HEALTHY LIVING

Malnutrition

2011-01-05T04:05:00.000-08:00

Malnutrition
Malnutrition means a pathological condition caused by the deficiency or excess of one or more nutrients. The abnormal food intake can come from inadequate food in quantities needed (inadequate caloric intake or, conversely, excessive) or of poor quality (nutritional deficiency or excess fat ...) other factors, including psychological and pathological, are also involved.

In developing countries, the biggest nutritional problem is the "undernourished", due to insufficient caloric intake. But around the world, various forms of malnutrition exist, resulting in particular obesity and serious deficiencies. Malnutrition has been called the "hidden hunger"or "hidden hunger"("hidden hunger" in English) by the United Nations, affecting two billion people suffer from deficiencies in vitamins and minerals, can cause fatal diseases.

Definition
Malnutrition must be defined as a pathology, and not as a state. This is a systemic disease with multiple consequences and causes just as varied. The idea of a separation between a quantitative and qualitative approach is both outdated and simplistic.

Malnutrition, either in the approach proposed in the World Health Organization, the humanitarian emergency dedicate themselves, and the various studies on the subject, may be due to several factors, most often associated. Nutritional deficiencies, either quantitative or qualitative (and often both), are a very common cause leading to a state of malnutrition. However, other factors come into play very often.

It may take several examples to illustrate what constitutes malnutrition:

* The Niger, Summer 2005: major cases of malnutrition encountered are mainly due to a major deficiency in food intake, due to the extended drought and the invasion of locusts from cultivated areas, these two causes that led to Crop largely insufficient.
* Liberia, 2004-2005: the food supply is sufficient for people, both through crop and substantial imports, as well as through regular food distributions by WFP. However, malnutrition rates are important, especially in urban areas. The main problem identified is mainly due to inadequate care practices, the causes are multiple. The mothers are not able to provide effective care their child, because of cognitive impairment, post-traumatic stress disorder, a pathological relationship with the child, etc..
* Afghanistan, 2002-2005: If nutritional deficiencies play an important role in malnutrition in this country, it was found that many children refused care (food being understood here in care) that their were provided, due to significant psychological trauma. This phenomenon of refusal to eat has been found in Rwanda after the genocide, and in many refugee camps and displaced whose residents had to experience traumatic events.

These few examples show that a purely dietary malnutrition can not be sufficient, and most international players to fight against malnutrition had to adapt their management by developing parallel programs, ranging from psycho-social stimulation malnourished in their psychological care.

Similarly, we can speak of malnutrition to the problem of obesity. Again, it would be simplistic to consider an inadequate food intake as the sole etiology. There is obesity linked to genetic factors leading to surabsorption nutrient or related to anatomical or physiological causes acquired (acquired disorders of the functioning of the organs of digestion, or mobility, for example). But the inadequacy of food intake is by itself often a consequence of a psychological disorder.

Consequences: State of malnutrition in the world
In 2006, more than 3.5 billion people suffer from iron deficiency, two billion are at risk of iodine deficiency and 200 million preschool children suffer from vitamin A deficiency.

In developing countries, nutritional deficiencies cause diseases such as kwashiorkor, anemia (which attacks the blood and prevents concentration), rickets (which prevents the normal development of bones of the child) or blindness ( caused by deficiencies in vitamin A). The 2004 report from UNICEF and the World Bank assesses terrifying: iron deficiency among infants 6 to 24 months affect the mental development of 40 to 60% of children in developing countries; deficiencies iodine have reduced intellectual capacity of those countries from 10 to 15%, and cause the birth of 18 million mentally disabled children a year, lack of vitamin A causes the death of a million children each year.

In adults, most often affected are women: anemia caused by iron deficiency causes the deaths of 60,000 young women during pregnancy and childbirth, lack of folic acid causes death from heart disease in ten . Deficiencies add up and make the body more vulnerable to other diseases. The economic impact is enormous, the loss of energy associated with deficiencies causing a fall of 2% of GNP in the countries most affected.

Undernourishment affects some 800 million people worldwide, while obesity affects more than 300 million people (see those articles for details). According to MSF, averaged over 2009 a child died of malnutrition every six seconds (more than five million over the year).

The fight against malnutrition is also one of the eight Millennium Development, initiated in 2000 by the UN. The third target of this goal is to halve the number of undernourished people between 1990 and 2015.

Some examples of actions against malnutrition
Action against malnutrition takes into account the characteristics of this disease have been described above. It specifically targets children who are affected first. It is conducted by a variety of structures from international organizations to the humanitarian organizations.

For example:

- UNICEF works to prevent the worst effects of malnutrition by giving countries and aid funding to deliver essential micronutrients to strengthen the immune system, such as iron and vitamin A during immunization campaigns or through fortified foods. UNICEF, government, salt producers and private sector organizations are also working to eliminate iodine deficiency, which is the leading cause of mental retardation and brain damage preventable through information campaign on universal salt iodization (USI). In communities, UNICEF also explains how to provide children with good nutrition to people in their care, practicing breastfeeding, for example. In emergencies, UNICEF evaluates nutritional and health needs of affected populations, promotes breastfeeding by creating safe spaces for pregnant women and nursing, provides essential micronutrients, supports therapeutic feeding centers for children with severe malnutrition and providing food for orphans.

- The association ANTENNA TECHNOLOGIES has developed tools and training to produce locally, sustainable and lasting a unique dietary supplement: Spirulina, a micro algae that can be grown locally and provides essential nutrients such as vitamin A, acidic Essential amino, iron, ... In relation to local structures, ANTENNA develops in different African and Asian production areas of spirulina then that access to financial independence through the marketing of about 60% of the production, the rest being distributed in schools, clinics, hospitals, ... To complete, centers of education in nutrition and vegetable crops are now being developed.

See also Nutrition

wikipedia

Food

2010-12-21T04:11:00.000-08:00

Food
Food is the domain of all that relates to food for a living organism to function.

By extrapolation is defined as any power secondary system which ensures the provision of basic and primary energy to a system dependent for its first operation. In the technical field and we talk for example power or fuel for a combustion engine. This understanding will not be developed in this article on the food function in the life sciences.

Food is responsible for approximately 3 / 4 of the ecological footprint of individuals (?) and is one of the major issues of health and sustainable development.

Biological approach
The chemical reactions necessary to life are dependent on nutrient intakes. In higher organisms they are either synthesized through photosynthesis (plants) or drawn into organic compounds (animals and fungi). There are other energy sources for micro-organisms: for example, some archaea derive their energy by producing methane by oxidizing sulfur compounds.

Healthy Eating
For humans, a healthy diet is to follow a balanced diet, that is to say to eat too much or too little of key nutrients such as vitamins and trace elements, proteins, fruits, vegetables and take his meals preferably at regular times.

Some traditional diets have a favorable impact on health. The inhabitants of the Japanese island of Okinawa have the life expectancy is longer in the world. Their diet has many similarities with that of the "Mediterranean diet": use oil, no animal fats, consumption of vegetables and fish diet frugal. But it seems desirable to ask the question of their microbiota for understanding why these facts. healthy eating is not a deprivation of food, but a diversification of the latter.

The food goes into the factors that may affect life expectancy. A team of researchers from the University of Cambridge (United Kingdom), in partnership with the Medical Research Council, conducted a survey on 20 244 individuals for 14 years (1993-2007), of which 1987 died during investigation to determine the impact of lifestyle on life expectancy. The study concludes that the "ideal way of life" - no tobacco, alcohol or less half a glass a day, eating 5 fruits and vegetables daily, exercise for half an hour a day - bound the life expectancy of 14 years compared to the total of four risk factors. The accumulation of four risk factors (tobacco, alcohol, lack of fruits and vegetables and exercise) increases the risk of death by 4.4, three factors of 2.5, two factors of almost 2 to 1 factor 1.4. According to Professor Kay-Tee Khaw, the first signatory of the study, "this is the first time we analyze the cumulative effect of risk factors on mortality.

Recent developments in developed societies
The current way of life in developed societies threatens to undermine the principles of healthy eating.

Obesity is steadily increasing in the world including in France for 30 years. She now covers 8% of adults and 10% of children: a fringe of increasingly large and young population. Eating habits harmful to health are being developed:

* Consumption of soft drinks, ice cream, sweet desserts and products containing simple sugars;
* Diets nutritionally unbalanced and generally cons-productive as followed later feeding periods even richer;
* Snacking on fatty foods and sugary (encompasses 60% of teenagers), that cut hunger for foods helpful;
* Prepared dishes too much salt (which increases sharply hypertension and always encouraged to eat more salt), and few fresh foods (so fewer vitamins in particular).
* Consumption of processed foods containing a large number of chemical additives often. "Most processed foods are so processed and contain many additives it is almost impossible to know what you eat and, more importantly, what are the consequences of such a type of food medium and long term . "Argue in essence about 2007 Catherine Vialard Ruchon-Duran and Bernard, author of a three-year investigation on food.

The World Health Organization (WHO) launched an extensive campaign to promote healthier eating. In France, the National Health and Nutrition (PNNS, Ministry of Health) specifically encourages consumption of fruits and vegetables more important (slogan: 5 fruit and vegetables a day).

However, the twenty-first century, part of the population in developed countries facing problems of malnutrition are linked to the difficulty of this population to have sufficient income to eat well, what is called food security.

Situation in developing countries and LDCs
* Improved Quantitative

In contrast to the problems of food consumption in industrialized countries, hunger is still prevalent in the newly industrializing countries and regions in the traditional ways of life.

Yet signs of improvement are visible: food insecurity declined from half a century. Only 13% of people worldwide are malnourished as against 37% in the early 1970s. For others the amount of food available to each individual reaches the limit set by FAO, that is to say 2500 calories per day.

However, undernutrition still concerns 854 million people worldwide. Yet experts agree that global agriculture can probably feed 12 billion people. The only question that arises is that of food distribution.

Undernutrition is due to food shortage could be caused by:

* political instability or armed conflict. Take the example of Darfur.
* natural disasters (eg droughts or floods in Mauritania in India).

The food shortage causes a rapid increase in prices of food, depriving them of access to food for the poorest populations. Africa, Asia, South East and the Middle East are the main areas where lack of food is the most important.

* Qualitative improvement:

The diet of traditional societies is based on one main product (a grain like rice, maize, wheat), where a certain monotony in the meals. Most countries are experiencing or have experienced what is called the nutrition transition, which is characterized by a more balanced improvement, where consumption of vegetables, dairy and meat rose.

Cultural approach
Food is, with perhaps reproduction, one of the only basic physiological activities have stimulated much the various human cultures. Human beings have invented a particular practice to decorate the best food: cooking. He also sought to streamline their practice, creating the best diet to meet their nutritional needs.

The cultural approach to food has been highlighted by social anthropologists in the last century [when?]. In this sense, man does not eat that food but also symbols of the imagination. The principle of inclusion involves the appropriation of qualities of food by the eater. The action to incorporate consequently gives the eater the attributes of the food ingested. According to geographical locations, the habitat and culture of each company, the food is value-laden, meaning and the principle of incorporation takes its theoretical validity. The Maasai, for example, do not eat because the pitches when attacked, he took a defensive posture and folds on itself, this behavior is considered "cowardly" by the Maasai and they do not consume to avoid not take its attributes during incorporation. Man does not arbitrarily consumes food and each culture has food codes. The man eats so through cultural rules and requirements. Cultures that are in the same habitat will tend to differentiate between them by choosing the order of the edible (Jean-Pierre Poulain) respectively.

Nutrition

2010-12-11T22:55:00.000-08:00

Nutrition
Nutrition (Latin nutrire: food) refers to the processes by which a living thing transforms food to ensure its operation. Nutrition is also a multidisciplinary science, with two main thrusts. Physiology of Nutrition deals with how the organization operates food processing, that is to say metabolic processes. This includes the study of the role of macro-and micronutrients in cellular biochemical mechanisms, and consequences on the tissue of an imbalance between energy absorbed and the energy expended by the body. The psychology of nutrition analysis feeding behavior of the individual or group. It focuses on issues such as "Why do we eat? Or "How do we choose our food? . In humans, these issues are related to environmental factors such as the built environment, media and health policies, as well as its characteristics such as income or culture.

Definition of food
Nutrition concerned with the relationship between living organisms and foods, it is necessary to define what is included as food. There are two definitions, according to the physiological or psychological approach. In the first, the food includes everything that is nutritious, that is to say that "ingestion is necessary for survival, good health and growth of youth". The psychological approach is more restrictive, considering that "the substance most nutritious food can hardly count as if nobody eats it [because] people do not usually think about what they eat in terms of nutrients. In other words, a food within the meaning of everyday life depends on cultural context: for example, whale eyes are nutritious because they contain protein and vitamin A , but an individual may not consider this an acceptable food.

Nutrients
There are many different nutrients, divided into two categories: macronutrients and micronutrients.

Macronutrients
The organization draws its energy from sugars (or carbohydrates), fats (or lipids) and proteins. These three energy nutrients form the class of macronutrients. The organization may also draw its energy from alcohol (or ethanol), but it is not necessarily a recommended diet, unlike the previous three nutrients. Energy is measured in joules or calories, which are respectively the symbols J and cal. The conversion is 1 kcal 4.186 kJ, or 1 kcal 0.289 kJ. Energy is supplied to the body by reacting with oxygen, that is to say, by oxidation, which generates 9.44 kcal per gram of fat, 5.6 kcal per mL of alcohol, and varies with the type of carbohydrate: 4.18 kcal per gram of starch, 3.94 kcal per gram of sucrose and 3.72 kcal per gram of glucose. The energy obtained by oxidation of a gram of protein is 5.6 kcal but that does not match what the body withdraws, which is 4.70 kcal for this particular case. All organs for extracting energy is the digestive system, which converts sugars into glucose (or galactose), protein amino acids and fats into fatty acids. Each of these transformations is divided into several functional blocks: for example, the transformation consists of glucose digestion, hormonal regulation (that is to say the hormones present in plasma), use and storage ( in the liver, adipose tissue and muscle).

Sugars (or carbohydrates)
Carbohydrates are found in foods such as rice (up to 79.95 g per 100 g of long grain white rice, uncooked) or bread. According to the British Nutrition Foundation, the three main sources are cereals and 45%, potatoes and salty snacks to beverages and 12% to 10%. Carbohydrates are divided into categories depending on the number of sugar units: monosaccharides (or dares) to a unit, disaccharides (such as sucrose or disaccharide) to two, and polysaccharides (or glycans) beyond. A similar classification is obtained by considering the degree of polymerization DP: DP monosaccharide for 1 to 2, for oligosaccharide DP 3-9 polysaccharide and beyond.

The site of absorption of carbohydrates depends mainly on the class but also other factors related to the subject or quantity. For example, monosaccharides such as lactose is normally absorbed in the small intestine, but if the subject has an intolerance to lactose (carbohydrate in milk) lactose then continue his run of the small intestine to the large intestine where it is fermented to produce volatile fatty acid, the gases from this process include bloating generate, and are used for diagnosis of lactose intolerance by testing the presence of hydrogen. About 75% of adults have lactose intolerance, for example in Asian populations, and other problems related to the absorption of sugars exist such as sucrase-isomaltase deficiency affects 10% of Inuit in Greenland.

Carbohydrates are necessary for the body, and the concentration in the blood (usually between 70 mg / dl and 100 mg / dL) should be maintained at a fairly high level because the brain depends entirely. According to the average required by the brain, a daily intake of 130 g is recommended for adults. In practice, this contribution is easily exceeded, with a median of 220 g to 330 g in men and 180 g to 230 g in women. One of the interests of the physiology of nutrition is to see how the body adapts depending on the amount of nutrients provided. In the case of carbohydrate, if the quantity is low then the body tries to save the drawing more energy from fat, otherwise, energy can be taken from carbohydrates, which are then transferred from the blood into cells by insulin, and excess can be converted by the liver through a process called de novo lipogenesis (DNL). The excess is stored as fat and not carbohydrates, an explanation for the change being that the energy density of fat is higher than that of sugars, thereby minimizing the weight gain to maintain the mobility of the body.

Fats (or lipids)
Most fats are not soluble in water, which distinguishes them from carbohydrates and proteins. The classification of lipids Bloor distinguishes four categories. Simple fats are fatty acids linked by an ester bond to alcohols. For example, the result of a triglyceride molecule of glycerol esterified to three fatty acid molecules, and it is in the vegetable oil and animal fats. The fatty complexes have the same composition but with additional molecules: by esterifying glycerol with two fatty acid molecules and a phosphate complex is obtained phosphoacylglycerol. The derivatives are obtained by hydrolysis of the previous two, and what does not fit into any of the three categories is another (such as squalene). The structure of fatty acids is also classified according to the length of their carbon chain (short, medium, long, long) and the presence of at least one carbon-carbon double bond (unsaturated acid was then and this class contains the trans fatty acid).

It is considered acceptable that 20-35% of energy comes from fat. The role of all fatty acids is not yet well understood, and it is not possible to determine appropriate levels for their consumption in general. However, levels are considered adequate (which is not a recommendation) for certain essential fatty acids: the α-linolenic acid, omega-3 group, it is 1.6 grams per day for young men and 1.1 g for young women, and γ-linolenic acid, omega-6 group, the amounts are respectively 17 g and 12 g per day. Unlike the previous group Omega-9 does not contain essential fatty acids, but more research is needed on the health benefits.

During digestion, fats are emulsified in the stomach. The emulsifier is bile produced by the liver and stored in the gallbladder. The emulsion then enters the small intestine where the lipids are degraded by a process called lipolysis, associated with other molecules in a lipoprotein to be transported in the blood. A lipoprotein is shown in the diagram cons: lipids are inside and the outside is formed of different types of apolipoprotein, Apo noted, and phospholipids.

There are five classes of lipoproteins, various functions. For example, high density lipoprotein HDL avoid noted that cholesterol accumulates in blood vessels leading to the liver for disposal, these lipoproteins are called good cholesterol, and those doing the opposite is the bad cholesterol, LDL noted. The concentration of LDL increases with the intake of saturated acids or trans fatty acid, which also increases the risk of cardiovascular disease. Remove these acids from the diet may require fundamental changes that could give place to deficiencies, but it is possible to reduce the quantity, eg in the Mediterranean diet.

Protein
Proteins of animal origin are the main source in North America and Western Europe. The animal includes both the meat that is produced by animals, such as eggs (13.62 g protein per 100 g of fried egg) or cheese (19.80 g protein in 100 g Camembert). Vegetarians do not consume meat, and vegans rejecting all animal products, their proteins must come from vegetables and grains, which are also the two main sources in Africa, Asia and Latin America.

A protein consists of amino acids linked by bonds petptiques. These amino acids are separated into two categories: essential, that is to say, those that the body can not synthesize and must be supplied by food or non-essential. What is essential depends on the organism: for example, arginine is necessary for the survival of a cat but not for man past the infant stage. These categories are further refined by considering the essential amino acids under certain conditions. Indeed, some amino acids can be synthesized but with limited capabilities in general and variants under the conditions of the subject: for example, the synthesis of proline is limited in burn patients.

Proteins are an essential component of the body and perform a large number of roles. For example, a hair consists of keratin, a protein and is involved with another protein, collagen, in the strength and elasticity of the skin. Problems related proteins may also be associated with diseases, such as glutamate is involved in the crises of epileptic seizures. An inadequate intake of protein may therefore have strong and diverse body. The recommended amount of protein is given empirically to 0.80 each day per kilogram of body weight. It is recommended that the diet does not exceed 35% protein.

The PDCA (protein digestibility corrected amino acid scoring pattern) summarizes the quantities of amino acid, but due to controversies and technical developments, the amounts recommended by FAO and WHO can differ greatly according to reports. In 1985, he was advised to take each day less than 10 mg / kg threonine, and almost 30 mg / kg in 1991 to about 15 mg / kg in 2001. Technical Report 935 FAO / WHO is compiling an inventory in 2007. The digestion of proteins takes place primarily in the small intestine and releases the amino acids that continue to other organs. In case of under-nutrition, certain amino acids can be converted to glucose by gluconeogenesis.

Vitamins
A vitamin is a compound necessary for the metabolism of an organism, in the sense that a "about being deprived develop deficiency diseases and signs of abnormal metabolism, and restore the missing components will prevent or cure diseases and make the normal metabolism [B 1]. The fact that a vitamin is a compound distinguishes eg minerals, and necessity means that it can not be synthesized. Organisms are capable of various syntheses, the name vitamin is on the organism. Thus, vitamin C can be synthesized by most animals from glucose, and is therefore regarded as a vitamin for the synthesis of this species can not as humans and other species of the taxon Haplorrhini, bats -mouse or guinea pigs [B 2]. The reason for this deficiency in humans comes from the inactivity of the gene for the enzyme L-gulonolactone oxidase, necessary for synthesis from glucose, on chromosome 8.

Vitamin C is found in vegetables and fruits such as kiwi fruit (105.4 mg per 100 g) or cantaloupe (36.7 mg per 100 g). Vegetables and fresh fruits and raw are the best source, since the vitamin C content decreases sharply with age or cutting, and cooking strongly in [B 1].

Thirst
The sensation of thirst can be understood by studying the mechanisms of red blood cells. The interior of a red blood cell, called cytoplasm, is separated from the outside by a membrane that allows water to pass, and for this reason is called semi-permeable. There is pressure from within and outside the cell, according to the respective concentrations of solutes. If the concentration outside is lower than in the cell, then it begins to swell because of osmosis and can eventually explode because the membrane does not stretch. The exterior is to say, the plasma is then described as hypotonic. Conversely, it may be hypertonic and the cell then tries to restore the pressure by letting the water out. This second scenario arises when there is not enough water in the body, less water means a higher concentration of solutes outside the cell. This pressure is a highly sensitive mechanism to trigger feelings of hunger: an increase of 2 to 3% is enough to feel a strong need to drink as well in humans as monkeys or rats. This effect is verified by injecting a solution with a high salt concentration, and intensity of thirst is proportional to the pressure.

However, the body also has its regulatory mechanisms: the base of the brain responds by secreting antidiuretic hormone that acts on the kidneys to conserve water by filtering urine. This pressure increases when a person eats, and this action also affects the kidneys, which need more water to waste. So drink before or during a meal helps to balance. Moreover, another body's response to increased pressure is a dry mouth due to reduced saliva. However, it can be concluded that having a dry mouth is a body mechanism to ensure that the individual drink: a cons-simple example is that individuals with salivary gland failing drink appropriate amounts, and thus feeling they feel does not push them to drink.

Understanding of the osmotic pressure provides an overview of basic mechanisms, but many problems remain open, such as how an organization determines the amount of water to drink.

Power
Nutrition is defined here as the science which examines the relationship between food and health: a study of food composition, properties, and their use by the body. These studies lead to the diet. It also takes into account as part of nutrition, eating behavior of individuals, especially during meals or when snacking.

However, from clinical observation of disease whose origin was a dietary deficiency (eg scurvy), nutrition for today also diseases such as cardiovascular problems and cancer (with the method Kousmine example), osteoporosis and hypertension (excessive salt in particular), type 2 diabetes, obesity, autoimmune diseases, Alzheimer's disease.

Nutrition plays a vital role in preventing many diseases. For example, more than 100,000 cancer cases could be prevented each year in France, by simply changing eating habits.

We must also remember that nutritional status is a prognostic factor in the evolution of cancers. An undernourished person is at greater risk of complications that a person receiving a power supply to the body's needs.

The complex processes which nutrients are - interactions between food, degradation, transformation of energy and release this energy, transport and use of chemicals for construction (anabolism = construction catabolism = waste disposal) and specialized tissues maintaining good overall health - are only partly understood. Significant nutritional choices, however, must be made to ensure the good health of individuals, such as very young children and the elderly, and whole populations suffering from malnutrition.

Adaptation of feeding practices to the satisfaction of physiological needs is dietetics.

See also Protein

wikipedia

Protein

2010-12-11T22:34:00.000-08:00

Protein
A protein is a biological macromolecule composed of one or more chains of amino acids linked together by peptide bonds. In general, when we talk about protein chain contains a large number of amino acids, and peptide for small assemblies.

The order in which amino acids are linked together is encoded by the genome and is the primary structure of the protein. The protein folds on itself to form secondary structures, which are quantitatively the most important alpha helix and beta sheet, which creates hydrogen bonds between the atoms of carbon and nitrogen of two peptide bonds neighbors. Then, the different secondary structures are arranged against each other to form the tertiary structure, often reinforced by disulfide bonds. The forces that govern the folding forces are the classical physical. In the case of proteins formed by the arrangement of several channels, the quaternary structure describes the relative position of the subunits relative to each other.

There are several chaperone proteins [chaperone] that facilitate or are necessary to protein folding to the active state.

Protein folding is the subject of intense research in the field of structural biology, combining the techniques of molecular biophysics and cell biology mainly.

Proteins are the essential elements of the life of the cell may play a structural role (like actin), a role in mobility (eg myosin), a catalytic (enzymes), a regulatory role of compaction of DNA (histones) or expression of genes (transcription factor), etc.. In fact, the vast majority of cellular functions are performed by proteins.

Etymology
The proteins were discovered by the Dutch chemist Gerhard Mulder (1802-1880). The word protein comes from the Greek protos which means first, essential. This probably refers to the fact that proteins are essential to life and they often constitute the majority share (≈ 60%) of cell dry weight. Another theory, that would make reference protein, as the adjective protean, with the Greek god Proteus who could change shape at will. Proteins indeed adopt many forms and provide multiple functions. But this was not discovered until much later in the twentieth century.

Synthesis
Proteins are assembled from amino acids based on the information present in the genes. Their synthesis involves two steps:

* The transcript where the DNA sequence encoding the gene associated with protein is transcribed into messenger RNA
* Translation or messenger RNA is translated into protein at the ribosome, based on the genetic code

The assembly of a protein is thus amino acid amino acid of its N-terminus at its C-terminus. Also, a gene is not necessarily associated with a single protein but often several.

Structure
Proteins are molecular objects whose precise description introduces the concept of structures (more or less hierarchical).

Protein function is conferred by three-dimensional structure, that is to say how amino acids are arranged against each other in space. That is why methods for determining three dimensional structures as well as measures of protein dynamics are important and are a very active research field. In addition to these experimental methods, many studies focus on computational methods for predicting the 3D structure from the sequence.

Function
Proteins perform many different functions within the cell and organism:

* Protein structures that allow the cell to maintain its organization in space,
* Transport proteins, which provide for the transfer of various molecules in and out of cells,
* Regulatory proteins, which modulate the activity of other proteins,
* Signaling proteins that detect external signals, and ensure their transmission in the cell or organism,
* Motor proteins, allowing cells or organisms to move.

Phenotype
The plan for making proteins depends primarily on the gene. Gold sequences of genes are not strictly identical from one individual to another. Moreover, in the case of living beings diploid, there are two copies of each gene. And these two examples are not necessarily identical. A gene exists in several versions so from one individual to another and sometimes within the same individual. These different versions are called alleles. The set of alleles an individual form the genotype.

Since genes come in several versions, the proteins will also exist in different versions. These different versions of proteins will lead to differences from one individual to another, such person will have blue eyes but another has black eyes, etc.. These characteristics, visible or not, to each individual are called the phenotype. At the same individual, a group of proteins similar sequence and function is identical isoform said. Isoforms may be the result of alternative splicing of a single gene, the expression of several alleles of a gene, or the presence of several homologous genes in the genome.

Evolution (Theory)
During evolution, the accumulation of mutations have diverged genes within species and between species. Away from the diversity of proteins associated with them. However, we can define protein families, themselves corresponding to gene families. Thus, in one species can coexist genes and therefore proteins, forming a very similar family. Two closely related species are likely to have representatives of the same family of proteins.

We speak of homology between proteins when different proteins have a common origin, a common ancestral gene.

The comparison of protein sequences can reveal the degree of "kinship" between different proteins, we are talking here of sequence similarity. Protein function can diverge progressively as the similarity decreases, giving rise to families of proteins with a common origin but have different functions.

Sequence analysis and protein structures revealed that many were organized into domains, that is to say by parties acquiring a structure and performing a specific function. The existence of proteins with multiple domains may be the result of recombination in a single gene of several genes originally individual, and each protein composed of a single domain can be the result of the separation of several genes in a gene originally encoding a protein with multiple domains.

Food
In food, proteins are broken down during digestion from the stomach. This is where proteins are hydrolyzed by proteases and cut into polypeptides and then provide amino acids for the body, including those so-called essential that the body can not synthesize. Pepsinogen is converted to pepsin when it comes into contact with hydrochloric acid. Pepsin is the only proteolytic enzyme that digests collagen, the main protein of connective tissue. The bulk of protein digestion occurs in the duodenum.

Almost all proteins are absorbed when they arrive in the jejunum and only 1% of ingested proteins are found in feces. Some amino acids remain in the epithelial cells and are used for the synthesis of new proteins, including some intestinal proteins, consistently digested and absorbed and recycled by the small intestine.

Foods rich in protein
* Dried vegetables (soybeans, lentils, dried beans, for example, also rich in iron) and whole grains;
* Dairy concentrates or dried (eg cheese, also rich in calcium and vitamin B);
* Meat (also rich in iron);
* Fish;
* Egg;
* Bread, pasta, rice, other cereals (also rich in carbohydrates, B vitamins, minerals, fiber);
* Dried fruits and nuts (almonds, peanuts (groundnuts), hazelnuts, walnuts, cashews, pine nuts, pistachios: between 15 and 30% protein).

See also Cell

wikipedia

Irritable bowel

2010-12-06T06:09:00.000-08:00

Irritable bowel
In medicine, irritable bowel syndrome (also called functional bowel disorders) is a group of states of the colon and in some cases, the small intestine. It is an extremely common condition.

Diagnosis
Diagnostic criteria have been developed (called ROME III): recurrent abdominal pain at least three days per month for at least three months, the pain is relieved by defecation and accompanied by a change of pace stools and their consistency.

Many other symptoms may accompany gastrointestinal symptoms: headache, fatigue, irritability, urinary symptoms or difficult periods, depression ...

Clinical examination is substantially normal but must seek another cause described the pain.

Mechanism
The precise causes are unknown although stress, especially in childhood, may play a role.

Epidemiology
This disease affects nearly 10% of the global population, most often women between 20 and 40 years (two times more affected than men), distributed in a manner roughly equal between shapes constipation-predominant and diarrhea-predominant one (the transition between these forms is common).

Symptoms can appear in childhood.

In 10% of cases, the syndrome appears to result from gastro-enteritis.

It has a significant economic cost, the multiple necessary consultations, and sometimes, by misdiagnosis leading to inappropriate treatment.

Treatment
There is no cure, but taking probiotics can prevent potential crises.

The doctor-patient relationship is an important component of care and consultation can only be truly effective.

One approach, drawing on a component of Chinese medicine is to practice internal exercises to evacuate bloating, flatulence, stress and anxiety. The patient for whom it should become independent and can thus improve their quality of life without expensive medication or therapeutic intervention. Other types of behavioral psychotherapy can improve symptoms.

Pharmacologically, the doctor may prescribe antacids, prokinetics, antispasmodics, inhibitors of proton pumps, an antidiarrheal medication cons or constipation, or an antidepressant at low doses as the most bothersome symptoms.

The Tegasorod proved moderately effective for constipation, but its use has been limited due to the increase of cardiac events.

In diarrheal forms, alosetron, an inhibitor of 5-hydroxytryptamine3, seems to have some efficacy.

Peppermint seems to have a significant beneficial effect.

For simple forms of colitis
First, it is about restoring the digestive functions, some excerpts of his (wheat husk) are used for their fiber content. There may however be an exacerbation of pain at baseline. The actual action of these products is discussed and other fibers, such as more soluble espaghul, plantain extract of India, could have a better efficiency.

Prognosis
The discomfort is often extended up to several years, over 7 years in more than half of cases. It is unnecessary, as a rule, to move to other diseases. Spontaneous resolution of symptoms, however, is quite common with time.

See also Fibromyalgia

wikipedia

Fibromyalgia

2010-11-11T20:44:00.000-08:00

Fibromyalgia
Fibromyalgia is the term for a syndrome long known as the idiopathic syndrome polyalgic diffuse (SPID), or FMS in English (for Fibromyalgia Syndrome). The word fibromyalgia comes from the Latin fibra ("filament"), ancient Greek myos ("muscle") and ancient Greek algos (pain).

This condition is characterized by a painful muscle disease (diffuse myalgia) extended or localized to various regions of the body, particularly in the form of tactile allodynia, as well as asthenia (fatigue) persistent.

History
Fibromyalgia has been studied since the early eighteenth century, under many names, such as muscular rheumatism or fibrositis. Some, considering the fact that it affects mostly women, rank among the group since then challenged women of hysteria.

W. Graham made the first modern description of the disease in 1953. In the years 1970 and 1980, it is considered a psychiatric illness with a depressive side. It was assumed from the fact that muscle pain resistant to conventional painkillers at the time.

Dr. Muhammad B. Yunus in 1981 published the first controlled clinical symptoms of fibromyalgia. The work of Dr. Yunus validation known symptoms and tender points typical of this disease. He proposed diagnostic criteria based on fact, failing a blood test reliable. In 1984, Yunus suggested a relationship between fibromyalgia and other diseases (such as chronic fatigue syndrome), and in 1986 demonstrated the effectiveness of drugs based on serotonin and norepinephrine.

The term "diffuse idiopathic syndrome polyalgic (SPID) was created by Professor Kahn in the 1980s, but the term Anglo-Saxon fibromyalgia prevailed in medical conferences and has been in Frenchified" fibromyalgia. " This term was introduced in 1976 to better describe the symptoms, from Latin fibra (fiber), and the Greek myo (muscle) and algos (pain).

The disease has been recognized by the American Medical Association as a debilitating disease in 1987, naming fibromyalgia. [Citation Needed] In The Same Article year year, the Journal of the American Medical Association aussi Called The disorder fibromyalgia.

The American College of Rheumatology committee defines the criteria in 1990. The RTA developed a theory based on a disorder causing neurohormonal sensitization centrale.1990s.

It was not until 1992 that the World Health Organization has recognized this as rheumatic disease, whereas it was previously considered a psychiatric illness by doctors because of its scarcity, affecting primarily women, can give some encroachment behavioral and having no biological trace, this "syndrome" was wrongly attributed to female hysteria. A supposed cause is psychosomatic now abandoned.

Recent scientific discoveries have proven neurological aspect, related to deficiencies in neurotransmitters such as dopamine, serotonin and norepinephrine. Indeed, in the years 1990 and 2000, several studies show these impairments in people with fibromyalgia. And in 2006, studies show by functional MRI abnormal activity in the brain that processes pain in fibromyalgia, different activity in people without diabetes. Cause psychiatric and / or psychological abuse is now excluded.

Fibromyalgia 70.0 million was coded as unspecified rheumatism in the International Classification of Diseases (ICD). Since January 2006, it is now coded in 79.7 million under his own name, indicating that the disease is fully recognized.

Epidemiology
A mean (World) from 2 to 10% (by country) population "industrialized countries is affected by this disease (2% of the U.S. population with a marked female predominance).

In France, a government report of 2007 gives a French prevalence estimated at 3.4% in women and 0.5% in men.

It affects about 900,000 people in Canada (2008), about 2% to 3% of adults.

Fibromyalgia is 10 to 20% of the reasons for consulting services in some of Rheumatology.

Diagnosis
Fibromyalgia is sometimes regarded as a controversial diagnosis, some authors claiming that it is a "no diagnosis," insofar as it selects fibromyalgia often having excluded all other common rheumatic diseases.

Indeed there is still no test current, specific and 100% reliable for validation of fibromyalgia. The difficulty comes mainly from the fact that people can see all their lab tests come back normal and that many of the symptoms found in other diseases (rheumatoid arthritis, osteoporosis, ...). In most cases, the physician's conclusion is based on differential diagnosis, taking into question all the other options, symptoms, and patient profile.

This disease usually occurs in early to mid-adulthood but can occur in childhood. It involves a significant work-related disability in 10% to 30% of those affected.

Differential Diagnosis:

* Myofasciitis macrophages by muscle biopsy, cognitive
The twenty-first century, scholars prefer the term multi-fibromyalgia, some biological research showing sub-categories.

Criteria of the American College of Rheumatology
The classification criteria most commonly accepted were developed in 1990 by the American College of Rheumatology, often nicknamed criteria "ACR 1990". They define fibromyalgia according to the presence of the following:

* A history of widespread pain throughout the body for over three months, and affecting all four quadrants of the body (both sides, and below and below the belt).

* Painful points, 18 in number (although the patient may have hurt other parts of the body). During diagnosis, the physician must exert a force of 39 newtons on these points. The patient should feel a sharp pain on at least 11 of these points for fibromyalgia can be confirmed. Note that the location and number of tender points can vary depending on the period, the circumstances ...

This set of criteria was created to classify individuals as having fibromyalgia, for research purposes. Its margin of error considered low, and the lack of another more accurate test of this test have established de facto the clinical setting.

