Maybe you've used some of these excuses, though likely not about Zika: "No need for this smelly bug spray" or "I lived here for years and never got chikungunya, why would I get Zika?" or even, "It's not like I'm planning to have a baby any time soon."
Zika is usually a mild virus, and people rarely die from it. For pregnant women, though, it's more serious, as Zika can cause microcephaly and other severe fetal brain defects.
On Wednesday, the Senate did act on one crisis, giving preliminary approval to a plan to save debt-stricken Puerto Rico from defaulting this week on a $2 billion debt payment, with final passage expected Thursday.
However, following the terror massacre inside an Orlando, Fla., nightclub, the Senate was unable to strike a compromise on dueling gun control measures, sparking additional finger-pointing and outcry from Americans about an ineffectual Congress.
On the Zika issue, Obama requested $1.9 billion back in February. But the Republicans controlling Congress instead forced the administration to redirect more than $500 million in unspent Ebola-fighting funds to combat Zika.
The failed House-Senate measure matched the $1.1 billion proposal passed last month by the Senate except for the added provisions and the attachment of companion spending cuts to defray its cost.
Democrats particularly opposed a provision that restricts the use of $95 million worth of federal grants to provide services such as birth control to women in Puerto Rico threatened by the virus. Democrats charged that the restrictions were targeted at clinic on the island run by Planned Parenthood, a group loathed by many anti-abortion Republicans.
In addition to the limits on Planned Parenthood, the bill would temporarily lift Clean Water Act permitting requirements on pesticide spraying for municipalities and other large-scale users.
Many things are sold to treat acne, the most popular being benzoyl peroxide. Many of these things have not been scientifically proven to help acne. However, a mix of commercial and homemade treatments can help with acne for various reasons.
Killing the bacteria that grow in the blocked follicles. This can be done by ingesting antibiotic medication, or by putting antibiotics on the skin. Antibiotics act quickly and are a powerful way of temporarily getting rid of acne. When the body develops a resistance to the antibiotics, the bacteria returns stronger than before.
Removing oil on the skin can be done by taking drugs that contain Vitamin A. Accutane is the name of the most famous treatment using massive quantities of Vitamin A.
Removing dead skin cells can be done by treatment with salicylic acid. This encourages the skin to peel away the top layer of cells.
Popping a pimple should not be done by anyone but a qualified dermatologist. Pimple popping irritates skin, can make the bacteria spread, and can cause scars. If you must pop a pimple yourself, it is advised to apply warm water to the area before popping it and to wash your hand thoroughly before beginning so as to avoid spreading bacteria via the hands. Applying hot water will open up the pores and reduce the damage because it will require less force to pop it.
Treating acne can improve physical symptoms, in addition to improving self-esteem or lessening acne-related anxiety and depression.
Some medications may take 4 to 8 weeks to take effect, so it is important to adhere to a treatment plan agreed upon by you and your medical provider, even if you do not observe immediate results. Even after results become noticeable, continuing to pursue treatment can help prevent further breakouts.
Cases of mild acne can often be treated with over-the-counter medications. Products containing benzoyl peroxide (Brevoxyl or Triaz) or salicylic acid (Propa pH or Stridex) help to clear up skin. Gently cleansing with warm water and mild soap (Dove, or Cetaphil) can also help clear up mild acne.
Acne that may be caused by hormonal flare-ups prior to menstruation may also be controlled with low-dose birth control pills containing estrogen.
If these treatments for mild acne are not effective, you may need stronger prescription medications or a combination of several different therapies. Mild to moderate acne can be treated by:
Draining large pimples and cysts by a medical provider
Using prescription antibiotic gels, creams, or lotions applied to the affected area
Using prescription retinoids applied to the affected area
Applying azelaic acid to the affected area
Taking oral antibiotics
Taking oral retinoids (isotretinoin) – this is the only medication approved for severe cystic acne, but has serious side effects such as mood disorders, depression, and suicidal ideation
Antibiotics that have been successful in treating acne include doxycycline, minocycline, tetracycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim, and azithromycin.
Certain therapies can be combined in the treatment of acne, such as combination of oral antibiotics and topical retinoids.
Severe acne may leave scars. Although some scars go away with time on their own, scars can be removed via laser resurfacing, dermabrasion, or other treatment by a dermatologist or plastic surgeon.
Acne vulgaris (or simply acne) is a long-term skin disease that occurs when hair follicles become clogged with dead skin cells and oil from the skin. Acne is characterized by areas of blackheads, whiteheads, pimples, and greasy skin, and may result in scarring. The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.
Genetics is thought to be the cause in 80% of cases. The role of diet and cigarette smoking is unclear and neither cleanliness nor sunlight appear to be involved. Acne primarily affects skin with a greater number of oil glands, including the face, upper part of the chest, and back.During puberty, in both sexes, acne is often brought on by an increase in androgens such as testosterone. Excessive growth of the bacteria Propionibacterium acnes, which is normally present on the skin, is often involved.
Many treatment options are available to improve the appearance of acne, including lifestyle changes, procedures, and medications. Eating fewer simple carbohydrates like sugar may help. Topical azelaic acid, benzoyl peroxide, and salicylic acid are commonly used treatments. Antibiotics and retinoids are available in both topical and oral formulations to treat acne. However, resistance to antibiotics may develop. A number of birth control pills may be useful for preventing acne in women.Oral isotretinoin is usually reserved for severe acne due to greater potential side effects. Early and aggressive treatment is advocated by some to lessen the overall long-term impact to individuals.
In 2013, acne was estimated to affect 660 million people globally, making it the 8th most common disease worldwide. Acne occurs most commonly during adolescence, affecting an estimated 80–90% of teenagers in the Western world. Lower rates are reported in some rural societies. People may also be affected before and after puberty. Though it becomes less common in adulthood than in adolescence, nearly half of people in their twenties and thirties continue to have acne. About 4% continue to have difficulties into their forties.
