Cause

Gastroenteritis is by far the commonest cause of dehydration. Any illness which results in persistent diarrhoea, vomiting, or reduced fluid intake can result in dehydration.

Clinical features

Apart from the features of the illness itself, the young child will pass urine less frequently (few wet nappies), or the volume will be less; his eyes may look sunken and dark; his tongue and mouth will be coated and dry; he will look gaunt and pasty; and will often be tired and lethargic. The child will have lost weight because of the fluid lost from the body.

Treatment

Mild cases of dehydration are treated by increasing the amount of fluid given to the child, or giving him oral rehydration fluid. In more severe cases, the child may need fluids to be given intravenously. This usually necessitates admission to hospital.

When to see your doctor

• if vomiting and diarrhoea persist;

• if any of the clinical features described above are present;

• if you are worried.

Prevention

Mild dehydration is a common consequence of many childhood illnesses. Significant dehydration can often be prevented by seeking prompt medical treatment when illness causes excess fluid loss or diminished intake.

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This is a simple procedure, performed under sterile conditions, in which a fine needle is introduced into the child’s bladder when it is full and a sterile sample of urine removed and sent to the laboratory for identification of the germ. (A full bladder sits in the region above the pubic bone, hence the name suprapubic.)

Only persons who are experienced in doing this procedure should perform it. Your doctor is likely to refer you to a paediatric specialist or paediatric hospital department.

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Most research indicated that by this age gender orientation is pretty well developed anyway, so fears that same-gender interest will cause “homosexual tendencies” or “perversion” or promiscuity are unfounded. If we cannot accept a range of feeling about everybody, we will always have trouble accepting any feelings about a special somebody.

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Sometimes the very commonplace nature of some things may lead to complacency.

Both city and country people need to be reminded that human hydatid disease is still common. Hydatid cysts are still widespread in animals, especially sheep, and in New South Wales, the worst affected state, the incidence in many areas has not changed in the past 20 years and in many cases is as high as 30 per cent.

Before any problem can be solved, those who take the decisions must be aware that a problem does exist and need to be informed about how to go about solving that problem.

At present, it seems that many of us in Australia are not aware that hydatid disease in man and in animals is still a problem.

If you are a country reader, ask what your shire or state is doing to eradicate hydatids. If you live in the city, indicate to your local Member that you are concerned that hydatids are still a problem.

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When the lymph glands are affected and associated with the red rash, glandular fever or infectious mononucleosis is often suspected. However, the specific blood tests are usually negative.

The disease may be mistaken for some other feverish illness and the diagnosis is difficult to make on clinical grounds alone, but biopsy or removal of infected tissue for examination under the microscope may show the parasite.

Although toxoplasmosis is such a common condition, serious effects from the parasite are rare. Its threat to the welfare of the foetus is its most serious complication.

If a woman has not previously come into contact with toxoplasma and picks up the infection during pregnancy, the parasite appears to be able to cross the placenta and affect the developing foetus.

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Its meditative, relaxing aspects are well understood, but T’ai chi is also beneficial for posture, breathing control and circulation. As a preventive therapy it works on the principle of balancing the yin and the yang forces in the body, calming the mind and promoting good health.

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While alcohol is definitely a sedative and can be counted upon to make one quickly fall asleep, this effect can wear off after just a few hours and be replaced by a phase of stimulation and irritability that keeps one awake. It is also true that while small to moderate amounts of alcohol are sedative in effect and make one feel drowsy, larger amounts taken over a prolonged period can, in some cases, actually interfere with sleep.

Alcohol at bedtime may also increase the effect of other medications, such as those that lower blood pressure, antihistamines, heart medicines that relax the arteries, sedatives and tranquilizers The combined effect may produce dizziness and falls, with the risk of a fractured hip or other broken bones, when the person gets out of bed during the night. Alcohol as a sleep aid, therefore, is not a very good idea.

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Signs and symptoms

Characteristic symptoms of rubella are swollen, tender lymph nodes in front of and behind the ears, at the base of the skull, and on the sides of the neck. In a day or two, a fine or splotchy dark-pink rash appears on the face; the rash spreads over the rest of the body within 24 hours. The rash usually lasts about three days and may or may not be accompanied by a low-grade fever (37.8°C-38.3°C), slight reddening of the throat and the whites of the eyes, and slight loss of appetite.

