Wednesday, May 27, 2009
Oral thrush is an infection in your mouth. It's one type of a fungal infection called oral candida. The membranes in your mouth (oral mucosa) become infected with a fungus, usually Candida albicans. (Oral candida is also known as oral candidiasis.)
There are four common types of oral candida; these types have different signs. The four common types are:
- oral thrush - also known as pseudomembranous oral candidiasis,
- acute atrophic oral candidiasis - also known as acute erythematous oral candidiasis,
- denture stomatitis - also known as chronic erythematous oral candidiasis and chronic atrophic oral candidiasis, and
- chronic plaque-like oral candidiasis - also known as chronic hyperplastic oral candidiasis.
These infections are most commonly found in babies, people who wear dentures and elderly people. They are uncommon in other people, and can be a sign of another condition or illness that's not been diagnosed.
An estimated 500,000 people in the UK suffer from AMD, 40% of these are over the age of 75.
What is AMD?
AMD is the most common form of macular disease, which affects the central part of the retina.
It is an age-related process and usually develops after a person reaches 50 years.
It generally involves both eyes, although they may not be affected at the same time or to the same degree.
Some 90% of these cases are dry AMD which cannot be treated but 10% are wet ADM.
Dry AMD means visual cells simply stop functioning.
Wet AMD is by far the most aggressive form of the disease.
The condition is caused by the growth of new blood vessels under the centre of the retina.
These can leak fluid, causing scar tissue to form and destroying central vision in a period of between two months and three years.
Peripheral vision is retained. The condition causes problems reading, seeing small objects and distorted vision.
What are the symptoms?
In the early stages of AMD, central vision may be blurred or distorted. Objects may take an unusual size or shape.
This process can happen quickly or develop over several months.
People with the condition may become very sensitive to light or actually see lights that are not there.
There may be some discomfort, although overall the condition is not painful.
How is AMD treated?
There is no treatment for dry AMD, but there are a number of treatments for the wet form of the condition.
Photodynamic therapy involves the injection of a light-sensitive medicine called verteporfin into a vein in the arm.
The medicine is able to identify the abnormal blood vessels in the macula, and attach itself to proteins in those vessels.
The medicine is then activated - by a laser which is shone into the eye - to destroy the rogue vessels.
This stops the vessels from leaking blood or fluid, therefore stopping the damage the vessels are causing to the macula.
The technique is designed to ensure that none of the healthy, but delicate tissues in the eye are damaged.
However, it can only be used on a proportion of patients.
A newer type of drug treatment for wet AMD is known as anti-VGEF (vascular endothelial growth factor) medication.
It works by blocking one of the key chemicals responsible for the growth of the new blood vessels.
The anti-VGEF medication has to be injected into your eye using a very fine needle.
The National Institute for Health and Clinical Excellence (NICE) approved Lucentis, an anti-VGEF medciation, for use in England and Wales in 2008.
What is Ankylosing spondylitis?
Ankylosing spondylitis is a painful, progressive rheumatic disease, mainly of the spine. It can also affect other joints, tendons and ligaments and other areas, such as the eyes and heart.
If left untreated, the disease can cause progressive stiffening of the spine, leading to immobility.
It is caused by inflammation in the joints between the vertebrae, and of the sacroiliac joints in the pelvis.
As a reaction to the inflammation, a small amount of bone erosion occurs.
After the inflammation has subsided, new bone is created as part of the healing process.
After repeated attacks, this additional bone growth can surround the disc.
Effectively this means that the bones begin to fuse together, although most sufferers will only experience partial fusion, usually in the pelvic area.
Sufferers initially experience stiffness and mild back pain, which is worse first thing in the morning.
The initial symptoms can be prevented and relieved by regular movement of the areas involved.
If this is not done, the formation of new bone can lead to increased stiffness, and to deformity with stooping posture in the spine.
Eventually the stiffness and deformity become irreversible.
Treating the condition
The best way to stop the progression of ankylosing spondylitis is to regularly exercise all parts of the spine and the chest area.
If started early and continued regularly - every day - the result is excellent with little restriction of movement or deformity.
These exercises are very specialised and have to be done irrespective of the patient's lifestyle.
Additional exercises may also be needed for the shoulders and the hips which are the most frequently affected joints other than the spine.
Swimming is a good sport for patients with spondylitis as it moves the shoulders and hips.
Anti-inflammatory medication may be prescribed to relieve the pain and inflammation, but it is not a substitute for a regular exercise programme.