Many different treatments exist for acne, including alpha hydroxy acid, anti-androgen medications, antibiotics, antiseborrheic medications, azelaic acid, benzoyl peroxide, hormonal treatments, keratolytic soaps, nicotinamide, retinoids, and salicylic acid. They are believed to work in at least four different ways, including the following: anti-inflammatory effects, hormonal manipulation, killing P. acnes, and normalizing skin cell shedding and sebum production in the pore to prevent blockage.
Commonly used medical treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies including antibiotics, hormonal agents, and oral retinoids. Procedures such as light therapy and laser therapy are not considered to be first-line treatments and typically have an adjunctive role due to their high cost and the limited evidence of their efficacy.
The social and economic costs of treating acne vulgaris are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over $2.5 billion each year in direct costs. Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom.
Misperceptions about acne's causative and aggravating factors are common and those affected by acne are often blamed for their condition. Such blame can worsen the affected person's sense of self-esteem. Acne vulgaris and its resultant scars have been associated with significant social difficulties that can last into adulthood.
Efforts are underway to better understand the mechanisms involved in sebum production. The aim of this research is to develop medications targeting hormones known to increase sebum production (e.g., IGF-1 and alpha-melanocyte-stimulating hormone). Additional sebum-lowering medications being researched include topical antiandrogens and PPAR modulators. Another avenue of early-stage research has focused on how to best use laser and light therapy to selectively destroy sebaceous glands in the skin's hair follicles to reduce sebum production and improve acne appearance.
The use of antimicrobial peptides against P. acnes is also under investigation as a novel method of treating acne and overcoming antibiotic resistance. In 2007, the first genome sequencing of a P. acnes bacteriophage (PA6) was reported. The authors proposed applying this research toward development of bacteriophage therapy as an acne treatment in order to overcome the problems associated with long-term antibiotic therapy, such as bacterial resistance. Oral and topical probiotics are also being evaluated as treatments for acne. Probiotics have been hypothesized to have therapeutic effects for those affected by acne due to their ability to decrease skin inflammation and improve skin moisture by increasing the skin's ceramide content. As of 2014, studies examining the effects of probiotics on acne in humans were limited.
Decreased levels of retinoic acid in the skin may contribute to comedone formation. To address this deficiency, and potentially replace the use of irritating topical retinoids, methods to increase the skin's production of retinoid acid are being explored. A vaccine against inflammatory acne has been tested successfully in mice, but has not yet been proven to be effective in humans. Other workers have voiced concerns related to creating a vaccine designed to neutralize a stable community of normal skin bacteria that is known to protect the skin from colonization by more harmful microorganisms.
After surgery, the relief of living and having fixed hearts is not enough for many patients. Instead, many patients are bombarded by difficult thoughts relative to pain, complications and ultimately, a challenged recovery. That said, these thoughts can manifest in emotional and behavioral changes after heart surgery.
In my own research, I learned that 30%-75% of patients report feeling anxious or depressed after heart surgery. That’s a pretty significant number. Personally, I experienced both emotional and behavioral changes following my valve replacements. I was moody. I was irritable. I was fatigued. I was tired of the pain.
Most recovery times range from one to three weeks for laparoscopic gastric bypass surgery and two to six weeks after gastric bypass surgery. There are many different habits after surgery that the patient will have to modify. Diet The patient cannot eat normally after the surgery and will have to take protein supplements and multivitamins to avoid nutritional deficiencies. Immediately after surgery, the patient will be on a liquid diet. This diet may include tea, broth, or electrolyte beverages such as Gatorade. Patients also have to avoid drinking from a straw or a bottle and should gingerly sip from a cup. Using this method will help the patient to avoid swallowing too much air and avoiding extreme discomfort. Carbonated beverages are also to be avoided. If they aren�t, the carbonation can expand the newly-formed pouch in the stomach. Staying hydrated is essential. However, a patient can not drink and eat at the same time as the liquid will expand the stomach and not enough food will be eaten and absorbed since the patient will feel too full to eat the correct amount of food to stay healthy. Examples of pureed foods that are accepted for the post-operative diet are: Protein shakes Broth only Blended poultry Low-fat yogurt or milk Mashed bananas After a couple of months, patients can move on towards a more solid diet of pureed substances. Most patients at this point can tolerate approximately 16 to 24 ounces a day. Dumping Syndrome If a patient strays from the correct diet and neglects to follow the modifications in his or her diet, then a symptom know as �dumping� can occur. If the patient eats foods that are too sugary or high in fat, or too much artificial sweetener, he or she can experience numerous maladies: Nausea Chest pain Vomiting Diarrhea Sweating Drinking Alcohol It is recommended that patients not drink alcohol for at least six months after surgery because it is high in calories, sugar, and low in nutritional value. Not only that, alcohol will actually deplete the body of nutrients. Pregnancy Doctors do not recommend that female patients get pregnant within a year after surgery because of injury that may be suffered to the mother and thereby injuring the fetus. This means that sexually active females should use some form of birth control for at least one year after surgery. Pain Medication Patients will have to avoid medication like NSAIDs (including aspirin and ibuprofen). Instead, patients are safe to take acetaminophen. The doctor should be consulted if the patient is not sure if a pain medication is safe. Exercise It is very important to maintain an exercise regimen after surgery to maintain a healthy weight and decrease weight gain. This exercise begins one to two days after surgery, which may seem odd, but movement of the legs helps to decrease the chances of acquiring deep vein thrombosis (a blood clot in the legs). Specific exercise plans will be drawn up by the doctor, which will begin with a low-impact program that will increase over time to more physical challenging exercises. Lifetime Diet It will always be important to maintain a very, low-fat and sugar free diet for the rest of a patient�s life. Good foods that doctors recommend are: Lean meat (chicken, turkey, pork) Fish Low-fat cottage cheese Tofu Whole grains Cheese Soft pasta Bariatric surgery requires extreme dedication from the patient undergoing the surgery to be diligent about the pre- and post-surgery instructions. By not following these directions, the person can suffer malnutrition, gain back weight, or worse, suffer
After a patient moves from the ER to the hospital, doctors will deal with any complications and help prevent future strokes. Here's what to expect during his hospital stay, and how to prepare for his care and recovery after he gets out.