The patient is contagious for the period from seven days before the onset of the illness until four or five days after the appearance of the rash. Infants born with rubella may be contagious for as long as a year after birth.

No other disease causes both a rash and tenderness and enlargement of the particular lymph nodes involved in rubella. The diagnosis of rubella can be confirmed by culturing throat secretions, blood, or urine to identify the virus, or by blood test results that show an increased level of the antibodies, protective substances that the body has produced to fight the infection.

Home care

Give aspirin or paracetamol to reduce fever or discomfort. Do not let your child come in contact with pregnant women.

Precautions

• Before becoming pregnant, a woman should either be immunized against rubella or should receive a blood test to find out if she is immune to the disease. If she is not immune, she should be immunized at least three months before trying to become pregnant.

• All children should be immunized against rubella.

• A pregnant woman who has been exposed to rubella should consult her doctor immediately.

• Be aware that a pregnant woman who is immune to rubella (having had the disease earlier or having been immunized) will not pass rubella to her unborn child by being exposed to the disease.

Medical treatment

Because it is so mild, doctors do not need to treat rubella in children. However, the doctor will establish the diagnosis by means of a physical examination and laboratory tests.

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Get a neck check. If any of those stroke symptoms sound vaguely familiar, visit your doctor and have him warm up his stethoscope. But after he checks your chest – heart disease, you know-ask him to listen for a bruit (BREW-ee) in your neck. When the carotid arteries on either side of your neck are narrowed by plaque, they make a rushing sound doctors call a bruit.

“It’s not foolproof, but when a general practitioner suspects stroke, he’ll perform one of these. If he doesn’t like what he hears, he’ll send you to a neurologist for a closer look,” says Dr. Penix.

Bring down your blood pressure.

Since guys who have high blood pressure before age 45 are 10 times more likely to suffer a stroke later in life, it’s vital that you bring yours down. “Regular aerobic exercise and weight loss are two of the best ways to begin to lower your blood pressure,” says Dr. Sacco. Try to get 30 minutes of moderate aerobic exercise at least three times a week. Here are the numbers to shoot for: A reading of 120/80 millimeters of mercury (pronounced 120 over 80) is considered normal. Experts say a reading above 140/90 should be of concern. And when your blood pressure is higher than 160/100, it’s definitely too high.

Play anyway. You don’t need to be diagnosed with high blood pressure to get active, but you can still cut your stroke risk. The Northern Manhattan Stroke Study at Columbia-Presbyterian Medical Center in New York City found that the risk of stroke is 2 1/2 times greater among people who do not exercise. “What impressed us was discovering just how little exercise it took to get these spectacular benefits,” Dr. Sacco says. People who walked 20 minutes three times a week were 57 percent less likely to suffer a stroke. Exercise such as bicycling, swimming, hiking, and tennis reduced stroke risk by nearly two-thirds.

Take a sip-occasionally. Alcohol can increase or decrease your stroke risk, depending on how much you drink. In this same study, occasional-to-moderate drinkers who consumed from one alcoholic drink a month to two drinks a day had a 50 percent lower risk than nondrinkers, according to Dr. Sacco. Alcohol-even grape juice, if you abstain from drinking-is thought to make blood less sticky, reducing the risk of clotting and increasing the “good” cholesterol. But don’t take this as a license to binge. Drinking more than two drinks per day raises your stroke risk and leads to other health problems.

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The researchers discovered that after analyzing tumorous cells, they could determine the status of a “tumor-suppressed” gene. If the gene, called retinoblastoma (RB), is not functioning properly the cancer will grow much faster and will require more aggressive treatment. And in a related study at the Memorial Sloan-Kettering Cancer Center in New York City, researchers found that bladder-cancer patients with malfunctioning RB genes tended to survive for only one year. Those patients with normal RB genes lived an average of eight years.

Experts say that improperly functioning RB genes may also contribute to cancers of the prostate, breast, eye, lung, and blood. The new test, which should be available in the near future, may allow doctors to detect malfunctioning RB genes and replace them with normal genes, thus saving the lives of many cancer patients.

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