Кровотечение. Скрытые кровотечения, обнаруживаемые лишь при анализе кала на кровь, и встречаются на высоте обострения язвенной болезни сравнительно часто. Массивные кровотечения у взрослых встречаются приблизительно у 10—15% больных, чаще у мужчин, чем у женщин. Тяжелые, угрожающие жизни кровотечения отмечаются приблизительно у 2% больных.
A child becomes dehydrated in one of two situations — either there is excessive loss of body fluids (usually due to diarrhoea and/or vomiting) or there is insufficient intake of fluids (for example, when the sick child is unable or unwilling to drink). If the illness is prolonged or severe, dehydration can become a problem, and the child may need medical assessment and treatment.
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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It is difficult to obtain a reliable urine sample from a baby or young toddler using the above methods, and the likelihood of contamination is high. If there is a high possibility that the child has a urinary tract infection, your doctor may recommend doing a suprapubic bladder tap.
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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If you listen carefully to pre-adolescents today, kids about nine or ten years old, you will hear the word «gay» used quite frequendy. We all have sexual feelings about both genders, and all the men and women I interviewed had clear memories of their first sexual encounters and feelings about the opposite- and same-gender friends. We learn to accept our sexual feelings for both genders and the strong ones most of us feel for the opposite gender, or we learn to fear them. In all of my interviews, the stronger the fear of homosexual concerns, the stronger the underlying fear of sexual interaction with the opposite gender. These feelings develop in tandem, and when we or our culture imposes sanctions against same-gender and/or opposite-gender sexual feelings, our natural flow of sexual development becomes disrupted.
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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Rabbits may have cysts present in their livers. These are often called hydatids, but they are not the cysts of the E. granulosis, the dog tapeworm.
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.
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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Diagnosis of this condition is rarely made in the simple cases and, in the more difficult ones, often only when other conditions have been excluded.
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.
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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A very common sight in the parks of China and Hong Kong is people practising the graceful routines of T’ai chi. It is becoming increasingly popular in western countries as well, as a wholistic means of engendering body awareness and reducing stress and anxiety. The slow, continous movements of T’ai chi have their roots in the martial arts but the aggressive, tactical aspects of karate or kung fu were removed by Taoist monks and replaced by a greater contemplation of the flow of energy though the body and self expression. Many of the movements, of which there are more than 100, are derived from the behaviour of animals and birds and are identified by names such as ‘the birds beak’ and ‘the stalk cools its wings’. It is always recommended that T’ai chi be practised in the open air and that the movements be properly taught by an experienced instructor.
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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Not wishing to be dependent on pills, many people who have difficulty sleeping take a drink of liquor, beer, or wine before going to bed, a remedy that, Geriatrics (41#6:81) reports, can be counterproductive.
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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AND TREATMENT
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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Don’t wait for a stroke before you swing into action. In addition to quitting smoking (another huge risk factor), there are several ways you can fight back against brain attack.
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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There’s more good news in the continuing battle against cancer. Researchers at the Baylor College of Medicine, Center for Biotechnology, in The Woodlands, Texas, have developed a test that may change existing treatment and possibly extend the survival rate for many of the over 50,000 women and men who are diagnosed with bladder cancer each year.
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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The Environmental Protection Agency (EPA) warns that eating fish from any of America’s 46 polluted waterways could result in a slight increase in a person’s risk of getting cancer.
Consumers shouldn’t worry about the warning because grocery stores fish markets and restaurants do not carry fish from the polluted waterways. The EPA says the chief danger is to sports fishermen and poor people who fish to provide food for their families.
The potential danger is all the more insidious because the pollution doesn’t produce any physical signs of contamination on the bass, walleye, catfish, trout pike sunfish, and other freshwater fish affected. However, the EPA stresses that the risk of getting cancer from eating such contaminated fish is relatively small.
While the EPA has not discovered the cause of the pollution, it is known that most of the contamination came from a pesticide, called dieldrin; and polychlorinated biphenyls, or PCf3s, widely used in electrical transformers.
The National Cancer Institute (NCI) says that even though there is only a small risk of getting cancer by eating contaminated fish, it does add to the overall risk of contracting the disease. NCI records indicate that as many as 2 out of every 10 Americans are diagnosed with cancer by age 70.
