Definition and differences between complete fractures, incomplete fractures

A fracture is defined by the discontinuity or breakage of bones of the human body.

There are:

Closed fractures

This type of fracture is no wound and therefore no risk of infection.

Open fractures

This type of fracture is followed by a wound and risk of infection.

Complete fractures incomplete fractures

Incomplete fractures are fairly typical of the child because the bone can break partially while respecting the continuity of the periosteum that surrounds it.

All the bones may be involved at all stages of life.

Risks and health issues fractures

If all the bones can be achieved, some fractures are more common than others: wrist, femoral neck (elderly), ankle, leg and upper limbs.
Fracture risk factors are now identified: personal history of fracture fragility, age> 60 years, corticosteroids, history of fracture of the proximal femur in a first-degree relative, body mass index (BMI = weight / height squared) <19, early menopause (before age 40), smoking, alcohol abuse, decreased visual acuity, neuromuscular and orthopedic disorders.

Causes and mechanisms of fractures
The periosteum covers the long bones, flat and allows their growth. In case of incomplete fracture, periosteum is respected despite a broken bone underneath.
Fractures are directly related to bone mass. Its reduction or deterioration of bone tissue results in an increased risk of fracture. Bone strength can be assessed by measuring bone mineral density (BMD) by densitometry. This measure is useful only for those at risk of osteoporosis (bone loss).

How manifests a fracture?

Any trauma can cause a fracture whose main symptoms are a cracking, pain and swelling of the fractured region.

Distortion may be visible or not according to the angulation of the fracture: in incomplete fractures, angulation and deformation are not marked.

Pain causes functional impairment, with inability example to set foot on the ground or to use the affected limb.

With what would it be confused fractures?

It should not be confused sprain or strain that affect joints and ligaments and fractures involving bones. A sprain can, however, be accompanied by avulsion fracture.
At the level of a member, a sharp pain with impotence can be caused by a muscle tear without fracture; only radiography make the difference.

Will it possible prevention of fracture?

The best prevention is still a good physical preparation, proper warm-up and a conservative sport.
Wearing appropriate clothing (knee, shin guards, helmet ...) avoids direct trauma.
The fight against risk factors is also recommended to prevent fractures. The diet should be balanced to avoid excess weight but also fight against deficiencies (lack of calcium and / or vitamin D). Tobacco and alcohol are two enemies of the bones and weaning is recommended.

If demineralization proven to bone densitometry (osteoporosis), hormone replacement therapy is offered in postmenopausal women (in the absence of cons-indication) and drugs fighting against bone destruction are available to all.

Fractures: when to consult?

Any persistent pain, swelling or deformity after trauma requires a medical consultation and possibly a radiograph.

Unnoticed or ignored, a fracture can worsen and cause chronic pain, osteoarthritis and / or deformation.

What does the doctor faces a divide?

The doctor will clarify the antecedents and fracture risk factors (see above), the mechanism of trauma and violence. He then studied active and passive motility of the member concerned asking you to move spontaneously. Finally, palpation of bony prominences can highlight deformation or painful point.

Only an x-ray will help confirm the diagnosis. In children, radiographs are sometimes difficult to interpret.
The curvature traumatic results in exaggerated bone curvature without obvious feature of fracture.

The green wood has a fracture line on one side of the bone fracture, but the other side is respected; finally, the lump of butter fracture corresponds more to a slowdown in the bone.
Fracture treatment is based on the quiescence of the bone and joints, pain medication and immobilization (plaster, resin ...).

Depending on the case and the deformation, surgery can be necessary to refocus or secured fragments.

How to prepare for my next visit?

We must not neglect pain following trauma and view. In case of cast immobilization, any pain should be reported to the doctor to check the cast is not too tight and does not interfere with traffic.

If anticoagulant therapy is prescribed (spots) must be followed carefully to prevent phlebitis.

Open fractures, closed fractures: what is it?

A fracture is defined by the discontinuity or breakage of bones of the human body. We distinguish closed fractures (without wound and therefore no risk of infection) open fractures (with wound and risk of infection).

All the bones may be involved at all stages of life.

The causal mechanism of injury determines the type of fracture: compaction, avulsion if ligament injury, fracture of the femoral neck geared for example ...

What are the risks and health issues fractures?

All bones can be achieved but some fractures are most common in function of the age and location.

Compaction is characteristic of the vertebrae and occurs mainly in case of osteoporosis. Similarly, the femoral neck fracture occurs in a special way in the elderly.

Fracture risk factors are now identified: personal history of fracture fragility, age> 60 years, corticosteroids, history of fracture of the proximal femur in a first-degree relative, body mass index (BMI: weight / height squared) <19, early menopause (before age 40), smoking, alcohol abuse, decreased visual acuity, neuromuscular and orthopedic disorders.

What are the mechanisms of fractures?

A fracture occurs most often after trauma. Depending on the bone density (measured by BMD), a more or less violent trauma is necessary to break the bone.

For example: in a young patient, high energy is required to cause a fracture of the femur (accident of the public highway, high-rise fall ...) in an elderly patient, a simple fall from standing height enough.
In case of an open fracture, there is a communication between the outside and the fracture; the risk of infection is important because this communication represents an ideal gateway for infection.

How manifests a fracture?

Whatever the type of fracture, trauma is necessary for the cause. The main symptoms are a cracking, pain and swelling of the fractured region. Pain causes functional impairment, with inability example to set foot on the ground or to use the affected limb.

In an open fracture, skin lesions are visible with a break in the skin leaving collect a piece of bone. Nerves, muscles and vessels can also be affected.
In case of compaction, often vertebral pain is located in the back. No deformation is visible but palpation of the vertebra is painful. Signs of sciatica (leg pain) are also possible.
The bony avulsions follow a movement of a joint beyond the physiological possibilities; ligaments stretch and tear a piece of bone; exquisitely painful point is felt on palpation.

With what would it be confused fractures?

It should not be confused sprain or strain that affect joints and ligaments and fractures involving bones. A sprain can, however, be accompanied by avulsion fracture.
In the elderly, a broken hip meshed, that is to say, the femoral head and neck are nested, may go unnoticed because despite the pain, heel and leg can still move. Only radiography wide in these indications, will make the diagnosis.

Will it possible prevention of fracture?

The best prevention is still a good physical preparation, proper warm-up and a conservative sport.
Wearing appropriate clothing (knee, shin guards, helmet ...) avoids direct trauma.
The fight against risk factors is also recommended to prevent fractures. The diet should be balanced to avoid excess weight but also fight against deficiencies (lack of calcium and / or vitamin D). Tobacco and alcohol are two enemies of the bones and weaning is recommended.

If demineralization proven to bone densitometry (osteoporosis), hormone replacement therapy is offered in postmenopausal women (in the absence of cons-indication) and drugs fighting against bone destruction are available to all.

In case of suspected fracture, call for help, sit or lie the victim of severe pain to avoid discomfort and hold the two parts of the broken bone with a hand placed on each side to avoid they are mobile (intense pain factor). At best, place the fracture on a plane and straight support.

Tetanus immunization is checked for open fractures.

Fractures: when to consult?

Any persistent pain, swelling or deformity after trauma requires a medical consultation and possibly a radiograph.
Similarly, back pain, especially in patients with risk factors such as osteoporosis or treatment with corticosteroids should motivate a consultation not to neglect vertebral collapse.

What does the doctor faces a divide?

History of fracture risk factors (see above), mechanism of trauma and violence helps the practitioner to suspect a fracture. Palpation of bony prominences can highlight deformation or evocative painful point of a fracture or avulsion.

Elective pain on palpation of the spine fears vertebral collapse, but only the radiographic support or refute the diagnosis. Compaction can affect every facet of the vertebra or represent a compression fracture; MRI may specify any neurological compression.

In case of fracture of the femoral neck, several x-rays may be needed to clarify the type of fracture.

The common treatment of these fractures is the quiescence of the joint and the fight against pain.

Some are operable as femur fractures, open fractures or fractures settlement of unstable spine. For others, an asset or pulling suffice.

For open fractures, early antibiotic treatment prevents the risk of infection.

How to prepare for my next visit?
We must not neglect pain following injury and should be consulted.

In case of cast immobilization, any pain should be reported to the doctor to check the cast is not too tight and does not interfere with traffic.

If anticoagulant therapy is prescribed (spots) must be followed carefully to prevent phlebitis.
Wounds and sutures should be monitored; if they turn red, inflammatory with fever, a consultation is needed quickly.

Definition of rotavirus gastroenteritis

Rotavirus gastroenteritis is a digestive infection caused by the invasion of a virus called "rotavirus" extremely contagious. Rotavirus gastroenteritis by changing seasonal epidemics, with a peak in winter, and mainly affects young children. It is also a nosocomial disease, by definition, hospital-acquired, as many children are infected while in hospital for another reason: bronchiolitis example.

Health risks and challenges of rotavirus gastroenteritis

Any diarrhea and / or vomiting is a risk of acute dehydration; it is especially important that the person is more fragile (very young or very old) and malnourished (importance of malnutrition in developing countries). Acute dehydration of a fragile person puts his life at risk. *

In a study published in 2005, Melliez and colleagues assessed morbidity and cost of digestive rotavirus infections in children under 5 years: they attribute to it every year 300,000 180,000 acute diarrhea and city consultations, 18,000 hospitalizations and death of ten.

The study Shrik * published in 2009 shows that nearly half (49.1%) of children admitted to the emergency for acute gastroenteritis suffer from rotavirus. They are very young: nearly 90% have less than 2 years and almost 20% less than 6 months.

For InVS, 43% to 51% of viral gastroenteritis in hospitalized under 5 are due to rotavirus. Complications, first dehydration occur in 20% of cases and cause thirty deaths annually. They are more common with rotavirus, particularly among infants less than 6 months.

In the city, only 20% of gastroenteritis due to rotavirus would, because of many "competitors" viral, including calicivirus (including the principal, Norovirus, may be more common than rotavirus), adenoviruses ... But gastro Rotavirus -entérites are most severe.

In people over 75 years, the mortality of viral gastroenteritis (all virus) is around 350 deaths annually. But the deaths are probably more because dehydration causes very poorly tolerated blood disorders in these individuals often malnourished, with several diseases and treatments delicate to handle: antihypertensive and cardiovascular drugs first.

Causes and mechanisms of gastroenteritis

The virus penetrates the intestinal cells and blocks its operation. The cells do not absorb water and food, the movement is reversed: they reject the intestine water and minerals essential to good blood balance. This digestive cell leakage is called "entero-toxigenic" it causes diarrhea and vomiting.
This viral invasion can permanently change the bacterial flora; and install a milk intolerance (sugar and protein) unwelcome in children.

Contagiousness is extreme: the stool of a baby can issue up to one billion viral particles of the 3rd day of the 5th day illness. Sometimes shedding continues for 15 days!

Symptoms and signs of gastroenteritis due to rotavirus

Rotavirus, like other gastrointestinal viruses, multiplies for two to three days after infection. The first symptom (usually but not always) has a high fever (up to 40 ° C) at the same time as diarrhea (from 3 stools / day more or less liquid) and sometimes vomiting. Vomiting is an unfavorable factor because they prevent food so rehydration. Any diarrhea carries a risk of dehydration, which made its danger.

Mild diarrhea

Mild diarrhea does not give signs of dehydration, there is no vomiting or weight loss.

Serious diarrhea

Serious diarrhea dehydrates. The symptoms are high fever, thirst (careful, toddlers do not know how to express it), a fold of skin (skin does not come back up immediately when pinched in the arm for example), the weight loss (5%), vomiting, loss of appetite ...

Severe diarrhea

Severe diarrhea sees signs of marked dehydration: persistent skin fold, sunken eyes,
dry mouth, crying without tears, gray complexion, significant weight loss +++ (10%), loss of consciousness leading to coma and death if no resuscitation is taken urgently.

With what should we be confused?

Any viral diarrhea is not: food poisoning bacteria (staphylococcus, E. coli, Salmonella) are not uncommon. The notion of a suspect food and similar cases in the entourage after the same meal referrals diagnosis. The presence of blood or mucus in the stool is a strong indication of bacterial infection.
Any diarrhea is not infectious: then there is no fever (except in special cases). The intolerance to cow's milk, gluten intolerance are causes to evoke systematically, especially when diarrhea persists.
Some diarrhea is associated with other infections or disorders: otitis, appendicitis, intussusception (occlusion) or deep UTI ...

Will it possible prevention?