Symptoms
Fibromyalgia come in various forms of chronic pain (pain free, widespread pain, burning, beating, bruising, crushing, pulling, etc..) Skeletal muscles, tendons and less frequently joints, which may affect the whole body or part (quadrant), most commonly the back, legs and arms. These symptoms vary throughout the day, week, month, year. The fibromyalgia patient has some or all of the following symptoms:

* Aching muscles, bones, joints, tendons;
* Physical fatigue;
* Mental fatigue, emotional emptiness, vacant look;
* General irritability (touch, stress, noise, light, presence of others, unusual odors, the smell of food, etc..) And impatience;
* Constant suicidal thoughts, depression;
* Need to consume carbohydrates (cakes, bread, potatoes, chips, etc.).
* Pretty severe disorders of memory (short or long term);
* Burning, beatings, blue crush, tear, etc.. ;
* Digestive system disorders (diarrhea, bloating);
* Dryness and burning eyes;
* Insomnia, difficulty sleeping great and regenerate during sleep (stage 4 sleep, deep sleep phase regenerator, is absent or too short);
* Heat in the palms and soles (need to pass his hands or his feet under the tap to relieve pain);
* Great difficulty concentrating, especially for reading, focus on what a speaker says;
* Worsening of symptoms with consumption of sugar and sugary foods or hunger;
* At least 11 tender points on the 18 listed in the ACR test
* Tremor, feelings of weakness;
* Sensation of the body rusted, stiff aching.

These disorders are often associated with gastrointestinal problems (like the gluten allergy, or irritable bowel syndrome ...) and headache. The daily life of a fibromyalgia can be easily compared to that of a person with rheumatoid arthritis.

Abnormalities of cerebrospinal fluid
Discovering the most consistently replicated in the laboratory is a high concentration, in patients, levels of substance P, a neurotransmitter associated with pain perception. The presence of metabolites for the formation of monoamine neurotransmitters, serotonin, norepinephrine, and dopamine, which play a role in the body's natural analgesic, has been proven to be abnormally low, while the concentration endogenous opiates (such as endorphin and enkephalin) appear to be higher than normal. High concentrations seen in nerve growth factor (Nerve Growth Factor) has been proven. This substance is known to participate in the structuring and plasticity of the interconnections between the brain and spinal cord. There is also evidence of an increased stimulation of amino acid in the cerebrospinal fluid, with a proven correlation between levels of metabolites of glutamate and nitric oxide and the sensation of pain.

Hyperactivity and hypoactivity in some areas
Evidence of an abnormal reaction of the brain as part of fibromyalgia has been demonstrated by functional brain imaging. The first discoveries indicate a decreased blood flow in the thalamus, basal ganglia and medial areas of the brain. Compared with healthy people, these areas are less active (hypo) to equal pain, and have a delayed activation in response to pain . Some areas of the brain, however, show a deficit hyperactivity disorder (compared to normal people) to painful stimulation, particularly areas related to pain as the primary and secondary somatosensory cortex, insular cortex and cingulate cortex before. Patients also show abnormal neural activity in brain areas associated with pain perception associated with non-painful stimuli (eg mental pain), as in the prefrontal cortex, premotor cortex, the insular cortex, cingulate cortex, the .

Evidence of mal-function of the hippocampus, indicating the presence of reduced metabolites were also found by studies using magnetic resonance imaging, A significant correlations was found between the density these metabolites and an index of severity of clinical pain commonly used.

Concentrations of neurotransmitters
The correlation between the severity of clinical pain felt and the concentration of an amino acid neurotransmitter stimulating glutamate, has also been demonstrated by MRI. Accelerated atrophy usually related to age has been shown using a voxel-based morphometry (voxel-based morphometry, VBM) with areas of gray matter smaller than normal in the cingulate cortex, the insular cortex and parahippocampal gyrus.

Studies using positron emission tomography showed reduced synthesis of dopamine in the brain stem and the center of the limbic system. A correlation between the severity of pain and lack of synthesized dopamine was also demonstrated in the insular cortex. A study showed later, after a painful stimulus, the reactive synthesis of dopamine was wanton and grossly delayed in the basal ganglia.

This study confirmed a link between "18 tender points" recognized by the CRA and the dopamine D2 less available, specifically in the right putamen.

Finally, a decreased availability of opioids receptors in the striatum, forebrain and cingulate cortex has been demonstrated, with a link between the sensation of pain, and lack of available receptors in the nucleus accumbens.

Recent genetic studies attempting to confirm the link between genes for the synthesis of some neurotransmitters and fibromyalgia.

Sleep disorders detected by EEG
The first objective findings associated with the disease were reported in 1975 that were demonstrated the presence of alpha waves (usually associated with phases of light sleep) abnormal phase 4 (deep sleep) during the EEG of patients with fibromyalgia.

In fact, interrupting sleep phase 4 constantly on young and healthy, Moldofsky and his team were able to reproduce muscle tension allegedly comparable to that of fibromyalgia patients. However, these feelings have disappeared when the subjects were able to regain a normal sleep.

Since that study, many studies confirm sleep abnormalities in various subgroups of fibromyalgia patients.

Polymodal sensitivity
Several experimental studies resulting stimulation showed that fibromyalgia patients demonstrate increased sensitivity to pressure, the sensations of heat and cold, electrical stimulation and chemical. Of experiments on the regulatory systems of pain showed that fibromyalgia patients also show dysregulation of different inhibitory mechanisms of pain. They also show an exaggerated response to repeated stimuli, and decrease or absence of the analgesic response induced by physical effort. Together, these results point to a disruption of the central nervous system.

Neuroendocrine disruption
Studies of fibromyalgia patients have shown abnormalities in neuroendocrine functions as a conventional hypocortisolaemia, excessive secretion of adrenocorticotropic hormone in response to stimulation and resistance to glucocorticoid feedback. A gradual reduction in the presence of human growth hormone has also been demonstrated in some patient groups, while most show reduced hormone secretion in the face of intense physical exertion, or pharmaceutical stimulation. Other anomalies include a response time reduced TSH and thyroid hormones during hormonal stimulation. An increase relatively high levels of prolactin, with a disinhibition of prolactin secretion during hormonal stimulation and inadequate secretion of hormones produced by the adrenal glands were also found.

These changes could be attributed to the effects of chronic stress that causes the disease, which after having been received and processed by the central nervous system, activates the secretion of hormones neuronal corticotrophins hypotalamiques. This would result in a disruption of communication pituitary-adrenal gland, and an excess of hypothalamic somatostatin, which in turn inhibit the secretion of a number of other hormones.

Hyperactivity of the sympathetic nervous system
An analysis showed impaired activity and excessive sympathetic nervous system. with sympathetic reactivity glands reduced to various stressors, whether physical or mental. Patients with fibromyalgia have a variability of their heart rate down, the index of the balance nice / parasympathetic indicating sustained sympathetic overactivity, particularly at night. In addition, levels in neuropeptide Y (NPY) in plasma are low in patients, this neuropeptide is localized with norepinephrine in the sympathetic nervous system. Unlike the circulatory levels of epinephrine and norepinephrine were sometimes described as high, low and normal.

Injection of interleukin 6 (a cytokine that stimulates the production of hormone secretion of corticotropin hypotalamique, which in turn stimulates the sympathetic nervous system activity) causes a sharp increase in circulatory levels of noradrenaline and an increase heartbeat. These increases are higher in patients with fibromyalgia than in healthy people.

Aggravating factors
The symptoms of fibromyalgia are known under the following conditions, stress, and can trigger reactions in the neurotransmitters or hormones:

* Trauma, stress and emotional trauma;
* Other disease;
* Noise;
* Circle of people;
* Lack of protein in the diet;
* Insufficient quantity of food;
* Poor management of sleep (too little or too much);
* Fatigue or physical stress too much;
* Heat and heat waves;
* Cold
* Use of influencing neurotransmitters.

For some patients, the cycles correspond to:

* A barosensibilité - reaction to changes in atmospheric pressure;
* A moisture sensitivity - reaction to humidity;
* A thermosensitivity - response to temperature.

It speaks broadly of hypersensitivity.

Chronic fatigue
Common symptoms associated with fatigue often called "chronic" reaction (not to be confused with chronic fatigue syndrome, can have some more FMS). This fatigue is described as reactive as fluctuating depending on the environment and circumstances, could disappear completely and then reappear.

Chronic fatigue syndrome is not related to an excess of substance P. The mechanisms of pain are probably different for these two conditions.

Variability of symptoms
There are various forms of severity in fibromyalgia, which may possibly correspond to various causes, or variants of the disease. The problem is to find a ladder (marker) severity of reliable, non-existent because no marker has yet been updated. However, some research work would tend to prove that a correlation exists between levels in substance P and the severity of symptoms.

Given the involvement of neurotransmitters in the disease, each FMS has its cycles, its symptoms, intensities and durations. Variants of fibromyalgia are very broad, a little severe fibromyalgia to keep a life almost "normal" severe disabling fibromyalgia there is a plume of very difficult variants classifiable.

Subjectivity, the interpretation of symptoms, the physician's interpretation, the pain tolerance, the vagaries of symptoms, remissions, intensities, amplitudes, psychological management, chronicity, treatment failures, failures of dialogue, understanding, and so on, bring a very complex disease for the patient, and even more complex to convey.

However, we find some common ground as a predominance of stiffness and tiredness on waking up to subside more or less independently of each long-term symptom (from minutes to hours or even continuing the day, several days), fatigability exacerbated sleep disturbances (no deep sleep support points bothersome / painful, agitation), then a whole series of other satellites whose symptoms are most common headaches, impaired concentration (variable) of impaired memory (short term), blurred vision (fog, shift), irritability, mood swings, behavioral problems (attitude), speech (concentration, memory, fatigue) , digestive disorders, the restless leg syndrome, Raynaud's disease, tinnitus, tingling, itching, restlessness, etc..

A third of fibromyalgia have a depression or a neurotic state of hysterical type, for some type of reaction (psychological, neurological severe). The prevalence of depression is higher in patients with fibromyalgia in the general population, but remains comparable to that observed in other contexts of chronic pain. As is the case in other chronic diseases, these elements of anxiety and depression do not, however, prejudge a morbid personality pre-existing, they may well be the consequence of chronic pain.

This syndrome remains poorly recognized and poorly received, both by those around him by the government and some doctors, it can push people sick in isolation, even depression and / or guilt to suffer and become disabled by this condition painful and exhausting.

Treatment
Although there is no treatment that has demonstrated an overall efficiency, there are solutions with proven clinical effects, including certain medications, exercise and patient education. In 2008 there is no cure, no treatment is guaranteed a long-term effectiveness.

Contrary to what is indicated some therapists, no treatment is based mainly on a diet, homeopathy, psychoanalysis or psychotherapy is effective proven superior to the placebo effect. These techniques are de facto unable to process the neural aspect of the disease. However they may reduce feelings of stress, depression that can induce the disease.

For optimal management, the Canadian Agency for Drugs and Technologies in Health recommends a combination of painkillers, education about fibromyalgia, exercise, evaluation and treatment of mood disorders and sleep.

See also Osteoporosis

wikipedia

Birth Control

2010-11-09T22:58:00.000-08:00

Birth Control
Birth control has been since the beginning of the twentieth century, various policies to reduce fertility rates, especially through contraception. It is defined by the World Health Organization (WHO) as "the use of agents, devices, methods or procedures to reduce the likelihood of conception or avoid". Contraception refers only to temporary and reversible methods, otherwise it is of sterilization: castration, vasectomy or tubal ligation. Besides contraception and sterilization, birth control policies, sometimes linked to a Malthusian design, conduct also incentives (fiscal, economic, political, etc.)

Etymology
The term originates contraception:

* Contra: cons
* (Con) desk, Latin conceptio of concipere: design: formation of a new being, to give birth.

Contraception from Antiquity to Malthus
Already in Mesopotamia (1600 BC Jesus Christ), women use stones to not conceive: they choose oval or rounded stones they bring into the vagina, as far as possible, the intrauterine method. In Egypt, the Ebers Papyrus prescribes several recipes contraceptive consisting of crocodile dung, soda, honey and gum arabic. They say condoms are the first Egyptian, made with the intestines of small animals (chats. ..). According to some authors, there would also, in Egyptian papyri, writing saying that Ramses would have to distribute contraceptives to the population limit overcrowding and the risk of famine.

For their part, the Aramaic Hebrew use of confession, the advice of the rabbi (second century AD), the Moukha, sponge placed in the vagina that prevents sperm from reaching the uterus.

The Greeks and Romans used them on abortion and infanticide in cases of failed drugs and amulets.

The Gauls for their part did not have this problem.

Writings of the ancient advocated for women to skip several times after having sex to bring out a product consisting of mucus and sperm, preventing fertilization.

Soranus of Ephesus describes the practice of abortion and the construction of a buffer that prevents the ascent of sperm, talking sponge Levant, known for their flexibility and their absorptive capacity. These sponges, known as "miniatures," were always used in the twentieth century.

The Catholic Church, the clearest way, has always opposed to contraception. His recommendation natural methods of birth control is contrary to prove that there are many alternatives to contraception (Natural Family Planning), which help prevent what it sees as a moral evil goal. The Roman Church condemns any conjugal act deliberately amputated his procreative meaning. However, sexuality has to be "source of joy and pleasure", and spouses may find this fun and enjoying it, just as having a responsible fatherhood. But this responsibility and possible regulation of birth can be done in respect of the truth of the relationship, and an expression of freedom subject to the will. Thus the Catholic Church preaches Does abstinence periods fertile sign of love, respect, freedom and will, rather than from failure to observe the profound significance of the body implied by the artificial means of contraception. The Catholic Church promotes all the techniques that enable couples to have children as long they respect the inseparable connection between sexual union and procreation.

There are a bunch of wacky beliefs contraceptive, contraceptive use here are some recipes from the eleventh to the fifteenth century:

* Ignite a cabbage stump and off in the menstrual blood;
* Not to be pregnant for a year, just for women to spit three times into the mouth of a frog;
* Attach the eye of a deer with a ladle root marjoram and drizzle in the evening from the urine of a red bull;
* Make a belt with the hairs of the ears of a mule, an animal sterile, or drink his urine, talismans with his ears or his testicles;
* Elephant dung mixed with mare's milk in scope talisman is placed over the vulva;
* Wash in the fountain of Saint Martial and drinking water from the fountain of San Esteban;

It was not until the sixteenth century to see the first condom herbal invented by Gabriele Falloppio. We also test at that time, various injections intra-vaginal. In general, we prefer to speak of then hugs and maneuvers reserved postcoital. In 1661, Madame de Sevigne speaks in his "Letters to his daughter" to use "restringents" or sleeping alone.

Of the nineteenth century Malthusianism
In the nineteenth century, Thomas Malthus observed that the curve of births exceeds the curve of subsistence. Fearing overpopulation, he advocates the use of birth control would not prevent the enjoyment.

The birth control policy implementation in various countries has followed different goals and different means. She was able to go with Eugenics (such as Nazism) or with forced sterilization methods (Japan, USA, Sweden, Nazi Germany, Peru under Fujimori in the 1990s, etc.).. At other times, it rather led to behavior to a decline in fertility rates, particularly through the right or the economy. Other countries have instead implemented a pronatalist policy, aimed at increasing fertility (notably France under the Third Republic, and fascist Italy or Nazi Germany). The population explosion in the twentieth century, world population from 1.6 to 6 billion people from 1900 to 2000, but supported policy advocacy of birth control.

From the late nineteenth century, the birth control policies are becoming popular, especially in the Anglo-Saxon, combining several factors, including fear of an explosion of births of people in the colonized, the popularity of eugenic theories, but also the progress of secularism and feminism, which asserts the right to dispose of his body.

After the Second World War, binding methods (in particular programs sterilizations constraints) have lost their legitimacy at the same time as eugenics, although some programs have been continued (in the U.S. until the 1960s, the Peru in the 1990s). States have a tendency to operate through incentives not binding under the name of family planning, with the notable exception of India and China. The restrictive nature of the methods of birth control has been denounced in particular in the 1980s, some authors stressing the continuity between the methods used by democratic regimes and those used by totalitarian regimes. Meanwhile, religious fundamentalism and the movement "pro-life critics of these policies.

Promotion of the control populations (partly supported by international organizations like WHO) has led to deploy contraception in countries with fragile economies and population growth after the agricultural revolution (the ability to increase feed populations) and the medical revolution (international deployment medicine, hygiene practices and substantially reducing mortality). These policies were initiated in the 1950s by India and Pakistan, and will continue so brutal in China and India during the 1980s. In India, Sanjay Gandhi, son of Prime Minister Indira Gandhi, so does punish recalcitrant populations, while implementing Deng Xiaoping in 1979, the "one-child policy."

These two countries, the most populous of the twentieth century have indeed been heavily used contraception, abortion and sterilization to limit their population growth. Thus, in the Canton Chinese Linyi (Shandong Province), a campaign of forced sterilizations and abortions has assigned 7,000 women in 2005. The family planning officials wanted to correct the evil force of numbers of births in this region. The peak was reached in 1983 with over 50 million people affected by a variety of ways (16 million sterilized women and 4 million people, 14 million abortions, 18 million insertions of intrauterine devices ). In some cases, forced contraception has also been used as in Tibet.

Schooling, access to care, increasing the duration of the celibacy of women and urbanization reduce the birth rate. Under such conditions, most people adopt a birth rate close to the western rate. In general, birth control policies have had a moderate effect, however, despite the investment made in the 1970s. In Brazil, the decline in fertility has occurred in the absence of family planning program, caused by the rising level of education of women. It also could have occurred before the implementation of policies of birth control.

The birth control policies in France
Having a smaller population than Germany, France applies a pro-natalist policy in the early twentieth century. It thus prohibits, July 31, 1920, contraceptive propaganda. This policy will be continued throughout the Third Republic, then under Vichy. Reforms of family law in the 1960s will be a relative term.

On 8 March 1956, the association is created Maternity happy, she will advocate for providing access to contraception and the French to abolish the 1920 law.

The year 1961 will know in March, the condemnation of "any method of contraception or sterilization means which is intended to hinder the birth of children" by the Assembly of Cardinals and Archbishops of France. Then in June, the opening of the first Planning Centre in Grenoble by Henri Fabre, and a second in Paris in October.

In 1967, the Act is repealed Neuwirth law of 1920, allowing contraception, which will be repaid in 1975 with the Veil law.

Only 5% of French women aged 18-45 years using any contraceptive method, and over two-thirds of unwanted pregnancies occur in women who report using a contraceptive method. While the age at first sex does not move for 20 years (17 years on average), the average age of mother at birth of her first child is constantly increasing (26.5 years in 1977 to nearly 30 years in 2004).

Methods of birth control
Many contraceptive methods are used by humans since time immemorial. The efficiency and ease of use vary greatly.

Contraceptive methods can be broken down into several categories:

* Methods "barriers"
o condom
o female condom
o spermicides
o diaphragm and cervical cap
* Hormonal contraception Women
o pill
+ Combined pill
+ Progestin pill
o hormonal implant
o injectable progestin
o patch or contraceptive patch
o vaginal ring
o IUDs with hormones, see below

# Male hormonal contraception

* Being tested: association of a progestin pill or hormonal implant hormone (similar or identical) to testosterone (for the maintenance of male sex characteristics) as a pill or injection acting several weeks; efficiency (absence of sperm in semen) would require three months of taking medication without interruption to the shutdown, it would take three months for sperm fertilizing.

# IUDs (intrauterine device) or IUD (which is not a method of contraception but contragestation)

* IUD "classic" copper
* Hormonal IUDs also named SIU (intrauterine system)

# Methods of sterilization

* Surgical
o Tubal ligation
o vasectomy
* Nonsurgical
o Essure procedure

# Natural methods

* Coitus interruptus or "withdrawal"
* Shower vaginal inefficient
* Methods observing the female menstrual cycle
o temperature method
o observation of the mucus or Billings method
o Symptothermal method, which combines several observations: temperature, cervical mucus and position of the cervix uterus
o rhythm method
* Breastfeeding on demand
* As defined, sexual abstinence itself can be classified as a contraceptive method

The natural methods are sometimes not regarded as means of contraception. That said, it falls within the definition given by WHO as "methods or procedures to reduce the probability of conception" and as such seem to have a place in this article.

For the record, excluding sexual practices such as vaginal penetration sodomy, oral sex or mutual masturbation, does not normally lead to fertilization, but it is possible that sperm come in contact with the vagina.

There are two more methods of contraception known as "emergency", is the morning after pill (which actually combines action and contraceptive contragestative) and IUD insertion.

Until the 1960s, contraception was almost exclusively mechanical. It became massively with the advent of medical hormone therapy ("the pill").

Challenge and controversy
Of its implications on population, birth control is a major philosophical, religious and political issue, subject to controversy.

Contraception has long been considered undesirable, and sometimes prohibited, each human being considered as an additional wealth and sex as pleasure is sometimes regarded as shameful and repressed. In the twentieth century, Western sexual liberation movements have changed that perception. Contraception is now often seen as a means of individual control of fertility and reproduction for personal fulfillment.

Some religious groups refuse to use contraception. Protestant and Muslim authorities have not adopted a single position.

Catholicism is against the use of any artificial contraception and birth control advocates by the methods of natural family planning.

In 1930, Pope Pius XI and banned all artificial methods interfere with the ability to laprocreation. Twenty-one years later, Pius XII authorizes periodic abstinence and birth control, for economic reasons, eugenic, social or medical.

On 29 July 1968, the encyclical Humanae Vitae Paul VI condemns the use of the contraceptive pill and any artificial birth control. It advocates, however, responsible fatherhood, which may use the methods (called natural) birth control. The Catechism of the Catholic Church recalls the pleasure and joy in sexuality are gifts from God intended for husbands. The regulation of birth, however, must be within a framework of freedom and desire, love and respect of spouses through abstinence fertile periods.

This message is often misunderstood, poorly received (but also poorly conveyed by means of modern communications, which form the teachings of the Church does not always lend itself well), and source of many divisions of people with the Catholic Church , who focus on this aspect of his teaching.

See also Pregnancy

wikipedia

Backache

2010-11-01T00:47:00.000-07:00

Backache
According to the figures recorded in France, the origin of back pain is poorly identified in 95% and 5% of people over thirty years of suffering back pain not relieved by medication. Therefore maintaining a healthy back is essential, especially when we know that this part of the body is stressed due to slopes from 1500 to 2000 every day.
The term back pain is any pain sitting in the spine or near it, whatever the origin, nature and intensity of pain. According to the origin of pain, there are the neck, back pain and back pain. These are the most common, especially among manual workers, while the neck affect more people working in offices.
In France, back pain affects 80% of people significantly at least once in their life. If the annual incidence varies with age, it seems less important in the age group of 20-24 years (4-18%) and highest in the age group of 55-64 years (8 to 32%).

Anatomy
The etymology of the word comes from the spine or ράχις ράχη Greek, meaning "back, backbone, and was formerly for spelling Rhachi to remind the rho. The vertebrae are the bony elements of the spine, or backbone. According to those, there are only 32 or 34. Given their constitution, they stack perfectly on top of each other to form the spine.

The spinal segment
A typical vertebra consists of a vertebral body with a core of spongy bone surrounded by a thin layer of cortical bone. The top and bottom of the vertebral body are delimited by the plates, relatively flat surfaces. Behind the vertebral body, the pedicles and the blades form the vertebral foramen leaving passage to the spinal cord. The joint between two vertebrae is achieved by means of the intervertebral disc and facet joints. The intervertebral disc is inserted between the plates of two adjacent vertebrae, plays a role absorber and allows a good distribution of loads and pressures. It consists of a nucleus pulposus and annulus fibrosus of a. The nucleus is a gelatinous structure composed largely of water which makes the drive the ability to absorb shocks and protect the column of significant efforts and repeated while the annulus fibrosus is a cartilaginous structure surrounding fibrous multi-oriented the nucleus to contain it perfectly.
On each side, the foramina allow the passage of nerve roots from the spinal cord to reach different parts of the body.
The intervertebral disc is composed of cells representing 1-5% of its volume, water and extracellular matrix. The role of cells is vital because they secrete extracellular matrix components, mainly collagen and proteoglycans, and enzymes, degradation agents. They are responsible for maintaining and renewing the matrix.
Cells need nutrients to function. But their supply is difficult because the intervertebral disc of the adult is not vascularized. Some cells can be up to 8 mm from the nearest blood vessel. However, preservation of adequate nutrition is essential because cells are responsible for the renewal of the extracellular matrix during life and thus indirectly to the maintenance of biomechanical properties of the intervertebral disc.
Variations in nutrient concentration, pH, mechanical stresses and the rate of cellular demand can stimulate or inhibit cellular activity.

The different levels of the spine
The spine is divided into five regions: the cervical spine, thoracic spine, lumbar spine, sacrum and coccyx. For each level is a numbering system adopted increasing from top to bottom.

* The cervical spine in the neck

There are seven vertebrae C1 to C7 named. The first cervical vertebra is the atlas C1 and has a circular shape and function to support the skull. The second cervical vertebra C2, the axis has a tooth or "odontoid process" pivot on which the atlas and the skull. C1 and C2 are often called upper cervical region and C3-C7 cervical region below.

* The thoracic spine in chest

It includes twelve vertebrae named T1 to T12. The thoracic spine is especially stable and strong due to the presence of his lengthy "process thorny" and it is connected to the rib cage. Nevertheless, some ribs are not connected to T11 and T12: these are floating ribs.

* The lumbar spine in the lower back

It includes five vertebrae named L1 to L5, which grows in size from L1 to L5. The vertebrae in this region are indeed the largest and most resistant of the column since they carry and distribute the bulk of the weight and stresses the body both at rest and in motion. Compared to the thoracic region, the pedicles are larger and longer and the spines are larger and square.

* The sacrum in the pelvis

It is located below the basin and consists of five fused vertebrae named S1 to S5.

* The coccyx

Three to five vertebrae that make up the coccyx are located at the tip of the spine. These bones have the same shape as the other forming the spine: it is solid bone with no holes from which the nerves to reach the other parts of the body.

Levels of curvature
From the side, the spine has four curves anatomical two lordosis (curvature concave rear) at the cervical and lumbar kyphosis, and two (concave curves ahead) at the thoracic spine and sacred. The reverse curves correspond to the hinges of the spine, joints that are predominantly loaded during movements of the spine. We distinguish the cervico-thoracic T1-C7, the lumbo-thoracic T12-L1 and hinge sacro-lumbar L5-S1.
These physiological curves and the muscles and ligaments of the spine equilibrium condition.

Systemic
Spine pillar of the body is connected to surrounding structures: the ligament system, muscular system and vasculature.

* The system ligament and muscle

Each vertebra articulates with the vertebra above and behind (except the atlas and caudal vertebrae). The vertebrae are articulated by three joints, the intervertebral disc and two posterior apophyseal joints Inter. The strength is mainly provided by the spinal ligaments and muscles antagonistic movement. In addition to the complex corporeal disco or disco-somatic inter-apophyseal joints and posterior intervertebral ligaments and muscles are part of the vertebral segment spinal arthritis, a complex joint system making possible the movement of the spine.
In addition, the spine is the insertion and anchoring muscles to posture and the neck he received much of céphalogyres muscles that move the head.

* The vascular system

The spine has its own vascular system. It is located near many vessels such as the vertebral artery, the inferior vena cava, renal veins and thoracic aorta, which continues through the abdominal aorta, the anterior radicular artery of Adamkiewicz and the sympathetic nerve plexus .

Mechanisms
The intervertebral disc undergoing changes over the events and life.

* Biochemical Events

The main biochemical event is the decrease in the rate of cell renewal. About 90% of the cells are alive in the disk of a healthy teenager, against 46% at the age of 44 years and 27% at age 57 years. Similarly the vertebral disc is composed of 90% water at 10% growth against 60.

* Events morphological

The morphology of the intervertebral disc changes during degeneration. At first it is spongy and firm. The first changes that affect the annulus weakens, then begin to develop small cracks. Over time, the disc loses water, it becomes smaller and loses altitude. Accordingly, the adjacent vertebrae move and approach each other. The intervertebral space decreases, the facet joints are found more and more compressed, the result is a pressure at their surfaces. Eventually, the facet joints undergo damage up to arthritis.
These changes within the disc, facet joints and ligaments lead to instability of the spine. Every movement is a source of additional wear and increased aging of the spine. In fact, cracks in the annulus grow in number and importance.Le nucleus can then pass through the damaged annulus and introduced into the spinal canal. This phenomenon is known as a herniated disc (see § 2.1.1). The party pushed out of the disc is in contact with the spinal nerves, which is a primary source of pain or warning to the patient. In addition, the disc releases enzymes and chemicals that produce inflammation and a new source of pain, which become increasingly intense. In addition to this degeneration, osteophytes grow but nobody really knows the cause, some doctors argue that it is a body's response to try to stop the movement induced between the spinal segments. These osteophytes can cause problems by exerting additional pressure on the nerves through the intervertebral foramen. The pressure around the irritated nerve roots can cause pain, numbness and weakness in the lower back, buttocks, legs and feet. Finally loss of mobility and stiffness of spinal segment, thickening of ligaments and facet joints, the drying of the disc and the presence of osteophytes are factors preventing normal movement. Paradoxically, a stiff joint does not cause pain so intense that a joint that "floats", despite the progress of degeneration, some people may feel relief.

Etiology
Excluding mechanical trauma, the phenomenon of degeneration is related to aging. However its severity is modulated by genetic inheritance and environment. Disc degeneration usually begins during the second decade and only gets worse over time. At the age of 49 years, 97% of lumbar discs show signs of degeneration. This degeneration may be aggravated in some individuals because of their genetic heritage. Environmental factors promoting degeneration include smoking, exposure to vibration, port charges and repeated heavy physical activity.

Degenerative
The elderly are the most affected by degenerative diseases. However, as we have already seen, certain factors "at risk" such as obesity may accelerate the wear process.

Disc herniation
By stage of degeneration, one can observe two types of cervical disc herniations:

- The cervical disc herniation "soft" at an early stage of degeneration.
- The cervical disc herniation "hard" at an advanced stage.

The first stage of degeneration may be linked to the appearance of tears in the annulus as a result of normal wear and tear on the disc or a sudden injury due to twisting or excessive deformation of the disc, surpassing the resistance of the annulus. Pain in the back raised remain until healing tears. However, multiple lacerations weaken in no small disk, which then begins its degeneration. The collapse of the disc causes compression of the vertebrae, it no longer performs its function of shock absorber between the vertebrae. This sort of problem causes primarily a mechanical back pain. The weakened disc can then trigger a slipped disc. If the annulus tears, the material in the nucleus can escape the disc, causing compression of a spinal nerve in addition to inflammation of the nerve root. The pain then the key areas through which the nerve to the leg. This is sciatica.

Spondylosis
Arthritis, cartilage wear can affect any bone in the human body. For the spine we talk more specifically spondylosis or osteoarthritis when it induces a loss of cartilage, bone overgrowth and formation of osteophytes at the facet joints. Generally, intervertebral discs are the first part of the spine to wear, so people suffering from spondylosis are also experiencing problems of degeneration in their spinal discs.

Stenosis
* Spinal Stenosis

Spinal stenosis refers to lower section of the lumbar spinal canal where the spinal cord passes. The spinal cord ends at L2. Below, the spinal canal contains only the spinal nerves that pass through the pelvis and legs. When the stenosis reduced the spinal canal, spinal nerves are then compressed within it. This results in pain and numbness in the buttocks and legs and weakness of muscles supplied by the nerves involved. Since the nerves pass through the bladder and rectum, poor bladder control and bowel may occur: it is an emergency. If the pressure is not dissipated, it can cause paralysis of the bladder and intestines. Doctors recommend immediate recourse to surgery to relieve compressed nerves.

* Foraminal stenosis

The spinal nerves exit the spinal canal between the vertebrae in a tunnel called intervertebral foramen. We are talking about when foraminal stenosis narrows the intervertebral foramen due to the collapse of a disc. Induced loss of height causes the collapse of the vertebra above the disc to the one located below it: the opening between the vertebrae narrows to compress the nerve. The phenomenon of arthritis in the facet joints leads to the formation of osteophytes which will tend toward the foramen, causing additional compression and irritation. Foraminal stenosis may cause a "double pain", mechanical and neurological from irritation of the nerve root.

Conservative treatment
As soon as possible, doctors prefer to use treatments other than surgery. These so-called conservative treatments aim to relieve pain and other symptoms. When back pain occurs, it is suggested, first, follow some simple guidelines in the home, allowing for 90% of returning things to normal after one month:

- Sleep with a pillow between your knees and lie on the side improve comfort. Some doctors recommend to lie on his back and put a pillow under your knees.
- There is no specific exercise against backache to improve the condition of people suffering from acute pain. However, it may be useful for people suffering from chronic pain and help them return to their activities and their work.
- Drugs without prescription need, such as ibuprofen and paracetamol are excellent for short-term treatment of low back pain.
- The use of ice or warm compresses may help some people, although their effectiveness has not been proven.
- Most experts agree on the fact that bed rest is associated with a longer recovery period. In addition, people are more likely to develop depression, blood clots in the legs and decreased muscle tone.

Drugs
There are many kinds of drugs commonly prescribed to try to control back pain. However, none can cure back pain. The drugs are the main objectives of reducing sleep disorders and pain control, inflammation and muscle spasms.

* Analgesics Level 1

This is paracetamol and anti-inflammatory drugs such as ibuprofen. The long-term use may be associated with gastric irritation, kidney problems.

* Muscle relaxants

Muscle spasms are not considered as a cause of back pain and most of the muscle relaxants have no effect on muscle spasms and are no more effective than analgesics. They cause drowsiness in 30% of cases and their regular use is recommended.

* Analgesics

These drugs are considered an option for control of acute pain and are associated with serious side effects such as dependence, decreased reaction time, nausea and confused judgments, in a large percentage of the population taking more a few days the most noticed is constipation. Some studies report their effectiveness in the short term pain relief. However, their use does not accelerate recovery.

* Steroids

Oral form, they can be beneficial for the treatment of acute sciatica. As epidural injections, it has not been proven that this substance has the power to decrease the duration of symptoms or improve the patient's condition and are not recommended for the treatment of acute pain without sciatica. The perceived benefits in chronic pain with sciatica remain controversial. Injections into the joint spaces, facet joints can be beneficial to people suffering from sciatica. It has never been proven that the "trigger point injections" are effective in acute pain but the combination of a steroid and a local anesthetic may be useful in cases of chronic pain. Their use remains controversial.

See also Osteoporosis

wikipedia

Fanconi anemia

2010-10-27T07:40:00.000-07:00

Fanconi anemia
Fanconi anemia is a rare genetic disorder part of bone marrow failure syndromes Hereditary (Inherited Bone Marrow Failure Syndromes in English). It affects both sexes and its diagnosis is often made at the stage of appearance of bone marrow failure, hematologic changes are made to a severe aplastic anemia or leukemia. The only treatment is based on the marrow. It is named after the Swiss pediatrician Guido Fanconi, who described this disease in children from the Alpine valleys where geographic isolation favored inbreeding.

The clinical picture combines small size, birth defects, skin lesions, the appearance of secondary bone marrow failure and an increased risk of leukemia and cancer.

Etiology
Genetic disease of autosomal recessive (except for very few patients in group B), associated with chromosomal instability, Fanconi anemia (FA) is characterized by great phenotypic heterogeneity. In this clinical heterogeneity, is also genetic heterogeneity. The number of Fanconi genes is steadily increasing and so far we know 13 genes whose mutations are responsible for the disease.

These genes are called FANCA FANCB, FANCC, FANCD1 (also known as BRCA2 gene is involved in familial breast cancer), FANCD2, FANCE, FANCF, FANCG, FANCA, FANCJ, FANCL, and FANCN FANCM. They are worn by all autosomes except FANCB gene that is carried on the X chromosome, explaining why patients in this group are all boys and is the only group for which the transmission is related to sex. For a given patient, only one gene is involved and 2 copies of each gene must carry a mutation, one of these copies from the father and one mother.

The gene most frequently involved is the FANCA gene involved in two-thirds of patients. Mutations in FANCA, FANCC, FANCG and FANCD2 are found in more than 90% of patients. Other genes are rarely involved with some of them less than 5 known patients.

The hypothesis that these genes were involved in a common pathway could be confirmed with the identification of the FANCD2 gene is the gene most conserved during evolution, most of the proteins encoded by genes FA (Fance , FancB, FANCC, FANCA, and FANCG FancF) indeed belong to a protein complex, known as "FA core complex," whose function is mono-ubiquitin, thus activating the protein FANCD2, the latter occurs in process of DNA repair (repair of double strand breaks) that allow the maintenance of genome integrity.

Incidence and prevalence
Fanconi anemia was found in all ethnic groups, its incidence is estimated at 1/350.000 births.

As with all recessive disease its frequency is increased in case of inbreeding. A founder effect can be found for sub-populations. For example, Ashkenazi Jews from New York, the gene in question is most often FANCC and certain mutations in this gene are in this population, found with great frequency. Similarly, a very specific mutation of the gene FANCA is found in almost all patients of Boer in South Africa.

Description
There is a vast phenotypic heterogeneity: the clinical picture is highly variable from one patient to another and this is true in the same family.

The main symptoms are:

- Small size: it starts during the uterine life (growth retardation intrauterine) and children born small. In the vast majority of cases, short stature is moderate (2 standard deviations) but it may be more pronounced in some patients.

