickled by feathers
Pupaphobia — Fear of puppets
Pyrexiophobia — Fear of fever
The Phobia List: R
Radiophobia — Fear of radiation or x-rays
Ranidaphobia — Fear of frogs
Rectophobia — Fear of rectums or rectal diseases
Rhabdophobia — Fear of being severely punished, beaten by a rod, or severely criticized
Rhypophobia — Fear of defecation
Rhytiphobia — Fear of getting wrinkles
Rupophobia — Fear of dirt
Russophobia — Fear of Russians
The Phobia List: S
Samhainophobia — Fear of Halloween
Satanophobia — Fear of Satan or The Devil
Scabiophobia — Fear of scabies
Scelerophibia — Fear of bad men or burglars
Sciaphobia — Fear of shadows
Scoleciphobia — Fear of worms
Scolionophobia — Fear of school
Scopophobia — Fear of being seen or stared at
Scoptophobia — Fear of blindness in visual field
Scriptophobia — Fear of writing in public
Selachophobia — Fear of sharks
Selaphobia — Fear of light flashes
Selenophobia — Fear of the moon
Seplophobia — Fear of decaying matter
Siderodromophobia — Fear of trains, railroads, or train travel
Siderophobia — Fear of stars
Sinistrophobia — Fear of things to the left or left-handed
Sinophobia — Fear of China, Chinese, or Chinese culture
Sitiophobia — Fear of food or eating
Soceraphobia — Fear of parents-in-law
Social Phobia — Fear of social situations
Sociophobia — Fear of society or people in general
Somniphobia — Fear of sleep
Sophophobia — Fear of learning
Soteriophobia — Fear of dependence on others
Spacephobia — Fear of outer space
Spectrophobia — Fear of specters or ghosts
Spheksophobia — Fear of wasps
Stasibasiphobia — Fear of standing or walking
Statue Phobia — Fear of statues or effigies
Staurophobia — Fear of crosses or the crucifix
Stenophobia — Fear of narrow things or places
Symbolophobia — Fear of symbolism
Symmetrophobia — Fear of symmetry
Syngenesophobia — Fear of relatives
The Phobia List: T
Tachophobia — Fear of speed
Taeniophobia — Fear of tapeworms
Taphephobia — Fear of being buried alive or cemeteries
Tapinophobia — Fear of being contagious
Taurophobia — Fear of bulls
Technophobia — Fear of technology or computers
Teleophobia — Fear of definite plans or Religious ceremony
Telephonophobia — Fear of telephones
Teratophobia — Fear of bearing a deformed child, monsters, or deformed people
Testophobia — Fear of taking tests
Tetanophobia — Fear of lockjaw or tetanus
Textophobia — Fear of certain fabrics
Thalassophobia — Fear of the sea or the ocean
Thanatophobia — Fear of death, dying, being buried, cremation, or entombment
Theatrophobia — Fear of theaters
Theologicophobia — Fear of theology
Theophobia — Fear of gods or religion
Thermophobia — Fear of heat
Tocophobia — Fear of pregnancy or childbirth
Tomophobia — Fear of surgery or surgical operations
Topophobia — Fear of fear of certain places or situations
Toxicophobia — Fear of poison or being accidently poisoned
Traumatophobia — Fear of injury or battle
Tremophobia — Fear of trembling
Trichinophobia — Fear of trichinosis
Trichopathophobia — Fear of hair
Triskaidekaphobia — Fear of the number 13
Tropophobia — Fear of moving or making changes
Trypanophobia — Fear of injections
Tyrannophobia — Fear of tyrants
The Phobia List: U
Urophobia — Fear of urine or urinating
The Phobia List: V
Vaccinophobia — Fear of vaccination
Verminophobia — Fear of germs
Vestiphobia — Fear of clothing
Virginitiphobia — Fear of rape
Vitricophobia — Fear of step-father's
The Phobia List: W
Walloonphobia — Fear of the Walloons
Wiccaphobia — Fear of witches and witchcraft
The Phobia List: X
Xanthophobia — Fear of the color yellow or the word yellow
Xenoglossophobia — Fear of foreign languages
Xenophobia — Fear of strangers or foreigners
Xerophobia — Fear of dryness
Xylophobia — Fear of wood, wooden objects, or forests
Xyrophobia — Fear of razors
The Phobia List: Z
Zelophobia — Fear of jealousy
Zemmiphobia — Fear of the great mole rat
Zeusophobia — Fear of God or gods
Zoophobia — Fear of animals
There are many hundreds of named phobias, and this is the most complete list of which we know.
Although there are many hundreds of 'different' phobias, all phobias are in fact very similar: a particular stimulus, be it spiders, snakes, or pretty well anything else triggering the phobic individuals fear response when it isn't appropriate.
The Phobia List: A
Ablutophobia — Fear of washing, bathing, or cleaning
Acarophobia — Fear of itching or the insects that cause itching
Acerophobia — Fear of sourness or things that are sour
Achluophobia — Fear of darkness or the dark
Acousticophobia — Fear of noise or sound
Acrophobia — Fear of heights or high levels
Aeroacrophobia — Fear of open high places
Aeronausiphobia — Fear of vomiting secondary to airsickness
Aerophobia — Fear of draft, swallowing air, or airbourne noxious substances
Agateophobia — Fear of insanity or becoming insane
Agliophobia — Fear of pain
Agoraphobia — Fear of open spaces, leaving a safe place, or crowded public places
Agraphobia — Fear of sexual abuse
Agrizoophobia — Fear of wild animals
Agyrophobia — Fear of streets or crossing the street
Aichmophobia — Fear of needles, pins, or pointed objects
Ailurophobia — Fear of cats
Albuminurophobia — Fear of kidney disease
Alektorophobia — Fear of chickens
Algophobia — Fear of garlic
Alliumphobia — Fear of opinions or beliefs
Altophobia — Fear of dust
Amathophobia — Fear of riding in cars
Amaxophobia — Fear of walking
Amnesiphobia — Fear of amnesia
Amychophobia — Fear of scratches or being scratched
Anablephobia — Fear of looking up
Androphobia — Fear of men
Anemophobia — Fear of wind or air drafts
Anginophobia — Fear of angina, choking, or narrowness
Anglophobia — Fear of England, English Culture, or English People
Angrophobia — Fear of anger or becoming angry
Ankylophobia — Fear of immobility of a joint
Anthophobia — Fear of flowers
Anthropophobia — Fear of people or society
Antlophobia — Fear of floods
Anuptaphobia — Fear of staying single
Anxiety — Fear of Anxiety
Apeirophobia — Fear of infinity
Aphenphosmphobia — Fear of being touched
Apiphobia — Fear of bees
Apotemnophobia — Fear of persons with amputations
Arachibutyrophobia — Fear of peanut butter sticking to the roof of the mouth
Arachnephobia — Fear of spiders
Arithmophobia — Fear of numbers
Arsonphobia — Fear of fire or flames
Asthenophobia — Fear of fainting or weakness
Astraphobia — Fear of thunder and lightning
Astrophobia — Fear of stars and celestial space
Asymmetriphobia — Fear of asymmetrical things
Ataxiophobia — Fear of ataxia (muscular incoordination)
Ataxophobia — Fear of disorder or untidiness
Atelophobia — Fear of imperfection
Atephobia — Fear of ruin or ruins
Athazagoraphobia — Fear of being forgotton, being ignored, or forgetting
Atomosophobia — Fear of atomic explosions
Atychiphobia — Fear of failure
Aulophobia — Fear of flutes
Aurophobia — Fear of gold
Auroraphobia — Fear of Northern lights
Autodysomophobia — Fear of one that has a vile odor
Automatonophobia — Fear of ventriloquist's dummies, animatronic creatures or wax statues
Automysophobia — Fear of being dirty
Autophobia — Fear of solitude, being alone, oneself, or being by oneself
Aviophobia — Fear of flying
The Phobia List: B
Bacillophobia — Fear of microbes
Bacteriophobia — Fear of bacteria
Ballistophobia — Fear of missiles or bullets
Barophobia — Fear of gravity
Basiphobia — Fear of inability to stand or falling
Bathmophobia — Fear of stairs or steep slopes
Bathophobia — Fear of depth
Batophobia — Fear of heights or being close to high buildings
Batrachophobia — Fear of amphibians, frogs, newts, or salamanders
Bibliophobia — Fear of books
Blennophobia — Fear of slime
Body Dysmorphic Disorder — Fear of having ugly or unattractive features
Bogyphobia — Fear of bogies or the bogeyman
Bolshephobia — Fear of Bolsheviks
Botanophobia — Fear of plants
Bromidrophobia — Fear of bodily odor or bodily smell
Bufonophobia — Fear of toads
The Phobia List: C
Cacophobia — Fear of ugliness or things that are ugly
Cainophobia — Fear of newness or novelty
Caligynephobia — Fear of beautiful women
Cancerophobia — Fear of cancer
Cardiophobia — Fear of the heart
Carnophobia — Fear of meat
Catagelophobia — Fear of being ridiculed or ridicule
Catapedaphobia — Fear of jumping from high and low places
Cathisophobia — Fear of sitting
Catoptrophobia — Fear of mirrors
Cheimaphobia — Fear of cold
Chemophobia — Fear of chemicals or working with chemicals
Cherophobia — Fear of gaiety
Chionophobia — Fear of snow
Chirophobia — Fear of hands
Cholerophobia — Fear of anger or Cholera
Chorophobia — Fear of dancing
Chrematophobia — Fear of money
Chromatophobia — Fear of colors
Chronomentrophobia — Fear of clocks
Chronophobia — Fear of time
Claustrophobia — Fear of confined or small spaces
Cleisiophobia — Fear of being locked in an enclosed place
Cleithrophobia — Fear of being enclosed
Cleptophobia — Fear of stealing
Climacophobia — Fear of stairs, climbing stairs, or falling down stairs
Clinophobia — Fear of going to bed
Cnidophobia — Fear of stings or being stung
Coimetrophobia — Fear of cemeteries
Coitophobia — Fear of coitus, sex, or sexual intercourse
Cometophobia — Fear of comets
Coprastasophobia — Fear of constipation
Coprophobia — Fear of feces and fecal matter
Coulrophobia — Fear of clowns
Counterphobia — Fear of The preference by a phobic for fearful situations
Cremnophobia — Fear of precipices
Cryophobia — Fear of extreme cold, ice, or frost
Crystallophobia — Fear of crystals or glass
Cyberphobia — Fear of computers or working on a computer
Cyclophobia — Fear of bicycles
Cymophobia — Fear of waves or wave-like motion
Cynophobia — Fear of dogs, canines, or rabies
Cyprianophobia — Fear of prostitutes, venereal disease, or STDs
The Phobia List: D
Daemonophobia — Fear of demons or daemons
Decidophobia — Fear of making decisions
Defecaloesiophobia — Fear of painful bowels movements
Deipnophobia — Fear of dining or dinner conversation
Demophobia — Fear of crowds
Dendrophobia — Fear of trees
Dentophobia — Fear of dentists
Dermatopathophobia — Fear of skin disease or skin lesions
Dextrophobia — Fear of objects at the right side of the body
Diabetophobia — Fear of diabetes
Didaskaleinophobia — Fear of going to school
Dikephobia — Fear of justice
Dinophobia — Fear of dizziness or whirlpools
Diplophobia — Fear of double vision
Dipsophobia — Fear of drinking
Dishabiliophobia — Fear of undressing in front of someone
Doraphobia — Fear of fur or skins of animals
Doxophobia — Fear of expressing opinions or of receiving praise
Driving Phobia — Fear of driving a motorized vehicle
Dromophobia — Fear of crossing streets
Dutchphobia — Fear of the Netherlands, the Dutch, Dutch Culture
Dysmorphophobia — Fear of deformity
Dystychiphobia — Fear of accidents
The Phobia List: E
Earthquakophobia — Fear of earthquakes
Ecclesiophobia — Fear of churchs
Eisoptrophobia — Fear of mirrors or of seeing oneself in a mirror
Electrophobia — Fear of electricity
Eleutherophobia — Fear of freedom
Emetophobia — Fear of vomiting or throwing up
Enetophobia — Fear of pins