The integral partial breastfeeding protects children against rotavirus gastroenteritis.
Hand hygiene and food (kitchen) is essential to limit epidemics and the number of people in a community (family, nursery).

Vaccination against rotavirus is 100% effective against the serious forms and hospitalizations. But it is not recommended in the general population by the Board of Public Hygiene since it protects against that half (at best) officials gastroenteritis virus. The oral vaccine is administered at the 6th week of life, especially to infants exposed to harsh conditions and / or random surveys. Two vaccines are licensed. One requires two doses to be taken by mouth and the other three doses.

When to consult?

Any liquid sudden diarrhea with vomiting requires rapid consultation of a doctor. Hospital emergency if the stools are continuous.

How to prepare for the consultation of doctor?

Immediately begin oral rehydration with "oral rehydration salts (ORS)" counter in pharmacies. In small regular amounts or even the syringe to the beginning if the child refuses solute bottle (1 sachet in 200ml of water).

Note the number of stools per day and their liquid or soft nature, presence or absence of blood and mucus.

Recall the context: current epidemic in the family, school, nursery, home nanny ...
But also other ongoing illnesses that make it very fragile person, heart and kidney disease in particular.

What does the doctor?

It checks the intensity of dehydration (weight, etc.), it evaluates the difficulty of re-hydrate and nourish the patient.

It identifies the exact cause as much as possible to develop the relevant treatment.

According to the condition, he decides to no supervision or hospitalization for intensive care.

It prescribes rehydration with oral rehydration solution (ORS) that restores blood and intestinal balance and recharge during illness. This resolves spontaneously within a week in mild cases. He explains the isolation of infants (out of the crib, or in the nanny) and hygiene rules to limit the spread of gastrointestinal virus. It adapts the current drugs, diarrhea and dehydration.

Information about frostbite

Frostbite of the extremities occur mainly in the mountains where the weather conditions are changing rapidly with falling temperatures of 6.5 ° C every 1000 meters. They are one of the consequences of prolonged exposure to cold. These are injuries to the movement disorders caused by cold, which mainly affect the extremities (hands and feet) and the face. Cold, humidity, but also skin contact with metal objects favor.

Risks and health issues frostbite

Cooling the body can cause many cold injury. Frostbite and hypothermia are the most serious. Frostbite concern mainly the fingers, toes, ears and nose, as these organs are devoid of major muscles to produce heat.

Mechanisms frostbite

The cold-induced vasoconstriction which decreases blood perfusion and thus oxygenation of the extremities. In case of exposure to cold, the body indeed preserves heat in internal organs, reducing peripheral blood circulation (the ends). Hands and feet thus tend to cool more quickly, leading up to frostbite.

How is he clear?

The first symptoms are tingling in the extremities. The skin then becomes white and cold, with a loss of sensitivity and blistering. When heated, pains are felt swelling.

A few days later, the affected area becomes black by tissue necrosis (tissue death) and in some cases the gangrene may require amputation of the limb.

With what should we be confused?

It should not be confused frostbite and chilblains. Frostbite is benign lesions caused by exposure to cold without freezing of tissues (temperature of the upper air freezing, 0 ° C).

The affected area is red, swollen with a tingling sensation or pain.

Will it possible prevention?

Prevention requires certain precautions: wear shoes and warm clothes and insulating wind and humidity, no excursion mountain without adequate equipment, always report their departure with an approximate schedule return for delivery of communication in case of problems.

Whatever the weather, we must fully cover, wear gloves and a hat that protects the ears, and use a lip balm that will prevent chapping and protect from the sun.

When to consult?

If symptoms such as tingling or pain, it is imperative to warm hands and extremities. Attention must slowly warm the tissue and avoid rubbing the affected parts.

Never use hot objects such as water bottles, and seek emergency at the stage of frostbite.

What does the doctor?

Frostbite evolve in three phases: numbness, movement disorders and tissue necrosis.

In the first stage, impairment is reversible with warming, including extremes: hot and sweet drinks, warming blanket.

Blood flow will be facilitated by loosening clothing and shoes and stirring the hands and feet.

From the second stage, the care is specialized treatment in hospital or ICU: not undertake any warming but wrap the victim in a blanket.

Warm baths of end abuses in warm water at 38 ° C can be provided.

At the stage of necrosis, sometimes amputation is the only treatment option.

How to prepare for my next visit?

The loss of sensitivity is one of the first signs of frostbite. The fingers are white as devoid of blood; at this stage, it is advisable to return the blood and sensitivity by moving, massaging or by warming under the armpits.

Definition of Gingivitis

Gingivitis is an inflammation of the gums caused by bacteria present in aggression in dental plaque, now called "bacterial biofilm." This disease occurs at all ages, to greater or lesser degrees. It can lead to a destruction of the surface portion of the gum; which causes severe pain to prohibit the supply.

Risks and health issues of gingivitis

If it is not treated in time, gingivitis may develop into periodontitis with loss of bone around the tooth, mobility and possible loss of it. Periodontally all tissue fixation and supporting the teeth, that is to say, the gum, the ligament and bone. Various studies show that gingivitis affects between 50 and 80% of people, and periodontitis 20 to 50%.

Gingivitis has a general impact on health: the bacteria in the mouth can spread in the body. Gingivitis is thus a risk factor of infarction, diabetes, and even premature births ...

Causes of Gingivitis

About 500 bacteria can cause gingivitis and their presence in the mouth varies by geographic areas and populations. The inequality of individuals with that infection is due to the familial susceptibility and oral hygiene. Those who have never had any decay are more likely to develop gingivitis: because the bacteria causing tooth decay compete with those responsible for gingivitis and reduce the "silence".
Power does not come into play in this disease although a vitamin C deficiency is a contributing factor. Bone loss is not related to age: gingivitis can begin in childhood and grow in the absence of proper oral hygiene.

Note: Some heavy treatments, such as immunosuppressive drugs given to transplant people favor gingivitis.

How manifests gingivitis?

The gums are red, sore and bleeding in simple non aggressive tooth brushing. That in the absence of anti-coagulant treatment in the absence of net deficiency of vitamin K and without liver disease that impairs blood clotting.
These signs are localized or generalized to the gum.

With what would it be confused gingivitis?

With dermatological diseases (leukoplakia or lichen type for doctors) that may develop in the mouth of otherwise unhealthy or defective oral hygiene, such as alcohol and tobacco abuse. Not periodontal disease.
Bleeding gums is the major sign of gingivitis that avoids confused with other diseases.

Will it possible prevention?

Good oral hygiene is both the prevention and treatment of gingivitis. The hygiene must be rigorous, effective and non traumatic: it is necessary to properly use his toothbrush, which must be adapted to the size and shape of the teeth.

A brush or a dental floss eliminate uninvolved interdental plaque by brushing.
Although the mechanical action is most useful when brushing, fluoride toothpaste helps protect the teeth more effectively. However, an antiseptic toothpaste, which can be useful against bacteria, should not be used all the time.

When to consult?

Consulting his dentist every year for at least scaling, is part of the prevention of gingivitis. If the gums bleed when you brush, she is ill: do not take this lightly but signs quickly consult your dentist for advice.

What does the dentist?

The dentist begins by analyzing the appearance of the gums (shape and color). He may need an x-ray to assess the quantity and quality of the bone under the gums if it suspects periodontitis. It can make a bacterial sample (simply rub the gums with a swab).

It establishes its diagnosis and treatment plan.
For simple gingivitis, an effective oral hygiene will be stimulated, after scaling and removal of dental plaque.
If periodontitis is installed, a mechanical treatment called surfacing (root cleaning and disinfection of the pockets, surgical or otherwise) is necessary.

How to prepare for my next visit to the dentist?

Summarizing medical history: our prescription medicines, surgery (especially transplant) and caries.

Explain the reason for the consultation (discomfort, pain, aesthetics), indicate whether it is a recurrence of gingivitis, if it has already been processed, and for how long is the inflammation.
Finally, family history (if parents are prone to gingivitis) give an indication.

Definition of glaucoma
Glaucoma is an increase in intraocular pressure within the eye, by excess and / or excessive retention of the aqueous humor.
We distinguish acute glaucoma, occurring suddenly, chronic glaucoma (80% of cases) progresses insidiously.
Glaucoma is called "closed-angle" when the angle between the iris and the cornea is very narrow, and "open angle" when no angle closure was observed.

Risks and consequences of glaucoma

Glaucoma

Chronic open-angle glaucoma is seen in all ages but is most common after age 40.
It is desirable to make it a routine screening from 70 years because it is the second cause of blindness in developed countries after macular degeneration related to age. 10% of global visual impairment due to glaucoma according to WHO (Action Plan against blindness, 2006-2011).
According to the Society of Ophthalmology (SFO), chronic glaucoma affects about one million A press conference of its 2011 congress, the SFO evokes up to a million people, but unaware of their disease.

The danger of glaucoma is the alteration of sight until total blindness if left unchecked. The decrease in visual acuity indicates an advanced form of glaucoma which should no longer be with a proper care.

Acute glaucoma

The acute form is urgent: acute glaucoma can cause blindness in 48 hours by compression of the optic disc area of the retina where the optic nerve emerges and blood vessels.
When glaucoma, slow compression of the optic disc gradually narrows the visual field (first peripheral vision) and central visual acuity (ability to distinguish two points when looking straight ahead).

Causes and origins of glaucoma

Aqueous humor is secreted fluid in the eye with a special area called "ciliary body", located on the outskirts of the lens. It is normally flows through resorption in the trabecular meshwork located in the iridocorneal angle (between the iris and the cornea). Many circumstances may inhibit or block this resorption. Since the production of aqueous humor does not stop for all that, the pressure increases faster or slower depending on the nature of the obstacle.

Old age affects the trabecular meshwork, which absorbed more slowly the aqueous humor.
The shape of the eye affects the anatomy of the anterior chamber angle. The eye very shortsighted closes the anterior chamber angle, which can block the flow of aqueous humor while the trabecular meshwork is "normal". The addition of other factors contributing to angle-closure glaucoma can cause an acute angle-closure.

Among these factors is the dilalation of the pupil (iris opening) by drugs and narcotics, by autonomic imbalance. Such parasympathetic hypertonia in the dark, cold, pain, stress or excitement. Trauma or ocular inflammation may also close the iridocorneal angle.

Finally, the presence of chronic diseases altering the arteries of the retina (mainly diabetes and / or hypertension) makes the papilla very sensitive to lower intraocular pressure. So we made a lot easier when you already acute glaucoma is a chronic glaucoma, especially if it is ignored, and when you suffer from diabetes or high blood pressure.

10% of glaucoma are called "closed angle"; it is most often an inherited anatomical anomaly. All other glaucoma are said to "open angle": the resorption of aqueous humor is the only cause, without angle anomalies.

Symptoms and signs of glaucoma

When chronic glaucoma moved silently and can not be manifested as blurred vision and reduced visual field. This is the regular monitoring of vision and eyestrain that can detect it.

In acute glaucoma, the eye suddenly becomes painful (but not always), very red (vessels dilate), and hard. The vision is blurred and not corrected with glasses or a magnifying glass. Mydriasis (constant enlargement of the pupil) is often present. Other symptoms should alert as headaches, nausea, or general malaise.

Will it possible prevention of glaucoma?

Yes, by the early detection of glaucoma factors, particularly advancing age. Consult an ophthalmologist regularly from the age of 40 years, even more so when a parent is already suffering from glaucoma.
Of course, avoid as much as possible situations that place the parasympathetic hypertonia: dark, cold, emotions, coffee, pain, stress, smoking, certain medications such as antihistamines, antispasmodics and antipsychotics.

It is recommended to avoid coffee increases the intraocular pressure and tobacco. However, the abuse of television, wearing lenses, reading or computer work are not sufficient in themselves risk.

When to see the doctor?

Systematically by regular eye balances to avoid an emergency situation, very dangerous for the view.

Emergency when acute glaucoma are signs: red eye, hard to palpation closed eyelid, vomiting, headache, blurred vision uncorrectable.

How to prepare for my consultation?

We must stand with the summary of all prescription treatments because some favor glaucoma.

What does the doctor?

The GP suggests the diagnosis for consideration and guidance urgently to a city in ophthalmologist or hospital if it is an acute glaucoma. He does the same for glaucoma but consultation may not take place within two hours.

He may prescribe eye drops immediately adapted to reduce the first pressure by draining the aqueous humor and then closing the pupil, which releases the iridocorneal angle. These are beta blockers, miotics, adrénaliniques, inhibitors of carbonic anhydrase, derivatives of clonidine and prostaglandins.