What causes Ankylosing Spondylitis?
The cause is not yet known. However, it has been discovered that almost all the 80,000 clinically diagnosed people in the UK share the same genetic cell marker HLA B27 (Human Leucocyte Antigen B27).
There is evidence that a normally quite harmless micro-organism, which would be dealt with by our immune system, sets up an adverse reaction after coming into contact with the B27 individual, triggering the condition and causing flare-ups.
Thursday, May 14, 2009
How does blood clot?
Blood clotting, the mechanism by which the blood sticks together to form small solid clots is a natural and vital function of the body. Blood coagulation is triggered by blood cells called platelets which, through a series of chemical reactions, produce a substance called thrombin.
This converts a blood protein fibrinogen to fibrin which then create a series of tiny threads which lead the plasma in the blood to become sticky.
The process protects the body from excessive bleeding, ensuring that a clot forms at the site of a wound or injury - either inside or outside the body.
What happens when the clotting mechanism goes wrong?
More than 30 substances in the blood are known to affect clotting and it is essential to get the balance of substances right.
If the blood is prone to clot too little then there is a risk of haemorrhage; too much and there is a risk of clots forming where they are not wanted and leading to life-threatening conditions such as strokes and heart attacks.
What can be done to prevent clots forming?
There are several widely-used drugs which stop clots forming.
These are prescribed to people who are known to be at risk, including
- people with artificial heart valves
- people who have had a heart attack
- people who have had a stroke
- those who have had or are at risk of deep vein thrombosis
- people suffering from atrial fibrillation
- patients undergoing orthopaedic surgery
- people with angina
One of the most commonly used anti-coagulants is aspirin. The blood's natural anti-clotting substance, heparin, is given by injection, while warfarin is the most widely prescribed anti-coagulant taken orally.
How are these drugs used?
As well as its pain-relieving properties, aspirin is increasingly used to help thin the blood.
People who have suffered a heart attack or stroke are given clot-dissolving drugs immediately and will generally be prescribed long term anti-coagulant drugs.Taking low doses of aspirin daily is one of the cheapest and most effective means of preventing a further attack.
In the UK 300,000 people suffer from a heart attack every year and the vast majority will be prescribed low dose aspirin afterwards to try to make platelets in the blood less sticky and prevent a second attack.
Many of the 1.4 million angina sufferers in the UK are also prescribed low-dose aspirin. Aspirin has also been recommended for those embarking on long haul flights because of the increased risk of a clot forming in the leg during periods of prolonged inactivity.
Heparin was first discovered in 1916. It is found naturally in many cells in the body. Heparin comes in two main forms and is routinely given intravenously after a clot has been diagnosed. The two forms act in a slightly different way on the thrombin in the blood and have the effect of prolonging the time a clot takes to form.The newer form, low molecular weight heparin, has been associated with fewer bleeding complications compared to unfractionated heparin.
It can be administered either by drip or injection under the skin. For immediate effect, such as after a DVT or a pulmonary embolism, an intravenous dose is given to ensure it is more rapidly delivered to the blood stream. The effects of heparin on clotting can be measured with a test called APTT and, as with warfarin, the dose needs to be adjusted to make sure it is at the right therapeutic level.
The common APTT ratio is between 1.5 and 2.5.
Warfarin is an anti-coagulant taken in tablet form.
It acts by interfering with vitamin K which is vital for blood clotting and the manufacture of prothrombin in the body. Patients who have undergone major heart surgery, including valve replacement and heart bypass surgery will generally take these ant-coagulants to avoid the chance of a clot forming around the new valve or artery.
Patients will be generally be given heparin for several days followed by 3 to 6 months of warfarin.
Patients taking long term anticoagulant therapy such as warfarin need to have their blood checked regularly to make sure they are on the right dose.
What is the INR?
Warfarin will slow the clotting time of the blood which an be measured by a test called the international normalised ratio or INR, a measurement adopted by the World Health Organization.
The desired INR range is usually between 2.0 - 3.0.
This is calculated by measuring the patient's actual prothrombin or clotting time against a n expected or control time. The individual response to warfarin varies so it is important that INR measurements are closely monitored.
Usually the INR will be measured with a daily blood test when a patient is first prescribed warfarin until doctors are sure the clotting time is within a safe range.
This will then be reduced to two or three times a week, then weekly and eventually monthly or even quarterly for those who are stable and not taking other medications.