- Birth defects: they are highly variable. The most frequent sit on the face (especially microcephaly and appearance of the face) and the radial column: abnormal or inch radius. They can also affect the kidneys and urinary tract, genitals, gastrointestinal tract, heart, eyes, hearing aid, the central nervous system, endocrine glands, bones ...

- There is no general delay in psychomotor development and intellectual

- Signs skin spots combine cafe-au-lait spots and achromic melanodermia. They are increasing over time.

Hematological signs appear at a median age of 7-8 years. The first signs of cytopenia (low rate of blood cells) anemia, neutropenia or thrombocytopenia. Gradually settles a severe aplastic pancytopenia responsible for causing repeated infections and transfusion requirements. Over 90% of patients progressed to aplastic anemia before the age of 20. Acute leukemia, mostly myeloid type, can complicate this process.

Cancers, siege varied, are in three circumstances:

- Toddlers aged under 5 years on transfer of genes FANCD1/BRCA2, and FANCJ/BRIP1 FANCN/PALB2. Mutations in these three genes also involved in all prédispostions family to breast cancer, affecting less than 5% of patients.

- Patients over 20 years, who were able to survive beyond adolescence through a bone marrow transplant.

- Rarely, in adult patients experiencing genetic mosaicism, in whom the diagnosis of Fanconi anemia had not been raised most often far.

Diagnosis
The diagnosis is often suggested clinically but unfortunately for many patients, it is at the stage of bone marrow failure.

Faced with an array of children's bone marrow, elevation of alpha-fetoprotein blood and fetal hemoglobin are arguments for AF.

The cellular hypersensitivity to DNA cross-linking agents is the basis of laboratory diagnosis and testing of chromosomal breaks is essential to confirm a diagnosis of AF. It looks for the existence of spontaneous chromosome breaks and, especially, the increase in the number of breaks after exposure to an agent known as "brittle": caryolysine, cyclophosphamide Some figures ... chromosome, whose appearance is secondary to the breaks: Sorting Figures -tetra-radial and radial, are also characteristic for cytogeneticist.

So rare, fracture test may be normal in the blood due to a genetic reversion (somatic mosaicism).

More recently a new diagnostic test, whose development has been possible thanks to the understanding of the way Fanconi showed his interest: the test FANCD2. He is on blood lymphocytes but also on fibroblasts obtained from skin biopsy, the latter approach allows the diagnosis of genetic forms with reversion.

Treatment & management
- The allogeneic hematopoietic stem cell (HSC) remains to date the only treatment for Fanconi anemia. CSH may be obtained from a related donor marrow (or sibling) or unrelated (donor marrow voluntary written on a file) and may also come from a cord blood which can be familial or not related (cord blood bank). Transplantation corrects the bone marrow failure and allows the survival of patients. It does not fix well on other events. It does also not immune to cancer development. The results of these grafts, especially for grafts made with unrelated donors, currently improved through the use of new packaging, made with fludarabine and cyclophosphamide or without irradiation.

- In case of impossibility of realization of a transplant, treatment with androgens can partly correct the bone marrow failure. Its effect is often limited in time, also the toxicity of androgens is important virilization and induction of liver tumors.

- The management of patients is also involved many organ specialists who will deal with the consequences of existing defects and to ensure systematic monitoring, particularly for screening in situ cancers.

Transmission mode
It is an autosomal recessive except for exceptional patients in group B for which transmission is related to sex (see above). In a family where a patient has already reached the 2 parents are heterozygous and the risk of birth of another child with regard to pregnancy 4.

Prenatal diagnosis
The severity of this disease justifies prenatal diagnosis for families who wish, implying that they are asylum-termination of pregnancy if the child is reached. Several approaches are possible:

- The search for chromosome breakage in the fetal blood was historically the first possibility. It assumes a fetal blood sampling at the umbilical vein. This can be done late in pregnancy and is not without risk to pregnancy.

- In families where the disease has been studied, the gene involved known and the causative mutations identified accurately, a molecular diagnosis is possible. This is feasible on biopsy trophoblast (placenta) from the 16th week of gestation.

- Accurate identification of mutations may also allow preimplantation genetic diagnosis in an IVF procedure.

See also Anemia

wikipedia

Anemia

2010-10-25T07:58:00.000-07:00

Anemia
Anemia (year of private-and ancient Greek haimos, "blood") is an abnormal blood count characterized by a decrease in hemoglobin concentration intraerythrocytic (and sometimes the lack of erythrocytes or red blood cells ). This lack leads to poor transport of oxygen through the blood.

It is diagnosed by blood count, a test performed on blood.

If the drop on the red blood cells and platelets or leukocytes, are referred to as bicytopenia. If the three lines are down, we speak of pancytopenia.

Signs and symptoms
The signs and symptoms common to several anemia are:

* Weight Loss
* Lack of appetite
* Fatigue (tiredness);
* Muscle fatigue;
* Dyspnea, panting;
* Tachycardia, palpitations (indeed, to maintain proper oxygenation of peripheral tissues with less GR (therefore low hemoglobin), the heart must accelerate its pace)
* Pallor (especially at the level of the conjunctiva: look inside the lower eyelid; fingertips as well);
* Headache;
* False dizziness;
* Faintness;
* Disorders of skin appendages: hair brittle nails flattened.

In worsening anemia generate dizziness and rapid heartbeat during intense efforts even slightly. On some sites, it can manifest as chest pain (angina). If anemia is chronic and very prolonged (several years), it may even appear to see run, non-obstructive hypertrophic cardiomyopathy.

In cardiac auscultation, one can find a functional murmur (that is to say without underlying cardiac abnormality). Indeed, the decline in the number of red cells in the blood causes a decrease in blood viscosity. Laminar flow normally in the heart becomes turbulent and therefore creates a heart murmur reversible after correction of anemia.

Causes
Anemias are classified into several families according to the mechanism of anemia:

* Central Anemia: the reticulocyte is reduced:
o myelosuppression
o abnormal structure of the bone marrow hematopoietic
o hormonal stimulation decreased (EPO)
o iron deficiency anemia (IDA)
iron malabsorption
malnutrition
occult bleeding (GI) / heavy periods (chlorosis of young girls ")
o deficiency anemia B12 or folate
o production of inhibitors of erythropoiesis, as in inflammation.

* Anemia device: the reticulocyte count is normal or increased
o acute blood loss
bleeding, including bleeding and repeated hidden in a colon cancer
o hemolytic anemia: red blood cell destruction (hemolysis)
Because extra-corpuscular:
# Immunologic, autoimmune
# Hemolytic disease of the newborn
# Splenomegaly: spleen too big trap red blood cells
question particle: the globule is destroyed because of its fragility
# Sickle cell disease (SCD)
# Thalassemia
o anemia plant regeneration after

They can also be classified according to their characteristics on blood counts:

* Anemia aregenerative: reticulocytes are no longer produced the sign anemia plant.
* Hypochromic anemia
* Macrocytic anemia: the size of erythrocytes (mean corpuscular volume) is greater than the standard, vitamin B12 or folate for example.
* Microcytic anemia: the size of red cells (complete blood count |MCV) is less than the standard, for example iron deficiency.

Exploration of anemia
It is important to note that the number of red blood cells and hemoglobin are lower in women and children than men (because of its androgenic impregnation).

1) The number of red cells is normally:

* 5 (4.5 to 5.5) million / cu mm in adult males;
* 4.5 (3.9 to 5.0) million / mm ³ in adult women and children.

2) The hemoglobin (Hb) of blood is normally:

* 15 (13.5 to 16) g/100 mL in adult males;
* 13.5 (11.5 to 15) per 100 mL in the adult woman and child.

There is talk of anemia if the hemoglobin level below 13 g / dL in adult men and less than 12 g / dL in women.

In pregnant women, there is a physiological hemodilution, then placed the minimum rate at 10.5 g / dL.

Laboratory tests
To diagnose anemia, only the NFS (Blood count and globular) is required. In addition, we will assay of reticulocyte if anemia or macrocytic normo. Indeed, the account of reticulocytes to determine if the anemia is regenerative (there is increased birth of new GR to adapt, so the manufacturing process of GR works fine but there is a loss to explain the increased anemia) or aregenerative (there is no manufacture of new GR or less, no adjustment of production (which should increase) in the loss.

To determine the etiology of anemia, as the context, we can perform various tests by the suspected cause:

* Iron status: serum iron, ferritin, total iron fixation capacity of transferrin, transferrin saturation
* Vitamin B12 serum ± intraerythrocytic
* Serum Folate ± intraerythrocytic
* CRP
* Profile inflammatory protein
* Ultra-sensitive TSH, T4
* Total bilirubin and conjugated
* Lactate dehydrogenase (LDH)
* Haptoglobin
* Finger blood smear
* Search by irregular agglutinins direct Coombs test Coombs ± sensitized
* Blood cultures
* Parasitic Serology
* Thick blood smear and in search of malaria
* Hemoglobin electrophoresis
* medullary bone marrow± biopsy puncture with Perls stain
* Test of resistance of erythrocytes to hemolysis in sucrose or in acidic
* Determination of G6PD and pyruvate kinase
* Study the life of erythrocytes labeled with technetium 99m
* Schilling Test
* Blood lead levels, because anemia can be induced by lead poisoning
* Exploration of hemostasis: PT, APTT, Bleeding time, Clotting Factors
* Creatinine, urea, uric acid

Special cases
* Aplastic anemia: this is a rare type of unknown cause. It is characterized by the absence or decrease of erythroblasts (red blood cell precursors) in bone marrow. It may also be due to leukemia.
* Sickle cell anemia: blood cells have a shape stretched reducing their ability to transport oxygen. It is a mutation of hemoglobin molecules.
* Iron deficiency anemia: The origin is a lack of iron scavenger of oxygen.
* Anemia with paroxysmal nocturnal hemoglobinuria.

Treatment
The principle of treatment of anemia is the treatment of its etiology. In some emergency situations where anemia is symptomatic, if not deep, blood transfusion is performed.

See also Blood Transfusion

wikipedia

Pink Ribbon

2010-10-03T08:22:00.001-07:00

Pink Ribbon
The pink ribbon is an international symbol used by individuals, companies and organizations involved in raising awareness of breast cancer.

Purpose
The main goal of Pink Ribbon is to make people aware of breast cancer.

* 1) Prevention - the act of preventing breast cancer
* 2) Detection - discovering breast cancer
* 3) The treatment - a cure
* 4) Take care - give attention

History of the Pink Ribbon
The first tape to be considered meaningful object in history was the yellow ribbon (yellow ribbon), which was mentioned in a marching song, sung by the United States Army. In 1917, George A. Norton copyrighted the song for the first time. The title song was "Round Her Neck She Wears a Yeller Ribbon" ("Around her neck she wears a yellow ribbon"). In the 1940s, the song was rewritten by several musicians. Based on this song, the wife of a hostage in Iran, named Penney Laingen, was the first to use the ribbon as a symbol of awareness. She tied yellow ribbons around trees, to illustrate his desire to see her husband again. Friends and family members have followed through loyalty. Like all Americans could see this message, the ribbon became a medium of expression. "

In the 1990s, AIDS activists were inspired by the medium of the tape and decided to make ribbons for those fighting against AIDS. The ribbon representing AIDS turned red, the color of passion. During the Tony awards, we took pictures of the actor Jeremy Irons, with red ribbon stapled to his chest. As the audience followed the presentation of the statues, the band attracted the attention and became famous overnight. The year 1992 was declared "The Year of the Ribbon" by The New York Times.

Pink Ribbon was first introduced by the Susan G. Komen Breast Cancer Foundation. She put pink visors to survivors of breast cancer who participated in the Race for the Cure since early 1990. A few months later, in 1991, each member of the New York City race received a pink ribbon. However, the tape was not of such great importance for them, since it was a minor detail in an important event.

Alexandra Penney, who in 1992 was editor in chief of Self, a magazine devoted to women's health, worked in the second annual National Breast Cancer Awareness Monthissue. Evelyn Lauder, vice president at Estee Lauder, was invited to be editor of special issue NBCAM in 1992. Penney and Lauder came up with the idea of creating a ribbon and to enlist the cosmetics giant to distribute it in stores in New York. Evelyn Lauder then promised to distribute the ribbons in the entire country, but at this point, we had not yet decided the color of the ribbon.

However, Charlotte Hayley, a lady of 68 years struggling against breast cancer, produced peach ribbons. She sold them along with a card saying, "The annual budget is 1.8 billion U.S. dollars, and only 5 per cent of that budget goes to prevention of cancer. Help us wake up our legislators by wearing this ribbon. " His message spread quickly. This aroused the interest of Penny and Evelyn Lauder for the concept of Hayley. They saw an opportunity to revive the idea of working with her Hayley. Hayley but rejected the offer saying they were too commercial.

After Lauder, Hayley and the lawyers had discussed the different possibilities, they found a "new" color. The new color was the pink ribbon, which became an international symbol of breast cancer awareness.

Pink Ribbon International
The purpose of this organization is to create a supportive community worldwide and to inform patients, specialists, families and friends of the Pink Ribbon and Breast Cancer. Pink Ribbon International exists in different countries under the following names: Pink Ribbon International

Spanish: Rosa Lazo
French: Pink Ribbon
Italian Nastro Rosa
German: Rosa Schleife
Dutch: Roze Lint
Danish: Den Lyserøde Sløjfe
Czech: Růžová Stužka
Finnish: Roosa SWAD
Norwegian: Rosa Sløyfe
Polish: Różowa Wstążka
Russian: розовая лента
Swedish: Rosa Bandet
Turkish: Pembe Kurdele

Awareness Month Breast Cancer
The awareness month breast cancer is an annual international campaign organized by major charities involved breast cancer, in order to increase awareness of the disease, raise funds for research into its causes, its prevention and cure. The campaign also offers information and support to those affected by breast cancer.

AstraZeneca has created the awareness month for breast cancer in 1985. AstraZeneca is a multinational pharmaceutical company and is the manufacturer of Nolvadex (tamoxifen), Arimidex (anastrozole) and Faslodex (fulvestrant), medicines used to treat breast cancer. Since the beginning, the NBCAM (the month of breast cancer awareness) has been to promote mammography as the most effective way to fight against breast cancer.

The number of companies that are involved in breast cancer awareness has grown over the years. Estee Lauder, Avon, Komen and other commercial and noncommercial organizations participate in several events and activities during the month of October. This awareness campaign is also known in France under the name "Pink October".

See also Breast

wikipedia

Clavicle

2010-09-16T06:37:00.000-07:00

Clavicle
The clavicle, from the Latin meaning Clavicula small wrench, designates a bone anatomy of the anterior upper chest, placed between the upper tip of the sternum and the top of the shoulder. Its overall shape is that of an inverted "S". It is an elongated bone epiphysis has only located at the sternoclavicular joint, the other end not as an epiphysis not caused by endochondral ossification. She has two ends (including the pineal gland). It has a protrusion, the deltoid tubercle, which corresponds to the insertion of the deltoid muscle.

Upper face
The upper surface of the clavicle gives attachment to the deltoid muscle on the outer third and posterior to the trapezoid on its outer third and anterior

On both internal and third previous fits the pectoralis major which fits behind the superficial cervical fascia. (The clavicle has a tuber, called the deltoid tubercle at the distal end of the superficial cervical fascia.)

More behind the fascia fit muscle sterno-occipital and sterno-mastoid muscle (the muscle sterno-mastoid being located behind the muscle sterno-occipital). While the muscle sterno-hyoid and sterno-hyoid inserted at the posterior edge of the inner part.

On the most posterior part of the upper surface of the clavicle and always on his first two thirds, fits the average cervical fascia.

Underside
The underside of the clavicle is cut in half by a groove (located on the middle third of the clavicle) inside which fits the subclavian muscle.

The posterior lip of this insertion of the fascia-pectoro-axillary clavicle and the insertion of the medial ligament coracoclavicular.

Under the posterior lip is now the nutrient foramen of the clavicle.

The medial part of the clavicle has an articular surface articulating with the sternum extended its posterior part by a slight protuberance called Knocker Farabeuf.

Outside this surface, fit costoclavicular ligaments and muscle sterno-hyoid, the latter being inserted at the posterior edge of the clavicle and the ligament costo-clavicular nearest the front edge.

The lateral part of the clavicle is flattened and has an articular surface corresponding to that of the acromion along an axis oblique inward looking forward. Alongside this articular surface fits the trapezoid ligament (insert form whose base is located along the articular surface and the top on the conoid tubercle).

Located inside the conoid ligament is the tuber on which the conoid ligament conoïdien fits.

See also Tendonitis

wikipedia

Tendonitis

2010-09-13T05:32:00.000-07:00

Tendonitis
Tendinitis is a painful inflammation of a tendon, and is part of musculoskeletal disorders.

Definition
The human body contains many tendons but most do not ignite. A small group is manifested especially by inflammation, it is the tendons of the muscles:

* Carpal tunnel at the wrist, resulting in carpal tunnel syndrome;
* Elbow, causing epicondylitis (commonly called "tennis elbow") or epitrochleitis (tendinitis golfer);
* Of the rotator cuff (shoulder), causing the tendinitis of the rotator cuff;
* Triceps surae or Achilles tendon (Achilles tendon);
Tensor fascia lata *, causing the syndrome ilio-tibial band or "syndrome wiper" in the knee;

Also:

* Of the bridle, tied to a rotation, tendinitis usually found among cyclists;
* Quadriceps or patellar tendon.

When the synovial sheath is affected, it is called tenosynovitis.

Etiology
* Burnout
* Intense efforts and / or repeated (often in athletes)
* Articular malposition
* Drugs (fluoroquinolones)
* Some parasitic and infectious diseases (eg In Lyme disease caused by certain Borrelia can be transmitted by tick bites), 2nd or 3rd stage, some patients develop tendonitis, synovitis or bursitis recurring.)

Diagnosis
* Pain on palpation of the tendon
* Pain in the tension of the muscle tendon
* Feeling sad when hooking movements involving the tendon
* Nodosities tendon (tenosynovitis involving chronic fibrosis)
* Pain due to change of weather (rain, wind ...)

Treatment
Methods commonly used:

* Rest or immobilization by splinting (Orthopedic) (always essential)
* NSAIDs
* Analgesics
* Corticosteroid infiltrations
* Physiotherapy, whose treatment by radial shock wave lithotripsy extracorporeal derivative

Methods which no empirical evidence of their effectiveness:

* Chiropractic
* Phytotherapy (horsetail, Harpagophytum procumbens)
* Osteopathy
* Etiopathy
* Kinothérapie, massage, physiotherapy

See also Arthritis

wikipedia

Insulin

2010-09-01T06:35:00.000-07:00

Insulin
Insulin (from Latin insula, island) is a peptide hormone secreted by β cells of islets of Langerhans in the pancreas. She, with glucagon, a major role in regulating energy substrates, which are the main glucose, fatty acids and ketone bodies. In the couple formed by insulin and glucagon, insulin has the primary role in mammals: its absence is fatal within a few months in other species, especially birds, is the reverse: glucagon is the major hormone.

Overall, the action of insulin is often summarized by its hypoglycemic effect (decrease of glucose in the blood). It is probably fair to say that insulin is secreted according to nutritional status and physical activity, so that after meals, under the influence of elevated blood glucose (the concentration of glucose in the blood), but also under the direct influence of the presence of food in the gut, insulin secretion is stimulated, allowing the storage of glucose, end products of digestion of carbohydrate foods.

Storage areas are dietary glucose muscle, adipose tissue and liver. If food abundance, insulin also stimulates the conversion of carbohydrates into fatty acids for storage in adipose tissue. In this situation of plenty food, after meals, insulin blocks the production of glucose by the liver. By putting glucose in stock food and stopping the production of glucose by the liver, lower blood sugar. In between meals, the decrease in the secretion of insulin allows the release of stocks of glucose (liver glycogenolysis) and de novo production of glucose by the liver (gluconeogenesis). The de novo production of glucose by the liver may be prolonged because it uses the muscles directly, rather than energy reserves quantitatively much greater in adipose tissue.

During prolonged fasting (beyond a few days in adults, but only a few hours in neonates and infants), the continuing decline of insulin production allows the ketone bodies, which allows savings muscle, because ketones are derived from fatty acids in adipose tissue. Insulin also has important effects on the metabolism of proteins, it inhibits protein degradation and promotes amino acid uptake, inhibits lipolysis finally.

Beyond its immediate effect on regulating the flow of substrates, insulin has effects over long-term growth, is an anabolic hormone. It is interesting to note here the strong homology between insulin and the main growth factor, insulin-like growth factor (IGF-1), or growth factor related to insulin. Insulin as a signaling molecule in the presence of food in the digestive tract can be likened to a hormone of abundance, indicating the surplus energy for growth. Insulin has anabolic effects directly, by affecting the metabolism of carbohydrates, proteins and lipids, but also indirect, through regulation of carrier protein of IGF-1.

Diabetes are diseases of the secretion of insulin. In its severest form, diabetes mellitus (or type 1 diabetes) is fatal if not treated within a few months in an array characterized by hyperglycemia, loss of muscle and adipose tissue, and mass production and non-regulated not only glucose but also of ketones is diabetic ketoacidosis. In the West, diabetes mellitus is a disease that is not fatal, thanks to the drug insulin that diabetics must inject several times a day. This is not the case in most countries of sub-Sahelian Africa where the insulin drug is often lacking.

Discovery
The role of the pancreas in diabetes has been discovered by von Oskar Minkowski in 1889 in Strasbourg, where his assistant informed him that the dogs had made the day before their thirst and urine attracted flies ... The work of the physiologists of the early twentieth century, influenced by Claude Bernard, helped establish the concept of secretion by the pancreas of a substance to regulate glucose utilization. Several researchers have prepared extracts of pancreas in order to purify a sample that could have therapeutic utility in diabetes. Nicolae Paulescu was an important precursor, but its preparations were not purified somewhat usable. The best extracts were prepared by Frederick Grant Banting with the help of Charles Best, a medical student in the laboratory of John James Richard Macleod during the summer of 1921 in Toronto. The first product developed by Banting and Best, very active and very impure opened the door to treatment of diabetes through masterful job and ultra-fast J. B. Collip, a chemist, who has prepared a few weeks in relatively pure extract and use in therapy. Banting and MacLeod were the winners of the Nobel Prize in Physiology or Medicine in 1923 rewarding their work.

History has remembered the name of the first diabetic who received preparations of Banting and Best and Collip purified by one: Leonard Thompson received 11 January 1922, a first injection will decrease slightly and very transiently blood sugar, and will be followed an abscess at the injection site, due to impurities in the preparation. A few days later, the injection of a purer product has indisputable effects on blood glucose and symptoms: effectiveness of the hormone had been proven in humans.

The first insulin was purified from the pancreas of beef and pork. In the 1930s, various preparations have yielded long-acting forms of insulin crystallization in the presence of zinc or extension of time to absorption in the skin by adding protamine (NPH insulin, prepared by Hagedorn ).

Since the early 1980s, insulin is synthesized by genetically modified organisms. Most countries have abandoned the preparation of insulin from the pancreas of beef in the aftermath of the mad cow disease, although no cases of transmission of virus or prion by insulin was never observed.

Structure and production
Insulin is a hormone made up of two polypeptide chains linked by two disulfide bridges and one intrachain disulfide bond in the chain A: A chain of 21 amino acids and B chain of 30 amino amines.La structure of insulin was determined by Frederick Sanger, was the subject of the first of his two Nobel Prizes in 1958. Insulin is produced by β cells of pancreatic islets of Langerhans in the form of pre-proinsulin consists of a single peptide chain, two fragments, the signal peptide (23AA N-ter) is removed ( cretion was the destrois disulfide bonds), we obtain the pro-insulin will undergo the removal of C-peptide to become insulin (active form). Proinsulin has a structure very similar to that of two major growth factors, IGF-1 and IGF-2, and elevated levels of these hormones allow biological effects by signaling after binding to receptors other: Hypoglycemia in massive secretion of IGF-1 and IGF-2 by tumors. Insulin circulates a concentration of the order of nanomoles per liter.

Stimulation of secretion
Blood glucose filtered through the capillary pore in the lymph that bathes the β cells of islets of Langerhans. The concentration of glucose around the β cells is the same as in the blood. The cell matter by a glucose transporter GLUT2 nonsaturable (the other body cells have a receptor rapidly saturated). The concentration of intracellular glucose therefore reflects that of blood. The glucose enters the beta cell is immediately followed by its phosphorylation by a specific hexokinase, glucokinase, whose kinetic characteristics play an important role in coupling glucose / insulin (50% loss of activity of glucokinase is the cause of a particular form of diabetes, MODY-2). Glucose metabolism in β cells increases the ATP / ADP. This induces the closure of a potassium channel sensitive to the increase in the amount of ATP. If K + (potassium) stop discharging it hyperpolarizes the β cell is a cell excitability, since it has an electrical activity when the extracellular glucose concentrations above 5 mmol · l-1. This depolarization opens voltage-sensitive calcium channels: calcium enters the cell and triggers the exocytosis of vesicles containing insulin.

Types
We traditionally distinguish insulin according to their time and their duration of action: ultra-fast, fast, slow and semi-slow or fast mix and semi slow.

The longer period of action is primarily by adding zinc or protamine in the insulin, allowing the formation of crystals or precipitates whose dissemination into the blood is much slower. The modern insulin preparations involve molecules like insulin, whose effectiveness has been preserved, but the kinetics of absorption is changed. This provides similar with the speed of movement of the subcutaneous tissue to blood is accelerated (like "fast", which lispro, aspart and glulisine) and analog whose rate of absorption is reduced by precipitation in the subcutaneous tissue, either in the presence of zinc (analog detemir) or by modifying the isoelectric point (analog glargine).

See also Diabetes Type 1

wikipedia

Anti-diabetic drug

2010-08-28T06:30:00.000-07:00

Anti-diabetic drug
A diabetes medicine is a medicine used to treat diabetes mellitus. Antidiabetic generally act by lowering blood glucose. There are different types of antidiabetic agents, and their use depends on the nature of diabetes, age and situation of the person, and many other factors.

Thus, in type 1 diabetes, there is no physiological insulin secretion. Insulin administration is the mainstay of treatment and the use of oral antidiabetics is not indicated. In contrast, in type 2 diabetes, insulin secretion is present but insufficient to obtain a physiological effect. Treatment therefore consists of the administration of oral antidiabetic which will increase the secretion or promote tissue sensitivity to insulin.

Oral antidiabetic
Oral hypoglycemic agents (OHA) are used in diabetes type 2 (non-insulin-dependent), where they can be sometimes (not always) prescribed in combination with insulin. There are four classes of drugs that have proven effective for treating type 2 diabetes.

* The sulfonylureas.
* Biguanides.
* The glitazones.
* Inhibitors of alpha-glucosidase.

Other oral agents have not demonstrated efficacy in preventing clinical complications of diabetes. However, the standards of HAS (Haute Autorité de Santé) changes each year, as many studies are underway.

Biguanides
The Biguanides decrease hepatic gluconeogenesis and insulin resistance of the body:

* Metformin, a drug of first choice in the treatment of diabetes non-insulin-dependent

Main article: Metformin.

* Phenformin (not used)
* Buformine (Switzerland)

Glitazones
The Glitazones (Thiazolidinediones) decreased tissue resistance to insulin. They are used as third line in the treatment of type 2 diabetes.

* Pioglitazone (Actos ®)
* Rosiglitazone (Avandia ®)
* Troglitazone (not used out)

Side Effects
* Weight
* Edema from sodium and water retention.
* Visual disturbances.
* Respiratory Infections (Colds, sinusitis ...)
* Insomnia.

In combination with metformin:
* Edema.
* Anemia.
* Headaches.
* Joint pain.
* Blood in the urine.
* Erectile dysfunction.
* Flatulence.

In combination with a sulphonylurea:
* Edema
* Dizziness
* Flatulence,
* Hypoglycemia
* Presence of sugar or protein in urine,
* Increased appetite
* Headaches
* Dizziness
* Fatigue
* Excessive sweating.

Cons indications
* Hepatic.
* Congestive heart.
* Severe renal impairment.
* Recent myocardial infarction.
* Pregnancy.
* Breastfeeding.

Their use with insulin may increase the risk of heart failure. Studies are underway to better evaluate the benefit / risk.

Drug Interaction
This medication may be prescribed with a biguanide, however, this association has not proven its clinical effectiveness.

The combination of these molecules with corticosteroids, antiasmathiques bronchodilators, diuretics or angiotensin converting enzyme may require more frequent monitoring of blood glucose, or a change of dosage of oral antidiabetic.

Inhibitors of alpha-glucosidase
Inhibitors of alpha-glucosidase inhibitors inhibit the last stage of digestion of sugars. Those methods can not be absorbed in the gut and still undergoing colonic bacterial fermentation volatile fatty acids or is excreted in the feces. This class of antidiabetic agent is used in addition to the other or at cons-indication to other treatments.

* Acarbose
* Miglitol

Side Effects
* Digestive problems (flatulence, flatulence, intestinal discomfort, diarrhea, bloating ...)
* Rash.

These effects tend to diminish during treatment.

Cons-indication
* Disorder of digestion and absorption.
* Inflammatory bowel.
* Intestinal hernia.
* Antecedent subocclusif syndrome.
* Severe renal impairment.
* Children under 15 years for acarbose and 18 for miglitol.
* Breastfeeding.
* Pregnancy.

See also Rosiglitazone

wikipedia

Bladder Cancer

2010-08-26T06:53:00.000-07:00

Bladder Cancer
The inner wall of the bladder is lined with transitional cells that are responsible for most cancers of the bladder. The development and management depends very much on the invasiveness of the tumor. We distinguish cancer superficial bladder cancer invasiveness. If the cancer is superficial good prognosis, invasive cancer of the bladder is much more severe and requires aggressive treatment.

Incidence
The bladder cancer is a tumor frequently. In 2000, 10,700 new cases were diagnosed in France, including one third of bladder cancers are related to smoking. The incidence of this cancer is the sixth largest in France by its frequency among cancers.

Risk factors
The factors most important are tobacco and some chemical carcinogens. As such the bladder cancer can be considered an occupational disease.

The main industrial chemicals in question are:

* Aromatic amines;
* Hydroxylated derivatives halogenated and sulphonated;
* Derivatives of aniline;
* Some polycyclic hydrocarbons;
* Industrial derivatives of tryptophan;
* Arsenic.

Also found at the origin of bladder cancer drugs (phenacetin, cyclophosphamide) or pelvic irradiation. The lesions of urinary bilharziasis may degenerate into malignant lesions like squamous cell carcinoma of the bladder, this parasite is found mainly in Egypt and West Africa.

There is also an endemic nephropathy tubulointerstitial pore water in the Balkan region, which may be complicated by urothelial cancer. This disease is caused by food poisoning by mycotoxin, ochratoxin A, produced by a fungus of cereals.

Several mutations in certain genes increase the risk of bladder cancer, including the p63 gene, the gene encoding the receptor for epidermal growth factor and other genes.

Symptoms
The clinical features suggestive of malignant tumor of the bladder are not specific. We note first the micro or macro-hematuria, dysuria, urinary signs of infection to clear urine, recurrent urinary infections. The alteration of the general condition and the pain often mark an advanced stage of disease.

Clinical symptoms require confirmation with achievement

* Finding a dipstick haematuria,
* Examination of urine cytology may confirm the presence of red blood cells and abnormal cells, but this has a low sensitivity,
* Cystoscopy to visualize the bladder lesions and perform at the same time for pathological studies of biopsies of lesions and confirmation of diagnosis. is an essential examination.
* Imaging examinations such as CT and MRI of the pelvis are helpful in staging. In this final stage, the injection of ferumoxtran-10 would detect lymph node metastases, even in small sizes, with very good sensitivity and specificity.

Staging
The bladder cancer develops from the inner lining of the bladder. In untreated, the disease spreads beyond the mucosa through the bladder wall, spreads through the lymphatics to the lymph nodes of the pelvis and through the veins throughout the body . Staging helps to know the exact stage of the disease, to apply the best treatment and to estimate the prognosis of the disease.

Pathology
There are different pathological types of malignant tumor of the bladder. The term bladder cancer is the carcinoma of the bladder. There are three forms:

* The transitional cell carcinoma is the most common form. It represents 90% of bladder cancers.
* Squamous cell carcinoma is rare, it corresponds to 7% of cancers.
* Adenocarcinoma is rare, about 1%.

The non-cancerous lesions consistent with lymphoma, sarcoma and neuroendocrine tumeus bladder whose treatment differs carcinomas.

The TNM-UICC 2002
T (tumor)

* Tx Primary tumor can be classified
* T0 tumor can not be classified
* Ta papillary superficial (respecting the basement membrane)
* Tis carcinoma in situ (plan, respecting the basement membrane)
* T1 Tumour invades subepithelial connective tissue
* T2 Tumor invades the muscle (or detrusor)
o T2a superficial muscularis
o T2b deep muscularis
* T3 tumor invading the bladder tissue died (fat)
o Achievement T3a microscopically
o Achievement T3b macroscopically
* T4 Invasion of adjacent organs
o Prostate T4a or uterus or vagina
o T4b pelvic wall or abdominal wall
N (regional lymph)

* Nx Lack of sufficient information
* N1 Metastasis in a single pelvic lymph node <2> 2 cm but <5> 5 cm

M (Distant metastasis)

* M0 No distant metastasis
* M1 Presence of distant metastases

The prognosis
Prognostic factors are:

* TNM stage;
* Histological grade;
* The presence or absence of hydronephrosis;
* The quality of transurethral resection for patients treated with combined radiation and chemotherapy.

The 5-year survival for localized tumors of the bladder is 60% irrespective T. It is independent of the type of local treatment. The 5-year survival of forms with pelvic lymph node is 5-25% depending on the size of the lymph node. The 5-year survival is 10-15% in patients treated with chemotherapy. Most deaths were observed within 2 years after diagnosis.

The metastatic disease have a very poor prognosis, with a survival time close to a year.

Treatment endo-bladder
The treatment consists of either intravesical BCG immunotherapy (whose effectiveness remains controversial on the final outcome) or chemotherapy mitomycin C. Interferon alpha is being studied.

Systemic
Chemotherapy may be used in several situations:

* Associated with radiotherapy.
* Before the surgery to try to reduce the size of the tumor and allow intervention. It is a neo-adjuvant chemotherapy. Several studies suggest an advantage to achieve this chemotherapy under certain conditions without his interest is formally established.
* After the surgery, it is called adjuvant chemotherapy whose goal is to reduce or delay relapse. In this situation also several studies suggest an advantage to this chemotherapy without his interest has been fully demonstrated.

For chemotherapy systemically effective molecules in bladder cancer are cisplatin, methotrexate, vinblastine, adriamycin, paclitaxel and gemcitabine. Today, the protocol used in the adjuvant and metastatic protocol GC (gemcitabine cisplatin). This protocol is equivalent to the MVAC protocol in terms of efficiency. It is less toxic. Vinflunine may be used in second line after failure of platinum-based chemotherapy.

Chemotherapy combined with radiotherapy can be combined cisplatin and 5FU.

See also Pancreatic cancer

wikipedia

Salmonella

2010-08-22T06:45:00.000-07:00

Salmonella
Salmonella are enteric bacteria of the genus Salmonella, named in honor of the American veterinarian Daniel Elmer Salmon even if the man who discovered the genre was Theobald Smith, who worked under the direction of Salmon to the Bureau of Animal Industry (BAI ) 1884.

Taxonomy
According to the recent work of taxonomy, in particular by DNA hybridization, the genus Salmonella comprises two species, the main (long considered the only one), Salmonella enterica consists of over 2000 serotypes or subspecies - which The most common is Salmonella enterica Enterica - themselves divided into numerous serovars (Enteritidis, Derby, Hadar, Infantis, Paratyphi, Typhi, Typhimurium, Virchow, etc..).

Salmonella species are the following:

* Salmonella bongori;
* Salmonella enterica;
* Salmonella enterica arizonae;
* Salmonella enterica Diarizonae;
* Salmonella enterica Enterica;
* Salmonella enterica houtenae;
* Salmonella enterica indica;
* Salmonella enterica Salamae;
* Salmonella subterranea (since 2004).

In 2000, the National Reference Centre for Salmonella and Shigella (CNRSS) of the Institute Pasteur in Paris, had listed 883 Salmonella strains of human origin. Serovars Enteritidis and Typhimurium accounted for 36% and 29%. We know today more than 2000 serotypes of salmonella.

Biochemical characters
They are Gram-negative enterobacteria, mobile (peritrichous cilia), aero-facultative anaerobes, oxidase - Nitrate reductase + fermentation of glucose, lactose -, H2S + (or -), urease -, lysine decarboxylase +, using lane mixed acid, indole-, not having the beta-galactosidase, high infectivity, responsible for gastroenteritis, food poisoning and typhoid fever and paratyphoid (S. typhi and S. paratyphi).

Infectious dose
There is no standard infectious dose, which depends:

1. the pathogenicity of the strain (or serovar) considered
2. factors of host susceptibility
3. microbial concentration (dose in contact or ingestion).

Antigenic characters
Like all Enterobacteriaceae, Salmonella somatic O antigens have (located in the wall). There are 67 different O-antigen is a major characteristic of a group of Salmonella O-antigen is a minor accessory. The deletion mutation of the O-antigen leads to partial or complete loss of pathogenicity.