The emergency measure eye pressure (tonometry) and examination of the fundus, performed by an ophthalmologist in town or in the hospital, confirmed the diagnosis of glaucoma. Added to gonioscopy and exploration of the visual field that evaluate its causes and consequences eye.

Depending on the size of glaucoma or in case of ineffective treatments eyedrops, surgery with or without laser may be necessary.

Who is the bone marrow transplant?

The treatment of certain cancers may go through a bone marrow transplant, or more accurately a stem cell transplant contained in the bone marrow. This approach is used in particular in patients with leukemias or lymphomas.

What is the principle of this treatment?

Blood cells (red cells, white cells and platelets) are made in the bone marrow from stem cells. The treatment of some cancers of the blood through the destruction of all such cells, and the reconstruction of a healthy bone marrow which produce healthy blood cells. This is where the graft.

Bone marrow transplant in practice

In practice, this therapeutic approach is carried out in two separate steps: in the first, the patient's bone marrow destroyed by chemotherapy or radiation therapy to eliminate tumor cells. The patient then finds herself momentarily devoid of immune system. Personnel must be protected from infection, and it is why it is placed in a sterile room.

During the second stage of treatment, the patient receives a stem cell transplant that will quickly restore the destroyed marrow. The graft may be a marrow sample previously taken to the patient. There is talk of autograft. This option is only possible if the cancer does not touch the bone marrow cells. The patient may also receive the marrow from a donor (allograft) or umbilical cord blood is rich in stem cells from cord blood bank.

Become a bone marrow donor

According to the Agency of Biomedicine, "Bone marrow transplant is only possible between a patient and a donor whose biological characteristics are as close as possible. When the patient does not have a donor among his brothers and sisters, the doctor uses the records to find a compatible donor. This compatibility is rare: one in a million chance between 2 random people. But that opportunity exists and can save a sick ".

To become a marrow donor, you must register on the National Register marrow transplant. For this, it must be over 18 and under 51, be perfectly healthy and answer a medical interview about his medical history and lifestyle.

Flu definition

Influenza is a viral infectious disease. The influenza virus of the family Myxovirus, mainly attacks the upper respiratory tract (nose, throat, bronchi) and sometimes the lungs. Viruses mutate from one year to another and are extremely contagious: they spread around the world in the form of sometimes dramatic epidemics (Spanish flu in 1918 and 1919 with 40 million dead, Asian flu in 1957 and flu Hong Kong in 1968).

Risks and consequences of influenza

Flu, mild in healthy subjects, can be fatal in younger or older people and / or patients (diabetes, cancer, kidney or heart problems). Each year, 5-15% of the population are affected during routine epidemics, with significant economic impact (sick leave, lower productivity ...) and 5 million serious cases and 250 000 to 500 000 deaths. Deaths occur mainly in people over 65 years.

Flu Causes and mechanisms

The influenza virus circulating nowadays and cause human epidemics are of two types: A and B. These viruses are genetically programmed to be able to mutate very easily, with minor modifications but imposing reformulate the vaccine each year..
These flu viruses are spread easily from one person to another by air via the microdroplets and particles expelled during coughing or sneezing. The virus enters through the mouth and nose and infects the body.
High population concentrations, dry and cold weather are conditions favorable to the spread of the flu.

Symptoms and signs of flu

The first symptoms appear several days after infection (1-4 days), but the patient is already contagious before symptoms appear. The flu lasts about a week and is characterized by a strong sudden fever, signs of soreness and muscle pain, headache and malaise. Dry cough, sore throat, and rhinitis (runny nose) directed towards diagnosis, especially as the environment is also achieved.

Symptoms resolve spontaneously or with symptomatic treatment in 1 to 2 weeks.
In compromised patients, complications of influenza may occur in the form of bacterial infections, of extrapulmonary involvement (digestive disorders, meningitis ...) or even fatal malignant flu (acute respiratory failure).

With what should we be confused?

Seasonal flu is not to be confused with avian influenza or "bird flu" that affects the moment the birds. Avian influenza viruses are indeed unable to directly infect humans.
Also, do not confuse the flu, viral, with other bacterial infections. Antibiotics are in the case of the influenza viruses on completely ineffective.

Will it possible prevention?

Vaccination remains the main flu prevention means for limiting the spread of the epidemic and avoid complications.
All seniors and all those at high risk of complications should benefit as it reduces mortality from 70 to 80%. Influenza viruses are constantly changing, vaccines are adjusted each year by the global network of the World Health Organization.

The Insurance supports vaccination of people aged over 65 and patients, regardless of age, with the following chronic diseases:

- Type 1 diabetes and Type 2 diabetes;
- Disabling stroke;
- Severe chronic kidney disease and primitive nephrotic syndrome;
- Severe neurological and muscular disorders (including myopathy), severe epilepsy;
- Cystic fibrosis;
- Severe heart failure, serious arrhythmias, severe valvular heart disease, severe congenital heart disease;
- Severe chronic respiratory insufficiency;
- Severe primary immunodeficiency requiring prolonged treatment, infection with human immunodeficiency virus;
- Sickle cell anemia;
- Asthma or chronic obstructive pulmonary disease;
- Children and adolescents aged 6 months to 18 years, whose health condition requires prolonged treatment with acetylsalicylic acid (complicated Kawasaki syndrome and juvenile chronic arthritis).

When to consult?

In young adult and free of pathologies, evolution of influenza is usually favorable spontaneously or with symptomatic treatment with free access to the pharmacy. However, in case of influenza in a fragile person (young children, persons over 65, chronic illness ...), a quick reference is needed.

What does the doctor?

The doctor confirms the diagnosis on questioning and clinical examination. The epidemic context, as well as health bulletins progression of influenza help make the diagnosis of presumption.
In uncomplicated cases, no sampling or examination is required. Treatment is symptomatic, to reduce fever and relieve pain. Antibiotics are antibacterial agents no effect on viruses and are therefore not indicated in the treatment of influenza (except in cases of bacterial infection).
Antivirals can be useful in certain directions but do not replace the vaccine.
If severe, hospitalization may be necessary, sometimes resuscitation.

How to prepare for my next visit?

Any worsening or persistent signs beyond 7 days must consult a doctor. In all cases and to prevent contamination of those around, simple measures are to be adopted: cover your mouth when sneezing, blowing nose in disposable paper handkerchiefs, avoid shaking hands, kissing, frequently washing hands or disinfect their hands with hydroalcoholic solution and well wear a surgical-type mask.

Why and how to wash their hands?

Bacteria and viruses are spread by hands. To eliminate them, use an alcohol-based or liquid soap. Bar soaps retain surface germs because they do not kill bacteria, it is not their function. They dissolve the lipid film that protects but it must then rub to remove germs. Washing hands is the SCRUB!

Use hot water temperature "bearable" (never above 45 ° because of the risk of burning), and do not forget to rub the furrows: wrists, between fingers, under fingernails. Rinsing should be careful to avoid maceration by residual soap. Close the valve with a disposable tissue, and dry your hands with a disposable paper towel. This expense of paper at a time can interfere ecological economics.

We can book the practice at the entourage of the sick and those in contact and confined environments where sharing germs is inevitable: offices, schools, community houses ...

When to wash your hands?

These are good habits to take every day, all year round.

It is essential to wash hands after:
- The working day, on the way home,
- Borrowing public transport,
- Stay in a public place,
- Having crossed an infected person,
- Going to the toilet,
- Blowing your nose, coughing, sneezing or spitting
- Removing his protective mask.

And ALWAYS before:
- Cooking,
- Eating,
- To take care of children, especially infants.

What mask and for whom?

The anti-projections said masks do not protect healthy people against the virus, but the patient to avoid infecting others and the environment.

To remain effective, they must be changed every 4 hours when wet. Which occurs relatively quickly due to the condensation of the breath.
Removing the mask, taking him by the fasteners to discard it immediately and wash your hands afterwards.

They are issued free pharmacy on prescription.
There pediatric masks for children 1 to 12 years.

How to use paper handkerchiefs?

Disposable paper handkerchiefs are an effective anti-viral dissemination weapon becomes a temporary mask when sneezing, coughing or blowing nose. It is also essential to use them to manipulate surfaces or objects that might be contaminated.

They must ALWAYS be discarded immediately after use.

Where to throw handkerchiefs, towels and used masks?

Elimination is household waste, placing them in an airtight bag.
Use double packaging if the bags are threatening to tear easily.
The simplest, but also the most expensive, is to place the masks and handkerchiefs in small plastic bags before throwing them in your trash "general".

How to limit the contamination of others and his own?

- Cover your mouth and nose with a disposable tissue when sneezing or coughing. In the absence of tissue, sneeze and cough into your elbow or hands by washing them immediately.
- Limit the bare minimum physical contact: no kisses, no hugs, no curly braces. The new A / H1N1 virus is contagious VERY.
- Wash your hands after hand contact: with a hydro-alcoholic solution (in your purse or pocket) when no source of water and soap is available.
- Do not use cloth towels in public toilets, but disposable towels or failing a tissue (in your purse or pocket).
- Health authorities have not officially recommended the routine use of masks. The mask called "surgical" anti-projections not protect from contamination but decreases the amount of miasma sucked.

Only the mask FFP2 ensures effective filtration of the virus, PROVIDED be used properly: mandatory use that may fail more often, however, in generating a false protection.
- Before traveling: check with the travel company, the Embassy or Consulate.

What to do when there is a flu at home?

- Isolate the sick day and night, if possible in a single room, even change the organization of the house. This piece will be regularly aired. Avoiding physical contact: stay at least 1 m according to official recommendations, 2 meters according to US data protection CF patients.
- Make the patient wear a surgical mask spray suppression in the presence of another person: ideally continuously until he coughs to protect the environment.
- Do not share any personal effects with the patient: towels, cutlery, toys. However, their washing can be done in the usual way without putting them apart.
- Clean surfaces and shared items (remote controls, flushing, door handles ... etc.), Hot water, with usual household products. The virus remains infective on surfaces likely to 6-8 hours.
- If compel strict rules of hygiene, especially hand washing.

How long does it contagious?

Influenza infection begins 24 to 48 hours before the onset of signs and persists 4-5 days or a week in total.

Definition of halitosis

Halitosis, scientific term for bad breath, is an unpleasant odor or smelly from the mouth. Halitosis, also common in men than in women (women, however, tend to see), increases with age.

Risks and consequences of halitosis

There is little statistical data to determine the actual frequency of halitosis, especially no objective and universal test sets bad breath. Halitosis is, however, a common reason for dental consultation: between 5 and 10% of the population are regularly affected by bad breath, but everyone can be at a time of his life.

Causes and origins of halitosis

The term is defined by the air emitted from the mouth and nose during breathing.
Abnormal breath (halitosis or bad breath) is an unpleasant odor (rotten fish, eggs, rotten apple ...) and can be linked to a local or general pathology. It may be transient (food after eating garlic, tobacco or coffee) or longer (disorders of the oral cavity, head and neck, digestive or lung).

Symptoms and signs of halitosis

Bad breath in the morning upon waking is normal, due to a reduction in the production of saliva in the night and stasis food debris. Only persistence must consult their dentist.
Bad breath is often associated with dry mouth. In addition, weight loss, or high-protein diets, foods (garlic, onion, spices) or lifestyle (smoking, alcohol, coffee) promote bad breath, which is often difficult to realize oneself.

With what would it be confused halitosis?
The pseudo-halitosis is the impression for patients to have bad breath. In fact, a review would show a breath quite normal. Psychological support to convince them is often necessary.

Will it possible prevention of halitosis?

Perfect oral hygiene is a prerequisite: brushing after every meal, flossing, brushes against plaque, cleaning the back of the tongue (tongue scraper), denture care ...
Diet also plays a big role. Better to avoid garlic, onions, spices, dairy products, cauliflower, asparagus, alcohol, coffee, and reduce the amount of protein (beware protein diets). The fight against dry mouth through regular hydration (drinking water), especially at bedtime. And this is one more opportunity to stop smoking if not already done.

When to consult?

It is very difficult to see his own breath. So it is a third party that reveal most often bad breath and will point to the person concerned. Detection devices such as "fresh kiss" are commercially and quantify the odorous gases.

What does the doctor during halitosis?

... Or rather the dentist. The practice dentist a complete physical examination of the mouth looking for a local cause (hygiene, condition of the gums, coated tongue ...).
The importance of halitosis can then be evaluated by a sensory examination says with a score of 1 to 5 and / or electronic halimétrique (measurement of odorous gases).