Enissophobia — Fear of having committed an unpardonable sin or criticism
Entomophobia — Fear of insects or bugs
Eosophobia — Fear of dawn or daylight
Ephebiphobia — Fear of teenagers
Epistaxiophobia — Fear of nosebleeds
Epistemophobia — Fear of knowledge
Equinophobia — Fear of horses
Eremophobia — Fear of being oneself or lonliness
Ereuthophobia — Fear of redlights, blushing, or the color red
Ergasiophobia — Fear of work, functioning, or Surgeon's operating
Ergophobia — Fear of work
Erotophobia — Fear of sexual love or sexual questions
Euphobia — Fear of hearing good news
The Phobia List: F
Francophobia — Fear of France, French people, or French culture
Frigophobia — Fear of cold or cold things
The Phobia List: G
Gamophobia — Fear of marriage
Geliophobia — Fear of laughter
Geniophobia — Fear of chins
Genuphobia — Fear of knees
Gephydrophobia — Fear of crossing bridges
Gerascophobia — Fear of growing old or old people
Germanophobia — Fear of Germany, German People, or German culture
Geumaphobia — Fear of taste
Globophobia — Fear of balloons
Glossophobia — Fear of speaking in public or trying to speak
Graphophobia — Fear of writing or handwriting
Gymnophobia — Fear of nudity
Gynephobia — Fear of women
The Phobia List: H
Hadephobia — Fear of hell
Hagiophobia — Fear of saints or holy things
Harpaxophobia — Fear of being robbed
Hedonophobia — Fear of feeling pleasure
Heliophobia — Fear of the sun
Hellenologophobia — Fear of Greek terms or complex scientific terminology
Helminthophobia — Fear of being infested with worms
Hemaphobia — Fear of blood
Hereiophobia — Fear of challenges to official doctrine or of radical deviation
Herpetophobia — Fear of reptiles or creepy, crawly things
Heterophobia — Fear of the opposite sex
Hierophobia — Fear of priests or sacred things
Hippopotomonstrosesquippedaliophobia — Fear of long words
Hobophobia — Fear of bums or beggars
Hodophobia — Fear of road travel
Homichlophobia — Fear of fog
Homilophobia — Fear of sermons
Homophobia — Fear of sameness, monotony, homosexuality, or becoming homosexual
Hoplophobia — Fear of firearms
Hormephobia — Fear of shock
Hyalophobia — Fear of glass
Hydrargyophobia — Fear of mercurial medicines
Hydrophobia — Fear of water
Hydrophobophobia — Fear of rabies
Hygrophobia — Fear of liquids, dampness, or moisture
Hylephobia — Fear of materialism or epilepsy
Hypegiaphobia — Fear of responsibility
Hypnophobia — Fear of sleep or being hypnotized
The Phobia List: I
Iatrophobia — Fear of doctors or going to the doctor
Ichthyophobia — Fear of fish
Ideophobia — Fear of ideas
Illyngophobia — Fear of vertigo or feeling dizzy when looking down
Insomnia — Fear of Inability to Sleep
Iophobia — Fear of poison
Isopterophobia — Fear of termites, insects that eat wood
The Phobia List: J
Japanophobia — Fear of Japanese
Judeophobia — Fear of Jewish People
The Phobia List: K
Kakorrhaphiophobia — Fear of failure or defeat
Kenophobia — Fear of voids or empty spaces
Kinesophobia — Fear of movement or motion
Koinoniphobia — Fear of rooms
Kolpophobia — Fear of genitals, particularly female
Kopophobia — Fear of fatigue
Kosmikophobia — Fear of cosmic phenomenon
Kyphophobia — Fear of stooping
The Phobia List: L
Lachanophobia — Fear of vegetables
Lalophobia — Fear of speaking
Lepraphobia — Fear of leprosy
Leukophobia — Fear of the color white
Levophobia — Fear of things to the left side of the body
Ligyrophobia — Fear of loud noises
Lilapsophobia — Fear of tornado or hurricanes
Limnophobia — Fear of lakes
Linonophobia — Fear of string
Liticaphobia — Fear of lawsuits
Lockiophobia — Fear of childbirth
Logizomechanophobia — Fear of computers
Logophobia — Fear of words
Luiphobia — Fear of lues or syphillis
Lutraphobia — Fear of otters
The Phobia List: M
Macrophobia — Fear of long waits
Mageirocophobia — Fear of cooking
Malaxophobia — Fear of love play
Maniaphobia — Fear of insanity
Mastigophobia — Fear of punishment
Mechanophobia — Fear of machines
Medomalacuphobia — Fear of losing an erection
Medorthophobia — Fear of an erect penis
Megalophobia — Fear of large things
Melanophobia — Fear of the color black
Melophobia — Fear of music
Meningitophobia — Fear of brain disease
Menophobia — Fear of menstruation
Merinthophobia — Fear of being bound or tied up
Metallophobia — Fear of metal
Metathesiophobia — Fear of changes
Meteorophobia — Fear of meteors
Metrophobia — Fear of poetry
Microbiophobia — Fear of microbes
Microphobia — Fear of small things
Misophobia — Fear of being contaminated with dirt or germs
Mnemophobia — Fear of memories
Monopathophobia — Fear of definite disease
Motorphobia — Fear of automobiles
Mottephobia — Fear of moths
Murophobia — Fear of mice
Mycophobia — Fear of mushrooms
Myrmecophobia — Fear of ants
Mythophobia — Fear of myths, stories, or false statements
The Phobia List: N
Narcissistic Personality Disorder — Fear of -
Necrophobia — Fear of death or dead things
Neopharmaphobia — Fear of new drugs
Nephophobia — Fear of clouds
Noctiphobia — Fear of the night
Nomatophobia — Fear of names
Nosocomephobia — Fear of hospitals
Nosophobia — Fear of becoming ill
Nostophobia — Fear of returning home
Novercaphobia — Fear of your step-mother
Nucleomituphobia — Fear of nuclear weapons
Nudophobia — Fear of nudity or nakedness
Nyctohylophobia — Fear of dark wooded areas or forests at night
The Phobia List: O
Obesophobia — Fear of gaining weight
Ochlophobia — Fear of crowds or mobs
Ochophobia — Fear of vehicles
Octophobia — Fear of the figure 8
Odontophobia — Fear of teeth or dental surgery
Oenophobia — Fear of wines
Oikophobia — Fear of houses, home surroundings, or being in a house
Olfactophobia — Fear of smells
Ombrophobia — Fear of rain or of being rained on
Ommatophobia — Fear of eyes
Oneirogmophobia — Fear of wet dreams
Oneirophobia — Fear of dreams
Onomatophobia — Fear of hearing a certain word or of names
Ophidiophobia — Fear of snakes
Ophthalmophobia — Fear of being stared at
Opiophobia — Fear of Fear of medical doctors experience of prescribing needed pain medications for patients
Optophobia — Fear of opening one's eyes
Ornithophobia — Fear of birds
Orthophobia — Fear of property
Ostraconophobia — Fear of shellfish
Ouranophobia — Fear of heaven
The Phobia List: P
Pagophobia — Fear of ice or frost
Panophobia — Fear of everything
Panthophobia — Fear of suffering or disease
Papaphobia — Fear of the Pope
Papyrophobia — Fear of paper
Paralipophobia — Fear of neglecting duty or neglecting responsibility
Paraphobia — Fear of sexual perversion
Parasitophobia — Fear of parasites
Paraskavedekatriaphobia — Fear of Friday the 13th
Parthenophobia — Fear of virgins or young girls
Pathophobia — Fear of disease
Patroiophobia — Fear of heredity
Peccatophobia — Fear of sinning
Pediculophobia — Fear of lice
Pediophobia — Fear of dolls
Pedophobia — Fear of children
Peladophobia — Fear of bald people
Pellagrophobia — Fear of pellagra
Peniaphobia — Fear of poverty
Pentheraphobia — Fear of mother-in-law
Phagophobia — Fear of swallowing or eating
Phalacrophobia — Fear of becoming bald
Pharmacophobia — Fear of taking medicine or drugs
Phengophobia — Fear of daylight or sunshine
Philemaphobia — Fear of kissing
Philophobia — Fear of falling in love or being in love
Philosophobia — Fear of philosophy
Phobophobia — Fear of phobias
Phonophobia — Fear of noises, voices, one's own voice, or telephones
Photoaugliaphobia — Fear of glaring lights
Photophobia — Fear of light
Phronemophobia — Fear of thinking
Phthisiophobia — Fear of tuberculosis
Placophobia — Fear of tombstones
Plutophobia — Fear of wealth
Pneumatiphobia — Fear of spirits
Pnigerophobia — Fear of choking of being smothered
Pogonophobia — Fear of beards
Poliosophobia — Fear of contracting poliomyelitis
Politicophobia — Fear of politicians
Polyphobia — Fear of many things
Ponophobia — Fear of overworking or of pain
Porphyrophobia — Fear of the color purple
Potamophobia — Fear of rivers or running water
Potophobia — Fear of alcohol
Proctophobia — Fear of rectums
Prosophobia — Fear of progress
Psellismophobia — Fear of stuttering
Psychophobia — Fear of the mind
Psychrophobia — Fear of the cold
Pteromerhanophobia — Fear of flying
Pteronophobia — Fear of being tickled by feathers
Pupaphobia — Fear of puppets
Pyrexiophobia — Fear of fever
The Phobia List: R
Radiophobia — Fear of radiation or x-rays
Ranidaphobia — Fear of frogs
Rectophobia — Fear of rectums or rectal diseases
Rhabdophobia — Fear of being severely punished, beaten by a rod, or severely criticized
Rhypophobia — Fear of defecation
Rhytiphobia — Fear of getting wrinkles
Rupophobia — Fear of dirt
Russophobia — Fear of Russians
The Phobia List: S
Samhainophobia — Fear of Halloween
Satanophobia — Fear of Satan or The Devil
Scabiophobia — Fear of scabies
Scelerophibia — Fear of bad men or burglars
Sciaphobia — Fear of shadows
Scoleciphobia — Fear of worms
Scolionophobia — Fear of school
Scopophobia — Fear of being seen or stared at
Scoptophobia — Fear of blindness in visual field
Scriptophobia — Fear of writing in public
Selachophobia — Fear of sharks
Selaphobia — Fear of light flashes
Selenophobia — Fear of the moon
Seplophobia — Fear of decaying matter
Siderodromophobia — Fear of trains, railroads, or train travel
Siderophobia — Fear of stars
Sinistrophobia — Fear of things to the left or left-handed
Sinophobia — Fear of China, Chinese, or Chinese culture
Sitiophobia — Fear of food or eating
Soceraphobia — Fear of parents-in-law
Social Phobia — Fear of social situations
Sociophobia — Fear of society or people in general
Somniphobia — Fear of sleep
Sophophobia — Fear of learning
Soteriophobia — Fear of dependence on others
Spacephobia — Fear of outer space
Spectrophobia — Fear of specters or ghosts
Spheksophobia — Fear of wasps
Stasibasiphobia — Fear of standing or walking
Statue Phobia — Fear of statues or effigies
Staurophobia — Fear of crosses or the crucifix
Stenophobia — Fear of narrow things or places
Symbolophobia — Fear of symbolism
Symmetrophobia — Fear of symmetry
Syngenesophobia — Fear of relatives
The Phobia List: T
Tachophobia — Fear of speed
Taeniophobia — Fear of tapeworms
Taphephobia — Fear of being buried alive or cemeteries
Tapinophobia — Fear of being contagious
Taurophobia — Fear of bulls
Technophobia — Fear of technology or computers
Teleophobia — Fear of definite plans or Religious ceremony
Telephonophobia — Fear of telephones
Teratophobia — Fear of bearing a deformed child, monsters, or deformed people
Testophobia — Fear of taking tests
Tetanophobia — Fear of lockjaw or tetanus
Textophobia — Fear of certain fabrics
Thalassophobia — Fear of the sea or the ocean
Thanatophobia — Fear of death, dying, being buried, cremation, or entombment
Theatrophobia — Fear of theaters
Theologicophobia — Fear of theology
Theophobia — Fear of gods or religion
Thermophobia — Fear of heat
Tocophobia — Fear of pregnancy or childbirth
Tomophobia — Fear of surgery or surgical operations
Topophobia — Fear of fear of certain places or situations
Toxicophobia — Fear of poison or being accidently poisoned
Traumatophobia — Fear of injury or battle