Salmonella flagellar antigens have also H. They are present in two different forms (phase). In both of these forms (biphasic) or in the form of a single phase (monophasic). These two phases are encoded by two different genes, but very similar, they must originate from the duplication of a single ancestral gene.

Finally, Salmonella ser. Typhi, S. ser. Paratyphi C and S. ser. Dublin possess the capsular antigen Vi polysaccharide nature can (more or less) hide the somatic O. The latter is unmasked by the destruction of Vi antigen (heating at 100 ° C for 10 min).

Habitat
Salmonella can survive several weeks in dry and several months in water. They occur so frequently in aquatic environments polluted, contaminated by feces of carrier animals is very important. Aquatic vertebrates, including birds (Anatidae) and reptiles (Chelonia) are important vectors of salmonella. Poultry, cattle and sheep are animals frequently contaminant, Salmonella may be found in foods, including meat and raw eggs.

Syndromes typhoid and paratyphoid
Four serotypes of Salmonella have adapted to humans, which is the only reservoir and in whom they cause a specific disease. These S. typhi (typhoid bacillus), S. paratyphi A, S. paratyphi B (bacillus Schotmüller) and S. paratyphi C (bacillus Hirschfeld), incidentally S. sendai. The germs enter, even in small numbers, through ingestion and after a fairly long incubation (up to 3 weeks) cross the intestinal mucosa and invade the lymphoid tissue pre-intestinal (Peyer). From there, the germ passes with the lymph into the circulation, which determines a state sepsis. Sepsis is a complication not accidental but part of the normal evolution of the disease. In addition, Peyer's patches may ulcerate and cause intestinal perforation and peritonitis. The patient recovered carrier of germs can remain for months or years, especially persistent bacteria in the bile ducts.

The release of endotoxin plays an important role in the pathogenesis of the disease, hence the danger of administering a high dose of antibiotic that may cause mass lysis of bacteria.

Transmission occurs primarily through drinking water during epidemics spread. But direct contact or food may also be implicated in the spread. The strict bacteriological control of drinking water and monitoring the reservoir of germs (carriers) account for the dramatic reduction of typhoid and paratyphoid in countries with developed health.

Food poisoning or salmonella enteritis
Responsible group consisting of potentially all other serotypes (over a thousand), most of which have never yet been found in humans. These are encountered in various Salmonella species, most having never been linked to a specific host and can also infect humans. It is therefore a zoonosis.

The organism enters through the digestive tract and must be ingested in large numbers to cause disease in healthy adults. The gastric acidity was also in charge of the destruction of the majority of ingested bacteria. The contagion is carried by massive ingestion of foods in which the germ has swarmed like in a culture medium.

However, infants and young children are more susceptible to infection which can be achieved by ingesting a small number of bacteria. It has been shown that, in infants, the contamination could be through inhalation of bacteria-laden dust. After a short incubation period of a few hours one day, the germ multiplies in the intestinal lumen causing an intestinal inflammation with diarrhea often muco-purulent and bloody. In infants, dehydration can cause a state of severe toxicosis. The disease usually is mild. There is normally no sepsis, but it can occur exceptionally as a complication in patients debilitated (Hodgkin's disease, eg.). Extraintestinal localizations are possible, especially salmonella meningitis in children, osteitis, etc....

Epidemiology of foodborne illness
Epidemiology involves food, especially meat, eggs and dairy products.

These have a high salmonella outbreak in the summer. The majority of salmonella enteritis occur in young children, in the form of scattered cases. At least 25% of summer enteritis in young children are caused by salmonella. In Western Europe, S. typhimurium represents nearly 70% of isolates!

See also Escherichia coli

wikipedia

Climate Change

2010-08-17T07:26:00.000-07:00

Climate Change
A Climate change is a lasting change (of the decade million years) statistical parameters (mean parameters, variability) the Earth's global climate or its various regional climates. These changes may be due to processes intrinsic to the Earth, external influences or, more recently, human activities.

Anthropogenic climate change is caused by emissions of greenhouse gases caused by human activities, modifying the composition of the atmosphere of the planet. In addition this development the natural variations in climate.

In the work of the IPCC, the term "climate change" refers to any change in time, whether due to natural variability or human activity.
Instead, the United Nations Framework Convention on Climate Change, the term refers only changes due to human activities. The Framework Convention uses the term "climate variability" to refer to climatic changes of natural origin.

The ancient climate changes
1 The previous phases in human history are the paleoclimatology. They can track, over the continental drift and successive periods of glaciation, variations related to climate change affecting soils and species, by their nature. The carbon cycle is now involved;
2 Glaciations: the cycle of climate change can now detail the seven previous glaciations:

1. (650 )
2. until 450,000 years ago: de Waal Interglacial
3. until 400,000 years ago: Beestonian stage or Nebraskan
4. until 350,000 years ago: Cromer interglacial or Aftonien
5. until 320,000 years ago: Mindel Glaciation, Elster or Kansien or
6. until 270,000 years ago: Holstein Interglacial or Yamouthien
7. until 200,000 years ago: Wolstonian, or Saal, or Illinoian
8. until 125,000 years ago: Eem Interglacial of Sangamonian or Eemian
9. until 70,000 years ago: Würm glaciation, the Weichselian or Wisconsin or
10. until 11,625 years ago: the Holocene Interglacial (Holocene Climatic Optimum), sometimes referred to as "the new warming" of the Holocene

3 Beginning of written human history and recognition of changes in climate by the chroniclers.

1. 535-536: 535-536 of Climate Change (Climate Exchange of 535-536), found by the Byzantine Procopius
2. Tenth century - the fourteenth century: Climate Optimum of the Middle Ages, a localized heating in Europe and even North America
3. 1550s - 1850s: Little Ice Age

4 The last phase is contemporary attempts to describe the multiple effects of global warming, it is separated from the rest given the constant interference of anthropogenic climatic balances since the advent of the industrial revolution and control of polluting energy by mankind.

1. Retreat of glaciers since 1850

The recent global warming
It was first mentioned by several authors, then modeled by Svante Arrhenius in 1896. The term (global warming in English) was invented by climatologist Wallace Broecker (in) in the journal Science August 8, 1975. Since then, the IPCC says that global warming tends to get carried away and the process cycles and climate control are standard and exceeded by 1950, including:

1. The thawing of permafrost containing methane (CH4), whose action on the greenhouse effect is 23 times the carbon dioxide (CO2).
2. The melting of polar ice and glaciers increases absorption by soils and oceans of solar radiation.
3. During heat waves more frequent, the vegetation slows its growth and thus its ability to extract carbon from the atmosphere.

It would be a shift to a climate of high magnitude imbalance, without that we can usually know if a point of no return is reached.

The IPCC does not conduct research in its own name but has the task of evaluating scientific information, technical and socio-economic surveys are needed to better understand the science behind climate change risks to human, identify possible consequences of this change and consider possible strategies for adaptation and mitigation. At least eight of the ten warmest years since 1850 are after 1997.

Volcanic crises
The exhaust emissions from volcanoes have two opposite effects:

1. aerosols (SO2 and dust) darken the atmosphere, increasing rainfall and cool climate;
2. in a second time, large quantities of greenhouse gases emitted causing a greenhouse effect. The greenhouse effect has resulted, like the climate in a greenhouse, to amplify the temperature difference: where the sun's heat is reflected and preserved if there is no Sun, heat comes more difficult and therefore it is colder.

The majority of species extinctions in the past seems due to a sudden climate change.
The fall of the Chicxulub meteor is often cited as a cause of the collapse of biodiversity in the late Jurassic, but it seems (Courtillot, 2004) that volcanic eruptions (or self-induced shock meteor) that have left traps (in the Deccan, India) have the most gigantic drastically disrupted the climate for hundreds of years at a rate exceeding the pace of evolutionary adaptations of species possible. In particular, the crisis of the Siberian Traps is associated with the disaster of the Permian.
Significant and measurable disturbances following the eruption of Pinatubo (1991) and in 1783-1784, that of Laki (Iceland eruption cloud which has left a trace in the records of mortality in Europe (Courtillot, 2005)). In 1815, the Tambora eruption has also affected global climate, with strong disturbances in 1816.

See also Environmental health

wikipedia

Environmental health

2010-08-14T08:42:00.000-07:00

Environmental health
"Health-Environment" is a term coined in the late twentieth century. It means speaking for the common field assumptions, knowledge and theories concerning the prospective relationship possible between:

* Firstly environmental variables (biogeographic factors, pollution and environmental nuisances ..) but also factors concerning the quality of food, the indoor environment (air, noise, electromagnetic fields, radioactivity ...) and (job exposure to toxins, abnormal fatigue or stress-specific factors)
* And other: health,
* And monitoring them.

This area is changing, thanks to advances in modeling, software tools and the Internet (databases increasingly rich and interconnected) and statistical information more easily collected and less available (cf. problems caused by data rights and / or confidentiality of private data) showed the importance of a more comprehensive approach, integrating heuristics and better psycho-social aspects, and landscape epidemiology. These advances make it possible to compare statistically the description of the evolution of the health status of a population to different environmental indicators and / or demographics.

Recent studies, passing the data to environmental and health worldwide, based on statistics accumulated since 1940 show that emerging diseases are rising for a century (almost fourfold in 50 years).
Viruses highly pathogenic and potentially pandemic high HIV / AIDS, Severe Acute Respiratory Syndrome (SARS) virus, West Nile fever, Ebola, H5N1, etc.. appear recently emerged in humans, from the Animal.

History of the concept
During the twentieth century, with the emergence of environmental medicine, environmental conditions have become increasingly important as an explanatory factor of health, including the development of ecotoxicology and landscape epidemiology.
Agenda 21 established at the Earth Summit in Rio (June 1992) for sustainable development considered in one chapter entitled "Protection and promotion of human health" that public health was dependent on the quality of the biophysical environment and it was therefore necessary to link Health and Human Environment.
At the WHO conference in Frankfurt in 1989, "Environmental Health" was defined as including "those aspects of human health and disease are determined by the environment. This refers to the theory and practice of monitoring and evaluation in environmental factors that can potentially affect health ".
The notion of black spots appeared recently in the PRSE II for example, better cross and take into account the environmental and health inequalities.

Factors and issues
Environmental health is determined by many factors. These factors are related both to the natural environment (ecosystems) and the built environment (housing, cars ..) including the conditions and places of work and mobility. These include:

* Air quality (including indoor air, including tobacco smoke), micro-and nanoparticles, pesticides and other pollutants;
* Water quality (see water management, access to drinking water for all, prevention of waterborne diseases, including through the pools and bathing water;
* Soil quality (pathogens and parasites content, pesticide residues, radioactivity, organic pollutants and metal or metalloid contaminants are persistent), particularly in cities, in and around industrial areas around transport infrastructure
* Housing (including schools, prisons, campsites, hotels, retirement homes, etc..
* Personal hygiene and exposure of the body (possibly in utero) to different sources of stress (and other pathogenic microbes, consequences of trauma (hitting, tattooing, piercing) ... and some cosmetics);
* Climate change and its health effects (heat waves, emerging diseases);
* Increased exposure to UV, following the hole in the ozone layer, compounded with sunburn and increased risk of cancer;
* Natural disasters (see Occurrence and severity, but also degree of preparation and coping with disasters);
* Quality Food (agriculture, transport / storage, manufacturing, distribution ...);
* Management of health risk (outbreaks, nosocomial infections ...);
* Management of hazardous (including toxic waste and / or hazardous, radioactive, contaminated sites and soils, effects of war, pollution caused by unexploded munitions dumped ... including remediation, waste management and excreta (especially in case of epidemic);
* Lead Poisoning and Prevention childhood lead poisoning;
* Planning, Sustainable Development, QEH
* Nuisance caused by light pollution (including light trespass);
* Noise pollution;
* Light pollution (which is a factor of endocrine disruption;
* Environmental impact studies or not taking into account the impacts on health (theoretically compulsory since the Air Act (Act Barnier) in France);
* Occupational Health;
* Radiological Health (⇒ reduce exposure to UV radiation or X radiation and / or radionuclides);
* Exposure to vectors of microbes or parasites (mosquitoes, ticks, rodents, etc.).
* Location of war, civil war, political refugee or refugee climate ..
* And maybe some electromagnetic fields

In Europe
The Sixth Action Programme of the European Union for the environment includes a section on "Environment and Health" to "attain a quality environment that does not jeopardize or adversely affect human health" . It proposes:

- Identify the risks to health (including children and elderly) to "legislate accordingly";
- Introduce environmental and health priorities into other policies, and legislation on water, air, waste and soil;
- Develop research in the field of environmental health;
- Better assess the risks of chemicals (see REACH Directive);
- Prohibit or restrict the most dangerous pesticides and use of best practices
- Implement legislation on water (Water Framework Directive ...);
- Produce standards on air quality and a strategy on air pollution;
- Produce and implement a directive on noise.

The cost of diseases with certain environmental origin has been evaluated for the EU to about 50 billion € over 30 years.

In Belgium
In Belgium, the federal plan Health-environment called NEHAP (NAP Belgian healthcare environment).

There is a second Scientific Institute of Public Health (IPH) involving the federal and community levels Belgian (Flemish, French, germanophone) which includes a cell of environmental health.

Insofar as the health environment is part of preventive health, the three Belgian Communities are competent. For the French Community of Belgium, it is the Directorate General for Health. The Walloon Region is in theory not responsible for the health-environment, but for the environment, however the materials are related. In this context it is the Directorate General for the Environment.

There are other community or regional institutions involved in environmental health such as SPAQuE or the IBGE (Brussels Institute for Environmental Management).

Finally, in the field of Public Health, University of lessons specific environmental health are offered (School of Public Health at the Free University of Brussels).

In Switzerland
A Plan of Action and Environmental Health (AGE), established following the Earth Summit in Rio, has lasted ten years and ends in late 2007 without any result seems planned. This plan coordinated by the Division of Environmental Health and BAG had three priorities:

"Nature and well-being"
"Mobility and well-being"
"Housing and welfare.

In September 2004, the Swiss Romande relayed this work with an "Action Plan on Environment and Health ASPP encourage local projects Romand.

See also wine and health

wikipedia

Rhumatologie

2010-08-12T08:12:00.000-07:00

Rhumatologie
Rheumatology is a specialty that focuses on the diagnosis and treatment of diseases of the musculoskeletal system, that is to say, diseases of bones, joints, muscles, tendons and ligaments, but rheumatologists ( physicians specializing in rheumatology) also treat certain neurological devices such as sciatica and above all the collagen vascular diseases, autoimmune diseases which can have many extra-articular manifestations (skin, eye, kidney, lungs, etc..).

Diseases
These diseases can be classified into families:

* Inflammatory diseases: rheumatoid arthritis, ankylosing spondylitis, lupus erythematosus ... usually an autoimmune disease
* Infectious diseases: Septic arthritis, spondylodiscitis
* Skeletal diseases: osteoarthritis, osteoporosis, ...
* Neoplastic diseases: benign and malignant
* Metabolic disease: gout, chondrocalcinosis ...
* Dysplastic borne disease: genetic disorders of bone ...
* Other diseases affecting the joints, such as the Reflex sympathetic ...

These groups are expressed in disease signs or bone articular joint, there is no "arthritis" but osteoarticular rheumatism or different causes and therefore different prognosis.

Inflammatory
* Rheumatoid
* Lupus Erythematosus
* Sjögren's syndrome
* Scleroderma (systemic sclerosis)
* Dermatomyositis
* Polymyositis
* Polymyalgia rheumatica
* Osteoarthritis
* Septic Arthritis
* Gout, pseudogout
* Spondyloarthropathies
o Ankylosing spondylitis
o Reiter's syndrome
o psoriatic arthropathy
o spondylitis enteropathica
o reactive arthropathy
* Vasculitis
o polyarteritis nodosa
o purpura Henoch-Schönlein
o Serum sickness
o Wegener's granulomatosis
o giant cell arteritis
o arteritis
o Takayasu's arteritis
o Behcet's Disease
o Kawasaki disease (mucocutaneous lymph node syndrome)
o Buerger's Disease (thromboangiite obliterans)

See also Lupus Erythematosus disseminated

wikipedia

Disorder Attention Deficit

2010-08-08T22:26:00.000-07:00

Disorder Attention Deficit
ADHD or attention deficit disorder / hyperactivity disorder (in English Attention-deficit hyperactivity disorder, ADHD or Attention-deficit disorder, ADD) is a neurological disorder characterized by impaired concentration (ADD) with or without hyperactivity / impulsivity . Its detection and caring are the subject of much controversy. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) ADHD is a behavioral disorder in the true sense of the term, although the risk of developing a disorder or conduct opposition is higher than average. The child who is taken with ADHD has behaviors that require greater coherence and greater consistency on the part of adults who revolve around him. The child is not provided a behavioral problem.

Neurological aspects
This mental state manifests itself, in terms of neurological deficit by dopamine, a neurotransmitter.

Chemical transmission of neuron A (transmitter) to neuron B (receiving)

1. Mitochondria
2. Synaptic vesicle with neurotransmitters
3. Auto receptor
4. Where the exchange is deficient (synapse)
5. Postsynaptic receptors activated by neurotransmitter (induction of a postsynaptic potential)
6. Calcium channel
7. Exocytosis of a vesicle
8. Recaptured neurotransmitter

It appears, however, that much controversy exists about whether ADHD is truly a neurological disorder as it is often claimed. Some research also aimed to highlight the inconsistency of some studies linking this issue to a neurological disorder.

Genetic factors
AD / HD has a hereditary aspect, involving in particular the role of dopamine transporters. The affected genes include dopamine D4 receptors, dopamine beta-hydroxylase, monoamine oxidase A, catecholamine-methyl transferase, the serotonin transporter (SLC6A4), 5-hydroxytryptamine receptor 2A (5-HT2A) receptor 5 - hydroxytryptamine 1B (5-HT1B), the 10-repeat allele of the DAT1 gene, the 7-repeat allele of the DRD4 gene, and dopamine beta hydroxylase gene (DBH TaqI).

However, this dimension is never inherited a genetic malfunction: it is a neurological condition naturally, which would have even promoted the survival of our ancestors, hunter-gatherers. It would have been gradually eliminated from the population once it sedentarised. The genetics of ADHD would be an original state of humankind and the non-ADHD the result of a recent adaptation, evolution still lower among populations (semi-) nomadic (it applies to the lactose intolerance, which is an original working of the human body, so that lactose tolerance is an adaptation related to the rearing of cattle, particularly in Europe and North and Central Africa).

In certain nomadic populations or recently settled, particularly in Africa and among Native Americans, the 7-repeat allele of the gene DRD4 is much more common and can reach more than half of the population.

Dietary factors
Some heavy metals such as lead or certain dyes or preservatives (sodium benzoate), absorbed as food, are suspected of contributing to hyperactivity and poor concentration in children:

* The dyes are widely used in children's diets. Some were able to exacerbate hyperactivity in children who had been diagnosed with ADHD. These studies have also highlighted the possible role of sodium benzoate, used as a preservative, may also be a factor in hyperactivity in children from the general population. The researchers have yet to verify if it is a synergy between sodium benzoate and certain colors, or whether the effect of sodium benzoate alone.

Epidemiology
The diagnosis is often at school age when symptoms interfere with the adaptation and reach about 3% to 5% of children in Western countries. It seems that ADHD is more common in North America and Europe, and in Northern Europe than in the south.
* In the West, about one fifth of cases of ADHD are hyperactive-dominant (H), while the attention deficit disorder (ADD) is dominant in four fifths of cases.
* The symptoms decrease with time, but it is estimated that two thirds of adults retain this status.
* This syndrome more readily reach girls (between 3 and 9 times more) but these figures may be skewed because that seems more normal hyperactivity in boys. There is a great disparity of prevalence figures of this syndrome in different countries or time studied, ranging from less than 1% (Hong Kong) to 25% (USA). The explanation for these differences is unclear: different assessment criteria, cultural factors? Swanson said in 1989 that the prevalence sometimes seems to be correlated to the marketing policy of primary treatment (methylphenidate).

Classification
One of the first descriptions of the syndrome dates back to 1902. The disease is recognized during the 1960s, where it appears in the BOMs.

* The International Classification of Diseases (ICD-10) conducted by the World Health Organization defines hyperkinetic disorders (code F90) as "disorders characterized by early onset (usually during the first five years of life) a lack of persistence in activities that require cognitive involvement and a tendency to move from one activity to another without finishing any, associated with an overall activity disorganized, uncoordinated and excessive. "
* U.S.: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) prepared by the American Psychiatric Association, Disorder Attention Deficit / Hyperactivity Disorder (ADHD) is characterized by two sets of events: the attention deficit on one side, and hyperactivity-impulsivity on the other.
* France: In the French classification of mental disorders in children and adolescents (CFTMEA), hyperkinesia with attention deficit disorder (code 7.00), classified as conduct disorders and behavior, is characterized " the psychic side [with] difficulties to attract attention, a lack of consistency in activities that require cognitive involvement, a tendency for activity disorganized, uncoordinated and excessive, and a degree of impulsivity - the motor level [by] a motor restlessness or hyperactivity incessant."

Treatment
Drug treatment of ADHD is generally based on psychostimulants that stimulate the central nervous system. Methylphenidate hydrochloride (Ritalin ® in France, Belgium Rilatine ®), which is also in the list of drugs, is one of the most widely used drugs in this indication, the latter existing as sustained release or not. It does not appear to induce dependence in the topic, since the beaches to stop treatment are observed. Mention was made of cases of stunting, but recent surveys have revealed their character in some idiopathic overactive, unrelated to the treatment.

Another type of treatment has been recently developed: the Strattera. The molecule is atomoxetine. It is a specific inhibitor of the reuptake of norepinephrine (not psycho). But now, it is not yet on sale in France. The only way to get it, is to ask his doctor to make a request for ATU (temporary use).

In Europe, the evaluation is done by a child psychiatrist who has sole authority to issue methylphenidate. In North America, contrary to the ethical rules of European psychologists, psychologists and / or psycho can do a job evaluation, but not diagnostic. This portion is reserved for a doctor. In France, they are neurologists who can diagnose ADHD, with or without H.

Symptoms
* Impulsivity
* Hyperactivity
* Forward
* Easily angered, frustrated
* Mood swings, especially when disturbed during activities
* Inattention, difficulty concentrating for an extended period
* Lack of time, dreams
* Difficult to get to work
* Memory Problem
* Too many things in mind both
* Starts too many things at once without finishing
* Low tolerance for boredom
* Difficult to follow established procedures
* Anti-conformism
* Frequent changes in hobbies, center of interest, work, etc..
* Agitation, excitement
* Cyclothymia
* Lack of organization
* Feeling of insecurity
* Feeling of lack of self-realization

ADHD is often associated with other disorders, and if untreated, can cause many psychological complications. The most common disorders are:

* Disabilities oppositions in 30-50% of cases
* Conduct disorders in 25% of cases
* Anxiety disorders in 25% of cases
* Of the motor disorders are very common
* Persistent developmental stuttering
* Learning difficulties sizeable
* Of dyslexia, 50% of dyslexics also have ADD

These characteristics are certainly in no specific cases of the disease and are found in varying degrees, in children not meeting the criteria of ADHD As such, a number of people deny the relevance of the designation of such criteria as constituting a syndrome, dedicated to a specific medical treatment. For the diagnosis of ADHD can be clearly established, it must be complied with criteria defined by internationally recognized classifications (such as DSM-IV and ICD-10), the main manifestations of the disorder (inattention, impulsivity, hyperactivity) are a real gene for the subject, they are present before the age of 7, occur in two distinct environments permanently for at least six months and lead to school difficulties, social and / or professional.

In addition to the diagnostic criteria, we must eliminate any problems that might cause a disturbance in attention, such as: neglect, family problems, trouble with vision or hearing, petit mal epilepsy, anemia...

Hyperactive children and gifted
It is sometimes difficult to see the difference between gifted children and children with attention deficit hyperactivity disorder because it is common for gifted children also suffer from hyperactivity. This also poses the question of adapting teaching general education or prevention through the difficulty of evaluating the factors and events. Indeed in both cases the child:

* Demonstrates little attention in class, bored
* Tends to oppose the authority of Professor
* Suffers from a lack of self esteem
* A few friends
* Puts in doubt the rules and regulations
* Perfectionist
* Has an uneven development
* Demonstrated an excessive self-criticism
* A depressive tendencies
* Avoid taking risks
* Is afraid of failure
* Is impatient with others
* Do not like routine
* Raises many more questions than normal
* Is excessive in its interests
* Has a strong character
* Resists the guidance
* Questions the learning procedures
* Do not clear or areas not illogical
* Is concerned with humanitarian issues
* Built complicated rules
* Would be the chief
* Uses language to manipulate others
* Is intolerant
* Neglects his duties
* Can be seen as disruptive, next to the plate
* Can be perceived as stubborn, narrow-minded
* Is frustrated by the inactivity
* Can be seen as hyperactive
* May seem disorganized and dispersed
* Is frustrated by the lack of time
* Sometimes has a funny sense of humor, others do not understand his and vice versa
* Is independent
* Prefers individual work
* Research to organize things and people
* Has an extensive vocabulary
* Has varied and extensive knowledge
* Has high aspirations for himself and others
* Is terribly demanding of himself and other
* Is creative
* Is inventive
* Is intuitive
* Demonstrated hypersensitivity
* A lot of energy and liveliness

ADHD in adulthood
The ADHD child often persists into adulthood. Symptoms also remain the most often and do not disappear in 30% of cases. There is also a significant overlap with addictive disorders, abuse and dependence of legal substances (alcohol, tobacco, sedatives, benzodiazepines) or illegal (cocaine, cannabis, heroin and opiates). Some studies show that the risk of abuse or substance dependence is two times higher and that the same risk of combining drugs and alcohol is 4 times higher.

See also Autism

wikipedia

Medicare

2010-08-08T08:08:00.000-07:00

Medicare
Medicare is the name given to the health insurance system managed by the Government of the United States and intended for people over 65 or meet certain criteria. The name comes from a contraction between "medical" (medical) and "care". The first law which established Medicare was enacted July 30, 1965 during the presidency of Lyndon B. Johnson as amendments to the legislation of social security, as part of its draft "war against poverty". During the passage of the law, President Johnson said of former President Harry S. Truman's first recipient from the program, delivering the first Medicare card.

Financing and cost
Medicare is partially financed by taxes imposed by the law of contribution for federal employment assistance and health in 1954. For employees, the tax represents 2.9% of salary (half is paid by the employee, the other by the employer). Until December 31, 1993, the law provided a maximum amount beyond which the salary could not be imposed. But from 1 January 1994, this limit was removed. For independent. Tax is 2.9% on net income paid in full by him.

The fiscal year 2002 (2004 figure), Medicare cost 256.8 billion U.S. dollars: USD 230.9 billion were financed by taxes, the rest by the government.

In 2003, Medicare accounted for 13% of the U.S. federal budget. Calculations of the CMS, 33% of every dollar spent on health care in the United States is supported by Medicare and Medicaid. In the other direction, Medicare and Medicaid covered 61% of expenditures in nursing, 47% of hospital expenditure and 27% of medical expenses.

Medicare has indeed a very large cost for poor results because the cost of the system is due to the high prices of private and Medicare should cover.

Operation
In general, individuals can receive assistance from Medicare if they (themselves or their spouses) contributed at least 10 years, are aged over 65 and live permanently in the United States.

Individuals who are under 65 years may also be eligible provided they are disabled or be at the final stage of kidney disease. These people need to be eligible to receive aid either the Social Security Fund is financing the retirement pensions of rail workers.

In 2005, Medicare provided coverage of diseases for 42.5 million Americans. With the arrival of the baby boomers retire, experts estimate that 77 million Americans are covered by Medicare.

The Medicare program is divided into two funds: a hospital insurance and medical insurance fund. Two other special funds include: a cover that is combined with private insurance, and coverage for detoxification.

However, none of these funds will fully fund the cost of care. The program provides for the payment of insurance, deductible expenses, but the individual must pay a large part of his pocket (out-of-pockets costs). Other government programs such as Medicaid, to help pay certain expenses associated with Medicare. Programs such as Medigap help bridge the difference, however, that these assurances are legally established by the CMS, they are sold and administered by private companies.

See also Health Insurance

wikipedia

Bulgarian nurses case

2010-08-05T06:01:00.000-07:00

Bulgarian nurses case
The case of Bulgarian nurses is a lengthy diplomatic and judicial, which took place in Libya between 1999 and 2007 in which the defendants, five Bulgarian nurses (Kristiyana Vultchéva, Nasya Nenova, Valentina Siropulo, Valya Chervenyashka and Snejana Dimitrova) and one Anaesthetist of Palestinian origin naturalized Bulgarian (Ashraf al-Hadjudj) were accused of several crimes.

Case Summary
The five nurses arrived in Libya in 1998 to work in pediatrics, Ashraf al-Hadjudj, the young Palestinian anesthesiologist, initially conducting an internship training and participated with nurses on humanitarian operations in the Benghazi hospital.

Early in 1999, the Libyan medical discover that over 400 children treated at the hospital and having undergone blood transfusions were infected with HIV. Twenty-three Bulgarians working in or for the hospital and a Palestinian doctor are arrested and imprisoned, he and five nurses were accused, following a criminal investigation of several crimes, some facing the death penalty :

* Criminal actions on Libyan territory leading to the premeditated murder of several people (crime punishable by death);
* Participation in an organized conspiracy to commit a crime abroad from international terrorism with the aim of achieving security of the State of Libya;
* Voluntary HIV contamination of at least 393 children, which triggered an epidemic of AIDS in Children's Hospital in Benghazi Al-Fatih;
* Shares in breach of the standard and Libyan traditions (including production and consumption of alcohol, adultery and lust).

During the eight years of litigation in Libya, a fifty-infected children will die of AIDS or opportunistic infections.

The nurses and doctor denounced during a trial of their conditions of detention and torture by their captors, but they were not pursued by the Libyan court and instead lodged a complaint for defamation.

In a trial related to this case, a Bulgarian doctor, Zdravko Georgiev, the doctor, husband of Kristiyana Vultcheva, came to Libya after the indictment of it, was also sentenced to 4 years in prison for illegal possession of foreign currency, then put under house arrest, and is still waiting for an exit visa (August 2007).

On July 24, 2007, after their death sentences confirmed on appeal, was commuted to life imprisonment, five nurses and doctor were eventually extradited to Bulgaria, after lengthy negotiations conducted by the European Union and the proposed a financial compensation for families of patients. They were repatriated in a French plane, and were pardoned by Bulgarian President upon arrival in Sofia. Beginning in November 2007, Nicolas Sarkozy, accompanied by singer Sylvie Vartan has done much for the media coverage of this case and for their release, visited the medics. The President has received both an honors awarded by the President of Bulgaria.

The epidemic in Libya Al-Fath
The outbreak of El-Fatah is the largest and most serious incident documented in the history of nosocomial (hospital-acquired) HIV (the virus that causes AIDS) and that of hepatitis C even though the modes of transmission were documented and the means of protection known and disseminated worldwide. The Libyan public opinion has been very wound up and many foreign medical workers were arrested - six were eventually charged. The Libyan leader Muammar Gaddafi initially accused the American CIA or Israeli Mossad conspiracy to conduct a fatal experiment on Libyan children.

The crisis broke out in the open in November 1998 when the Libyan magazine "La" (number 78) published a paper on AIDS at the Benghazi Children's Hospital. In December the Libyan Writers Association reports more than 60 AIDS cases so far this year alone in Libya. "The" then ask Sulaiman al-Ghemari, the Libyan Minister of Health, which reveals that most cases involve children. Parents believe their children have been infected by blood transfusions in the main children's hospital in Benghazi. The magazine "The" has been censored and closed but it was finally revealed that over 400 children had been infected.

Libya has sought and received an emergency team of WHO was missionnée in December and remained in Libya until January 1999. The WHO team has produced a classified report secret (still available) on the situation.

The WHO report of Dr. PN Shrestha (1999)
The report of the World Health Organization (WHO) in 1999 described the visit by the WHO team (Dr. PN Shrestha, Dr. A. and Dr. V. Eleftherious Giacomet) in Libya in Tripoli, Sirte and Benghazi between 28 December 1998 and January 11, 1999 while the Bulgarians were still employed in the hospital staff.

This report is apparently classified as confidential and we do know that some elements reported by experts at trial:

"This report strongly suggests that nosocomial HIV infection in the Al-Fateh hospital were caused by multiple sources of infection. In addition, the WHO team notes the lack of supplies and equipment required such as containers of blades, sterilizers, incinerators, gloves, etc.. [...] The WHO has noted several similarities with previously documented outbreaks of emerging diseases among children in Elista in the former Soviet Union in 1988 and in Romania in 1990. In particular, the practice of using persistent intravenous catheters for injections in hospitalized children, as well as sharing the same syringes without proper sterilization, would appear among the probable causes of the emergence of Benghazi."

See also World Health Organization

wikipedia

Arthritis

2010-07-29T09:00:00.000-07:00

Arthritis
Arthritis (from Greek arthron: articulation) is an acute or chronic inflammation of the joints whose origin is rheumatic or infectious. It does not mean the disease listed under the name of osteoarthritis but a clinical sign of one of many joint diseases.

It is a disease usually mild but can be very debilitating. It is most often initiated by the friction of abnormal fibers of a tendon (consisting mainly of collagen) abnormally applied on a bone or a joint.

Description
It speaks of inflammatory monoarthritis, when one joint is affected by the phenomenon. Among monoarthritis may be applied:

* Microcrystalline arthritis

1. gouty arthritis or gout (urate of sodium)
2. chondrocalcinosis (calcium pyrophosphate crystals)

* Post-traumatic arthritis
Arthritis * infectious (bacterial, viral or fungal), also known as septic arthritis

also known as:

* Means an attack of oligoarthritis February-March joints.
* Lyme arthritis (a consequence of borreliosis)
* Reactive arthritis (eg in response to infection by the bacterium Yersinia (yersiniosis))
* Arthritis by misuse, which means most often rheumatoid arthritis (RA), to describe multiple joint damage.

Symptoms
* Pain in the inflamed tendons, stress (only early effort, then disappearing with the heating in case of mild inflammation)
* Stitches even at rest or chronic pain in more severe cases, possibly:
* Inflammation (redness, warmth)
* Swelling of the joint (bursitis) and reduced mobility

* Rest (with immobilization of the joint, the elbow and shoulder, for example tennis elbow), or in severe cases:
* Physiotherapy
* Orthopaedic
* Arthroplasty
* Joint prosthesis

Prevalence
Nearly 10% of the population, regardless of the country, would be affected by some form of arthritis.
People should make movements and efforts are often victims répétififs (sports, workers at the chain, knitter, butcher, gardener, etc.). A known example is the tennis elbow of the player too hard courts, but the tendinitis is common in other sports practices and represent approximately 50% of the same reasons for visiting athletes.

A new form of tendonitis of the wrist appeared with the increasing use of the computer mouse.

Consequences

* Although many causes, arthritis can lead to ultimate
No deterioration of the articular surfaces, and
o the progressive loss of joint function.
* Depending on the cause, vary
No clinical signs and
o the rate of deterioration of the articular surfaces

for a particular context of arthritis.

Septic arthritis and willingly Typically, the bed of a rapid deterioration, sometimes very fast, articular cartilage, while osteoarthritis, especially early, is above all the mark of a slow deterioration, sometimes very slow .

The impact of osteoarthritis and rheumatoid arthritis on the budget and resources of nations is important.

Prevention
* In sports, heating prior to training and competition reduces the risk of tendonitis, as well as drinking enough. The materials used and the soil also play (eg tendinitis distance runners). After the workout, stretching is also known to reduce the risk of tendinitis. A ground not too hard, suitable footwear and appropriate ergonomics materials used also reduce this risk.

See also Osteoporosis

wikipedia

Spermatogenesis

2010-07-28T04:42:00.000-07:00

Spermatogenesis
Spermatogenesis is the process of sperm production, which takes place in the seminiferous tubules of the testes. It includes events which spermatogonia, stem cells diploid (2n chromosomes), lead to sperm, haploid male gametes (n chromosomes).

Spermiogenesis in turn is the differentiation of spermatids into spermatozoa.

By the 1970s, scholars have noted a deterioration of spermatogenesis in rich countries (Europe, USA, Japan). They were first observed significant differences in sperm quality by region studied, and comparisons over time have shown that - in all cases studied - average number of sperm per milliliter of semen decreases from year to year. He has been halved in 50 years.

Introduction
Spermatogenesis begins at puberty, peak around 20-30 years, gradually slowing to quarantine but may continue into old age. Spermatogenesis is a slow and continuous process requiring approximately 74 days in humans, and runs in spurts or waves along the seminiferous tubule.