Following the consultation, the character and identity of the supposed origin of halitosis usually possible to offer an effective treatment. In the absence of local cause, buccal, the dentist can direct to the doctor contractor who may send the patient to an ENT doctor or other specialist.
In all cases, the treatment of halitosis is based on the treatment of the cause, buccal or extraoral. Lozenges, toothpastes or mouthwashes may also be prescribed to mask odors or participate in treatment.

How to prepare for my next visit?

Identify the circumstances or promoting foods bad breath allows to discuss with her doctor, who will confirm or invalidate their role.

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Definition of hallux valgus

Hallux valgus, often called "onion" by association is actually a deviation of the big toe of the foot outward. Frequently, the head of the first metatarsal is prominent and produces what is called the onion.

The onion can become inflammatory and autoentretient deformation: the angle of deviation increases, with repercussions on all the other toes (second toe claw, formation of a cor ...).

Pain and infection can be aggravated hallux valgus and onion.

Risks and origins of hallux valgus

5-10% would be affected by hallux valgus.

Women between 40 and 50 years are more prone to it, with pain, difficulty wearing shoes and deformation of the forefoot.

Men and children are exceptionally achieved (ratio of 1 man 30 women).
Genetic factors shape of the foot (wide forefoot or foot with a toe first feature called Egyptian foot), wearing certain shoes (heels, pointed toes ...) and finally the age and menopause promote hallux valgus and onion.

Causes and mechanisms of hallux valgus

Several factors combine to result in a distortion:

Hereditary predisposition

A hereditary predisposition made the bed of hallux valgus, with an angle between the first and second metatarsal increased.

Ill-fitting footwear

Hallux valgus is compounded by ill-fitting footwear or poor running technique.

Friction and inflammation

Friction and inflammation generated create a vault at the joint; this inflammation increases angulation and deformity.

What are the symptoms hallux valgus?

The Hallux valgus is visible by looking at his feet, the big toe is deflected outward with a fingernail located in a different axis of the other nails. The arch or swelling is the seat of inflammation at the base joint of the big toe.
The overlying skin is thickened and hardened. The skin is red, glistening from the fulcrum with the shoes.
The hallux valgus leads to a big toe that causes neighboring toes forward with an overlap of two toes: corns, blisters and thus pain are common.
Complications can also occur with toe claws, a true osteoarthritis annoying walking and infections friction areas.

With what would it be confused onion or hallux valgus?

Do not confuse foot deformities related to other causes with hallux valgus.

Indeed, paralysis, trauma or arthritis can deform the foot. An apparatus and / or rehabilitation allow to improve walking and symptoms.

Will it possible to prevent hallux valgus?

Prevention involves wearing shoes fit the foot (size, wide end and round, alternating small heels and flat shoes). The use of protective pads can help to slow the progression of an onion.
Pedicure treatments relieve and prevent the symptoms, as well as stretching exercises and massages.

Hallux valgus: when to consult?

It is advisable to consult early, before the stage of disability or complication.

At an early stage of the onion, change shoes or correct walking technique can be enough to break the vicious circle.

At a more advanced stage, the treatments will be heavier and sometimes less effective.

What does the doctor deal with an onion?
The doctor confirmed the diagnosis clinically.

It will also eliminate neurological or traumatic causes of hallux valgus. With the X-ray of the foot, angulations were measured and the impact on the entire foot visualized: the stage of hallux valgus can be determined (stages 1-3) and treatment.
A simple orthotic may be proposed by a podiatrist / Medical pedicure; it is a protective shell for onions that reduces friction and pressure. Damping products or gel base are available and play the same role.
Anti-inflammatory drugs relieve during inflammatory and painful flare and sometimes surgery is proposed. The operation tends to realign the toe by acting on the muscles, tendons and joint capsules, or directly on the bone (osteotomy).

How to prepare for my next visit?

In case of painful symptoms and inflammation of the joint, the installation of ice can temporarily relieve, pending such an anti-inflammatory prescription and causal treatment.

Definition of hemochromatosis

The type 1 hemochromatosis is an iron overload in the body by increasing the intestinal absorption of dietary iron. It is an autosomal recessive genetic disease, by mutation of the HFE gene that regulates the digestive transfer of dietary iron.

It is often misunderstood and is revealed mostly belatedly after 40 years first in men. In women, menstruation (menses) limit the expression of the disease until menopause.

It is not present in the black African populations nor the populations of Southeast Asia; but that can change with the global mixing.

Symptoms and health issues of hemochromatosis

The frequency of the disease is estimated in Western and Northern Europe to a patient for 200 or 300 people; it's a lot and uncertain because most patients are unaware that they are achieved. The figures are hypothetical, because of late diagnosis, or not at all when the expression of the disease is low.

However the length and quality of life of untreated patients is reduced because of:

Involvement of the liver first

- Cirrhosis, which can lead to cancer, especially if there are risk co-factors (chronic hepatitis B or C, chronic alcoholism ...)

The achievement of the pancreas in addition to the liver

- Diabetes increased by the usual risk factors (dietary imbalance, physical inactivity)

Involvement of the heart

- Heart failure and arrhythmias

The achievement of the sex glands

- Subfertility and sexual dysfunction (impotence)

The achievement of the skin

- The skin complexion is a metal "bronze" grayish.

Joint involvement

- These disorders are early and often related to its true cause, the source of pain and disability in everyday life.

Causes and mechanisms of hemochromatosis

This autosomal recessive hereditary disease is almost always caused by a mutation of the HFE gene, which produces hepcidin, a hormone regulating the digestive absorption of iron.

A so-called C282Y mutation affects almost 100% of cases and 70 to 95% of European patients. Obvious patients are usually carrying a double mutation C282Y: 6 came on the chromosome of their father and on chromosome 6 came from their mother. They are called homozygous for the mutation.
Holders of a single mutation in one of their two chromosomes 6 are called heterozygous; they have little or no suffering, so even less often diagnosed.

Penetrance of the mutation (expression) is very variable, so its gravity; severe cases are rare in practice.
But as the mutation is common in the general population (5 to 10% of heterozygous mutations), the risk that a man and a woman have children together with is great.

Normally, only 5 to 10% of dietary iron is absorbed from the gastrointestinal tract, or 1 mg / day roughly corresponding to the daily losses (one liter of blood contains 500 mg of iron). Hepcidin limits this iron entrance.

In his absence, the absorption increases freely. Among adolescent women, the menstrual blood flow more or less correct this increase in gastrointestinal absorption. This correction disappears at menopause.

What are the signs of the disease?

The accumulation of iron in the body first saturates the liver which is the natural reserve of iron, then the pancreas.

Iron deposits in joints cause chronic pain.

The muscles are in turn achieved, including the heart muscle. This explains heart failure and chronic fatigue hemochromatosis.

Unfortunately for them, in the absence of correct diagnosis on their prescribed iron and vitamins, including vitamin C, to "get back"; or vitamin C increases the absorption of iron, which is itself in excess. Therefore aggravates poisoning wanting to do well.

One cause paradoxical and known as hemochromatosis is iron supplementation in anemic or blood transfusions from undiagnosed patients.

The disease is labeled in four stages of increasing severity: I, II, III and IV, as the importance of achieving organs: liver, pancreas, heart, sex glands, muscles, joints ...

    In Stage 1, shows no sign of disease, even blood tests are normal. This is the stage of young patients before 15-20 years. Women do not express the disease or rarely before menopause.
    In stage II, the disease is still not visible but the blood abnormalities are present from 20 years. One of the first signs is the painful joint handshake.
    In stage III, blood abnormalities are revealed during a balance sheet to the signs of the disease appear around age 30 in men later in women:
    asthenia (fatigue) chronic joint pain and inflammation, liver cirrhosis, heart disease or sexual dysfunction (impotence).
    Stage IV is the stage where the achievement of various organs is clear and irreversible, usually after 40 years later in women.

With what should we be confused?

    Rheumatic fever as gout or chondrocalcinosis; especially as the joint symptoms of hemochromatosis occur more around 40 years and think rather to the "joint aging" as a former chronic disease.
    The liver damage from alcohol or viral hepatitis may unduly disrupt explorations when the doctor is satisfied with this explanation. Or there may be excessive alcohol and hemochromatosis, given its frequency in the population.
    Take diabetes for hemochromatosis for general overhead while diabetes is an iron overload.

Will it possible prevention of type 1 hemochromatosis?

Because of the frequency of this genetic disease in the population, routine screening is feasible in the population, at birth or later after 40 years when the disease clearly revealed. However, this option was not chosen until now.

It is therefore the opportunity during a family survey around a diagnosed cases.
In heterozygous people, almost not affected, dietary advice may be sufficient to scarce bloodletting.

When to see the doctor?

In case of permanent fatigue and joint pain, and whenever we know or doubt of a close family member that would be achieved.
It is important to make the diagnosis early because the treatment is not effective when the organs are damaged, that is to say, in stage III and IV.

What does the doctor?

It conducts a complete physical examination, seeking joint damage characteristic of hands and liver and heart damage, which are the most urgent to know.

A battery of tests done things in perspective. But only two tests are needed to diagnose the disease in a non-inflammatory context:

    the transferrin saturation, if hemochromatosis is the early stage (I)
    and ferritin levels in the blood (serum ferritin) if the disease is already later stage (II, III or IV).

The definitive diagnosis is made by genotyping the patient and the review of the HFE gene mutation involved. If he confirms the genetic disease, we proceed to a family survey (first degree relatives) with the patient's consent, to know the mutation carriers and provide support after full assessment.

For parents waiting for a child, genotyping of the parents figure the risk of transmission to the child.

Treatment is by regular bloodletting: every three months at least, every week if needed in the beginning. Possibly one resorts to iron chelators to quickly reduce intoxication.

This treatment is only effective before achieving proven organs, particularly the liver cirrhosis. Hence the importance of family to detect treatable patients inquiry quickly and avoid complications.

How to prepare the medical consultation?

By collecting family data to rule out or talk hemochromatosis, on one hand, and blood tests over time if we kept them.

Definition of hemorrhoids

Hemorrhoids (or hemorrhoidal disease) are anal conditions related to dilated veins in (called internal hemorrhoids) or around the anus (called external hemorrhoids).

The expression "having hemorrhoids" is a misnomer since everyone has anatomically hemorrhoids; in case of symptoms, we should speak of "hemorrhoidal crisis." Internal hemorrhoids (deep part of the anus) are purple and are not visible; you need a device (anoscope) to see.

Risks and health issues hemorrhoids

Hemorrhoidal disease is a common condition in adults (one in two people in life), responsible for a large number of medical consultations. The frequency is the same for both sexes, but men seem to complain earlier. This frequency increases with age with a maximum after 70 years. Some risk factors have been identified but remain controversial: alcohol, coffee, obesity ...

Causes and mechanisms of hémarroïdes

Hemorrhoids are vessels normally present at the anus. Anatomically, there are external hemorrhoids and the internal hemorrhoids, deeper.

The cause of the haemorrhoidal expansion is still unclear. Hemorrhoids often appear to support an increase in abdominal pressure (constipation ...) which interferes with venous return and lead to venous dilatation. In fact, several factors are probably involved as a relaxation of the supporting tissues related to age and / or encouraging terrain.

Symptoms and signs of hemorrhoids

The output of hemorrhoids outside the anus causes symptoms of discomfort, itching, pain and bleeding rectal called. Such bleeding are related to the erosion hemorrhoidal packets; blood is red, occurring at the end of defecation (he tries toilet paper, splashes bowl ...).

A possible complication is the local formation of a clot causing an external hemorrhoidal thrombosis most often. One then notes a bluish swelling with a more or less intense pain until elimination of the blood clot.
The other complication is related to the loss of blood and iron, which can in extreme cases lead to an iron deficiency anemia (iron deficiency).

With what should we be confused?

Rectal bleeding should not always be attributed to hemorrhoids. Other diseases such as tumors must be removed first before bleeding.

Moreover, anal fissure, ulceration thermometer, inflammatory bowel disease (colitis, proctitis ...) can also give bleeding and pain. Their treatments are specific.

Will it possible prevention?

There are no preventive measures to avoid completely the hemorrhoidal attacks. Local hygiene, without excess, and physical activity to fight against physical inactivity are recommended.

The fight against constipation is an axis of treatment with use of mucilage and / or increasing the daily intake of dietary fiber. Foods to eat are whole wheat bread, fresh fruits and vegetables, legumes (lentils, split peas), grains (oats, bran, wheat).