Do anti-coagulants have any side-effects?
The main side-effect of taking anti-coagulants is increased likelihood of bleeding - particularly if the INR is above the desired level. The risk of bleeding increases in people aged over 65, those with a history of stroke or gastrointestinal bleeding.
With aspirin the main complication is gastrointestinal bleeding because of damage to the stomach lining. Low dose aspirin pills are usually given an enteric coating which protects the stomach tissue.
One relatively rare warfarin side-effect is skin necrosis, which usually becomes apparent within a week of starting treatment. Lesions appear on the skin which are due to small clots in the blood vessels under the surface.
Combined treatment with warfarin and aspirin has been recommend in the UK for prevention of heart attacks in people at risk though this may increase the risk of a haemorrhage. Heparin's side effects also include osteoporosis, hair loss and hypersensitivity. Warfarin should be avoided in pregnancy because it crosses the placenta to the baby, though use of heparin in pregnancy is safe.
Warfarin can also interact with other drugs, including some antibiotics, barbiturates and alcohol so it is essential that patients discuss any medications with their doctor.
A diet high in vitamin K which is found in leafy green vegetables may also inhibit some of the warfarin effect.
What causes anxiety disorders and what are their symptoms?
There are several possible reasons for anxiety disorders, including biological and environmental factors such as genetics, biochemical changes in the brain and traumatic life events.
Symptoms may include:
- Panic, fear, apprehension
- Uncontrollable obsessive thoughts
- Repeated flashbacks of traumatic experiences
- Ritualised behaviour such as repeated hand-washing
- Problems sleeping
- Cold or sweaty hands
- Shortness of breath
- Inability to be still and calm
- A dry mouth
- Numbness or tingling in the hands or feet
- Upset stomach
- Tense muscles
Often there appears to be no particular reason why symptoms occur since the feelings of panic are dissociated from events which are happening or about to occur.
But they can be extremely disabling and have a great effect on the person's friends and family and their ability to work. People who suffer from anxiety disorders may also have other mental illnesses, such as depression.
Anxiety disorders often respond well to treatment.
This can include behavioural therapy, counselling to find out the cause of the anxiety, relaxation techniques and drugs which control the symptoms or correct chemical imbalances.
People who suffer from these disorders have repeated panic attacks which are often difficult to predict. Symptoms include sweating, shaking, shortness of breath, nausea, dizziness, fear of dying or losing control and hot flushes.
Some symptoms, such as chest pain, can mimic those of a heart attack, increasing the sense of anxiety.Panic disorders usually first occur in late adolescence or early adulthood.
Women are thought to be twice as likely to suffer from them as men.
Research suggests the condition is sometimes genetically inherited.
Phobias are irrational, persistent and uncontrollable fear of something.
Common phobias include agoraphobia - fear of open spaces, claustrophobia - fear of closed spaces, social phobia and fears of specific objects, such as spiders or snakes. The fear can be so overwhelming that people go to great lengths to avoid the situation or thing they are afraid of. People with severe agoraphobia, for example, may find it difficult to venture out of their homes.
Obsessive compulsive disorder
People who have obsessive compulsive disorders resort to ritualised behaviour as a means of overcoming irrational fears. Common obsessions include fear of dirt or germs, a need for absolute tidiness or order and repeated doubts, for example, about turning off electrical or gas appliances.
The person often realises their behaviour is irrational, but this alone does not help to dispel their fears. Compulsive behaviour includes repeated hand washing, following rigid patterns of behaviour, such as putting on clothes in the same order every day or avoiding cracks in the pavement. Many people have compulsive behaviour, but it is only when it begins to interfere with daily activities and relationships that it becomes a serious disorder.
Obsessive compulsive disorders often start in adolescene or early adulthood and may be linked to other mental health problems, such as depression.
Post-traumatic stress disorder
Post-Traumatic Stress Disorder (PTSD) follows a severe of terrifying emotional experience.
Events which may trigger PTSD include serious accidents, violent attacks, abuse and war.
Often emergency staff suffer from PTSD as a result of dealing with trauma.
They may experience extreme distress, including unexpected flashbacks to the event, nightmares, depression, detached feelings, trouble being close to members of their families, irritability and mood swings and even feelings of violence.
Symptoms usually begin within three months of the trauma, but sometimes they start many years later. Sometimes they only last for a short period, but they may be long-lasting if no help is received. Medication such as antidepressants or anxiety-reducing drugs can treat symptoms like depression and insomnia and therapy can help with coming to terms with the trauma.