Tubule
The tubule is limited by a tubular sheath formed of thin blade or basement membrane of fibroblasts. Some of these include fibroblast contractile filaments and fibers of collagen and are the myoid cells or myofibroblasts -

* The tubular sheath is called basal membrane of the seminiferous tubule or membrana propria.
* These tubes are surrounded by connective tissue ("filler") and also formed interstitial cells of Leydig which is, of course, shot through the arterioles and venules providing oxygen. (See testis) These cells or endocrine cells of Leydig secrete mostly testosterone (and dihydrotestosterone), they form the interstitial gland of the testis.
* The wall of the tubule consists of a stratified epithelium consisting of two types of cells
o germline cells arranged in 4-8 layers
o Sertoli cells, cells based on the high basal membrane and reaching the lumen by their apical pole;
* In the adult seminiferous tubules, the different layers of germ cells are the stages of spermatogenesis that occurs centripetally, from the spermatogonia located against the basement membrane to sperm released into the light: Under the microscope, there that these tubes are "filled" cells apparently different, organized rings. At the periphery, there are stem cells (spermatogonia, while the center are the sperm. In fact, undifferentiated cells grow and eventually become male gametes:
o spermatogonia
o spermatocyte I
o spermatocyte II
o Spermatid
o Spermatozoid

Spermatogenesis
Firstly, through multiple mitoses from a spermatogonia, we obtain a stock. Then the spermatogonia grows and becomes spermatocyte I. At this stage, are still stem cells with chromosomes 2n. Meiosis I produces spermatocytes spermatocytes II, which have more than n chromosomes (see meiosis). Following meiosis led to spermatids, which migrate to the "light" of the tube. The differentiation of these eventually gives the sperm in the center of the tube. It said then that spermatogenesis is "centripetal".

This process is continuous, that is to say that the cells become successively and are replaced by new spermatogonia obtained by mitosis.

In the seminiferous tubules, we also note the presence of large cells, Sertoli cells, which support and nourish the spermatogonia and are therefore essential for spermatogenesis.

The tubules lead by a drainage system, which becomes the epididymis vas deferens leaving testis. The cells are propelled into the channel, and mixed with seminal fluid in the prostate to form semen during ejaculation.

Hormones
Three hormones play an important role in spermatogenesis:

* Testosterone
* LH (luteinizing hormone)
* FSH (follicle stimulating hormone)

LH and FSH are produced by the pituitary gland while testosterone is produced in the Leydig cells.

FSH acts directly on spermatogonia and Sertoli cells to speed spermatogenesis (assimilation plus testosterone). LH, in turn, increases the production of testosterone, which also acts on spermatogonia (and in particular permits the final differentiation) and the Sertoli cells. If testosterone production reaches a certain threshold, the Leydig cells send negative feedback to the pituitary gland that inhibits the production of LH and FSH. It is therefore a self-regulating system that does not allow the excessive production of testosterone, and therefore sperm.

General decrease in the number of sperm produced during spermatogenesis?

By the 1970s, experts were astonished significant differences in sperm quality, according to the region from the patient or donor.,
10 years later, first whistleblowers confirm these disparities, but note that the analysis of sperm counts for years 1935 to 1980 all indicate a decline in sperm counts in all regions studied.
Over sixty studies suggest that at least in Western countries, men face a general problem of degradation of spermatogenesis. The magnitude of the phenomenon, its causes and its translation in terms of male fertility are still controversial;

In France: For example, according to the sperm counts of 1351 sperm donors CECOS Paris, there has been no change in the volume of semen produced by about 20 years, from 1973 to 1992, but average concentration of spermatozoa has cons decreased significantly (- 2.1% / year from 89 x106 / ml of semen 1973 60x106 per ml in 1992.
Meanwhile, the percentage of normal sperm Mobile fell 0.6% per annum and that of normal form sperm decreased by 0.5% per year.
After making adjustments for age and duration of sexual abstinence, on these 20 years, each new generation (by calendar year of birth) has lost 2.6% of sperm from the cohort born in the year before, and the rate of motile sperm decreased by 0.3% per year, and the sperm of normal shape decreased 0.7% / year.

See also Pregnancy

wikipedia

Stress Test

2010-07-26T06:40:00.000-07:00

Stress Test
The exercise test or stress test or exercise electrocardiogram or ergometry is an examination consisting of an ECG recording during the course of a calibrated exercise. It can help in the diagnosis of coronary artery disease. It may be associated with the measurement and analysis of ventilatory volumes and flows. It is useful in assessing respiratory and metabolic diseases and also to assess the behavior of an individual athlete or not vis-a-vis the effort, which may allow refinement of the athletic training or retraining.

Materials
ECG
The electrodes may be standard. However, an ECG recording on a subject full exercise contains many artifacts, due to the mobilization of the patients, the high amplitude respiratory problems of adhesion of electrodes (sweating). The device Eletrocardiography is often provided with features to improve the electrical signal and its interpretation:

* Algorithm for the recovery of the isoelectric line (the boundary issue in "waves");
* Averaging over several successive complex, and to reduce noise, essentially random;
* Alarms serious events;
* Help define criteria for positivity.

The ECG is often but the digital recording format is proprietary, not allowing the playback on other systems.

The unit of effort
The ergometer allows a graduated effort that can quantify levels of power measured in watts. These may include:

* A treadmill and Tilt: The patient walks on it at a speed and a growing inclination defined according to different protocols, one of the most used being the so-called "Bruce". The effort is then relatively physiological. The joint constraints are weak (except for the back). The rise is faster in most cases. The patient is obliged to follow the movement of the belt which allows him to make a greater effort if it is unmotivated. In return, the patient monitoring (exercise tolerance) must be careful because he can not stop the effort itself (risk of falling).
* A cycle ergometer, the patient cycles at a constant speed but a progressive brake is applied, making the effort more and more important. The joint constraints are more important (knees, hips). The rise is low, thereby prolonging the test if the subject is sports. The maximum effort is lower in the patient not motivated.

Protocol
The patient is not fasting. He did not need to be hospitalized. He must be aware of the examination, his interest and risks of the latter (if it can be required to sign an acceptance form).

The examination is done in the presence of a physician and an assistant (medical electrophysiology technologist or respiratory therapist in Canada, nursing).

The patient is shirtless and ECG electrodes are put in place after preparation of the skin (shaving, trimming). The diversions are common but we prefer to have the electrodes in the standard back to the roots of members, rather than the latter.

The first recording of the electrocardiogram is done at rest. The patient then began his effort.

This is continued until the occurrence of one of the following criteria:

* Muscular exhaustion or breathlessness too large;
* Heart rate reaching the maximum frequency theoretical (= 220 - patient age);
* Development of a criterion of positivity: the most common is the appearance of a shift in ST segment horizontal or downward, beyond a certain voltage;
* Emergence of a serious heart rhythm disorder;
* Onset of malaise, a fall in blood pressure.

Cardiovascular indications
The exercise test can help diagnose coronary artery disease and target intensity (target heart rate) of rehabilitation training in case of optimal management of cardiac patient movement activities.

Like any diagnostic test, it has a sensitivity and specificity. They are both close to 60% for the stress test. According to the Bayes theorem we can calculate the positive predictive value and negative predictive value depend on the estimated frequency of coronary disease.

To summarize, there is practically no effort to test if it is almost certain diagnosis (or lack thereof), the probability of having the disease only changing slightly depending on whether the test is positive or negative. The stress test is especially useful if you have a belief through: if the test is positive, the probability that the patient is sick becomes significant (positive predictive value). If test is negative, we can eliminate the disease with a low probability of error (negative predictive value).

In case of positivity of the exercise test, the doctor may:

* Be dealing directly with drugs: anti-anginal and fight against the risk factors ...
* Is the diagnosis confirmed by angiography which allows for targeted treatment: for medicine, coronary angioplasty or bypass surgery.

Additional tests
* You can measure oxygen consumption during exercise testing and calculating and maximum oxygen consumption, called VO2max. This is done through a mask applied on the patient's face during exercise, enabling instant analysis of inspiratory and expiratory flow and expired gas composition test is interesting in the top sportsman level to adapt its training. It is also measured in cases of severe heart failure because it's an important indicator of prognosis (life expectancy).
* You can simultaneously perform echocardiography during stress testing. This is called an ultrasound effort, which allows for a more refined of coronary disease: improved sensitivity and specificity, topographical diagnosis of the diseased artery. Its realization, however, requires a special table, the heart is best viewed when the patient lies on the left side (left lateral position) and thus to make the effort in this position.
* You can pair the stress test with intravenous injection of radioactive material to produce a myocardial perfusion imaging or cavitary (display content = blood in the cavities) or muscle (direct visualization of the heart muscle) . The review allows for a more refined (better sensitivity, better specificity, topographical diagnosis of the diseased artery).

See also Heart

wikipedia

Dystonia

2010-07-24T05:16:00.000-07:00

Dystonia
When dystonia is a group of movement disorders, neurological origin in the motor centers is located in the brain. It is expected to extrapyramidal hyperkinesias. In most cases, dystonia expressed in tension and poor posture, such as the head (torticollis). The therapy is used include botulinum toxin.

The described dystonia has nothing to do with the autonomic dystonia.

Types of dystonia
The dystonias include athetosis, tremor, and chorea Ballismus. Distinguish one can also affected by degree of spread between focal (only one region of the body), segmental (more than one body region affected) and generalized (affecting the whole body) dystonia. Furthermore, a distinction is made between primary dystonia with no obvious cause (including all hereditary dystonia) or secondary dystonia with certain causes (eg severe injury).

Examples
* The cervical dystonia or spasmodic torticollis, which manifests itself in a posture of the head.
* The blepharospasm, also known as blepharospasm or Blinzeltic that leads to uncontrollable blinking. In severe cases, subjects are virtually blind.
* The oromandibuläre dystonia, which affects the mouth and the masticatory apparatus. Concerned it is hard to eat.
* The spasmodic dysphonia, the spasms of the voice called. Affected breathy or pressed to speak and be understood any more.
* The members of dystonia, which can act as writer's cramp, cramp or musician Fußdystonie. In all cases it leads to a spasm of the limbs, which makes people unable to write, make music or to leave.
* The Segawa syndrome, which is characterized by anomalies in the position of the legs and is caused by a genetic defect on chromosome 14.

Dystonias are not affected by the compressible. Often, though, there is the phenomenon of a geste antagonist, in which, for example, tapping on the chin or touching the skin alleviates the symptoms.

The cause of dystonia is a disorder of regulation of the unconscious motor activity in the basal ganglia in the brain. Especially the internal globus pallidus seems to play a role (see Parkinson's disease). In most cases, no genetic correlations are observed. In hemifacial spasm the facial nerve is confined within the skull by an arterial loop.

Diagnostic short-lasting dystonia are frequently confused easily with tics. The latter describe the person concerned a kind of tension that forces them to execute a movement that can be short term but also suppressed.

Therapy
The sessions are held with a limited extension of the dystonia often by local injections of botulinum toxin (usually serotype A). The effect is gradually after three to seven days and reached its peak after three weeks. The injections must be repeated each at intervals of weeks to months, with decreases in some patients the effect. In this case, the dose may be switched to a certain limit or increase in serotype second Resistance in advanced or extended dystonia is the maximum administrable dose of therapy is a limit, a possible side effect is dry mouth, for example.

Other drugs, which find therapeutic use, are anticholinergics. The elimination of the affected muscles may also be operational by the appropriate - but later renewable - nerve fibers are severed. In the testing is currently the method of deep brain stimulation. These regions of the brain are electrically stimulated by an implant, which can improve the movement.

See also Epilepsy

wikipedia

Royal Army Medical Corps

2010-07-22T05:41:00.000-07:00

Royal Army Medical Corps
The Royal Army Medical Corps (RAMC or "Medical Corps Royal Army" in French) is a body of the British Army which provides medical services to military personnel and their families in times of war or peace .

With the Royal Army Veterinary Corps, Royal Army Dental Corps and Queen Alexandra's Royal Army Nursing Corps, the RAMC forms the Army Medical Services.

Because the RAMC is not a military wing, and after the Geneva Convention, its members are allowed to use their weapons only in self defense. For this reason, they marched in two traditions:

* The officers did not take out their swords (they hold their sleeve with their left hand and salute with his right hand)
* The other grades do not fix bayonets to their guns

Grades
Officer career RAMC:

* Doctor (Doctor (Medical Officer))
* Pharmacist (Pharmacist)
Physiotherapist * (Physiotherapist)
* Officer of Health and Environment (Environmental Health Officer)
* Support Medical Officer (Medical Support Officer)
* Technical officer (technical officer - Biomedical Scientist / Radiography / Clinical Physiologist / Operating Department Practitioner)

Career soldier RAMC:

* Physiologist (Clinical Physiologist)
Health Technician * Combat (Combat Medical Technician)
* Practitioners of Surgery (Operating Department Practitioner)
* Pharmacy Technician (Pharmacy Technician)
* Technician-Environmental Health (Environmental Health Technician)
* Biomedical Science (Biomedical Scientist)
* Manipulator in medical electroradiology (radiography)

Unlike other medical officers of other countries, those in the RAMC (and those of the Royal Navy and Royal Air Force) do not use the prefix "Dr." but only their grade, although it 's address them as "Doctor."

See also

wikipedia

Macular Degeneration

2010-07-20T21:37:00.000-07:00

Macular Degeneration
The term macular degeneration, a group of diseases of the human eye is summarized by the macula lutea ("the point of sharpest vision") - also called "yellow spot" called - involve the retina, accompanied by a gradual loss of function located there tissue.

Etiology and prevalence
Starting point for the sickness is not the nerve tissue of the retina, but its support structures, the retinal pigment epithelium, Bruch's membrane and choroid. With progressive disease is affected by the death of retinal cells in the central vision field. By far the most common form of macular degeneration is the age-related (or senile) macular degeneration (AMD), by definition, only after the 50th Age occurs. By changing age structure of the proportion of people who are affected by such disorders has increased significantly. The age-related macular degeneration is the leading cause of blindness in people over the age of 50 years in developed countries. It causes 32% of Neuerblindungen, followed by glaucoma and diabetic retinopathy by 16% of Neuerblindungen.

Worldwide, 25-30 million people are infected and about 500,000 new cases are added annually. In Germany, suffering from a form of macular degeneration, an estimated two million people in Austria are a total of 125,000 people affected.

Causes
Smoking is associated with the largest effect on the risk for future AMD, in addition to genetic predisposition and high blood pressure. Defects in the genes CFH, C3 and ARMS2 were confirmed in several studies as risk factors for the occurrence of AMD, but not for the further course of the disease.

Forms
Macular degeneration due to high myopia is known as myopic macular degeneration. There are genetic, so-called macular dystrophy, such as Best disease and Stargardt's disease, also called an "inverse" Retinitis pigmentosa is known to attack first the macula. Macular degeneration can also be toxic, as a result of Chloroquineinnahme occur, for example, for prophylaxis of malaria or rheumatism, and as a consequence of inflammation (so-called Presumed Ocular Histoplasmosis Syndrome, POHS).

The vast majority of patients but is of the age-related (or senile) macular degeneration (AMD) affected. The term "age" indicates the age down as the biggest risk factor besides smoking and genetic load. AMD is classified according to the Hamburg professor of ophthalmology Sautter in two forms: dry and the wet macular degeneration.

Dry macular degeneration
The dry (atrophic) form represents about 80% of cases, but only 50-10% of blindness caused by AMD. It begins by deposits of so-called drusen, metabolic end products (lipofuscin), and may in advanced stage in a flat cell death (geographic atrophy) pass the retinal pigment epithelium. Their progress is usually slow and insidious. Due to the frequent location below the point of sharpest vision but it can sometimes also lead to rapid loss of vision, and a protrusion of the visual cortex. This makes itself felt through distorted vision (metamorphopsia).

The dry form is no generally accepted treatment is known. It is discussed whether progression could be inhibited by administration of high doses of vitamins. A longer-term ingestion of such high doses of vitamins may increase the risk for certain cancers, so a careful Nutzen-/Risikoabwägung should be done together with the treating physician. Recent studies such as AREDS for a possible preventive effect of the carotenoid lutein or WAFACS for a possible preventive effect of vitamin B complex (Vitamin B6 - pyridoxine, Vitamin B9 - Folic acid and vitamin B12 - Cyanocobalamin).

Wet macular degeneration
The dry may pass into the wet (exudative) macular degeneration, in which form under the retina flat vascular membranes (Choroidal neovascularization, CNV), which are prone to bleeding.

The occurrence of a distorted vision of the eye doctor should be consulted, as should be dealt with expeditiously. Report any losses can not be eliminated. In about 20 percent of cases are successfully treatable form in small blood vessels grow into the visual cortex. After a precise diagnosis by means of the optical coherence tomography Fluoreszenzangiografie and treatment can be started. In photodynamic therapy (PDT) is a substance photosensitising (verteporfin) is injected into the vein in your arm and exposed the place of the regenerated vascular membrane with a "cold" laser. This can often be a closure of the membrane can be achieved - deserted the new vessels - which is staying further Sehverfall.

Currently, new therapies with inhibitors of blood vessel growth, called anti-VEGF's (anti-Vascular Endothelial Growth Factor, German growth factor) inhibitors tested clinically. The currently most promising anti-VEGFs are ranibizumab (approval in the EU on January 24, 2007), Novartis and as a cheaper off-label bevacizumab treatment. In many patients it leads to a vision improvement. The aptamer pegaptanib since February 2006 in Germany for the treatment of age-related macular degeneration (AMD). It was developed with the aim to block highly specific and with high affinity to VEGF. This is possible too, but according to the results presented by different studies, the loss of sight "only slowed, not stopped. Other inhibitors of vascular growth are Corti statins.

Functional impact
The damage to the macula leads to

* Decrease in visual acuity, and thus the ability to read,
* Loss of contrast sensation,
* Loss of color vision,
* Decrease in the ability to adapt to changing light conditions (adaptation)
* Increasing the sensitivity to glare
* Central visual field defects.

Fixed the person an object, it is not possible to identify him clearly. The offender may see a clock but the clock does not recognize or see a conversation partner, not its features. Age of onset and severity of symptoms vary and depend on the form of the disease.

Since the disease is usually limited to the macula, is the external field and thus obtain the orientation ability of those affected. Even in darkness the parties involved are usually quite good, as the rods remain functional outside of the central retina.

macular degeneration are distinguished from the degeneration of the peripheral retina shares (for example, retinitis pigmentosa).

For the early diagnosis usually the Amsler grid test is applied.

Read also Eye

wikipedia

Mother

2010-07-20T05:43:00.000-07:00

Mother
A mother is the biological parent or social female of a child, the biological parent or social male of a child being the father.

The word means "mother" is one of the most popular in the world through all the Indo-European (my root), and in many others (eg Chinese: Pinyin ma). In French, the word mother, which results from a child learning by repetition comes from Latin and Greek that means mamma breast. It connotes a certain affection and maternal role in the life of the child.

In the case of mammals like humans for example, the mother carries the child (first called an embryo and fetus) in her uterus from conception until it is sufficiently developed to be born. Once the child is ready, the mother gives birth and gave birth to the child. After birth, the breast of the mother produces milk to feed the child.

For non-gendered, "mother" is sometimes used to mean "parent", in the case of unicellular organisms that reproduce by fission, the "mother" means the cell that divides to produce "daughters".

Mothers have an important role in educating children and the title mother can be given to a woman who is not the biological parent of the child but who fills the role of it and bring up child . This is usually an adoptive parent or a stepmother (the wife of the father of the child).

Mothers are celebrated in many countries. In France, Mother's Day on the last Sunday of May, unless it coincides with the day of Pentecost. In this case, it held the first Sunday in June In Switzerland, Mother's Day is held the second Sunday in May In the United Kingdom, a similar feast (Mothering Sunday) held the fourth Sunday of Lent. In the U.S., Australia and Canada, mothers are honored on the second Sunday in May (this is the Mother's Day, a name which dates from the late nineteenth century).

Different uses of mothers
In most societies, mothers who raise their children alone are called "single mother" (child born outside marriage) or "mother-daughter (the mother is still very young).

A woman carrying a child for another person or a couple is called "surrogate mother".

The stepmother may have two different statuses. Another wife of the father or mother of the bride or the bridegroom. Similarly to the stepfather.

The term mother is also working to designate any person of the stereotype of a mother (example: "Mother Michel).

In the Christian religion, "mother" is a sort of title for certain members of the religious community such as the abbess. We can also say Mother Superior. A famous religious styled Mother is Mother Teresa. The Virgin Mary the title Mother of God.

The term mother is also used metaphorically to describe:

* The source or creator as in Avarice is the mother of many evils. (Hazrat Ali)
* What is higher in the hierarchy as the "mother ship"
* What is the first in someone's life (mother tongue)
* What is first and most important (motherboard)
* What are the principles of all things: The Mothers (see Faust II, Goethe)
* Creation of Nature: Mother Nature

Read also Pregnancy

wikipedia

Virgin Olive Oil

2010-07-18T20:59:00.000-07:00

Olive Oil
Olive oil is the fat extracted from olives (fruit of the olive tree) during the pressing in an oil mill. It is a cornerstone of Mediterranean cuisine (or Mediterranean diet and main source of omega -9).

Use
Olive oil has been known since antiquity: the ancient Greeks and Romans used it for cooking (the origin of the Mediterranean cuisine) and their cosmetics, and the Hebrews in time when the Temple existed, to light their candle.

Olive oil can be used both raw (in salad dressings or in place of butter in the pasta for example) or cooked (cooking meat or vegetables or frying). It is important however not to use too high temperature (above 210 ° C), beyond which it deteriorates. However it is more resistant to heat than other oils (about 180 ° C). This is called the point of cracking.

It has properties beneficial to health, including cardio-vascular, thanks to its vitamin A, vitamin E and monounsaturated fatty acids. The benefits are mainly related to vitamins observed in cold oil consumption, as in salads, as vitamins are destroyed beyond 40 ° C. Compared to other unsaturated fatty acids, olive oil is quite stable during cooking and storage in this case its beneficial effects on cholesterol. It helps to fight against breast cancer.

Its organoleptic characteristics vary with soil and agronomic practices, variety (or cultivar), and stage of maturity at harvest. Today it is a staple product, but enthusiasts choose bottles priced rivals sometimes with great wines. Indeed, several olive oils are classified as Appellation d'origine contrôlée (AOC).

Tasting
The organoleptic characteristics are grouped into three such important topics:

* Taste: bitter taste is the only one that can present the olive oil. It determines the intensity at the tasting.

* Flavors: aromatic sensations all of its oil is fruity, it determines the intensity at the tasting, category (ripe fruit, green fruit, fruity black) analogue and its description (reminiscent of apple, tomato ...).

* Kinesthetic and tactile sensations: an olive oil can make a specific sensation, the ardence (or hot), and differences in creaminess. It determines the intensity of spice to the taste, the smoothness can be comments, but there is no scale for the sensory sensation.

None of the sensations above is considered a defect.

The defects are recognized by professionals:

* The rancid (oxidation), musty, homer (excessive fermentation of olives in a heap), the lees (fermentation of pulp particles in unfiltered oils with or without sedimentation).

These defects have in common their origin in a lack of attention to the quality of work, and their consequences in a disappearance of bitter and pungent attributes.

Characteristics and composition
The characteristics of olive oil are the following:

* Smoke point: 210 ° C against 180 ° C for the normal temperature frying.
* Density: 0.92 (1 liter of olive oil weighs approx. 920g).
* Calories: 9 kcal per gram
* Conservation: olive oil rancid less quickly due to its low iodine: 78/88 83/98 cons for peanut oil and 120/132 for the sunflower oil. It keeps best if stored cool and protected from light. It is best to use within two years after its manufacture.

Olive oil is composed of about 99% fat. The remaining 1% is the minor compounds, which is essentially (in order of importance): squalene, triterpene alcohols, sterols (β-sitosterol), phenols and derivatives of tocopherol.

The fat of olive oil is composed of triglycerides. These consist of fatty acids of various kinds, whose distribution is characteristic of olive oil, and a further level of detail, different varieties or place of production. When triglycerides are degraded fatty acids which were sheared off and roam freely in the oil: they are so called "free fatty acids. Their percentage in the oil is what is known as "acidity" of the oil, and is expressed in "grams of oleic acid per 100 grams of free oil." This acidity does not perceive as taste sour, but in the form of specific degradation, such as a musty taste.

Categories
In retail, there are only two categories of virgin olive oils: extra virgin olive oil (HOVE) and virgin olive oil (HOV). The category extra virgin olive oil is better according to criteria of chemical and organoleptic criteria. Free acidity (see above) is limited to 0.8% for HOVE, so it can reach 2.0% for the HOV. The parameters of oxidation were also slightly more severe. Organoleptic criteria are evaluated by panels appropriate, the HOVE is free of defects, while a HOV may contain defects such as lees or day off to a level of 2.5 on a scale of 10 points.

There are categories of virgin olive oils lower (current and lampante), but they can not be used to benefit consumers and are reserved for trade or industry.

There are also olive oil obtained by refining industry and commerce, after assembly with HOVE or HOV, under the name: "Olive oil composed of refined olive oils and oils virgin olive". These oils are less common in the retail trade.

The different categories of olive oil are a name corresponding to the criteria set by the regulation:

* The "virgin olive oils" are obtained from the fruit of the olive tree solely by mechanical or other physical conditions (heat) that do not damage the oil and n 'having undergone any treatment other than washing, decantation, centrifugation or filtration, to the exclusion of oils obtained using solvents or mixtures with other oils. They are pure fruit juice and the acidity of the oil is low, the better the quality. It ranks them in descending order of quality "extra virgin olive oil" (absence of sensory defects, presence of fruit, acidity and less than 0.8% expressed as oleic acid), 'virgin olive oil "(intensity Maximum defect organoleptic 3.5 out of 10, presence of fruit, acidity, maximum 2%), "ordinary virgin olive oil" (maximum intensity of organoleptic defects sur10 6 and maximum acidity 3.3%) and "olive oil Virgin lampante (organoleptic defect greater than 6 in 10 and / or acidity level of 3.3%). In European legislation, the category "ordinary virgin olive oil" does not exist and the corresponding oils are grouped as "virgin olive oil lampante.

* The "refined olive oils" are obtained by refining (industrial) of virgin olive oil, whose free acidity expressed as oleic acid may be greater than 0.3 g per 100g and the other characteristics are that are prescribed for this category.

* The "olive-oil composed of refined olive oils and virgin olive oils" are made of a blend of refined olive oil and virgin olive oils other than lampante which free acidity may be greater than 1.0 g per 100 g.

* The "oil crude olive" are obtained by solvent treatment of olive pomace, excluding oil obtained by any mixture with oils of other kinds.

* The "olive-pomace oils refined" are obtained by refining crude oil crude olive pomace, whose free acidity may be greater than 0.3 g per 100 g.

* The "olive-pomace oil" are obtained by cutting oil refined olive pomace and virgin olive oil other than lampante which oleic does not exceed 1.0 g per 100 g .

Read also Breast

wikipedia

wine and health

2010-07-18T08:19:00.000-07:00

wine and health
The most harmful effect of wine dates from antiquity, there is nothing related to the product but with an adjuvant, lead, added in the form of Sapa in ancient Rome. Jean-Pierre Saltarelli analyzed in wines of the Popes in Avignon and the colica pictunum Viscount de Turenne, the consequences of this addition to the wine. Lead, which was used for baseline and to sweeten wine merchant number and acid green, left a heavy legacy. It causes poisoning, which was first described under the name of colica Pictonum is lead poisoning.

He was aware since antiquity, and some authors argue that this poisoning was a cause of the decline of the Roman Empire. According to the precepts of Pliny and Columella not only the wines were treated with lead salts to soften, but the water supply pipes were lead. During the Middle Ages, the most common substance used was lime rust or white lead, dissolved in vinegar, then during the Renaissance, he was more often used white lead, called sugar or white lead, and litharge, lead oxide or red lead.

Yet it was not until 1473, to denounce the dangers of "liming wine. It was Nicolas Ellembourg, monk of the Benedictine Abbey of Ottobeuren who made this relationship. Then, the following century, Jacques-Auguste de Thou, first described the symptoms of poisoning: "When a man is attacked, his body became paralyzed as: his face is pale, restless mind, of heart pain, vomiting, hiccups continual thirst, difficulty urinating, severe pain in the stomach, intestine, hypochondria, kidneys, and there are even some whose Feet, legs & hands become paralyzed after being attacked with epilepsy commotions ". It was Citois Francis, a native of Poitiers and physician of Cardinal Richelieu, who gave him the name colica Pictonum, in his treatise De novo populari apud Pictones doloro colica bilious Diatribe.

The last element was the lead-containing capsule tin / lead. They were finally banned from 1 January 1993 to avoid a possible migration of lead salts always possible for a bottle lying around the corks.

Bu unreasonable amount, the wine has harmful effects on health. In particular, ethanol present in wine can cause several syndromes:

* In the brain, it alters neuronal survival and maintenance of brain connections.
* Level of the digestive system, it increases the risk of cancers of the mouth and upper airway, the esophageal cancer and colon cancer also increases the risk of breast cancer, other cancers and causes cirrhosis.

Also found in wine traces of methyl alcohol. The latter is a powerful neurotoxin. There are always at doses ranging from 35-350 mg per liter. It comes from the hydrolysis of pectins from grapes during the fermentation.

Like any alcohol, the wine may have adverse effects on the health of people with high triglyceride levels easily (Hypertriglyceridemia). For sensitive topics and drunk in large doses, the wine is part of liquor that may lead to alcoholism. The wine was a part of his remuneration, at a time when water was not always really clean.

Yet, as Constant Bourquin said: "I see some benefit and even a certain advantage to love the wine and gluttony, therefore, be drawn at all (and I do) by alcohol. If it was possible that a good wine was the equivalent of what it is does not contain alcohol, without hesitation, I am fond of this wine. But wine is wine that because of its natural content of alcohol. So, I bow and I am a reason. Feeling that I could express how Anatole France: Alas, gladly "

Read also Alcoholism

wikipedia

Ganoderma Mushroom

2010-07-17T10:48:00.000-07:00

Ganoderma Mushroom
The glossy ganoderma (Ganoderma lucidum) is a basidiomycete fungus of the family Polyporaceae. Also known as Reishi in Japan, it grows on the ground and has a foot and a hat, unlike most "polypore" if one adds the appearance of stained wood, it is unmistakable, not to mention the crooked neck and head eccentric who sometimes irresistibly resemble E. T.

Description

* Hat 4 at 15-20 cm, rounded or kidney shaped, yellow and red-brown, furrowed and wrinkled slightly zoned concentrically and radially (like wood), covered with a cuticle cornea, bright lacquer. Margin clearer then dashing.
* Tubes and fine pores, and yellowish brown, often covered with a whitish bloom.
* Foot 4-20 cm (length varies), usually lateral, gnarled, dark brown and shiny.
* Flesh thin, beige-brown, fibrous, low odor.

Although tough, the fungus disappears in winter. However, it can be dried and preserved for many years.

Ecology
The glossy ganoderma is from June to November in Europe on the ground nearby and buried roots of hardwood (including fruit trees). While not uncommon, it grows alone or in very small groups.

Use
Tough and bitter, it obviously lends itself to use any gourmet.

Dried and / or reduced to powder and then presented in different packaging, it is instead used in Chinese and Japanese traditional medicine as a tonic or immune stimulant, especially, it is also known anticancer properties that have been partially confirmed by scientific studies. Thus, mushroom cultivation began in the Far East.

Read also Lingzhi

wikipedia

Escherichia coli

2010-07-17T08:51:00.000-07:00

Escherichia coli
Escherichia coli, or E. coli also called coli, an intestinal bacterium is very common among mammals humans. Discovered in 1885 by Theodor Escherich in stools of infants, is usually a commensal fecal coliform. However, some strains of E. coli can be pathogenic thus inducing gastroenteritis, urinary tract infections, meningitis, or sepsis.

Description
E. coli is a gram-negative bacillus radiation-immune family Enterobacteriaceae femtograms weighing 110. It is a common host of commensal intestinal microflora of man and warm-blooded animals (mammals and birds). Its establishment in the digestive tract occurs during the first hours or days after birth. E. coli is so throughout the life of the host bacterial species dominant aerobic intestinal flora. E. coli is probably the most studied organism on this day since the age of its discovery and easily cultivated (cell division every 20 minutes at 37 ° C in a rich medium) make it a tool study of choice. The profusion of scientific publications that mention it witnessed, and she plays the role of "workhorse" in all molecular biology laboratories.

History
Theodor Escherich, observing the frequency of neonatal diarrhea, had already raised the issue of involvement in the E. coli enteritis. After World War II, knowledge has converged to establish the concept of virulence of certain strains of E. coli. In the 1950s, many strains of E. coli have been implicated as causative agent of infantile diarrhea. We now know that certain strains "specialized" E. coli are associated with very different pathologies (including extra-intestinal), both in humans and in animals, diarrhea, gastroenteritis, urinary tract infections, meningitis, septicemia, "hamburger disease", the hemolytic Uremic etc..

For prevention, surveillance of HUS at the Centre National de Reference E. coli, located in the Biodiversity Unit of Emerging Bacterial Pathogens to the Pasteur Institute (France), which is responsible for studying the pathogenic strains.

Since the 1950s, bacteriologists have tried, through the antigenic differences of E. coli, to subdivide the species into serotypes by immunizing rabbits with somatic and flagellar antigens. The serogrouping remains the method most used today.

The serotype is the combination of the two antigens, somatic O and flagellar H (eg O157: H7 and O111: H8), while serogroup is determined by the O antigen (eg, O157, O111). However, the serotype is not sufficient to characterize the E. coli pathogens. Each serotype is not necessarily correlated with pathogenicity.

Recently, a laboratory in California (LS9) explained that this bacterium uses to produce hydrocarbons, a technique that may be responsible for the synthesis of oil.

Antigens and serogrouping
The somatic O antigen defining serogroup, is contained in the lipopolysaccharide present on the cell wall of Gram-negative strains. H flagellar antigen is proteinaceous structure within the flagellum (cilliature peritrichous) allowing the mobility of the bacteria. The K antigen surface is not always present but if present, it blocks the agglutinability of the antigen O.

The somatic O antigens
There are over 150. The somatic antigens are composed of complex lipopolysaccharide. Currently some medical laboratories using agglutination with sera to determine the serogroup, but this technique is limited by the number of higher and higher serum to produce by the presence of cross-agglutination between the O antigens of E . coli, Shigella, and those of Salmonella, and the passage of the creamy consistency of the colony textured with the consequent lack of synthesis of O antigen For this reason, a molecular serotyping technique has been developed.

The O antigen is part of the lipopolysaccharide (LPS) of the outer membrane of Gram-negative bacteria. It contains a large number of repeating units of oligosaccharides from March to June sugars whose combination determines the diversity of antigens O. The genes encoding enzymes involved in the synthesis of O antigen are clustered in the rfb gene cluster.

The rfb cluster can be amplified specifically with a primer and, after restriction endonuclease MboII, a profile rated "R" can be obtained by electrophoresis, corresponding to serogroup E. coli. A profile of electrophoresis is based on the location of restriction sites suitable for MboII. Thus all clusters of genes corresponding to a somatic antigen have a restriction pattern of its own. This profile is then analyzed with R software Taxotron ® and compared to a database, in perpetual development. For example, the profile will have a number R111 R, corresponding to serogroup O111 obtained with serum.

Flagellar H antigens
The H antigens are not used to identify E. coli pathogens but have a great interest in epidemiological perspective: the identity of the H antigen is a component to ensure that it is the same strain.

The diversity of antigen H is due to different types of flagellin component structure of the flagellum. It allows the flagellum motility. Typing is also achieved by agglutination, but is developed in very few laboratories in the world. However, some strains lose their mobility and are classified as non-mobile (NM or M-). A molecular serotyping technique has also been developed to determine the antigen H.

The H antigen is encoded by the gene fliC. The N and C terminal parts of flagellin are highly conserved and is the middle part, more variable, which gives the specificity of antigen H. The E. coli also still have the fliC gene but are unable to synthesize functional flagella. After amplification and restriction of the fliC gene, it is possible to type the H antigen by comparing the pattern obtained from a database of profile-type. For example, the profile fliC (rated E) has a number F8, corresponding to the type H8 obtained with serum.

The surface antigen or envelope K
There are three types of K antigen designated by the letters L, A or B.

* The antigen is the most common but is heat labile (it was destroyed in half an hour. 100 ° C). So the heating causes a loss of antigenicity, the power to fix the antibodies and the power to hide the O antigen
* The A antigen is rare, it is a capsular antigen (encapsulated E. coli are relatively frequent in urinary tract infections). The Hep A is highly thermostable (you have to destroy autoclaving)
* The B antigen is always present in E. enthéropathogènes coli of infantile gastroenteritis. It has a thermolability intermediate: after half an hour. 100 ° C, there is always B antigen O antigen but may come into contact with the serum by "holing" of the envelope, antibody binding is always positive but the antigenicity is lost gradually (depending on the duration of heating).

Difference between antigen and B antigen A or L: in a homogeneous culture dish,

* 80% + of colonies and 20% of colonies - for A or L
* Homogeneous distribution throughout the population for B.

Read also Appendicitis

wikipedia

Appendicitis

2010-07-16T06:42:00.000-07:00

Appendicitis
Appendicitis is an inflammation of the ileocecal appendix. Appendicitis can occur at any age but especially before age 30. Untreated, it can be fatal, especially by peritonitis and sepsis thus requires an emergency appendectomy.

Appendicitis is the most common surgical emergency. The clinical presentation may take various forms, complex polymorphism (symptomatic) but do not parallel clinical anatomy. The diagnosis of appendicitis is typical clinic.