Alcohol and spices are good contributing factors as well as prolonged sitting: When is prone to hemorrhoids, it is best to avoid them.

The ointment application can also relieve symptoms.

When to consult?

The occurrence of bleeding from the anus should lead to a medical consultation urgently to eliminate gastrointestinal bleeding and / or tumor. If necessary, an exploration through a colonoscopy will list possible causes and to take samples.

What is the doctor?

The doctor makes the diagnosis by questioning and clinical examination. The latter includes an examination of the anus and, if possible, a digital rectal examination.

The doctor may refer you to a specialist colleague (proctologist, gastroenterologist) for additional tests: Anoscopy explores the anus, proctosigmoidoscopy back in the digestive tract (rectum, sigmoid) and colonoscopy shows almost full. A blood test may help verify the absence of anemia.

The proposed treatments for hemorrhoids are of three types: medical, surgical and instrumental. The effectiveness of drugs is controversial veinotonic; correction of bowel dysfunction (fight against constipation or diarrhea), however, is unanimously recognized.

The drugs against pain (analgesics) are effective on pain of internal and external hemorrhoidal thrombosis, as well as nonsteroidal anti-inflammatory.

Instrumental techniques (coagulation) are reserved for surgical or medical treatment failures.
If thrombosis, incision under local anesthesia relieves symptoms.

How to prepare my next appointment?

Identify triggers or relieve seizures allows to establish appropriate therapeutic strategies. Furthermore, hemorrhoids can manifest as prolapse (externalization) Intermittent: note the frequency of prolapse.

Definition of toxic hepatitis

Toxic hepatitis, like all hepatitis, means any inflammatory disease of the liver. Toxic hepatitis is related to drugs, alcohol consumption or toxic products or food (plants, mushrooms ...). Some exposure to solvents or other substances may occur in the workplace and also cause acute or chronic hepatitis of toxic origin.
Hepatitis toxic, such as viral hepatitis can progress to fulminant form and death.

Risks and challenges of toxic hepatitis

Alcohol is the # 1 cause of toxic hepatitis. One of the most common causes also toxic hepatitis is drug-induced hepatitis with about 1,000 drugs known to be potentially hepatotoxic. The toxicity depends on several factors such as genetics, diet, age ... Certain medications are only revealed toxic to the liver after they are placed on the market; some have been withdrawn due to the frequency and severity of this side effect.

Toxic hepatitis occurring in the workplace are part of the framework of occupational diseases; the most dangerous products have been replaced by less toxic products. However, vigilance is needed to reintroduce new substances.

Causes and Symptoms of toxic hepatitis

Whatever the mechanism involved, severe hepatitis can lead to liver destruction and unless liver transplantation, death.
The product absorbed, inhaled or ingested, can be toxic by itself or its metabolites in the body after conversion. Moreover, some products can cause hepatitis in an individual and not in another, we speak of interindividual variability.
Among the implicated drugs include acetaminophen, which can cause injury from 6-8 g that can become irreversible or death beyond 12 g.
Alongside these drug-induced hepatitis, toxic hepatitis related to fungi like Amanita phalloides. This releases a poisonous mushroom liver damage toxin responsible; its mortality is 15%.

How manifest toxic hepatitis?
Acute hepatitis, toxic or not, manifested by nonspecific symptoms of the cause, but may first be asymptomatic. Otherwise, fatigue, nausea, abdominal pain (under the right ribs in the liver) dominate. The appearance of dark urine and jaundice is characteristic of hepatitis. Very severe cases may even lead to liver transplant exist: it is fulminant hepatitis with rapid destruction of the liver.

Unlike viral hepatitis there are no signs of infection, and toxic cause is strongly suspected in the concomitant symptoms with the consumption of a drug or a fungus. The time to onset of symptoms is also variable: a few hours for fungi up to several days for toxic drugs or other.

Phalloïdien The syndrome is characteristic of poisoning by mushrooms (Amanita phalloides, Amanita Verna, Amanita virosa ...). Symptoms include diarrhea and dehydration in benign forms and an array of sometimes severe acute hepatitis with confusion, bleeding ...

With what should we be confused?

Toxic hepatitis should not be confused with viral hepatitis, which are viral infections. In addition, any symptoms occur after taking the drug or fungus is not synonymous with hepatitis. Allergies, gastroenteritis or simple mundane intoxications are fortunately more common than liver disease. The doctor will make a difference in particular based on blood tests.

Will it possible prevention?

Toxic hepatitis is associated with exposure to a toxic, the best prevention is the non-exposure to this toxic. The alcoholic abstinence is therefore essential; at least, consumption should be moderate.

Strict adherence to drug regimens can prevent drug-induced hepatitis dose-dependent.

For mushrooms, it is better not to consume those collected without being sure of their safety. Your pharmacist can help you in this regard, provided picking mushrooms in their entirety (foot base). Avoid storing them in plastic bags (rotting), separate the poisonous mushroom species that does not come contaminate edible, eat in moderation and any uncertainty, do not consume.

When to consult?

If symptoms following ingestion of mushrooms, it is imperative to consult quickly. Life support measures are sometimes necessary. Similarly, in case of accidental or intentional overdose drug, call the SAMU Centre 15, itself interconnected with the Poison Control Center, is imperative.

What is the doctor?

Besides the usual clinical examination and screening for signs of gravity requiring immediate hospitalization, the doctor will try to reconstruct the history of the disease symptoms to relate to taking medication or exposure to toxic (taking of alcohol for example). For this, the questioning is fundamental, the temporal relationship between the onset of signs and also taken.

Blood samples are generally prescribed to confirm hepatitis (transaminase elevation), judge its severity (impact on coagulation in particular) and rule out other causes, particularly for viral serology.

The first therapeutic measure is of course to stop taking the medication or exposure to toxic. Then symptomatic measures up to resuscitation will be taken. The monitoring is based on control of liver function and coagulation; sometimes the liver damage is such that only a liver transplant patient saves it.

How to prepare my next appointment?

The examination is an important step in diagnosis. Try to remember the absorbed drugs, plants or consumed mushrooms and potential contact with toxic in the last six months before the symptoms. This will help your doctor; well, tell her if others around you, family or professional, have the same problems.

Definition of viral hepatitis

Viral hepatitis is an infection that mainly affects the liver and causing inflammatory lesions.

Six viruses cause hepatitis: viruses A, B, C, D, E and G. There is talk of hepatitis "acute" during the invasion phase of the organism by the virus; we speak of "chronic" hepatitis as the disease persists beyond six months after infection. Hepatitis B, C and D can become chronic hepatitis, which makes dangerousness.

Risks and health challenges of viral hepatitis

The three most common viral hepatitis are Hepatitis A, B and C. Hepatitis A is usually mild and heal in 10 to 15 days. However, hepatitis B and C are more serious as they can become chronic and develop into cirrhosis and liver cancer.
280,000 people (0.65% of the adult population) are chronic carriers of hepatitis B. For hepatitis C, 180 million people are infected with the virus worldwide, of which 500 000 a 650 000.

Causes and Symptoms of viral hepatitis

Hepatitis is transmitted by viruses. The hepatitis A virus (HAV) is transmitted through the digestive tract (fecal-oral) and primarily affects young adult or child. It is eliminated by the stool and do not persist chronically in the body.
Viral hepatitis B is consecutive in turn to infection by the hepatitis B virus (HBV); its transmission is through contact with bodily fluids of infected persons (unprotected sex, prick or cut with blood transmission during pregnancy ...).

The infection heals spontaneously in most cases but can sometimes remain in the body: People are then carry the virus without showing symptoms, while others have a progressive chronic hepatitis.

The Hepatitis C virus (HCV) is transmitted by blood, primarily by use of intravenous drugs. Spontaneous cure of hepatitis C is rare (20% of cases) and the infection becomes chronic in most patients.

How manifest viral hepatitis?

Acute hepatitis manifested by symptoms that are common to all hepatitis. They may first be asymptomatic; their diagnosis will be made after the event on serology. Otherwise fatigue, nausea, abdominal pain (under the right ribs in the liver) dominate. The appearance of dark urine and jaundice are characteristic of hepatitis. Very severe cases may even lead to liver transplant exist: it is fulminant hepatitis with rapid destruction of the liver.
In hepatitis A, the illness resolves spontaneously without the risk of chronicity. In hepatitis B and C, the change can be made to chronicity that will be diagnosed by blood tests. Cirrhosis and liver cancer are then two formidable complications.

With what should we be confused?

It initially be confused hepatitis viruses among themselves. Hepatitis A is a mild disease which does not have the risk of becoming chronic.
All hepatitis are not infectious and viral; certain liver injury has a drug issue, alcoholic or immune.
Finally, it should not be confused jaundice and hepatitis. Jaundice reflects the poor liver function. Other diseases are responsible as gallstones, Gilbert's disease (hereditary anomaly) or anemia.

Will it possible prevention?

Prevention is essential and differs between the relevant virus.
For hepatitis A, it is based primarily on hygiene: hand washing, food washing, not sharing cutlery and utensils ... A vaccination is recommended for the traveler who had no history of hepatitis A (unimmunized) and traveling in heavily contaminated areas.

For hepatitis B, the preventive measures are many. The condom use is essential during sex with a partner or unknown HIV status; gloves for health professionals is essential. Screening for hepatitis B is also mandatory in case of pregnancy or when giving blood.
Vaccination is widely proposed, for professional or non-professional. Only a history of neurological disease like multiple sclerosis indicate that vaccination-against.

Hepatitis C finally the sharing of injection equipment among drug users is prohibited. The posttransfusionnelles contamination have now become exceptional because all blood donations are screened and treated.

When to consult?

Any fatigue, jaundice or unexplained persistent symptoms should motivate a medical consultation to make a diagnosis. Some forms of hepatitis may represent genuine emergencies: the liver is destroyed and can not perform its functions. Coagulation disorders and impaired consciousness (encephalopathy) lead to death within hours if no treatment is established.
Screening for hepatitis B and C, even in the absence of symptoms, is in any way significant.

What is the doctor?

The doctor can only suspect hepatitis. It will look for arguments in favor of a mode of transmission (drug use, sex ...) The clinical examination is not specific for hepatitis. In case of abdominal pain, palpation find a pain in the right upper quadrant abdomen; haemorrhagic signs are detected and are a sign of seriousness.

The diagnosis is often made after a blood test reveals elevated liver enzymes, transaminases (up to 20 to 40 times normal). Coagulation is also tested and can be collapsed in severe hepatitis. The key consideration is the serology of hepatitis. Antibodies against viruses A, B and C are most often requested. These antibodies require a delay before they appear; several blood tests are sometimes necessary.

In cases of hepatitis A, no further action is usually required. However, in the case of hepatitis B or C, regular blood tests or examinations as the liver biopsy will be proposed to ensure that hepatitis does not become chronic and active. In this case, the treatments involved in interferon as antiviral for example.

How to prepare my next appointment?

Even in the absence of symptoms after acute hepatitis B or C, it is essential to respect the prescribed blood tests. Only early detection and treatment will prevent the dreaded complications.

Definition of herniated disc

The herniated disc is an anatomical mechanism. Herniated disk in fact corresponds to the output of the disc located between the vertebrae of the spine.

Protruding outside its casing, the disc can compress the nerve roots and trigger eg vector sciatica. Thus, the herniated disc is often less known than its main symptom of sciatica.

All regions of the back can be involved, but the lumbar region (lower back) is widely the most affected.

Origins of herniated disks

Disc herniation is common in young subjects between 30 and 40 years.

Some postures like sitting position (drivers ...) or carrying heavy loads (snap-action, wrong move ...) favor herniated discs.

The age or trauma also accelerate aging of the disc and hernia.
Some risk factors are also identified to promote herniated disc: This is overweight and pregnancy. Genetic predisposition may also exist in some families; herniated discs while generally occur earlier than in the general population.

Causes and mechanisms of a herniated disc

The spine or vertebral spine is formed of a stack of vertebrae separated by intervertebral discs.

In case of overweight, improper movement or simply degeneration, this gelatinous disc can deform and break its protective bag. It then projects and forms the herniated disc.

A herniated disc can be asymptomatic if it compresses any nerve.
On the contrary, it can cause inflammation and pain if it compresses certain nerve roots (sciatica or femoral).

Symptoms and signs of a herniated disc
A herniated disc can long remain asymptomatic and cause no discomfort. In favor of a motion or time, it may be in pain, simple backache to the paralyzing sciatica.