Tremophobia — Fear of trembling
Trichinophobia — Fear of trichinosis
Trichopathophobia — Fear of hair
Triskaidekaphobia — Fear of the number 13
Tropophobia — Fear of moving or making changes
Trypanophobia — Fear of injections
Tyrannophobia — Fear of tyrants
The Phobia List: U
Urophobia — Fear of urine or urinating
The Phobia List: V
Vaccinophobia — Fear of vaccination
Verminophobia — Fear of germs
Vestiphobia — Fear of clothing
Virginitiphobia — Fear of rape
Vitricophobia — Fear of step-father's
The Phobia List: W
Walloonphobia — Fear of the Walloons
Wiccaphobia — Fear of witches and witchcraft
The Phobia List: X
Xanthophobia — Fear of the color yellow or the word yellow
Xenoglossophobia — Fear of foreign languages
Xenophobia — Fear of strangers or foreigners
Xerophobia — Fear of dryness
Xylophobia — Fear of wood, wooden objects, or forests
Xyrophobia — Fear of razors
The Phobia List: Z
Zelophobia — Fear of jealousy
Zemmiphobia — Fear of the great mole rat
Zeusophobia — Fear of God or gods
Zoophobia — Fear of animals
Tuesday, February 26, 2008
Measles
One of the most highly contagious diseases in humans is the measles. It is caused by a virus that invades the tissues of the respiratory system, particularly the lungs and throat passages. The most visible sign of measles is a rash that covers the face and body during the course of the disease. Although adults can get measles, it is more common in children. Measles is also known by the name rubeola.
How measles is spread
When a person infected with the measles virus coughs or sneezes, thousands of tiny particles of the virus are spread into the air. If an uninfected and unvaccinated person inhales these, he or she will become immediately infected. The virus particles make themselves at home in the moist passages of the nose, throat, and lungs.
Symptoms
The first symptoms, or signs, of measles appear about 10 to 14 days after a person is exposed to the measles virus. The earliest signs of the disease resemble those of the flu. The patient has a runny nose, a sore throat, and a fever. The fever is usually very high, sometimes as high as 104 ° or 105 ° F (40 ° C). The lining of the eyes becomes inflamed and very red. This condition is called conjunctivitis. Tiny bluish white spots appear on the insides of the cheeks. Within several days, a red rash appears on the face and behind the ears. The rash then spreads to the rest of the body.
For most patients, the symptoms of the disease do not go any further. In some patients, however, complications can occur. These include pneumonia, an illness that occurs when the lungs become infected. The measles virus can also attack the brain, causing an illness called encephalitis. This complication can cause the patient to have convulsions, or to go into a coma. If the virus infects the liver, it can cause the disease hepatitis. All of these complications are very serious. In some instances, they can be fatal.
Treatment
A case of the measles generally lasts 10 to 12 days, though with complications it will last much longer. The patient must get plenty of rest and drink fluids. Some people who are infected with the measles find bright light to be painful. In these cases, the patient's room should be kept dark. Because of the danger of complications, and also because measles is so easily spread, it is extremely important for the patient to stay home until completely recovered.
Prevention
When a disease is as contagious as measles, it is very important to prevent it from spreading and becoming an epidemic. An epidemic occurs when large numbers of people are infected with the same disease within a short period of time. Epidemics can spread across cities, states, and continents, and they can even spread around the world.
One way to prevent the spread of disease is through vaccination, or the use of substances that prevent people from getting the disease. Scientists have developed a very effective vaccine against measles. The vaccine also protects against mumps and rubella (sometimes called German measles). It is usually given to children twice before they can attend school. In the United States, the vaccine is widely available. In some countries, it is not available, and those countries suffer frequent epidemics. It is very important to discuss the vaccine, and the disease, with a doctor.
How measles is spread
When a person infected with the measles virus coughs or sneezes, thousands of tiny particles of the virus are spread into the air. If an uninfected and unvaccinated person inhales these, he or she will become immediately infected. The virus particles make themselves at home in the moist passages of the nose, throat, and lungs.
Symptoms
The first symptoms, or signs, of measles appear about 10 to 14 days after a person is exposed to the measles virus. The earliest signs of the disease resemble those of the flu. The patient has a runny nose, a sore throat, and a fever. The fever is usually very high, sometimes as high as 104 ° or 105 ° F (40 ° C). The lining of the eyes becomes inflamed and very red. This condition is called conjunctivitis. Tiny bluish white spots appear on the insides of the cheeks. Within several days, a red rash appears on the face and behind the ears. The rash then spreads to the rest of the body.
For most patients, the symptoms of the disease do not go any further. In some patients, however, complications can occur. These include pneumonia, an illness that occurs when the lungs become infected. The measles virus can also attack the brain, causing an illness called encephalitis. This complication can cause the patient to have convulsions, or to go into a coma. If the virus infects the liver, it can cause the disease hepatitis. All of these complications are very serious. In some instances, they can be fatal.
Treatment
A case of the measles generally lasts 10 to 12 days, though with complications it will last much longer. The patient must get plenty of rest and drink fluids. Some people who are infected with the measles find bright light to be painful. In these cases, the patient's room should be kept dark. Because of the danger of complications, and also because measles is so easily spread, it is extremely important for the patient to stay home until completely recovered.
Prevention
When a disease is as contagious as measles, it is very important to prevent it from spreading and becoming an epidemic. An epidemic occurs when large numbers of people are infected with the same disease within a short period of time. Epidemics can spread across cities, states, and continents, and they can even spread around the world.
One way to prevent the spread of disease is through vaccination, or the use of substances that prevent people from getting the disease. Scientists have developed a very effective vaccine against measles. The vaccine also protects against mumps and rubella (sometimes called German measles). It is usually given to children twice before they can attend school. In the United States, the vaccine is widely available. In some countries, it is not available, and those countries suffer frequent epidemics. It is very important to discuss the vaccine, and the disease, with a doctor.
Epilepsy
Normally the brain's cells communicate with other cells by firing tiny electrical signals. Sometimes something goes wrong, and the cells signal many times faster than normal. That abnormal signaling causes an attack called a seizure. Seizures usually include sudden, abnormal movements and behaviors. People who have had two or more seizures have a condition called epilepsy.
Symptoms
The main symptom, or sign, of epilepsy is the seizure. There are two types of seizures: generalized and partial. Generalized seizures result from abnormal signals in most of the brain. Partial seizures result from abnormal signals in part of the brain.
During a generalized seizure the person may fall down and lose consciousness. The muscles may jerk, turn stiff, or become limp for a few minutes. Breathing can stop temporarily. After a violent seizure the person feels confused and tired. In some cases a generalized seizure is hard to notice. The person may just lose consciousness for a few seconds and stare or blink.
During a partial seizure the person does not usually fall down. The person may have sudden emotions or see, taste, or smell things that are not real. The person may seem to be in a dream. The muscles on one side of the body may jerk, or the person may repeat strange movements.
Causes
Many different things can cause epilepsy. It may result from a brain injury, either before or after birth, or a brain tumor. Diseases that affect the brain, including meningitis and encephalitis, can also lead to epilepsy. Epilepsy can sometimes occur after a person has a stroke (a blot clot or bleeding in the brain). Some cases of epilepsy may be genetic, or passed down from parent to child. In about half the cases of epilepsy the actual cause is not known.
Prevention
Because the cause of epilepsy is often unknown, the condition is difficult to prevent. People can prevent some types of epilepsy by protecting the brain from injury. Wearing a seat belt in cars can protect the head during an accident. Wearing a helmet while skating, biking, or playing sports can also prevent brain injury. Treating diseases and health problems that affect the brain can also help to prevent epilepsy.
Treatment
There is no cure for epilepsy, but there are a number of drugs that help to control seizures. A special diet can also help. If medicine and diet do not work, doctors may perform surgery on the brain. They may also place a small machine under the patient's skin. The machine sends electricity to the brain, which helps to reduce the number of seizures a person has.
People can help a person having a seizure by doing several things. They should help the person roll onto his side and put a pillow under his head. They should loosen the person's collar if possible. They should not put anything in the person's mouth. It is also important to move sharp or hard objects out of the person's way.
Symptoms
The main symptom, or sign, of epilepsy is the seizure. There are two types of seizures: generalized and partial. Generalized seizures result from abnormal signals in most of the brain. Partial seizures result from abnormal signals in part of the brain.
During a generalized seizure the person may fall down and lose consciousness. The muscles may jerk, turn stiff, or become limp for a few minutes. Breathing can stop temporarily. After a violent seizure the person feels confused and tired. In some cases a generalized seizure is hard to notice. The person may just lose consciousness for a few seconds and stare or blink.
During a partial seizure the person does not usually fall down. The person may have sudden emotions or see, taste, or smell things that are not real. The person may seem to be in a dream. The muscles on one side of the body may jerk, or the person may repeat strange movements.
