السبت، 24 نوفمبر، 2012

Osteoarthritis

Osteoarthritis (OA, also known as degenerative arthritis, degenerative joint disease), is a clinical syndrome in which low-grade inflammation results in pain in the joints, caused by abnormal wearing of the cartilage that covers and acts as a cushion inside joints and destruction or decrease of synovial fluid that lubricates those joints. As the bone surfaces become less well protected by cartilage, the patient experiences pain upon weight bearing, including walking and standing. Due to decreased movement because of the pain, regional muscles may atrophy, and ligaments may become more lax.[1] OA is the most common form of arthritis,[1] and the leading cause of chronic disability in the United States.[2]

"Osteoarthritis" is derived from the Greek word "osteo", meaning "of the bone", "arthro", meaning "joint", and "itis", meaning inflammation, although many sufferers have little or no inflammation. A common misconception is that OA is due solely to wear and tear, since OA typically is not present in younger people. However, while age is correlated with OA incidence, this correlation merely illustrates that OA is a process that takes time to develop. There is usually an underlying cause for OA, in which case it is described as secondary OA. If no underlying cause can be identified it is described as primary OA. "Degenerative arthritis" is often used as a synonym for OA, but the latter involves both degenerative and regenerative changes.

OA affects nearly 21 million people in the United States, accounting for 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will show symptoms.[3] In the United States, hospitalizations for osteoarthritis soared from about 322,000 in 1993 to 735,000 in 2006.[4]
Signs and symptoms
The main symptom is acute pain, causing loss of ability and often stiffness. "Pain" is generally described as a sharp ache, or a burning sensation in the associated muscles and tendons. OA can cause a crackling noise (called "crepitus") when the affected joint is moved or touched, and patients may experience muscle spasm and contractions in the tendons. Occasionally, the joints may also be filled with fluid. Humid weather increases the pain in many patients.[5]

OA commonly affects the hips, feet, spine, and the large weight bearing joints, such as the hips and knees, although in theory, any joint in the body can be affected. As OA progresses, the affected joints appear larger, are stiff and painful, and usually feel worse, the more they are used throughout the day, thus distinguishing it from rheumatoid arthritis.

In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly. OA at the toes leads to the formation of bunions, rendering them red or swollen.

OA is the most common cause of water on the knee, an accumulation of excess fluid in or around the knee joint. [6]
Causes
Although it commonly arises from trauma, osteoarthritis often affects multiple members of the same family, suggesting that there is hereditary susceptibility to this condition. A number of studies have shown that there is a greater prevalence of the disease between siblings and especially identical twins, indicating a hereditary basis [7]. Up to 60% of OA cases are thought to result from genetic factors. Researchers are also investigating the possibility of allergies, infections, or fungi as a cause.
Two types
Primary
This type of OA is a chronic degenerative disorder related to but not caused by aging, as there are people well into their nineties who have no clinical or functional signs of the disease. As a person ages, the water content of the cartilage decreases due to a reduced proteoglycan content, thus causing the cartilage to be less resilient. Without the protective effects of the proteoglycans, the collagen fibers of the cartilage can become susceptible to degradation and thus exacerbate the degeneration. Inflammation of the surrounding joint capsule can also occur, though often mild (compared to that which occurs in rheumatoid arthritis). This can happen as breakdown products from the cartilage are released into the synovial space, and the cells lining the joint attempt to remove them. New bone outgrowths, called "spurs" or osteophytes, can form on the margins of the joints, possibly in an attempt to improve the congruence of the articular cartilage surfaces. These bone changes, together with the inflammation, can be both painful and debilitating.
Secondary
This type of OA is caused by other factors but the resulting pathology is the same as for primary OA:

Congenital disorders, such as:
Congenital hip luxation
People with abnormally-formed joints (e.g. hip dysplasia (human)) are more vulnerable to OA, as added stress is specifically placed on the joints whenever they move. [However, recent studies have shown that double-jointedness may actually protect the fingers and hand from osteoarthritis.]
Cracking joints—the evidence is weak at best that this has any connection to arthritis.
Diabetes.
Inflammatory diseases (such as Perthes' disease), (Lyme disease), and all chronic forms of arthritis (e.g. costochondritis, gout, and rheumatoid arthritis). In gout, uric acid crystals cause the cartilage to degenerate at a faster pace.
Injury to joints, as a result of an accident.
A joint infection, e.g. from an injury.
Hormonal disorders.
Treatment
Generally speaking, the process of clinically detectable osteoarthritis is irreversible, and typical treatment consists of medication or other interventions that can reduce the pain of OA and thereby improve the function of the joint.