These symptoms can appear suddenly and disappear or persist chronically.
Some triggers are often found, such as coughing, laughing or sneezing by increased abdominal pressure or forward leaning position.

The most common disc herniations are located in the lower back, with back pain and leg. The simple "back pain" is called low back pain, while pain that goes down the leg below the knee and is called sciatica or femoral neuralgia according to the compressed nerve root.

The sciatica associates for its pain with lumbar spine pain (irradiation) in a leg.

Herniated discs are possible in the cervical spine (neck area) and then cause arm pain spreading to the fingers.

With what should we be confused herniated discs?
It initially not confuse the word "hiatal hernia" and "herniated disc".

Hiatal hernia is a digestive disease which corresponds to the passage of a portion of the stomach above the diaphragm.

Furthermore, the pains of sciatica or back pain should not be confused with pain caused by another disease such as renal colic. Renal colic (kidney stones) also causes pain starting from the lower back and radiating to the front (towards the external genitalia).

Conducting a dipstick (or urinalysis) will usually very quickly diagnosis.

Will it possible to prevent slipped discs?
Simple lifestyle tips to prevent or limit the consequences of a protrusion or herniated disc.

This is to exercise regularly, to warm up before starting an effort to maintain and ensure a satisfactory abdominal and dorsal (support the spine).

Overweight should be avoided as much as possible by a balanced diet.
Gestures and postures are fundamental steps of prevention:

straight back, straight look, squat by bending the knees to lift a load, rest periods to stretch and stretch when sitting, straight-backed chairs and if possible swivel to avoid torsion.

The backpacks port is preferred to handbags and high heels (above 5 cm) are not recommended.

In addition to these tips and if proven herniated disc, you should not look too far forward or to make efforts (charging port ...).

Some simple exercises improve symptoms (on the back, bring knees to chest ...): consult your doctor.

Weight loss will also be beneficial.

When to consult?
In case of pain in the back or sciatic pain, signs must be warning signs and motivate emergency consultation.

This is the loss of strength (motor deficit) in one leg or paralysis (inability to take off the foot), difficulty urinating or bowel movement or otherwise of incontinence.
This is called medical emergencies which can sometimes require surgery to decompress the nerve roots crushed by the herniated disk.
Similarly, the unbearable pain despite treatment constitutes an emergency.

What is the doctor?
The doctor looks for certain signs suggestive of the original disc pain: increased cough, pain in the leg elevation (Lasegue), pain in the leg pressure between two vertebrae ...

The examination will specify the triggering circumstances (effort, wrong moves ...) and a complete neurological examination eliminate paralysis or complication.

Additional tests such as radiography of the spine or lumbar spine CT (or a magnetic resonance imaging or MRI) may be prescribed and confirm the presence of disc herniation (conflict between the disc and the nerve root). They are not systematic in front of a classic sciatica.

Treatment aims to relieve pain by non-steroidal anti-inflammatory drugs, drugs against pain and muscle relaxants. The local injection of anti-inflammatory corticosteroid is also possible in case of failure of the first treatment.

Strict bed rest is usually offered for one or two days maximum, as it promotes muscle weakening back.

The prescription of physical therapy is also beneficial, especially to prevent recurrences.
Lumbar restraint belts are useful and help to keep activity during treatment.
Radical treatment is offered in second-line in case of failure of medical treatment. Two techniques are possible: surgically remove the disc or dissolve.

How to prepare my next appointment?
It is desirable to distinguish circumstances or movements that trigger pain. In fact, your doctor or physical therapist can offer the amenities of position or posture.

At work, the occupational physician can also help you in terms of ergonomics.

Definition of genital herpes

Genital herpes is a sexually transmitted disease or STD that is transmitted during vaginal sex, anal or buccogénital. Genital herpes is caused by viruses called herpes simplex virus (HSV) in which there are two types (HSV1 and HSV2). This virus affects the mucous membranes and skin, causing mostly benign manifestations. Some forms of herpes can be severe and widespread in frail patients (newborns, pregnant women, immunocompromised). Once the virus contracted genital herpes, there is life in the body and symptoms may appear periodically: this is called "herpes outbreaks."

Risks and consequences of genital herpes

Genital herpes now affects 2 million people in France. The impact on the sexual life and quality of life can be important when extensive or frequent recurrences (four to five outbreaks a year). In addition, herpes lesions favor the transmission of other sexually transmitted diseases. The health challenge is to minimize the transmission of genital herpes.

Women are the first victims of genital herpes which 60-80% of cases are related to the HSV2 virus.

Symptoms and origins of genital herpes

The development of genital herpes requires two phases:

The primary herpetic infection phase

This phase infects cells of the skin or mucosa after sexual contact, for example. The virus replicates and infects other cells.

The reactivation phase or recurrence

The virus can remain dormant for many years and reactivate with more or less significant symptoms (burning, itching, lesions ...).

Two types of virus are involved, but HSV2 is usually responsible for genital herpes, while HSV-1 is found in the herpes labialis infections or "cold sore".

What are the symptoms of genital herpes?

The symptoms of genital herpes vary from one person to another. The primary infection may be asymptomatic (no symptoms) or be accompanied by signs such as pain or itching before the appearance of lesions. Lesions are in the region of the vagina, anus or penis and begin with a rash with vesicles (small transparent bubbles).

Subsequent outbreaks occur at varying rates but can be disabling. The symptoms are the same as those of the initial thrust and last 7 to 10 days. A tingling sensation may precede the rash.

With what he does not confuse genital herpes?

The cold sore or fever blister is associated with a virus from the same family, the HSV1. However, both viruses can indifferently achieve the genitals (genital herpes) and the face (herpes labialis). Thus, a patient with a cold sore may well infect her partner during a buccogénital sex.
Other causes of genital ulcers or lesions require medical care: any genital lesion so requires consultation and diagnosis (syphilis, HPV ...).

Does it possible to prevent genital herpes?

The only prevention is to avoid transmission of the virus. We must therefore abstain from genital sex, anal or oral sex with someone who has lesions, as they are not completely healed. Condom use does not completely protect the transmission of the virus (all contaminating areas are not covered). There is no vaccine against the virus of genital herpes.

If herpes outbreak with lesions and blisters, some steps may decrease or relieve symptoms: dry the affected areas, wear loose clothing, avoid touching the lesions and hand washing in all cases, not apply ointments without medical advice ...

When to consult?

Herpesvirus infections may be symptom-free or discreet: only a routine screening will put in evidence.
In general, any occurrence of genital warts or lesions should motivate a consultation with a doctor or dermatologist.

What does the doctor?

If lesions (primary infection or recurrence), the doctor can visually establish a presumptive diagnosis. When in doubt or confirm the diagnosis, blood tests and / or removal of lesions or vesicles with a swab, used to verify the presence of HSV1 or HSV2.

No treatment cure herpes, but antiviral drugs (local and systemic) can accelerate the cure of a herpes outbreak in some patients. The doctor will decide whether to prescribe or during a flare, long-term, prevention of relapses in patients with frequent recurrences and disabling.
The physician's role is also to support the pain, evaluating the triggering factors or circumstances suggest a psychological care if necessary and then recommend measures to reduce transmission (condom use during flare-ups in particular).

How to prepare my next appointment?

Definition of herpes labialis

Herpes labialis is also called cold sore. This is the most common form of the herpes. It is caused by a virus (Herpes simplex virus type 1 or HSV-1) and is characterized by lesions of the oral region, preceded burns. Certain circumstances (fever, stress, fatigue ...) trigger recurrence and outbreaks of cold sores because the virus, once in the body, stays there for life.

Risks and consequences of herpes labialis

The forms of cold sores affecting the mouth and face are the most common, with infection typically occurring in childhood or in young adults. Between the ages of 20 and 40 years, 40-60% of the population would infected with HSV1. The HSV1 is responsible for a significant share of herpes especially among women. One of the major risks is the primary infection, that is to say the genital HSV1 infection during pregnancy, with consequences Infectious dramatic in newborns.

Causes and mechanisms of cold sores

The development of herpes labialis requires two phases:

Herpes primary infection phase

The primary herpetic infection phase infects cells of the skin or mucosa after direct contact with lesions (vesicles) shedding of the virus; This excretion is maximum in the first hours of vesicle formation. Excretion occurs at the time of primary infection, extensive

A phase reactivation or recurrence

There are also equally contaminating asymptomatic shedding. The virus multiplies and infects other cells. It can lie dormant for many years and reactivate with more or less significant symptoms (burning, itching, lesions ...).

Two types of virus are involved, but HSV1 is most often responsible for cold sores.

Symptoms of cold sores

Primary infection is rarely spotted, symptoms occurring most often in childhood or in young adults. It occurs a few days after contact with a person carrying the virus excretory lesions. Sometimes this primary infection is symptomatic and is manifested by a lesion in the lips accompanied by fever, swollen glands (pain, diet discomfort) or flu symptoms. Symptoms, including the feeding difficulty, must be taken seriously in children because they expose to dehydration.

Recurrences or cold sore outbreaks occur during many triggers fever, sun exposure, fatigue, rules, stress ...
The cold sore then manifested by the appearance of vesicles in clusters, often preceded by localized burning or itching on the outer edge of a lip. The cold sore can also affect the nose, chin or expand in the region of the mouth.

With what he does not confuse cold sores?

Scratching damage may cause similar superinfection impetigo (contagious infection of the skin). The lesions can then expand and autoentretenir with scabs and pus.

In case of persistent injury beyond a few days (7-10 days), medical consultation (attending physician or dermatologist) is required.

Does it possible to prevent cold sores?

Initial infection with HSV1 is most often during childhood, making it difficult to prevent contamination. It is nevertheless necessary to avoid kissing someone who has a cold sore and avoid using objects in direct contact with saliva or mouth.

Once contaminated, simple measures can limit outbreaks, avoid contamination or autocontamination and reduce symptoms.

Some circumstances favor outbreaks such as fever, stress, fatigue, alcohol, sun exposure (UV) or cold.
In return period, avoid direct contact between the vesicles and others (kisses), including those at risk such as infants, pregnant women and anyone with immune deficiency or atopic dermatitis (risk of serious complication). To avoid autocontamination, do not touch the blisters, do not rub your eyes or moisten the lenses with the saliva; it must instead wash hands regularly.

Applying an ice cube on the cold sore reduces the burning sensation or itching. Furthermore, the antiviral creams available in pharmacies are to be implemented at the first symptoms before the blisters appear.

When to consult?

Herpesvirus infections may be symptom-free or discreet: only a routine screening will put in evidence.
Cold sores are common and only a serious primary infection (infants, pregnant women, immunocompromised ...) is a therapeutic emergency.

What does the doctor?

If lesions (primary infection or recurrence), the doctor can visually establish a presumptive diagnosis. When in doubt or confirm the diagnosis, a blood test and / or a sampling of blisters or lesions with a swab, used to verify the presence of the virus. This diagnosis Direct virological is recommended that in case of damage atypical or before complications.

No treatment cure herpes, but antiviral drugs (local and systemic) can accelerate the cure of a herpes outbreak in some patients. The doctor or pharmacist will judge the appropriateness of prescribing during a flare or even long-term, prevention with frequent recurrences and disabling.

How to prepare my next appointment?

Do not hesitate to prepare a list of questions to avoid forgetting the D-Day Note the number of outbreaks and contributing factors: your doctor may help you and sometimes prescribe antivirals preventively.

Definition of hypertension

High blood pressure (or hypertension) is defined by the elevation of the pressure exerted by the blood on the walls of arteries. This blood pressure is characterized by two numbers (eg 130/70), the first (maximum) corresponding to contemporary pressure of cardiac contraction (systolic) and the second (minimum) is the heart relaxation in pressure between beats 2 ( diastolic). The unit of measurement is millimeters of mercury (mmHg) (or sometimes mercury cm: 140/70 mmHg = 14/7 cm Hg).

Hypertension is defined by numbers of higher blood pressure 140/90 mmHg or equal measured lying after several minutes of rest repeatedly by a cuff placed around the arm and connected to a mechanical or electronic manometer.

Risks and Complications of Hypertension

In the short term, sudden high blood pressure may be responsible for acute pain organs such as the brain (Stroke, hypertensive encephalitis), kidney (acute renal failure) or the heart (heart failure, acute coronary insufficiency ).

However most of the consequences of high blood pressure are long-term, linked to changes for several years at low noise of hypertension unsupported. The blood pressure will be liable for damages on all the arteries of the body by stiffening and onset or worsening of atherosclerosis.