Causes
Many different things can cause epilepsy. It may result from a brain injury, either before or after birth, or a brain tumor. Diseases that affect the brain, including meningitis and encephalitis, can also lead to epilepsy. Epilepsy can sometimes occur after a person has a stroke (a blot clot or bleeding in the brain). Some cases of epilepsy may be genetic, or passed down from parent to child. In about half the cases of epilepsy the actual cause is not known.
Prevention
Because the cause of epilepsy is often unknown, the condition is difficult to prevent. People can prevent some types of epilepsy by protecting the brain from injury. Wearing a seat belt in cars can protect the head during an accident. Wearing a helmet while skating, biking, or playing sports can also prevent brain injury. Treating diseases and health problems that affect the brain can also help to prevent epilepsy.
Treatment
There is no cure for epilepsy, but there are a number of drugs that help to control seizures. A special diet can also help. If medicine and diet do not work, doctors may perform surgery on the brain. They may also place a small machine under the patient's skin. The machine sends electricity to the brain, which helps to reduce the number of seizures a person has.
People can help a person having a seizure by doing several things. They should help the person roll onto his side and put a pillow under his head. They should loosen the person's collar if possible. They should not put anything in the person's mouth. It is also important to move sharp or hard objects out of the person's way.
Mumps
One of the most common and highly contagious diseases of childhood is mumps. This disease is caused by a virus that infects a pair of glands located in front of the ears. When the glands are infected, they become swollen. This gives the cheeks a chipmunk-like appearance. Although mumps can infect adults, it is more commonly found in children between the ages of 5 and 15 years
How mumps is spread
The glands that are infected by the mumps virus normally produce saliva. Because of this, when a person is infected, pieces of the virus become mixed in with the saliva produced by the glands. Any contact with the saliva of an infected person can therefore spread the disease.When an infected person coughs or sneezes, tiny particles of the virus are spread into the air. If these are inhaled by an uninfected person or a person who has not been vaccinated against the disease, that person will become ill with mumps. The disease can also be spread by touching something, such as bedding, that has infected saliva on it.
Symptoms
Once a person is infected with the mumps virus, it usually takes two to three weeks for symptoms, or signs of the disease, to appear. The first symptoms a patient will feel are very general and resemble those of the flu. The patient may have a runny nose and a slight fever. Soon the area in front of the ear becomes swollen and puffy. The swelling can spread to the upper neck and jaw. In most patients, the swelling is found on both sides of the face. The swelling is rarely severe, but sometimes the patient may have trouble chewing and swallowing.
Complications from mumps are rare but they can occur, particularly in older children. In some cases the meninges, a tissue that covers parts of the nervous system, can become inflamed. This leads to a disease called meningitis. Other complications can involve other glands in the body.
Treatment
The main symptoms of mumps—the swollen cheeks and neck—begin to go away after four or five days. There is no specific treatment for mumps. Because it is so contagious, patients should stay home. They should also get plenty of rest. Most patients can return to school or work after the swelling and other symptoms have gone away. However, it is always best to ask a doctor about this.
Prevention
Once a person is infected with mumps, he or she cannot get the disease again. This is called immunity. Another way to gain immunity from mumps is to be vaccinated against the disease. The vaccine used to protect against mumps is very effective. The same vaccine also protects against measles and rubella (also called German measles). Children in the United States usually receive this vaccine twice before they start school.
In some countries the vaccine is not as easily available. Those countries suffer frequent epidemics. This means that the disease spreads to large numbers of people within a short period of time. Epidemics can spread across cities, states, and continents, and they can even spread around the world. It is very important to prevent diseases like mumps from spreading and becoming an epidemic. One way to prevent this is by vaccination. It is very important to discuss the mumps vaccine, and the disease itself, with a doctor.
How mumps is spread
The glands that are infected by the mumps virus normally produce saliva. Because of this, when a person is infected, pieces of the virus become mixed in with the saliva produced by the glands. Any contact with the saliva of an infected person can therefore spread the disease.When an infected person coughs or sneezes, tiny particles of the virus are spread into the air. If these are inhaled by an uninfected person or a person who has not been vaccinated against the disease, that person will become ill with mumps. The disease can also be spread by touching something, such as bedding, that has infected saliva on it.
Symptoms
Once a person is infected with the mumps virus, it usually takes two to three weeks for symptoms, or signs of the disease, to appear. The first symptoms a patient will feel are very general and resemble those of the flu. The patient may have a runny nose and a slight fever. Soon the area in front of the ear becomes swollen and puffy. The swelling can spread to the upper neck and jaw. In most patients, the swelling is found on both sides of the face. The swelling is rarely severe, but sometimes the patient may have trouble chewing and swallowing.
Complications from mumps are rare but they can occur, particularly in older children. In some cases the meninges, a tissue that covers parts of the nervous system, can become inflamed. This leads to a disease called meningitis. Other complications can involve other glands in the body.
Treatment
The main symptoms of mumps—the swollen cheeks and neck—begin to go away after four or five days. There is no specific treatment for mumps. Because it is so contagious, patients should stay home. They should also get plenty of rest. Most patients can return to school or work after the swelling and other symptoms have gone away. However, it is always best to ask a doctor about this.
Prevention
Once a person is infected with mumps, he or she cannot get the disease again. This is called immunity. Another way to gain immunity from mumps is to be vaccinated against the disease. The vaccine used to protect against mumps is very effective. The same vaccine also protects against measles and rubella (also called German measles). Children in the United States usually receive this vaccine twice before they start school.
In some countries the vaccine is not as easily available. Those countries suffer frequent epidemics. This means that the disease spreads to large numbers of people within a short period of time. Epidemics can spread across cities, states, and continents, and they can even spread around the world. It is very important to prevent diseases like mumps from spreading and becoming an epidemic. One way to prevent this is by vaccination. It is very important to discuss the mumps vaccine, and the disease itself, with a doctor.
Influenza
The illness popularly known as the flu is one of the most common of the winter season. The word flu is short for the disease's full name, influenza. The disease is caused by a virus that invades the nose, throat, and lungs. In most cases, people who get the flu will recover in a week or so. In some instances, however, complications such as pneumonia can occur, leading to severe illness and even death.
How influenza is spread
In an infected person, the influenza virus lives in the tissue of the nose and lungs. When an infected person coughs or sneezes, tiny particles of the virus are released into the air, where they can be inhaled by another (uninfected) person. The virus quickly invades the tissues of the nose, migrating eventually to the throat and, finally, the lungs.
Influenza spreads quickly, especially in the winter, when many people are indoors. Because of this, an outbreak of influenza can quickly turn into an epidemic. Epidemics occur when large numbers of people are infected with the same disease within a short period of time. They can spread across cities, states, and continents, and they can even spread around the world. One of the worst epidemics of all time was the influenza epidemic of 1918–19. In one year, influenza killed more than 20 million people throughout the world. Other influenza epidemics have occurred since then, but none has been as deadly.
Symptoms
The initial symptoms, or signs of the disease, include body aches, chills, and fever. There may also be a sore throat and some coughing and sneezing. Patients often become extremely tired, and some may also experience sharp headache pain.
In some people—especially elderly people or very young children—infection with the influenza virus can lead to serious complications. These can include pneumonia and bronchitis, which are infections of the lungs or parts of the lungs. In some instances, infection with the influenza virus can lead to death.
Treatment
Treatment for influenza consists mainly of getting plenty of rest and drinking lots of fluids. Most people recover from a bout of influenza within one to two weeks. In the late 20th century, scientists developed medications that can treat influenza. However, in order for these medicines to work, they must be taken at the first sign of the disease. It is important to talk to a doctor about the illness and how it should be treated.
Children and teenagers should never use aspirin or aspirin-containing products to treat the headaches and body aches that accompany influenza. Using aspirin to treat influenza in children and teenagers has been connected to the development of a rare but serious illness called Reye syndrome.
Prevention
One of the best ways to avoid getting influenza is to be vaccinated against the influenza virus every year. Because the virus infects millions of people each year, getting vaccinated is also a good way to prevent the infection from spreading. For many diseases a single vaccine is all that is ever needed to protect against the virus. The influenza virus changes every year, however, so scientists must create new vaccines each year to protect against the new form of the virus.
How influenza is spread
In an infected person, the influenza virus lives in the tissue of the nose and lungs. When an infected person coughs or sneezes, tiny particles of the virus are released into the air, where they can be inhaled by another (uninfected) person. The virus quickly invades the tissues of the nose, migrating eventually to the throat and, finally, the lungs.
Influenza spreads quickly, especially in the winter, when many people are indoors. Because of this, an outbreak of influenza can quickly turn into an epidemic. Epidemics occur when large numbers of people are infected with the same disease within a short period of time. They can spread across cities, states, and continents, and they can even spread around the world. One of the worst epidemics of all time was the influenza epidemic of 1918–19. In one year, influenza killed more than 20 million people throughout the world. Other influenza epidemics have occurred since then, but none has been as deadly.
Symptoms
The initial symptoms, or signs of the disease, include body aches, chills, and fever. There may also be a sore throat and some coughing and sneezing. Patients often become extremely tired, and some may also experience sharp headache pain.
In some people—especially elderly people or very young children—infection with the influenza virus can lead to serious complications. These can include pneumonia and bronchitis, which are infections of the lungs or parts of the lungs. In some instances, infection with the influenza virus can lead to death.
Treatment
Treatment for influenza consists mainly of getting plenty of rest and drinking lots of fluids. Most people recover from a bout of influenza within one to two weeks. In the late 20th century, scientists developed medications that can treat influenza. However, in order for these medicines to work, they must be taken at the first sign of the disease. It is important to talk to a doctor about the illness and how it should be treated.
Children and teenagers should never use aspirin or aspirin-containing products to treat the headaches and body aches that accompany influenza. Using aspirin to treat influenza in children and teenagers has been connected to the development of a rare but serious illness called Reye syndrome.
Prevention
One of the best ways to avoid getting influenza is to be vaccinated against the influenza virus every year. Because the virus infects millions of people each year, getting vaccinated is also a good way to prevent the infection from spreading. For many diseases a single vaccine is all that is ever needed to protect against the virus. The influenza virus changes every year, however, so scientists must create new vaccines each year to protect against the new form of the virus.
Chicken pox
One of the most common diseases of childhood is chicken pox. This disease is caused by a virus. Although most patients contract it between the ages of 2 and 6, chicken pox can strike at any age. Chicken pox is a fairly mild illness in children. It can be very serious in adults, however. It is also extremely serious in people with certain diseases such as leukemia or AIDS because their immune systems are weak and therefore they cannot fight off the disease.
How chicken pox is spread
Chicken pox is highly contagious, meaning that it can spread very easily. When an infected person coughs or sneezes, tiny particles of the virus are released into the air. The disease can be spread when an uninfected person inhales these particles. The virus particles can also be on the clothing or bedding of an infected patient. If an uninfected person touches the clothing or bedding he or she can become infected with the disease.
Symptoms
The first symptoms, or signs of the disease, are very general and resemble those of the flu. These include a slight fever, runny nose, and mild cough. The patient will not feel very hungry and may also have headaches and feel very tired.
Roughly two weeks after being exposed to the virus, red spots appear on the face and body. These spots are filled with fluid, and they itch terribly. Eventually the spots form scabs, which soon fall off.