Conservative care
No matter the severity or location of OA, conservative measures such as weight control, appropriate rest and exercise, and the use of mechanical support devices are usually beneficial. In OA of the knees, knee braces, a cane, or a walker can be helpful for walking and support. Regular exercise, if possible, in the form of walking or swimming, is encouraged. Applying local heat before, and cold packs after exercise, can help relieve pain and inflammation, as can relaxation techniques. Heat — often moist heat — eases inflammation and swelling, and may improve circulation, which has a healing effect on the local area. Weight loss can relieve joint stress and may delay progression[citation needed]. Proper advice and guidance by a health care provider is important in OA management, enabling people with this condition to improve their quality of life.

In 2002, a randomized, blinded assessor trial was published showing a positive effect on hand function with patients who practiced home joint protection exercises (JPE). Grip strength, the primary outcome parameter, increased by 25% in the exercise group versus no improvement in the control group. Global hand function improved by 65% for those undertaking JPE. [12]


Medical treatment
Medical treatment includes NSAIDs, local injections of glucocorticoid or hyaluronan, and in severe cases, with joint replacement surgery. There has been no cure for OA, as cartilage has not been induced to regenerate. However, if OA is caused by cartilage damage (for example as a result of an injury) Autologous Chondrocyte Implantation may be a possible treatment.[8] Clinical trials employing tissue-engineering methods have demonstrated regeneration of cartilage in damaged knees, including those that had progressed to osteoarthritis.[9] Further, in January 2007, Johns Hopkins University was offering to license a technology of this kind, [10] listing several clinical competitors in its market analysis.

Disease, amoebic dysentery

Disease, amoebic dysentery

What is amoebic dysentery?



When
published my conversation with my friend in the previous issue of avian
influenza, and jokingly promised publication of an article for amoebic
dysentery. Have I got several questions related to this subject. Some
people caught it when he visited his country, and others have heard of
people who are infected, making the name of the disease without the
familiar truth among the people of the Arab community. Thus I found myself compelled to answer questions from readers on the subject that you have stated this as a joke in my past.

What is amoebic dysentery?

Amoebic dysentery is a disease happen because of the agent (parasite) is a nurse (amoeba histolytica).

Infection

Are infected with the disease by eating contaminated foods and liquids parasite. Of course, this is happening in countries that do not apply the rules of hygiene and health care overall. Most
of the cases in the United States but you get in immigrants from
developing countries or in those who have traveled to, or in the remote
village institutions that do not apply the rules of hygiene known and
this is rare.



Symptoms

After exposure to the parasite symptoms. It is worth noting that only one out of ten people get to have symptoms. Thus, this disease may be a (silent) devoid of any symptoms. Symptoms include diarrhea, abdominal pain, and perhaps this pain Magsa. And probably got out the blood with the stool in addition to fever. There
is a rare but dangerous mutants you dysenteriae invasion of the liver
and form the so-called bag (abscess) filled with pus. In rarer cases, the spread may happen to other organs of the body like the brain and lungs.



Nursery

Nursery
as it is known is the period between infection with the pathogen
patient factor (Kjerthom and the virus and the parasite) and the
appearance of symptoms. In the case of amoebic dysentery, the incubation period ranging between one week to four weeks ago. This
is usually added to the immune status of the patient. The more weak
immune status was faster onset of symptoms and the symptoms are more
severe and the patient is sick more.