History
Paul Georges Dieulafoy will be the first French doctor in March 1896 to give a detailed description of appendicitis: "The vermiform appendix of the cecum can participate in the lesions of typhlitis and pérityphlite or be the site of lesions independent ... "but it should be noted that, in his Manual of Internal Pathology, Dieulafoy never speaks but typhlitis from appendicitis.

The term appendicitis belongs to an anatomical pathologist, U.S. Boston, Reginald Heber Fitz (1843-1913) and this word appears for the first time in an article published in 1886 "Perforating Inflammation of the vermiform appendix: with special reference to early diagnosis and ITS treatment ". For cons, the use of the term "appendicitis" is older, dating back to 1872.

Amyand Claudius made the first successful appendectomy in history in 1735. Charles McBurney, American surgeon, published in the late 19th century a series of reports that were the mainstay of treatment for appendicitis.

Anatomy
The appendix is located on the cecum, proximal colon. It forms an outgrowth of ten centimeters in length and has no proper role. However, one hypothesis is that the appendix would be a "protected reserve for friendly bacteria".

Epidemiology
It is the emergency abdominal surgery the most common. It most frequently affects the person between 10 and 20 years, with a discreet male. Outstanding forward 3 years is rare in young children.

Bacteriology
Polymorphic bacterial flora: Escherichia coli, Bacteroides. Can be caused by Yersinia enterocolitica.

Appendicular lesions
* Catarrhal appendicitis: congestion
* Suppurative Appendicitis: nick phlegmonous (stalls); empyema appendix (appendix distended by a collection of pus)
* Gangrenous appendicitis: gangrene
* Perforated Appendicitis

Peritoneal lesions
* The bursa is red, edematous, the peritoneal effusion is variable.
* False membranes accolent viscera and omentum. Agglutination visceral realizes the butt and sometimes paralytic ileus. The isolation of a collection of pus collection abscess.

Symptoms
The pain is progressive, and colicky, begins in the epigastric region and then secondarily to locate the right iliac fossa. Augmented by breathing, coughing, exertion. Irradiation: navel, thigh, lumbar fossa. This pain is typical, however, that in this case two.
The food and bilious vomiting. More often there is only nausea.

Treatment
The only treatment is surgical and consists of appendectomy. It must be carried out immediately after the diagnosis was made in order to avoid complications (peritonitis). The gesture is preceded by the setting on antibiotics.

Read also Stomach Cancer

wikipedia

Anorexia

2010-07-14T22:46:00.000-07:00

Anorexia Nervosa
Anorexia nervosa (Greek ἀνορεξία (anorexia), "loss of appetite") is one of eating disorders (ED), not to be confused with anorexia as a medical condition. It is mainly reflected a concern tyrannical appearance, leading to drastic food shortages. The causes are multiple and overdetermined. In any event, they are a psychopathology of body image. Fashion and phenomena of imitation between adolescents are often implicated, but they remain difficult to isolate the history of the subject who suffers from his home environment and precipitating life events.

The sociology proposes to take into account the share of social aspects, such as the fact that anorexia nervosa does not appear in the same proportions across all cultures and all eras. In some cultures, it is absent. Often, people who suffer from these disorders are mostly teenage girls, even if there are more and more boys.

History
The first case mentioned in history is that of Catherine Benincasa, Saint Catherine of Siena, who lived in the fourteenth century (1347-1380). Yet, already in the Middle Ages, periods of fasting and severe privations during in mystical religious communities. Another famous case is that of Elizabeth of Wittelsbach, known as Sissi, Empress of Austria-Hungary, who lived in the nineteenth century (1837-1898). In the twentieth century, it is also possible to quote the philosopher Simone Weil.

The first description of the disease is attributed to Richard Morton, who gave him the name of "nervous consumption" in the seventeenth century (1689). Charles Lasègue, French physician of the nineteenth century was one of the first to give a description of the psychopathological he called the "hysterical anorexia. Initially, experts believed in the disruption of the pituitary. It was not until the 1950s that come with the idea of a psychic origin of anorexia nervosa therefore accepting that - until proven otherwise - the physical problems associated are the consequence of stopping power.

From the 1980s, the eating disorder psychopathology have attracted attention of specialists, including their structural relationship with addiction.

In France, a bill is presented to fight against anorexia, in 2008.

Definition
Anorexia nervosa is a psychiatric disorder which was reflected in a significant weight loss, but it is tied to a specific dietary restrictions voluntarily, sometimes involuntarily, even if the causes of these self-inflicted deprivation remain unconscious for sufferers. In anorexia nervosa, the patient fight against hunger, while in anorexia, it has lost appetite.

The diagnostic criteria for anorexia nervosa are usually used:

* Refusal to maintain body weight at or above a minimally normal weight for age and height (eg weight loss leading to maintenance of body weight less than 85% of that expected or failure to gain weight during the growing season leading to a weight of less than 85% of that expected);
* Intense fear of gaining weight or becoming fat, while weight is below normal;
* Altered sense of weight or shape one's own body (body image), undue influence of weight or body shape for narcissism or self-esteem, or denial of the seriousness of the current low.

Anorexia is one of the most deadly diseases of the psyche. The mortality rate at 10 years is 5%, roughly 20% in the longer term, since the health of those who survive remains irreversibly undermined.

Epidemiology
Anorexia affects less than 0.5% of young women in the pure form anorectic. The bulimic syndrome affects 1% of young women and 0.1% of young men. This disease mainly concerns young girls 12-20 years but may appear as young as 9 or 10 years. The boys are less affected (9 out of 10 anorexics are female) but the evolution of morality tends to make them more likely to become ill.

Different types
We can distinguish two types of form of anorexia nervosa (besides the fact that he has admitted there are as many ways to be anorexic as people with the disorder):

* Restrictive type: during the current episode of anorexia nervosa, small intensely about her diet and did not regularly presented to binge or resorted to self-induced vomiting or taking laxatives (ie -d. laxatives, diuretics, enemas).
* Type with binge eating / vomiting or taking laxatives: during the current episode of anorexia nervosa, small intensely about her diet and has regularly presented binge eating and / or used self-induced vomiting or taking purgatives (laxatives, diuretics, enemas).

Causes
They remain unknown. There are likely genetic factors, suspected on family structures and twins.

Cases of anorexia nervosa are increasing in the Western world. This is true in all European countries, the United States and Canada, Japan, in white populations in South Africa and in the better-off South America. They are found mostly in white populations and are rare in African Americans and Africans. There are only very few cases of anorexia nervosa outside the Western sphere, as shown by different studies among Alaskan Eskimo populations, or in India.

Some explain this separation by the fact that Western society is more focused on individualism, which develops the competition. Black populations in Africa and the Americas would be less affected by anorexia because they have a spirit and a more communal way of life less focused on the individual competition.

But there is also risk activities that increase the risk of TCA, including anorexia nervosa. Such is the case of ballet dancers, who are required an absence of curves, small hips and a flat chest. According to various European and American studies, 15-30% of future ballerinas exhibit behavior identical to that of food anorexic or bulimic to mentally control their weight. Other studies on students supermodels, or the professional jockeys, show the same behavior.

We also note that anorexia is more common in middle and upper classes.

Psychopathology
In psychopathology, we consider anorexia as an addictive behavior. The link to the primary orality and / or secondary education are obvious and can be understood as an avatar of the Oedipus complex or its precursors. The conduct of food refusal can also be seen as avoidance of a process of intellectualization of primary identification and / or secondary. It is a symptom of poor integration of the unconscious body image in relation to secondary sexual characteristics, curves of female puberty, etc.. for young women. The disorder often occurs in family contexts individuals (low marks on the difference between generations, etc..). The internal object relationship with mother is marked by a refusal or inability to identify with an adult woman sexually. The defense mechanisms by rationalization, intellectualization and asceticism are frequently at the forefront. But there is another current from the United States and Canada that combines the area of anorexia phobia, while Bulimia fall under dependency. (Graduate Institute of Mental Health Douglas clinical eating disorders, Montreal, Qc, Canada)

"Being thin" is a pretext, support the need to master a world that seems extremely harmful (the judgments of others is distorted both in intensity and direction).

People in the medical profession in contact with people with anorexia have noted a strong feeling of guilt and obsessive routine. In the brain anorexic information "I am guilty" is linked to a morality that rejects everything that is "unfair" it implies that being guilty, they must be punished. And when you are punished, they should not feel happy. The greatest pleasure available in human nature is the primary need from food, feed the anorexic becomes "unacceptable".

The guilt may come from a series of causes and effects misunderstood (Divorce, thoughts of others, sexual practice no longer welcome, rejection in love ... / anything can be sources) If you understand the cause of discomfort the individual would be responsible for the "problem". The anorexic often mixes two pieces of information: "to be present at an event" and "be responsible for the event."

Diagnosis
Must be established or confirmed by experts and reflect the overall mental functioning, defense mechanisms, the type of anxiety (depression, psychosis) and the type of object relationship. Teenagers sometimes have an eating anorexic-looking but passengers are sometimes covered attitudes of identification with peers, to celebrities or other models. If the problem persists, it must be specialized consultations and ad hoc treatments. Be careful to distinguish what would report to addictive disorders, borderline or psychotic disorder with sometimes hidden delusions of poisoning. Clinically, the border between the two poles of organization psychopathological, psychotic and borderline is not always easy to distinguish.

Under the current criteria of DSM-IV [9] for anorexia nervosa, all the following conditions should be met:

a) refusal to maintain body weight above the normal minimum (less than 85% for age and size)

b) intense fear of gaining weight or becoming fat, despite underweight

c) alteration of the perception of weight or the shape of his own body (dysmorphic disorder)

d) undue influence of weight or body shape on self esteem, or denial of the seriousness of the current low

e) amenorrhea for at least three consecutive cycles in women menstruate (amenorrhea).

Complications
Physically, this disease leads to weight loss. Losing weight is directly related to food deprivation. It induces a so-called malnutrition.

The food deprivation quickly leads many deficiencies in minerals, vitamins and other essentials. These, and weight loss will lead to disruption or damage to the body: muscle loss, drop in blood pressure, faintness, fainting, hair loss, anxiety, insomnia, fatigue, feeling cold permanent memory loss, amenorrhea (cessation of menses), calcium deficiency, osteoporosis, major relationship problems (loss of friends, family conflicts). The physical disorders may ultimately threaten the life of the person. Mortality is estimated at just under 6% per decade in the disease.

The anxiety and the need to lose weight will be responsible for a physical hyperactivity.

Treatment
Formerly, treatment was mainly based on the isolation of the family environment. However, lack of scientific evidence of his interest, it is no longer practiced. Hospitalization, when necessary, is to assist in weight regain. To do this, (the) patient is ideally accompanied (e) by a team comprising a doctor, a dietician and a (e) psychotherapist. The management must afford a psychotherapeutic work just make sense of symptoms and solutions. The fear of becoming fat may then be absorbed or disappear. A specialized treatment is usually necessary. It must be multi-disciplinary medical, psychotherapeutic and / or educational and nutritional. The main difficulty is the refusal of treatment, for fear of gaining weight and becoming obese. We need to help / patient (e) to realize that he suffers from a disease that is treatable.

The treatment is to initiate dialogue with the youth / e by working towards a re-feeding and weight regain. A general practitioner is holding parallel, monitoring of weight and health. In severe cases, hospitalization is necessary: it often enables the girl to enter into other relationships and develop a sense that is alien to exist by itself. Parents can also be supported in a family psychotherapy.

In all cases, a nutritional approach is essential. It is important to note that, in fact, no therapy can be undertaken before the patient was able to reach a certain weight, allowing it to fully understand the concepts presented. And this is what calls the new method Maudsley. Coming from a British hospital, this method seems to get favorable results, particularly among young anorexic clients whose age is between 11-14 years. It reduces mortality and ensure the treatment of malnutrition. What differentiates this method is the heavy involvement of parents in the treatment plan, which was unthinkable, it is thirty years, or, conversely, the patient was removed from his family.

By cons, in some extreme cases, severe means of recharge will be necessary (nasogastric). In other cases involve older teenagers and adults resistant to all forms of aid seriously putting at stake their health and their lives, it will be necessary to obtain a warrant from the Court to allow a psychiatric assessment to determine if there is a possibility to hospitalize a person against his will.

The treatments give positive results, both physically and psychologically more precisely when the patient is treated within a period of four years. It requires great patience to psychiatrists, psychotherapists, physicians and paediatricians who work to support. Relapse is the rule, but after months or years of common struggle, the teenager or adult she has become, may be opened to greater autonomy and less dependence on their eating behavior.

It is estimated that the cure is achieved in approximately 50% of cases, and one third of cases, patients remain more or less eating disorders, low weight and a very strong fear of becoming fat. Relapses are part of the treatment, if they are regarded merely as failures that led to discouragement and abandonment. They must be worked and developed in psychotherapy it can be integrated as a stage of treatment. It is also estimated that 20-25% of cases where anorexia nervosa persists. In any case, treatment should be considered in the medium to long term. It does not get rid of this type of problem by miraculous treatment. The eating disorders are testing the process of adolescence, thought, action, sexual differentiation, autonomy, etc.. They also call into question the balance and achievement of children.

There is no medication has shown any efficacy in this disease.

Anorexia infants
In addition to adolescents, anorexia can directly affect infants. Anorexia symptomatic newborns is a sign of functional disorder of reflex centers located in the brain, and if the child is premature, this disturbance is due to lesions cerebromeningeas at birth (cerebral hemorrhage, anoxia , for example). In this case, refusal of food is obviously important and tenacious, and, thus, differs from anorexia so-called "primitive", where the new-born hypotonic, do not take or refuse the breast and nipple.

Since its birth, the child is caught in a relationship with the mother who comes between the need and demand. The purpose of eating that meets the need is also subject to an application of love to the foster mother. The child needs to be nurtured and loved in the same time or the mother who loves him also asked to absorb the food she prepares for him. Since the desire of the child fits between the need and demand based on a lack. The infant may have to reject the food and food and confusing amou.

Runs organicists and biological hypotheses
Many assumptions are Organicist worked for decades, not all are outdated, like all other psychopathology, research in the area are ongoing and none of them is needed now as can be retained as final. We must be careful when you take that knowledge and disseminate it.

In 1994, was isolated a hormone secreted by fat tissue cells, adipocytes. This hormone, called leptin, would inform the brain about the fat reserves of the body. Leptin is the product of the expression of the gene obese (ob). The mutations ob induce a greater morbid obesity associated with diabetes bold. The secretion of leptin action would reduce food intake and promote weight loss. Plasma leptin levels are strongly correlated with fat mass measured by body mass index. The loss of weight due to food restriction is associated with decreased plasma levels of leptin. There would leptin receptor in the arcuate nucleus of the hypothalamus. Increased levels of circulating leptin is detected by neurons in the arcuate nucleus. It follows a set of complex responses, humoral, viscero-motor and behavioral inhibit food intake.

One means by which leptin decrease food intake would decrease appetitive value of food. The leptin would alter the state of the circuit meso-limbo-cortical involvement in reward mechanisms. Weight loss resulting from a chronic food restriction increase the rewarding effects of stimulation of the lateral hypothalamus and conversely, injection of leptin would decrease the effect of rewarding stimulation of the lateral hypothalamus in the rodent. This mechanism could be useful in analyzing the phenomenon of chronicity in anorexia nervosa.

Adipocytes do not secrete leptin only. Another peptide was recently identified, adiponectin, which occurs in the regulation of glucose and lipid metabolism. Blood levels of adiponectin are decreased in obesity and increased in normal weight bulimics. Epidemiological studies of twins show that there is a legacy part of an eating disorder.

* For monozygotic twins, Kendler et al. are:

- 56% concordance in anorexia - 23% concordance for bulimia

* And dizygotic twins:

- 5% in anorexia - 8.7% in bulimia.

There is therefore possibly a biological vulnerability partly hereditary, passing perhaps the gene encoding leptin or other neurotransmitters involved in regulating eating behavior.

Read also Weight loss

wikipedia

Compulsive hoarding

2010-07-13T06:35:00.000-07:00

Compulsive hoarding
The Compulsive hoarding is obsessive-compulsive disorder which leads to raise or not to throw a large number of useless objects even if their accumulation causes major discomfort. Combined with the conservation of waste or excrement and domestic hygiene and faulty body it is called 'Diogenes syndrome.'

Symptoms
There are few studies on the Compulsive hoarding. However, Randy Frost, professor of psychology at Smith College in Northampton, Massachusetts, and Dr. Hartl in 1996 gave the following symptoms:

* Accumulation voluntary or inability to take a large number of possessions that seem useless to any other person or a very limited interest.
* Place of life cluttered as to limit the movements
* Discomfort and pain caused by the accumulation of objects.

In their study, a patient, D., lived with her two children aged 11 and 14 years. She described his behavior as a "small problem that had emerged several years ago" when marital difficulties. D. said his father had had the same problem and that it had even begun to put things aside from a very young age. D. also suffered from other obsessive-compulsive disorder. The volume of accumulated objects occupied 70% of his house. Aside from the bathroom, no room in the house could be employed properly. The two main access doors to the house were locked and the occupants had to go through the garage to enter.

Several studies have shown a correlation between the Compulsive hoarding and obsessive compulsive disorder. However, there are individuals who show symptoms of compulsive accumulation without suffering from other obsessive-compulsive disorder. Patients suffering from hyperactivity or attention deficit are often victims of Compulsive hoarding.

Physiology and treatment
It was noted that individuals who exhibit these symptoms tend to have a cerebral glucose metabolism differs from others.

The disorders are usually treated by psychotherapy (cognitive-behavioral therapy) or antidepressants.

Famous Cases

* The Collyer brothers, Langley and Homer Collyer Lusk, called Hermits of Harlem, who accumulated 136 tons of knick knacks in their building has three floors in New York. Deaths in 1947, they are buried at Cypress Hills.

Read also Schizophrenia

wikipedia

Aids Africa

2010-07-09T07:04:00.000-07:00

Economic Impact of AIDS in sub-Saharan Africa
Epidemiology
34-46000000 people worldwide are infected with the AIDS virus. For 2003 alone, more than 3 million people died. That same year, Africa whose population is only 11% of the world population, housed two thirds of all patients with HIV in the world. Today, one African out of 12 is infected with the virus and / or sick.

The impact of the disease does not measure other than deaths. The social consequences are also significant. AIDS destroys the efforts made to enable the empowerment of women, destroyed the meager progress in terms of education, impacting the health care of people (in South Africa today, 80% of inpatient public hospitals are HIV positive. recedes malaria but tuberculosis and diseases related to malnutrition are progressing by leaps and bounds). The population growth in Africa is stopped. Perinatal mortality is regrimpea dramatically. Life expectancy has dropped to 49 years in the countries of Southern Africa when she is 78 years in European countries and North America.

Throughout the world, people aged between 20 and 40 years are most affected. This means that the forces, the African economic engines, are missing. The economic impact is considerable.

Impact on economic indicators and growth
Economic growth! a country is usually correlated to life expectancy. Consider that 0.5% economic growth is earned for each 5 years of additional life expectancy. With a life expectancy at 49 years, economic growth in Africa is seriously jeopardized. Spending on infrastructure, personnel and training required AIDS incurred considerable economic development of countries already well off track. Labor markets underdeveloped, the savings rate and insufficient investment, inadequate standards of governance and a generally low level of education are factors that aggravate the impact of AIDS on the entire region.

It is very difficult to quantify precisely the economic consequences of a given disease on the development of a region. The Committee "Macroeconomics and Health," World Economic Forum has tried to do for the whole of Africa, AIDS would cost between 11.7% and 35.1% of annual GNP. In fact, these figures may be slightly overestimated since the majority of the workforce consists of achieving workforce unskilled, easily replaceable in the business.

In all cases, the economic impact of the AIDS epidemic on African countries is and will be major. Current studies are unable to quantify the impact on agriculture, industrial production, food security and more on the inevitable social consequences of the epidemic: the destruction of families and social structures, millions of orphans left to their same (it is estimated 41 million orphans in Africa in 2010), reduction to zero of community networks. Some authors conclude that in the coming years, African economies will "implode under the impact of AIDS".

Macroeconomic Impacts
Three types of approaches are possible to assess the impact of AIDS on macroeconomic indicators

* Approach "cost of illness': it is to multiply the number of people affected by the virus treatment costs and lost revenue. This approach generally leads to overestimate the cost in developing countries, where the real impact on the cost of labor is difficult to estimate given the oversupply of labor supply.

* The functional approach that examines the impact of disease on the labor market, skilled labor and capital. AIDS affects all three parameters.

* Finally, the empirical approach that examines the slowdown in GDP growth in the countries most affected.

None of these three approaches gives satisfactory mink today, the real impact of the epidemic on the economies of African countries. Therefore, the experts here and there multiplied projections and estimates. Thus:

* WHO published in 2000 estimated that a country with more than 20% of its population HIV-positive undergoes annual decline of 1% of its GDP.

* The UNAIDS, the UN agency specializing in AIDS, in 2002, estimated that its share drop to 2.6%.

* The World Bank forecasts that the GDP of South Africa will, in 2010, 17% lower than it would have been without AIDS.

Some authors stress that the most difficult tasks lie ahead. Considering that the epidemic is in its infancy in the countries of southern Africa, they foresee a collapse of the economies of these countries in the next 10 years.

* In terms of catastrophic predictions, some experts at the World Bank fears that high mortality rates, difficulties in training and imparting knowledge to young people and the disintegration of family structures, might lead to child labor and the abandonment of policies of education for all.

* Finally, many experts point out that the standards of public health indicators are now considered by international investors. The countries most affected African countries are developing. A decrease in international investments will have a major effect on their growth.

Micro-economic implications
Private companies are affected by macro-economic aspects of the epidemic because the environment in which they deploy their efforts is affected. However, companies have largely tendency to consider the impact of the epidemic to the extent that it affects their capacity for investment, production or sale. Yet there are five major areas directly affected by the epidemic and affecting enterprises in the first place:

* Workforce
* Customer
* Capital cost
* The reputation of the company and more generally its image
* The market environment in which it operates.

AIDS affects each of these five areas.

Impact on workforce
In sub-Saharan Africa, four countries will see a reduction in their workforce of more than 30% in 2020 compared to what it would have been without the epidemic. Fourteen countries have decreased between 10 and 30% while 18 countries will see a decrease of 10%. In southern Africa, the workforce most affected is low and unskilled workers. From an economic standpoint, it is true that the pool of unskilled labor seems inexhaustible given the high rates of unemployment. The costs of AIDS to businesses are also less important. However, the combination of poverty, lack of training and a high prevalence of HIV makes the future market of labor rather dark, not conducive to business development as their markets. Conversely, the costs are more important than the workforce affected is qualified (see box). As we know, the skills profile of those most affected with the epidemic evolves. Initially, the most affected are those who can afford to travel and maintain multiple sexual liaisons. They are classified as economically leaders. As as the epidemic progresses, the social level and qualifications of people tend to regulate itself and the poor and least skilled become more obvious for demographic reasons.

Given the higher prevalence in the unskilled labor, companies, realizing the cost of AIDS on their economies, may be tempted to employ only workers whose seronegativity is proved. Such discrimination is illegal but in a labor market where unemployment is the rule, institutional safeguards should be put in place, further increasing labor costs.

The evolution of the epidemic, especially in southern Africa, are concerned that we're still only a beginning. For example, the mining company AngloGold estimated that the cost of AIDS in 2002 amounted to between 1.1% and 5.8% of its total labor costs. She believes that in 2009, this cost will be between 8% and 17%.

Other business impacts
It is difficult to accurately assess the consequences of the epidemic on economic demand. The most diseased population, young adults, is not only working but also one who consumes. It is known that the AIDS epidemic reduces the GDP of a country and thus the income per capita. Studies on the impact of AIDS on households clearly show a reallocation of resources to health care costs and funeral at the expense of education, housing, clothing and food.

The capital cost of the epidemic is largely dependent on market demand. In a large study of World Economic Forum and in a study in South Africa by the Bureau of Economic Research, companies seem to be few to be aware of the impact of AIDS on their own balance. Thus, investment firms do not seem to suffer for the moment.

Some companies are already engaged in the fight against AIDS. Renowned Global Business Coalition brings together heavyweights of Western trade. In Africa, chambers of commerce and industry have begun to react and try to unite businesses around AIDS, the image of South African SABCOHA. It is virtually impossible to assess now the impact of involvement in communication on the part of companies in the fight against AIDS. On the one hand, corporate citizens, submerged in the problems of their clients, are certainly more likely to be favorably received. On the other hand, in the vast majority of African countries, AIDS is so afraid that the consequences could be quite the opposite effects. Nobody can predict today what the outcome of this dilemma on the purchasing decisions of consumers.

Finally there is political risk. Social pressure increased due to inflation of poverty, reduction of state resources, the disintegration of civil society (especially the family and education), lower investment outside and habitual difficulty of governments in Africa to maintain transparency of information are factors of destabilization of power often already fragile. This is an additional risk for companies.

Read also HIV Testing

wikipedia

Xenophobia

2010-07-07T04:39:00.000-07:00

Xenophobia
Xenophobia is an irrational or systematic hostility against one or more persons, motivated mainly by their nationality, culture, religion, ideology, or geographical origin, it can also be defined as a "hostility to what foreign ".

Xenophobia can be manifested by an attitude ranging from a simple bias to violent actions. It is generally accepted that for a country, municipality or organization to reserve certain rights or benefits to its members or its members shall not be regarded as xenophobia, but as a simple consequence of ownership or the territorial jurisdiction. It goes a little differently for the specific rights attached to citizenship, although the Declaration of Human Rights and the Citizen devotes this distinction in the title, and that within the European Union, principle of Community preference to be admitted in the economic and commercial. However, according to several authors, such Delacampagne Christian, this "bias" runs directly counter to fundamental principles that inspired the French Revolution all the inhabitants of a country they have citizenship or not, must be treated the same way and enjoy exactly the same rights and privileges as citizens of the country. For him, the concepts of nationality and citizenship should be abolished to form a single country worldwide.

Has two Greek roots, derived from Greek (xenos, "stranger" and phobos, "rejection, fear), the word xenophobia is a neologism appeared in French in the early 20th century.

Origin and meanings of the word
It is a feminine noun derived from the neologism "xenophobic" whose invention is attributed to Anatole France, in 1901. In connection with the Dreyfus affair, the writer denounces demagogues by associating them with "misoxènes, xenophobic, and xénoctones xénophages (...)». The word "xenophobic" appears for the first time in a dictionary, the New Larousse Illustre, 1906. Twenty years later, in his famous pamphlet "The Treason of the Intellectuals" (1927), Julien Benda spoke of xenophobia as an aspect of patriotism: "Another character trait that makes the patriotism in the modern clerk: xenophobia. The hatred of man for someone from the outside "(...), its proscription, his contempt for what is not" home ".

The word "xenophobia" is used by the French Academy for the eighth edition of his Dictionary (1935) with the following definition: "A state of mind, feeling that he is xenophobic". This definition by reference to the emotions or behavior, whether individual or collective, is the most common meaning and is found in most dictionaries in 2009: TLF / "expressed hostility towards foreigners, which foreign. Toupic / "Literally, xenophobia is the irrational fear, morbid things foreign. In the ordinary sense, the term "xenophobia" is rather used to characterize an feelings towards other human beings."

The great dictionary of the terminology of the Office Quebecois French language has two entries for the term "xenophobia": one in sociology ("adverse Prejudice against foreigners. Note: Xenophobia is based on stereotypes, generalizations baseless, born of rumors, misunderstandings, different customs. ") and one in Psychology (" Hostility vis-à-vis foreigners, social origin, not pathological. ")Both definitions emphasize the social rather than psychological such beliefs or emotions. This reflects an evolution of the signified that oscillates between the nomination of a line of irrational mind and that of a social phenomenon or rather a common sense between psychological and sociological conceptualization infancy.

In all cases, the concept of xenophobia reminiscent of alien and multiple stigmata of otherness: geographic, racial, national, gendered, linguistic, cultural, religious, social, etc.. Xenophobia can then take various forms borrowed from racism, sexism, elitism.

Racism and xenophobia
A particular challenge lies in the semantics and uses the comparison of concepts of racism and xenophobia. At the end of the twentieth century, the two terms tend to be used in a manner indistinguishable in everyday language and in the mass media, as if the word's oldest and most widely used of "racism" suffered a sense of euphemism as and disappear as the ideas on the biological basis of race. There is talk of "cultural racism" or "anti-racism youth" as a metaphor referring to a symbolic differentiation comparable to those that existed in the biological beliefs about race and sometimes persist with them.

Racism, however, appears as a set of separate semantic and ideological xenophobia: rooted in beliefs about the relationship between mind, psyche and physiological differences, primarily those related to sex and skin color European political culture, racism was in the past, the subject of scholarly theorizing, often related to skin color, usually placing the whites over blacks. These theories have led, even beyond their original culture, symbolic hierarchies correlated with degrees of whiteness or blackness of skin, what is called the "Colorist".

From racism, Albert Memmi gives the following definition: "Racism is the development, widespread and ultimately, biological differences, real or imaginary, in favor of the plaintiff and against his victim in order to justify aggression. This research underlines the political dimension of the violent and racist idea, leading to collective action and / or military at the expense of races deemed inferior or dangerous. By contrast, the notion of xenophobia evokes less systematic organization of the symbolic and physical violence, as if it was less clear and more diffuse, at least as long as it does not turn into a radical form of conflict would become something else , racism, homophobia, sexism, religious persecution, etc..

This apparent moderation of xenophobia in relation to racism, however, must be put into perspective by taking into account the historical context: attitudes in the late 20th century were marked by the memory of the Holocaust and its racist underpinnings. In many societies, including Western, racism is so disqualified as a scientific theory than political speech. The laws define and punish which are not sufficient to eradicate all belief about it but forced to forms of euphemism. As a result, the xenophobia is sometimes substituted with racism of yesteryear, only introducing more caution in the designation of the stigma of otherness reviled.

Sociological definition
It is possible to give the following definition of xenophobia "all the words and deeds to appoint an unjustified abroad as a problem, a risk or a threat to the host society and to keep the away from this company, that the alien is off and may come, or ever in this company or long installed ".

This definition opens a perspective for research and reflection including implied representations or technology from abroad as a problem, risk or threat, and the expressions dispassionate adapted to social and legal suffered xenophobic discourse in societies that condemn. This perspective also avoids reducing xenophobia prior to its popular manifestations, including racist (profanity, slurs, stereotypes ...) or that of ordinary discrimination (in hiring, in business, in everyday action the police ...) and thus at prejudging, unconsciously, the popular character of this phenomenon. It also avoids, on the political level, to reduce the phenomenon solely xenophobic discourse and electoral success of small groups and extreme right parties, the question arises when the reasons for their resurgence in the center of the political system, particularly in Europe, the late 20th century.

One can distinguish conceptually different forms of xenophobia as their social origins: popular xenophobia xenophobia and elitist by differentiation in sociology élitste between a ruling minority and a mass governed; and xenophobia xenophobia protest of government, if we reported the phenomenon to the xenophobic usual distinction between "parties of government" and other parties, or simply between rulers and ruled. These distinctions are then used to wonder about the dynamic social and historical relations between the elite and governing forms of xenophobia and its popular forms or Adversaries: which are the source of periodic lifts of xenophobia in the political history of human societies? What explains that in certain configurations socio-historical, xenophobia (again) become a central feature of political life?

Read also Arachnophobie

wikipedia

anxiety disorder

2010-07-04T06:51:00.000-07:00

Anxiety
Anxiety is the phenomenological psychiatry biological and behavioral state of alert, somatic and psychological stress, in connection with an unpleasant feeling of fear, anxiety or other emotions. Physiological events may accompany the state of anxiety: dizziness, nausea, palpitations, difficulty breathing, chest of contrition, sweating. However, when physical symptoms are present, one class rather then the phenomenon under the name of anxiety.

When anxiety is unnecessary, or it is disproportionate to its purpose, or caused by disease or intake of a substance, known as anxiety disorders, which are a condition in which an individual does longer able to control his anxiety.

At its highest level, anxiety is manifested by a total grip on the individual who loses his perceptions of the environment, time, emotions to which he is accustomed. We then speak of "Raptus anxiety" (eg following an overdose on amphetamines). The degree of intensity may be so great that it is virtually essential to practice medical treatment.

For psychoanalysis, the anxiety is distinguished from anxiety, the nature (object loss, depression, psychosis, castration) should be investigated in the framework of psychoanalytic interviews in order to establish its intrapsychic function for illuminate the point of view of consciousness and beyond in a cure. Also in psychoanalysis, four emotions are repressed and need to be felt among people anxious: fear, regret, frustration and disappointment.

Epidemiology of anxiety disorders
Anxiety disorders are very common. As defined in DSM-IV (International Classification of psychiatric disorders), it affects nearly 30% of the U.S. population and its age of onset is 11 years. It features an increased risk of depression. It is also associated with certain behaviors that can cause health problems, such as smoking, alcoholism or physical inactivity.

The management remains very partial, nearly 40% of Americans suffer from anxiety disorders receive no treatment for this condition.

Anxiety existence
Theorists like Paul Tillich and psychoanalysts such as Sigmund Freud described this kind of anxiety as the "trauma of nonbeing." The human being comes at a time in his life where he realizes that there is the possibility of ceasing to exist (die). It then develops the anxiety about the reality and existence. According to Tillich and Freud, religion becomes an important mechanism for dealing with this type of anxiety, since many religions define death as a divine and eternal continuity of life on earth as opposed to the complete end of existence.

According to Viktor Frankl, author of the book Man's Search for Meaning (in English), the lowest instincts of the human face of mortal danger is to find a way of life to combat this "trauma of non- being "at the approach of death, when the temptation to succumb to (even by suicide) is very strong.

Drugs
The specific symptoms of anxiety are most often supported using certain medications such as benzodiazepines. Diazepam was among the first drugs used for this purpose. Today, medical professionals have a much greater range of products used to reduce symptoms of anxiety. The administration of such products may be dangerous and should be supported by a doctor or, preferably, a psychiatrist. It is also advised not to suddenly stop this kind of treatment once started. This is mainly benzodiazepines and other types of drugs such as buspirone, the captodiame, meprobamate, hydroxyzine, or the etifoxine, and the good old Rivotril.

Cognitive behavioral therapy
Cognitive Behavioral Therapy (CBT) is the most common way to treat anxiety. The goal of this therapy is to prevent the patient avoids the source of his anxiety and help the patient to develop specific techniques to cope.

Unlike prescription drugs, the effectiveness of cognitive behavioral therapy depends on various factors, including the level of competence of the therapist concerned. In addition to therapy "conventional", there are many cognitive-behavioral programs that patients can use to heal. This may include techniques to:

* Limit any negative thoughts to oneself.
* Develop the ability to have positive thoughts.
* Develop the ability to replace negative thoughts with positive thoughts.
* Describe step by step the patient to the source of his fear.
* Provide patient information that can help cope with anxiety. (For example, we can say to a patient suffering from the panic he feels the palpitations may not actually be detrimental to the health significantly).

Other strategists treatment of traditional Chinese medicine such as acupuncture may provide some beneficial results in regulating the secretion of serotonin available to the body thereby reducing anxiety disorders.

Helping Yourself
There are those who suffer from anxiety many ways to help themselves and relax, which play an important role in the treatment of symptoms of anxiety. This includes:

* Good eating habits - including a reduction in the consumption of caffeine, sugar and a general improvement in dietary habits. Reducing consumption of caffeine should be spread. Some patients with anxiety, these measures would significantly reduce the symptoms of anxiety. It is also advisable to consume as much as possible of fatty acids such as Omega-3
* Physical activity - Physical activity is an effective measure to deal with stress thanks to its ability to reduce the rate of cortisol in the body of the patient. It is worth noting that the rapid palpitations that can lead to physical activity in some cases trigger a panic attack, it is advisable to stagger the implementation of any physical activity program.
* Laugh.
* Breathing techniques - such as diaphragmatic breathing.
* Sleep well.
* Meditation.
* Relaxation techniques - a state of relaxation can be found by using relaxation tapes, yoga or therapy to relax.
* Stress management, which may include changes in lifestyle and / or its way of managing time. There are many books on this subject.
* Strategies to cope with panic attacks, such as "self-talk positive and breathing techniques.
* The search for his purpose in life - Some experts have suggested that anxiety is, in some cases due to a kind of "boredom" to life. They recommend looking for an occupation in which the patient may have a meaning in life.
* It is recommended for those who do not know the exact cause of their anxiety to determine if they are concerned about a specific circumstance or event or a concern related to existence.

Read also anxiety dizziness

wikipedia

Weight loss

2010-07-04T06:40:00.000-07:00

Weight loss
A weight loss is a loss of weight. It reflects an imbalance between energy intake and expenditure. It may be voluntary, in an aesthetic or therapeutic, or involuntary, can then reveal certain organic diseases scalable, or eating disorders.

A normal and stable weight is one of the best markers of a normal healthy adults. Between 20 and 50 years, the weight increases and stabilizes physiologically to decrease spontaneously after 75 years.