Treatment
People with chicken pox should try not to scratch the spots. Scratching can cause the spots to leave deep scars. The itching can be relieved by using medications such as calamine lotion, which has a soothing effect. In addition to using calamine lotion, patients may wish to bathe the pox spots and sores with cool water. It is important to keep the spots clean so that they do not become further infected with other harmful germs. Bed rest is important.
It is extremely important to never use aspirin or aspirin-containing products to treat the headaches and body aches that accompany chicken pox. Using aspirin to treat chicken pox has been connected to the development of a severe disease called Reye syndrome. This syndrome can cause liver and brain damage, and even death.
A case of chicken pox generally lasts from a week to ten days overall. Because the disease is so contagious, it is important for the patient to remain confined to bed until the scabs have fallen off. Complications are rare but can occur in some cases. In some instances, the virus becomes dormant. This means that it remains in the body but no longer causes the symptoms of chicken pox. In these cases, it is possible for the virus to become re-activated in adulthood, when it causes a related disease called shingles. Scientists developed a chicken pox vaccine, or substance that protects people from getting the disease, in the late 20th century.
How chicken pox is spread
Chicken pox is highly contagious, meaning that it can spread very easily. When an infected person coughs or sneezes, tiny particles of the virus are released into the air. The disease can be spread when an uninfected person inhales these particles. The virus particles can also be on the clothing or bedding of an infected patient. If an uninfected person touches the clothing or bedding he or she can become infected with the disease.
Symptoms
The first symptoms, or signs of the disease, are very general and resemble those of the flu. These include a slight fever, runny nose, and mild cough. The patient will not feel very hungry and may also have headaches and feel very tired.
Roughly two weeks after being exposed to the virus, red spots appear on the face and body. These spots are filled with fluid, and they itch terribly. Eventually the spots form scabs, which soon fall off.
Treatment
People with chicken pox should try not to scratch the spots. Scratching can cause the spots to leave deep scars. The itching can be relieved by using medications such as calamine lotion, which has a soothing effect. In addition to using calamine lotion, patients may wish to bathe the pox spots and sores with cool water. It is important to keep the spots clean so that they do not become further infected with other harmful germs. Bed rest is important.
It is extremely important to never use aspirin or aspirin-containing products to treat the headaches and body aches that accompany chicken pox. Using aspirin to treat chicken pox has been connected to the development of a severe disease called Reye syndrome. This syndrome can cause liver and brain damage, and even death.
A case of chicken pox generally lasts from a week to ten days overall. Because the disease is so contagious, it is important for the patient to remain confined to bed until the scabs have fallen off. Complications are rare but can occur in some cases. In some instances, the virus becomes dormant. This means that it remains in the body but no longer causes the symptoms of chicken pox. In these cases, it is possible for the virus to become re-activated in adulthood, when it causes a related disease called shingles. Scientists developed a chicken pox vaccine, or substance that protects people from getting the disease, in the late 20th century.
Rabies
also called hydrophobia , or lyssa acute, usually fatal, viral infectious disease of the central nervous system. The disease is usually spread among domestic dogs and wild carnivorous animals; all warm-blooded animals are susceptible to rabies infection. The virus, a rhabdovirus, is often present in the salivary glands of rabid animals and is excreted in the saliva; thus, the bite of the infected animal introduces the virus into a fresh wound. Under favourable conditions, the virus propagates along nerve tissue from the wound to the brain and becomes established in the central nervous system. The disease develops most often between four and six weeks after infection, but the incubation period may vary from 10 days to eight months.
Rabies often begins with excitation of the central nervous system expressed as irritability and viciousness. A rabid animal is most dangerous during the early stages of the disease because it appears to be healthy and may seem friendly but will bite at the slightest provocation. Wild animals that appear to be tame and that approach people or human habitations in the daytime should be suspected of having rabies.
Infected dogs usually show a short excitation phase that is characterized by restlessness, nervousness, irritability, and viciousness and is followed by depression and paralysis. Sudden death without recognizable signs of illness is common. Dogs that develop the predominantly excited type of rabies invariably die of the infection, usually within three to five days after the onset of symptoms. Those that develop the paralytic type of rabies without any evidence of excitation or viciousness may recover on rare occasions. Paralysis of the “voice” muscles in rabid dogs may produce a characteristic change in the sound of the bark.
Rabies in humans is similar to that in animals. Symptoms include depression, headache, nausea, seizures, anorexia, muscle stiffness, and increased production of saliva. Abnormal sensations, such as itching, around the site of exposure are a common early symptom. Repeated episodes of painful contraction of the muscles of the throat may occur upon attempting to swallow or may be elicited by the sight of water. This reaction to water is called hydrophobia (“fear of water”). Rabies in humans is almost always fatal. Death ordinarily occurs within three to five days after the onset of symptoms due to cardiac or respiratory failure. Sometimes rabies is characterized by paralysis without any evidence of excitation of the nervous system. In such cases the course of the disease may be prolonged to a week or more.
If administered soon after infection, serum or vaccine can be effective in combating the disease. This is a type of passive immunization whereby animals are immunized with attenuated rabies virus, and antibodies from these animals are injected into infected persons to give them temporary immunity to rabies. The treatment is effective if given within 24 hours after exposure but has little, if any, value if given three or more days after infection by rabies. Immediate treatment of animal-bite wounds by cleansing with soap and water is extremely important because much, if not all, of the virus can be thus removed.
Vaccines prepared from rabies virus can be used to protect people who are likely to be in contact with infected animals. The safest and most effective vaccines are human diploidcell vaccine (HDCV), purified chick embryo cell culture (PCEC), and rabies vaccine adsorbed (RVA). When a person not protected by previous immunization is bitten by a rabid animal, treatment is a dose of serum followed by a series of vaccinations. With the older vaccines, at least 16 injections were required, whereas with HDCV, PCEC, or RVA, 5 are usually sufficient.
Rabies often begins with excitation of the central nervous system expressed as irritability and viciousness. A rabid animal is most dangerous during the early stages of the disease because it appears to be healthy and may seem friendly but will bite at the slightest provocation. Wild animals that appear to be tame and that approach people or human habitations in the daytime should be suspected of having rabies.
Infected dogs usually show a short excitation phase that is characterized by restlessness, nervousness, irritability, and viciousness and is followed by depression and paralysis. Sudden death without recognizable signs of illness is common. Dogs that develop the predominantly excited type of rabies invariably die of the infection, usually within three to five days after the onset of symptoms. Those that develop the paralytic type of rabies without any evidence of excitation or viciousness may recover on rare occasions. Paralysis of the “voice” muscles in rabid dogs may produce a characteristic change in the sound of the bark.
Rabies in humans is similar to that in animals. Symptoms include depression, headache, nausea, seizures, anorexia, muscle stiffness, and increased production of saliva. Abnormal sensations, such as itching, around the site of exposure are a common early symptom. Repeated episodes of painful contraction of the muscles of the throat may occur upon attempting to swallow or may be elicited by the sight of water. This reaction to water is called hydrophobia (“fear of water”). Rabies in humans is almost always fatal. Death ordinarily occurs within three to five days after the onset of symptoms due to cardiac or respiratory failure. Sometimes rabies is characterized by paralysis without any evidence of excitation of the nervous system. In such cases the course of the disease may be prolonged to a week or more.
If administered soon after infection, serum or vaccine can be effective in combating the disease. This is a type of passive immunization whereby animals are immunized with attenuated rabies virus, and antibodies from these animals are injected into infected persons to give them temporary immunity to rabies. The treatment is effective if given within 24 hours after exposure but has little, if any, value if given three or more days after infection by rabies. Immediate treatment of animal-bite wounds by cleansing with soap and water is extremely important because much, if not all, of the virus can be thus removed.
Vaccines prepared from rabies virus can be used to protect people who are likely to be in contact with infected animals. The safest and most effective vaccines are human diploidcell vaccine (HDCV), purified chick embryo cell culture (PCEC), and rabies vaccine adsorbed (RVA). When a person not protected by previous immunization is bitten by a rabid animal, treatment is a dose of serum followed by a series of vaccinations. With the older vaccines, at least 16 injections were required, whereas with HDCV, PCEC, or RVA, 5 are usually sufficient.
Pompe's disease
also called Glycogenosis Type Ii, hereditary defect in the body's ability to metabolize glycogen, resulting in a muscle disorder that is usually fatal during the first year of life. The defect responsible, absence of the enzyme alpha-1,4-glucosidase, is extremely rare, occurring in fewer than one in every 150,000 births, and is transmitted as an autosomal recessive trait. In Pompe's disease, glycogen accumulates in all body tissues, but especially in the muscles, causing enlargement of the heart, cardiac muscle failure, and breathing difficulties. Accumulation of glycogen in other tissues causes mental retardation and enlargement of the liver and spleen. Death usually results from cardiorespiratory failure. Juvenile and adult forms, with similar but milder symptoms, are also known.
Simmonds' disease
pituitary disorder characterized by panhypopituitarism, a form of hypopituitarism in which all pituitary secretions are deficient. Effects include dwarfism, atrophy of the sex glands, shrinkage of the breasts and suppression of milk secretion, atrophy of the thyroid and the adrenal cortex, lowering of the metabolic rate, tendency toward lowered blood sugar, and lessened resistance to infection and shock. Some effects of panhypopituitarism have been simulated among emotionally deprived young children. Such children have shown remarkable recovery when removed from the injurious environment. The German doctor Morris Simmonds (1855–1925) first described this disease in 1914.
McArdle's disease
also called Glycogenosis Type V, rare hereditary deficiency of the enzyme glycogen phosphorylase in muscle cells. In the absence of this enzyme, muscles cannot break down animal starch (glycogen) to meet the energy requirements of exercise. Muscle activity is thus solely dependent on the availability of glucose (blood sugar) and other nutrients in the circulating blood. Victims of McArdle's disease are chronically weak because their muscles are incapable of prolonged exertion; even moderate exercise produces muscle cramping and severe pain. Unlike most other types of glycogenosis, the disease is not fatal, and the missing enzyme does not impair the functioning of other body systems. McArdle's disease is inherited as an autosomal recessive trait
Plummer's disease
also called toxic multinodular goitre thyroid condition characterized by marked enlargement of the thyroid gland (goitre), firm thyroid nodules, and mild overproduction of thyroid hormone (hyperthyroidism). Plummer's disease, which usually occurs in older people, is of unknown etiology. Its symptoms resemble those of Graves' disease (q.v.), a condition believed to be an autoimmune disorder caused by antibodies to the thyroid.
Typically, persons affected by Plummer's disease develop a goitre many years before the onset of symptoms of hyperthyroidism; most patients are over age 50 before the characteristic accelerated heart rate and other cardiac conditions appear. Unlike other forms of hyperthyroidism, the disease seldom causes bulging of the eyes (exophthalmos). Swelling of the thyroid gland may obstruct breathing or swallowing, requiring surgery to remove the excess tissue; the cardiac symptoms, resulting in congestive heart failure in some cases, can also be fatal. In the absence of obstruction or cosmetic reasons for removing the gland, the goitre may be treated with drugs that block thyroid activity or with radioactive iodine therapy; however, the multiple thyroid nodules characteristic of the disease may raise suspicion of cancer, necessitating surgical excision of the gland.