Diagnosis

Like
any disease it must be the person who doubts afflicted with the disease
physician review, where the doctor will some laboratory studies, the
most important examination of stool samples in search of this parasite
and other parasites and bacteria that infect the intestine. Of
course, the signs and symptoms are similar among many of the pathogens,
which makes laboratory testing is necessary for the diagnosis of flour.
Has
forced the doctor to send multiple samples for laboratory testing,
where the parasites may not always appear in each test it is necessary
to know that the experience of these parasites is not high in developed
countries due to lack of spread of the disease which makes the clinical
signs and the experience of the doctor a crucial factor in this area. One
of the reasons for the difficulty of diagnosing amoebic dysentery that
the shape of some cells and some other parasites may be similar to the
variable dysenteric when looking under the microscope, so the technical
informant may think the presence of infection if not already exist, as
it may be thought that the patient is not infected in the event of
injury severe. In
particular, there is a similarity between the transformed dysenteric
and convert another is called (variable Despar), in the case showed the
result of laboratory testing that the patient is infected with dysentery
amoebic with no symptoms of the parasite may be (variable Despar), in
fact, and this transformed the latter is not a factor as a nurse
originally . Unfortunately, there are no tests yet distinguish between these two converts. It
might be wise to the doctor in case of such an outcome assuming the
worst and deal with the patient, was diagnosed with Baltol dysenteric. We
recall here that there is an examination bloody to investigate the
variables of amoebae, but this test is not conducted in natural
conditions has been requested by the doctor in case of invasion of the
intestinal wall the parasite or in the case of organ involvement other
than the intestine (such as the liver, brain and lungs, as we
mentioned).



Treatment

There are a number of antibiotics used to treat amoebic dysentery. It is imperative that the doctor may prescribe medication. And
we mention this because it is common practice in our country that the
patient give his medication to another patient as a result of the
similarity can look. This
is not without danger as the various diseases may resemble the symptoms
and the medication that is useful in the treatment of a patient may not
be effective in the treatment of another patient. Added
to this is that many medicines are not free from the effects of GA
prophetess and some contra-indicated in some cases associated with
disease. If
this problem is uncommon in Western countries as a result of the
relative spread of health awareness, these wrong practices are very
common in our country. In case of diagnosis of dysenteric Baltol the doctor will choose the appropriate antibiotic. It
will give one medication in mild cases, but may resort to the use of
both types of drugs in severe cases where the drug is given first for a
certain period, then the other drug is given after the completion of the
first taking the drug.




Prevention

Perhaps
more people need to learn the prevention of infection with this
parasite are those who will visit developing countries for periods
longer or shorter. Perhaps
more importantly, focus on the water, where it is necessary to avoid
non-sterile water in the country, and particularly for children, and
replace them with bottled water or carbonated water. And
must avoid ice cubes that are used with water and refreshments,
Contrary to what people think, the freezing does not kill parasites
nurse. If
traveling to some tropical countries where there are no bottled water
bottles must be a question the doctor about some CD-sterile which can be
added to the water to kill parasites and bacteria in it (usually iodine
tablets). The
other thing is to avoid fresh fruits and vegetables is cooked because
it is a most important means of transmission of parasites and germs in
general. Are advised to peel fruits cleaned with soap and water. In addition, avoid eating milk and dairy products and dairy Kalojban and avoid buying food and drinks from street vendors

Disease, amoebic dysentery

Disease, amoebic dysentery

What is amoebic dysentery?



When
published my conversation with my friend in the previous issue of avian
influenza, and jokingly promised publication of an article for amoebic
dysentery. Have I got several questions related to this subject. Some
people caught it when he visited his country, and others have heard of
people who are infected, making the name of the disease without the
familiar truth among the people of the Arab community. Thus I found myself compelled to answer questions from readers on the subject that you have stated this as a joke in my past.

What is amoebic dysentery?

Amoebic dysentery is a disease happen because of the agent (parasite) is a nurse (amoeba histolytica).

Infection

Are infected with the disease by eating contaminated foods and liquids parasite. Of course, this is happening in countries that do not apply the rules of hygiene and health care overall. Most
of the cases in the United States but you get in immigrants from
developing countries or in those who have traveled to, or in the remote
village institutions that do not apply the rules of hygiene known and
this is rare.