This is particularly true for brain arteries (responsible stroke brain stroke), heart (responsible for myocardial infarction and heart failure), and kidney (causing chronic renal failure), but all arteries are affected including the legs (peripheral arterial disease). The achievement of all of the arteries and the heart is called cardiovascular disease is the second cause of death with 150 000 deaths per year (2011) after cancer.

The consequences of high blood pressure are all the more rapid and severe that it is significant (higher numbers) and that it is associated with other cardiovascular risk factors such as diabetes, high cholesterol ( LDL), smoking, obesity and lack of physical exercise. Age, male gender and personal and family history of cardiovascular disease are also risk factors.

The causes of high blood pressure

In the vast majority of cases, high blood pressure is called "essential" that is to say that no cause is found. However, several risk factors for arterial hypertension are known as overweight, lack of physical activity or diet, particularly excess salt and diabetes mellitus.

In about 10% of cases, hypertension may be secondary to another disease. It may be a kidney disease and / renal artery (stenosis), adrenal or hormonal diseases.
Exceptionally high blood pressure may be linked to a single genetic mutation family.

Symptoms of high blood pressure

Hypertension is often "silent" that is to say, it is not accompanied by any symptoms. Thus more than half of adults with hypertension do not know. This is a serious factor because during the time that high blood pressure develops, it continues its deleterious effects on the arteries and heart.

When hypertension is severe and / or sudden, it may be accompanied by headache, nausea with or without vomiting, nosebleed. Black spots or white flashes can occur in vision.
The reference method for measuring blood pressure is taken after several minutes of rest, lying down, taking the armband, the 2 arms. Currently the electronic measurement is favored at home and in the office, preferably with an arm device validated rather than wrist (SFHTA 2011). Several successive measurements of blood pressure are necessary for diagnosis of hypertension.

Blood pressure varies throughout the day, it may be useful to obtain a measure covering a wider time so as to better reflect the stresses exerted on the arteries. For this, it is possible to achieve a measure of blood pressure over 24 hours (Holter blood pressure) or standardized way several times a day (MAPA: Automated Measurement of Blood Pressure).

With what does he not be confused with high blood pressure?
Blood pressure may exceed the limit of 140/90 mm of mercury from time to time, for example because of the emotion that causes the consultation (high blood pressure so-called "white coat"). To make sense of things, the doctor may ask the patient to take his blood pressure at home, thanks to a self-measurement electronic device.

In hypertension "white coat", blood pressure falls below 135/85 mmHg at home. A home is recommended, sitting, three measurements in the morning at breakfast, three measurements in the evening before bedtime, three days in a row (rule 3). The measurements are spaced a few minutes (2011 recommendations of the Society of Hypertension).

It may overestimate blood pressure in obese people. We must then verify with a suitable cuff.
Finally, the equipment check (blood pressure) is necessary because calibration is rarely regularly from the manufacturer. With possibly resulting in a breach of hypertension or an unfounded alert.

Are there possible prevention of hypertension?

Yes. It is to act on the factors that can be modified, that is to say, the healthy lifestyle: eat more balanced, limit salt intake, fat and alcohol, engage in an activity regular physical, weight control, stop smoking.

These good habits are essential for those who have a genetic predisposition to hypertension, that is to say, those whose father and / or mother have high blood pressure, especially if she appeared before the age of 50 years

When to consult?

Given the usual lack of symptoms of hypertension, it should be systematically search each medical and regularly after 50 years.
In the presence of the symptoms mentioned above, it is necessary to consult promptly their physician to develop a rapid and appropriate treatment.

What is the doctor?
The first "treatment" of arterial hypertension is that of the management of hypertension risk factors. This includes moderate in salt consumption, no smoking, a diet low in fat, regular physical activity and diabetes control if necessary.

The application of these rules before the onset of high blood pressure can prevent or delay the HTA.
If these lifestyle and dietary rules are insufficient, it is necessary to use antihypertensive therapy. Several classes of antihypertensive medications exist. These classes should be mentioned diuretics that help eliminate salt by action on the kidneys, beta blockers that slow heart rate, calcium channel blockers that increase the caliber of the arteries, and IEC ARA2 blocking a system increasing blood pressure and finally the central antihypertensives playing on the dilation of blood vessels.
These classes can be combined to get a better blood pressure control.

Hypertension: essential
- Chronic disease very common and frequency increases with age
- Purveyor of serious cardiovascular disease complications: stroke, heart attack, heart and kidney failure, ...
- Cardiovascular disease = 2nd cause of death (150,000 / year)
- Silent disease, often goes unnoticed: the importance of routine screening
- Risk factors and progression of hypertension: Smoking, diabetes mellitus, excessive salt intake, high cholesterol, lack of exercise, overweight
- No cause found in most cases: essential hypertension.
- Treatment: involves correcting +++ risk factors and if insufficient antihypertensive treatment.
- The importance of prevention of hypertension: management of risk factors prior to the onset of hypertension
- Antihypertensive: several classes of drugs that can be combined to achieve proper blood pressure control.
- Voltage Monitoring is essential: in the office and at home with a self-measurement.

Zika virus disease

key facts

The Zika virus disease is caused by a virus transmitted primarily by Aedes mosquitoes.
Affected individuals may have a mild fever, rash (rash), conjunctivitis, muscle and joint pain, malaise or headache. These symptoms usually disappear within 2 to 7 days.
A scientific consensus has to say that Zika virus is causing cases of microcephaly and Guillain-Barre syndrome. Links with other neurological complications are being investigated.

Introduction

Zika virus is a flavivirus transmitted by mosquitoes and was first identified in Uganda in 1947 in monkeys, through a monitoring network of jungle yellow fever. It was then identified in humans in 1952 in Uganda and the United Republic of Tanzania. Zika virus disease outbreaks have been recorded in Africa, the Americas, Asia and the Pacific.
From the 1960s to 1980, human infections have been observed in Africa and Asia, accompanied usually mild symptoms. The first major outbreak of Zika virus disease was notified on the island of Yap (FSM) in 2007. In July 2015, Brazil reported a link between Zika virus infection and Guillain syndrome Closed off. In October 2015, he also noted the link with microcephaly.

Signs and symptoms

We do not know very well the incubation period (the time from exposure to onset of symptoms), but is probably a few days. The symptoms resemble those of other arboviruses such as dengue and include fever, rash, conjunctivitis, muscle and joint pain, malaise and headache. They are generally mild and disappear within 2-7 days.

Complications of Zika virus disease

After a comprehensive review of available data, a scientific consensus has to say that Zika virus is the cause of microcephaly and cases of Guillain-Barré syndrome. Intense efforts are continuing to study, within a framework of rigorous research, the link between this virus and a number of neurological disorders.

Transmission

Zika virus is transmitted to humans by the bite of an infected Aedes mosquito, primarily Aedes aegypti, in the tropics. These mosquitoes bite during the day in general, with a peak of activity in the early morning and in late afternoon and early evening.
These mosquitoes also transmit dengue, chikungunya and yellow fever. Zika virus transmission through sex is also possible. We are currently investigating other routes of transmission, blood transfusions, for example.

Diagnostic

One suspects the Zika virus infection based on the symptoms and recent travel history (eg the fact of living in an area where we know that the virus is present or for going there). Diagnosis can be confirmed by laboratory analysis of blood or other body fluids, such as urine, saliva or semen.

Treatment

The Zika virus disease is usually relatively mild and requires no specific treatment. Affected individuals need much rest, drink enough and take common drugs against pain and fever. If symptoms worsen, they should visit a doctor. There is currently no vaccine.

Prevention

Mosquito bites

Protection against mosquito bites is an essential measure for the prevention of Zika virus infection.
To achieve this, we can apply repellents, wear clothing (preferably light colored) covering as much as possible the body, install physical barriers such as insect screens, close doors and windows, sleeping under mosquito nets, and using repellents containing DEET, IR3535 or the icaridin following the instructions on the product label.
Particular attention should be paid to those who may not be able to protect themselves effectively, such as young children, the sick or the elderly. Travelers and people living in affected areas should take basic precautions described above to protect themselves from mosquitoes
It is also important to empty or clean all potential breeding (nesting) mosquitoes as buckets, cans, flower pots, gutters or old tires. Communities need to support the efforts of local authorities to reduce mosquito density in their locality. Health authorities can also advise to make insecticide sprays.

sexual transmission

Zika virus can be transmitted through sexual intercourse. It is a worrying fact because of the association between Zika virus infection and adverse pregnancy outcomes or adverse fetal outcomes.
In active transmission areas of Zika virus, everyone infected with HIV and their sexual partners (especially pregnant women) should be informed of the risks of sexual transmission.
WHO recommends properly advise men and sexually active women and give them access to a full range of contraceptive methods so that they can make an informed choice about whether to conceive a child and when to do it, to avoid any adverse pregnancy outcome or adverse fetal outcomes.
Women who have had unprotected sex and do not want to get pregnant for fear of Zika virus infection must have easy access to emergency contraception and counseling services associated. Pregnant women should practice safer sex (including through the correct use and consistent condom) or abstain from any report for at least the duration of their pregnancy.
In areas without active transmission Zika, WHO recommends that men and women who traveled in areas of active transmission of having safe sex or abstain from any report for 6 months to avoid spread infection through sexual intercourse. Sexual partners of pregnant women who live or have traveled to areas where the Zika virus spreads locally must have safe sex or abstain from any report throughout pregnancy.

WHO action

WHO helps countries to stem the Zika virus disease by applying the measures outlined in the Strategic Response Framework:

define the necessary research on the Zika virus disease and establish a priority on bringing together experts and partners;
strengthen surveillance of Zika virus and potential complications;
strengthen communication skills concerning risks to engage communities to better understand the risks associated with the Zika virus;
strengthen the capacity of laboratories to detect the virus;
help health authorities to implement vector control strategies to reduce populations of Aedes mosquitoes;
prepare recommendations for clinical care and monitoring of people with complications Zika virus, in collaboration with experts and other organizations working in the health field.

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for bigger breasts and firmer

One of the parts of the body of a woman who greatly influenced the passing of time, is undoubtedly the breast. Many think that augmentation is the only solution to counter this natural process, but it is not so. With SenUp, you can once again get an enviable cleavage in a short time and without any surgery. We discover the features of this product.

There are many firming creams in circulation. This is because its formula has been made in cutting edge laboratories, scientists from experts in the field who have selected the best ingredients present in nature and mixed to obtain a product effective and quality.

Which are extremely rich in a group of substances called phytoestrogens. Phytoestrogens are substances of plant origin, with a molecular structure very similar to that of the sex hormones, normally produced by the body female.

Phytoestrogens through the skin and penetrate deep, favoring the increase in size of the mammary glands (the corpuscles that, at the end of a pregnancy, are in charge of producing breast milk). In this way, the breast begins to naturally increase volume.

At the same time, slow down skin cell aging, immediately back toned, elastic and resistant. So the breast, as well as becoming bigger, looks more firm, full and harmonious.

How does it work

In a few weeks, it increases the volume of the breast (even two sizes), improves the shape and texture, and helps to rejuvenate the skin and to eliminate all imperfections on it (like spots and stretch marks).
Basically, you can get a bigger breasts and harmonious, in a few perfect words. The fact that this is possible without resorting to surgery can create some skepticism but this product has been tested in depth (with experiments on human beings), and research has proven beyond any doubt its effectiveness.

To be more precise, the vast majority of women who have undergone the tests (95%, a rate unprecedented) said he was satisfied with the results and have obtained the breast he had always wanted.

We analyze in detail the ingredients.

Fennel seeds
Fennel seeds help to increase the volume of the breast, stimulating the production of estrogen by the body. The estrogens cause the increase in volume of the mammary glands.
Aniseed
The aniseed help the blood to circulate better under the skin. For this reason, they favor the oxygenation of tissues and the arrival of nutrients to the cells (all slowing down the aging process).
hay greek
The greek hay contains large amounts of phytoestrogens, which perform the same action of estrogen produced naturally by the body of a woman and help to increase breast volume.
Pueraria mirifica
Pueraria mirifica is extremely rich in estradiol, a very powerful phytoestrogen, which helps to firm the breasts and make it rounder and voluminous.
Wheat germ oil
The wheat germ oil contains nutrients that regenerate the skin and keep it moisturized. Moreover, it is rich in antioxidants and, therefore, counteracts the action of free radicals (which cause damage to the skin and accelerate the aging).
Jojoba oil
Jojoba oil is an excellent moisturizer for the skin. By adjusting the water balance, it improves skin texture and helps to eliminate stretch marks.
Vitamin E
Vitamin E is one of the most important ingredients to keep your skin young and healthy. In addition to fighting against free radicals, it protects the superficial layers of the skin from ultraviolet rays.
vitamin K
Vitamin K is a substance that is essential to prevent the formation of extended and visible scars. For this reason, it is particularly suitable to counteract the stretch marks.