Once a patient's stroke has been evaluated and his condition has been stabilized, he'll be transferred out of the ER and into a hospital bed. How long he spends in the hospital depends on a number of factors, including the type and severity of his stroke, what medical complications arise, and the extent of his disability. But it's unlikely that he'll be in the hospital for long. According to the National Center for Health Statistics, the average length of hospitalization for stroke in 2005 was 5.2 days.
Even though the person you're caring for is out of the ER, serious complications may still arise. An estimated one out of five stroke patients dies during his hospital stay.
The patient's treatment team has two main goals: To prevent another stroke from occurring and to minimize and respond to any complications.
To this end, the person you're caring for will undergo more testing to determine the cause of this stroke. Although the doctors should know what type of stroke he had, they'll still need to pinpoint the exact cause. They may perform one or more of the following tests:
Carotid ultrasound to determine if either carotid artery is narrowed or blocked. This test is noninvasive and painless: A technician applies jelly to the patient's neck, then slides an ultrasound wand over the skin covering his carotid artery.
Transcranial Doppler test for blockages in the large brain arteries. This test is similar to the carotid ultrasound, although the sound waves go through the patient's skull instead of his neck.
Cerebral angiogram to look for atherosclerosis or a brain aneurysm. The patient will be sedated to minimize his anxiety and discomfort during this procedure. A long, thin catheter, or tube, is inserted into a large artery in his groin, then maneuvered all the way through blood vessels into his chest. Once the tube reaches his carotid artery, dye is injected, which travels through the artery into the brain. Then a series of X-rays is taken to spot any abnormalities in the blood vessels of the brain. Because this procedure carries a slight risk of causing another stroke, it will be performed only if other tests are inconclusive.
Depending on the patient's test results, his doctors will treat him to reduce his risk of having another stroke:
For an ischemic stroke, he may be given anticlotting drugs, have a procedure known as a carotid endarectomy, or both.
For a hemorrhagic stroke, he may need to have a torn brain artery or aneurysm repaired, both of which require major surgery.
No matter what type of stroke he had, risk factors such as high blood pressure, high cholesterol, and diabetes will be evaluated and treated.
Complications could include brain swelling, seizures, clots in his legs, aspiration due to difficulty swallowing, arrhythmias, bleeding stomach ulcers, and pressure sores. The patient's doctors will be on the lookout for these serious and potentially fatal complications.
The patient's hospital stay may be even more stressful for you than his stroke and time in the ER. Now that you're no longer in crisis mode, you have more time to think -- and worry -- about the future. But try to use that time to prepare for life after his discharge instead:
Figure out how much care he will need. The extent of his stroke-related disability may not be immediately obvious, but it will become clearer as his recovery progresses. Talk to his rehabilitation team about how much care he'll need immediately after discharge, then discuss options for his care with his family or friends. Will he be able to return to his own home or to a family member's home? Or will he need more short-term or long-term a
Greater trochanteric pain syndrome is also often called trochanteric bursitis. The main symptom is pain over the outside of your upper thigh. Most cases are due to minor injury or inflammation to tissues in your upper, outer thigh area. Commonly the condition goes away on its own over time. Anti-inflammatory painkillers, physiotherapy and steroid injections can all sometimes help.
Hip pain in athletes involves a wide differential diagnosis. Adolescents and young adults are at particular risk for various apophyseal and epiphyseal injuries due to lack of ossification of these cartilaginous growth plates. Older athletes are more likely to present with tendinitis in these areas because their growth plates have closed. Several bursae in the hip area are prone to inflammation. The trochanteric bursa is the most commonly injured, and the lesion is easily identified by palpation of the area.
Quadricep, hamstring, and Iliotibial band injuries can be quite painful. However, there are several ways to help stablize muscular pulls. Compression braces can help provide stabilization to the torn muscle fibers and improve the ability to walk or help protect from futher injury. Ice packs and cold wraps help reduce pain and inflammation, and pain relief gels can provide temporary relief of painful symptoms. Many athletes use magnetic products to stimulate blood flow and reduce pain.
Greater trochanteric pain syndrome is a condition that causes pain over the outside of your upper thigh (or thighs). The cause is usually due to inflammation or injury to some of the tissues that lie over the bony prominence (the greater trochanter) at the top of the thigh bone (femur). Tissues that lie over the greater trochanter include muscles, tendons, strong fibrous tissue (fascia), and bursae.
Greater trochanteric pain syndrome used to be called trochanteric bursitis. This was because the pain was thought to be coming from an inflamed bursa that lies over the greater trochanter. A bursa is a small sac filled with fluid which helps to allow smooth movement between two uneven surfaces. There are various bursae in the body and they can become inflamed due to various reasons.
However, research suggests that most cases of greater trochanteric pain syndrome are due to minor tears or damage to the nearby muscles, tendons or fascia and an inflamed bursa is an uncommon cause. So, rather than the term trochanteric bursitis the more general term, greater trochanteric pain syndrome, is now preferred.