Symptoms

After exposure to the parasite symptoms. It is worth noting that only one out of ten people get to have symptoms. Thus, this disease may be a (silent) devoid of any symptoms. Symptoms include diarrhea, abdominal pain, and perhaps this pain Magsa. And probably got out the blood with the stool in addition to fever. There
is a rare but dangerous mutants you dysenteriae invasion of the liver
and form the so-called bag (abscess) filled with pus. In rarer cases, the spread may happen to other organs of the body like the brain and lungs.



Nursery

Nursery
as it is known is the period between infection with the pathogen
patient factor (Kjerthom and the virus and the parasite) and the
appearance of symptoms. In the case of amoebic dysentery, the incubation period ranging between one week to four weeks ago. This
is usually added to the immune status of the patient. The more weak
immune status was faster onset of symptoms and the symptoms are more
severe and the patient is sick more.

Diagnosis

Like
any disease it must be the person who doubts afflicted with the disease
physician review, where the doctor will some laboratory studies, the
most important examination of stool samples in search of this parasite
and other parasites and bacteria that infect the intestine. Of
course, the signs and symptoms are similar among many of the pathogens,
which makes laboratory testing is necessary for the diagnosis of flour.
Has
forced the doctor to send multiple samples for laboratory testing,
where the parasites may not always appear in each test it is necessary
to know that the experience of these parasites is not high in developed
countries due to lack of spread of the disease which makes the clinical
signs and the experience of the doctor a crucial factor in this area. One
of the reasons for the difficulty of diagnosing amoebic dysentery that
the shape of some cells and some other parasites may be similar to the
variable dysenteric when looking under the microscope, so the technical
informant may think the presence of infection if not already exist, as
it may be thought that the patient is not infected in the event of
injury severe. In
particular, there is a similarity between the transformed dysenteric
and convert another is called (variable Despar), in the case showed the
result of laboratory testing that the patient is infected with dysentery
amoebic with no symptoms of the parasite may be (variable Despar), in
fact, and this transformed the latter is not a factor as a nurse
originally . Unfortunately, there are no tests yet distinguish between these two converts. It
might be wise to the doctor in case of such an outcome assuming the
worst and deal with the patient, was diagnosed with Baltol dysenteric. We
recall here that there is an examination bloody to investigate the
variables of amoebae, but this test is not conducted in natural
conditions has been requested by the doctor in case of invasion of the
intestinal wall the parasite or in the case of organ involvement other
than the intestine (such as the liver, brain and lungs, as we
mentioned).



Treatment

There are a number of antibiotics used to treat amoebic dysentery. It is imperative that the doctor may prescribe medication. And
we mention this because it is common practice in our country that the
patient give his medication to another patient as a result of the
similarity can look. This
is not without danger as the various diseases may resemble the symptoms
and the medication that is useful in the treatment of a patient may not
be effective in the treatment of another patient. Added
to this is that many medicines are not free from the effects of GA
prophetess and some contra-indicated in some cases associated with
disease. If
this problem is uncommon in Western countries as a result of the
relative spread of health awareness, these wrong practices are very
common in our country. In case of diagnosis of dysenteric Baltol the doctor will choose the appropriate antibiotic. It
will give one medication in mild cases, but may resort to the use of
both types of drugs in severe cases where the drug is given first for a
certain period, then the other drug is given after the completion of the
first taking the drug.




Prevention

Perhaps
more people need to learn the prevention of infection with this
parasite are those who will visit developing countries for periods
longer or shorter. Perhaps
more importantly, focus on the water, where it is necessary to avoid
non-sterile water in the country, and particularly for children, and
replace them with bottled water or carbonated water. And
must avoid ice cubes that are used with water and refreshments,
Contrary to what people think, the freezing does not kill parasites
nurse. If
traveling to some tropical countries where there are no bottled water
bottles must be a question the doctor about some CD-sterile which can be
added to the water to kill parasites and bacteria in it (usually iodine
tablets). The
other thing is to avoid fresh fruits and vegetables is cooked because
it is a most important means of transmission of parasites and germs in
general. Are advised to peel fruits cleaned with soap and water. In addition, avoid eating milk and dairy products and dairy Kalojban and avoid buying food and drinks from street vendors