What is arsenic?
Arsenic is a semi-metallic naturally-occurring chemical. It is all around us in the environment and we are all exposed to small doses on a regular basis.It is difficult to detect as it is generally odourless and flavourless, meaning people have little idea when it is around.
What is the risk?
Arsenic can kill humans quickly if consumed in large amounts, although small, long-term exposure can lead to a much slower death or other illness. Studies have linked prolonged exposure to arsenic with cancer, diabetes, thickening of the skin, liver disease and problems with the digestive system. It has also been associated with nervous system disorders - feeling tingling or losing sensation in the limbs - and hearing difficulties.
What happens if you are poisoned?
A person exposed to large amounts of arsenic - either through eating or drinking it - will usually die, and symptoms will appear within 30 minutes of exposure. There is a similar outlook for people who breathe large amounts of it, although the onset of symptoms may be delayed as the concentration is likely to be lower. Physical contact with arsenic can cause, initially, the skin to thicken and, with prolonged contact, blood flow to the heart to become decreased.
What are the symptoms?
The first sensations include a metallic taste in the mouth, excessive saliva production and problems swallowing. The next stage is to suffer vomiting and diarrhoea coupled with garlic-like breath, stomach cramps and excessive sweating. As the poison's effects progress, the patient will suffer seizures and go into shock, dying within a few hours. If death does not occur at this stage, it will happen a few days when the kidney fails.
What is the treatment?
Arsenic poisoning can be treated if it is caught early enough, through a series of injections into muscles. The patient needs 2.5mg to 5mg per kilogram of body weight of a drug called dimercaporal every four hours for the first two days followed by two injections on the third day then one a day for the next five days.
What is the environmental threat?
There is growing concern about levels of arsenic in the environment, both from natural occurrence and from pollution. Forty million people in West Bengal and Bangladesh are thought to be at risk from arsenic-contaminated water supplies, although studies are continuing into what effect the poisoning is having.
The contamination is thought to have occurred naturally, as a result of arsenic being released from rocks into underground water supplies. The US Environmental Protection Agency has an ongoing research programme to look into arsenic in the environment and to establish what constitutes a safe level.
What are the benefits?
Small doses of arsenic have been shown to send some forms of cancer into remission, and it can also help thin blood.Homeopathists have also used undetectable amounts of it to cure stomach cramps.
However, therapies involving the chemical are still in the experimental stages.
Over 3,000 people a year die of the disease in the UK and numbers are predicted to rise to 10,000 a year by 2020. Those infected are mainly builders, plumbers and shipyard workers, but teachers, children and nurses are believed to have been put at risk since asbestos was used in the construction of several schools and hospitals.
Families of those who work with asbestos can also be infected if asbestos particles are brought into the home on clothes. It can take up to 40 years for symptoms to show.
What are the symptoms?
The main symptoms include shortness of breath on exertion, a persistent cough, chest pain or tightening of the chest, nail abnormalities and thickening of the fingers and toes.
What is the treatment?
There is no cure for asbestos diseases, but, as severity depends on the length of exposure and amount of asbestos dust inhaled, early identification through chest x-ray can prevent further exposure and worsening of conditions.
People who develop mesothelioma have a particularly bad prognosis. Around 75% die within one year of diagnosis. Mesothelioma can take between 20 and 40 years to develop after exposure to asbestos dust.
Other cancers related to asbestos include lung cancer (worsened by cigarette smoking) and cancers of the oesophagus, stomach, colon and rectum.
People with pleural diseases can have their lungs drained at intervals to relieve the build-up of fluid.
Some people with asbestos diseases may need oxygen masks to help them breathe. Asbestosis, for example, leads to a thickening of the lower part of the lungs, making them less elastic and causing breathing problems.
Action to prevent infection
The UK Health and Safety Commission announced in August that white asbestos could be banned by next year except in circumstances where no alternative material can be found. Discussions are taking place between September and the end of the year. Brown and blue asbestos have already been banned.
Wednesday, May 6, 2009
Do you toss and turn at night, wishing for sleep but unable to get a decent night's rest? If so, you are not alone. About half of all Americans occasionally have trouble falling or remaining asleep, according to the National Sleep Foundation.
Many different factors can disrupt rest. While the source of sleep
Avoid the 'Big Three'
Avoid the 'Big Three'
Caffeine, alcohol and nicotine are three substances that can rob anyone of precious shut-eye. Avoiding all three can aid your attempts to sleep.