As the pain improves, gradually begin to exercise. It is best to work with a physical therapist to learn proper exercises and how to advance your activity. Swimming may be a good option because it stretches the muscles and builds good muscle tone without straining your hip joint. However, swimming does not build bone mass. When you are ready (a physical therapist can help determine that), slowly and carefully resume walking or another activity against the resistance of gravity.
A hip fracture can change the quality of your life significantly. Fewer than 50% of those with a hip fracture return to their former level of activity. In addition, while recovering from a hip fracture, several possible complications can be life-threatening. These include pneumonia and a blood clot in the leg, which can dislodge and travel to cause a clot in the lungs. Both are due to immobility following a hip fracture and hip surgery.
A groin pull can be caused by a quick change in direction while you're moving—often occurring in sports such as hockey, tennis, and basketball. A groin pull can result in pain, tenderness, and stiffness deep in the groin, making activity difficult.
Repetitive strain injury (RSI), also known as occupational overuse syndrome, is a medical condition. It causes pain in the muscles, nerves, or tendons after a person uses the same part of the body over and over again, or without taking breaks. It is usually caused by doing the same thing repeatedly or without breaks. Using a computer for long periods of time is a common cause of this problem.
Repetitive strain injury is described as a sudden, intense pain in affected parts of the body, often the wrists, neck, back or hands, that keeps coming back. It is different from more specific diagnoses, because there are many possible causes for RSI. The pain is often spread across different muscle groups and inspection of the affected area usually cannot show any differences from that of a healthy person. Because of this, treatment for RSI is usually limited to rest and exercises, and sometimes wearing a brace.
Treatment for Repetitive strain injury
This is often the first recommendation. Moving the affected area is important, but avoid stressing the joint. In conservation, this is often not practical without taking time-off from work. Too much inactivity can cause atrophy of muscles and increase the severity of the disorder.
Stretching Routines are implemented to help reduce hypertonic muscles and increase their flexibility and dexterity.
Splinting and Analgesics may help "mask" symptoms for a while, but unless the "real" cause of dysfunction is eliminated, the symptoms come right back. The long-term success rate of Splints and Anti-Inflammatory Medications is extremely low.
Wrist Braces and Splints are not effective in treating carpal tunnel syndrome and repetitive strain injuries, but can assist if worn during nighttime only. These devices are meant to keep the wrist from dropping into flexion so that the wrist stays in the straight, neutral position in order to reduce impingement of the carpal tunnel. But instead, wrist braces often increase the symptoms of carpal tunnel syndrome and repetitive strain injuries, especially if worn during the daytime.
Do not allow a complete range of motion of the fingers, wrist and elbow joints from flexion into full extension, and full abduction (splaying) of the fingers, which is absolutely critical in effectively rehabilitating carpal tunnel syndrome and repetitive strain injuries.
Provide finger extension of only 1-5 of the digits, and with most of the emphasis on the Metaphalangeal joint (most proximal finger joint). This means that there is only one joint being exercised, while the others stay stiff and are only affected by isometric, (non-moving) exercises.
Provide only wrist extension without finger extension and finger abduction!
Do not include finger, wrist and elbow extension, along with full abduction (splaying) of the fingers, all in one exercise motion, without any type of gripping or squeezing action required.
Rheumatic fever is an inflammatory disease that happens in children and young adults as a result of becoming infected by group A streptococci bacteria. The first attack usually happens between the ages of 5 and 15. It affects the heart, skin, joints and the central nervous system. It is most common in the Middle East, eastern Europe, South America and the Far East and is rare in western Europe and North America. Treatment includes resting in bed and antibiotics. Wolfgang Mozart, the famous composer famously died of rheumatic fever.
Treatment for Rheumatic fever
Ttreating rheumatic fever is to eradicate the bacteria which initially caused the immunologic response. This is usually accomplished with the use of penicillin. For penicillin-allergic patients, there are other options such as erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or azithromycin (Zithromax, Zmax). It is important to make sure that the acute infection is treated, but such treatment won't necessarily change the course of rheumatic fever once the immunologic response has begun. Your doctor will decide on the best treatment option for you. The joint pains are treated with aspirin or aspirin-related medications. It may be necessary to use very high doses to decrease the symptoms.
Carditis is treated by high-dose steroids but other cardiac medications may be needed to control the inflammation of the heart. This is a serious condition and is most often initially managed in an acute-care setting such as a hospital.
Challenging and unpredictable symptom to treat is the chorea (involuntary movements). It often responds to antipsychotic medications such as haloperidol (Haldol) but may continue for a protracted period. For patients who develop Sydenham's chorea, it can be the most difficult of the symptoms, since it involves involuntary movements and can interfere with daily activities. These individuals must remain on chronic long-term antibiotics to prevent recurrence of the strep infection, which has been known to cause recurrence of the chorea.
Rheumatism or Rheumatic disorder is a general term for medical problems that can hurt the heart, bones, joints, kidney, skin and lungs. The study of these problems is called rheumatology.
Treatment for Rheumatism
Many traditional herbal remedies were recommended for "rheumatism". Modern medicine, both conventional and complementary, shows that the different rheumatic disorders have different causes (and several of them have more than one) and need different kinds of treatment.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over-the-counter and by prescription. They are used to help ease arthritis pain and inflammation. NSAIDs include such drugs as ibuprofen, ketoprofen and naproxen sodium, among others. For people who have had or are at risk of stomach ulcers, the doctor may prescribe celecoxib, a type of NSAID called a COX-2 inhibitor, which is designed to be safer for the stomach. These medicines can be taken by mouth or applied to the skin (as a patch or cream) directly to a swollen joint.
Drugs That Slow Disease Activity
Corticosteroids. Corticosteroid medications, including prednisone, prednisolone and methyprednisolone, are potent and quick-acting anti-inflammatory medications. They may be used in RA to get potentially damaging inflammation under control, while waiting for NSAIDs and DMARDs (below) to take effect. Because of the risk of side effects with these drugs, doctors prefer to use them for as short a time as possible and in doses as low as possible.