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Researchers have discovered that potassium deficiency may contribute to high blood pressure. The results of a recent study involving several healthy men who ate either a low-potassium diet or a normal potassium diet for one to two months showed that those on the low-potassium diet had considerably higher blood pressure levels after eight weeks than did the men on normal potassium diets.
The best way to add more potassium to your diet is to consume plenty of fruits and vegetables such as bananas, beans, and potatoes. While there is no Recommended Daily Allowance for potassium, most medical experts suggest a daily intake of from 2 to 3.5 grams. Your doctor can tell you more specifically how much your potassium intake should be each day. This is especially important if you are on medication or have some type of illness or disease.
The potassium in such fruits as bananas may also help ease the discomfort and pain of indigestion. Recently, researchers in India conducted a test involving 40 people who had all suffered stomach pain and nausea for several months. Half of the subjects were given a natural treatment consisting of capsules which contained banana powder. These people took eight capsules a day for about 2 months. The other 20 subjects in the test were given nothing for their pain and nausea. And all 40 subjects avoided such things as antacids and/ or ulcer medication.
The results of this test showed that half of the subjects who took the banana capsules gained complete relief. Most of the other people in this group reported at least some level of relief from their almost constant discomfort. Eighty percent of tired people in the other group—those who were given nothing for their indigestion—reported no relief at all.
Other research suggests that potassium-rich foods, such as bananas arid potatoes, may also help to reduce your chances for having a stroke. A 12-year study conducted by the Department of Community and Family Medicine at the University o California in San Diego has provided strong evidence in support of that theory- e study, involving over 850 men and women, showed that the people with the l° intake of potassium had the highest number of stroke- associated deaths. The people who consumed high levels of potassium seemed to be relatively «stroke-free». Also, according to the study, an increase in daily potassium intake by 400 milligrams showed an almost 40 percent reduction in the risk of having a stroke.
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The key to successful weight control is the ability to make changes in your diet that can be maintained on a long-term basis. In some instances, doctors believe that ‘»consistent weight management—losing and regaining weight repeatedly—may actually be more harmful than being overweight. In fact, dieters who don’t maintain their initial weight-loss, often regain so much weight that they become heavier than they were before they went on a diet.
The safest and most effective way to diet is to go slowly, never losing more than two pounds a week. Losing more than two pounds in a week’s time usually means the weight-loss is in fluids and muscle, and not in fat. Your diet should ideally consist of as wide a variety of foods as possible. In some instances, under medical supervision, you may be placed on a highly restricted diet. Such a diet will force you to pay closer attention to the composition of each meal.
The most recommended diet places special emphasis on vegetables, fruit and complex carbohydrates, which are high in fiber and rich in vitamins and minerals. Such a diet contains fewer calories and less total fat, saturated fat, cholesterol, salt, alcohol, and slightly less protein. You don’t have to eliminate any individual foods with this diet, but you will have to cut down on your intake of certain foods, while increasing your consumption of others.
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Simply put, chiropractic treatment relies on physical manipulation and adjustments of the spine for therapy, rather than on surgery or drugs. Before consulting a chiropractor about a lower back problem, there are several things you should know.
1) Since lower back pain can have many different causes, including kidney disease, bladder tumor and prostate cancer, it is essential to have the condition and its cause properly diagnosed. Since a chiropractor deals with manipulation and adjustments of the spine, some patients may require the treatment of another specialist. In other words, some lower back problems require treatment which is beyond the scope of a chiropractor.
2) While chiropractors are licensed health care practitioners, individual chiropractor’s credentials may differ, which can have an effect on the type of therapy regimen prescribed. There are also varying state laws regarding credentials and certain kinds of treatment. Make sure you check out a chiropractor’s credentials before undergoing any treatment.
3) Chiropractors generally diagnose like other doctors. Chiropractic treatment, however, does not involve the use of drugs or surgery as therapy— it involves adjustments and manipulation.
4) As a chiropractic patient, you should undergo a comprehensive consultation, which includes a review of your body systems and your medical history. You should also undergo a thorough physical examination in which the chiropractor looks for «subluxation» or the partial dislocation of a joint. The physical should also look for postural problems and/or problems caused by improper positioning or functioning of one bone in relationship to another.
5) A chiropractor should come highly recommended by former and current patients. One way to find a good chiropractor is to talk with friends or associates who have had chiropractic treatment. Their positive recommendations should give you confidence in the chiropractor’s ability.
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