Rheumatism arthritis

Rheumatism arthritis

Include
rheumatism and arthritis, the pain, stiffness and swelling in the
joints, and there are many kinds of this disease is most prevalent
chronic arthritis and rheumatoid arthritis, and both may lead to severe
disability. The
disease results in inflammation of the sinus cavity, sinus cavity, one
of the small bags filled with fluid, which works to soften the surfaces
of separation between the bones and muscles. The
third type any disease muscle is a pain in the muscles of the injured
person and people call rheumatic muscles may result in the disease by
stress or in the course of getting a cold or flu or any disease Rahah
other. Either disease, swelling of the muscles, it leads to swelling in
the muscles of the injured, the strings strong that connect muscle to bone. The
main figures are for arthritis, arthritis, bone (osteoarthritis) is the
most common and rheumatoid arthritis, the second common species. Bone
arthritis: the disease is also called the erosion of the joints, occurs
when taking detailed in corrosion. Many of the older people are living with arthritis, bone, may occur if the wound is also detailed several times.



The joints most affected joints are always hands and knees and lower back and neck. May
produce a severe disability, especially if the hips and knees was very
ill. Suffer arthritis patients with bone pain in the affected area, and
feel a sense Babsrh or friction when moving. In arthritis, bone breaks down the cartilage between the bones making the bones rub against each other. The Kaaburat grow bone and cartilage in the joint stiff-date swelling and deformity.



Arthritis and bone can not be cured, and doctors usually seek to relieve pain and prevent the patient from becoming disabled. Treatment includes drugs, especially aspirin and exercise programs tailored to this goal.



The
orthopedic surgeons to repair the severe joint injury or replace it
with one made of metal or plastic or other materials. Rheumatoid
arthritis.



And called the people or doctors name the biggest obstruction. And more victims of this type are between the age of 20.40 years, but may also affect children and the elderly. Be affected joints rheumatoid arthritis, hot and painful, red and swollen. This disease affects mainly the wrists and Albraszm but may occur in any detail.



In many cases, arthritis Alormatesma spread in the whole body, causing damage to organs and connective tissue. If left without control joints, the patient may Ttibs in the end, the situation is distorted. The
rheumatoid arthritis remains throughout the life of the patient may
resolve varying periods of time. Alrahhoiatkd doctors that some
micro-organisms or autoimmune (the body to attack itself interweave), or
both cause inflammation of rheumatoid arthritis.



Doctors
are trying to prevent the disease from blocking his victims, using the
convenience and special exercises, aspirin and other drugs. In
severe cases, may use a doctor injecting a gold compounds and can be
replaced with the detailed damage to hard or repaired. Anakrsalsour
other than arthritis, including gout and known disease of kings, and
spondylitis rheumatoid, arthritis, septic, and the suffering of victims
of gout emergence of swelling is painful, but they feel better between seizures. Affected by the first detailed Alokaah that connects the big toe foot, in most cases. The cause of gout and presence of excessive amount of uric acid (uric) in the blood. During a seizure, this acid in the form of needle shaped crystals in the joints. Some people inherit the disease gout.



The alcohol and driving a fatty meal to a fit of frenzy in people with gout, but it does not cause disease. You
may have some other member Kalcletan. Has become a sick headache or
fever, gout, and often it may not be able to walk because of severe
pain. And
continue to acute attacks of gout for several days or several weeks if
not treated then the symptoms go away completely to begin a new bout.



The longer the disease longer and shorter periods of Nubia between seizures. Rheumatoid spondylitis affects mainly young men. The inflamed joints of the spine, and arises when the patient appeared rigid stoop. Most of the victims of the disease have a rare blood type is called e. For. A. B 27 (HLAB - 27) treatments include physical therapy and drugs.



The
septic arthritis Vzbbh bacteria, the most common forms occur after
inflammation in the lung or skin, or surgery in the joint or several
sexual diseases. In most cases, early treatment with drugs to prevent antibiotics from disability