Some people who are very sensitive to caffeine find that consuming this stimulant disrupts their sleep for the next six to 12 hours. Try to cut back on caffeine, which is found in chocolate and some teas as well as coffee and sodas.
Nicotine is another stimulant that disrupts sleep. Studies have shown that it both delays sleep and keeps you from waking up promptly.
Most people think of alcohol as a sedative, and they are right. However, that same glass of wine or spirits that causes you to feel more relaxed initially may actually interfere with getting a good night's sleep. Alcohol can help you fall asleep more quickly, but it also makes frequent awakening more likely in the last half of your nightly sleep cycle.
Tweak Your Sleep Space
Tweak Your Sleep Space
Your sleep environment has a major impact on the quality of rest that you get. Keeping the bedroom cool, dark and quiet can help you sleep more soundly. You can purchase special curtains that will make your room darker. Or, try a mask that covers your eyes. Some people find that running a humidifier (in dry climates) or dehumidifier (in humid climates) is conducive to better sleep.
A comfortable mattress also is vital to good sleep. Some people prefer a firm mattress while others like a softer bed. Choose the right mattress for you. If you sleep with a bed partner, make sure your mattress is large enough to comfortably accommodate two people.
Little touches -- such as playing soft music or decorating your room in warmer tones -- can make a big difference. Experiment with different adjustments until you create the perfect sleep environment for you.
A midday nap is a wonderful indulgence for many people, but for others it can wreak havoc on the nighttime sleep routine. If naps interfere with your nighttime sleep, try to nap for less than an hour, and preferably no longer than 30 minutes. Never nap after 3 p.m.
Depending on how you have reacted in the past, it may be better not to nap at all if you can help it. However, sometimes a nap is worth the risk of potential
Exercise can make your sleep more restful, but only if you plan your workout correctly. Studies show that people who exercise regularly tend to fall asleep more quickly and remain at rest throughout the night. Aerobic
However, for some people, exercising within two hours of bedtime can actually make it more difficult to fall asleep. If you're one of them, then late afternoon may be the optimal time to exercise if better sleep is your goal. Exercise raises your body temperature, but some studies indicate that this rise is followed by a fall in body temperature around five hours later in the day. This fall in temperature may make sleep easier.
Get Up, Stand Up No matter how many steps you take to improve sleep, you may experience After you are out of bed, go to another room and engage in a quiet activity, such as reading, watching TV or knitting. If you start to feel drowsy, return to bed. Do not try to go back to sleep until you feel tired. If this type of insomnia becomes persistent, try to develop a consistent routine of going to bed and waking up at the same time every day (this is actually good advice for anyone, whether or not insomnia is present). Do not break this pattern (even on weekends) unless absolutely necessary. Have your own sleep tips or looking for help getting a good night's rest? Join the discussion at the Insomnia and Sleep Problems Message Board.
Get Up, Stand Up
No matter how many steps you take to improve sleep, you may experience
After you are out of bed, go to another room and engage in a quiet activity, such as reading, watching TV or knitting. If you start to feel drowsy, return to bed. Do not try to go back to sleep until you feel tired.
If this type of insomnia becomes persistent, try to develop a consistent routine of going to bed and waking up at the same time every day (this is actually good advice for anyone, whether or not insomnia is present). Do not break this pattern (even on weekends) unless absolutely necessary.
Have your own sleep tips or looking for help getting a good night's rest? Join the discussion at the Insomnia and Sleep Problems Message Board.
Southgate Smiles Dental Care is a state of the art dental practice in North London, UK, offering a wide range of dental treatments. Our goal is to give you world-class excellence in dental care using the very latest technology in a warm and caring environment.
We hope you enjoy your time browsing our site, and if you have any suggestions, please drop us an e-mail!
Sunday, May 3, 2009
If you smoke, it’s unwise to do it before bedtime. Though smokers often feel like it calms them down, nicotine is actually a stimulant. Worse, withdrawal from nicotine can occur quickly, so a craving for a cigarette may rouse you in the middle of the night.
Please follow my future posts to find out how to get sound sleep. :)
Why do I have hair loss? Nu Hair website provides information about hair loss disease, symptoms, causes and treatments. Read about hair restoration options on medical hair transplants, new hair systems, hair pieces, wigs and hair growth medications.
Family Eye Care West and EYEWEAR SHOWCASE