Rabies is a neurotropic virus, viral zoonotic disease that causes acute encephalitis.
Usually, people (and animals) die from it (it is fatal). There is no cure for it. People who are treated soon after becoming infected have a chance to survive.
The disease is transmitted through the saliva and the blood. The usual form of getting it is a bite of a rabid mammal. Pets, like dogs need to be vaccinated against it, in most countries.
Treatment for Rabies
There is no cure for Rabies. There is a vaccine against it. The vaccine was first developed by Louis Pasteur and Pierre Paul Émile Roux in 1885. This vaccine used a live virus grown in rabbits, and weakened (through drying it). The first person to be vaccinated was Joseph Meister (a 9 year old boy who had been bitten by a dog). Vaccines similar to this are still used today, but other vaccines (growing the virus using cell cultures) are more used.
Wound care involving soap and a virus-killing cleanser (this should always be done for any animal bite)
A onetime injection of human rabies immune globulin (or HRIG), which is a substance that provides rapid, short-term protection against rabies
Injection of the first of a series of vaccine doses to provide protection against rabies after an exposureThe decision to treat for rabies: The likelihood of an animal having rabies depends heavily on the species of the animal, its behavior, and where you were exposed to the animal. For example, in some areas of the country, such as the Texas-Mexico border, stray dogs have an extremely high likelihood of being rabid. In other areas, stray dogs may have little chance of being rabid.
Rickets is a disease that happens in young children. It happens in children who do not get enough vitamin D and calcium. It causes larger spaces inside bones, and makes them dry, like sponges. It can make the legs curve toward each other (so the knees touch) or away from each other. Rickets in adults is called osteomalacia. The word "rickets" comes from the Greek word rhakhis, which means "spine."
People need both vitamin D and calcium to make their bones strong. Vitamin D helps the bones absorb (take up) calcium. Low vitamin D makes it hard to absorb calcium.
The human body makes vitamin D3 in the skin, from cholesterol. Then the liver changes vitamin D3 into calcitriol, which sends calcium from the blood into the bones. The bones need calcium to stay strong. However, the skin will not
Treatment for Rickets
Compared to the treatment of affected children, prevention of the disease in the first place is clearly a better approach for children, desirable step for communities, and possibly less expensive for society as a whole. Thus it is essential to identify the appropriate target population and their nutritional needs before preventive interventions against rickets can ensue.
Based on the known epidemiology of the resurgence of vitamin D-deficient rickets in the United States, the appropriate approach would presently be to increase supply of vitamin D to exclusively-breastfed infants with darkly-pigmented skin, but also to their mothers during pregnancy.
In African countries, infants and young children who suffer from calcium insufficiency represent suitable targets for preventative actions. In India, there is evidence that young children need more calcium, whereas pubertal girls are at the highest risk of vitamin D-deficiency rickets (feasibly due to cultural habits which limit exposure to sunlight).
One of the most important steps is to identify the appropriate dose of preventive product. For vitamin D, children should receive the equivalent of 200–400 IU per day to prevent rickets. An alternative approach in temperate climate is the exposure of the face and head to approximately 60 minutes of sunshine per week.
Rheumatoid arthritis (RA) is a serious, painful, and chronic (long-lasting) disease. It is an autoimmune disease - a disease where the body's immune system attacks healthy cells. When a person has RA, their immune system attacks the joints and the tissues around the joints in the body. This causes different problems, like:
The capsules around the joints get swollen
The body makes too much synovial fluid (the special fluid that is supposed to cushion the joints)
Tough fibrous tissue builds up in the synovium area (which is also supposed to help cushion the joints)
Eventually, RA can destroy a person's articular cartilage. Normally, articular (having to do with the joints) cartilage covers the end of bones where they come together to form joints. This keeps the bones from rubbing against each other. If the articular cartilage has been destroyed by RA, the bones will rub against each other, which is very painful.
No one knows what causes RA, but some theories are that it has to do with hormones, environment, and genes. There is no cure, but doctors have determined ways to help slow down and reduce the impact of the disease. Women are two to three times more likely than men to get rheumatoid arthritis. Most cases of RA occur in people between the ages of 25 and 55
Treatment for Rheumatoid arthritis
There is no known cure for rheumatoid arthritis. To date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. Early medical intervention has been shown to be important in improving outcomes. Aggressive management can improve function, stop damage to joints as monitored on X-rays, and prevent work disability. Optimal RA treatment involves a combination of medications, rest, joint-strengthening exercises, joint protection, and patient (and family) education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and patient occupation. RA treatment is most successful when there is close cooperation between the doctor, patient, and family members.
The degree of destructiveness of rheumatoid arthritis varies among affected individuals. Those with uncommon, less destructive forms of the disease or disease that has quieted after many years of activity ("burned out" rheumatoid arthritis) can be managed with rest plus pain control and anti-inflammatory medications alone. In general, however, function is improved and disability and joint destruction are minimized when the condition is treated earlier with second-line drugs (disease-modifying antirheumatic drugs), even within months of the diagnosis. Most people require more aggressive second-line drugs, such as methotrexate, in addition to anti-inflammatory agents. Sometimes these second-line drugs are used in combination.
Silicosis is a disease that is caused by small particles of silica (glass) getting trapped in the lungs. When people have silicosis, the changes in their body often are cyanosis (when skin goes a blueish color), a fever, when the body gets hotter or being not able to breathe properly. Sometimes doctors do not realize that someone has silicosis, and think that they have other illnesses like pneumonia, tuberculosis or fluid in the lungs.