Typically, persons affected by Plummer's disease develop a goitre many years before the onset of symptoms of hyperthyroidism; most patients are over age 50 before the characteristic accelerated heart rate and other cardiac conditions appear. Unlike other forms of hyperthyroidism, the disease seldom causes bulging of the eyes (exophthalmos). Swelling of the thyroid gland may obstruct breathing or swallowing, requiring surgery to remove the excess tissue; the cardiac symptoms, resulting in congestive heart failure in some cases, can also be fatal. In the absence of obstruction or cosmetic reasons for removing the gland, the goitre may be treated with drugs that block thyroid activity or with radioactive iodine therapy; however, the multiple thyroid nodules characteristic of the disease may raise suspicion of cancer, necessitating surgical excision of the gland.
Huntington disease
also called Huntington chorea a relatively rare, and invariably fatal, hereditary neurological disease that is characterized by irregular and involuntary movements of the muscles. Huntington disease is caused by a genetic mutation that causes degeneration of neurons in the basal ganglia, a pair of nerve clusters deep within the brain, that control movement. Symptoms usually appear between the ages of 35 and 50 and worsen over time. They begin with occasional jerking or writhing movements, called choreiform movements, or what appear to be minor problems with coordination; these movements, which are absent during sleep, worsen over the next few years and progress to random, uncontrollable, and often violent twitchings and jerks. Symptoms of mental deterioration may appear including apathy, fatigue, irritability, restlessness, or moodiness; these symptoms may progress to memory loss, dementia, bipolar disorder, or schizophrenia. The disease was first described by the American physician George Huntington in 1872.
A child of someone with Huntington disease has a 50 percent chance of developing the disease; a genetic test is available. No effective therapy or cure is available for the disorder, although choreiform movements may be partially and temporarily suppressed by phenothiazines or other antipsychotic medications.
A child of someone with Huntington disease has a 50 percent chance of developing the disease; a genetic test is available. No effective therapy or cure is available for the disorder, although choreiform movements may be partially and temporarily suppressed by phenothiazines or other antipsychotic medications.
Alzheimer disease
degenerative brain disorder that develops in mid to late adulthood. It results in a progressive and irreversible decline in memory and a deterioration of various other cognitive abilities. The disease is characterized by the destruction of nerve cells and neural connections in the cerebral cortex of the brain and by a significant loss of brain mass. The disease was first described in 1906 by Alois Alzheimer, a German neuropathologist.
Alzheimer disease is the most common form of *dementia. The disease develops differently among individuals; this suggests that more than one pathologic process may lead to the same outcome. Typically, the first symptom to appear is forgetfulness. As the disease progresses, memory loss becomes more severe, and language, perceptual, and motor skills deteriorate. Mood becomes unstable, and the individual tends to become irritable and more sensitive to stress and may become intermittently angry, anxious, or depressed. In advanced stages, the individual becomes unresponsive and loses mobility and control of body functions; death ensues after a disease course lasting from 2 to 20 years.
About 10 percent of those who develop the disease are younger than 60 years of age. These cases, referred to as early-onset familial Alzheimer disease, result from an inherited genetic mutation. The majority of cases of Alzheimer disease, however, develop after age 60 (late-onset); they usually occur sporadically—i.e., in individuals with no family history of the disease—although a genetic factor has been identified that is thought to predispose these individuals to the disorder.
The presence of neuritic plaques and neurofibrillary tangles in the brain are used to diagnose Alzheimer disease in autopsy. Neuritic plaques—also called senile, dendritic, or amyloid plaques—consist of deteriorating neuronal material surrounding deposits of a sticky protein called beta amyloid. This protein is derived from a larger molecule called amyloid precursor protein, which is a normal component of nerve cells. Neurofibrillary tangles are twisted protein fibres located within nerve cells. These fibres consist of a protein, called tau, that normally occurs in neurons. When incorrectly processed, tau molecules clump together and form tangles. Both neuritic plaques and neurofibrillary tangles, which also may be found in smaller amounts in the brains of healthy elderly persons, are thought to interfere in some way with normal cellular functioning. However, it is not known whether the plaques and tangles are a cause or a consequence of the disease.
Other features have been noted in the brains of many persons with Alzheimer disease. One is a deficiency of the neurotransmitter acetylcholine; neurons containing acetylcholine play an important role in memory. Abnormal concentrations of aluminum also have been found in neurofibrillary tangles and neuritic plaques, but it is not known whether the element plays a causative role in the disease.
Underlying genetic defects have been identified for both late- and early-onset cases of Alzheimer disease. A defect in the gene that codes for amyloid precursor protein may increase the production or deposition of beta amyloid, which forms the core of neuritic plaques. This gene, however, is responsible for only 2 to 3 percent of all early-onset cases of the disease; the remainder are attributed to two other genes. A defect in the gene that directs production of apolipoprotein E (ApoE), which is involved in cholesterol transport, may be a factor in the majority of late-onset Alzheimer cases. There are three forms of this gene—ApoE2, ApoE3, and ApoE4—one of which, ApoE4, is associated with a higher risk of disease.
There is no cure for Alzheimer disease. The medication tacrine slightly slows the progression of the disease by slowing the breakdown of acetylcholine, but it is not effective in all patients and can become toxic to the liver. Most treatment aims to control the depression, behavioral problems, and insomnia that often accompany the disease.
*dementia
chronic, usually progressive deterioration of intellectual capacity associated with the widespread loss of nerve cells and the shrinkage of brain tissue. Dementia is most commonly seen in the elderly (senile dementia), though it is not part of the normal aging process and can affect persons of any age.
The most common irreversible dementia is Alzheimer disease. This condition begins with memory loss, which may first appear to be simple absentmindedness or forgetfulness. As dementia progresses, the loss of memory broadens in scope until the individual can no longer remember basic social and survival skills or function independently. Language, spatial or temporal orientation, judgment, or other cognitive capacities may decline, and personality changes may also occur. Dementia is also present in other degenerative brain diseases including Pick disease and Parkinson disease.
The second most common cause of dementia is hypertension (high blood pressure) or other vascular conditions. This type of dementia, called multi-infarct, or vascular, dementia results from a series of small strokes that progressively destroy the brain. Dementia can also be caused by Huntington disease, syphilis, multiple sclerosis, acquired immune deficiency syndrome (AIDS), and some types of encephalitis. Treatable dementias occur in hypothyroidism, other metabolic diseases, and some malignant tumours. Treatment of the underlying disease in these cases may inhibit the progress of dementia but usually does not reverse it.
Alzheimer disease is the most common form of *dementia. The disease develops differently among individuals; this suggests that more than one pathologic process may lead to the same outcome. Typically, the first symptom to appear is forgetfulness. As the disease progresses, memory loss becomes more severe, and language, perceptual, and motor skills deteriorate. Mood becomes unstable, and the individual tends to become irritable and more sensitive to stress and may become intermittently angry, anxious, or depressed. In advanced stages, the individual becomes unresponsive and loses mobility and control of body functions; death ensues after a disease course lasting from 2 to 20 years.
About 10 percent of those who develop the disease are younger than 60 years of age. These cases, referred to as early-onset familial Alzheimer disease, result from an inherited genetic mutation. The majority of cases of Alzheimer disease, however, develop after age 60 (late-onset); they usually occur sporadically—i.e., in individuals with no family history of the disease—although a genetic factor has been identified that is thought to predispose these individuals to the disorder.
The presence of neuritic plaques and neurofibrillary tangles in the brain are used to diagnose Alzheimer disease in autopsy. Neuritic plaques—also called senile, dendritic, or amyloid plaques—consist of deteriorating neuronal material surrounding deposits of a sticky protein called beta amyloid. This protein is derived from a larger molecule called amyloid precursor protein, which is a normal component of nerve cells. Neurofibrillary tangles are twisted protein fibres located within nerve cells. These fibres consist of a protein, called tau, that normally occurs in neurons. When incorrectly processed, tau molecules clump together and form tangles. Both neuritic plaques and neurofibrillary tangles, which also may be found in smaller amounts in the brains of healthy elderly persons, are thought to interfere in some way with normal cellular functioning. However, it is not known whether the plaques and tangles are a cause or a consequence of the disease.
Other features have been noted in the brains of many persons with Alzheimer disease. One is a deficiency of the neurotransmitter acetylcholine; neurons containing acetylcholine play an important role in memory. Abnormal concentrations of aluminum also have been found in neurofibrillary tangles and neuritic plaques, but it is not known whether the element plays a causative role in the disease.
Underlying genetic defects have been identified for both late- and early-onset cases of Alzheimer disease. A defect in the gene that codes for amyloid precursor protein may increase the production or deposition of beta amyloid, which forms the core of neuritic plaques. This gene, however, is responsible for only 2 to 3 percent of all early-onset cases of the disease; the remainder are attributed to two other genes. A defect in the gene that directs production of apolipoprotein E (ApoE), which is involved in cholesterol transport, may be a factor in the majority of late-onset Alzheimer cases. There are three forms of this gene—ApoE2, ApoE3, and ApoE4—one of which, ApoE4, is associated with a higher risk of disease.
There is no cure for Alzheimer disease. The medication tacrine slightly slows the progression of the disease by slowing the breakdown of acetylcholine, but it is not effective in all patients and can become toxic to the liver. Most treatment aims to control the depression, behavioral problems, and insomnia that often accompany the disease.
*dementia
chronic, usually progressive deterioration of intellectual capacity associated with the widespread loss of nerve cells and the shrinkage of brain tissue. Dementia is most commonly seen in the elderly (senile dementia), though it is not part of the normal aging process and can affect persons of any age.
The most common irreversible dementia is Alzheimer disease. This condition begins with memory loss, which may first appear to be simple absentmindedness or forgetfulness. As dementia progresses, the loss of memory broadens in scope until the individual can no longer remember basic social and survival skills or function independently. Language, spatial or temporal orientation, judgment, or other cognitive capacities may decline, and personality changes may also occur. Dementia is also present in other degenerative brain diseases including Pick disease and Parkinson disease.
The second most common cause of dementia is hypertension (high blood pressure) or other vascular conditions. This type of dementia, called multi-infarct, or vascular, dementia results from a series of small strokes that progressively destroy the brain. Dementia can also be caused by Huntington disease, syphilis, multiple sclerosis, acquired immune deficiency syndrome (AIDS), and some types of encephalitis. Treatable dementias occur in hypothyroidism, other metabolic diseases, and some malignant tumours. Treatment of the underlying disease in these cases may inhibit the progress of dementia but usually does not reverse it.
Pick disease
form of premature dementia caused by atrophy of the frontal and temporal lobes of the brain. It resembles Alzheimer disease but is much less common. Pick disease is characterized by a progressive deterioration of intellect, judgment, and memory, resulting in increased irritability, inappropriate behaviour, depression, and paranoia. Histologically some cerebral nerve cells are swollen and contain abnormal inclusions called Pick bodies. The cause of Pick disease is unknown, but in some cases the disease appears to be inherited. Average survival from onset (generally between the ages of 40 and 60) to death is about 10 years; there is no specific treatment. The disease was first described by the German neurologist Arnold Pick.