Etiologies
The main causes of weight loss are:

* The eating disorders: Anorexia nervosa and other forms
* The weight loss with diet and kept hypercatabolism:
No endocrine or metabolic disorders: hyperthyroidism, diabetes, primary hyperparathyroidism, pheochromocytoma.
No significant consumption of caffeine and smoking.
No digestive disease: malabsorption of adult celiac disease, Crohn's disease, the losing enteropathy and chronic pancreatitis.
o slimming paraphysiological of age.
* The accompanying weight loss: cancers, infectious diseases, neurologic, liver, heart, kidney or severe respiratory, other chronic diseases such as psychiatric illness or alcohol.
* The weight loss are iatrogenic, favored by polypharmacy in the elderly.
* Slimming presumed isolated, mainly due to psychological causes.

Read also Obesity

wikipedia

World Health Organization

2010-06-30T06:03:00.000-07:00

World Health Organization
The World Health Organization (WHO), (in English: World Health Organization (WHO)) is the UN specialized agency for health. It reports directly to the Economic and Social Council and is headquartered in Geneva, Switzerland, on the common-Pregny Chambésy.

According to its Constitution, WHO aims to bring all peoples of the world at the highest possible health, health being defined in this document as "a state of complete physical, mental and social not merely the absence of disease or infirmity. "

Its current CEO is Dr. Margaret Chan since January 4, 2007.

History
Founded April 7, 1948, O. M.S. was preceded by various international organizations and agreements.

Around 1850 First, various provisions are made to harmonize quarantine measures to protect mainly while the European states against the plague. Beginning in 1851 the international sanitary conferences are struggling to reach agreements. Regarding the plague, cholera and yellow fever, however, the International Sanitary Conventions are signed. In 1907, was created in Paris "International Office of Public Health (OIHP), with a permanent secretariat and a" standing committee ". This committee organizes several conferences, including that of 1926 International Sanitary Convention adopts a container for the first time, provisions relating to smallpox and typhus. At the end of the First World War, the United States objects that the OIHP passes under the control of any new League of Nations (SDN). Until the Second World War, two international health agencies will coexist in Europe, and OIHP Health Organisation of the League of Nations while the other side of the Atlantic, the Pan American Health Organization will be a third international health organization.

The Spanish flu (H1N1) from 1918-1919, which caused 50 million deaths (five times more people than the First World War), pushed the League of Nations (SDN) to create "health committee" of the League, considered the ancestor of the WHO. Dominated by France and the United Kingdom, the Committee covers health surveillance in the late 1920s, 70% of the world.

In the 1980s, O. M.S. experienced some "wilderness" because of questionable choices (almost dismantled the Office of tuberculosis) and the hostility of some countries (USA, United Kingdom) objected to what they saw as a political expensive. Private foundations, as well as the World Bank, were then loaded on global health issues.

Lion Murard speaks however of a "a kind of second birth" of the WHO from 1995. Indeed, the O. M.S. then created the Division of Communicable Diseases (1996), the Global Outbreak Alert and Response Network (2001) in Geneva responsible for reporting "all events that could lead to public health emergencies of international concern" and not just the occurrence of Quarantine traditional three diseases: plague, yellow fever and cholera, and promulgated a new International Health Regulations (adopted in 2005) that robs governments of their right of veto on the epidemiological information. According to historian Patrick Zylberman, the return of the WHO largely explained by the re-emergence of illnesses such as AIDS, tuberculosis (in 1985-91 in New York), fever (in India in 1994), Ebola (Zaire in 1996) etc... The O. M.S. is launching a global alert on March 12, 2003 travel to Asia and Canada, without prior permission by the State because of the SARS epidemic, and opposes China on statistics and the development of the epidemic.

Due to the sudden death of its director general, Lee Jong-wook, 22 May 2006, the acting head is provided by Anders Nordström, to the election of his successor, Dr Margaret Chan, November 8 2006.

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wikipedia

Myoma

2010-06-27T06:34:00.000-07:00

Myoma
The myoma is a benign tumor composed of muscle tissue. This is one of the so-called hormone-sensitive diseases.

One differentiates:

* The rhabdomyomas consisting of striated muscle tissue, very rare;
* And leiomyomas (or liomyomes) very common, consisting of smooth muscle fiber, as in uterine fibroids, often called, wrongly, uterine fibroid.

"Uterine Myoma" is the name given to benign disease and frequently characterized by the formation of fibroids in the uterine muscle.

The fibroid degenerates into cancer almost never (only 0.5% of fibroids degenerate into malignant tumor).

Epidemiological
Approximately 20-30% of Caucasian women and 50% of African women have fibroids. The prevalence is also much higher in the West Indies and the DOM / TOM. Some sources argue that the risk of having fibroids is up to nine times higher among African women, African-American and Afro caribiennes than among Caucasian women.

Causes
The origin of leiomyomas is poorly understood, but it is known that fibroids are associated with an excess of estrogen, which may be associated with a lack of progesterone.

The uterine lining, due to the hyperoestrogenism is weakened and inflamed, so it will bleed more easily, and there is bleeding.

Treatment
It often involves an injection of progesterone, either to overcome the lack of progesterone is to decrease the secretion of estrogen during the second part of the menstrual cycle (secretory phase).

Read also Tumor

wikipedia

Traditional Chinese medicine

2010-06-25T23:00:00.000-07:00

Traditional Chinese medicine
Traditional Chinese medicine consists of a theory explaining the functioning of the human being in good health, from different angles: physiology, psychology, anatomy, etc. It also explains the causes of diseases and biological and psychological mechanisms that are the consequences. In contrast to Western medicine, Chinese medicine seeks to understand each be whole, as well as healthy patient, both visible and invisible symptoms, by managing the balance of the internal energy (Chi or Qi) .

Medicine is a long history, whose production perhaps dates back to 3000 BC, possibly much longer. In the first known Chinese medical treatise (the Huangdi Nei Jing), one finds for example the description of five members (appointed Wu Zang) and the six entrails (named Liu Fu) with diagrams.

The literature of Chinese medicine
Some systems count the time out occurred very early in China are visible on the oracular messages from the Shang Dynasty, the earliest examples of Chinese writing. Nevertheless, the exclusive use of ring systems (sexagesimal cycle or imperial eras) is that the notion of linear development is not very active. Regarding the medical books, often adds his commentary each time the original text without an overhaul. We thus find the same book chapter by age and origin significantly different and thus for the Chinese, the Nei Jing Su Wen has become so valuable that the modern book. One can even say that, according to tradition, ancient times are closer to the primordial perfection in modern times. At best, therefore we can only rediscover what the ancients knew. At the beginning of Ling Shu Huang Di asks his minister and coach Bo Qi not to invent a medicine, but to restore an ancient doctrine. Moreover, the modern book did he not inspired the Nei Jing?

Read also Traditional Tibetan Medicine

wikipedia

Herpes simplex

2010-06-14T10:22:00.000-07:00

Herpes simplex
The herpes infection is a viral disease causing chronic recurrent skin rashes and carried by the herpes simplex virus. It is also the leading cause of genital ulcers mainly in Europe. Genital herpes facilitates the transmission of the AIDS virus.

Affection and recurrent painful genital herpes is neonatal herpes responsible formidable.

This disease, lived uneasily in any form whatsoever, can never be completely cured and therefore requires the holder to take precautions, including outside attacks (there are potentially infectious).

Herpes is a disease is considered benign in healthy subjects, it can be very serious in people with impaired immune systems, infants or pregnant women.

Virus

* The herpes virus, herpes simplex virus (HSV) belongs to the family Herpesviridae. This family also includes the varicella-zoster virus, and cytomegalovirus (or HHV-5), and Epstein-Barr virus.
* The herpes virus (HSV) has two types:
No HSV-1 accounts for 95% of oral-facial herpes, and herpes many neuro-meningeal and ophthalmic. According to studies he is also responsible for 20-40% of genital herpes by oral genital infection.
No HSV-2 primarily responsible for genital herpes, but 5% of oral-facial herpes.

The HSV-2 generally give rise to more recurrences than HSV-1, but the primary infection is more symptomatic.

* Persistent throughout life despite the immune response during primary infection
* The HSV dermoneurotropes are viruses such as varicella, they persist lifelong in the trigeminal ganglion for orofacial manifestations and lymph sacred events anal, genital and buttocks.

Epidemiology
Contamination is strictly inter-human for both viral types.

Over 90% of adults have been in contact with HSV. However, only a small proportion of these individuals will develop symptoms.

It seems that it is possible to be in contact with the virus without being infected, but the contagion is very strong, much stronger than for HIV.

The prevalence of herpes labialis is 80-90% of the total adult population.

Most children under 2 years are already infected because of kisses infected adults.

The oral-facial herpes which is the most common form of herpes (commonly called "cold sores" or "cold sores") is most often due to HSV1.

* Herpes labialis: 7-8 out of 10 primary goes unnoticed. Transmission occurs through direct contact with a person excretory virus, it can be excretory virus one to two days before the blisters appear and up to one week after their disappearance (viral shedding, symptomatic) . An infected person can also transmit the virus without having thrust = herpes asymptomatic virus secretion that is present on the skin without causing gall.

* Genital herpes : Transmission is by direct contact with a subject excreting HSV. Here asymptomatic viral shedding plays an important role, indeed symptomatic individuals abstain from sex because of pain. The prevalence of genital herpes by about 20%.

Pathophysiology
The virus enters the organism occurs during a contact with an infected person (even if no cutaneous) viruses penetrate the host when there is a gap mucocutaneous, and will multiply in epithelial cells where they are responsible for cell degeneration with ballooning nonspecific. These mechanisms may be the cause of the manifestations of primary herpes infection. In a second step, the virus will reach the ganglion corresponding to the infected area, centripetally, in "up" along the sensory nerves. Finally, the herpes recurrences occur when, in response to physical stress or psychological variable, viruses returning the skin to develop it again. These episodes are more or less frequently from one individual to another, and of varying intensity, but fixed in their topography.

Oral infection
It's the classic cold sore which is transmitted primarily by oral contact. Gives partial protection against HSV-2.

The most common form is the form lip. It evolves through several stages:

1. Preliminary signs: itching, feeling there was a slight swelling, redness ...
2. Papules: lip swells locally (sometimes a big part of the lip swollen for a few days before they find) and blushed.
3. Ripening Papules: papules become blisters and then the vesicles containing a clear liquid. The vesicles then eventually burst, releasing the liquid. At that time, the virus being released, the risk of contamination is highest.
4. Drying: after bursting the vesicles giving way to often painful wounds (burns) and then dry quickly enough to form scabs disappear in a few days.

Access herpes labialis lasts 8-15 days. The disease is contagious at all times, but even more so when the lesions are still present (including the form of crusts, that we should not touch, which may bleed slightly but it is visible).

Basic precautions to be taken
Hygiene precautions are essential to reduce the risk of contamination, and must be respected both by the patients as the surroundings, even in the absence of visible crisis. These precautions also help reduce the risk of self-inoculation, which may bring the virus in very sensitive areas (or ocular herpes, with serious consequences).

These measures may appear cumbersome in everyday life: yet they remain the only way to avoid the disease, which can sometimes have dramatic consequences. Indeed, the simple cold sore can develop into more serious forms, a simple progression of the virus, or self-contamination of other areas of the body. Many people ignore these instructions or do not want to put them into practice, which explains that the virus is so widespread.
Some people are more at risk than others: immunocompromised, newborns, pregnant women, atopic dermatitis. Any person affected, although the disease is limited at the moment to simple cold sores, is contaminated and must take the following precautions to protect its environment:

* Wash hands thoroughly and regularly, especially after contact with the lesion (without scratching) do it with even more attention if we are going to touch food or dishes, or another person's personal affairs ( particularly business hygiene), although the virus retains its infectivity than two hours on a dry surface,
* Avoid using objects that have been in direct contact with saliva or mouth of an infected person,
* Avoid oral-genital sex to avoid transmitting herpes sores in the genital
* Separate towels,
* Do not touch your eyes (an automatic gesture fast enough for transmission), and of course, does not dampen his contact lenses with saliva (very direct risk of contamination),
* Do not scratch the lesions, and more generally, do not touch the infected area,
* If the movement is automatic, the habit of never touching the sores, and wash their hands (including nail) every time you are doing it,
* Keep affected areas as clean and dry as possible and do not squeeze under clothing too close to the body,
* Avoid contact with a newborn (his immune system is still fragile)
* If cold sores (even beginners or almost finished), avoid kissing, including the cheeks, and until the lesions are completely dry.

Read also Herpes herpes

wikipedia

Scurvy

2010-06-06T08:13:00.000-07:00

Scurvy
Scurvy is a disease caused by a deficiency in vitamin C harmful resulting in humans who lacks the intragenic summary, there is severe by the death of the infant, breastfeeding insufficient bone growth slowed, periodontitis, an incoherent immunity manifested by purulence gums, bleeding, and at worst death.

Scurvy, now virtually disappeared, adds substantially all other diseases, even the most benign, can sometimes make them deadly.

Causes
Vitamin C is a precursor of coenzyme of the enzyme involved in the hydroxylation of collagen. This hydroxylation is essential for the formation of triple helical collagen fibers that maintain the structure of tissues. Vitamin C acts as an antioxidant: there are groups proline hydroxylation and especially lysine of collagen, by attacking a molecule of oxygen, thereby maintaining the structure of the vessels. An oxygen atom is used for the hydroxylation of an amino acid, but the other atom is present as free radical O.. This is a powerful oxidant, it weakens the capillaries of the gums, leading to the appearance of scurvy. Therefore, the release of two hydrogen atoms by ascorbic acid will inhibit the oxidative attack of the radical, according to the following reaction: 2 H + O → H2O.

Achievement scorbutic language Scurvy occurs initially by fatigue and edema by members, and bleeding of mucous membranes of the nose and gums, and numerous bruises under the skin. The teeth loose teeth to fall. Unable to stand, individuals infected die of exhaustion or a respiratory infectious complication.

History
* Circa 1600 BC, AD: First described in the Papyrus Ebers.
* 1535: Between 14 December 1535 and April 15, 1536, during the second voyage of Jacques Cartier in Canada, 25 of the 110 crew members die from the disease. One day, Cartier encountered Domagaya, son of the Iroquois chief Donnacona, who seemed touched by the mysterious disease. A few days later, he sees him again, but this time in perfect health. He questioned and it gives the recipe of taking the branches of a tree called anneda (white cedar), "it was necessary to crush the bark and leaves saide wood, and put everything in boiling water." The sailors quickly find their strengths through this beverage. We also read that it is rather an infusion needle and pine bark. It is now a drug in the pycnogenol.

* 1600: A report of the Royal Navy reports that about 10,000 sailors were victims of scurvy during the previous 20 years.
* 1747: On board HMS Salisbury, James Lind performs an experiment showing that oranges and lemons cured scurvy.
* 1795: Following the results obtained by James Lind, the Royal Navy provides a daily ration of lemon or lime to its sailors.
* 1805: The invention of Nicolas Appert canned food (canning) allowed a balanced diet with vitamins and therefore marine.
* 1913 EV McCollum (U.S.) begins to establish the nomenclature of vitamins and calls of vitamin C (scurvy-Preventing "water-soluble C) the substance that protects against scurvy.
* 1928-1932:
o Albert Szent-Györgyi (Nobel Prize 1937) isolated "hexuronic acid" from the cabbage, orange and pepper, while looking for a substance capable of combining oxygen to prevent the occurrence of brown spots on rotting fruit.
o WAWaugh CGKing and isolate the vitamin C of lemon and orange and discover that "hexuronic acid" is vitamin C. The hexuronic acid is renamed ascorbic acid (abbreviation antiscorbutic).
o Walter Norman Haworth establishes the chemical formula.
* 1933: Tadeusz Reichstein synthesizes vitamin C.

Read also Vitamin C

wikipedia

Eukaryote

2010-04-07T08:01:00.001-07:00

Eukaryote
The field of eukaryotic or Eukaryota (from the Greek eu, well and karuon, core) groups, according to the nomenclature of Whittaker, all agencies included in four major realms of the living world: animals, fungi, plants and protists (which should be added according to the nomenclature Chromista Cavalier-Smith, this clade is still challenged by recent studies). They are characterized mainly by cells with a nucleus. They therefore constitute a very broad group of organizations, uni-or multicellular, defined by their cellular structure.

Definition
Eukaryotic cells possess, in contrast to prokaryotes (Archaea and Bacteria):

* Organelles, dividing the space into compartments specialized cell, such
o the nucleus (containing DNA),
o mitochondria, endoplasmic reticulum, the Golgi apparatus, ribosomes, peroxisomes, chloroplasts and vacuoles in plants;
* A complex cytoskeleton, composed mainly of actin and myosin;
* The ability to perform endocytosis;
* DNA is divided into several chromosomes;
* Cell division called mitosis (involving centrioles and mitotic spindle);
* A true sexual reproduction, where each mating type makes an equal share of genetic material.

Read also Cell

wikipedia

Stethoscope

2010-04-02T06:53:00.000-07:00

Stethoscope
A stethoscope (from Greek stethos, "chest", and scope of ancient Greek "skopein," observe ") is an acoustic medical device, used for auscultation, that is to say the listening to internal sounds in the human body.

Historical
The stethoscope was invented in France in 1816 by Dr. Rene Laennec. It was only a question of a simple bundle of rolled paper, allowing to remove the ear of the patient's physician for reasons of modesty. He created auscultation mediate vs. immediate auscultation where he had his head stuck in the patient's chest. The first written description of its system dates back to March 8, 1817. Laennec secondarily constructed in several models of wood.

The model was improved in 1830 by Pierre Piorry who built an adapter ivory atrial side. Around the same time, a flexible tube connects the pavilion to the listener but the rigid model will still persist a few decades.

The stethoscope bi-atrial (both ears) was conceived in 1829 but built only in 1851. The tube was made of rubber but this solution proved fragile and had to be abandoned. A second model, more rigid, was born in 1852 in base metal tubes.

Around 1870, stethoscopes differentials appear: two pavilions, each mounted on a tube and connected to an ear, were used to compare auscultation in two different places.

In 1961, Dr. David Littmann Stethoscope created the contemporary chalet with its double reverse, which is still used today.

The stethoscope contemporary
Currently, stethoscopes have one or two houses, provided with a metal membrane that is applied to the skin of the patient. This membrane vibrated by the sound body, is connected by one or two flexible tubes to the operator ends up in his ears. The rigidity of the system at atrial, is done with a metal frame: the lyre. By its construction, it is an acoustic amplifier (large pavilion, small headphones). Sensors can filter certain frequencies to gather sound more specifically acute or severe, depending on the diagnosis to be made. Models with electronic amplification have been built, with no real commercial success.

The stethoscope is used by health professionals to listen to the heartbeat, the respiratory murmur, the thrill arterial or fetal abdominal sounds, or used in the measurement of blood pressure.

Read also wikipedia

Bacteria

2010-03-30T09:19:00.000-07:00

Bacteria
Bacteria (Bacteria) are unicellular prokaryotic organisms (characterized by an absence of nucleus and organelles).

Most bacteria possess a cell wall carbohydrate, peptidoglycan. The bacteria most large measure over 2 mu.m and was considered until recently that the smallest measured 0.2 mu.m, but has recently discovered "ultramicrobacteries, including freshwater.
They have many forms: spherical (cocci), or elongated rods (bacilli), form more or less spiral. The study of bacteria is bacteriology, a branch of microbiology.

Bacteria are ubiquitous and are present in all habitat types encountered on Earth. They can be isolated from soil, freshwater, marine or brackish water, air, ocean depths, radioactive waste, the crust on the skin and the intestines of animals. There are approximately 40 million bacterial cells in a gram of soil and 1 million bacterial cells in a milliliter of fresh water. It is estimated that there would be (at a given time) four to six quintillion (4 × 1030 to 6 × 1030) between 4 and 6 trillion trillion trillion bacteria in the world, representing a large part of the world's biomass. However, many of these bacteria are not yet characterized as unculturable in the laboratory. The bacteria are of considerable importance in biogeochemical cycles as the carbon cycle and nitrogen fixation from the atmosphere.

In humans, it has been calculated in 1012 that bacteria colonize the skin, 1010 bacteria colonizing the mouth and 1014 live bacteria in the intestine, making it ten times more bacterial cells than human cells in the body human. Most of these bacteria are harmless or beneficial to the organism. However, there are many species of pathogens that cause many infectious diseases such as cholera, syphilis, plague, anthrax, tuberculosis. The most common fatal bacterial diseases are respiratory infections: tuberculosis alone killing about 2 million people per year, mostly in sub-Saharan Africa. Bacteria can cause respiratory or intestinal disorders while others may be responsible for wound infection. Bacterial infections can be treated with antibiotics, which often inhibit one of their vital functions (eg, penicillin inhibits the synthesis of cell wall).

The bacteria can be very useful to man in the process of wastewater treatment in food processing during the manufacture of yoghurt or cheese and industrial production of many chemicals.

History
Bacteria are microscopic, so they are visible with a microscope. Antony van Leeuwenhoek was the first to observe bacteria through a microscope of its production in 1668. He called them "animalcules" and published his observations in a series of letters he sent to the Royal Society.

The word "bacteria" appears for the first time with the German microbiologist Christian Gottfried Ehrenberg in 1828. This word derives from Greek βακτηριον, which means "stick".

In the nineteenth century, the work of Louis Pasteur revolutionized bacteriology. He showed in 1859 that fermentation is caused by micro-organisms and that this growth was not due to spontaneous generation. It also demonstrated the role of microorganisms as infectious agents. Pasteur also conceived of culture, processes of destruction of micro-organisms such as autoclaving and pasteurization.

The German physician Robert Koch and his colleagues devised techniques to culture bacteria on solid medium. Robert Koch was a pioneer in medical microbiology, he has worked on cholera, anthrax (anthrax) and tuberculosis. It clearly showed that bacteria could be the causative agent of infectious disease and he proposed a series of postulates (Koch's postulates, still used today) confirming the etiologic role of micro organism in a disease. He won the Nobel Prize in Physiology or Medicine in 1905.

Although we knew the nineteenth century that bacteria are the cause of many diseases, there was no disinfectant available. In 1910, Paul Ehrlich developed the first antibiotic, by changing dyes selectively stained Treponema pallidum, the spirochaete that causes syphilis-into compounds that kill the pathogen selectively. Ehrlich received the 1908 Nobel Prize for their work on immunology, and pioneered the use of dye to detect and identify bacteria, his work is the basis of Gram stain and Ziehl-Neelsen.

The microbiologist Martinus Beijerinck and Sergei Winogradsky initiated the first studies of environmental microbiology and microbial ecology by studying soil microbial communities and water and relationships between these micro-organisms.

If bacteria were known in the nineteenth century, there is still no antibacterial treatment. In 1909, Paul Ehrlich devised a treatment against syphilis before the use of penicillin in therapy suggested by Ernest Duchesne in 1897 and studied by Alexander Fleming in 1929.

In 1977, Carl Woese's work through molecular phylogeny divided the prokaryotes into two groups: the Bacteria and Archaea.

Cell Structure
As prokaryotic (no nucleus organization), the bacteria are relatively simple cells, characterized by an absence of nucleus and organelles such as mitochondria and chloroplasts, they are not over the endoplasmic reticulum or device golgi.

An important characteristic of bacteria is the cell wall. Bacteria can be divided into two groups (Gram positive and Gram negative) based on the difference in the structure and chemical composition of cell wall highlighted by the Gram stain. Bacteria Gram positive have a cell wall containing peptidoglycan (or murein) thick and teichoic acid bacteria while Gram negative peptidoglycan present an end located in the periplasm between the cytoplasmic membrane and outer cell membrane. The wall gives the bacterium its shape and protects against bursting under the effect of very high osmotic pressure of cytoplasm. The peptidoglycan provides the rigidity of the wall. However, there are bacteria without walls: it is the mycoplasma.

Intracellular
The bacteria were seen as simple bags of cytoplasm, but many levels of structural complexity have been discovered since, as the discovery of the prokaryotic cytoskeleton, and the localization of specific proteins in the bacterial cytoplasm. These subcellular compartments have been named "Hyperstructure bacteria (" bacterial hyperstructures "in English).

Bacteria possess a chromosome form a filament of DNA, the heredity. The bacterial chromosome is generally circular. In addition to this genomic DNA, bacterial cells often contain circular DNA molecules called extra-chromosomal plasmids. The cells also contain numerous ribosomes for protein synthesis through the mechanism of translation. The cytoplasm of prokaryotes often contains substances intracellular reserves are stocks of nutrients in the form of glycogen, starch or poly-b-hydroxybutyrate (PBH). Some species of aquatic bacteria possess gas vesicles that provide buoyancy cells. Other species, magnetotactic bacteria have the peculiarity of having a magnetosome.

Extracellular
Many bacteria possess extra-cellular structures such as flagella used for movement of cells, allowing the attachment fimbriae and pili sexual essential to the phenomenon of conjugation. Heterotrophic bacteria can use their flagella to move to areas rich in organic substances (nutrients) through the phenomenon known as chemotaxis.

Some bacteria can produce thin layers outside the cell wall, usually composed of polysaccharides (sugars). When the layer is compact, it is called capsule. The capsules are such a barrier protecting the cell against the external environment and also against phagocytosis. It also facilitates attachment to surfaces and biofilm formation. Klebsiella, Bacillus anthracis, Streptococcus pneumoniae are examples of encapsulated bacteria. When the layer is diffuse, it is called mucoid layer. When the layer is thicker, it is called glycocalyx. The glycocalyx allows bacteria to adhere to a substrate.
Some bacteria described as sheathed bacteria produce a dense outer layer and rigid sheath. This phenomenon is common among bacteria of the water forming channels filamentous (Sphaerotilus natans example). The sheath protects cells against the turbulence of the water. The bacteria group Cytophaga - Flavobacterium produce a mucous layer that allows them to remain in close contact with a solid medium. Other bacteria such as Spirillum can wrap a protein layer called the stratum S.

Read also Virus

wikipedia

Cell

2010-03-21T08:02:00.000-07:00

Cell
The cell (from the Latin cellula small room) is the structural unit, functional and reproductive constituting all or part of a living being (except viruses). Each cell is a living entity, which in the case of multicellular organisms, works independently, but coordinated with others. The same type of cells are present in tissues themselves together in bodies.

The cell theory implies the unity of all life: all living things are composed of cells whose basic structure is common and homeostasis of internal environment, environment physico-chemical and controlled environment for developing cells of 'species.

History of concept
* 1665: Robert Hooke discovers cells in cork dead, these cells are thought to himself cells of a monastery, hence the name. He then observed the cells in living plants, using the first microscopes.
* 1839: Theodor Schwann discovered that plants and animals are all made of cells, concluding that the cell is the common unit of structure and development, which founded the cell theory. He gave his name to Schwann cells.
* The belief that life forms can appear spontaneously (spontaneous generation) is disproved by Louis Pasteur (1822-1895).
* 1858: Rudolf Virchow stated that cells arise from the result of cell division ( "omnis cellula ex cellula), which is based in cellular terms the question of the egg and the chicken. It is precisely this part which is contested by proponents of creationism or its latest incarnation, intelligent design.

Cell theory
1. The cell is the constituent unit of living organisms. It is also the functional unit.
2. The body depends on the activity of cells or tissues grouped to provide different functions.
3. The biochemical activities of cells are coordinated and determined by certain structures found inside cells.
4. The proliferation of cells allows the maintenance of organisms and their multiplication.
5. This theory was formulated in 1838 by Schleiden and Schwann the cell is living unit (everything is living cell). This theory also suggests the presence of organelles within these cells.

The cell machinery to produce the order
The cell is a highly organized state of matter that maintain order while being subject to the principles of thermodynamics requires the establishment of structures that use energy, material exterior (one creates the order in the cell but overall entropy increases), the cell is a thermodynamically open system.

An enclosed conducting trade with the outside
The cell is a spatial unit, delimited by a membrane. This, far from being a tight deadline, is an area of exchange for the establishment of flow.

The plasma membranes, despite their diversity have exceptions (some thermophilic archaea possess a single layer of lipids), the same structure:

* A phospholipid bilayer composed of amphiphilic lipids, which is a basic filter allowing the passage of hydrophobic substances, inhibiting that of hydrophilic.
* Transmembrane proteins and peripheral roles various (transfers, transport, signal transduction ...)

The membrane acts not only as a filter, that is to say, by allowing certain molecules according to the concentration difference (mistakenly called concentration gradient) but also using energy (osmotic, chemical ...) to encourage the flow endergonic. It also allows the passage of light, heat ... As surface contact with the outside, it also ensures the transmission of information necessary for the responsiveness of the cell to environmental changes and coordination with other cells.

The plasma membrane creates an air space closed in constant exchange with the surrounding environment.

Compartmentation: development of microenvironments with specific properties
The presence of a biological membrane surrounding a space, either the cytoplasm or an organelle of light, will help in controlling the exchange of macromolecules, ions (and any other molecule) the establishment of conditions favoring certain reactions to others: by varying the different physico-chemical factors (pH, ion concentration ...), the nature of enzymes and products, their number ...

This environment allows the biosynthesis and degradation of organic molecules, thus maintaining a highly organized structure with a constant recycling of molecules that form.

This compartmentalization is particularly pronounced in the case of eukaryotes: it allows the functional specialization of different organelles (the composition of their light is different, they are the seat of different reactions: they will thus be able to support the production of this product in a compartment , its destruction in another).

The cell flow organized matter and energy
This basic structure (membrane organizing exchanges surrounding a compartment, rather than specific chemical reactions) will enable the establishment and maintenance of flows of matter, energy, information ... through the cell. So there is a real organization of cell-external trade, which will allow the "system unit" (as defined in thermodynamics) to maintain its highly organized structure.

Finally, the cell is not a stable and unchanging but rather a dynamic entity requiring a constant supply of matter and energy to allow its operation and maintenance of its structure: the only organization persists, its constituents being in perpetual renewal.

The resting potential of the cell determines the potential difference (-70 mV), with the interior of the cell negative.

Read also Basal Cell Carcinoma

wikipedia

Cardiology

2010-03-20T09:50:00.000-07:00

Cardiology
Cardiology is the medical specialty that explores the heart and its diseases. The doctor who cares is called the cardiologist. By extension, he is also interested in vascular disease.

The cardiac examination
Search factors cardiovascular risk:

* Elderly
* Smoking
* Hypertension (Taken from the Blood Pressure)
* Dyslipidemia (Design Exploration of a lipid abnormality)
* Diabetes (for a measurement of FPG)
* Obesity (BMI calculation)
* Sedentary lifestyle

Some of these cardiovascular risk factors are known to change, and are important to investigate the extent they can be modified precisely, that is to say, reduced, treated, eradicated, etc.., In the case of smoking, of hypertension, dyslipidaemia of, overweight, diabetes, etc.. instead of eg age or family history, which are not modifiable.

History (interview):

* Search for chest pain, shortness of breath (dyspnea), palpitations

Clinical examination:

* Cardiac auscultation,
* Taking the pulse and blood pressure,
* Auscultation of lungs
* Research of pulse, auscultation of the vessels in search of a breath
* For signs of heart failure: peripheral edema, enlarged liver ...

Terminology
Cardiology can be divided into sub-specialties:

* Rhythmology who studies cardiac arrhythmias and conduction disorders,
* Angiology who studies diseases of blood vessels,
* Phlebology who studies diseases of veins,
* Pediatric cardiology in children.

Depending on the technique used, we may have a case:

* Hemodynamicien analyzing pressures and heart rates following different methods,
* Practicing the coronary angiography to visualize the coronary arteries,
* Cardiologists who will dilate the diseased coronary arteries using a balloon inserted through blood,
* Electrophysiologist who analyzes the electrical phenomena of the heart by inserting probes into the heart chambers.
* Raises stimulating pacemakers or implantable defibrillators.
* Echocardiographer examining the heart with the aid of ultrasound

Invasive cardiology is to explore the heart by inserting probes directly into the heart chambers. These sensors are mounted through the skin by the venous or arterial network.

Interventional cardiology involves the treatment of heart disease by methods of invasive cardiology.

Academic Organization
Academic cardiology is organized through national scientific societies that organize conferences, publish journals and select panels of experts on specific subjects to publish recommendations.

In France, it is the French Society of Cardiology (SFC), whose members are appointed by cooptation, which has that role. The SFC has several more specialized subsidiaries (echocardiography, Rhythm ...).

European National Societies are meeting within the European Society of Cardiology (ESC), whose annual convention held in late August and which publishes the European Heart Journal.

In the United States, the American College of Cardiology takes this role.

There are also organizations together professionals and volunteers whose purpose is the dissemination of information to the general public. This is the case of the French Federation of Cardiology in France, and the American Heart Association the United States, this latest addition to publishing in scientific journals of cardiology and organizing its own international convention.

Reviews of Cardiology
There are numerous professional journals on cardiology, the most prestigious being in English. We can cite among them:

* Circulation (common abbreviation: Circ.)
* Journal of the American College of Cardiology (J Am Coll Cardiol);
* American Journal of Cardiology (Am J Cardiol);
* American Heart Journal (Am Heart J);
* Journal of the European Society of Cardiology - European Heart Journal (Eur Heart J);
* Formerly British Heart heart.

In German, one can cite Herz.

In French, include:

* The Journal of Cardiology;
* The Archives of heart disease;
* The Cardiologist, newspaper syndicate;
* Letter from the cardiologist;
* The echocardiography.

Read also Heart

Basal Cell Carcinoma

2009-12-26T12:28:00.000-08:00

Basal Cell Carcinoma
Basal cell carcinoma is a skin cancer whose development is very favorable treatment.

Other skin cancers are squamous cell carcinoma and malignant melanoma.

Epidemiology
This is the most common cancers (almost half the cases) in the United States and its incidence is increasing.

It particularly affects people with fair skin (blond or red) and is correlated with exposure to sunlight and ultraviolet radiation.

The clinical forms / appearance
Basal cell carcinoma may take many forms. The pathognomonic appearance (signs for sure diagnosis) is a translucent pearl.

* The plan scar carcinoma: the form of small translucent papule at the beginning and then spread gradually turns into a baking center whitish scar
* The basal cell carcinoma ulcer: shape digging the thickness of the skin (ulceration), with or without sharp edge, up to the underlying anatomical structures and damage them.
* The basal cell carcinoma nodular form of small nodules protruding, globose, waxy tinge.
* The basal cell carcinoma and budding vegetation: dark red, bleeding freely, was differentiated squamous cell carcinoma.
* The basal cell carcinoma Pagetoid: looks like a pink tablecloth covered with scales.
* The basal cell carcinoma erythematosus: a red form with beaded edges.
* The basal cell carcinoma or sclérodermiforme morpheaform comes in the form of a white plate.
* The Basal cell carcinoma Pigmented (tattoos) look very black to differentiate it from pigmented melanoma and seborrhoeic warts.

Histology
A pathological examination shows that the tumor cells are cells of the basal layer of the epidermis with abnormal proliferation and irregular.

Surgery
Treatment consists mainly of a simple surgical excision with a safety margin around the edges of the visible lesion. Microscopic examination of the surgical specimen must show that the removal of the tumor is considered complete for the tumor is definitively treated, and removed the tumor does not grow back. If excision is incomplete, the tumor will grow back from some tumor cells still present within the skin.

Other treatments
They are only available in case of failure of surgical removal and their effectiveness is reduced with increased recurrence and cosmetic results below:

* Local radiotherapy;
* Phototherapy after pre-sensitization of the tumor Metvix (r) or Metvixia (r) by country
* Use of certain medications especially topical imiquimod in basal cell carcinoma superficial.

Prophylaxis
This is mainly to protect themselves from sun exposure, especially if you are a patient at risk (fair skin, blond or red).

See also

wikipedia

Sanatorium

2009-12-15T04:17:00.000-08:00

Sanatorium
The sanatorium is a medical specialty in the treatment of tuberculosis. First sanatorium France, the Marine Hospital at Berck-sur-Mer was built near the Dover Strait, a coastal dune isolated in 1861, initially for scrofulous children, rickets and "nodes", names that used to cover the 'real time of tuberculosis (scrofula is a violation tuberculous lymph node and skin), and other diseases related to malnutrition, pollution and poor hygiene and accommodation which prevailed in the industrial mining area.

Etymology
The word comes from the Latin root meaning sanatorius own healing.

Founding Principles
The sanatorium is based on:

1. treatment with the treatment of air, light and sun.
The natural landscape (sea, forest, mountain ..) and the distance from the pollution of cities and industries were also expected to contribute to a return to health. The building must be adapted to the entrance of sunlight and fresh air.
2. isolation of infectious TB.
Promiscuity is a factor of contagion, sanatoriums are often very large and designed them to facilitate hygiene.

History
Sanatorium (sometimes written in the plural sanatoriums in the nineteenth and early twentieth century) have been massively built in the early twentieth century in remote areas of pollution, mountain, sun on trays or on the seafront to enjoy the outdoors and of disinfectant and restorative virtues of the sun (architecture heliotropic).

France alone, 250 sanatoriums, which were constructed from 1900 to 1950, at which time, antibiotics have to fight against this scourge. At the end of the twentieth century the century, antibiotic resistance and the resurgence of the disease in poor countries and the former Soviet Union suggest that sanatoria could perhaps regain their former position.