It was first noticed in 1705 by Bernardino Ramazzini (an Italian doctor). He saw something that looked like sand in the lungs of stonecutters. The name silicosis is from Visconti in 1870. The name comes from the Latin silex which means flint.
Treatment for Silicosis
There is no specific treatment for silicosis. Removing the source of silica exposure is important to prevent the disease from getting worse. Supportive treatment includes cough medicine, bronchodilators, and oxygen if needed. Antibiotics are prescribed for respiratory infections as needed.
Treatment also includes limiting exposure to irritants, quitting smoking, and having routine tuberculosis skin tests.
People with silicosis are at high risk for developing tuberculosis (TB). Silica is believed to interfere with the body's immune response to the bacteria that cause TB. People with silicosis should have skin tests to check for exposure to TB. Those with a positive skin test should be treated with anti-TB drugs. Any change in the appearance of the chest x-ray may be a sign of TB.
Patients with severe silicosis may need to have a lung transplant.
Sudden infant death syndrome (SIDS) is the sudden and unexpected death of a human baby which is unexplained even after an autopsy and investigation. SIDS is sometimes referred to as cot death or crib death.
The name is only applied to cases where the baby is less than one year old. By definition, SIDS deaths occur under the age of one year. Most happen when the infant is 2 to 4 months of age. This is a critical period because the infant's ability to arouse from sleep is not yet mature.SIDS is defined as a syndrome.
Babies are at the highest risk for SIDS during their sleep. Male infants die more often than female infants; about 60% of the cases are male infants. Infants also die more often during winter months.
The reason for SIDS are unknown, but there are different theories:
Problems with blood flow to the brain
Problems with levels of serotonin
Effects of the bacterium Clostridium botulinum (which causes botulism)
Toxic gases
Vaccinations do not increase the risk of SIDS, and may reduce the risk slightly.
Infanticide and child abuse cases may be misdiagnosed as SIDS due to lack of evidence. and caretakers of infants with SIDS are sometimes falsely accused. Accidental suffocations are also sometimes misdiagnosed as SIDS and vice versa. Grief support for families affected by SIDS is particularly important. The death of the infant is typically sudden, without witnesses, and requires an investigation.
Treatment for SIDS,Sudden infant death syndrome
Observations made by EMS personnel at the scene may assist in the investigation. Such observations should include the following:
Location and position of the infant, including the type of surface on which the body lies, the body temperature, the degree of rigor mortis (if present), and any marks and bruises
Type of bed or crib used and any defects
Amount and position of clothing and bedding materials
Presence of toys, pillows, or other objects that may cause asphyxiation
Condition of the residence
Temperature of the room in which the infant was found
Type of ventilation and heating
Presence of children or others
Reactions of caretakers and others at the scene
In the ED, post-ALTE care includes resuscitation and general stabilization. The patient should be placed on cardiac and respiratory monitoring, including arterial oxygen saturation. The blood glucose level should be determined; hypoglycemia may be associated with apnea, with or without seizure.
The objectives of the workup are to identify “serious” ALTEs and to attempt to establish the cause of the ALTE. ALTE alone is not a definitive diagnosis; a more specific final diagnosis (eg, ALTE secondary to seizure) is preferred. In many instances, however, such specificity cannot be achieved, and the final diagnosis is idiopathic ALTE or ALTE of undetermined etiology. On a cautionary note, the diagnosis of ALTE secondary to reflux is one of exclusion. Ideally, this diagnosis should be made only after a period of observation and reflux monitoring.
Rubella (also known as German measles) is a disease caused by the Rubella virus.
It is often mild and an attack can pass unnoticed. However, this can make the virus very difficult to diagnose.
The disease can last 1–5 days. Children recover more quickly than adults.
The virus usually enters the body through the nose or throat. Like most viruses living along the respiratory tract, it is passed from person to person by tiny droplets in the air that are breathed out.
Rubella can also be transmitted from a mother to her developing baby (fetus) through the placenta. This can be very dangerous to the fetus, especially if the mother gets rubella early on in her pregnancy. Rubella can cause deafness, heart problems, intellectual disability, and many other problems in developing fetuses.
Treatment for Rubella
There is no effective antiviral treatment for rubella. Treatment of symptoms includes plenty of fluids and pain relief if required. Paracetamol may be used to reduce fever and pain. Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor.
Exclude people with rubella from childcare, preschool, school and work until fully recovered or for at least 4 days after the onset of the rash.
Rubella is best prevented by the measles, mumps and
rubella (MMR) combination vaccine or the measles, mumps, rubella and varicella (MMRV) combination vaccine. Most people who have two doses of a rubella-containing vaccine will be protected against rubella infection.
Vaccination after exposure will not prevent infection.
All health care and childcare staff (men and women) should be tested for immunity to rubella and if not immune, should be immunised.
Anyone with suspected rubella should consult a doctor both to check that the diagnosis is correct and so that contacts (in particular, pregnant women) can be advised. A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person.
Pregnant women may be treated with antibodies called hyperimmune globulin that can fight off the virus. This can help reduce your symptoms. However, there’s still a chance that your baby will develop congenital rubella syndrome. Babies who are born with congenital rubella will require treatment from a team of specialists. Talk to your doctor if you’re concerned about passing German measles on to your baby.
Stevens–Johnson syndrome is a disease of the skin. In most cases, it is caused by an allergic reaction to drugs. This accounts for about half the cases. Lymphoma, and other infections are responsible for most other cases. The disease is characterized by cell death that causes the epidermis to separate from the dermis.
Treatment for Stevens-Johnson syndrome
The management of patients must be prompt; early diagnosis with the early recognition and withdrawal of all potential causitive drugs is essential to a favorable outcome. Morbidity and mortality increase if the culprit drug is withdrawn late. We observed that death rates were lower when causative drugs with short elimination half-lives were withdrawn no later than the day when blisters or erosions first occurred. No difference was seen for drugs with long half-lives.