Hodgkin disease
an uncommon cancer of the lymphatic system (malignant lymphoma) that usually strikes young adults and people 55 years of age or older. Most patients can be cured if the disease is detected in its early stages, but even those with advanced Hodgkin disease have a significant chance of recovery. The overall cure rate is approximately 75 percent.
In its early stages the disease is characterized by local, painless swelling of one or more lymph nodes and sometimes by swelling of the spleen, liver, or other organs. In addition to swollen lymph nodes, symptoms may include fever and itching followed later by weight loss and fatigue. A microscopic examination of affected tissue, usually obtained from a lymph node, is required to confirm diagnosis.
The cause of Hodgkin disease remains unknown, but numerous infectious agents, including bacteria, protozoa, and viruses, have been suggested. Previous infection with the Epstein-Barr virus, the causative agent of mononucleosis, has been linked to many cases of Hodgkin disease. Hodgkin disease tumours develop from B lymphocytes. Treatment consists of chemotherapy, radiation, or a combination of both, depending on the stage of development of the disease.
The disease is named after Thomas Hodgkin, who first described it in 1832.
In its early stages the disease is characterized by local, painless swelling of one or more lymph nodes and sometimes by swelling of the spleen, liver, or other organs. In addition to swollen lymph nodes, symptoms may include fever and itching followed later by weight loss and fatigue. A microscopic examination of affected tissue, usually obtained from a lymph node, is required to confirm diagnosis.
The cause of Hodgkin disease remains unknown, but numerous infectious agents, including bacteria, protozoa, and viruses, have been suggested. Previous infection with the Epstein-Barr virus, the causative agent of mononucleosis, has been linked to many cases of Hodgkin disease. Hodgkin disease tumours develop from B lymphocytes. Treatment consists of chemotherapy, radiation, or a combination of both, depending on the stage of development of the disease.
The disease is named after Thomas Hodgkin, who first described it in 1832.
Monday, February 25, 2008
Mesothelioma
Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos.[1] In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* fatigue or anemia
* wheezing, hoarseness, or cough
* blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients
Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation[citation needed]. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies, has proved disappointing. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
Radiation
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston.Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy
In February 2004, the United States Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.
Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* fatigue or anemia
* wheezing, hoarseness, or cough
* blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients
Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation[citation needed]. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies, has proved disappointing. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
Radiation
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston.Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy
In February 2004, the United States Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.
Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
Saturday, February 23, 2008
Haemophilia
Haemophilia or hemophilia (from Greek haima "blood" and philia "to love") is the name of a family of hereditary genetic disorders that impair the body's ability to control blood clotting, or coagulation. In the most common form, hemophilia A, clotting factor VIII is absent. Haemophilia B, also known as factor IX deficiency, is the second most common type of hemophilia, but Hemophilia B is far less common than Hemophilia A, the latter occurring in about one in 25,000 male births.
The effects of this sex-linked, X chromosome disorder are manifested almost entirely in males, although the gene for the disorder is inherited from the mother. This is more common in males because the female has two X chromosomes while the male only has one, meaning that if a male's x chromosome is defective, there is not another to "cover up" the disorder like females have. Sometimes this disease is considered to be dominant because of its dominance in the male XY chromosome pair. In about 30% of cases of Hemopilia B, however, there is no family history of the disorder and the condition is the result of a spontaneous gene mutation. A mother who is a carrier also has a 50% chance of giving the faulty X chromosome to her daughter. That does not give the daughter the hemophilia disease, but it does result in the daughter becoming a hemophilia carrier. Females are almost exclusively asymptomatic carriers of the disorder, and may have inherited it from either their mother or father.
These genetic deficiencies may lower blood plasma clotting factor levels of coagulation factors needed for a normal clotting process. When a blood vessel is injured, a temporary scab does form, but the missing coagulation factors prevent fibrin formation which is necessary to maintain the blood clot. Thus a haemophiliac does not bleed more intensely than a normal person, but for a much longer amount of time. In severe haemophiliacs even a minor injury could result in blood loss lasting days, weeks, or not ever healing completely. The critical risk here is with normally small bleeds which due to missing factor VIII take long times to heal. In areas such as the brain or inside joints this can be fatal or life debilitating.
The bleeding with external injury is normal, but incidence of late re-bleeding and internal bleeding is increased, especially into muscles, joints, or bleeding into closed spaces. Major complications include hemarthrosis, hemorrhage, gastrointestinal bleeding, and menorrhagia.
Causes
It is caused by a lack of clotting factors:
* Hemophilia A involves a lack of functional clotting Factor VIII. (This represents 90% of haemophilia cases.[citation needed])
* Hemophilia B involves a lack of functional clotting Factor IX.
* Hemophilia C involves a lack of functional clotting Factor XI.
* Hypofibrinogenemia involves a lack of functional clotting factor Factor I. Because it is so rare, about 1 or 2 cases per million births, it has no definite treatment approved by the FDA. It affects males and females equally. The blood of people with Hypofibrinogenemia neither clots nor contains sufficient amounts of Fibrinogen.
History
The earliest possible implicit reference to hemophilia may have been in the Talmud[4], a Jewish holy text, which states that males did not have to be circumcised if two brothers had already died from the procedure. In 1000, the Arab physician Abu al-Qasim al-Zahrawi (known as Albucasis in the West) wrote a more explicit description of hemophilia in his Al-Tasrif, in which he wrote of an Andalusian family whose males died of bleeding after minor injuries.
In 1803, Dr. John Conrad Otto, a Philadelphia physician, wrote an account about "a hemorrhagic disposition existing in certain families." He recognized that the disorder was hereditary and that it affected males and rarely females. He was able to trace the disease back to a woman who settled near Plymouth in 1720. The first usage of the term "hemophilia" appears in a description of the condition written by Hopff at the University of Zurich in 1828. In 1937, Patek and Taylor, two doctors from Harvard, discovered anti-hemophilic globulin. Pavlosky, a doctor from Buenos Aires, found Hemophilia A and Hemophilia B to be separate diseases by doing a lab test. This test was done by transferring the blood of one hemophiliac to another hemophiliac. The fact that this corrected the clotting problem showed that there was more than one form of hemophilia.
Haemophilia in European royalty featured prominently and thus is sometimes known as "the royal disease". Queen Victoria passed the mutation to her son Leopold and, through several of her daughters, to various royals across the continent, including the royal families of Spain, Germany, and Russia. Tsarevich Alexei Nikolaevich, son of Nicholas II, was a descendant of Queen Victoria and suffered from hemophilia.
Prior to 1985, there were no laws enacted within the U.S. to screen blood, even though the technology existed. As a result, many hemophilia patients who received untested and unscreened clotting factor prior to 1992 were at an extreme risk for contracting HIV and Hepatitis C via these blood products. It is estimated that more than 50% of the Hemophilia population, over 10,000 people, contracted HIV from the tainted blood supply in the United States alone.
About 18,000 people in the United States have hemophilia. Each year, about 400 babies are born with the disorder. Hemophilia usually occurs in males and less often in females.
Genetics
Females possess two X-chromosomes, whereas males have one X and one Y chromosome. Since the mutations causing the disease are recessive, a woman carrying the defect on one of her X-chromosomes may not be affected by it, as the equivalent allele on her other chromosome should express itself to produce the necessary clotting factors. However the Y-chromosome in men has no gene for factors VIII or IX. If the genes responsible for production of factor VIII or factor IX present on a male's X-chromosome are deficient there is no equivalent on the Y-chromosome, so the deficient gene is not masked by the dominant allele and he will develop the illness.
Since a male receives his single X-chromosome from his mother, the son of a healthy female silently carrying the deficient gene will have a 50% chance of inheriting that gene from her and with it the disease; and if his mother is affected with haemophilia, he will have a 100% chance of being a haemophiliac. In contrast, for a female to inherit the disease, she must receive two deficient X-chromosomes, one from her mother and the other from her father (who must therefore be a haemophiliac himself). Hence haemophilia is far more common among males than females. However it is possible for female carriers to become mild haemophiliacs due to lyonisation of the X chromosomes. Haemophiliac daughters are more common than they once were, as improved treatments for the disease have allowed more haemophiliac males to survive to adulthood and become parents. Adult females may experience menorrhagia (heavy periods) due to the bleeding tendency. The pattern of inheritance is criss-cross type. This type of pattern is also seen in colour blindness.
As with all genetic disorders, it is of course also possible for a human to acquire it spontaneously through mutation, rather than inheriting it, because of a new mutation in one of their parents' gametes. Spontaneous mutations account for about ⅓ of all haemophilia A and 20% of all hemophilia B cases. Genetic testing and genetic counseling is recommended for families with haemophilia. Prenatal testing, such as amniocentesis, is available to pregnant women who may be carriers of the condition.
Treatment
Though there is no cure for hemophilia, it can be controlled with regular infusions of the deficient clotting factor, i.e. factor VIII in haemophilia A or factor IX in hemophilia B. Some hemophiliacs develop antibodies (inhibitors) against the replacement factors given to them, so the amount of the factor has to be increased or non-human replacement products must be given, such as porcine factor VIII.
If a patient becomes refractory to replacement coagulation factor as a result of circulating inhibitors, this may be partially overcome with recombinant human factor VII (NovoSeven®), which is registered for this indication in many countries.
In early 2008, the US Food and Drug Administration approved Xyntha® (Wyeth) anti-hemophilic factor, genetically engineered from the genes of Chinese hamster ovary cells. Since 1993 (Dr. Mary Nugent) recombinant factor products (which are typically cultured in Chinese hamster ovary (CHO) tissue culture cells and involve little, if any human plasma products) have been available and have been widely used in wealthier western countries. While recombinant clotting factor products offer higher purity and safety, they are, like concentrate, extremely expensive, and not generally available in the developing world. In many cases, factor products of any sort are difficult to obtain in developing countries.
In Western countries, common standards of care fall into one of two categories: prophylaxis or on-demand. Prophylaxis involves the infusion of clotting factor on a regular schedule in order to keep clotting levels sufficiently high to prevent spontaneous bleeding episodes. On-demand treatment involves treating bleeding episodes once they arise. In 2007, a clinical trial was published in the New England Journal of Medicine (NEJM) comparing on-demand treatment of boys (< 30 months) with Hemophilia A with prophylactic treatment (infusions of 25 IU/kg body weight of Factor VIII every other day) in respect to its effect on the prevention of joint-diseases. When the boys reached 6 years of age, 93% of those in the prophylaxis group and 55% of those in the episodic-therapy group had a normal index joint-structure on MRI. Prophylactic treatment, however, resulted in average costs of $300,000 per year. The author of an editorial published in the same issue of the NEJM demands more clinical studies addressing the cost-effectiveness of prophylactic treatment.
Armour and other pharmaceutical companies knowingly sold blood clotting products contaminated with HIV and hepatitis C to ten thousand hemophiliacs across America in the late 1970's and early mid 1980's. When the Federal Government banned their products from being sold in America, they promptly turned around and sold the HIV contaminated factor products overseas in Europe and Japan.