The first hospital dedicated to phthisis (pulmonary tuberculosis) in France was that of Sainte-Marie de Villepinte (Seine-Saint-Denis) completed in 1880 on the initiative of the "work of consumptive girls" created in 1878. A second hospital was consumptive completed 8 years later (in 1888) to Ormesson (Val-de-Marne) only for treatment of young boys aged 2 to 16 years, managed by the "Work of children with tuberculosis" also created in 1888. A branch will open in Villiers-sur-Marne in 1893. At that time, tens of sanatoriums were already in Germany, and several were active in Switzerland and the United States. The late French was offset in particular through the dissemination by the Belgian doctor Moeller in 1894 an illustrated booklet on the German and Swiss sanatoria, and two dissertations in medicine in Paris by Siegmund-Adolph Knopf (phthisiologist German practicing in the United States), and Paul French Beaulavon, respectively in 1895 and 1896, the sanatorium. Knopf encourages sanatoriums in strings of small cottages along the lines of "Adirondack Cottage Sanitorium" (State of New York, USA), Dr. Edward Livingston Trudeau, minimizing the risk of contagion model which prefigured that of "Muskoka Cottage Sanatorium (Ontario, Canada). In 1899 Dr. Frederick Rufenacht Walters (English) will also produce an illustrated book on the various existing models of sanatoria.

Adults reluctant to be hospitalized in a sanatorium, some projects have sought to allow couples or families to stay near the patients. One of these projects was launched in France in 1904 in Montigny-en-Ostrevent (Department of the North), initiated by Professor Albert Calmette at the Pasteur Institute in Lille on the model of the sanitarium in Saranac Lake United States, United, promoted by Knopf as a model of excellence, but could not operate because of the war (conscription by the Germans, and sabotage by the Germans before requisition by the British), being used today in the rehabilitation of seriously wounded.

See also Tuberculosis

wikipedia

Papule

2009-12-15T04:10:00.000-08:00

Papule
A papule is a skin ( "button"), full (no fluids or purulent discharge at the piercing), pink or red slightly prominent, disappearing when the pull of the skin.

* Epidermal papules
o warts
o epidermodysplasia verruciformis of Lewandowski-Lutz
* Dermal papules
o edematous
+ Papular urticaria
+ Prurigo
+ Erythema multiforme
+ Acrodermite papular infantile disease (Gianotto-Crosti)
o cellular infiltration by
+ Secondary syphilis
+ Lichen planus
+ Urticaria pigmentosa
+ Annulare
+ Malignant atrophic papulosis (Degos disease)
+ Tuberculides papular
+ Lichenoid sarcoidosis
+ Toxidermie lichenoid
+ Léprides papular
o dysmetabolic
+ Xanthomas
+ Amyloidoses
+ Mucinoses
* Follicular papules
o epidermal
+ Keratosis pilaris
+ Pityriasis rubra pilaris
Darier's disease +
o dermal
+ Eczematides follicular
+ Syphilitic follicular
+ Follicular mucinosis
+ Lymphomatoid papulosis
o miliary
+ Hidradenoma
+ Granulosis rubra nasi

See also Dermatologist

wikipedia

Masseter muscle

2009-12-15T04:04:00.000-08:00

Masseter muscle
The masseter muscle or masseter (musculus masseter in Latin) is a powerful muscle of the masticatory system (= muscles of mastication).

It consists of two beams, one superficial and one deep.

Description

* Cranial Advertisement:
o The beam is inserted into the superficial anterior 2 / 3 of the zygomatic arch, with insertion on the postero-inferior to the zygomatic bone by a fascial strip joining the lateral muscle.
o The bundle comes deep on the bottom edge of the zygomatic arch, including the zygomatic process of temporal bone.
* Route
o The beam surface is obliquely downward and backward.
o The vertical beam is deep down.

* Advertisement tail: it fits on the side of the mandible.
o superficial beam ends on the lower part of the ramus of the mandible (mandibular ramus), by covering the gonion (angle of mandible).
o The deep beam ends on the lateral surface of ramus, above the surface going up to coronoid process.

Comments
The muscle is covered with the masseteric fascia, which, with the two bundles of muscle and mandibular ramus, forming a box osteo-fibrous, fully closed, except for a space between the condyle of the mandible and the posterior edge of deep beam. It is through this space that pass the vessels and nerves of the muscle.

See also Dentistry

wikipedia

cyst

2009-12-15T03:52:00.000-08:00

cyst
In medicine, a cyst is a closed pocket with a distinct membrane and developing abnormally in a cavity or body structure. They may contain air, liquids or other materials, including parasitic organisms "encapsulated" form active slow reproduction or inactive form of "Spore" (Sporozoite).

Symptoms
The vast majority of cysts are completely benign. This is the case of simple biliary cysts (liver), renal cysts (except in cases of hereditary polycystic kidney), breast cysts. Their content is purely fluid, and their size varies from a few millimeters to several centimeters.

Other cysts may be related to tumor development or malignant Benin, in the case of those that affect the ovaries or pancreas for example. Sometimes it is by compression on adjacent organs they are harmful.

Examples

Many bodies are likely to develop cysts:

* Ovarian cyst
* Conjunctival cyst at eye level
* Pilonidal cyst at the sacro-coccigienne
* Coccygeal cyst
* Cyst
* Baker's cyst or popliteal cyst
* Amebic cyst: caused by Entamoeba histolytica
* Hydatid cyst: caused by Echinococcus granulosus (hydatid disease)
* Renal cyst and [[polycystic kidney]]
* Biliary cyst (cyst or hepatic)
* Salivary cyst, salivary glands
* Mucoid cyst of the lip
* Mucoid cysts of fingers
* Dental cyst (periapical cyst)
* Arachnoid cyst
* Dermoid cyst
* Sebaceous cyst
* Fibro-cystic disease of breast
* Chalazion: a cyst Meibomian gland
* Ganglion cyst
* Epididymal cyst

Appearance of cysts on imaging
In ultrasound, a cyst is in the form of a fully anechoic cavity (do not return echoes, and therefore appear black on the screen), rounded usually surrounded by a very thin wall, even invisible. A special feature is the visualization of a "posterior enhancement of echoes" the accumulation of ultrasonic rear of the cyst (which went through without being reflected) is responsible for the formation of a broad band appear whiter the surrounding tissue. This typical aspect allows, when the chance discovery of a cyst on one kidney for example, have a certain diagnostic and Benin say the character of this anomaly.

On a computed tomography (CT), cysts appear as a "ball" homogeneous, often invisible wall, where the average density (in Hounsfield units, HU) is that of a liquid, so close to 0 HU (between 0 and 10 in most cases).

On MRI, the cyst appears well demarcated, hypointense T1 and hyperintense T2 high.

* Nodule
* Sporozoite

See also Liver

wikipedia

Collagen

2009-12-15T03:41:00.000-08:00

Collagen
Collagen is a fibrous glycoprotein whose role can be compared to a frame. This is the most abundant protein in the body, representing a quarter of the protein mass of the body [precision needed]. It is secreted by cells of connective tissue and has a molecular weight of 300 kDa.

Unlike elastin also present in connective tissues, collagen is inextensible and good resistance to traction. It consists of different types according to their location. It is particularly essential to the healing process. After some transformations, we can make glue.

A structural protein
Biochemists know now more than 100 000 proteins. These molecules are involved in many processes. Some are at the heart of immunology. Others have an enzymatic activity essential for the proper functioning of the cellular machinery. Others are membrane receptors by which cells interact with the environment. Some, finally, participate in the structuring of organizations. This is the case of collagen, a protein essential connective tissue of animals.

A very abundant molecule
The proteins are separated into two categories. The functional proteins involved in biochemical processes (enzymology, immunology, membrane receptors, etc..). The structural proteins are shaping organizations contributing to their structure. Among these, collagen is particularly representative. This fibrous protein is by far the most abundant among all mammals, accounting for one fourth of their protein, about 5% of their weight.

A natural glue
When collagen is partially hydrolyzed, the three tropocollagen strands dissociate. They form the gelatin, a product widely used in food processing. Gelatin was also used in pharmaceuticals, cosmetics and photography. Collagen and gelatin are considered poor protein nutritional quality because they do not have all the amino acids in proper proportions.

The word collagen means "glue producer" (the name is in fact a Greek word kolla meaning glue). The properties of collagen have been used by the Egyptians there are 4 000 years. The Indians used it it is 1 500 years. The oldest known glue is made from collagen, and date of 8 000 years. Currently it is used in the products of beauty or as an additive in chicken.

The tropocollagen
The tropocollagen is the basic unit of collagen, and corresponds to a molecule asymmetric 280nm in length and 1.5 nm in diameter. It is a glycoprotein formed by winding 3 propellers left not α, carriers of carbohydrate (glucose, galactose). Amino acids are made for one third of glycine for one quarter of proline, hydroxylysine and 4-hydroxyproline. There are several types of molecular chains α. These channels are formed by repetitive sequences of three amino acids, of which the first glycine is repeated throughout the molecule. Carbohydrates are attached to hydroxylysine. The winding of 3 α chains, resulting in the formation of the tropocollagen molecule, whose cohesion is ensured by hydrogen bonds between glycine and hydroxyproline.

See also Vitamin C

wikipedia

Macule

2009-12-07T04:13:00.000-08:00

Macule
The macula is a skin lesion as a spot color and sizes. It presents no significant relief to the skin surface.

Colors

* Red erythematous patches
* Red purpuric spots
* Purple spots erythro-cyanic
* Vascular spots or spider
* White spots or discoloration
* Black spots or nevus

Size

* Generalized diffuse spots (erythroderma, exanthema)
* Generalized intermittent patches (morbilliform rash)
* Localized spots (erythema, purpura, vitiligo etc ...)

Location

* Thorax
* Members
* Face and scalp
* Skin folds (groin, cleft, axillae, inframammary, postauricular ...)
* Rash down from head to feet
* Rash mucosa (exanthem)
* Palmoplantar eruption
* Rash around joints
* Rash side extension
* ... Etc.

See also

wikipedia

Erythema nodosum

2009-12-03T06:30:00.000-08:00

Erythema nodosum
The erythema nodosum is a dermo-panniculitis nodular. The elementary lesion is a nouure: that is to say a firm nodule embedded in the skin, round, sensitive to palpation, sometimes red, and warm. These skin lesions that evolve quickly, appearing in the shins in varying numbers.

Diagnosis

Plot
Reached frequent in young women (25 to 40 years).

Positive
The clinical diagnosis is simply.

Pre-eruptive
It can involve fever, asthenia, arthralgia.

Eruptive phase
It is characterized by the appearance of rounded nodules dermo-hypodermic (or nouures), bright red or purple, bilateral, symmetrical, localized to the extensor surface of the members, movable relative to the plane deep to the skin.

Changes in several attacks, disappearing in 10 to 15 days without sequelae.

Histology
The biopsied lesion showed an inflammatory infiltrate in the dermis, with accumulation of neutrophils, lymphocytes and macrophages.

Inflammatory

* Sarcoidosis (Löfgren syndrome)
* Behcet Syndrome
* Inflammatory bowel disease (IBD): Crohn's disease, ulcerative colitis

Infections

* Streptococcal
* Primo-infection of TB
* Infection Digestive "Yersinia enterocolitica"
* Infection "Chlamydia"
* Infection "Salmonella (Salmonellosis)
* Scratch disease cat
* Hepatitis (virus A, B, C)
* Deep Mycoses
* Brucellosis
* Leprosy

Drugs
Sulfonamides, analgesics and NSAIDs, iodinated derivatives.

Treatment
* Treatment of the cause
* Analgesics, anti-inflammatory drugs
* Rest
* Potassium iodide

See also Erythema

wikipedia

Erythema

2009-12-03T06:23:00.000-08:00

Erythema
he rash is the skin lesion most common, characterized by congestive redness of the skin, diffuse or localized, disappearing when the vitropression (that is to say in support, notably through a watch glass) . It is usually the external manifestation of vasodilation, which when it is accompanied by exudation erythema gives a false character "papular".

Except in a few cases, the elementary lesion there's usually no other local changes.

Typologies
The rashes are due to passive accumulation of venous blood. There may be cyanosis due to heart failure or respiratory failure, a acrocyanosis, frostbite, livedo reticularis or livedo racemosa.

The rashes are due to active vasodilation. They may be diffuse or localized.

* Among the diffuse erythema we recognize

The morbilliform erythema, resembling that of measles: those for measles, rubella, fifth disease, viral disease in the cocsackies, infectious mononucleosis, toxoplasmosis or iatrogenic, dys antibiotics, barbiturates, etc..

Erythema scarlitiniformes are those that evoke the stains caused by scarlet fever. These diffuse plaques bright red, slightly Granita to palpation, without an interval of healthy skin. They are hot or bitter, intensifying in the folds. They may progress to desquamation in large pieces.
They include scarlet fever, rubella, erythema caused by toxic shock syndrome staph, one of Kawasaki disease, or erythema iatrogenic, due to antibiotics, sulfonamides, or poisoning by mercury (erythema mercurial).

Roséoliformes erythema, characterized by small pink spots, pale and well separated from each other, are due to a virus or are iatrogenic (skin reaction to antibiotics, barbiturates ...). They include roseola, secondary syphilis, the sudden rash.

* Among the range is localized erythema

- Lucite,
- Intertrigo,
- The photodermatosis,
- Lupus erythematosus,
- Dermatomyositis and erysipelas

The rash may be localized due to emotional as erythema and appear modest countenance that.

Among erythrodermas, it ranks last psoriasis, contact dermatitis, atopic dermatitis, the drug eruptions and hématodermies and erythema migrans due to a bacteria of the genus Borrelia transmitted by tick bite (Lyme disease).

Telangiectasia
The telangiectasia is a permanent dilation of superficial vessels, forming linear streaks of bright red, sometimes anastomosing network and disappearing when the vitropression. It is hereditary or acquired.

* Hereditary disease Rendu-Osler, ataxia-telangiectasia, poikiloderma congenital angioma plan.
* Acquired: facial rosacea, scleroderma, stellate angioma in pregnancy or cirrhosis and hepatic veins.

Differential Diagnosis
* Purpura: will not clear the vitropression; changing color.
* Angioma Plan: congenital; vitropression the stump and revealed telangiectasia.
* Papules: infiltrated.

See also Bubble (damage)

wikipedia

Discolouration

2009-12-03T06:16:00.000-08:00

Discolouration
The discoloration is an elementary lesion in dermatological pathology. It is characterized by a blotch of different color skin, corresponding to an abnormal pigmentation.

The pigmentation may be excessive or inadequate, localized or generalized.

Discoloration generalized

* Albinism
* Argyria
* Hemochromatosis
* Addison's Disease

* Melanodermia arsenical
* Ochronosis
* Wilson's disease

Discoloration regional

* Chloasma
* Scars
* Freckles
* Fixed Eruption
* Leprosy achromiante
* Riehl's melanosis
* Melanosis turners
* Pityriasis versicolor
* Scleroderma drops
* Syphilides achromiantes (necklace of Venus in women)
* Vitiligo

Localized pigmentations

* Nevus pigmentation
o pigmented nevi
o Recklinghausen disease
o acanthosis nigricans
o incontinentia pigmenti
* Urticaria pigmentosa

See also Human Papillomavirus

wikipedia

Bubble (damage)

2009-12-03T05:58:00.000-08:00

Bubble (damage)
A bubble is a cavity cutaneous large (greater than 5 mm) causing an uprising circumscribed epidermal containing a collection of clear fluid, serous, inflammatory, or hemorrhagic.

Etymology

* Lang: lat: bulla: decoration shaped ball
* Lang: fr_vx: Buille: Seal

Definition of the bubble in dermatology
The elementary lesion of Dermatology is caused by a delamination between different layers of the skin (epidermis, dermis, hypodermis).

We can highlight the fragility of the epidermis by searching the Nikolsky sign. This sign is characteristic of a loss of adhesion between keratinocytes of the epidermis. It is absent in diseases responsible for a rift between dermis and epidermis.

You should know suggest the diagnosis before the bubble:

* Erosions post-bullous
* Ulcers,
* Sometimes extensive skin undermining,
* Or crusts.

Localization of bullous lesions
* Reached mucosa, eye, mouth, genitals
* Full skin lesions, facial (peri-orifice, temples ..), roots of the limbs, extremities, areas of friction, the photo-exposed areas ...

Evolution
The bubbles can leave scars, adhesions, including bubble OPHTHALMIC.

Differential diagnosis
* Skin lesions forming a cavity containing the liquid which are not bubbles:
o gall smaller for making 1 to 3 mm in diameter,
o the pustule, which is a bubble containing pus, or microbial amicrobien
o the cyst, which is a bubble with a wall cleaner,

* Skin lesions not containing liquid:
o nodule
o infiltrate,
o sclerosis,

Headquarters histological detachment
For some writers, the bubble is epidermal or subepidermal (dermal-epidermal junction), and not dermal or hypodermal. The headquarters detachment is variable:

* Intra-epidermal
* Sub-epidermic cleavage in the area of dermo-epidermal junction:
o lamina lucida
o basement membrane
o necrosis of epidermal basal seat.

Classification according to the seat histological
* Bubble intra-epidermal:
No acantholysis by:
o by ballooning degeneration:
+ Varicella
+ Zoster
+ Herpes
o cell necrosis:
+ Toxidermie,
+ Erythema multiforme,
o by spongiosis:
+ Bullous prurigo;
* Bubble subepidermic:
o disease-Dühring Brocq,
o epidermolysis bullosa,
o porphyria.

Etiologies

* Caused by an external agent:
o traumatic:
+ Bulbs
+ Epidermolysis bullosa,
o heat:
+ Burns:
# Sunburn,
# Other burns
+ Frostbite
o chemical contact dermatitis: allergic, irritant, caustic,
o parasite: parasitic prurigo
o Plant: dermatitis meadow Oppenheim,
* Drug:
o toxidermas bullosa:
+ Toxidermie recurrent pigmented,
+ Toxidermie bullous polymorphous
+ Halaal bullous
* Toxidermas to type of erythema multiforme,
* Lyell's syndrome toxic
* Infections:
o impetigo
o virus:
+ Herpes
+ Zoster
+ Orf
* Erythema multiforme,
* Lyell's syndrome:
o drug (toxicity)
o staphylococcal
* Pemphigus,
* Pemhigoïdes:
o bullous pemphigoid,
o herpes gestationis called pemphigoid gestationis
o cicatricial pemphigoid,
* Dermatitis herpetiformis
* Porphyria cutanea tarda,
* Epidermolysis bullosa.

See also Dermatologist

wikipedia

Estrogen

2009-12-01T05:00:00.000-08:00

Estrogen
Estrogens or estrogens are a group of steroids, whose function, naturally, is to be a primary female sex hormone. They are produced primarily by the development of ovarian follicles, corpora lutea (corpus luteum) and the placenta. Some estrogens are also produced in small amounts by other tissues such as liver, adrenal, breast and fat tissue. These secondary sources of estrogen are especially important for women in post-menopausal.

The three naturally occurring estrogens are estradiol, estriol and estrone. In the body, they are all originally produced androgens under the influence of enzymes. Estradiol is produced from testosterone and estrone from androstenedione. Estrone is less potent than estradiol, and among women post-menopause, there are more estrone than estradiol.

While estrogens are present in both sexes, we found a quantity significantly greater among women than among men. It promotes the development of secondary sexual characteristics like breasts, and are also involved in controlling the menstrual cycle, which explains why most of the pills contain.

The use of estrogen, particularly associated with progesterone, is a treatment (hormone replacement therapy) controversial symptoms of menopause.

In addition to their roles in reproduction, but also feminine male, estrogens are involved in the development of central nervous system in homeostasis of the skeleton and cardiovascular system. They also have effects on the liver and adipose tissue.

Cellular estrogen receptors
The main estrogen receptors are intracellular proteins belonging to the family of nuclear receptors encoded by two distinct genes in animals with both types of receptors: these receptors alpha (ERα) and beta (ERβ) of estrogen . The man and woman have these receptors are distributed differently in different organs. A third potential receptor, belonging to another family (receptor coupled to G proteins), encoded by a third gene, called GPR30 has recently been described. The effects of estrogen on their cell / tissue targeted through these receptors can be classified into two categories: the genomic effects, eg on gene expression, and non-genomic effects that directly affect other players in molecular cells, mainly proteins.

Disease and estrogen
Estrogens are involved in diseases with high impact on society by their frequency and / or severity. These are mainly of hormone-dependent cancers in women, breast or uterus. In this case breast cancer is in most cases a hormonal disease linked to the duration and intensity of exposure to estrogen. Men who have estrogen do little or no breast cancer when they have a mammary gland, a rudimentary, but this ...

All factors contributing to increased estrogen exposure are risk factors: an early puberty, lack of breastfeeding, a late menopause.

Obesity is a major risk factor because it exists in the fat of enzymes that convert the hormone estrogen (aromatase). Conversely physical activity by reducing the reserves of fat is protective.

Excessive consumption of alcohol also acts by increasing the level of estrogen by activation of this enzyme.

HRT for menopause and birth control pills containing estrogen are carcinogens.

The late first pregnancy is a major risk factor because it increases the duration of exposure to estrogen while breasts are immature.

Finally, and importantly, estrogen drugs like tamoxifen or raloxifene prevent the occurrence of cancer in a proportion exceeding 50%. These drugs represent the best treatment for preventing recurrence of cancer with estrogen receptor (over 70% of breast cancers).

Estrogens protect against osteoporosis (decrease in the frequency of that when estrogen levels are correct), a disease affecting many women after menopause. However, estrogen effects have neuro-protective proven.

Estrogen secreted naturally by women is one of the reasons advanced on the reduced incidence of cardiovascular disease in the past. The protective role of an artificial treatment is much less clear.

See also Menopause

wikipedia

Spinal Muscular Atrophy

2009-12-01T04:43:00.000-08:00

Spinal Muscular Atrophy
The SMA is the name given to a group of inherited disorders characterized by weakness and atrophy of muscles. The disease is transmitted as an autosomal recessive.

Symptomatology
Attacking the nerve cells (neurons) that stimulate and control the voluntary muscles, the disease causes deterioration. Because of this, motor neurons located in the spinal cord are no longer able to transmit signals to muscles, which prevents them from functioning normally. Therefore, muscle weakening and atrophy (base). It never affects the intellectual functions.

It may be noted:

* Muscle weakness and low muscle tone.
* (To be completed ...)

Cause
A mutation on chromosome 5 is frequently involved (as for many genetic diseases affecting the muscles) but it can also be (very rare) form of a scope on the X that only affects men.

Classification
Among the proximal spinal amyotrophy, there are four types (two infantile, juvenile type and adult type):

1. Type I, known as severe infantile spinal muscular atrophy, occurring before the age of 6 months and characterized by the absence of acquisition of the base station. There are subtypes of ASA type I variable severity;

1. type II, or intermediate spinal muscular atrophy, occurring at age 6 to 18 months and characterized by the absence of acquisition of walking;

1. type III, also called juvenile spinal muscular atrophy, occurring after the age of acquisition of walking (after 18 months - 2 years);

1. type IV or adult spinal muscular atrophy, manifested in adulthood. These various forms of the same disease with differences in terms of age of onset, severity of symptoms and prognosis.

The first three types are grouped under the term spinal muscular atrophy (ASI), while the term anterior spinal muscular atrophy (ASA) refers to all four types.

The term Anglo-Saxon SMA (for "spinal muscular atrophy) is also used.

The biggest danger is respiratory disease, pneumonia or other, against which the child fight hard.

* There are alternative types called Bis and Tierce and the classifications from the acute disease (Werdnig-Hoffman for type 1) in the chronic syndrome (Kugelberg-Welander for type 3) through forms intermediaries.

The categories mentioned here are challenged because they are neither objective nor realistic because of differences in quality of life of patients (eg type 3 may be a more serious clinical condition that a type 1a)

prognosis, treatment and evolution
If this type of pathology was seen raising the age of death of such holders (once very early) from improving supported (including through the ventilation but also by appropriate access to computers), illness still greatly affects life expectancy. Certain medications (chemotherapy) seem to give promising results:

* Butyrate
* Valproic acid
* Hydroxyurea
* Riluzole
* And more ...

see also Poliomyelitis

wikipedia

Human Papillomavirus

2009-11-28T13:14:00.000-08:00

Human Papillomavirus
The human papillomavirus (HPV), also called for HPV Human papillomavirus is a DNA virus belonging to the family of Papovaviridae. He is responsible for sexually transmitted most frequently since the estimate of people infected by this virus is between 10 and 30%.

There are over 200 genotypes of HPV. Some genotypes are transmitted through sexual contact and infect the genital mucosa, while others are transmitted by skin contact and infect the skin.

The clinical manifestations of the best known of the contamination of sexual genital warts (also known as "genital warts," or "warts" or "rooster combs), already described by Hippocrates. But the seriousness of this infection is that certain genotypes are mandatory factor for cervical cancer of the uterus, allowing a glimpse, through vaccination against the virus, hoping to one day wipe out this cancer.

Clinical manifestations of cutaneous HPV infection include common warts and plantar warts.

Finally, the transmission may be from mother to child during delivery, although this rarely happens.

Virus
Papillomavirus; non-enveloped virion, the capsid is composed of cubic symmetry 72 capsomers in icosahedral structure of 55 nm in diameter, double-stranded DNA, circular, closed, replication in the cell nucleus. Naked virus, it is particularly strong in the external environment (cold, organic solvents, detergents). Its genome consists of 8000 base pairs.

* Viruses with tropism for squamous epithelium
* The human papillomavirus are primarily in the α-papillomavirus genus. There are over 200 genotypes. 120 have been identified and sequenced. They have a narrow host specificity (for a species) and a specificity of tissue.
* They are designated by numbers according to their historical chronology of discovery
* There are three main groups:
o types and genital mucosal potential carcinogen high: HPV-16, 18, 31, 33, 35, 45, 51, 52, 58 ...
o types and genital mucosal low potential carcinogen: HPV-6, 11 (papillomas and condyloma acuminata anogenital)
o skin types: HPV-1, 2, 3, 4, 5, 7, 8, 10, 27, 57, 60, ...

The genome of genital viruses encode eight genes (and as much protein)

Epidemiology
Human papillomaviruses are often present on normal skin of healthy subjects. It speaks of asymptomatic skin infections, which appear early in childhood. Most HPV infections are latent or transient. The lesions induced by these viruses regress spontaneously in most cases.

Genital
These genital infections were the most studied.
HPV is the leading cause of sexually transmitted infections (STIs) in the United States. Although its prevalence is high (almost 25% of females after puberty, it is particularly important in young women under 20 years):

* More than half of low-grade lesions regress spontaneously within a few years, 10% of lesions progressing to high grade
* About one third of high-grade lesions regress spontaneously, 5% progressing to cancer,
* Total less than 0.3% of infections progress to cancer.

It thus considers that the majority of sexually active people have had at least one HPV infection in high potential carcinogen in their lives, especially during the early years of sexual life.

The virus is transmitted by direct contact, oral, self-inoculation (transmission of warts is favored by scratching) and indirect contact (contaminated objects and surfaces - the local showers, pools, etc.. Promote the spread of warts foot) transmission is sexual in the case of ano-genital warts; transmission of laryngeal papilloma occurs from mother to child during passage through the birth canal.

* From 1% to 2% of men and women infected present clinically exophytic warts visible.
* The incubation period is about 2 to 3 months for warts exophytic, but it can be calculated in years in the case of cancer or precancerous lesions.
* The clinically visible exophytic lesions are rarely associated with cancer:
o Only some HPV genotypes are associated with cancers of the cervix, vulva and penis, and anorectal cancer. The DNA of some serotypes of HPV is present in at least 80-90% of cervical dysplastic lesions (neoplasia cervical intraepithelial) and cancers of the cervix (HPV 16, 18, 31, 33 or 35). The genotypes (HPV 6 and 11) that cause most often exophytic warts were not associated with these cancers.
* Perinatal transmission of symptomatic infection appears rare.
* When it occurs, infection is associated with genital lesions and lesions of the vocal cords. It ignores the duration of the incubation period. Usually, the perinatal transmission becomes clinically apparent during the first 2 years of life.
* Patients infected with HIV often have anogenital warts extended to meet shortly to treatment.
* The progression to cancer is closely associated with smoking and HIV infection.

Other infections
The human papillomavirus (HPV) is also found in other squamous epithelia, the oropharyngeal mucosa but above the esophageal mucosa. HPV is often observed in benign and malignant lesions where it induces the cells pathognomonic of infection: the Koilocytes.

* Benign tumors of the esophagus.

The benign lesions in the esophagus are papilloma virus (or SCP, squamous cell papilloma).

The involvement of HPV is strongly suspected in view of the existence of a koïlocytose more or less pronounced in these lesions, but the proof is made by PCR in 20% of cases (0% in countries with low risk such as Finland, over 50% in high risk countries such as China during a campaign screening of esophageal cancer.

This suggests that HPV (especially types 6, 11 and 16), it is not sufficient to induce the formation of papillomas, was certainly a role of cofactor in the development of these benign tumors (Chang et al. 1991).

It seems that very few papillomas can progress to squamous cell carcinoma.

* Malignant tumors of the esophagus

Malignant tumors of the esophagus are squamous cell carcinomas, adenocarcinomas grow on them in a Barrett's esophagus. HPV seems heavily involved in the etiology of squamous cell carcinoma of the esophagus (squamous cell carcinoma: SCC): one finds there also Koilocytes.

The first study demonstrating the role of HPV in the genesis of esophageal lesions is an animal study. Highland cattle in Scotland are frequently esophageal papillomas; experimentally papillomatosis was induced by the bovine papillomavirus 4 (BPV4). These animals frequently develop cancer of the esophagus, and 96% of animals with this cancer are also carrying BPV4-induced papillomas. It was shown that ingestion of ferns (which are rich in carcinogenic and immunosuppressive drugs, eg azathioprine) was a factor in the malignant transformation of papillomas.

In men, HPV is often found by PCR in the CSC (from 25% to 40% in studies) type 6, 11, 16, 18 and 30, but most often type 16. As for the benign lesions, found more frequently in HPV cuts CSC from countries at high risk or high risk than in those from low-risk countries.

It is now accepted that HPV is a cofactor of carcinogenesis in relation to squamous cell carcinoma of the esophagus, acting in synergy with other risk factors (nitrosamines, mycotoxins, opium smoking, excess tobacco or alcohol ...).

Clinical manifestations of genital damage
* The infection can be subclinical or clinical, but it is usually asymptomatic.
* In women, the cervix is the most common site of genital HPV infection. The infection often multiple sites (cervix, vagina, vulva, etc..).

Flat condyloma
Keratinized lesions slightly elevated.

Condyloma
* The growths on the skin or mucous membranes of the anogenital region are often multiple and polymorphous appearance with exophytic outgrowth between one finger-or cauliflower-like and papular lesions.
* The natural history of infection is characterized by a fluctuation in the size and number of warts and, in many cases, their eventual disappearance. The size and number of warts may grow during pregnancy.

Man-tree
Dede Koswara, Indonesian fisherman, was long nicknamed the "Tree Man" because of the spectacular affection he has developed and is carrying a genetic disorder called epidermodysplasia verruciformis, which makes it impossible to develop an immune response towards Screw papillomavirus in cutaneous tropism. His whole body was covered with protuberances having the appearance of fungi or roots, making her skin appear as bark.

Dede Koswara was finally made in 2008, and expects a return appearance and a normal life, although a recurrence can not be excluded.

Diagnosis
* Diagnosis is made by direct examination of the external genitalia, using a magnifying glass or colposcope may be helped by applying acetic acid to 5%, and Lugol.
* The diagnosis of genital infection with HPV 16 or 18 is by looking for viral DNA (by "hybrid capture" by RNA probes, or gene amplification (polymerase chain reaction or PCR), in vitro) during of conducting a smear. However this test is based on the detection of DNA viruses. A positive result shows only the virus but the positive predictive value for the risk of developing cancer is low (10 to 20%).
* The diagnosis of genital HPV infection is also looking for viral mRNA (Nuclisens EasyQ HPV). The expression of viral oncoproteins E6 and E7 initiates the process of cancer by affecting cell cycle control. This new test is based on the detection of mRNA of E6 and E7 oncoproteins in human cells. The mRNA of oncoproteins E6 and E7 are markers predictive of the activity of oncogenic HPV to identify women at risk of developing HSIL (CIN2 / 3) and carcinoma of the cervix. The principle of this test is based on the amplification and detection of E6/E7 mRNA by NASBA (Nucleic Acid Sequence-Based Amplification) in real time.
* There is no serological test on the market.

Treatment and support
There is no treatment to cure an HPV infection. The destruction of visible lesions may however be made more or less simple. The lesions of the cervix are treated by cryotherapy (application of liquid nitrogen) by the laser or through surgery or by removing a portion of the cervix (cone biopsy) or by removing it entirely. Local treatments are also possible (podofilox solution or gel 0.5% Podophyllin 10-25% which must be applied by a doctor).

Other treatments stimulators of immunity are currently under development.

After treatment, it is possible that the virus is still present even if the warts have disappeared. It is therefore important to monitor the recurrence of lesions for several months after resection.

* The cell-mediated immunity may help eradicate HPV over time(?).
* The warts are often very persistent and recurrent. However, we observed a complete disappearance of external genital warts in 80% of patients who present. Cervical lesions disappear in about 90 to 95% of cases.

Prevention
* Condoms reduces much of the transmission of HPV and the incidence of persistent HPV infection (which means that regular use of condoms results in a regression of preexisting lesions more frequently than if not used). There may, however, contamination by contact with skin areas not covered by the condom.
* In October 2005 came a vaccine against HPV types 6, 11, 16 and 18. This vaccine called Gardasil is likely to prevent precancerous lesions and cancers of non-invasive cervical cancer caused by HPV type 6, 11, 16 and 18.

The conferred immunity lasts at least five years. Its effectiveness is almost complete (98%) among women not infected by a virus in the vaccine. It does not seem effective, or for other genotypes, neither for women already infected. Efficiency is not known beyond five years, partly because of the length of developing cancer of the cervix.
Vaccination especially for adolescents before their first sexual intercourse or at age 14 years, and it recommends that the CSHPF which advocates a routine vaccination at this age.
Vaccination is not without interest at a later age, in women who have never been infected by at least one of the viral types in the vaccine, in which case, the vaccine has the same protective efficacy than the younger subjects.
Vaccination does not preclude the continuation of screening for cervical cancer of the uterus or the use of condoms.

See also Cervical Cancer

wikipedia

Eczema Treatment

2009-11-28T13:04:00.000-08:00

Eczema
Eczema (also known as dermatitis and eczema examples is a skin disease little known, inflammatory contagious, but may be in extreme conditions. There are two main types of eczema: atopic eczema, characterized by a genetic predisposition, affecting mostly young children and contact dermatitis, more common in adults, which is an allergic hypersensitivity immune cell been in contact with a substance.

Clinical
Eczema is characterized by lesions shredded (with irregular contours), sometimes microvesicles (acute eczema) or dry. These lesions are characterized functionally by intense itching, that is to say itching can be tormenting.

Treatment requires:

* The identification of the cause (allergen) and eviction.
* Generally the use of creams cortisoneas.
* Various additions have been proposed to rapidly wean steroids, including supplementation of omega-3 and omega-6. These fatty acids can be used by internal or creams. Among oils include evening primrose oil, safflower oil, cumin, perilla, emu, argan who have all the virtues anti-eczema topical.
* Oil of Tamanu (Calophyllum inophyllum) is used at all times in traditional medicine in Polynesia for a successful fight against eczema without the side effects of cortisone or corticosteroids.

* For the nature of atopic eczema only: creams / ointments for topical tacrolimus, a molecule that acts as IMMUNOSUPPRESSANTS (local use). These drugs based on tacrolimus are indicated only in severe cases of eczema in adults and rebel general treatments. This product has just been a warning from the FDA due to leukemia and cancers unexplained following the application of this product.

The use of moisturizers and stress reduction generally helps to reduce the importance of the disease.

In some types of eczema creams containing cortisone (such Nerisone or Diprosone) have the opposite effect to that desired, as the appearance of cracks, dryness, itching and bleeding. It is therefore advisable to relieve the areas infected with calendula soothes naturally. Creams incorporating oil Borage (Borago officinalis) or black cumin (Nigella sativa) provide omega-3 and omega-6 and needed hydration required.

Biotin, Vitamin B8: Seborrheic dermatitis

wikipedia

Dermatologist

2009-11-28T12:52:00.000-08:00

Dermatologist
Dermatology is the branch of medicine dealing with the skin, mucous membranes and appendages (nails, hair). It is traditionally associated with the venereology, that is to say, the study of venereal disease or sexually transmitted infections (STIs).

Histology and physiology

The skin consists of several layers:

* Hypodermis
* Derm
o reticular dermis
o Deep dermis
o papillary dermis
* Basement membrane
* Skin
o Stratum germinativum
o Stratum granulosum
o Stratum spinosum
o Stratum corneum

Elementary lesions

* Atrophy
* Bubbles
* Discoloration
* The erythema (and rash)
* Keratoses
* The macules
* Nodules
* Papules
* The purpura
* The pustules
* The scales
* Sclerosis
* Tumors
* Ulcers
* Vegetations or warts
* The vesicles

Signs functional [

* Itching
* Pain
* Hyperhidrosis

Physical Signs

* Effect of vitropression
* Nikolsky's sign
* Fluorescence at the Wood's lamp
* Lines of Blaschko

Explorations dermatological

* Skin biopsy

Read also Acne

wikipedia