Second, intravenous fluid replacement must be initiated using macromolecules or saline solutions.
Third, the patient must be transferred to an intensive care unit or a burn center. Prompt referral reduces risk of infection, mortality rate and length of hospitalization.
The main types of symptomatic treatment are the same as for burns, and the experience of burn units is helpful for the treatment of TEN: environmental temperature control, careful and aseptic handling, sterile field creation, avoidance of any adhesive material, maintenance of venous peripheral access distant from affected areas (no central line when possible), initiation of oral nutrition by nasogastric tube, anticoagulation, prevention of stress ulcer, and medication administration for pain and anxiety control are all essential.
However, TEN and burned patients are not identical: burns happen in a very short time period (a few seconds) and do not spread thereafter; the TEN-SJS progress occurs during several days, including after hospital admittance. Cutaneous necrosis is more variable and often deeper in burns than in TEN.
Sickle cell anaemia is a genetic disease. It affects red blood cells. It changes the cells from flexible disks into rigid crescents. When many red cells take this shape veins get blocked. This can cause damage to many organs. The organ damage increases with time and leads to an early death.
This is a life-long disease which starts in childhood. The red blood cells take up an abnormal, rigid, sickle shape. The cells also become sticky. This causes difficult blood flow when cells flow through long narrow capillaries. Low oxygen increases the problem. As they pass through low oxygen areas most cells take up this shape. The cells then stick to the inner wall of blood vessels, especially the branching point of veins. This leads to a blockade of blood flow in many organs. Severe complications may result.
Treatment for Sickle-cell disease
Allogeneic bone marrow transplantation (BMT) can cure SCD, but it is difficult to decide which patients should be offered BMT. Many risks are associated with BMT, and the risk-to-benefit ratio must be assessed carefully. With the advent of cord blood stem cell transplantation and with the development of less immunoablative conditioning regimens, perhaps BMT will gain wider acceptance and use. The lack of availability of a matched donor may limit the utility of BMT.
An expert panel has released evidence-based guidelines for the treatment of SCD, including a strong recommendation that hydroxyurea and long-term, periodic blood transfusions should be used more often to treat patients. Other recommendations include the following :
Use of daily oral prophylactic penicillin up to age 5
Annual transcranial Doppler examinations between the ages of 2 and 16 years in patients with sickle cell anemia
Long-term transfusion therapy to prevent stroke in children with abnormal transcranial Doppler velocity (≥200 cm/s)
In patients with sickle cell anemia, preoperative transfusion therapy should be used to increase hemoglobin levels to 10 g/dL
Rapid initiation of opioids for the treatment of severe pain associated with a vasoocclusive crisis
Use of analgesics and physical therapy for the treatment of avascular necrosis
Smallpox was a very bad disease with a high mortality rate. It is caused by a virus. There are two different species of viruses that can cause the disease. They are Variola major and Variola minor. Some people also call smallpox Variola, named after the viruses' scientific name.
Only humans can get this disease. Variola major kills between 20% and 40% of those who get it. Variola minor kills only about 1%. Many people who survive become blind because of the damage the virus does to the eyes.
During the first half of the 20th century, between 300 million and 500 million people died of this disease. Even in 1967, about 15 million people caught the disease, and about two million people died of it, according to the World Health Organization (WHO).
The first vaccine for smallpox used the results of cowpox infections. It was invented by Edward Jenner. It was used to stop people from getting smallpox. The word "vaccine" came from "vaccina", the Latin word for cow, because cowpox was used. The WHO (World Health Organisation) said that they were trying to eradicate (completely destroy) smallpox in 1963. They vaccinated people all over the world. In 1980, the WHO said the disease no longer existed, and no one would ever get sick from it again. However, live copies of smallpox are kept in different maximum-security laboratories around the world.
Treatment for Smallpox
The infected person is immediately placed into strict isolation (as opposed to quarantine, which is used for healthy, asymptomatic people who may have been exposed to the infected person).
Quarantine: Anyone who has come into contact with the infected person for up to 17 days prior to the onset of that infected person's illness (including the treating doctor and nursing staff) may be required to remain in quarantine until a definite diagnosis is made. If the suspected case is indeed smallpox, these individuals will have to remain in quarantine for at least 17 days to ensure that they are not also infected with the virus.
If a person in quarantine develops the signs and symptoms of smallpox infection, they are immediately moved to strict isolation.
The most likely scenario of a smallpox outbreak is from a terrorist attack or a laboratory accident. Given the highly infectious nature of the organism, researchers estimate that one infected person can infect up to 20 new contacts during the infectious stage of the illness. If one infected person appears at a hospital, it is assumed that more people have been infected.
Because of the medical, legal, and social implications of quarantine and isolation, coordinated involvement at the federal, state, and local levels is mandatory. In reality, strict quarantine of a large segment of the population is probably not possible.
Infectious disease specialists are consulted, along with state, federal, and local health authorities.
Severe acute respiratory syndrome (SARS) was an atypical pneumonia. It started in November 2002 in Guangdong Province, in the city of Foshan, of the People's Republic of China. The disease was caused by the SARS coronavirus (SARS CoV), a new coronavirus. It was also a part-time STD, it can be spread through both sexual and casual contact.
SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than 24 countries in Asia, North America, South America, and Europe before the SARS global outbreak of 2003 was contained. According to the World Health Organization (WHO), a total of 8098 people worldwide became sick with SARS during the 2003 outbreak; 774 of these died.
After the Chinese government suppressed news of the SARS outbreak, the disease spread rapidly, reaching Hong Kong and Vietnam in late February 2003, and then to other countries via international travellers. The last case in this outbreak occurred in June 2003. There were a total of 8437 known cases of the disease, with 813 deaths (a mortality rate of 9.636%).