Later criminal and civil lawsuits were brought against these manufacturers and the Armour Pharmaceutical subsidiary of French chemical company Rhone-Poulenc. In Europe and Japan several high level executives received prison terms as a result of their knowingly selling HIV contaminated products to hemophiliacs.
In America the pharmaceutical companies eventually paid out around 650 million dollars to compensate the haemophiliacs who were infected with HIV. [12]
As a direct result of the contamination of the blood supply in the late 1970s and early/mid 1980s with viruses such as Hepatitis and HIV, new methods were developed in the production of clotting factor products. The initial response was to heat-treat (pasteurize) plasma-derived factor concentrate, followed by the development of monoclonal factor concentrates, which use a combination of heat treatment and affinity chromatography to inactivate any viral agents in the pooled plasma from which the factor concentrate is derived. The Lindsay Tribunal in Ireland investigated, among other things, the slow adoption of the new methods.
It was claimed that Rasputin was successful at treating the Tsarevich Alexei of Russia's hemophilia. At the time, a common treatment administered by professional doctors was to use aspirin, which worsened rather than lessen the problem. It is believe that, by simply advising against the medical treatment, Rasputin could bring visible and significant improvement to the condition of Alexei.
People affected with Hemophilia are recommended to do some specific exercises for elbow, knee, and ankles like stretching of calves, ankle circles, elbow flexion, and Quadriceps set etc. These exercises are recommended after an internal bleed occurs and on a daily basis to strengthen the muscles and joints to prevent new bleeding problems.
The effects of this sex-linked, X chromosome disorder are manifested almost entirely in males, although the gene for the disorder is inherited from the mother. This is more common in males because the female has two X chromosomes while the male only has one, meaning that if a male's x chromosome is defective, there is not another to "cover up" the disorder like females have. Sometimes this disease is considered to be dominant because of its dominance in the male XY chromosome pair. In about 30% of cases of Hemopilia B, however, there is no family history of the disorder and the condition is the result of a spontaneous gene mutation. A mother who is a carrier also has a 50% chance of giving the faulty X chromosome to her daughter. That does not give the daughter the hemophilia disease, but it does result in the daughter becoming a hemophilia carrier. Females are almost exclusively asymptomatic carriers of the disorder, and may have inherited it from either their mother or father.
These genetic deficiencies may lower blood plasma clotting factor levels of coagulation factors needed for a normal clotting process. When a blood vessel is injured, a temporary scab does form, but the missing coagulation factors prevent fibrin formation which is necessary to maintain the blood clot. Thus a haemophiliac does not bleed more intensely than a normal person, but for a much longer amount of time. In severe haemophiliacs even a minor injury could result in blood loss lasting days, weeks, or not ever healing completely. The critical risk here is with normally small bleeds which due to missing factor VIII take long times to heal. In areas such as the brain or inside joints this can be fatal or life debilitating.
The bleeding with external injury is normal, but incidence of late re-bleeding and internal bleeding is increased, especially into muscles, joints, or bleeding into closed spaces. Major complications include hemarthrosis, hemorrhage, gastrointestinal bleeding, and menorrhagia.
Causes
It is caused by a lack of clotting factors:
* Hemophilia A involves a lack of functional clotting Factor VIII. (This represents 90% of haemophilia cases.[citation needed])
* Hemophilia B involves a lack of functional clotting Factor IX.
* Hemophilia C involves a lack of functional clotting Factor XI.
* Hypofibrinogenemia involves a lack of functional clotting factor Factor I. Because it is so rare, about 1 or 2 cases per million births, it has no definite treatment approved by the FDA. It affects males and females equally. The blood of people with Hypofibrinogenemia neither clots nor contains sufficient amounts of Fibrinogen.
History
The earliest possible implicit reference to hemophilia may have been in the Talmud[4], a Jewish holy text, which states that males did not have to be circumcised if two brothers had already died from the procedure. In 1000, the Arab physician Abu al-Qasim al-Zahrawi (known as Albucasis in the West) wrote a more explicit description of hemophilia in his Al-Tasrif, in which he wrote of an Andalusian family whose males died of bleeding after minor injuries.
In 1803, Dr. John Conrad Otto, a Philadelphia physician, wrote an account about "a hemorrhagic disposition existing in certain families." He recognized that the disorder was hereditary and that it affected males and rarely females. He was able to trace the disease back to a woman who settled near Plymouth in 1720. The first usage of the term "hemophilia" appears in a description of the condition written by Hopff at the University of Zurich in 1828. In 1937, Patek and Taylor, two doctors from Harvard, discovered anti-hemophilic globulin. Pavlosky, a doctor from Buenos Aires, found Hemophilia A and Hemophilia B to be separate diseases by doing a lab test. This test was done by transferring the blood of one hemophiliac to another hemophiliac. The fact that this corrected the clotting problem showed that there was more than one form of hemophilia.
Haemophilia in European royalty featured prominently and thus is sometimes known as "the royal disease". Queen Victoria passed the mutation to her son Leopold and, through several of her daughters, to various royals across the continent, including the royal families of Spain, Germany, and Russia. Tsarevich Alexei Nikolaevich, son of Nicholas II, was a descendant of Queen Victoria and suffered from hemophilia.
Prior to 1985, there were no laws enacted within the U.S. to screen blood, even though the technology existed. As a result, many hemophilia patients who received untested and unscreened clotting factor prior to 1992 were at an extreme risk for contracting HIV and Hepatitis C via these blood products. It is estimated that more than 50% of the Hemophilia population, over 10,000 people, contracted HIV from the tainted blood supply in the United States alone.
About 18,000 people in the United States have hemophilia. Each year, about 400 babies are born with the disorder. Hemophilia usually occurs in males and less often in females.
Genetics
Females possess two X-chromosomes, whereas males have one X and one Y chromosome. Since the mutations causing the disease are recessive, a woman carrying the defect on one of her X-chromosomes may not be affected by it, as the equivalent allele on her other chromosome should express itself to produce the necessary clotting factors. However the Y-chromosome in men has no gene for factors VIII or IX. If the genes responsible for production of factor VIII or factor IX present on a male's X-chromosome are deficient there is no equivalent on the Y-chromosome, so the deficient gene is not masked by the dominant allele and he will develop the illness.
Since a male receives his single X-chromosome from his mother, the son of a healthy female silently carrying the deficient gene will have a 50% chance of inheriting that gene from her and with it the disease; and if his mother is affected with haemophilia, he will have a 100% chance of being a haemophiliac. In contrast, for a female to inherit the disease, she must receive two deficient X-chromosomes, one from her mother and the other from her father (who must therefore be a haemophiliac himself). Hence haemophilia is far more common among males than females. However it is possible for female carriers to become mild haemophiliacs due to lyonisation of the X chromosomes. Haemophiliac daughters are more common than they once were, as improved treatments for the disease have allowed more haemophiliac males to survive to adulthood and become parents. Adult females may experience menorrhagia (heavy periods) due to the bleeding tendency. The pattern of inheritance is criss-cross type. This type of pattern is also seen in colour blindness.
As with all genetic disorders, it is of course also possible for a human to acquire it spontaneously through mutation, rather than inheriting it, because of a new mutation in one of their parents' gametes. Spontaneous mutations account for about ⅓ of all haemophilia A and 20% of all hemophilia B cases. Genetic testing and genetic counseling is recommended for families with haemophilia. Prenatal testing, such as amniocentesis, is available to pregnant women who may be carriers of the condition.
Treatment
Though there is no cure for hemophilia, it can be controlled with regular infusions of the deficient clotting factor, i.e. factor VIII in haemophilia A or factor IX in hemophilia B. Some hemophiliacs develop antibodies (inhibitors) against the replacement factors given to them, so the amount of the factor has to be increased or non-human replacement products must be given, such as porcine factor VIII.
If a patient becomes refractory to replacement coagulation factor as a result of circulating inhibitors, this may be partially overcome with recombinant human factor VII (NovoSeven®), which is registered for this indication in many countries.
In early 2008, the US Food and Drug Administration approved Xyntha® (Wyeth) anti-hemophilic factor, genetically engineered from the genes of Chinese hamster ovary cells. Since 1993 (Dr. Mary Nugent) recombinant factor products (which are typically cultured in Chinese hamster ovary (CHO) tissue culture cells and involve little, if any human plasma products) have been available and have been widely used in wealthier western countries. While recombinant clotting factor products offer higher purity and safety, they are, like concentrate, extremely expensive, and not generally available in the developing world. In many cases, factor products of any sort are difficult to obtain in developing countries.
In Western countries, common standards of care fall into one of two categories: prophylaxis or on-demand. Prophylaxis involves the infusion of clotting factor on a regular schedule in order to keep clotting levels sufficiently high to prevent spontaneous bleeding episodes. On-demand treatment involves treating bleeding episodes once they arise. In 2007, a clinical trial was published in the New England Journal of Medicine (NEJM) comparing on-demand treatment of boys (< 30 months) with Hemophilia A with prophylactic treatment (infusions of 25 IU/kg body weight of Factor VIII every other day) in respect to its effect on the prevention of joint-diseases. When the boys reached 6 years of age, 93% of those in the prophylaxis group and 55% of those in the episodic-therapy group had a normal index joint-structure on MRI. Prophylactic treatment, however, resulted in average costs of $300,000 per year. The author of an editorial published in the same issue of the NEJM demands more clinical studies addressing the cost-effectiveness of prophylactic treatment.
Armour and other pharmaceutical companies knowingly sold blood clotting products contaminated with HIV and hepatitis C to ten thousand hemophiliacs across America in the late 1970's and early mid 1980's. When the Federal Government banned their products from being sold in America, they promptly turned around and sold the HIV contaminated factor products overseas in Europe and Japan.
Later criminal and civil lawsuits were brought against these manufacturers and the Armour Pharmaceutical subsidiary of French chemical company Rhone-Poulenc. In Europe and Japan several high level executives received prison terms as a result of their knowingly selling HIV contaminated products to hemophiliacs.
In America the pharmaceutical companies eventually paid out around 650 million dollars to compensate the haemophiliacs who were infected with HIV. [12]
As a direct result of the contamination of the blood supply in the late 1970s and early/mid 1980s with viruses such as Hepatitis and HIV, new methods were developed in the production of clotting factor products. The initial response was to heat-treat (pasteurize) plasma-derived factor concentrate, followed by the development of monoclonal factor concentrates, which use a combination of heat treatment and affinity chromatography to inactivate any viral agents in the pooled plasma from which the factor concentrate is derived. The Lindsay Tribunal in Ireland investigated, among other things, the slow adoption of the new methods.
It was claimed that Rasputin was successful at treating the Tsarevich Alexei of Russia's hemophilia. At the time, a common treatment administered by professional doctors was to use aspirin, which worsened rather than lessen the problem. It is believe that, by simply advising against the medical treatment, Rasputin could bring visible and significant improvement to the condition of Alexei.
People affected with Hemophilia are recommended to do some specific exercises for elbow, knee, and ankles like stretching of calves, ankle circles, elbow flexion, and Quadriceps set etc. These exercises are recommended after an internal bleed occurs and on a daily basis to strengthen the muscles and joints to prevent new bleeding problems.
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