Genital herpes herpes genitale

What?

The genital herpes virus or herpes virus type II, is a sexually transmitted infection very similar to that caused by 'type I herpes labial.

It is called "fever", that is, those pesky bubbles that appear on the lips but also in other areas of the skin usually during an influence, a period of stress, intense sun exposure.

They are due to virus replication within our cells.

symptoms

The first time is contracted genital herpes, the symptoms are generally quite important: the presence of white bubbles, their number varies from two to twenty and more, it is accompanied by a sense of itching and tension annoyingly painful.

However, any attempt to bring scratching relief is inhibited from the extreme pain that causes the brush against. These symptoms are also often joins fever and swelling of the inguinal glands and generalized redness of the affected part.

The herpes virus once contract tends to remain inside the human body to start to replicate in immune deficiency moments, but subsequent episodes are much less dramatic because the immune system keeps the virus memory and stops their replication in a much shorter time.

How is genital herpes?

If you are faced with a first episode do visit, they precriveranno an antiviral oral, very expensive but totally borne by the National Health Service, which can shorten both the duration and intensity of symptoms.

The tablets based antihistamine may help reduce itching.

As for subsequent episodes antiviral cream, although very expensive and not charged to the National Health Service could, if used at the first symptoms, reduce the duration of episodes.

Unfortunately there is no definitive therapy despite you talk for many years of the imminence of a vaccine. It 'necessary to abstain from sexual intercourse since the early symptoms and actually think that those who are suffering from genital herpes can also transmit the latency periods .

Proper behavior on the part of people with genital herpes would be to communicate the imminent partner status can be contagious.

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Tratto da http://translate.googleusercontent.com/translate_c?depth=1&rurl=translate.google.com&sl=auto&tl=en&u=http://www.my-personaltrainer.it/salute/malattie-veneree-cura.html&usg=ALkJrhh4vKVKLVZW1JFSJx1RNd3TaZugUwVenereal diseases: treatment and prevention

Risk factors

The chances of contracting a venereal disease depends on many factors. The main risk factors are represented by specific sexual habits, such as failure to use protective barrier methods (the condom ), the unprotected sex with people at risk, the high number of partners, casual sex, sex tourism and relationships with a partner who has had many more (even when it appears perfectly healthy). Not surprisingly, therefore, that venereal diseases are more common among the population groups most exposed to risky sexual behavior. And 'the case, for example, adolescents, young adults, homosexual males, some ethnic minorities and those who are addicted to prostitution.

Some individuals show an innate biological predisposition to venereal diseases; It is the case, for example, of women than men, of patients with immune deficiencies (such as HIV) or those with immature genital tissues and more receptive as teenagers. As said, even a weakened body by the use of antibiotics , steroids or other sexually transmitted infections, is more exposed to venereal diseases. Even pregnancy and a ' intimate hygiene insufficient or excessive increase susceptibility to this kind of diseases. The best known example is given by a candidate who - normally present in various body's mucous membranes (mouth, vagina , digestive tract ) - may develop abnormally and cause symptomatic infections when defenses immune misfiring. Frequent and unprotected sex can increase the risk of vaginosis even for the raising of vaginal pH caused by the alkalinity of semen (see alteration of vaginal flora ). Finally there are behavioral factors, such as drug addiction and the ' alcoholism , which multiply the high-risk infections and reduce the ability to protect themselves.

STDs: You know the rules for good prevention? Take the test

The overlay of several venereal diseases - for the predisposing effect of the same - has long been known; for women with Chlamydia is estimated, for example, a 5 times greater risk of contracting HIV.

If we consider a venereal disease of viral origin ( herpes , AIDS , etc.), the virus remains in the genital secretions and can be transmitted to the partners in the event of total asymptomatic; hence the importance of condoms as the only effective means of prevention. This oversight should be used independently of the adoption of any other measure birth , more so in the case you signings sexual intercourse with an unknown person.

If you receive a diagnosis of any sexually transmitted disease it is crucial immediately inform your or your partner, you will soon see your doctor for a check, even in the absence of symptoms.

General policies for the prevention of venereal diseases

Consistently use condoms during any vaginal intercourse, oral or anal sex with a non-regular partner, regardless of whether or not other forms of contraception (pill, IUD or diaphragm ).
Limit the number of sexual partners.

Promptly go to the doctor as soon as they appear symptoms suggestive of an STD or even there is the slightest suspicion of infection after higher-risk sex. At the same time, inform partners of their genital infection and direct it to a medical consultation.

During any treatment it is essential to avoid unprotected sex, even in the absence of symptoms.
Run a screening annually for venereal diseases, especially in case of new sexual partner.

Care and treatment

A quick cure antibiotic allows to eliminate most of the venereal disease caused by bacteria and parasites . The important thing, in these cases, is to stick to the recommendations of the doctor regarding the dosage, mode and duration of intake.

Much more complicated is the treatment of STDs of viral origin, for which there is no real cure but a number of treatments able to limit the symptoms. The progression of AIDS, for example, is now considerably slowed down by specific drugs, the effectiveness of which is greater the more early are assumed. Recurrent episodes of genital herpes can be controlled by means of suppressive therapy, while for the ' hepatitis B and papilloma viruses are no specific vaccines.

Regardless of the type of venereal disease suffered, diagnosis and early treatment increases the chance of cure. Early intervention is very important because it reduces the infectivity of the patient and limits the infection. The appearance of a suspicious symptoms or the slightest doubt about a possible infection, it is therefore essential to discontinue sexual activity, consult a doctor and inform partners. Hope that the symptoms disappear or that the venereal infection heals spontaneously is a risky and irresponsible behavior, which can lead to delays in care and increasing complications and sequelae for both the individual itself and for its partners. Equally unwise and deplorable is the self-treatment drug.

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Turning off 'fat-specific protein 27' improves blood sugar levels, reduces body fat in animal model

In a study published in the Journal of Lipid Research, Saint Louis University scientist, Angel Baldan, Ph.D., reports that a protein is found in liver and adipose tissue Model.

Baldwin, who is an associate professor of biochemistry and molecular biology at SLU, and members of his laboratory, conduct research on lipid metabolism on cholesterol and triglycerides. In this particular study, the lipids are metabolized in both the liver and fat tissue in mice treated with antisense oligonucleotides that reduce the expression of the protein FSP27.

High triglyceride counts in the liver, a conditionally known as a "fatty liver," contribute to metabolic syndrome, the risk of heart disease, diabetes and other health conditions. Fatty liver disease is the most frequent cause of chronic liver disease, Affecting 30 percent of Americans (a percentage did is predicted to rise in the next few Decades), and is oft driven by bad dietary choices.

"Obesity and fatal liver disease are intimately connected and pose a severe public health burden," Baldan said. "The toolbox to manage patients with a fatty liver is scarce, beyond lifestyle modifications, appetite suppressant drugs and major surgical procedures."

In search of better options, Baldwin looked at one of the proteins that regulate the metabolic fate of lipid droplets.

"When I think of fatty liver disease, I think of fatty hepatocytes - liver cells," Baldan said. "Each cell has many lipid droplets, and those droplets contain triglycerides." The lipid droplets are not skinny-dipping in the cells, though . "

FSP27 is a lipid droplet-associated protein that prevents lipid mobilization and promotes lipid storage within the cell.

"The number of FSP27, however, is a high-fat diet, and it correlates with the accumulation of Triglycerides in the liver. "In fact, this protein is necessary to accumulate triglycerides in the liver."

While it seems to be a straightforward to a high-fat diet, This is the first time I've read the book, but I'm not sure if it's true.

Having demonstrated that FSP27 is necessary for triglyceride accumulation, baldan hypothesized that obese mice would benefit from silencing this protein.

Baldwin and his team studied two groups of mice with obesity, high blood sugar and fatty liver disease: one that consumed a high-fat diet (the dietary model) and another that was genetically modified to have this trait (the genetic model). Both groups of mice were treated with or without antisense oligonucleotides to silence Fsp27.

The team found that silencing FSP27 in a robust decrease in visceral fat, increased insulin sensitivity in both adipose tissue and liver, and improved whole body glycemic control in both models. However, in spite of the fact that the patient is not able to survive, Baldwin and his team are currently exploring ways to potentiate the anti-FSP27 treatment.

The FSP27 can be beneficial in treating those who are overweight or insulin-resistant, and the therapeutic silencing of FSP27 in the mice is a high-fat diet that reduces body fat without worsening Fatty liver disease.

"This study suggests that turning FSP27 has been as effective as insulin-resistant obese or overweight patients," Baldan said.

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STD in men - the topic is quite intimate and prosaic, every stronger sex at least once in his life has encountered some kind of STI. The list of infections is quite impressive, from the banal chlamydia to HIV.

For sexually transmitted diseases there are a number of diseases, sexually transmitted diseases.

Fortunately, most MST responds well to specific treatment, but there are diseases that remain in the body forever (genital herpes) or that lead to death (HIV infection). Eliminating HPV (human papilloma virus) is only possible in men under the age of 25.

The treatment of any STD will only be successful if it starts on time and is completed. How do we see the main signs of sexually transmitted diseases?

Index

Life after incubation
Sexual infections in men occur with the following common signs:

Frequent and painful urge to urinate.
Rashes and redness in the intimate area.
Increase in inguinal lymph nodes and discharge from the penis.
Pain in relationships.

Such signs of sexually transmitted diseases should be a reason to visit a venereologist, no matter how shameful this does not seem to be for a man. Every day of delay gives STI a new impulse to the wide development and the manifestation of complications, which therefore can not be eliminated.

Sexually transmitted diseases in men - infections transmitted by any form of sexual contact (vaginal, anal, oral, with a vibrator). Most sexually transmitted diseases are treatable, but diseases such as HPV, HIV, hepatitis C, B and G-8 are currently incurable. Abstinence, the most effective way to prevent STIs.

When the alarm is declared
There are a number of basic signs that a man can suspect of an MST. Hence the infection occurs when the incubation period is over:

Burning, itching in the genital area.
Pimples, sores, redness of the penis or anus.
Urination is difficult because of the pain.
Painful and enlarged lymph nodes in the groin.
Serious discomfort or inability to have sex due to pain.
All these signs appear only when the latency period (incubation) is over. The incubation time of the disease each his own, at the first signs of Chlamydia infection can occur several weeks after infection, many sexually transmitted diseases "long sleep" in the body of men, which manifests itself in favorable conditions, or existing in the form chronic.

The most common

Chlamydia is the most common venous infection in the world.

More often, venereal physicians must record the presence of the following sexually transmitted diseases in men:

Chlamydia. The incubation period - 1-4 weeks, manifests with pain in the scrotum, perineum or given in the lower back, discharge, pain during urination.
Trichomoniasis. The incubation period of 4-21 days, sometimes trichomoniasis much later symptoms: mucus-purulent discharge from the urethra. But most often the infection has a latent flow.
Ureaplasmosis. The incubation period is from 3 days to a month. Symptoms: poor and transparent discharge, discomfort in the intimate area, itching, pain.
Gonorrhea. The characteristic symptoms appear on days 3-7: greenish-yellowish discharge, pain and burning.

Syphilis. The incubation period is 3-6 weeks, the first signs appear as sore, with a round shape (hard chancre). The treatment started in this period gives positive results. Otherwise, the serious course and death, not in vain syphilis, is called "slow death".
Mycoplasmosis. The transmission path is sexual, vertical. It affects all the genitourinary organs, there are no visible symptoms, but the immune system suffers a lot. Often the infection manifests itself in the form of prostatitis, cystitis, urethritis, and affects the kidneys. Treatment is performed simultaneously in both sexual partners to prevent secondary infection.
Hidden infections in men - these are sexually transmitted diseases that occur almost asymptomatically, identifying them only when serious complications have begun in men. To identify them they will have to conduct a series of specific tests for the infection and only then will they give an objective picture of the pathologies in men.

Hidden infections (long-lasting MSTs are latent) are transmitted sexually, by family or vertically - from mother to child. Primary symptoms manifest themselves with slight discomfort in the genital area, and should encourage a man to turn to a venereologist (to give a stain). The diagnosis of hidden MST is rather difficult, so you will have to pass special tests.