Treatment for SARS,Severe acute respiratory syndrome
The treatment of coronavirus-associated SARS has been evolving and so far there is no consensus on an optimal regimen. This chapter reviews the diverse treatment experience and controversies to date, and aims to consolidate our current knowledge and prepare for a possible resurgence of the disease.
Treatment strategies for SARS were first developed on theoretical bases and from clinical observations and inferences. Prospective randomized controlled treatment trials were understandably lacking during the first epidemic of this novel disease. The mainstream therapeutic interventions for SARS involve broad-spectrum antibiotics and supportive care, as well as antiviral agents and immunomodulatory therapy. Assisted ventilation in a non-invasive or invasive form would be instituted in SARS patients complicated by respiratory failure.
Antibiotic therapy
Anti-bacterial agents are routinely prescribed for SARS because its presenting features are non-specific and rapid laboratory tests that can reliably diagnose the SARS-CoV virus in the first few days of infection are not yet available. Appropriate empirical antibiotics are thus necessary to cover against common respiratory pathogens as per national or local treatment guidelines for community-acquired or nosocomial pneumonia (Niederman et al 2001). Upon exclusion of other pathogens, antibiotic therapy can be withdrawn.
In addition to their antibacterial effects, some antibiotics are known to have immunomodulatory properties, notably the quinolones (Dalhoff & Shalit 2003) and macrolides (Labro & Abdelghaffar 2001). Their effect on the course of SARS is undetermined.
SARS can present with a spectrum of disease severity. A minority of patients with a mild illness recover either without any specific form of treatment or on antibiotic therapy alone (Li G et al 2003; So et al 2003).
Gastroenteritis is a medical term for inflammation of the stomach and intestines. It causes diarrhea, vomiting and stomach pain. It usually happens because of infection by a virus or bacteria.
Other common terms for gastroenteritis include infectious diarrhea, stomach bug, and stomach virus. It is sometimes called stomach flu or gastric flu, but it is not related to the influenza virus (which is often shortened to 'flu').
Treatment for Stomach flu
Most people with gastroenteritis require no formal treatment. The key to a rapid and safe recovery at home (home remedy) is proper hydration. Home treatment consists of adequate fluid intake so dehydration is prevented. Clear fluids are recommended (Pedialyte especially for young children, Gatorade, PowerAde and other sports drinks), but not fruit juices or milk as they may prolong the symptoms. If dehydration occurs, the patient should be evaluated by a doctor. Many health care professionals choose to begin IV fluids, the treatment of choice for rapid rehydration.
Other medications may be prescribed to reduce the symptoms of gastroenteritis. To reduce vomiting, promethazine (Phenergan), prochlorperazine (Compazine), or ondansetron (Zofran) are often used. Some physicians suggest using these agents only as a suppository or rapidly disintegrating tablet on the tongue since patients may vomit the pills up. Others may prescribe diphenoxylate and atropineomotil (Lomotil) or lopermadine (Imodium) to slow diarrhea while others do not as the drugs may prolong the disease in some individuals. Many doctors recommend no medical treatment for gastroenteritis symptoms as all of the drugs have side effects and if the patient stays well hydrated, the symptoms usually stop soon anyway.
The two main culprits are the rotavirus, which is more common in the winter months, and the adenovirus and echovirus, both of which prefer the climate in the summer and spring. In fact, says Frankowski, the reason kids seem to get what people call the “stomach flu” so often, is because there are so many viruses that can cause it. The good news is that, while uncomfortable (and, let’s face it, gross), in most kids, a stomach bug is not a serious illness and will resolve on its own after a few days of TLC. Here’s our guide to spotting the symptoms, taking care of your little patient, knowing when to call your doctor and avoiding it altogether.
Herpes zoster (also known as Shingles or Zona) is a disease in humans. The same virus that causes chickenpox also causes shingles. The symptoms are pain and a rash with blisters.
Shingles is a viral disease produced by the varicella zoster virus (VZV), the same virus that causes chicken pox. Its symptoms include pain and a blistering rash that occurs along the nerves that contain dormant virus. You can not catch shingles. However, you can catch chicken pox through direct contact with someone who has shingles, by touching the area of the rash. Most people who get shingles are old. It sometimes infects younger people, or people with a weakened immune system. Stress may trigger shingles. The disease starts with tingling, itchiness, or pain on an infected person's skin. After a few days, the disease causes a blistering rash. This rash may be on the trunk or face. The rash grows into small blisters filled with fluid. These blisters dry out and crust over for several days. The rash causes anything from mild itching to extreme pain. The rash stays in one region of the body.
Treatment for Herpes zoster
There is no cure for shingles, but treatment may shorten the length of illness and prevent complications. Treatment options include:
Antiviral medicines to reduce the pain and duration of shingles.
Pain medicines, antidepressants, and topical creams to relieve long-term pain.
Initial treatment
As soon as you are diagnosed with shingles, your doctor probably will start treatment with antiviral medicines. If you begin medicines within the first 3 days of seeing the shingles rash camera.gif, you have a lower chance of having later problems, such as postherpetic neuralgia.
reduce the pain and the duration of shingles.
Over-the-counter pain medicines, such as acetaminophen or ibuprofen, to help reduce pain during an attack of shingles. Be safe with medicines. Read and follow all instructions on the label.
Topical antibiotics, applied directly to the skin, to stop infection of the blisters.
For severe cases of shingles, some doctors may have their patients use corticosteroids along with antiviral medicines. But corticosteroids are not used very often for shingles. This is because studies show that taking a corticosteroid along with an antiviral medicine doesn't help any more than just taking an antiviral medicine by itself.2
